Dear family and friends, let me try to explain military life

There are a handful of intensely proud moments of my life and not surprisingly, most have something to do with the military, either as a Sailor and Officer or as a military spouse. The commercial “America’s Navy — The Shield” -recently released around the time of the annual Army-Navy football game– captures in a few seconds what it feels like for me, and probably others who have proudly worn the uniform, when I think back to all the experiences I’ve had over my military career. Trying to explain that life to “civilians”, even the closest of family and friends, proved even more challenging during the holiday season as peacetime military service morphed into humanitarian service and then surreally, into global war on terrorism. I mention my service in previous posts but today is a bit different. So, for those of you in my life who wondered what I failed to share because I didn’t have much time to hang out during those short visits home, this is for you.

My list is by no means inclusive as I’m a retiree, a veteran and a military wife, so my experiences are wholly personal. Nor is it exclusive. I’ve learned how to deal with others from completely different backgrounds, religions, cultures, countries, family lives, moral and ethical differences. That’s my big takeaway after 20 years, having the ability to work with others, understand their viewpoints, manage their expectations. I still don’t like crowds and I would rather be in the background making the calls, rather than out in front center stage. This is the closest I’ll probably come to sharing my experiences in one shot.

1. Bootcamp was a cake walk. It’s nothing like the movies and, at the same time, it is. As a woman who went through recruit training when the infamous Navy Tailhook scandal was still raw and fresh, I look back with a smirk. For an only child who never had to share space or toys, recruit training beat out any possible prima donna notions I may have had when I landed in Orlando.

I’d spent the previous 11 months preparing mentally and physically for Orlando’s now-defunct boot camp so I knew how to do a  “manly” pushup (no knees on the deck for me!) and I had my hair cut to meet the regulations, trying to avoid the base barber’s shears like my fellow male recruits. HOWEVER, my cute chin-length bob was cut again shortly after arrival– not once, but twice, when my company commander, a salty E6 tough-as-nails, Goldwing-riding woman, decided that my hair was too unruly underneath that pisscutter garrison cap. Luckily, one of the girls in my squad had some styling experience; not a lot, mind you, but enough to fix it for the next 8 weeks of training. Sad to say though, if I didn’t wear makeup or earrings, I still looked a lot like a 12 year old boy.

By graduation day, I learned that all of us arrived with a bit of baggage and some needed a little more attention. Most of us made it to graduation without having to repeat any training. None of us went through completely alone.

2. Shower curtains exist but not everywhere. There are shower scenes in certain movies that remind me of my bootcamp experience, none of them remotely favorable. The shower scene in 1997’s Starship Troopers was a thousand times better than any of my shower experiences in bootcamp. My goodness, there was more than one shower head, so there’s space between bodies. There’s nothing fondly memorable about several women of ALL different shapes and sizes, buck-nekkid around a shower tree, trying to figure out what the H-E-double L you’re supposed to look at during your 5-minute-timed shower. The floor, yourself, the ceiling? Aagh. And don’t even think about flushing the toilet during showers! At least give a warning “Fire in the hole!”

3. You’re never alone. Not completely. From day one of boot camp to your last day in uniform, even when you want to be alone, you really aren’t.  That’s just not how we did things. My supervisors knew my business, even when I didn’t share anything. Good officers and chiefs, the senior enlisted sailors and heart of the Navy, are trained to notice when things are “off” or at least that’s what I’ve always believed.

Prevention is the best medicine and being aware of any underlying factors could help prevent a bad situation from getting worse. Sadly, there are outliers in every scenario. The suicide rate has gone up especially as our involvement in global conflicts has increased. I won’t go much into that here, but you can read further here, here, and here.

4. Deployment life was good when it was bad and boring on all other days. Groundhog Day, the movie, can’t hold a candle to a deployment at sea or on land. It’s hard for me to really describe this well, but I’ll try anyway.

A few years ago, I calculated that I spent about 18 months at sea over the course of a two year assignment. To this day, that tour was the best in my 20 year career. Sure, there were days when I hated climbing out of my bunk and heading down to my office. When I had one of those days, I reminded myself that I had an office with a door I could close when over 4000 others on my ship enjoyed personal space only when they went to the toilet. Even I slept in a bunk with a dark blue curtain dividing me from my roommates. (Remember #3 above?)

Some shipboard or ship-related events are personally memorable, but not necessarily good. The naked sailor who’d had a wee bit too much to drink at a liberty port and was found riding a carnival ride with his clothes in a pile nearby. (Why the ride operator let him on buck-nekkid is beyond me.) Memorable for me as a duty officer, not good for the sailor.

The kid who decided that he would hurl himself down a ladder hoping that he’d break a leg so he could get off the ship–screaming “cut it off” in the emergency room (he got some bruises and a bruised ego, but no broken bones). Memorable for our medical team, not good for the sailor.

Spending your 34th birthday on the flight deck during night landings, standing about 20 feet from where the jets stop on a dime. Yes, some are truly memorable and unforgettably good.

The humdrum life. When you are deployed in harm’s way and you pray that you all return home safely and in one piece, you know your mission from the start. However, I’m here to tell you that there’s an adrenaline rush when your skills are put to the test. In Afghanistan, the only times I got that rush was when crap hit the fan, and on my schedule, that was always at night and into the wee hours of the morning. Successfully getting back to a normal pace meant all pieces working together for however long it took to gain normalcy. Being able to positively affect and potentially save lives…that was the reason we were there.

5. When I see/hear “_______”, I think of “______”. There are so many stories that all veterans can share, much like sitting around the campfire. I’ve only got enough heart to share these for now…

When I see a canister of Pringles paprika flavor, I think of my old roomie, a critical care nurse from New Orleans, who was known to eat an entire canister in one sitting after a long night.

She came to the Navy with years of civilian experience including Hurricane Katrina. Her first Navy deployment, during her first year in the military, was to Kandahar taking care of dozens upon dozens of critically ill patients: The triple amputee British translator whose grandfather sat by his side for weeks as the British military prepared paperwork for him and his family to move to the UK. The Air Force pilots who were shot down outside Bastion, one never to regain consciousness, both medically evacuated to Germany within hours of arrival at our hospital. The triple amputee little girl whose father had to learn to change her colostomy bag. The nursing baby who was shot in the head through her mother while they rode on the back of a motorcycle in a busy marketplace in Bastion. The civilian contractor whose illness was so grave that he wouldn’t survive a flight to Europe and whose company balked about sending him to the closest trauma center that he ended up dying in our ICU, after making one last phone call to his family. The beloved American paratrooper who was a week from redeploying home to his family after a year in the Argandab Valley; he died 45 minutes before his wife, also a soldier deployed to Kabul, could be flown in to say goodbye. The young Ranger who was shot on a Kandahar city rooftop in the middle of the night. And these are just the patients I can recall immediately.

My roomie is my hero. She’s still serving, but this time with the Marines in West Africa. I can’t send them any care packages this Christmas because they aren’t able to receive mail, but I can send her an occasional email or Facebook message. I’m glad that she’s still in the military because frankly, she’s a rare find. She came out of a Kandahar deployment with all her wits about her, although she had a crazy schedule, cared for critical patients like a revolving door, was away from her children for months at a time, and had to learn about military life on the fly. She’s authentic and real and brutally honest. There are many who serve like her. If you meet her or someone like her, strike up a conversation. She’ll tell you the honest truth. And isn’t that what people want to hear?

 




The VA’s latest public scandal: The Cost of Doing More with Less

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Lately there’s been a lot of negative talk in the news about the U.S. Department of Veterans Administration (VA for short).  Some of it is deserved.  All of it was preventable.  None of it is easy to explain.

 

While I may not be 100% happy with the VA 100% of the time, I do appreciate the efforts of the VA collective. Thousands of people make the system tick and I thank them whenever I get a chance. You see, I’m eligible for VA benefits. Since I am overseas, I don’t use the medical benefits but that’s a personal choice (I’m also a military dependent so I use military health care when needed). I fully appreciate that I can seek the care for my service connected disabilities if and when needed.

 

Why am I not as distressed about the news as others may be? I also know, as a retired military health care administrator, that the world of federal health care management is far from black and white. No news or data report can fully express how gray that world truly is and if they tried, they would lose readership. Counting peanuts is boring. Reading about counting peanuts is deathly boring. However, understanding the results is critical. Like when you’re making peanut butter. I don’t mean to equate each veteran to a peanut, but when you imagine how many peanuts it takes to make a jar of peanut butter, imagine how many veterans are eligible for medical care in the entire VA healthcare administration.

 

When bad news isn’t good enough  Oftentimes in my career, I was a PowerPoint Ranger.  I crunched numbers, ran reports, made power points, presented my reports, and made my boss look good.  Anyone with decent tech skills can make bad numbers look well, less bad, on a graph without technically lying.  I have also been on the receiving end after presenting a poorly received report.  The data was good.  The presentation went well. The results were not what the boss wanted to hear.

 

It’s human nature to want the pat on the back and not the kick in the rear on the way out the door.  So I understand, I empathize with any sense of desperation felt by the worker bees and their administrative leaders far from the VA Headquarters in Washington, DC.  I especially understand any desires to salvage their reports and essentially their hides. I don’t condone this behavior because in the end, honesty is the best policy, but it doesn’t mean I support the incredibly negative backlash I see in the news.  The current negative spotlight is a terrific opportunity for the entire VA system to make right what’s wrong. It would not be an overnight fix but if it’s a systemic problem, as implied in recent news clips like this one and this, it’s a systemic fix.

 

This isn’t new information  It’s old!  Like nearly a decade old.  VA gurus, dust off the 2005 Congressional Budget Office (CBO) report, and re-run the numbers.  The title isn’t hard to find: “The Potential Cost of Meeting Demand for Veterans Health Care.”  If you don’t have enough time to read the report in one sitting, jump to the parts of interest or straight to the summary.  I found this closing statement particularly interesting.

 

“High anticipated growth in medical costs for the entire economy will play an important role in driving VA’s future medical costs regardless of the behavior of lower-priority veterans. But if VA’s appropriated budget does not grow at a rate consistent with health care cost growth, or if large numbers of currently unenrolled veterans decide to turn to VA for care, VA could again confront the decision of whether to freeze enrollment or to disenroll veterans who are currently using care within the VA system.”

 

Hello?! This hints at what could have happened in the next decade since 2005 but was far from predicting the as yet, unseen overall impact on the entire system.  The demand for services grew but so far, disenrollment has not happened.

 

Who knew we would be in Iraq and Afghanistan for 9 more years, with wounded warriors and potential VA patients needing long term care for their service connected disabilities?

 

In 2012, the Huffington Post published the article Iraq, Afghanistan War Wounded Pass 50,000.  It’s been nearly two years since and while it’s slowed, a good number probably have since transitioned out of the military.  What percentage of those veterans now seek care within the VA system?

 

Doing more with less I’ve also been on the receiving end of nice, tied up with a pretty ribbon, reports and openly questioned data.  While I am saddened by recent whistle blower news that certain Veterans Health Administration (VHA) facilities were falsifying data to higher headquarters and manually scheduling patient appointments in an effort to game the system, cook the books, and keep the true outrageously long patient waiting times out of the official reports… I am not surprised. The press is doing a great job keeping the focus on the care, on the veterans affected, and I, as a veteran, thank you.

 

However, the blame isn’t on just one person. Don’t make Secretary Shinseki the only fall guy when all is said and done.  The VA is in full reaction mode, desperate to appease Congress since political leaders have constituents to appease. He’s just the easiest target and he wasn’t even in the VA leadership until 2009, well after the CBO report was published.  He is a politically appointed leader of a huge bureaucratic institution that was charged to provide care for the largest veteran population in history with the largest budget of its kind in the world.  That’s a pretty high fall from grace if he fails, considering that he himself is part of the veteran population.

 

The pressures on leadership to do what’s right and avoid negative publicity  No one wants to be the bad guy. No one sets out in health care wanting to be the person who turns someone away because of a lack of resources. No one wants to tell their boss or worse, the public, that good care cannot be provided in a timely manner because of a lack of skilled manpower. No one wants to tell Congress that jobs cannot be quickly filled because all the qualified people with training and experience quit or retired after the last crazy fiscal year.

 

So what choices do federal health care workers have but to do more with less?  Less time, less consumable resources, less appointment slots. What do they have more of?  More paperwork, more reports, more patient population, more training requirements, more headaches.

 

Here’s a secret for Congress.  Just because the worker bees can do more with less, does not mean they can sustain it for an undetermined length of time.  Just because they have been able to do it for one year, two years, or even longer, does not mean that more resources are unnecessary.  The system and its players will eventually give up from sheer and utter exhaustion.  Sadly, patients who need them most may be lost in the battle.

 

More means more  We have a VHA that’s been deluged for most of the last decade. Remember the article I mentioned a moment ago claiming more than 50,000 war wounded in both conflicts in Iraq and Afghanistan?  Those are likely service connected disabilities, a key concept and requirement for VA benefits. You can surf the VA website and learn more about the other kinds of disabilities that are also covered by the VA.

 

We also have had all time highs in recruiting periodically in the last 20 years.  One would hope that the budgetary gurus have allowed the VA budget to grow in direct proportion to the military’s growth, but it’s probably a lot slower than needed.  Do you recall when the current administration pushed for and got a 30,000 troop increase for Afghanistan in 2009?  Those troops, whether injured on the battlefield or while lifting weights on their forward operating base, are potential VA patients.

 

Here’s an example for the common man to mull over:  If an individual left the military this year after 20 years of service at the age of 39 and is eligible for VA healthcare, he could be in the VA system for the next 42 years. (I used the Social Security Administration’s life expectancy calculator for this example)

 

He is not a drain on the VA system.  The system was built for him and others like him.

 

Increased patient numbers, increased access required, increased cost of care   The government has been responsible for the care of our disabled soldiers since the Pilgrims in 1636, but our current system has been in place since 1930.  Since its official formation, the VA has flexed, grown, and changed with its beneficiaries, but like other huge bureaucracies, it is a slow-growth.  The healthcare facilities cannot simply push back eligible patients when they seek care.  It is truly a vicious cycle.  They can possibly seek more funding if they show they have the need based on the number of patients they see.  They can increase their patient load if they increase the number of available appointments.  They can increase the number of available appointments if they have the providers.  They can increase providers if they have the funds.  Do you see the madness? I had a professor who once called this kind of thinking a “death spiral”… I tend to agree.

 

Guess what, America? Our greatest generation may be fewer in numbers because they are dying out and our veterans from the Korean and Vietnam eras may be fewer in numbers too. However those that hang on are living longer with more complex health issues thus requiring more and expensive resources. Did Congress think they funded the VA enough over recent years and hence the VHA to grow their resources so they could provide long term health care for our aging veterans as well as all the wounded warriors now in their system? Evidence is readily available that VA leaders have been asking for budgetary increases over the years. For instance, then Undersecretary for Health at the VHA, Dr. Robert Petzel, testified to the House Subcommittee on Health.

 

“During 2011, we expect to treat nearly 6.1 million unique patients, a 2.9 percent increase over 2010. Among this total are over 439,000 Veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom, an increase of almost 57,000 (or 14.8 percent) above the number of Veterans from these two campaigns that we anticipate will come to VA for health care in 2010.”

 

The VA did their part and shared their expectations for that fiscal year, 2011.  My friends, that was nearly four years ago, and we are still at war.

 

Continuity of Healthcare from Department of Defense to the VA  There are manpower experts, financial gurus, and planners who can calculate the expected cost of care per user within the military health care system.  How many more steps would it take to translate the cost of that same veteran into the VHA?  Do the two sides work well together to strategically translate the expected costs of a wounded warrior on the overall systems?  If they didn’t in the past, they are working in that direction.  After a couple of clicks on the internet, I found evidence that the General Accounting Office considers Continuity of Healthcare from the Department of Defense to the VA a key issue.  What have the institutions done with this knowledge other than read the reports?  By the way, the latest I could find was filed in 2012, so it’s likely that any real collaboration is relatively new and if it’s an early success, the VA ought to put it out in the press for all the world to read.

 

Perhaps that’s where the grassroot movements should also focus their anger and their efforts.  Help the VA get the resources it needs to bring itself up from the near bottom of public eye barrel.  Tell the leaders in Congress that they have the fiduciary responsibility to ensure the VA can operate effectively for the long haul and should no longer continue doing more with less.  Provide moral support to those who work hard to provide access and care within the VA system.  They will be under weeks and months of scrutiny by investigators, legislators, and the press.

 

There’s a light at the end of the tunnel.

 




6 things to do before getting out of the military

navy afghanistan

(*Updated 10/27/2015) Are you getting out of the military soon?  With the eventual massive downsizing of the US military, there will be a lot of veterans joining civilian ranks in the next year or two.  You may be one of them or know someone who will be making the transition.  They may be officers, enlisted, active duty, National Guard, Reserve.  They may have broken service, continuous service, families to support, or not.  There are so many variables that make each soldier, sailor, airman, and marine a unique case.  However, when I only had six months to prep for retirement, I discovered 6 things to do before getting out of the military that made life down the road, outside of the uniform, easier.  Maybe not perfect, but easier.

These are a handful of things I’ve noticed over the years as both an enlisted sailor and a naval officer.  Most I’ve done myself.  Some I wish I’d done better, if at all.  I’ll share them here because if the internet is forever, then my kin can find this info when I’m too far gone to remember.  Also, since my DH keeps throwing my name in the hat to his friends as a source to ask questions (questions are free and since I’m retired, apparently so is my time), I’m just going to point him to this post.

DISCLAIMER for all y’all Sea Lawyers:  These are all MY personal opinions… fact is, that in a decade or so, bureaucratic engines will change, “upgrade”, but not too much.  DO YOUR OWN RESEARCH, KEEP YOUR OWN NOTES, MAKE MULTIPLE COPIES OF WHAT YOU THINK IS IMPORTANT.  (You’ll see this again later)

If you’re in your last tour or THINK you’re going to leave the military during your current (or next) tour: 

  1. Communicate with everyone who needs to know what’s going on.  Determine your NEED TO KNOW list of people:  your significant other, your boss, your team.  Who else should be on this list and why?
    • Administration: They will track your paperwork, from your discharge requests to extension requests, if you need one later.  It helps to keep these folks on speed dial and to keep their contact information handy for several months after you leave the service.  While you’re at it, if you are offered more than one copy of your DD214, take them and lock them up someplace safe.  That single piece of paper proves your service time and allows you or your survivors to access benefits you deserve.  I don’t want to be morbid, but WHEN you die (you will, you know), your survivors may be due benefits or you may want to be buried with military honors in a national cemetery.  That DD214 helps.  A lot.
    • Finance: obviously you want that last paycheck, right?  If you’re getting separation pay, they will submit the information needed to pay you.  If you’re retiring, you’ll want their help to make sure all your financial data is moved over from the active duty or reserve pay system to the retiree side of DFAS.  Don’t assume it will be a quick fix.  Correcting any mistakes after the fact can be more than one pay period.  FYI:  Retiree checks only come once a month, not twice, so get used to that if you’re used to getting a nice paycheck twice a month.
    • Transportation/Household goods:  If you’re moving out of military housing or you’re moving to your home of record from a different city, state or country, you’ll need to get chummy with them ASAP.  During your planning process, keep in mind the typical “rush” periods in the military moving season and try to avoid them, i.e. the summer months.
  2. Make an appointment with medical and dental.  Visit your primary care manager and your dentist well before your LAST separation physical.  
    • Make a list of what you need to discuss as well as your current medications.  No one else knows your health better than you.  Your military provider has a limited amount of time for you (let’s say 20 minutes for starters).  If you write down what needs to be resolved or what’s missing from your current health record, you likely won’t forget it when you’re sitting in the treatment room between the time your vitals are taken and the doc comes through the door. Ask questions if you don’t understand something.  Help your medical providers help you complete your military medical care.
    • Get things taken care of while you’re active duty.  If you have any medical issues that need to be noted or resolved, do it.   Surgeries, follow up care, physical therapy, whatever you’ve been holding off because of deployment, presumed perceptions of weakness, whatever.  Take care of yourself now.
  3. Make a date with a copier.   If you came into the military before the electronic medical record, AHLTA, request two copies of your original medical record.  (One for you, one for any VA medical claims you may want to do later)   Order or make digital copies too.  If your local patient administration office cannot/will not make more than one copy, that’s okay. Take what they give you, sign out your old hard copy records and make your own copies. 
    • UPDATE (10/27/2015) In my volunteer time with my local Veterans of Foreign Wars Post, I’ve seen medical records copied onto CDs as well as scanned files of hard copy records that were pre-electronic medical records (before 2004 in many cases).
    • I recommend that you look through each page to make sure that they are (1) yours, (2) legible, and (3) complete. Before the electronic record, medical staff wrote on the front and back of medical forms. The older forms, nicknamed “onion skin”, are difficult to run through the feeder of a copier so usually need to be hand-copied. If any critical dates are missing, it’s best to fix it before you leave the military rather than hunt it down via the National Archives. 
    • If you’ve seen behavioral health, you’ll likely need to personally request release of those records from the behavioral health clinic that saw you, not necessarily the one where you’re currently stationed.
    • Now about those copies:  AHLTA records are a good waste of paper when printed out.  Seriously, they are good and they are a waste of paper because they are one-sided print outs.  Guess what?  If you decide to submit a disability claim for compensation with Veterans Affairs, for now you’ll need single sided copies. An actual person will be thumbing through your submission package (if you were lucky enough to submit a hard copy vice uploading to eBenefits–more on that in a second) and double sided paper is a time killer.
    • You’ll also have a HUGE pile of paper if you’ve served a while and saw medical on a regular basis.  The original, old style, handwritten medical visits are sometimes double-sided.  Double check both your medical and dental record copies for clarity and completeness.  While your medical and dental records are safely archived by the military “forever”, wouldn’t you want a copy for your own records?  So, trust and verify.  Always.
    • Unless you take advantage of the Benefits Delivery at Discharge (BDD) process, you’ll have to upload your supporting documents into the VA’s eBenefits website. If you can’t read the copies you have now, neither will the VA rater. Help your rater help you by providing the best documentation you can. 
    • Don’t sweat all the future changes within the military system.  Remember my disclaimer comment about bureaucratic changes?  Those AHLTA records from a decade ago will eventually change to something else. 
  4. Try not to burn bridges.  Do yourself and your teammates a favor in the last year of service:  Do a good turnover especially for any major projects toward the end. If you can avoid huge tasks at the very end, it may be best. Now if it’s something you need for a resume, do what is best for your mission and your final evaluation.  People remember the best and the worst about you.  I think that’s why careful observers will note a spike in improved efficiencies, better teamwork, and other positive notes just before a scheduled evaluation time.  You may one day want that letter of recommendation from the last supervisor or the Linked In review from your coworker.
    • Always remember: You are NOT indispensable.  Don’t kid yourself, even if you are senior enlisted or a senior officer (field grade for Army and Marine Corps).   SOMEONE can and will fill your shoes.  It may be difficult at first but the mission will continue, even if you are no longer part of the team.  Of course, if you’re one of THOSE civilians or contractors who can slide into the same job you just left, good for you.  (insert polite applause here)
  5. Be honest with yourself about what you can do at work and at home.  Try not to stretch yourself too thin with commitments at the end.  Although I was disappointed, I was appreciative of a teammate’s honesty when he needed to take time to take care of medical and other personal issues prior to retirement. The job market in San Antonio was difficult at the time, his family was feeling the pressure of an upcoming loss of income, and both college tuition and mortgage payments were on the horizon.  I knew I shouldn’t expect 100% of him all the time but was thankful that he worked hard when he was around.  Although it was far from ideal, I was given the chance to fill any workload gaps by shifting folks around well ahead of time.
  6. Prepare yourself.There’s a transition phase, however short, between military life and civilian. Take advantage of the mandatory and optional training available to you.  Make time for the optional training.  If you’re in a crappy job at the end of your military career, don’t be so mad at a situation where you lose in the end.  If you decide not to take advantage of the free information being handed to you, the free (and usually mandatory) transition training, the possible networking scenarios, the free resume training, opportunities for job counseling, veterans benefits training, SHAME ON YOU.  You volunteered for military service, whether you leave it with warm fuzzies or not.  You have so many great benefits out there compared to our predecessors who had little to none when they left the service.  Those men and women helped pave the way for what we enjoy now through grass roots work via veterans service organizations like the Veterans of Foreign Wars and the Disabled American Veterans.  

…and prepare your loved ones.

If there’s a move coming up, plan ahead.  Don’t wait until the last minute to have that last yard sale before the movers come.  Say your work goodbyes, if you’re so inclined, before your last month at work.  It’s less stressful at the end.  Prepare your children and their schools if you’re pulling them out mid-year (or request an extension early on if you have graduating seniors and don’t want to pull them out mid-year).  There’s nothing more stressful than having a couple of life’s major stressors all within a relatively short period of time.  What are some of life’s stressors?  Check out Spurgeon, Jackson, and Beach’s study, “The Life Events Inventory” in Occupational Medicine.

The three Musketeers reunited again!

The three Musketeers reunited again!

Military shadowbox

My shadowbox with a fraction of my personal collection after 20+ years in the Navy

As I think back to my own experiences leaving the military, I’m still amazed at how much I accomplished in less than 6 months.  6 months to go from full-speed ahead naval officer to retired Navy, active duty Army wife with a young child.  Of course, none of it could have happened without support from my family, coworkers, and the awesome administrative and medical staff who helped me navigate through bureaucratic waters with military medicine and the Compensation and Pension program staff at the U.S. Department of Veterans Affairs’ Frank Tejada Outpatient Clinic.

Final thoughts:  DO YOUR OWN RESEARCH, KEEP YOUR OWN NOTES, MAKE MULTIPLE COPIES OF WHAT YOU THINK IS IMPORTANT. (I told you you’d see it again)

By the way, if you see this book, check it out too.  If it isn’t a freebie, buy it at a bookstore or online.  It’s a start.  

Many thanks to Getty Images for the images above.

Updated: 10/27/2015




Memorial Day 2012: Kandahar Airfield a distant memory #1

kandahar nato role 3 hospital

I will never leave a fallen comrade. (Wall in old Role 3 before it was taken apart, plank by plank)

**If you are a bit of a worrywart and have a loved one downrange, you may not want to read further on my Kandahar musings.  Just saying.  My experience is from a healthcare administrator viewpoint and can seem a bit indifferent. If you’re one of my family members and wondered what it was like, life for me in KAF was not so bad in relation to many others.  If you wondered what I did while there, read on.

Today marks a significant holiday in the U.S.A.  Memorial Day.  It’s no longer just a federal holiday, a day off from work where everyone lines up along side the main street of YourTown, USA, or visit the military cemeteries or lay wreaths on tombs. It’s now a day that officially marks the beginning of the summer season, even though many schools are still in session.  It’s a long 3 day weekend, sometimes 4 day weekend, that involves travel, family, friends and BBQ.  But for me, today, marks nearly two years since my typical hell-atious nights in Kandahar at the NATO Role 3 hospital.

kandahar nato role 3 outer wall

Original R3 sign, now hanging in the new & improved NATO Role 3

Where else but Afghanistan can any weekend be marked by bombs, gunfire, and mortar attacks?

Flashback to 2010:  I worked the night shift at the Tactical Operations Center, as the main night TOC-O (officer), monitoring incoming injuries and trying to predict what might be coming our way.  While I was always offered the chance to rotate to the other shifts, I preferred the night shift.  I could do my data collecting/reporting when it was a quiet night and I could call home during the day when I was off, something that was crucial to my mental well-being as I had left a husband and a barely year-old daughter. Plus, I am simply not a morning person.  Never have been.  You’ll be lucky to get a good morning out of me before my first cup of cafe au lait.  So if I’m already awake and getting ready to go home, my boss downrange was likely to get a smiling face…as I walked out the door!

toc nato role 3

Me in the old TOC. Still all smiles because it’s only been 2 weeks since we landed in KAF

It was a 3 man team in my department with me, my patient administration clerk and our Air Evac nurse liaison who worked hard to get our wounded warriors to the next level of care.  It was my job to get them to Kandahar and it was the AE nurse’s job to get them out of Dodge.  From my isolated position in the TOC, I admired the general teamwork, tenacity, perseverance and sense of humor found throughout the different departments I crossed paths with like the Ward, ICU, lab, Primary Care, OR, trauma teams… it’s wonderful to observe the onesies and twosies individual augmentees seamlessly come together day and night, making it seem like they’ve been working together for years.  There are other blogs out there from their point of view, such as Q’s which can be found here.

My Crystal Ball  Initially, when I showed up for the night, I tried to predict how slow or busy we would be so I could tell the duty trauma team if they could catch some winks that night.  In reality, it was so we could all gauge how to manage our stripped down manpower.  You see, the assumption with the night shift is that it is generally slower, which is true.  In an ideal place, an ideal war, nights would be the time to catch up on things like patient data collection and analysis, personal correspondence, courses, reading, hobbies.  But Afghanistan is not your ideal place.  This is not your ideal war.  The enemy plays dirty, especially when they think your guard is down. And injuries that occur earlier in the day or evening are bound to need transferring to a higher level of care… to Kandahar and beyond.

So my nights were anything but predictable.  If we had more than 2 nights in a row where nothing more than a bellyache came into the trauma bay, then I immediately had my antennae up.  No need to be careless and comfortable.  There were quite a few nights in that brief six month tour where the whole friggin’ hospital night shift had to cover mass casualties for the first 30 minutes and we were sending corpsmen from the ward to the flight line to pick up wounded because we had no one else to do it.

Emma  I remember one of my favorite corpsmen was tagged to augment our regular crew when we needed a 2nd ambulance to go to the flight line.  I’ll call her Emma.  I knew she and another gal were being sent from the ward to the flight line to pick up patients.  They only knew that these wounded warriors were the most critical type of patient and that we needed a few extra hands. When it’s an emergent call to meet patients at the flight line in the middle of the night, it’s never a good thing.  I saw Emma coming in straddling one of our troops as he was rolled in from the driveway, performing CPR.  I knew that she had probably jumped on top of his lifeless body the second he was safely transferred from the helo to the ambulance.  She was in tears immediately afterwards, covered in blood, the exhaustion clearly marked on her young face.  He was only 19, the same age as she.  She did everything the books taught her to do from the minute the gurney was loaded off the helo and onto the ambulance. But it was already too late.  All I could do was let her chief know and the chaplain when he arrived that there were a couple of corpsmen that may need to take a break that night.

How do you mentally prepare our young caregivers for those sights and sounds?  How do you forget them yourself?  How do you keep your anger at an invisible enemy in check so it doesn’t cloud your judgment when a possible enemy combatant becomes your patient?  Aye, there’s the rub.  Some folks, like our incredible medical staff, followed up with the patients from beginning to end, nearly taking a very personal interest in each and every one or just a select few.  Others vented their frustrations and pent-up energy on the indoor football (soccer) field or field hockey arena or volleyball court.  There were possibilities of a decent social life and some even managed to, gasp, date.  Personally, I reveled in keeping to myself for the most part, not letting more than a handful too close, because then saying goodbye would be less traumatic.  I didn’t want to get close to patients, especially our precious little Afghan patients who were classified as Battle Injuries (blast wounds, gunshot wounds, and so forth).  I hated knowing enough about the culture to know that a one-armed little girl was worth less to her family.  What about the triple amputee who needed daily care?  What of her?  I didn’t want to be indifferent to their innocent plights of being in the wrong place at the wrong time.  Okay, there’s enough for another post entirely.

kandahar mountain When Chaos ruled It was one of those chaotic nights, where we had but a few minutes warning that an incoming helo was inbound with several patients from a nighttime firefight in the City.  The call from the Canadian gent with the rolling “R’s” in the Tower “Role 3, 3 minutes”.   What do you mean, 3 minutes?  Who the hell is coming in? That’s about when the medical ops officer or medic from some high OPTEMPO unit comes in to say, oh, by the way, you have X # patients coming in from this (fill in the blank with some really f#@!ed up scenario).  At least we got SOME warning, even if it was a few minutes before the helo landed.  Thankfully, it usually didn’t happen that way.  I’d have, oh, about an hour or 2 or 3 hours warning that something was going down.  The issue would always be:  “they are in the middle of a firefight in the city (or the orchards).  Once they can be safely extracted, they’ll be here in a few minutes.”  Yeah, a few minutes to get everyone needed to the flight line and the trauma bay.  That could be the difference between life and death.

So the secret was to prepare a backup to the backup to the backup and hope that God was on our side.  And act like you knew what you were doing the whole time instead of throwing the Hail Mary pass.  In the chaotic first moments, there was very little time to give all the pertinent information to the trauma team leader whose responsibility it was to make the tough calls, who to call in and when, and sometimes no need to call for backup from our slumbering day crews 15 minutes away in their barracks, who also needed their rest since the day shift can be super busy in the warm bloody months of war.  So usually it meant that we relied solely on the creative role management skills of the super-excellent providers who I had the honor to work with at night.  It also meant giving the staff enough warning about what was about to go down, but not too early of a warning.  For instance, there’s no reason to call a neurosurgeon in for a head injury until the CAT scan’s been done.  It really didn’t take our neurosurgeon all that long to get to the hospital, whether he was running, riding his bike or coming via duty van (he did all 3 modes of transportation).  Sometimes the best answer was the simplest and most obvious.  You’ve heard it before, the KISS method.  Keep It Simple Stupid/Silly/Schmuck.  Whatever you want for the last “S”.

The City over the mountain.  I never had a desire to visit Kandahar/Qandahar City.  Although it was only a few minutes by air, it was a couple of hours by uparmored vehicle.  You had to travel very s-l-o-w-l-y, looking for roadside bombs and other such Afghan road accessories that had no respect to life, infidel or believer.  The City seemed to always be in the headlines when we were there, probably because I noticed it more.  There were times when there was a firefight or an attack in the City at dusk or at night and you could see the lights in the sky over the mountain range.  Urban warfare in a former Taliban stronghold is not a pretty sight from the receiving end of the patient spectrum.  Gunshot wounds and mortar attacks, vehicle borne explosives, roadside bombs.

Dear Diary  In my diary that I kept that year, the weekend before Memorial Day’s holiday weekend was full of excitement and not the good kind.  Memorial Day weekend in comparison was slightly calmer.  We were scheduled to move on May 23rd from the old, beloved, well-worn and thoroughly tested Canadian built and managed tent and plywood hospital.  If you’ve seen MASH, you have a good idea what it looked like.  If you’ve seen the Canadian tv show “Combat Hospital”, the set is very closely based to what we worked in for the first part of our stay in Kandahar. The storyline, not so much.

The night of May 22nd was my last night of a weeklong mid-shift (3-11pm).  I was heading back to the night shift the following week and looking forward to it.  It was also the night of a full-force ground attack on the airfield that actually made it to the international news, thanks to an embedded journalist who was reporting “live” from a bunker.  One of the gates was under attack and there were also mortars coming in from the nearby mountain and fields.  The majority of the day shift had already headed out to supper, or to the gym, or to celebrate a couple of birthdays at the bigger eateries on the Boardwalk.  Then right at dusk, the Big Voice and the alarms sounded.  Ground Attack, Ground Attack… and all the bells and whistles that go with that general alarm sounded for what seemed like hours.  I put my clip into my 9mm, put a round in the chamber, gave the sole flak vest and helmet to my corpsman (that was drama in itself as he was trying to be a gentleman and I was trying to be the officer) and hunkered down to monitor the battlespace.  (My flak and helmet were in my barracks room… hey, we NEVER needed it until then… lesson learned) I had 3 critical patients flying in from the west within 30 minutes and I had to try to get the pilot NOT to land.

It may sound easy enough to call off a plane, but not so much in a war zone.  At that time, we had no less than a dozen ways to communicate in the old Role 3.  Each of our major partners had a special way to communicate from satellite to secure phones and mobile phones and our air support had radios.  So my mind raced to figure out how on earth to stop a plane in mid-flight?  I called the tower who was already on it and trying to get the pilot to land mid-way.  Every time the rocket attack alarm came on, I got down prone on the dusty wood floor with the red phone (British) to my ear trying to gauge what was coming in so I could pass the word to our trauma team on duty who was OUTSIDE the hospital, hunkered down in a bunker.  Oh, did I mention that the old hospital was tents and plywood?  During a rocket attack, there were only a handful of staff left.  Those who were the Rocket Nurses, tended to the patients who could not be moved, ensured that they were blanketed for safety.  And the TOC officer and the patient admin clerk.  Everyone hightailed it to a bunker until safe to return to duty.

Unfortunately, one of the patients, an Afghan civilian who was injured in a market attack in Bastion, was crashing on the flight so the pilot chose to take the risk and land on the airfield that was still heavily at risk of a mortar attack.  Here’s how I would like to think the conversation went but I think there was probably a bit of strain to my voice and the Tower’s and the pilot’s:  “Hallo there, we’re under a rocket and ground attack.  Could you please turn the plane around? (pause) Yes, I understand that you have patients on board.  But our ambulances are not going to be allowed on the airfield and I really don’t want to risk my crew going out there in the open.  Oh, you can’t?  The patient is crashing?…” and so the plane landed, my crew managed to get to them safely and our first 3 patients of the night entered the trauma bay.

As the alarms continued, the mortars landed.  One of them hit the Boardwalk, shortly after the “all clear”.

kandahar airfield boardwalk

Boardwalk early morning light

And then the injured started coming in from all over the airfield. And thankfully, so did our staff who managed to make it past the armed security checkpoints manned by very big, very formidable European soldiers with big guns (Romanians, Bulgarians, French). I was grateful for the appearance of the rest of our TOC team within an hour of the first alarm.  There’s something comforting about being in a bad spot with others and finding you are all on the same page.  We had a full house in the trauma bay and a full house of walking wounded in our primary clinic.  We had medics from other units in Kandahar who were also running/walking a mile from their hooches to help out where they could.  A lot of our folks had to figure out how to get out from the safety of our NATO barracks and literally low-crawl to the duty vehicle which was assigned to make rounds to get as much of our staff back to the hospital.  It was an all hands on deck evolution.  (Thankfully, I managed to get hold of my awesome roomie, G, who brought along my flak and helmet.  I didn’t look forward to being unprotected any longer nor did I like having to tell every senior officer who came in for an update why I didn’t have my flak on.)

Oh, have I mentioned that we were due to move to the brand spanking new brick-and-mortar hospital the very next day?  That meant that our inhouse supplies were at minimum and most of our supplies were about 300 meters away.  If I didn’t know better, I would have thought that the enemy knew that we were stripped down to the bare minimum.  (Yes, I was tempted to take the route of the conspiracy theory) The stars aligned right that night for them but not too well, because we adapted and overcame that challenge.

Our worst rocket attack injuries came from folks who were on the Boardwalk and rather than go to a secure bunker after the first alarm, decided to walk around and were caught by a rocket that hit a section.  We had minimal shrapnel type injuries as well and the only casualty (death) was one of the 3 patient transfers that flew in from Bastion. Thankfully, we didn’t lose any of our folks from the Expeditionary Medical Facility in Kuwait, who’d come to help us settle into the new facility, some of whom had arrived only that day.  One of the guys’ flak was shredded by shrapnel when one of the mortars hit the temporary tent they were assigned to (his flak was on the top bunk and thankfully, he was on the ground or in a bunker, a little freaked out but none the worse for wear).

We were able to finally leave around 3am, with orders to report back at 7am so we could finish moving to the new hospital.  To say I was functioning on fumes was an understatement.  But we all made it through that weekend, ready for the next big mass casualty.  And I don’t think anyone will ever forget that weekend for the rest of their lives.

The following week was more of the same kind of action.  The enemy was definitely voicing their opinion, like a bear waking from hibernation.  I described the night of the 27th of May into the morning of 28 May as “busy busy”: 3 US troops…a gunshot wound to the head, another to the chest, a 3rd “grazing” wound.  Later, 2 more came in as a transfer from another FOB south of us.  This time 2 head and neck injuries from an IED blast.  Then it slowed down…we only had 2 Afghan patients to transfer over to the Kandahar Military Regional Hospital nearby. And that was a typical night.  The next night was slow until the last couple of hours of the shift… when we had 4 more warriors come in after being wounded by a Suicide Vehicle-Borne Improvised Explosive Device attack.  2 more came within the hour from gunshot wounds.  And then it was quiet for 2 more nights… then hell broke loose again… then quiet… then hell… and so it went for the rest of the summer.

Blast wounds Of all the wounds we had come through our trauma bay, I came to hate blast wounds. When it was a quiet and still night before our ambulance pulled up from the flight line, the moaning and sometimes Ketamine lollipop-induced yelling would break the quiet.  Why did I so hate blast wounds?  They would not only take away limbs but pock-mark exposed body parts and significantly affect hearing, at least initially.  (more stories, tongue in cheek may be in order, but in a later post) But it might not just be one injured person, it could be several.  It could be a blast in a marketplace or a roadside bomb or a policeman’s wedding.

I’ve seen the haunted look in their eyes when their buddies are still in surgery after a dismounted IED blast. Among the worst are the daisy-chains. The most heart-wrenching stories are from the survivors. The trio of buddies who made it all the way from boot camp to the same squad downrange and ended up being wardmates. One of them hit a mine or IED while walking to investigate something in a nearby field as they were on patrol. Another one went to help and hit another mine. The 3rd… well, you get the picture. All 3 were thankfully wearing ALL their flak, protective gear, that protects their nether-regions and critical body parts, and leaves extremities exposed.  Each lost a limb or part of one.  All had shrapnel injuries.  The worst part of these injuries is how filthy the shrapnel is… I can still smell the blood mixed in with mud and burning flesh.  There’s nothing quite like it.

I admire the trauma teams and specialists (super awesome neurosurgeon from Boston, orthopedic surgeon, opthalmic specialists, radiologists and so forth) who I had to call in to fix these guys when they came in.  They may have been awoken from a restless slumber.  They may have already been up.  Regardless, sleep was now the last thing on their minds.  They had the look of fierce determination to save the patient, friend or foe, alike.  Okay, their patience was sorely tempted  when they got the occasional enemy combatant, especially the nutcase who kept spitting at them.  I actually walked over to see the Spitter (those were the days in the old tent hospital, where the trauma bay was within a 30 second sprint of my computers).  Detainees get a well-deserved bad rap.  But when you spit on the faces of the people who are trying to fix you up, even if you were trying to set a bomb in that field over yonder, we may just have to send you over to the Afghan military hospital down the street. (Detainees definitely didn’t want to go there…I suspect it was a bit like oh, torture.)  I’ll have to write about some of the detainee-centric memories in a later post…they are a lot like flashes of memory in my sometimes swiss-cheese brain.

Stay tuned as the memories coming flooding back, waiting to finally be put down, virtual pen to virtual paper.




Toto, we’re not in Kansas anymore

I’m looking forward to going home in a couple of months, especially because it’s getting HOT here. Thank goodness we’re in Central Asia though; it’s not as hot as in the Middle East. The temp is a lot like San Antonio in June. I’ve had prickly heat for the last month… I just can’t get enough water. I’m glad though that we have water bottles stockpiled alongside the common areas all over this place. I’m also happy to be working in an air-conditioned environment. Did I mention that it’s HOT?

Home update: Babybee’s growing like a weed! Apparently, she’s quite a chatterbug at school/daycare, too. She woke up from naptime/quiet time and said “Okay, quiet time is over” just like Miss Sandra says every day. Other recent additions to her growing vocabulary: “More”, “‘allo”…which, according to her Papi (Daddy), may be a combination of Hello and Hola, but I like to say she sounds French! Her hair’s grown quite a bit since I left in January and is falling in lovely curls around her pretty face. It won’t hold the bigger barrettes yet, but the ones from Ms. Annalyn work nicely. Even when Daddy puts every single one in her hair! I’ve attached a few Skype photos…sorry about the quality.

I’m heading to the gym now. If I miss too many days at the gym, I’m not a happy camper. If I time it right, I might just catch the Australian Rules football game that seems to run in the afternoon. The gym has several different channels showing at any given time…usually a movie. Top Gun was playing once…remember the volleyball scene? There was a bunch of guys from one of the other nations playing volleyball a few days ago in the sandpit…so NOT Top Gun. Even with their shirts off (American military aren’t allowed to take their shirts off, so that’s how I knew they weren’t American). Okay, back to the gym… then there’s always at least 2 channels showing sports, usually from the UK channels. Cricket is interesting, but not an adrenaline-raiser. World Cup fever is going on right now so that’s always something interesting to watch or at least to catch the updates. Rugby or Australian Rules football… I find very interesting and different than American football. No helmets, for instance… and little bitty shorts…

Okay, to the gym! Hoo-yah!

PS: I’ve attached some repeats from the old blog as well as some new ones from home, too.




MEMORIAL DAY…KANDAHAR STYLE

Yesterday was Memorial Day in America. When we lived overseas in Japan, we honored both American and Japanese holidays, which made for a lot of entertaining at times. Since I had a day off on Sunday, Memorial Day Monday seemed just like any other day. I woke up early and decided to go to the post office. I knew it was open because during a visit to the post office last week, I asked if they were going to close on Memorial Day, like the post offices back home (Natch). I had about 20 to 30 pounds of parcels to mail back home and another box of goodies for a former coworker who’s stationed nearby (SSG Z., I hope the chocolate makes it to you!) There’s still one more box underneath my bed left to mail and another rug (yes, another one) for either the kitchen or Babybee’s room. So I filled up my seabag (duffle bag for you Army and Air Force types) with my boxes and trudged down to the US Post Office, all the while, taking sips from my ever present bottle of water and praying that the line at the post office was relatively short. I’ve been there before where the line is nearly out to the road and waited for nearly an hour before getting inside the front door. It’s a bit like a popular amusement park ride’s line in the summer heat, except without the zigzag layout designed to cram hundreds of people into a small space and still manage to keep order. Thank goodness I’d thought ahead and pre-filled out all my customs forms, because that move certainly sped things up for me. I was in and out of there within 15 minutes.

Enroute back, I saw a sign, literally, that spoke volumes to me about the meaning of Memorial Day. “Enduring Freedom”… of course, I had to ask a soldier to step aside a moment so that I could take the photo. His last name was “Strong” and for a split second, I wanted to put him in the photo… “Army Strong”. I thought it would be a poignant moment, Memorial Day, Army “Strong”, Enduring Freedom sign, in the middle of the Kandahar Air Field…

This past week has had its share of busy and notsobusy nights for me. I needed the night off, just to reset my bad luck! As I’ve said in the past, when it’s busy at work for me, it’s not good somewhere else in this warzone. And for a couple nights in a row, we were just plain busy. So for my day off, I spent a good bit of it in my corner haven, in the air conditioned comfort of my barracks. When I finally rolled out of bed, it was after midnight and .I decided to go to the gym. Since I’m on nights, I knew I needed to get my internal clock used to sleeping during the day.

Now I’m going to try to get some shuteye… Goodnight, all. See you next time.!




KANDAHAR AIR FIELD…THIS IS REALLY A WARZONE???

Okay, despite the war that brought us all to Afghanistan, I know that this deployment is pretty good. We have a brand spanking new hospital for which we can be proud of the near-herculean efforts taken for us to move, bag and parcel, over the course of weeks (literally) and immediately after a near sleepless night of rocket attack alarms. We have a safe place to sleep and, now a safe place to work. The heat is bearable, for those from South Texas (it really does feel like San Antonio during the summer). The dust storms, small and large, give the airfield a “Wild, Wild West” feel. There’s always a new opportunity to meet people from all sorts of backgrounds and different nations across the globe. It’s hard not to say “Cheers” or “Brilliant” in reply or when spelling, using “zed” not “zee” or greeting someone with “Namaste”… you get the picture, don’t you? I wish at times that we had more time to get to know some of these folks outside of work. It seems just as I’m getting to know someone, I’ve got to say farewell! I’ve also been trying to walk a K9, Max, for at least a month, but my work schedule hasn’t allowed for much downtime during dog walking hours (daylight). We have a multitude of dining facilities from which to choose as well as a handful of proper restaurants, cafes, and fast food joints. There are a few gymnasiums where we, as Americans, can work out, although my preference is the NATO gym that’s very near my barracks. (It has my favorite cardio equipment, the Technogym Cardiowave.) For the shopaholic in me, there’s the opportunity to browse the little stores sponsored by the different nations as well as the KAF bazaar on Saturdays. I’m getting quite good with different rug styles and types here in Afghanistan. My personal favorites are made from Belgian wool: Khal Mohhamedi, Khawaja Roshnai. (See www.uacarpets.com to visit my favorite KAF rug shop! Ask for Ali or the owner, Jahan.)

So, as I think about some of the things I do during a typical week, food comes to mind. One of my favorite places to grab a bite to eat, especially outside of rush hour mealtime, is the Dutch restaurant, All Seasons. I love love love their pancakes with cheese and ham or cheese and bacon. They also have a lovely sweet tea with lemon and nice coffee, too. For my birthday (yes, I turned 39, again…LOL), I ordered the steak plate. For $14, I think I got a great deal, considering I would pay twice that in Japan or the US. I love going to the Dutch duty free store as well, because there is ALWAYS a great selection of sweets (chocolate and licorice) and my favorite Pringles flavor, paprika. Mmmmm. I also found a wonderful skin cream there that is for babies but works well, even as a face cream, Zwitsal. It smells so nice and fresh! (Another product for my “applications” drawer!)

Well, it’s time to knock off… I switch to night shift in a couple of days so hopefully, I’ll get back to a normal sleep schedule…well as normal as being in a warzone allows.




The wonderful world of Skype (or how to keep up with life at home when deployed to Afghanistan)

The last week or so has been filled with a lot of activity and some lack of sleep for many people here on KAF. The bad guys have been active in the region (what else is new?) and military medicine has saved life, limb and eyesight, hopefully winning the hearts and minds of the local populace. We’ve had a couple of rocket attacks in recent days, the latest of which even hit the world news stage, thanks to AP news and some embedded reporters who were witnesses to wartime activity. Needless to say, when I finally got home after a LONG night at the office (ha…what an understatement), only to catch a couple of hours of shut-eye before heading back to do it all over again, the first thing, the only thing I wanted to do was call home. THANK GOODNESS FOR SKYPE. There is a lot of comfort in knowing your loved ones are safe and secure back home. The only time Skype has “failed” me was when my family held a surprise birthday party for me and Skype just wouldn’t play along. We were able to have audio connectivity but not video, so I had to settle for photos emailed of the event. I loved the gesture, considering how much I hate suprises, and appreciated that the tech was available.

After 10 hours of sleep, I was refreshed enough at 4 this morning to Skype home, eat some cereal, and do some laundry. When I left for the self-serve laundry, I had at least 20 pounds of additional equipment on me. It’s surreal to walk around like any other day, but with Kevlar and flak. There were quite a few folks who had the same idea I did…laundry. Now there has been a delay of sorts on KAF laundry (a victim of a recent rocket attack, but now back in operation), but I think there are just more people who do their own laundry.

Speaking of laundry…there are many here deployed to Afghanistan’s smaller FOBs (forward operating bases) who live day in and out in much less comfortable living conditions than we here on KAF. I literally bumped into a former coworker on the Boardwalk the other day who was transiting through KAF enroute to his FOB after a couple weeks R&R back home. His unit’s been here 9 months and just recently got laundry facilities on their FOB. In the meantime, handwashing was the only way they would get clean clothing. So I consider myself very lucky to have to walk a few minutes away to a laundry “mod” or have my laundry picked up or dropped off at work.

Well, it’s time to head off to work… another day, another tax-free dollar.




Mother’s Day in Southern Afghanistan

The past few weeks have flown by…surprisingly. It’s as if one day, I woke up and whoa, it’s May….it’s Mother’s Day and I’m thousands of miles away from my child. This is not how motherhood should be in an idealized state, but due to choices I made long ago, this is how motherhood is for me, for now.  

Padre Jim’s homily on Sunday was tender and sweet, everything a proper homage to mothers everywhere should be.  I sat alone in a crowded chapel on Sunday, Mother’s Day, exhausted from a long night shift at work, but happy to have mass, wet hair and all.  Missing Sunday mass (or Saturday evening) is an awful way to start a week (or end a week), especially here on KAF, where every day is a lot like yesterday.  Sunday mass, for me, breaks up the monotony of work, of long weeks away from home and those I love. 

I was looking at photos from the last time I held Isabella, when she and Daddy visited me in Seattle this past February, before leaving for Afghanistan. I’m posting a favorite shot or 2 or 3 here… she’s since grown at least 2 inches and her hair has lovely soft curls in the back. We chat nearly daily, even if it means I only sleep for a few hours before calling home, since there’s a 9.5 hour time difference. Hearing her voice, her toddler-chatter, the childish giggles, and her sing-song “Mommymommymommy” to the tune of Frere Jacques… it’s worth every minute of sleep lost. Thank you, Daddy, for taking such good care of our baby… I can’t wait to hold you both in my arms. That day will be MY mother’s day 2010! (PS: Thanks for finally putting up the growth chart!)

About the photos… these are recent shots of things that caught my eye. The Kabob house, where my regular order is #3, lamb kabob plate with extra (2) hot sauces. The new prayer garden at the chapel, built by the Kandahar Air Field Knights of Columbus and dedicated in memory of a soldier who passed away recently. The Twix box…I like Twix and find the Arabic scroll pretty. Samples of artwork from previous rotations at our hospital… there are some very talented individuals who have passed through our facility!




S’long, Farewell, American fast food

Yesterday marked the last day of April and the last day for American fast food at the Kandahar Airfield Boardwalk. S’long Burger King. Farewell Pizza Hut. G’bye Subway. The familiar comforts of home for many an American solder/sailor/airman/civilian living here on KAF is now apparently closed, as a result of GEN McChrystal’s order to close AAFES fast food and other businesses here in Afghanistan. What’s interesting is that not only did fast food places close, but the tailor and press shop, too. If you didn’t need those services, such as the Army and Air Force, then that would make sense. However, there are a good number of Navy and DOD employees who prefer pressed uniforms or have uniforms (Desert Camouflage) that need tailoring or sewn (not velcro) collar devices and nametapes. Of course, one can always take out a needle and thread and whipstitch a bit, but heck, sometimes, it just looks better when it’s professionally done. Hopefully there will be another tailor or press shop opening soon.

There are still other modern comforts available here on KAF. There are a couple of places for decent coffee here on KAF, namely Tim Horton’s and Green Beans. The French cafe has yummy pastries and coffees as well. TGIFriday’s and a pizzeria are also available. Then there are the many dining facilities, all with their special themes (Canadian/North American, British, European, Far East, American…). It is quite easy for someone to gain weight here on KAF, simply by eating 3 square meals a day at the DFAC.

Thankfully, the kabob place is still open so I can get my fill of the lamb kabob plate. Mmmm… life is good.