The Afghan Experience

     Life at BAF (Bagram Air Field) is in full swing.  Any concerns I had before arriving about being bored to tears have been put to rest.  I was in the operating room (OR) doing anesthesia the day after arriving.  The operating room looks like many of the other ORs I have been in and anesthesia is pretty similar where ever you happen to be in the world so the OR has become my sanctuary.  I have been made the supply officer so I am in charge of ordering and tracking all anesthesia supplies.  The expectation of the leadership at the hospital is that we will work 84 hour weeks so there will be very little time for boredom. 

This is one of our three ORs.

This is my world.

     My typical day starts at 4:30am.  I get up in silence and climb down from the top bunk and try not to bump anything on my way into the hall.  I shave and shower and then head back to my room to try to dress in silence.  I get to the hospital at about 5am and call Cami and the kids.  We have family prayer and then I head in to the OR to set up my room for the day and make sure that all equipment is stocked.  Depending on the surgery schedule for the day we may run from 1 to 3 ORs at a time.  We treat all active duty members, contract employees, and also local nationals brought through the humanitarian arm of the military.  We see a lot of children.  I think that I have done 15 cases in the week I have been here and 3/4 have been local nationals. I have done appendectomies, gall bladder removals, deviated septum repairs, eye surgeries, vascular surgery, brain surgery for a gunshot wound to the head, tumor excisions and bone repair surgery.  We also get traumas in through the emergency department but not as many as you would think.  When we are the first to see a trauma it is called a POI, point of injury case.  I have seen only a handful of traumas come in but none have come immediately back to the OR. 

Facetiming family prayer and yes I had my eyes opened during the prayer.

     The people here are kind for the most part.  I sat next to a Pediatrician from Pakistan on my way to Atlanta from San Antonio.  When I told him I was headed to Afghanistan he educated me on the mentality of the people here.  He told me that the people are very simple, sincere and passionate.  They have uncompromising integrity and will never lie to you.  Honor is a huge deal.  He told me that because of these things the people believe whatever they are told about Americans.  He said one day they will sincerely love you and be so grateful for what you do and then the next day after listening to the Taliban or other extremists they will completely change.  I try not to be judgmental but sometimes it is difficult.  You will see women with their faces entirely veiled with lace over their eyes and long flowing robes.  My immediate first thought is about suicide bombers.  I am not sure about what the procedure is for patients to get on base but I have heard that there is a scanner in the process. 
     The military has come a long way since the days after the bombing of Pearl Harbor and the internment camps for Japanese Americans.  We now have hired huge numbers of local nationals to work on the base itself.  There are many who have shops and on base.  All of the housekeeping in the hospital and in our dorms is done by locals.  When they are cleaning the bathrooms in the dorms they have to be accompanied by an armed guard.  They prepare all of our food and we buy all of our bottled water from them.  It seems like we are crossing the stupid line a little and creating potential for problems by trying to be socially acceptable.  There have been a few cases of poison in some bottled water and some shootings on base but those have been the Afghan soldiers shooting our guys.  It seems like the extremist groups hurt their own people more than anyone else. We get a lot of trauma from Afghans shooting Afghans. I took care of a 13 year old boy today that was shot in the head. There is another patient currently in the ICU that was nearly beat to death. I just don't get it. I know that the hospitals in the US are full to bursting with similar stories of human tragedy, I guess it is the human story, sometimes I wonder what God thinks about all of this. I am sure it breaks His heart.
I had a positive experience the other day. I was taking care of a 12 year old Afghan girl having a huge bowel surgery. Her head was wrapped in a beautiful traditional scarf and she looked up at me shyly with these huge green brown eyes as I spoke with her through the interpreter. I gave her an epidural so that she would be comfortable after surgery and ever since then when I go back and check on her she gives me a huge radiant smile and waves. You can see that these people in general are good-hearted and love their families just like we do.

We are not allowed to take pictures of patient's faces but this is the little girl I did the epidural on, she was super cute.

Let me end with one final experience. After work we typically go work out at one of the many gyms. On this particular night we were attending an Abs class in a tent on the south side of the base. The class had just started when a loud siren started to sound out and then a voice over the speaker said, "Incoming, incoming". Everyone in the tent hit the deck and covered their heads so I followed suit. About thirty seconds later there was a loud earth shaking explosion. After about two minutes with no other explosions we moved outside into a bunker and waited for the all clear. We sat for about 30 minutes and the all clear was sounded. It was hard to feel scared because everyone we were with kept joking around. It was my first experience in being under fire and I can honestly say it wasn't really scary at all.  I know that some people, my father in particular, may freak out at this experience but I wanted to share it for two reasons.  #1 I want to let anyone who reads this know what it is really like here, without pulling punches.  #2  I think that it is important to remember that this is war.  We are under attack.  These rockets that are occasionally launched at us rarely do any serious damage to person or property but it is important to be vigilant.  I think that this is a metaphor for our own lives.  We should always remember that we are at war.  We cannot afford to forget that the enemy of God is always waiting for an opportunity to attack.  To send those fiery darts in our direction.  We know that if we are built about the sure foundation of Christ we cannot fall but it would be foolish to not do our part to protect ourselves and prepare for battle.  God be with you all.

After the rocket attack on the base I returned to my room to find the lights on for the first time.  I took advantage of the light to take some pictures.  This is my little closet. 

This is my bunk bed.  I am on the top.

My bunk with the 'curtain' opened

 .

This is one of the other sets of beds in our room.  I have never met the owners of these beds.

This is called my IBA, Individual Body Armor, and the 9mm Beretta that I have to carry everywhere but the OR.  All together this equipment weighs about 50lbs.

Me tucked away in my cubbyhole.

This is the sign in front of my hospital.  It is named for a soldier who was killed in action.  This day was less dusty and you can see the mountains in the background.

This is the hospital.  The tent has some exercise equipment in it so you can work out between patients.  

These are the giant T-walls that surround the hospital and most other buildings to protect them from rocket and mortar attacks. 

These are the Apache helicopters that go out and get wounded soldiers and bring them back to the hospital.

Just a picture of more T-walls and buildings that are plain and ugly.

This road is called Disney Drive also after a soldier who was killed in action.

I think that this valley looks a lot like Salt Lake for those who have been there judge for yourself.

This is a fortified shopping area with a barber shop and dining facility or DFAC as we call them.

This is the place I get my hair cut.  $6 for the best hair cut in Asia.  The ladies are Kyrgies as they call them, because they are from Kyrgyzstan , Asian in appearance but speak Russian.

Not much to look at is it?

Bagram Air Field is an old Russian base that we took over when Russia left.  Some of the structures are from the Russian occupation era.  This is one, it is called the Russian tower.  It is very creepy inside.  

Concrete and barbed wire pretty much sums it up.

These are armored police vehicles with turrets on top for 50cal machine guns.

This is the spin class I do on Monday, Wednesday, and Friday.  I have never sweat so much in my life.

This is the Abs class I was in when the rocket attack happened.

This is Major Scott who I am replacing.  We work together in San Antonio too.  She is super excited to get home, can you blame her!?

There is an Afghan restaurant on base called Aziz's, affectionately called Aziz's Diseases, because many people get sick after eating here but it is something of a right of passage, you can't come to Bagram and not eat there.  I played it safe with a vegetarian pilau.  It was pretty good and so far no disease.

This is one of the big gyms.  This one is called The Rock. 

This is a bad picture of some of my OR friends in the bunker the night of the rocket attack.

This is what a bunker looks like.

This is a mural painted on the wall right outside of the anesthesia office.  This is all the gear I have to pack around to and from the hospital everyday.  

Welcome to Afghanistan

Our story continues.  It has now been about a week since I last wrote and much has happened.  After our many delays in Virginia we flew to New Hampshire where we picked up enough fuel to get us to Germany, for which I am exceedingly grateful.  We landed in New Hampshire and to my great surprise we had to wait on the plane for an hour and a half while the fuel was pumped.  Most of the time they have you leave the plane for that process but for some reason they wouldn't let us get out and stretch.  I was sitting in an area of smokers and had to endure an hour and a half of belly aching about how blankety blank ridiculous it was that we couldn't get off the plane.  One guy satisfied his nicotine craving with a big ol' wad of chew and proceeded to fill a 24 oz clear bottle with his spittle juice.  Yowser! I looked out the window most of the time and marveled at the amazing fall colors in the early morning light.
    After we fueled up and got our weather radar fixed we were on our way to Germany.  It was about 6 in the morning by the time we started over the ocean.  The flight was six and a half hours long but it was totally dark and about 8pm by the time we got there.  I need to sit down and figure that one out.  We were off loaded by bus and shuttled to a terminal to wait for the plane to get refueled and for a new crew to come aboard.  I was exhausted by this time as my height prevented me from getting comfortable with my knees constantly in contact with the seat in front of me or being banged up by the beverage cart in the isle.  This uncomfortable position was made all the worse when the person in front of me reclined into my lap so I was feeling like I should do a dental exam on him and almost tie his shoes.  He had an assault rifle on the floor next to him so I just let it fly.  It is interesting to fly on a commercial plane that is loaded to the gills with automatic weapons and handguns.  It was crazy because they made us go through security and wanded all of us while our guns went through the x-ray.  I am not sure what else they could have been looking for, maybe someone had some finger nail clips confiscated.  Anyway I digress.   So at the terminal in Germany there was a pool table and phones and a little cafe and duty free shops.  You could also smoke in the building if you wanted to.  Tobacco must addle your brains as well as your lungs because some foolio threw a lit cigarette in a garbage can and started a fire that had to be extinguished.  I found a quiet corner and stretched out on the floor and fell asleep.  This two hour wait was actually pretty nice. 
    Once back on the plane I assumed my previous cramped position for the 6 hour flight to Manas AFB in Kyrgyzstan.  We arrived mid-morning and took a shuttle on to the base.  The landscape was similar in appearance to the Fillmore, Utah area for those of you that have been there.  Rolling dry plains surrounded by huge mountains.  The base itself was pretty crazy.  We were dropped off and began in-processing to the base which is military talk for making you sign a bunch of forms and go track a bunch of people down to sign a paper for you along with a bunch of meetings.  We were allowed to keep one of our bags and the rest had to be put on huge pallets to be loaded onto the C-17 that would fly us to Bagram.  Once we had done all of that we had to go and get more equipment issued to us including a helmet and flack vest made out of Kevlar and then 40 pounds of plates that you put into this already heavy vest.  They also issue you a full hazmat suit to go with your gas mask. In total you get two more bags of stuff and a sleeping bag and cold weather parka.  Then all but the vest and helmet gets put on pallets too.
     After getting all of our equipment we were assigned to a tent and had to go wait in line to pick up a set of sheets and a threadbare blanket and disgusting pillow.  We then went to find a bunk.  You will see in the pictures what kind of experience this was.  There were nice cafeterias with plenty of food and wifi. I called my family a couple of times and was impressed at how technology allows me to see my children's faces 9000 miles away.  I am so grateful for that capability because it really helps to not only hear your wife's voice but to be able to see her beautiful face to see that life exists outside your isolated experience.  You feel more a part of things even though you are away.
     After eating a good meal we attended a meeting at which we found out that we would be leaving for Bagram the next morning.  I had heard that on average people spend three days in Manas so we were all surprised and a little grateful that we wouldn't need to sleep in those scary beds more than once.  The plan was to report to the terminal at 0400 (which is 4am).  We were to be placed on 'lockdown' until 8am or 0800, meaning that we could not leave the terminal for any reason.  At about 0730 we were told there was to be a delay and they were going to release us to go eat breakfast but we needed to be back at the terminal at 1100 so that we could be ready to fly out by 1300 (1pm, military time just keeps counting up after 1200 until midnight then it stats over at 0000, zero hundred hours).  We stayed up and ate and I fell asleep on a recliner in a bar.  At the designated hour we put on our Kevlar vests and prepared to board the C-17.  This is a huge aircraft.  You could transport a small hour in one, Noah would have needed a couple.  There were 160 of us traveling into Bagram that day.  We were shuttled out to the flight line where we saw it for the first time.  The entire back end opens up and you can drive tanks and huge vehicles up inside it.  They have these passenger seats attached to pallets that slide into the floor and you can put in as many rows as you need.  The problem is that the pallets don't lock into place so when there is acceleration or deceleration you slide forward or backward about six inches as a huge mass of people.  It is a weird feeling.  It is extremely loud inside and the only bathroom is at the front of the passenger area so 160 pairs of eyes are on the door all the time.  Several people who clearly had tried to hold it but couldn't made the walk of shame back their seats after spending their few minutes in the bathroom.  The seats are packed together tighter than regular airline seats if you can believe that so the two hour flight is abject misery.  I think they secretly plan it that we so that you want to get off the plane when it lands.  You are also wearing a bullet proof vest that is super heavy and doesn't allow for much movement.  Needless to say when we started the decent into Bagram we were all ready to be off that beast.
     Bagram sits right at the base of the Hindu Kush which is a mountain range off the Himalayas.  To make it to the air strip the plane has to dive down quickly so that your ear drums feel like they are about to burst.  I struggled to keep my lunch down and luckily was successful.  The huge plane landed surprisingly smooth and rolled to a stop.  We had arrived in Afghanistan.  The back end of the plane opened up wide and the pallets holding all our gear were unloaded. We were then told we could deplane.  The sun was up and it was much warm than it had been in Manas.  The air was thick with dust and the large mountains surrounding us were just shadows in the dust filled air.  We lined up in four huge rows and started our march to the base.  I took a couple of pictures of the plane and was yelled at by a sergeant on the flight line who told me that it was against regulations to take any pictures on the air strip.  We were shepherded into a conference room and began to receive instructions on how our 'in-processing' was going to work.  We filled out paperwork and turned in paperwork we had been carrying since leaving our home stations.  Then we were told to find our stuff and a bus would take the hospital crew to our dorms.  Have you ever tried to find your green camo bag among 6000 green camo bags, I'd take the needle in the haystack.  After that ordeal we got on the bus.  I was not prepared for what followed.  Off of the flight line huge concrete walls called T wall or T barriers line every street and are topped in most cases with copious amounts of razor wire.  You get an eerie feeling as you see pock marked walls with scorch marks.  The mood gets serious very quickly as you get deeper into the base.  There is little color anywhere.  Everything is concrete, brown, or green.  A few murals painted on the T walls are visible here and there.  All of the buildings look the same.  There are a few tents but mostly nondescript cement buildings.  All of the vehicles passing us on the road look like they mean business with heavy armor and 50 caliber machine gun turrets on top.  For the first time I realize that I have entered an actual war zone.  This was different than the movie images I had in my mind, it was evident to me for the first time why they say war is hell.
     We pulled up to the dorm room building in our bus and got our bags.  The dorm is a two story concrete building.  Women's on the ground floor, men up top.  We were given our room assignments and told to find our spots and unpack quietly because the dorms are 24/7 quiet lights out because you have people on shift all the time and sleeping at odd times.  I walked into my dorm which was pitch black, blankets covered the windows letting in only a faint glow of light.  I carried my heavy bags as quietly as I could and found the bunk that was obviously meant for me.  I found a flash light and began to try to unpack.  My room has four sets of bunk beds.  Each bed has makeshift curtains around them to help dampen the light and noise that is inevitable.  There was another unoccupied bed that was piled with stuff to there are seven residents in our room.  I met my one room mate who is another CRNA who will be leaving next month.  He told me that the rest of the people in our room are various types of physicians.  I have only met three so there are three that I wouldn't even recognize in the hospital if I saw them.
     After unpacking I had to go to the hospital for orientation.  At this point I was just kind of there but not really.  I was going on about 6 hours sleep over the last three days and was just exhausted.  We were dismissed to go eat or do whatever until the next morning.  I went home and without getting undressed fell into bed and slept for about 14 hours.  In the morning I got up and got dressed and walked across the street to the hospital and began my new life as a deployed airman in Afghanistan.
     Most of my day to day life is pretty normal so I anticipate shorter descriptions and emails in the future.  We will continue this story in another week.  God be with you all.

This is all of us sitting in the C-17.  The photo bomber is one of my friends from San Antonio.  You can see some pretty intense faces in this group.

The top of my head is not why I included this picture but so you could see the back of the C-17 wide open as they load the huge pallets of gear. 

The lavatory of shame.

Back end loaded and closed.

This was my first glimpse of Afghanistan.  

This is the picture that got me in trouble.  See the guy in the vest. Well I didn't.  This is a huge plane.

Picture of the back end of the plane and a picture of the guy getting closer to yell at me.

This is the dark hallway of my dorm.  I will try to take pictures of my room but I am not sure they will turn out.

These are the bathroom rules. Kinda funny.

T Walls with murals.  Sorry it is blurry I am sure I will get some more pics later.

This is the street that separates the dorm from the hospital.  This was taken this morning, the moon was beautiful. Notice the mountains in the background. 

This is the side of our dorm building.

The sun coming up.  This is also looking down the street that the hospital is on.  There is a weather blimp up in the sky that looks like a black spec.

I thought this was a pretty funny lable.

My lunch this afternoon.  I decided not to have any of the mystery meat and stuck with the veggies.  All in all the food is pretty good.  

It begins. . . and the blog

So I am not going to write the details of my weeks twice so I am going to write my email and anyone who is interested can come see the pictures that go along with some of my experiences here on the blog. 
***********************************************************Repeat of last email********************************************
After months of training, shots, pokes and prods, paperwork, and fine print I am finally completely ready to go. My bags have been packed for more than a month and our farewell party is in the books.  We had a great day as a family at the 100 year anniversary of Boy Scouts and the LDS Church at McGimpsey Scout Park.  After the scout thing finished we went out to dinner and had father's blessings and then had our final movie night all together.
Sunday morning my family and I loaded all of my gear in to our van and drove to San Antonio International Airport.  We parked and dragged my heavy bags to the check in counter.  I was given gate passes for each of my family members so that they could come back to the gate with me.  The kids were very tired and lay down on the benches in the airport until it was time to say goodbye.  My heart nearly ruptured as I held my sweet wife close and felt her shake with her sobs.  I held her until there was no one else in line to board and I had to let go.  I walked to the gate and looked on my family for the last time in person for six months.  I boarded the plane and my journey to Afghanistan began.  We flew first to Atlanta and then to Norfolk, Virginia.  We waited for the “shuttle” to come and pick us up for about two hours and finally gave up and took a taxi to the Air Mobility Command Terminal on the naval base.  We received our itinerary for the remainder of our flight at that time.  Our tickets said that at 1245 the next afternoon we would fly from Virginia to Frankfurt, Germany.  We would layover in Germany for 2 hours and then fly to Manas Air Field.  We will have to wait in Manas for a “rotator” to take us from there to Bagram.   That final leg will be on a military plane.  There will be over 200 of us going to Bagram so I am interested to see how that is going to work.  
                After getting our itinerary and checking in our big bags we went to a hotel for the night.  For the last time in six months, I had a room to myself.  One of my good friends who is an Army reservist was mobilized to Fort Eustis in Virginia about three months ago.  We had made previous arrangements to meet up when I got here.  He came by and picked me and another guy up and took us to dinner.  We had a good visit and our final good dinner.  In the morning I packed up my stuff and took a taxi to the terminal with my travel buddy.  We got checked in and sat around for two hours before they loaded us on our plane.  It is a big commercial jet contracted from a civilian company by the military.  Once all of our gear was stowed we waited in our seats for about another hour.  At that time the voice came over the speaker telling us that we were overweight significantly and there would be a delay of at least 30 minutes while they decided what to do.  Finally another announcement over the intercom informed us that we would all have to get off the plane so that 60,000 pounds or gallons (can’t remember which) of fuel could be removed.  So here I sit back in the terminal waiting around.  I should have suspected something was amiss when our cab driver said as he pulled up to the terminal, 
“Just so you know I doubt you will be flying out today.  When they send you back to the hotel you should go and see the tankers in the bay, they are the biggest in the world.”
At the time I just laughed but now I am wondering if there isn’t some truth to that.  
I have already experienced some tender mercies from the Lord.  The travel buddy I have mentioned is one of the anesthesiologists that I work with in San Antonio and he is also a member of our local church group (for those who know he is in my stake).  We have kind of stuck together.  We both are relatively new to the Air Force and laugh together about how little we know about what we are suppose to be doing.  It is a great relief to have a kindred spirit around especially when my heart is already weighed down with longing for home.  
I am writing this addendum to the above email which I wrote while waiting in the terminal this afternoon.  It is now about10pm and I am still in Virginia.  Apparently the cab driver was correct.  We were told after about an hour and a half of waiting that our flight was going to be canceled until 3am because the crew had rest restrictions that would not allow them to fly over night because of the delays.  The airline put us up in a hotel and fed us and has made arrangements for us to get back to the terminal in the wee hours of the morning.  So I will have one more partial night in a private room in this promised land of America.  Until I can write again, have a great night!

There will be some additional info about what happened next in the pictures below. 

The kids and I at our early morning farewell at the airport.

Me and my incredible supportive bride trying to pretend that all is well but hoping we will never have to let go of each other.

Once we got to Virginia we waited for a shuttle to come pick us up.

And waited . . . .This is Dr Brian Landreth, an anesthesiologist from the hospital I work at and the friend I mentioned in the email.

And waited! Finally we all took cabs to Norfolk Naval Base.

This is my buddy from my home ward who is stationed temporarily in the Virginia area and I was fortunate enough to hook up with him for dinner.

Waiting in my hotel room to get the show on the road.

We arrived at the base terminal and passed through security which was an interesting experience in and of itself because most passengers had handguns and automatic weapons but the 'wanded' all of us to make sure we didn't have knives and otherwise had to comply with all other TSA regulations, except of course for all the GUNS. Go figure

We waited until three in the afternoon because of plane weight issues and crew rest and then were told that we couldn't leave until three in the morning.

Fortunately, we still got the in-flight meals that had already been 'prepared'.  The airline booked us all in hotels and paid for dinner vouchers and shuttles or cab rides to and from the terminal. Ouch!

So in the wee hours of the morning after a two hour wait (seeing a common theme here yet) we took off to New Hampshire which was like an hour away. Once there we refueled and the sun came up enough to see some beautiful fall colors through the window.  We were able to enjoy the colors from the plane window for another hour while things were getting fixed on the plane.  

I settled in to my comfy seat where my knees touched the seat in front of me when it was in the full upright position.  I tried to sleep but could never get comfortable enough.  

I listened to one and a half Work and Glory Novels throughout the flights and waits.  

So when we left the states it was early in the morning.  The flight to Germany was only six and a half hours of flying time but when we got there it was totally dark and about 9pm.  

After the long flight cramped in  my seat next to a pimple-faced Army soldier that used an expletive before every word and looked and smelled as though he had not showered or brushed his teeth since birth I stretched out on my back on the floor and fell asleep.  

In the military terminal you could smoke in the building so I woke up with an impressive headache.  Some smartypants put a lit cigarette in a garbage can that soon caught fire and had to be extinguished.  Those crazy Americans!

I took this picture out the window of the shuttle on the way back to the plane from the two hour wait in the terminal.  I wanted to show the kids what Germany looked like, so here it is.

I imagine that throughout this experience I will have many opportunities to say, "You know your deployed when . . .fill in the blank.  Well this time the blank is when your plane is filled with handguns and AR-15s. As I got on the plane I just snapped a few random pictures. See how many guns you can find. 

Look at the floor and in the seat pockets.

So I was fortunate enough to get to return to my same seat and same odoriferous next door neighbor for the next 6.5 hour leg of our journey to Manas Air Field in Kyrgyzstan or Kazakhstan . . . one of those stans.     

We arrived and were told to put our stuff in our rooms.  We followed the signs to Hotel Alaska to Tent City.  So named because these are Alaskan shelter tents. 

There were at least 25 of these tents all lined up.

This was mine, 516. You were handed a bundle of sheets and a pillow and blanket and told that using sheets was mandatory.

This is me on the bottom bunk.  It is no wonder you have to use sheets.  These mattresses were likely used during both world wars and then donated to some POW camps before we go them.  The sheets and blankets would have made a homeless guy cringe.  

This is what our tent looks like inside. 56 people sleep in one tent.

This looks like a still-shot from Shawshank Redemption but it is one of my friends posing with his bed number

We had to unload these huge trucks full of gear and put them on pallets to me shipped in our aircraft. 

Like this.

Then we got issued more gear.  Hazmat suits and cold weather parkas and sleeping bags along with our 60# plated flak vests and helmets.

The facilities here in Manas are actually not bad.

Good fresh fruit and local favorites like cabbage soup.

I thought the kids would be interested to know that we can eat all the candy we want and ice cream sandwiches.

And drinks and cereal of all varieties.

They leave a place set with a POW plaque above it with hats from each service helping us to always remember those who didn't come home.  There is a Bible on the table and a lemon and some salt on the plate.  The salt is for the tears shed in their behalf and the lemon for the bitter fate of those captured.