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

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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.