Potty Talk

Many people have written emails asking questions about every day life here in Bagram.  I am dedicating the majority of this weeks post to answering those questions.

Do you have community showers?

Luckily we do have private showers.  Each bathroom has four showers and there are two bathrooms on our floor.  So there are eight showers for roughly 140 men.   To conserve time and hot water there is a combat shower rule. The picture is worth a thousand words, mold and all.  The showers are alright but shower shoes are a must!  I am not sure that sitting on the wooden bench with your naked behind would be a good idea either.

Splinters are the least of your concerns if you sit on this bench.

Do you have normal bathrooms?

To borrow wording from our politicians, it depends on what you mean by normal.   Afghan toilets are a cross between the Asian hole in the ground you squat over and the regular American toilet.  They are about 14 inches off the ground so you end up in a modified upright birthing position.  There have been days after doing lower body workouts that I almost needed to call for backup to extricate myself from the throne.   They are very low and if you can’t complete your business in less than three minutes you can guarantee numb legs when you stand up. 

   One of the most offensive gestures in Afghanistan and in many places in this part of the world is to offer someone your left hand.  If young children show left hand dominance they are trained to use only their right hand. The left hand is considered the dirty hand.  Why you ask?  Well, it is used to clean one’s self after using the bathroom.  Why would anyone do that?  I asked myself this question when I first learned about this . . . . and then I tried Afghan toilet paper.  There are two types that I have encountered. The first is two-ply heavy duty 100% recycled tree bark that removes not only what ails you but several layers of skin to boot.  If I ever get a cold and blow my nose repeatedly with this stuff I will come home with a nose like Michael Jackson.  The second type is of the crepe paper variety 5/8-ply that ends up creating more dreadlocks than doing any good, most of the time you end up using your hand after completing the first stroke anyway.  Given these two options it is no wonder the locals just cut out the middle man and use their hand.   It is a small wonder that they sell baby wipes at the base store and they can’t seem to keep them in stock. 

How low can you go?!

Don't let the English writing fool you this stuff is horrible!

What is the food like?

   You can imagine that cooking for 50,000 people would be challenging.  There is usually food anytime you want it and usually as much of it as you can eat that being said usually one plate is more than enough.  There are five different DFACs, which is military for dining facilities.  Some people swear that some are better than others but I have yet to notice a significant difference.  For breakfast you can get powdered eggs made any way you like as long as it is scrabbled.  You also can eat as many hard boiled eggs as you would like, just plan on 90% of the egg white coming off with the shell.  You can always get turkey sausage, bacon, and biscuits with deep fried hash browns and your choice of oatmeal or grits.  They do have soy milk which is what I normally go for because the ‘cow’s milk’ is that long shelf life milk. Woof!  They usually have a pretty good selection of breakfast cereal and fruit too.

   Lunch typically looks a lot like what you had for dinner the previous day with a poor disguise.  Typically it will be a beef or lamb dish, some variety of chicken, instant mashed potatoes, a veggie, and salad with your choice of light Ranch or French dressing. 

   Dinner is the most variable although it varies in predictable ways.  Some nights you can get lasagna or spaghetti with stale toasted hot dog buns with a sprinkling of garlic powder.  Every Friday is steak and shrimp night.  I am told it used to be steak and lobster night but with the budget cuts . . . you know.   Sunday night is usually French toast night with a mystery topping.  I have had strawberries foster and have heard of bananas foster.  You can usually count on some sort of pie and some pretty good ice cream for dessert.  Occasionally they will prepare an Afghan dish and those are typically my favorite.  All in all the food is very good albeit lacking in variety.    

You are required to wash your hands before every meal, not a bad idea.

Fresh fruits and veggies are always available, they aren't always ripe but they are available.

Buckets-o-chicken

Making the rounds. 

This was one of the Afghan dishes that was pretty tasty.  Most of you know I don't eat much meat so it has to be good for me to eat it.  This rice dish had lamb in it.

My soy milk, cabbage and leftover surprise. Our typical lunch fare.

This is actually what I had for dinner tonight.  It is Sunday so we had French Toast Bananas Foster style  plus rice and red beans, asparagus, and potatoes.  Nice medley of flavors.

  

What is your schedule like?

   We have been ordered by the wing general to work 84 hours a week.  This means that you work a twelve hour shift every day or you do a 24 hour shift once a week and get the following day off.  We do the latter.  Our shifts go from 6:30am-6:30pm.  There are two anesthesia providers that cover the night shift.  Four of us are on during the day.  Usually there are between 0-6 scheduled cases each day divided between our three rooms.  You also have the potential to get trauma patients at any time.  Patients that are too complex for the smaller surrounding hospitals also come to us.  I would say that about 80% of our patients are local nationals.  We spend a lot of time during the day sitting in our small office watching TV, reading, listening to music or watching movies.  If nothing is going on we are allowed to leave the hospital for short intervals and run get a haircut or pick up something from the base store.  When our shift is over we can go work out or go to exercise classes.  If you are feeling particularly daring they have salsa dance classes, country western classes, ping pong or chess tournaments.  There are several movie theaters on base where you can watch pretty new movies.  I typically go to bed at about 9:30 so I can be up at 4:45.

This is the anesthesia office.  We had an early morning mortar attack and we all had to report in and wait for the all clear.

There is a set of bunk beds in our office for the night shift.

This is our med room in the office.

A game of Risk during some down time.  This is the hall in front of the ORs.

This is the Afghan Baazar.  It is a lousy picture. There are booths of crafts and local wares.

Walking around the hospital I discovered where they keep the search and rescue vehicles.  Certainly no messing around in this puppy.

There is a gazebo on the hospital roof where you can see the surrounding base and the mountains.  The mountain in the right side of the picture is 20,000 ft high.  

Closer shot of the mountains.

Air Rescue helicopters next door.

The flight line.

They have these huge trucks that come and pump out the septic tanks and then they burn the waste.  Pretty smelly any time you walk past them.

    

What is the church like?

   I am a member of the Kabul Afghanistan Military District.  I attend the Bagram Afghanistan Branch.  There is a chapel on base where we have our meetings.  There are two different times for sacrament meeting to accommodate all schedules, a 10am and 8pm meeting.  There is a branch president that is an American civilian contractor and both of his counselors are active duty military members.  I typically attend the 8pm meeting and there are between 25-30 regulars.  I am told there is at least double that during the morning meeting.  There are members from all over.  We have a sacrament meeting with one speaker and then have a Sunday school lesson.  On Monday’s there is a FHE group that meets.  There is a very special feeling in the meetings I have attended.  It is cool and amazing to think that the church has branches in the Middle East.  There are lots of opportunities to serve and get involved.  I am speaking on the life of Christ the week of Christmas.  I am looking forward to talking about the life of the Savior while I am living as close as I am likely to be to where He actually was born, lived and walked. 

    This experience is difficult but it is an incredible opportunity for personal growth on many levels.  I can feel myself being stretched and pulled as I grow.  I want to end with a quote my mom sent me this week. It is from Brigham Young,  he said that “the Prophet (Joseph Smith) progressed toward perfection more in thirty-eight years because of the severe tribulation through which he successfully passed than he would have been able to do in a thousand years without it."  Difficult times are a gift to us from God, they help us to progress and grow in ways that we could not otherwise.  I am grateful for this refiner’s fire.  Have a great week. Love you all. Hug a Veteran for me!

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.