"Man-uary"

Another week has come and gone. I had a birthday and started growing my first ever mustache. Most of the guys on night shift started growing mustaches in December. They kept trying to get me to join in but I have never been one for facial hair and so I respectfully declined their offers. On the 8th I was looking for some paperwork that I needed to submit to my commander back home. I had been looking for about 45 minutes when one of the main mustache boys asked what I was looking for. I made the mistake of telling him that if he could find it in less than 2 minutes I would grow a mustache for the rest of the month. In about 25 seconds I had the paperwork in hand and I was on my way to growing my first mustache.

This is Kim Freisen, the man behind my mustache.

 I am just under two weeks in and I have to admit that I am not impressed by my progress. Granted the other guys have several weeks on me but still I have a pretty sad looking caterpillar living under my nose. The sparse hairs are multicolored from blonde to red to black. It really bugs me to have it there. You can't eat anything or blow your nose without it ending up tangled in your lip hairs. My personal opinion is that very few guys were meant to wear Speedos and mustaches and I fall into neither category. I have begged to be able to shave it off but all requests have been denied. Darn those Air Force core values (Integrity, Service, and Excellence).

This is the mustache posse minus Kim who was still sleeping when this was taken.  We lined up from best to worst mustache, obviously best on the left!?  I keep telling myself that it is just because I am a week or so behind the rest but in my heart I know it's just because my 'stache stinks.

Takes you back to junior high doesn't it.

Sorry for the close up the nose shot but you have to get this close to really appreciate the grandeur of my facial hair.

In other news, I turned 37 on the 17th. The first gift I received was arriving at the hospital and putting in the code for the door lock and finding out that it no longer worked. 

This is the kind of door lock we have all around the hospital and the dorms.  It is called a cipher lock.  They usually have a 3-4 number code and they are all different so you just have to remember them.  They are putting these on all the dorm room doors because there has been a problem with thievery. 

I walked around in the dark until I ran into a colonel that was in the same boat. We just waited by the door until someone passed by. I hailed him over and told him that we didn't know the new code. He got all huffy and said that we should have received word through our chain of command. Clearly, we hadn't received the info but the guy just didn't let it go until he noticed that I was standing with a colonel and then his tirade just died in his throat. Stuff like this makes me wonder how we ever got to be the greatest military force in the world. Once inside I received a birthday package from my family and the OR crew made me a cake and sang. There were several people offering to give me birthday spanks but luckily I dodged that bullet.

Here is my fabulous birthday cake.

And here are those who were kind enough to celebrate with me.

You know you have been gone too long when your in-laws forget your name.  This is the label on the birthday package they just sent.  Just kidding Mom and Dad I know you love me, I just thought it was pretty funny.  Right up there with wedding presents that said "Congratulations Cami and Ryan", Ryan being an ex-boyfriend.

      That night we had our first battle casualties of the week. The one that came back to the OR was an Afghan soldier that was walking with his friend when an IED went off. His friend was nearly vaporized by the blast but he was peppered with shrapnel all up the left side of his body. A huge piece of shrapnel entered his left lung and he was losing large amounts of blood. Two chest tubes were placed in the field and then he was flown to us. Once in the trauma room he was assessed and sent to the CT scanner so the extent of his internal injuries could be evaluated. The trauma czar (yes they really call him that) came to the OR and told us that he needed to explore his abdomen for potential organ damage. He was brought into the operating room before we could get blood in the room to start transfusing him. Anesthesia drops the blood pressure of most patients but it really drops the blood pressure of volume depleted patients. This guy was in the latter category. I gave him medications that don't usually drop the blood pressure as bad and kept him only on a whiff of anesthetic gas but his pressure tanked. I gave some medications to bring it up but it doesn't work as well as replacing the blood that is lost. Eventually we got blood in the room and after slamming in six units he started to improve and stabilize. Trauma is almost like a separate animal all together. There are general surgeons that specialize in trauma but in anesthesia you need to learn to do it all. The hospital I work at in San Antonio is a Level I trauma center but rarely am I ever scheduled in that room. I had a great experience in Baltimore when the Air Force sent me to one of the busiest trauma centers in the country to prepare for battlefield trauma. It was a great experience but I had lots of people around to help and guide the resuscitation. Now we are baptized by fire in a feast or famine classroom. I am learning a ton and my confidence in my abilities grows all the time.

This experience is helping me to become a different person in all aspects of my life. It is hard to be away from home but being involved in something significant in the history of the world helps to distract my mind from homesickness. Be safe one and all.

I had to include this photo and the story that goes with it.  Someone ordered XL head covers for the OR and they are huge.  They must have been from the days when the beehive hairdo was all the rage.  Anyway, you could put one on and pull it down over your whole head and face.  One thing about growing up with five boys you are always looking for an opportunity to scare someone.  My unfortunate co-workers are now subjected to this habit of mine.  One day I went into the OR behind one of the nurses who was stocking carts.  I had one of the head covers pulled down over my face.  I ninja'd my way right behind her and quietly said "Boo" and simultaneously poked her in the back.  The most shrill scream I had ever heard erupted from this tiny nurse who spun around and once she saw my face shrouded by the head cover let out another eardrum rupturing scream accompanied by the most horrified facial expression I have had the pleasure of witnessing.  I doubled over laughing on the floor when three or four armed soldiers came bolting in to the room to see who had been murdered.  It was a glorious moment in Bagram history.

Resolutions

Every year at this time we tend to look back on where we have been and look forward to where we want to be.  One of the benefits of being deployed is plenty of time to reflect.  I have spent a lot of time thinking about things in my life that I want to improve or get rid of entirely.  One of the things that I have been thinking about is my weight.  Like many people, I have fluctuated in my weight ever since I got married.  There must be something in wedding cake that stops one’s metabolism.  After Connor was born my sweet Cami started a lifestyle change called Body For Life.  She did two consecutive 12-week periods of eating right and exercising and had such incredible results that I joined her for her third 12-weeks.  By the end we were both in the best shape of our lives.  We felt great and looked good too.

Originally I included our before picture but thought that I should get permission before I do.  This is after our 12-weeks of eating right and working out.  

Amazingly there is no shortcut to having a healthy strong body other than eating right and exercise.  It is almost as though there is a lesson to be learned there!

You would think that this picture would be a point of pride for me but it serves as a reminder of how far I've fallen.

  We maintained our figures for a short time and then fell back into old habits.  The lost pounds found their way back and I began to feel sluggish and wimpy again.  I know that this story is not unique to Cami and me but is one to which most can relate.  Years passed as did plenty of New Year’s resolutions to make changes that would lead to more permanent change.  There were periods during which I would meet my goals and drop some pounds and then would go right back to the same behaviors that got me in trouble to begin with.  Finding pounds was easy, losing them was hard.  I found that I had a talent for finding pounds and stopped trying to lose them.  I had a great job, lived in my dream home, had an amazing family and was literally living LARGE.  My weekly exercise consisted of walking behind my self-propelled lawn mower and occasionally helping someone move in or out.  I would still have the occasional desire to change, often associated with getting into my bathing suit which I become proficient in suppressing with a batch of cookies or two.  Things went on this way for years.  I would walk around comparing myself to those around me feeling justified by some and depressed by others.  I wasn’t happy.  I didn’t have any self control and I knew it.    

Hey, hey, hey!  Life was clearly treating me well, a little too well. 

It was at this time that I decided to change careers which meant going back to school.  My patient, wonderful wife supported me despite the great challenges this created for her and the kids, not the least of which was joining the United States Air Force.  In the back of my mind I remember thinking that in the military I would learn self-disciple and self-mastery which would be the solution to all my problems.  Not so.  After 30 months of school, living away from home while I did clinical rotations all over the country, I continued in my same well established habits.  Once I graduated and passed my board certification exam I went off to Commissioned Officer Training.  I was sure that this was the beginning of the end of my poor eating habits and roly-poly figure.  

These are pictures I took just before Commissioned Officer Training.  No need to exaggerate the belly fat, this is all natural.  

When I returned from training I was a few pounds lighter mostly because of a very short haircut.

To my great surprise the Air Force, out of necessity, had loosened its standards for physical fitness so that more people could pass.  I put my effort into getting into shape encouraged by the shrill voice of the drill sergeant always one step behind me.  I think the stress of that experience resulted in more weight loss than the exercise but I passed the physical assessment at the end of the 5 weeks without too much difficulty.  Life calmed back down as we settled into our new lives in San Antonio.  As a family we were introduced to Blue Bell ice cream, a Texas original that quickly became my new vice.  Once a year I was required to perform the physical fitness assessment which I found I could pass if I did push-ups and sit-ups for two weeks before and learned to ignore the desire to vomit while I ran. 

This story has now arrived at present day.  I am deployed in Afghanistan with lots of free time.  For the last twelve weeks I have done a decent job of exercising routinely and eating better than I did before I arrived.  I have seen good results in my physical appearance and in the way that feel.  

This is where I am after 12 weeks of being in Afghanistan.  There are some Abs in there somewhere but they are still hibernating under the protective coating of blubber.

However, in the back of my mind I know that I have not really changed the habits that will at some future time result in my return to the old me.  It is upon this aspect that I have been thinking and that I wanted to write today.  I know that all of us have things in our lives, habits that keep us from realizing our full potential.  Not everyone struggles with weight but this is an allegory of the human condition.  Our spirits can be just as out of shape and flabby as our bodies.  Addictions, pride, anger, laziness, dishonesty are the junk food for our souls.  We feel tired and worn out when our spirits are sick.  We can temper those feelings on a short-term basis by doing a few spiritual sit-ups like reading the scriptures for a few days, doing better at saying our prayers, and putting forth more effort to be aware of where we are.  Much of the time we fall right back into our old habits and things continue like this for years.  What is the solution?  What is the recipe for real change?  I think that the answer to this question is the same for physical and spiritual problems or weaknesses; it is the atonement of Jesus Christ.

The Book of Mormon teaches us that weakness is an invitation to come unto Christ, to recognize our inability to change on our own, to become humble enough to then seek out the Master and only then is the weak thing made strong.  Paul reiterates this teaching in the 12^th chapter of 2 Corinthians.  Paul beseeches the Lord to remove ‘a thorn of the flesh’ but the Lord tells him that His grace is sufficient for him (Paul) and that His (the Lord’s) strength is made perfect “in weakness”.  Paul’s attitude about weakness, infirmity, trial, persecution or distress of any form completely changes as he recognizes that “when I am weak, then am I strong”.  Finally, a modern day apostle, Elder Russell M. Nelson, in the October General Conference said, "We can change our behavior. Our very desires can change.  How?  There is only one way.  True Change--permanent change--can come only through the healing, cleansing, and enabling power of the Atonement of Jesus Christ.  He loves you--each of you.  He allows you to access His power as you keep His commandments, eagerly, earnestly, and exactly. It is that simple and certain. The gospel of Jesus Christ is a gospel of change!” 

http://www.lds.org/general-conference/2013/10/decisions-for-eternity?lang=eng

All of our weaknesses or problems are blessings because they are invitations to come unto Christ and be made whole.  Only when we yoke ourselves through covenant with Christ will our burdens, whatever they are, be made light.  I know that this is true.  I have experienced it in my own life and continue to each time I remember to look unto Christ and live.  Self-discipline then goes back to the root of being a disciple of Christ, living as he lived and using His strength where we are weak.  I have proven to myself over a lifetime that I can find temporary success through sheer willpower but in the end the only way to fully, completely, permanently change is through our Savior, Jesus Christ and His mercy and grace.  I think Nephi says it best in 2Nephi 25:23, “. . . for we know that it is by grace that we are saved, after all we can do.”  All we can do is to surrender ourselves, to approach the altar of God and place upon it our failings, our weaknesses, sin and pride and allow it to be taken from us.  There is no other way.  There isn’t supposed to be another way.

I hope that as each of us begin this new year we will be like Paul, Moroni and Elder Nelson and remember that if you will trust in the power and strength of Christ rather than in yourself you will be permanently changed into new creatures.  I love the Lord.  I am grateful for His incredible goodness.  I love all of you and I am grateful for your unwavering support and love. 

Random pictures from this week

Waiting in line at the post office again.  This time it only took an hour though.  The girl sitting down is Ryan Krampert.  She is one of our anesthesiologists and my night shift buddy.  She is sending home her Gorilla box with all of her stuff cause she is going home! 

Gotta love the post office.

I sent this 60 pound box home.  So far the heaviest box I have shipped.  I cover all boxes with packing tape because inevitably they will get we at some point on their journey back to the states.

2014 Comes In With A Bang

We did not end up having a white Christmas but it did snow quite a bit on New Year’s Eve.  In similar fashion to our Christmas Eve party the anesthesia crew got together to bring in the New Year.  We had food and played games.  We were on high alert because of the holiday and so we were all making predictions of when the next rocket attack would be.  Earlier in the day we had already had two mortars hit on base with no injuries.  Our party ended around 9pm and the day shift crew went home amid jokes that they shouldn’t even get undressed because they were bound to return shortly when the New Year’s ‘fireworks’ began.  The night was remarkably quiet.  Us nightshifters were sorely disappointed when we went to midnight chow and found the usual overcooked, dried out fare and nothing special for the New Year.  It is amazing what good food can do to boost morale and what lousy food can do to deflate it.  I had bet that we would hear from our extremist friends sometime between 2:30 and 3:30 in the morning as that seemed to be the time they most frequently became active.  However, the hour came and went and all was quiet.  We had been placed on what is called posture 2 for the 24 hours surrounding the holiday so no one was allowed to be outside or in the gyms.  You could only go from the hospital to the dorm building without loitering anywhere.  At 6am we were preparing for the day shift crew to come in for the day’s cases when there was the loudest earth shaking boom I had ever heard.  I literally felt the ground beneath my feet tremble.  All of us hit the floor and remained there for a couple of minutes.  We then put on our individual body armor and prepared to receive any casualties.  I went to the trauma room and listened to the chatter over the radio.  The initial report was that the impact had occurred at the Russian Tower and that there were casualties.  We set up multiple beds knowing that in the area of the Russian Tower there was the largest gym on base and was a pretty populated area.  As the seconds ticked by there was no confirmation of actual casualties.  Eventually we did get two active duty soldiers who had been within 25 feet of the blast but had not received any physical injuries but were ‘shellshocked’ from the impact and resulting shock wave. 

                This was the closest rocket impact I had ever experienced.  I was curious to see what kind of damage it had caused.  One of the day shift guys said that he would check out the impact site when it had been cleared and report back to us.  Once we confirmed that there was no patients to be bought to the OR we were dismissed to go home and get some rest.  Surprisingly I slept like a baby and returned to work about 9 hours later.  Once I got back to the OR I was informed of how close the rocket came to causing some serious damage.  The story was accompanied by pictures taken with the teller’s phone.  Apparently the rocket had landed right in the middle of a sleeping tent that had recently been vacated.  It decimated the tent and sprayed shrapnel a considerable distance.  The T-walls behind the tent were peppered with pockmarks from the flying debris.  A television set that had been left behind exploded.  There was a huge crater at the point of impact on the concrete floor of the tent site and holes were torn threw sheet metal where the splintered concrete had passed through.  The destructive force of the bomb was evident despite the lack of any human injury.  It was a sobering site to see and one had to assume that divine intervention had spared lives in more than one way that New Year’s morning. 

                I told this story to my parents and asked my Mom if she thought that it would scare people too much if I posted the pictures that my friend took on my blog.  Knowing that my purpose in writing the blog is to let people see what things are really like here, she said that she would want to see them and thought that it would be a good idea.  So I am posting them there if you care to look.  I have heard that the fighting season ends when the snow flies but so far that has not been the case.  We were told that the Taliban leaders told their people not to go into Pakistan for the winter as is customary but to stay in Afghanistan.  I am inclined to believe those reports as I have not seen any drop in the number of wounded soldiers we are seeing.  Most of the wounded are Afghan National Army soldiers.  I have heard that our guys are no longer allowed to raid homes but the Afghan troops are now doing that and we are backing them up.  It doesn’t make it any easier to see a young Afghan whose legs have been blown off by an IED.  If anything it is almost worse.  I know that our soldiers get the best of care for the rest of their lives with the best prosthetics and physical therapy that exists.  These young men once they are stabilized are sent to the Afghan hospital in Kabul where if they don’t die of infection they are sent home without the ability to get around and likely without follow up.  I have seen a couple of these guys that were injured years ago who finally make it back into our system and for the most part they are the living dead.  They have horrible wound or bone infections.  They have opium addictions from self medicating their chronic pain.  It is very sad to see. 

                I look forward to the day when there will truly be peace on earth.  There are so few places left where you can experience true peace.  Cultivate those special places even if they are within your own heart.  Don’t allow the anger and fear in the world to infect your soul.  These times are what we make of them.  They can be as dark and haunting or as fulfilling and incredible as we allow them to be.  Prophecies of our day are being fulfilled all around us but we don’t have to let our affections and hearts grow cold with the rest of the world.  There is a source of eternal peace and light and joy that no power can overcome.  Grab hold of that peace and take it with you that you might spread its power where ever you may be.  Have a wonderful week.

Our first snow fall.  This is one of the workout tents outside of the hospital.

This is the same kind of tent that was blown up by the rocket mentioned in my email.

Playing Taboo on Christmas Eve with the anesthesia crew.

It was crowded but fun

It was pretty intense there for a while.

Bringing in the New Year

A bunch of party animals

This is us before we saw what disappointing food was awaiting us

Waiting around on New Year's Day after the attack

You can't get some people down

Stacy Carr and I ready for anything

This was the front door of the tent that got hit by the rocket

The blown up TV

The point of impact

The crater

Keep in mind that this is about six inches of concrete it had to go through

Shrapnel holes

T-walls