Another Week

As another week closes and another begins I once again find myself typing another email.  When I first sit down I typically think that nothing noteworthy happened during the week but after thinking about it a while I remember little stories or insights I had that helped my perspective. 

This past week I talked to several family members at home that asked me how I feel about our being here in Afghanistan and if I thought that we were doing any good.  I have been asked that a lot.  It is a difficult question without a straight-forward answer.  My personal opinion is that yes, we are doing good here.  I believe that fundamentally our goal as the United States of America is to improve the lives of those we help.  Throughout history, with the possible exceptions of the Revolutionary War and our response to the bombing of Pearl Harbor, we have fought for the freedom of others. Despite incomprehensible costs measured in dollars and lives we have entered the fray to stop tyranny, slavery, genocide, and oppression of all kinds.  Many will say that the US only sticks its nose in other countries’ business if we stand to benefit from the outcome but while to a small degree this may be true for the most part we fight for the defenseless and come to the aid of those who are unable to help themselves.  Particularly for those of us with boots on the ground there is no other motivation than to offer up all that we have and are capable of giving.

I believe that many of the people here want the freedoms that they hear about but could not imagine how democracy would work in a land so steeped in tradition.  We have put a lot of effort into training the Afghan National Army and police forces but have seen that when left to themselves these forces abuses their power and become something like a mafia, supporting those who pad their pockets, walking through markets taking what they want and threatening or in some cases shooting those that oppose them.  I don’t know what the right answers are.  I have seen individual lives changed dramatically for the better through our presence here but when it comes to effecting lasting change in this country I am not sure that is a prize we can win.  There are many reasons why I say that.  The lack of education and natural resources make it incredibly difficult to set up any kind of stable infrastructure.  There isn’t any oil. The land is arid and mountainous.  For hundreds of years the only cash crop they have had success with is the opium poppy which is purchased primarily by those that support the terrorist cause with the money they make. 

The people generally are good-hearted and kind.  They are satisfied with so little of what the world offers.  Their existence is about daily survival.  Death is something with which each person is intimately acquainted.   Their lives are so tenuous and fragile that they have no extra energy to pursue democracy.  Many of the local village leaders have reported how much better their lives have been since we arrived but they have also said, “But you will leave us and then it will go back to the way it was before.”  Afghanistan has a long history if occupation and abandonment, its people have little confidence in the world’s concern for them.    So while I think we are going good, we are making things better and safer, we will eventually leave and when we do the rats come out of their hidey-holes and the infestation begins again.  A few armed men can easily take over a village of hundreds of unarmed simple farmers.  Many will be slaughtered for accepting help from or supporting the United States.  It is the way things work around here and the way it has been for thousands of years, I don’t think our 14 or 15 years in the area is going to fix that. 

That being said let me move on to some of the events of the week.  With all of the flooding recently the septic tanks in the dorms backed up flooding the ground floor with raw smelly sewage.  When the dorms were designed the male dorms in an act of chivalry were placed on the second floor so they would take the worst of a rocket blast were it to take a direct hit.  However, being on the second floor has had its advantages this week!  On Tuesday we had a couple of traumas come in.  The guys looked pretty good externally, some minor cuts and bruises.  Their MRAP had been blasted by a roadside bomb.  The vehicle took most of the damage but the blast wave obliterated the jaw of one of the soldiers who must have clenched his teeth as the bomb went off.  The other soldier had a burst fracture in his low thoracic spine from the incredible upward force of the blast.  He is paralyzed from the waist down.  The next day we got two more trauma patients that were attached with a vehicle born IED.  They were both in the local police station when they saw a vehicle coming straight for them.  One guy was at the window when it exploded and got a face full of glass which penetrated both of his eyes, blinding him.  Another man was on the second floor and when he saw the vehicle he jumped out of a second story window landing on his left leg.  He also broke his back and is paralyzed. 

Aside from the trauma we have seen, I had an active duty kid come in with half a chicken breast stuck in his esophagus.  He said he could feel it there but it just wouldn’t go down.  One of the GI docs took a scope and ran it down there to take a look.  Sure enough there was a half chewed chicken breast just sitting there.  He had to pull it out a tiny piece at a time.  It was pretty disgusting.  The moral of that story is to chew your food. 

Today at church we were talking about Noah and living in the world without being of the world.  I was reminded of an analogy that a former stake president had made using the instructions the Lord gave Noah on how to prepare the ark. After the ark was built the Lord commanded Noah to cover the outside and inside with pitch (tar).  This would seal the wood ensuring that the water would not be in direct contact with the wood.   Wood, no matter how strong, when soaked in water becomes soft and easily warped.  The ark had to be able to be surrounded by water and to be able to withstand the effects of the water on the wood.  The pitch served as a protective barrier sealing all of the cracks so that the boat could survive unharmed in the watery environment.  We, like the ark, have to live in the world floating amid the filth, vulgarity, immorality, evil and hate that it generates.  If we are sealed up we can navigate the waters of life unchanged by the buffeting waves of worldly water.  However, if we allow the cracks to let the water in, our strength begins to fail and little by little we become warped by the influences of our surroundings.  This process can be almost imperceptibly slow. Like the Trojan Horse that finds its way inside the heart of the city, the influences of the world that make their way through the unsealed cracks can have catastrophic effects upon our eternal progress.  To seal ourselves His we must do those small and simple things that day to day seem so insignificant but when accumulated over a lifetime form a thick protective coating from the influences of the adversary.  Temple attendance, Sabbath observance, Family Home Evening, Home and Visiting Teaching, meaningful personal and family prayer, personal scripture study, and service are the things that together keep us on the straight and narrow path and pressing forward toward Christ.  It isn’t rocket science, as Alma said,

O my son, do not let us be slothful because of the easiness of the way; for so was it with our fathers; for so was it prepared for them, that if they would look they might live; even so it is with us. The way is prepared, and if we will look we may live forever. Alma 37:46

I hope that your week ahead is full of light and that you enjoy your life and view each day as a precious gift from God.  I love you!

March Madness

This is the photo of our group which is all the people who work at Craig Joint Theater Hospital.  

This is a picture of all of the OR crew.

The night shift crew.

Me and Stacy, both CRNAs at SAMMC.

Moving a Blackhawk with a John Deere

This is the muddy path to the North DFAC where we eat breakfast in the mornings.  This shows how the dust turns to mud when it is wet.

Singing in the rain.

The horrible ice bath.

This is my brave face that I wear while soaking my foot.

The elevation of the RICE formula.

Back to the workroom.  Foot healed I ran 14 miles on that treadmill.

Afghans don't make kidney stones they make kidney boulders.  This is an example.  The kidney has to be cut open to get them out.

One night the OR nurses swapped roles with the techs.  This is Freisen driving the laproscope.

Capt Gabucan scrubbing in.

Landreth turning over one of the ORs.  Such a dedicated dude!

We play a lot of cards at night.  I have learned to play Nerts and Rummy.

Sometime playing cards with a bunch of people on high protein diets has smelly side effects.

Some of the crew playing Texas Hold 'em or whatever that is called.

I can't really believe that it is already time to write another email.  Time is plugging right along.  Today (17th in Afghanistan) marks 5 months in country.  I have started to receive information on my redeployment which to the normal person sounds like getting deployed again, re-deployment, but in the military that it is what they call going home.  We have checklists for everything.  When I got here I was handed a checklist and told that I would be strung up by my big toes if I didn't complete it in a timely manner.  Once the threats were over I talked to others that had been here longer and they ALL said "Ahh, I still have mine, they won't ever ask you for it. What are they going to do, send you home?"  However everyone completes the re-deployment checklist because they have no qualms about keeping you here another two weeks to let you think about what you should have done.  I won't get my checklist for another four weeks but I have been getting emails about it so I am moving in the right direction.  There are all kinds of meetings and briefings we have to go through with Combat Stress and the Chaplain's Office to make sure that we are mentally OK to go home.  We have to stop in Germany for a three day decompression group therapy session before they put us on a plane to fly home.  As of now, and this is all subject to change with or without informing me, my replacement gets here on April 28th.  We are required to have 4 days together for training purposes.  At that point we are placed on a list to get shipped out of the AOR (Area of Responsibility) out of harms way to Al Udeid Air Base in Qatar.  You can sit in Qatar for up to a week and from there you fly to Germany where you are trained how to be normal again and then you take a commercial flight home.  If all goes according to the current plan I should be home around May 12th.  Once you get back to your home base you are required to check-in and accomplish another checklist before you are released for 2 weeks of R&R.  So once I get back I will have two weeks of R&R and then we will leave for Europe on the 29th of May and will be gone until June 25th.  Not too shabby!

    Cami has given me the go-ahead to plan the majority of our European Adventure and it has been pretty fun.  I have talked to Cami and the kids about the things they want to do and I have researched the best, cheapest, safest, way to make it happen.  For those interested I will list out our itinerary, for those that are not interested, sorry, I really don't have too much else to write about this week.

May 29th Fly from San Antonio to London

May 30th arrive in London at 9:40am spend the day recovering from the flight and seeing whatever we feel like seeing on our own.

May 31st--Guided tour of London on a Double Decker red tour bus stopping at Buckingham Palace, Parliament/Big Ben, ride the London Eye, take a cruise down the Thames, London Bridge, and Westminster Abby. It is a thirteen hour day but the kids requested a ride on a Double Decker bus.

June 1st--Sunday activities, attending the ward in Hyde Park where many prophet's taught the restored gospel, and take it easy enjoying a calm day.

June 2nd--Another guided tour of Stonehenge/Windsor Castle and the town of Bath where some of my ancestors are from

June 3rd--Tour of Warner Bros studio where Harry Potter was filmed, then train to Paris.

June4th-11th--Meet up with the Texas Children's Choir group and participate in tour activities in Normandy, Notre Dame, and the Louvre

June 12th--Train to Marseilles, day in Marseilles

June 13th--Board our cruise ship and get ready to go

June 14th--Genoa, Italy where we will take a tour of Portofino and Genoa

June 15th--Rome, Italy, guided tour of the sites and possible visit to the square where the Pope will deliver his weekly message, assuming he is in town.

June 16th--Palermo, Sicily where I plan on eating pizza all day

June 17th--Tunis, Tunisia--Tour of Carthage and Medina

June 18th--Palma de Mallorca, Spain, Catamaran tour of the coast

June 19th-- Valencia, Spain hang out on the beach unless of course it is not a family friendly thing to do and then we will figure something else out. 

June 20th--Back to Marseilles, train to Geneva, Switzerland where we will stay the night

June 21st-  Train to Gimmelwald, a tiny town in the Swiss Alps

June 22nd--Gimmelwald

June 23rd--Head back to London

June 24th--Fly home

June 25th--8:13pm get home

Well that is the plan.  We are super excited.  My kids have been working very hard for nearly a year to cover their own way and I am very proud of their efforts.  I know that many of you have purchased candy bars or cards and made generous donations for which we are exceedingly grateful. 

It has been raining continuously for the last four days and I am reminded of the days of Noah.  The parking lot I normally cross to get to church was impassible being under a few feet of water.  The rain seems to have slowed the attacks so some good is coming from all the mud.  That is pretty much all I've got for the week. 

Marathons and Attitudes

Well I am finally writing another email.  My apologies for the long silence but in many ways it was unavoidable.  It seems like most of the action around here happens on the weekends and we have been extraordinarily busy for the winter season.  The extremist groups have been extremely busy in their efforts to manifest their power prior to the Afghan election in April.  They have been targeting officials high up in the Afghanistan National Army and unfortunately they have had some success.  We have an ICU full of leaders of all sorts that they have injured.  It is difficult to know how to feel emotionally when you see these things continuing to happen despite our efforts to suppress the violence.  I think that the main problem lies in the fact that the ‘bad guy’ is an ideal not an individual so your friend today can become your enemy tomorrow.  People who have access to our plans and facilities can feed that information to our enemies undetected until it is too late.  There have been multiple incidents here on base of people that have been infiltrated by these extremist ideals and have been caught poisoning our food or trying to plant bombs on base.  The hand of the Lord has been clearly evident in sparing life and is a testimony to me that God is aware of us always.  There is a lot of ‘tall-tale’ exaggeration going on about the specifics of these occurrences and so I will not join the speculation as I do not know the actual facts and leave it with what I have already said on the matter.

                This April 18^th will be the first Boston Marathon since the bombing last year.  The Boston Athletic Association that puts on the race each year is putting on a Boston Marathon Bagram version for us.  We found out about it with just over 7 weeks to prepare but who would pass up an opportunity like that?  I have been training putting in about 35 miles a week.  I injured my foot attempting to change my running style to a mid-foot strike which was extremely dumb on my part considering the short training time I have.  Someone told me that the mid-foot strike helps with knee pain which I suffer from so on a ten mile slow pace run I tried it and my knees didn’t hurt or at least I couldn’t feel my knees hurting because my calves were on fire for the last 4 miles.  The next morning I could hardly walk from the soreness in my calves but I also noticed the tendons on the top of my right foot were really hurting too.  As I stretched and moved around the calf soreness abated but the pain in my foot got worse.  I decided I had to stop running until it was completely better.  I started soaking my foot in a tub of ice water for ten minutes at a time which is a thrill in and of itself.  I highly recommend trying it if you have not had the pleasure.  After three days of staying off it and soaking it regularly it was on the mend.  I did my first easy three miles on it yesterday and it felt good.  I am going to continue to soak it after each run but I think I am back in the saddle.  I have a fourteen mile run next Saturday so hopefully I am all better or I will surely find out about it.  The race on the 18^th starts at 3 am and they give us six hours to finish so even if I have to crawl for part of it I should finish.  This will be marathon number three for me. I swore them off after the first one but somehow I just keep going back.  As I understand it we will receive the same T-shirts and medals as the people running the actual Boston Marathon and since I am nowhere near fast enough to qualify for Boston this is the only chance I will ever have to run in it even if it is 9000 miles from Boston.

                The last thing I wanted to write about this week is a lesson that I learned on attitude and duty.  Most of you know that on March 13^th it will be five months since I left home.  I feel like I have had a pretty good attitude about this deployment up until about 10 days ago.  It seemed as though a black cloud settled over our entire department.  There was a lot of complaining and whining and I was right in the middle of it.  I was doing my best to make Laman and Lemuel sound like Pollyanna and was succeeding.  I was confronted by the chief of my department about doing a task that I thought was unfair but gave a sort of noncommittal shrug to.  I did a mediocre job at the task and for about 4 days each time I came in there was a note of the board about some part of that task that was left undone.  On that fourth day I sort of lost it and went off on how I thought that it was unfair that I was assigned this task when it was really everyone’s responsibility.  I gave my tantrum of a speech and felt the righteous indignation of my cause burn in my heart and my coworkers balked a bit but finally agreed that I had a point.  As that night wore on I ‘came to myself’, playing through what I must have looked and sounded like in my mind.  I was horrified.  I was embarrassed and ashamed.  The attitude and tantrums had brought me nothing but misery.  Winning the argument had not solved anything or changed my situation or even made me feel better.  That night I decided to accept whole-heartedly the assignment I had been given and to do it to the best of my ability.  I sat down and wrote out the basic details of what I had been asked to do and then expanded upon them adding extra things in that I knew would make things better for my co-workers and for future deployers.  I went to work creating a system to make doing a great job easier and organized thing into a logical sequence.  By the end of the night I had a system in place and reported off what I had done to my department head.  She was clearly shocked at the complete reversal of my attitude from the day before.  That night when I came back into work there was no message on the board about things left undone.  I was filled with a tremendous sense of satisfaction at a job well done.  I continue to feel that satisfaction each day as I check off the tasks I have given myself.  Not that it really matters but since I have started to do my part others have stepped up and have found ways to lighten the burdens of others as well.  I still marvel at the difference in the way that I feel now and the way that I felt when I had the attitude of being picked on and unfairly yoked.  I think that this lesson is so applicable to our lives.  Relationships, callings, parenting, working, playing can become so much better as we accept full responsibility for their outcome.  We have way more control over situations that we like to realize.  Avoid the temptation to murmur to look at what you have compared to what someone else has, that comparison never yields anything but discontent.  Incredible growth and satisfaction comes to those who do their duty to the best of their ability and it is entirely independent of what anyone else is doing or not doing. 

                I hope this coming week holds great things for each of you.  Whatever is worthy of your time is worthy of your best effort.  Thank you all for your love and support during this amazing but difficult opportunity.  I wish you all the best.  

Washington Post Article

I know that I have not written an email this week.  Things have been busy but I wanted to post a link to a Washington Post article that was written recently.  I spoke with the reporters while they were here and I think that it fairly represents what is going on over here and highlights a couple of stories of young men I have cared for.  I hope all is going well for you.  Take care.

Washington Post Article

http://www.washingtonpost.com/world/national-security/the-last-casualties-as-a-long-war-ends-risks-still-prove-real/2014/03/04/55905998-8a90-11e3-a5bd-844629433ba3_story.html

At Long Last

A couple of emails ago I mentioned someone with henna dyed feet.  This is as close of a picture as I could find to what they looked like.

This picture was taken on the day I was told I had influenza.  This is a box that one of my classmates from CRNA school sent to me.  It was incredibly thoughtful of him to do something like that and it cheered me up greatly.

As you will recall from previous emails I was coerced into keeping my mustache for over a week after I could have shaved it so we could take a department picture in which everyone had a mustache.  This is the day that I finally got to shave it off.  I thought the biohazard sign was appropriate because when I would wake up in the morning or blow my nose my 'stache would be filled with all kinds of creepy stalactites.  Gross!

Kind of a bad picture but this is me having fun with the remains of my mustache.

  

This is the picture that I had to keep my mustache for.  I guess it was worth it.

We were suppose to take a hospital wide photo on the helicopter pad but at the last minute they cancelled it so Ally and I walked around taking pictures until the haircut place opened.  This is one of the rare totally clear days in Bagram.

Me and one of the heavily armored assault vehicles with a 50 caliber machine gun on the roof

Another of the giant armored vehicles that do patrols around base

An armored ambulance

Me and my mismatched name tapes

This is the group of OR staff that ran the Valentine's Day 5 or 10K.  We are only smiling because this was before we realized we didn't get T-shirts.  There was a live band you can see in the background.

A fuzzy picture of the runners during the race.

                                               This is Dr Bode who was voted to be cupid on Valentine's Day.  He is humongous.

Just hanging out with my bottled water.

This is high security tape sure to keep out anyone trying to get through this fence.

We saw this sign and found its location pretty funny.  I am not sure who put it there but I am pretty sure they were not in the Army.

I took this picture about an hour ago.  This is the flag I am taking home and using at my house.  I am planning on taking it to Normandy when we go this summer.  It is good to remember all of the places and countries over which our flag has flown and upon whose soil our men and women's blood has been spilled to defend what this flag represents.  I feel honored to be here making my own small sacrifice in a cause my nation has engaged in.  It gives me perspective and appreciation for what I have and so often take for granted.

Ground Hog Day

It is very appropriate that I am writing today’s message on Ground Hog’s Day.  If you have never seen the Bill Murray movie by that same name you really don’t need to because it is about a meteorologist newscaster guy (Bill Murray) covering the coming up of Punxsutawney Phil, the famous ground hog who looks for his shadow.  He wakes up every morning and repeats the previous day over and over and over.  Nothing he does changes the fact that he continually wakes up doomed to repeat Ground Hog’s Day.  I am feeling a lot like Bill Murray’s character.  So show you what I mean I will walk you through my schedule for the past week.

Monday

Wake up: 6pm

Us e the bathroom in the last cubical, shave, shower in the first shower cubical on the left, get dressed and head to work

6:30 pm: Arrive at work, change into scrubs,  get report from the day crew, check the ORs, stock supplies, inventory the narcotics, preop the patients for the next day’s cases, all that takes until maybe 7:30.

7:30 pm: Check personal, Air Force, Army and Bagram email accounts and answer any necessary   emails. 

8pm:  Call home and chat with Cami and the kids

8:30pm:  Start my personal study of the scriptures or conference talks. 

9:30pm:  Get dressed in my PT uniform to go workout.  Monday is upper body workout.

10:45pm:  Shower and change back into scrubs.

11:00pm: Watch some rerun of a basketball game on AFN (Armed Forces Network) the military version of cable TV.

11:50pm Change back into my regular uniform called OCPs to go to midnight chow.  Walk to the DFAC (dining facility), scan your ID card get no more than two Styrofoam take-out boxes.  Fill one with lettuce and kidney beans maybe some shredded carrots and bell peppers.  Go to the sandwich  line and get a turkey wrap with four pieces of turkey and one piece of swiss cheese with lettuce and cucumbers.  Get a cup of tortilla soup, walk back to the hospital and have dinner/movie, Monday we chose Crouching Tiger Hidden Plot or something like that.

2am:  Play cards with the OR crew until I get tired of loosing

3am:  Check email and Facebook to see what real people are doing

4am:  Check prices for European travel to get ready for our trip to France in June.

5am:  Eat one of the dinners I didn’t eat during the movie.  Watch AFN some more.

6am:  Call and talk to Cami again

6:30am:  Day shift arrives, report off.  Sit around and wait for breakfast to start at 7:30. 

7:30am:  Eat three boiled egg whites and oatmeal.

8am:  Head back to my dorm room and change into my jammies, brush my teeth and write in my journal.

8:30am: Try to go to sleep

Tuesday, Wednesday, Thursday, Friday, Saturday and Sunday were all exactly the same with the following exceptions

Tuesday: 

9:30:  Workout is Interval running and ABS

11pm:  Laundry Day, throw a load of laundry in but make sure it is done by midnight or it is thrown in a sack and put in the First Sergeant’s (aka the Shirt) office and you have to recite the Airman’s Creed to get it back because from midnight to 2am every day the laundry room is cleaned.  It usually only takes them about ten minutes to clean it but you can’t use it anyway.

1:30am:  Brought a US soldier to the OR with bilateral lower extremity amputations from an IED blast to the OR for 4 hours.

Also no cup of soup at midnight chow because it is usually Beef Noodle.  Movie was Fantastic Mr. Fox

Wednesday:

9:30:  Workout is Lower Body

Soup is Chicken Noodle.  Movie was Willow.

No oatmeal for breakfast.

Thursday:

Same workout as on Tuesday

Soup is Minestrone and movie was Johnny Lingo.

Friday:

Same workout as Monday

Soup is Vegetable, movie was The Help

Saturday:

At change of shift we usually will have an anesthesia staff movie night.  Day shift will get the stuff for build your own pizza or burritos or cheese dip and we will watch a movie together, this week it was Bourne Legacy. 

Workout is the same as Tuesday and Thursday

I don’t go to bed at 8:30 because church starts at 10am so I study some more.

10-11:30 Church

11:30am: Go to bed

I don’t work out on Sundays and I usually have French Toast for dinner or maybe a three-egg scramble with veggies but since I haven’t gone yet I can’t say what the day will bring.

They do try to break up the monotony with random things throughout the week.  Today in the hall there was a “Fashion Show” where people had to make their own costumes.  I will include those pictures on the blog.  That pretty much sums up the week, month, quarter . . . like Forest Gump says,” life is like a box of chocolates, you never know what you’re going to get.”  Hope your week goes well.  Be safe.

www.thebookofbrett.blogspot.com

Low clearance.  Writing in my journal before bed.

I had to include these two pictures to squelch all the nasty rumors going around that Dr Landreth never does anything.

A picture is worth a thousand words

A mustache update.  I know it doesn't look any different.  I was suppose to be able to shave it off on Feb 1 but one of the docs asked me to wait until his wife sent the 'mustache on a stick' things for a group picture.  I reluctantly consented because she sent it priority.  So another two weeks.

None of the advice I have followed has made any difference.

This is our OR locker room.  My locker is on the top with the blue towel.  The guy with the bottom locker that is open hangs his shorts on the outside of his locker door.  That isn't a big deal until he hangs his shorts up after he has been wearing them to run.  When he hangs them up they are completely soaked with sweat.  They drip dry creating a huge puddle on the floor that I have had the misfortune of stepping in and soaking my socks.  Gross!

The Ground Hog Day meal, soup is Corn Chowder.

The 'catwalk' for the fashion show.  I was coerced into coming to watch.

This is our leadership in the hospital and the honorable judges.

Everyone had to make their own costumes. Some were serious most were funny.

These guys had the most elaborate costumes made out of biohazard bags and drapes. 

This guy won for this move right here.