Home now....

Wow! I can't believe how fast time has flow by since I returned from Afghanistan. Coming home was a blast and it presented me with another, unique set of challenges.

One of the greatest adventures in life is trying to find a sense of belonging and purpose. I think that this is desire is intrinsic to each of us and endowed in us by our creator. It is cross cultural and plays a significant role in our lives.

When I came home, I found myself frequently checking the news, watching videos of things going on in Afghanistan. Up until the final day prior to leaving there was still question whether or not my team of physicians was going to get "extended" and sent down to Marjah to support that offensive. There is a part of me that even today wants to be back there and feel the rush of adrenaline as a trauma roles through the door. You feel like you belong, you are part of a huge family and you have a purpose. Having been immersed in that for months, and then being taken out of it leaves a sense of loss and a void. It is weird to read about places over there an know what it looks like, how it feels and smells. From what I have read, things have not slowed down one bit around FOB Shank.

I have been able to keep up with some of the guys from the serviceman's group. SSGT Chiu, Hancock, and SPC Bennett will be coming home soon and Lt. Stockhoff should be about home already.

Fortunately, that void can be filled with the great things in life: family, friends and faith. I have to stop watching the news and limited checking foxnews to only once a day. I enjoyed getting back to work. I have been pretty busy at Womack. In the past couple of months, I have completed by board certification in General Surgery. We are currently getting ready to make another move to Boston where I will be doing some specialty training in plastics and reconstructive surgery at Harvard. This is yet another chapter in our lives!

Where to begin...

This post is to just catch up. Since my last post on the 22nd of January I have been very, very busy. The last few days at Shank were a far cry from the dull days and shear boredom prophesied by those "in the know". This turned out to be a mixed bag of blessings.

The week where our replacements were supposed to arrive was heralded by the first snow in about 2 months. Between Shank and Bagram is a series of mountain ranges that have to be crossed by helicopters that due to not being pressurized try to stay below 10K feet. Already being up at 7K doesn't leave much room for just going over the top. There are some tight passes and I don't blamed them for not wanting to navigate these with zero visibility. With hard movement dates the next week, getting our replacements to Shank from Bagram was starting to get just a little scary.

Fortunately for us and unfortunately for the Afghani policman who was hit by a car we were able to get our replacements down on a MEDEVAC helicopter and start our transition. This transition was assisted with several casualties over the next few days. It was an interesting transition, to say the least. We didn't spend much time telling them how to take care of patients. The team replacing us has plenty of experience from the civilian world and they will be just fine. I won't say much about the patients because they were either Americans or related to a very touchy subject and situation. Let's just say, if you are an Afghani Army unit and you get into a firefight with a US Ranger platoon, as soon as you realize this, break contact. It is all fun and games until the Spectre gunship arrives on station.

It was very surreal to be leaving Shank. The tents and dust had really come to feel like home to me and it was actually uncomfortable leaving that all behind. My small, cramped room, shared with two other guys, lit by over a thousand Christmas lights (we liked the light better than the fluorescent ones issued by uncle sam), had become my refuge in the madness around us. We pretty much left everything that we had accumulated over the past six months: 32" TV, microwave, coffeemaker (hot water for hot chocolate), movies, books, electric blanket, all kinds of stuff. We just wanted to get home. Loading the helicopter and watching Shank fade into the background of the Hindu Kush was like breaking up with a girlfriend. It was just time to get on with bigger and much better things.

Once in Bagram we went through a bit of out processing, very painless. We were given our tour awards and made our escape out of Bagram to Kuwait as fast as possible. The key movement was getting to Bagram and from Bagram to Kuwait. Once in Kuwait, the rest is just a matter of waiting. Did I say "waiting"? It was pretty weird to be in Kuwait when it wasn't blistering hot. On the way to Afghanistan through Kuwait, we arrived at 0200 and it was 100 degrees and 100% humidity. It was suffocating and miserable. During the day, a south wind would pick up and with the 130 degree temperature it felt like a convection oven. On the way home, every time I stepped outside of the tent or building I braced myself for the onslaught of heat and each time I was surprised to feel the cool air. We waiting around in Kuwait for 4 days. Lots of waiting, and waiting. Did I say "waiting"? The real waiting began Saturday morning, so close to going home you could taste it, but then the waiting. We were up at 0200 in the morning and had to have all of our stuff out in front of our tent by 0300 to get it transported to the meeting area. Then a quick breakfast and formation at 0500. Waiting for customs... I don't think I have ever seen people have all of their belongings dumped out and rummaged through by customs officials on civilian flights. This task was accomplished by 1100, and we were sequestered in a compound to nap and watch TV until 1600. Another formation, and onto the buses to the airport. You could feel and anticipation of boarding the plane. On the way to the airport we pulled off to another muster area. Were we proceeded to wait for another seven, yes seven hours, only to be informed that the flight was delayed due to weather in Ireland. We were bused to a hanger and fed the airplane food that we were to have on the plane and waited some more. So now 0300 Sunday morning, we board the plane and after an ambien and benedryl we arrived in Ireland were I had a wonderful hamburger! A relatively quick two hour wait and back on the way to Atlanta. This leg was made to disappear by another chemical induced coma and I was back on American soil. From Atlanta and the obligatory 2 hour wait for the buses, we made the 2 hour bus ride to Fort Benning GA. I became reacquainted with my iphone and I absolutely loved getting plugged back in. I called home, checked email and made a hotel reservation for that night all in 15 minutes! After turning in my equipment, I caught a ride to the hotel and I just couldn't believe the comfort, the pillow, the bed, the shower, the toilet and high speed internet. I didn't know what to do, so I slept!

The next day seemed a blur to me. In true Army fashion, I boarded the bus to Atlanta at 1100 for my 1800 flight to Fayetteville. Once again, the iphone came through and I discovered a earlier flight. Immediately, upon arrival I went to the Delta counter and was changed to the 1455 flight, only 2 hours away from home now. Walking through the Atlanta airport was awkward and nearly overwhelming. All of the people, the noise, everyone living their own lives. No look of fear, no look of one struggling for their mere existence against waring governments and ideologies. No one expecting the blast of an IED or report of sniper fire. Everyone looking so clean smelling, beautiful and hopeful. I just hid in a corner and thought of my own homecoming.

The flight to Fayettevile was quick and painless. I was afraid that moving the flight up, even with some advance notice had thrown Sarah a curveball. Did I say the theme of this whole ordeal was waiting? I had dreamed of coming off the plane to a waiting family, cheers and hugs. Nothing, no one. I walked down to the baggage area, again, no one. So I proceeded to wait, yet again in front of the airport for another 1/2 hour for Sarah and the kids. It was frustrating, but this quickly evaporated when they pulled up. It was wonderful to hug my kids, kiss my wife and just feel their hugs and love.

The transition home has been interesting. All of this feels like it should be normal, but it just isn't normal yet. Shank is so far away from this place. It almost feels like it was a long dream. Like when you wake up from a deep sleep and intense dream and you can remember ever last detail of the dream. But you wonder if that place exists in some far off land. I read the news about the new offensive in the south, and there is this part of me that longs to be there and be part of something big. Many of my patients were in the news and it was funny to read what the press wrote about them and know what actually happened. It has been a long journey to Shank and back with a quick detour down in Delaram.

Some how I think that some bit of Shank will always be with me now and a bit of me left behind. This is a part of life; where ever you go and with whom you ever interact you will always leave a bit of you behind. We learn from our surroundings, adapt and overcome the challenges and trials thrust upon us. We are resilient and as we surmount the obstacles that we face, we leave hope and inspiration in our wake.

Picture 1: The last sunset over Shank...

Picture 2: Shank, fading in the background looking out the back door of a Chinook helicopter.

Picture 3: 8th Forward Surgical Team, on the Dust Off HLZ.

Things that I enjoy...

I was very inspired by my wife's blog. (www.mcmullin411.blogspot.com) She is a very talented writer and does a good job of communicating what she is thinking. Reading her post about her "Favorite Things" made me remember a Thanksgiving holiday several years ago. Sarah and I were newlyweds and trying to find our way in this world. We were living in our first apartment, a small 2 bedroom deal. Our furniture was stuff we pulled out of someone's dumpster and Sarah was still learning how to cook. We were living month to month on student loans and our jobs. At the time it was not a whole lot of fun but in retrospect that was priceless. I am sure that many readers have been in similar circumstances. We decided to play the "Thankful Game" where we took turns naming all of the things that we were thankful for. It began as the usual things and gradually degenerated into silliness.

Being here in Afghanistan has made me reconsider the "Grateful Game" to an even greater degree. I have been in Bagram for the past week. During this time, I grew so tired of listening to the soldiers, and airmen (mostly the airmen) complaining about their hard lot in life. Having to be deployed to Bagram. Their complaints ranged from the food, the showers, the dormitories, the weather, the gyms, the crowding, the noise, having to work to long, you name it, they complained about it. It was in stark contrast to being down in Delaram with the Marines. Now you have to understand that there is nobody who embraces suffering and pain more so than the Marines. It is amazing how egocentric we become and see our own lives as such challenges that we forget about the challenges that others face on a daily basis, without the hope of some better future.

I am afraid that I will have little patience for people who complain about the unfairness of life in America. About how they are owed money, or a job, or health care or any other entitlement from the government. Just by virtue of being born in the United States of America they have more opportunity than 95% of the rest of the world. Even with social hardships, family challenges and poverty. There are few people who have the same level of poverty as a middle class afghani. How do we take for granted these opportunities? Or how do we as a people squander them?

I was intrigued by an article in the Boston Globe about surgeons from the great ivory towers of medicine that are going to Haiti to help with the medical efforts. They describe these high and mighty department chiefs and chairmen, working in a tent, having limited supplies and having to make life and death decisions. Operating with malfunctioning equipment and poor conditions, as if it is some grand sacrifice for them to not have a MRI or CT scanner. In my mind I can't help but think of the hundreds of surgeons who have been doing this for the past 9 years in remote areas of Iraq and Afghanistan.

So here goes with my list:

1) I have to say my family. You never know what you have until you loose it. Deployment has taught me that the most valuable things in my life are my wife and kids.

2) I love the way Sarah smiles at me. It is so full of love, passion and joy. Just to see her smile brings a sense of calm in me. Without words, it tells me that she loves me, supports me and will walk with me to the end of the world and beyond.

3) Sydney... My love affair with Syd started on the day she was born. When I held her I was taken and captured by her eyes and charm.

4) Ainsley... Ainsley is like looking into a mirror and seeing what I enjoy most about life. She has a future that has no ceiling, with her desire and passion.

5) Zachary, he is my little man. Parents life their lives through their children and yes I think I am just as guilty. He has such a kind and gentle heart.

6) Audrey, she is my little panda bear. Enough said.

7) I love to go duck hunting. I love sitting in a blind watching Jack (my dog) play in the water. I love the sound of wings, whooshing overhead and the adrenaline rush and anticipation. I love the cold mornings and sunrises, clouded by thousands of geese launching into the air creating a roar that can be heard for miles.

8) I love Texas A&M and Aggie football. It gives me something completely visceral to be passionate about. Where I can yell as loud as I want and no one cares. I also like kissing my date at the games, and the more kissing, the better the outcome of the game!

9) I love operating. There are few other relationships as sacred as the relationship between a patient and the surgeon. In my mind, the human body is the ultimate testament to the glory and craftsmanship of God. It makes me shrink in awe to be able to explore the body an learn it's inner workings.

10) I love St Arnold's Rootbeer. I have never drank an alcoholic beverage in my life. St Arnold's rootbeer is just wonderful and even better when the factor sends me 2 cases to share with my team. Right now I am looking at the bottle I saved to drink on my last night here at Shank.

11) I love my sister's music.

12) I love weight lifting. It makes me feel strong and powerful.

13) I love running, after I am done running. While I am running I hate it and want it to stop. But after I am done, I love the way I feel. It is this thought that pushes me through the hate.

14) I love watching little kids open Christmas presents. The anticipation fills the air with electricity and energy. It makes me feel young.

15) I love the feeling from lifting up in the air while in a helicopter. This first time I rode in a helicopter was coming from Bagram to Shank and it was amazing.

16) I love ice cream with big chunks of brownie, cookie, cake or anything else. This is my great, and tragic weakness.

17) I love attending my wife's sunday school classes. She puts so much effort and energy into teaching you can feel her love of the subject.

18) I have learned to love and appreciate: In door plumbing, hot showers, good food, food with taste, the touch of another human, beautiful desert sunsets, cold desert nights and the stars. I cannot express how much I love living in a planetarium. Here I can see the Milky Way Galaxy extend from one horizon to another with more stars than I ever could have imagined to exist.

Christmas... New Years.. and then some

10 January 2010

Christmas was a pretty uneventful day. It felt a lot like being on my mission where the holiday is what I make of it. I read the nativity in the Bible and Book of Mormon on Christmas eve, slept in Christmas morning (hopefully it will be the last time I get to do that for a long time.) It was hard to fight off the feeling that it was the same day as any other here in Afghanistan. I can it the “Monday Phenomenon”. That is where every day feels like Monday and each day is little more than an arbitrary title granted to a defined 24 hours of time.

I was able to talk with my family on the phone on their Christmas morning. My favorite 45 seconds of the year is that magical time when little kids come screaming down the stairs and see what Santa Claus has left for them. To see their eyes light up and have their faith once again confirmed that there is something greater out there that recognizes their sacrifices of bad behavior for a glimmer of hope of toys and joy. It was so fun to hear Audrey squeal with delight and Zachary proclaim the coolness of his toys. I think Sydney is getting to the age of reason and Ainsley is approaching that point as well. It was fun to hear each of them. It is almost a sacrifice to hear and experience this afar. Sometimes it is easier just to insulate yourself against the heartache of being so far away and bury your head in the “Monday Phenomenon”. On the other hand you can open up a bit and join in and experience what you can, for a price. The best part came the next evening when my kids and Sarah were in College Station with my parents and I was able to see them on the internet. I loved watching them open their presents.

This year, I bought Sydney a pair of diamond earrings. She has been too scared to get her ears pierced. Sydney is an absolutely amazing little girl. She has an inner (and outer) beauty and cannot be described. It brings tears to my eyes to consider the thought that she is more than half way done with me as her father. In the next decade she will leave home, possibly find another man to replace me and carry on with her life. I will never, ever in all eternity forget holding her for the first time when she was born. Her little eyes so wide open, and me falling so deeply in love with this little one. I promised her that I would never, ever leave her or hurt her. I can only feel just by virtue of our own existence, that she could only promise to one day leave me.

New Year’s Day was pretty busy around here in Delaram. When I had arrived here they had seen a total of about 70 trauma patients over the span of several months. Over New Years, we saw about 18 patients. This was a pretty significant surge for the team here.

One of the patients illustrates, in my opinion one of the reasons why we are here, and the difference between us and the Taliban. He was riding a motorcycle away from a spot where and IED had just gone off. He was then shot off of the motorcycle by one of our snipers. A great shot by all accounts. Upon arrival to us he was billed as an Enemy Prisoner of War. He was dying when he arrived. We quickly got him to the operating room where we explored his abdomen, stopped the bleeding and got him warmed and resuscitated. He was promptly evacuated out to a higher level of care. He was given a large amount of blood and products, enough that some questioned whether or not we should be expending such resources on an enemy. Our response was that we treat everyone the same, especially the prisoners.

Several days later, we come to find out that he was merely in the wrong place at the wrong time. He was actually the son of one of the local village elders, who was pretty upset at his son being shot by the American’s and being an accused Taliban. We smoothed things over and his family was brought to the FST where they were introduced to the team that saved their son’s life. They were profoundly grateful and the fact that we saved their son, made all the difference. This is why we do what we do.

Being a medical professional in a war zone is quite an amazing experience. I say medical professional because this experience is not unique to surgeons. We are only as good as the team around us. Medics (in the field and at our FST), CRNA’s, OR techs, and admin guys included. If one of these links is weak, the whole chain will fail, and people will die. I have told my guys many times, that they need to be proud of what they are doing. When they fill out their soldier evaluations, they can put “Today I saved someone’s life”, and when people look at that they will reply, “Oh good, they did their job.” People will not understand what they did here, only them. On a deeper level, we are the answers to the prayers of thousands of people. When mothers, fathers, sons and daughters go to bed at night and ask for God to protect their Daddy or Mommy and to bring their Daddy or Mommy home alive; God doesn’t send angels with wings and trumpets, he sends an 18 year old medic with a tourniquet and airway. He sends a surgeon with a #10 scalpel and silk ligature. He sends a CRNA with a rapid blood transfusion machine and a whole stack of blood. We function as the angels and the answers to their prayers. I take great pride in that.

The past couple of weeks in Delaram have been really good. I have learned to appreciate our team at Shank, and I have seen things that I wish we had at Shank. I am going to include some photos of Deleram. This first is the gym. Wow! The gym… What to say about the gym. It is so ghetto that you will be able to lift at least one more set, just because it is so ghetto. When it rains, it turns into a mudpit, when it isn’t raining it is dusty and hot. This FOB is tucked right next to a village, which is run by the Taliban. They really, really, don’t like us there. Surprisingly, they don’t get much indirect fire here. There is a pretty decent running track with some rocks and a couple nice hills. The track goes around the garbage burn pit. That makes for good pulmonary function. Don’t get me wrong, I still hate running.

Picture 1 is the gym. Enough said. No words needed.

Picture 2 is a nice picture drawn by an astute young artist named Victor. Let’s just say that Victor “gets it”. Funniest card I ever received. Notice the army guy with some huge gun. I laughed for about 10 minutes looking at this one.

Picture 3 is of one of many fly traps we put up all over the place in Delaram. Yes it is covered with flies and this is after about 3 days up.

pics for the last post

For some reason it didn't publish my pictures for the last post. Here they are! More to follow.

Delaram...

23 December 2009

Another leg of my journey here in Afghanistan has begun. I am finally here at FOB Delaram, which is actually a Marine base. I am far away from Shank on the other side of the country. This FOB is in the Farrah province right next to Helmand. This place is much smaller than Shank but is actually pretty comfortable. Apparently it wasn’t always this way. When the FST I am working with arrived here they had no showers, small mess hall, and port-a-potties. The topography is much different, there are some mountains around here, large on a Texas scale but diminutive compared to those out and around Shank. It is very flat and very much a desert here. The trip here wasn’t too bad, I was delayed coming out of a place called Bastion, which is a huge, sprawling military camp. I stayed in a huge circus tent that was packed to the rafters with soldiers. That was a pretty cold and miserable night, but nothing a couple of ambien couldn’t handle.

Here is the run down on the pictures posted:

The first one is looking out of the back of a Chinook helicopter on my way to Bagram from Shank. This was the first leg of my long trip to Delaram. The Chinook was actually a pretty good ride compared to the Marine CH-53. That helicopter leaked hydraulic fluid the entire flight. According to those who have ridden them before, that is a good sign and that it is when they are not leaking that you have to worry!

Second picture is me, Specialist Brandt Bennett and Staff Sergeant Samuel Chiu. We took this picture at the small weapons range on the day it snowed real hard. I impressed them by shooting their M4 carbine at 25 meters and putting a group of 3 shot all inside the spade on a ace of spades playing card. I felt pretty cool.

The third picture is of a sunset over the airfield at Bastion.

This time of year, Christmas, we get lots of letters from people back in the US. There was one letter that particularly struck me and I wanted to share it with you:

Dear Military Hero,

Thank you for protecting our country. Even though in times of distress came you still didn’t give up on our country. And thanks for not backing down on our country. And I hope you are ok. Anyways tomorrow is a new day and I hope when this war is over that America (US) has won the war and that whoever is reading this will be ok. So please don’t give up on us. Thank you.

Sincerely,
Makaih

I found this letter particularly touching and intriguing. First of all, typing doesn’t do justice to the backwards “y’s” and misspelled words. I honestly felt the gratitude of this child in the letter. It is nice to have someone back there in the US, asking me to not give up and to push on when it gets hard.

Christmas is also coming soon! This is my second Christmas in a row being away from home. Last Christmas I was on call at the hospital. Santa Claus came to the hospital and left Christmas presents for the kids in my office. That was very sweet of Santa to be so considerate of them and me! I wore a Santa Claus suit to round on my patients. It was actually a pretty fun day, though I was away from my family.

This year, it is even more bitter sweet. Not only am I away from my own family, but I am away from my unit, my military family. Every week we get a devotional email from the military district leaders up in Kabul. This week there was a special devotional from Elder Paul B. Pieper of the Seventy. This was a special message to all of the military servicemen in the Middle East.

He points out that we who are reading his message are far away from home and all of things that we associate with Christmas, family, shopping, trees, parties, choirs and being with loved ones. Instead we are in harms way, on lonesome mountainsides and desert valleys surrounded by those who wish us harm. We are living in tents and temporary housing. He draws the parallel to Christ when he was born:
- far from home (his father in Heaven’s home)
- born in a manger (temporary housing)
- hostile environment
- spending his time in a foreign land, far from home
Christ has experienced all suffering and pain, so that he can know how to help us. How many times had the Savior longed to return to His father, to His father’s presence? I can think of at least one, suffering in Gethsemane and on the cross when the Father withdrew his Spirit from him. How the Savior must have longed to have that with him again?

By this Christ knows how to help the sinner, fallen from the presence of the Father and from the Holy Ghost. He knows how I feel being away from my little ones and my wife. I know that I can rely upon him to buoy me up and strengthen me.

This Christmas will be one that I will remember for the rest of my life. I do not want to waste it, wallowing in my own self-pity, but using it as a chance to draw closer to my Savior and be a stronger servant for it.

This morning I watched “Joy to the World” and that put me in a good mood and correct mindset. I read the account of Samuel the Lamanite as he prophesied of the coming of Christ. I was struck by how it must have been to see the Savior of the universe and of all of God’s creations as a small little baby, just like Sydney, Ainsley, Zachary and Audrey, tiny, soft, defenseless, and pure.

There is no serviceman’s group here in Delaram. I don’t even know if there are other LDS servicemen here. I miss my guys back at Shank. I miss my family, especially this time of the year

Nothing like a little change...

It has been a few weeks since I have updated my blog, for that I apologize. Things have slowed down somewhat compared to this past summer, but we are still pretty busy. We were told just the other day that we are the single busiest FST in all of CENTCOM. That means we do more and see more patients than any other area, including Iraq.

As you can see by the pictures, things have changed around here. We woke up in the morning to find the whole valley covered in snow. This was fun and beautiful for about 2 hours, then it just started getting wet, cold and slushy. Many of you who live in areas that snow know about "slushy". Except this is slushy with mud underneath. We had a fun snowball fight and built a snowman. I then spent the rest of the day underneath an electric blanket watching movies. Not a bad "snow day".

There are other changes afoot here at Shank. This week I will be moving locations on a back-fill mission for about a month. I will be going way far down south with a FST that is supporting the Marines near Helmand Province. It is kind of a bummer to be leaving my "family" during the holidays, but it will be good to have a change over the next couple of months. By the time I get back I will be down to single digit weeks before my return to civilization. I am going to fill in for a surgeon who is going home of R&R during his year long deployment. It also happens to be a good friend of mine from medical school. That to me, makes it all better. It will be quite an adventure just getting there and then we will see what life is like. I have been very fortunate to be in a "busy" FST and this experience has been one of a life time.

Change is really what we as humans and children of God are all about. Our adaptability is one thing that separates us from most all other species on earth. Moreover, the ability to change one's soul is what Christ is all about. To understand how this occurs through the atonement, we have to understand the fall of Adam and the effects of the fall.

"The fall" is a term to describe the sentinel event where Adam and Eve used their agency to partake of the fruit of the tree of knowledge of good and evil and separate themselves from the presence of God. The act was what allowed our own existence, yet is also introduced sin and death into the world. They became mortal, imperfect and unable to stand in the presence of God. All of our imperfections, are a result of the fall. Addictions, sins, sickness, pain, and punishment are a result of this action. In order to prepare a way for us to be worthy to return to the presence of God, He sent His Son, Jesus Christ who in Gethsemane and on the cross, paid the price for all of these effects of the fall. It is written that he "descended below all things.." so that he would know how to help lift us from our misery. Christ doesn't just empathize with our pain and suffering, he experienced our pain and suffering. As we come unto Him, and embrace the atonement, become justified and sanctified in Him, He changes our hearts and our souls. Through him, we are in essence "born again" and He changes us. This change is a process, sometime an arduous process. We repent and allow the atonement to change our lives.