Brian in Salerno

Our own little 4th of July

2009-06-21T16:34:00.007+04:30

Its June now in the desert, and yes, it is getting pretty hot here now. Fortunately I will be going home soon. In the hospital we have been super busy lately. As was seen on various news channels, there was a recent mosque bombing that resulted in numerous casualties. We received a lot of these and have been managing several burn patients for last few days. It is really sad what the ordinary Afghan has to deal with in his or her daily life.

Before it got really busy, we had another play day with various weapons on the open range. This was our chance to make our own little 4th of July fireworks show! Behind me is the mountain that we plan to kill with our fireworks. Here I am holding a smoke grenade. It's a lot bigger than the kind you find at your neighborhood fireworks stand.

Ooooo, pretty. Ok, enough smoke, lets shoot something bigger!

Now we're talking. It's time to load up the 50 cal. This string of bullets is sold beside the bottle rockets, and are also sold by the "gross".

Die mountain! Here I am shooting the "240" mounted on the back of the truck. I really need to get one of these, you know, in case I ever see a snake or something in the back yard.

All right, what else did we buy at the fireworks stand this year? Oh yeah, excellent choice! This is a handheld Mark 19 40 mm grenade launcher, perfect for those backyard family get-togethers. It works like a 6 shooter. The six shells you load can be flares, smoke grenades, parachute flares, explosive grenades, or for $2 extra, a random mixture. Die mountain!

Look at this guy, how cute is he? He's one of the local kids who came over to check out the action.

It feels wierd to me that I wear all this body armor and he's out here in regular clothes. I had to get a pic with him.

All right already, lets get to the big stuff! Ahh yes, the mother load, grand finale. I see we have a Carl Gustav 80 mm recoiless rifle, excellent for you deer hunters out there! These things have so much explosive percussion, that the Army only allows a soldier to fire it 5 times in one day, for fear of acute lung injury---awesome.

This is one of the 80 mm shells you load into the weapon. In case you missed them, they are located all the way in the back of the fireworks tent on the really really expensive table.

This is so cool, I had to include video. Turn up the volume and imagine you are here.

And for another grand finale, we decided to just have an all out murder the mountain fest, and see how much ammo we could burn through. Boy, I hope there is no one hiking in those hills today...

This is a little restaurant here on the FOB. It is run by an Afghani man, serving up the local food. It was great! It seemed to me similar to Indian food. We had bread, lentils, rice, beef stew, a pita packed with beef and cheese with a cream/yogurt dipping sauce, and hot green tea. Yum. All for $5.

Here we are (my CRNA partner and I) standing outside the bazarre. We saw these KPF (Khost Provicial Forces)--some of the good guys here in Afghanistan--vehicles with their rear mounted AK-47's, and had to get a picture. I was looking a little rough, because due to work in the OR, I hadnt had a shower in 2 days. Oh well.
Happy 4th of July America!

Chuck Norris Is With You

2009-05-18T14:15:00.009+04:30

Wow, I guess the time kinda got away from me. Its been 7 weeks since I last blogged. At least the time has been going by fast for me. We have been keeping pretty busy, especially with it being summer time and all the crazies having come out of their caves, or at least out of Pakistan which is a whole 10 miles away from us.

We have also been busy doing humanitarian work. There is a high incidence of a certain blood disorder here called Thallesemia. Kids who have this develop large spleens that consume all of their red blood cells, and removing their spleen can improve their quality of life. This is called a splenectomy. We perform lots of these. As you can see on the OR board for this week, there are plenty of splenectomies waiting to be done.

We just removed the spleen from this little boy. We placed it beside him to show how large these things can be.

But the action doesn't stop with the pediatric surgery of course. Here you see one of our Blackhawks parked on the helipad doing a hot off-load of an injured patient.

These are two of our flight medics. Matt and Derek split their time between Salerno and some of the other FOBs in the area.

This is an example of the type of trauma that can come to us on any given day. This is a CT scan picture of a patient who had shrapnel in the heart--never ideal. You are looking at a slice through the body, with the patient lying on his back. The starburst in the upper right part of the picture is the metal in the heart reflecting the x-ray beams away.

Occasionally we have traumas that consume most or all of our blood products here. When that happens, as it has a few times, we initiate the walking blood donor program. An announcement goes out over the loudspeaker for "Persons with A positive blood type please report to the CSH."

The call goes out and within minutes, hundreds of soldiers and airmen are lining up ready to donate blood for their buddies. Its really impressive.

It's days like today that make the time go by fast.

Yes, that's an In-N-Out Burger cap. Some people reading this blog have IN-N-OUT in their neighborhoods.

It's just another day flipping burgers here at Salerno.

After a hard day's work, it's time for some pizza, cooked up fresh in the sterilizers and eaten on the same OR tables where we were operating 1 hour before.

Later in the month, we were visited by Toby Kieth. He comes to perform for the troops every year, and has been for the last 7 years. When in country, he will be here for 10 days and put on 3 to 4 concerts a day to hit all the FOBs. While he and his main guitar player were playing at smaller FOBs during the day, his band was at Salerno setting up for our evening performance.

As small as Salerno is, it is large compared to some of the other FOBs and outposts out here, so the full band usually sets up at larger venues. Anyway, the band was here and walked through the hospital meeting people and thanking us for our service.

Here we are hanging out at the SF compound before the show.

The show rocked. It lasted around 2 hours. Toby Kieth is one of the funniest guys I have ever seen in concert.

The concert was held in a large tent structure that is used as the fire station. Toby also let us know about his chain of restaurant/bars called "I Love This Bar." They are located in about 7 states with more coming. In them he displays momentos and gifts received during all his trips to Iraq and Afghanistan. He let us know that for members of the military, food and drinks are always on the house. As you can imagine, that got a small cheer.

So as many of you know, I am very much into flying/aviation. The runway here at Salerno is gravel, so not every type of aircraft can land here. However, there is a fair variety I have managed to photo.

This is a very interesting looking jet. The engines are mounted high on the wings. This gives the plane an advantage as the jet intake is farther away from the dirt and gravel on the runway. I believe this plane is used by the Blackwater firm for manpower and supplies. If anyone can identify it, please comment! I would like to know.

If I am not mistaken, this is a Soviet make helicopter. I'm not exactly sure what it is doing here. If anyone can ID this, comment!

Here we are on top of a Blackhawk. Matt and Derek gave us a little tour.

This is a C-130 that looks different from the typical Air Force C-130 landing here. It is painted totally black and has grey Canadian flag markings. These are Canadian troops deplaning to join the fight here.

When these Chinooks are in flight, they are really loud and fun to watch. This one is shipping some type of cargo.

But the highlight was sitting in this Kiowa attack helicopter. These are very fast and agile, and not too much bigger than a Cessna 172. That's a 50 caliber machine gun mounted on the side beside my leg.

We on the FOB got to see one of these in action (kinda) one night. I was sitting in my room and heard the usual helicopters buzzing all over, but then I heard one firing its 50 cal. It sounds like a deep buzzing roar as its firing. I went out side and joined several other people outside watching. Of course, it's pitch black here and there was no moon out, but you could hear him hovering somewhere directly over our heads. Then suddenly there were tracer rounds appearing out of the blackness above, followed by the time delayed sound of the 50 cal machine gun, heading into the mountain side and creating bright flashes of light where they were hitting. I thought "wow, it would suck to be on the business end of that tonight."

Over at the special forces compound, they were hearing the same thing we were. Two of the guys were playing X-BOX Call of Duty and shooting each other up. Another guy came running in and said "they are shooting at someone over there, grab your rifle and come up on the roof!" They looked at their video game, looked at each other, and said "cool." They then paused the game. PAUSED IT! I think if I were about to take a sniper rifle with a night vision scope and go up to the roof and kill somebody, I wouldn't have the foresight to pause my video game with the intent to return to it once my deed was done. Well they ran up there with their assault weapons and there were others on the roof watching the show. They looked at these guys and said "what in the world are you guys doing, the helicopter is just target practicing." Oops.

Here is a picture of the cockpit of the Kiowa. I was particularly fond of the sticker that reads:

"CHUCK NORRIS IS WITH YOU"

M4---Medical Moustache March Madness

2009-04-02T13:57:00.007+04:30

So first I need to say great job to "Coop". At first she wasn't so into working out, but as the peer pressure continued, she's now a regular gym rat.

We decided we needed to create M4: Medical Moustache March Madness, because there was not enough moustache power in our hospital. Here is a mid month photo of most of the moustaches in the hospital.

By the end of the month, our numbers had fallen a bit, but for those of us willing to endure, the moustaches gave us great stength.

We have even had our own Puerto Rican to serve us drinks in the OR whenever we want.

The power of the moustache is strong with this Puerto Rican.

Sometimes, the moustaches just take over, and the real madness begins.

This is an old photo of Steve and I that I dug up. Funny, we had been out in the jungle in NAM for 3 or 4 months. The VC were all over us. We were pretty hard core back in those days.

Ahh yes, here is another old photo after I put my chopper down in the bravo2 LZ to pick up some of my buddies.

Like I said: madness.

Another example of madness that can occur happens when one of the locals brings in a worm he found that came out of his daughter's poop.

Not only do we examine and measure it carefully...

We then begin to play with it, and Steve considers eating it.

Alas, the month of madness has to come to an end at some point. This is shaving day!

Very ceremonial.

So sad to see them go...

Bye Bye moustache power

All I can say is, the moustaches were way too manly for this place.

An afternoon with special forces

2009-03-15T20:28:00.010+04:30

Given the nature of our mission in the hospital, we see a quite a few injured people. Often they are locals or Afghan military, but sometimes they are US soldiers. One of the more active groups here on the FOB is special forces. They have the occasion, quite frequently, to visit the hospital with injured enemy or buddies and use our surgical services, typically in the middle of the night. So seeing these guys as often as we do, we get to know some of them pretty well.

Every now and then we are invited to go out with them and blow stuff up.

Nate and I pose for the camera before the action begins.

This is one of the trucks they drive and was the one I rode in this day. The truck is loaded with toys, both inside and out.

So, I really did not think that after going through med school, I'd ever have the chance to hold a block of C4 explosive, but here I am! They showed me how to cut a wedge out of the end, embed detonation wire, and tape it up for use.

The guys are explaining how to tie the ring of detonation wire so that all 6 of our blocks of C4 will explode simultaneously.

Robyn and Derek are working on their blocks.

Our work is surveyed by our "instructor" for the day.

The rest of the group also checks over the placement of the blocks. As you can see, the SF guys can pretty much wear what they want, so they usually wear civilian clothes.

Not to waste any explosive, 3 pounds of C4 is molded into a shape charge and placed in front of this iron plate. The iron plate is about 1 cm thick. This charge is linked to the other 6 blocks, giving us about 12 pounds of C4!

Rich calls to the command post to inform them of our impending explosion. The people in charge probably wouldn't appreciate any large unannounced blasts. We set the fuse, which ignites the detonation cord. Since the det cord burns at a controlled rate, we have a set number of minutes to drive to our observation point.

After we blow a hole in the side of the mountain, we return to check the damage.

I would say the shape charge did its job.

But the fun is not over quite yet. I am holding a grenade I am about to throw over the side of the hill. Like I said, all kinds of toys in the trucks...

Get down! You can see the grenade over my head as I am falling to the ground.

After all the festivities, we join the guys back at their "SF compound" and are treated to a cook out. They built this bar area for themselves in their spare time.

Usually on Sunday nights they have one of these get togethers and light up the grill. You can pretty much see all the people who go around the base in civilian clothes and beards---SF, CIA, and FBI.

The best part is just getting to eat somewhere besides the dining facility once in a while!

"Small arms range---going hot"

2009-03-04T16:01:00.008+04:30

Before I get to the small arms range, I would like to take one moment to try to explain how dark it is here at night. You see, because of the maniacs up in the caves nearby, we can't have any lights on at night here. We all walk around using our red, green, or blue lights at night to see. White lights aren't allowed, as they can be seen from too far away. Now this makes for some excellent stargazing, just look up and you can see shooting stars, satellites, and the Milky Way galaxy clearly. However, it can be hazardous at times. This is the view I see when I step out of the hospital at night. The other night, while not using my light and thinking I knew where I was, I walked right into a tree. Not a little branch on my shoulder or something, I walked straight into the trunk! I felt real smart...turned on my light after that.

Robyn is sporting her new Navy PT attire she bought. She likes wearing the clothing of various services and confusing everyone. We let her get away with it and call her our mascot.

On this day we had some fun away from the hospital. The Army, unlike the Air Force, believes that if you are carrying around weapons, you are doing it for a purpose, and should the opportunity arise, you better be able to use that weapon. So every 2 or 3 weeks, you visit the firing range.

The range has 10 firing stations. The sandbags are located 25 meters from the targets.

Placed on each target is a sheet of paper with a silhouette of a person. That is the little black spot in the middle of the papers hanging. This represents a person 300 meters away.

Before we start, our group loads up about 2000 rounds of ammo.

I'm ready to shoot something! A loud voice transmits over the base intercom: "Attention on the FOB, small arms range--going hot." This lets people know why there are machine guns firing like crazy at the perimeter of the base.

With the barrels resting on the sandbags, we are firing at our targets with the lowest possible profile.
I look through the site, breathe in, breathe out, and squeeze slowly. This minimizes how much you move your weapon and increases accuracy.

My friend to my right let me know afterward that it was hard for him to concentrate on his target because my M-16 was ejecting shell casings all over him. Ha.

After going through several rounds of shooting, checking target, adjusting site, and shooting again, the weapon becomes "zeroed" and we begin to see better and better results on target.

My target. You can see my first 3 attempts (which were 3 shots each) low and to the right. My next 2 attempts were better, but not perfect. Unfortunately, at this point a trauma alert was heard over the loud speaker, so essential medical personnel had to go back to the hospital. We had to miss the majority of shooting, and getting to shoot the M-16 in burst mode. But they promised me we could come back soon. I will hold them to it!

Seeya next post.

Who Lives at FOB Salerno

2009-02-24T19:53:00.009+04:30

I would like to explain who lives here at FOB Salerno, and some history of one of the Army units. There are many different populations of people here. There are civilian local nationals who work on the base and civilian US personnel who work for KBR, which is a subsidiary of Haliburton. KBR handles many functions such as food service, laundry, plumbing, mechanical, electrical, construction, sanitation, firefighting, computer networking, and many other behind the scenes activities. The company, and all of its employees, are extremely well paid by our tax dollars. There are also CIA personnel and US DOD civilians who work here in various capacities.

There are a variety of Afghani military and police forces who are based here, or frequently visit. You have the Afghan police, the Afghan National Army (ANA), Afghan Border Patrol, Khost Provincial Forces (KPF), and Afghan commandos, who are Afghan special forces.

As far as military personnel, there are a variety of special forces, including Army special forces, Delta force, and I also believe Army Rangers. All three of these forces are independent and they don’t like mingling with each other. The various special forces usually have medics attached, so we get to interact with them occasionally.

There are also quite a few Air Force personnel on base, mostly medical, but also some special forces. These guys go out and find the enemy, then guide Air Force jets in air to ground strikes. There are a few Navy people, and a few Marines.

The vast majority of personnel here however are Army soldiers who belong to the 101st Airborne, headquartered in Fort Campbell, KY. There is an air assault aviation brigade here, utilizing the attack helicopters Kiowa and Apache, and the transport helicopters Blackhawk and Chinook. Most of the soldiers belong to the 4th Brigade Combat Team 506th Infantry Regiment.

The 101st Airborne Division "Screaming Eagles" patch

Following is a brief history of the 506th Infantry Regiment copied from globalsecurity.org.

The mission of the 4th Brigade Combat Team, 101st Airborne Division is to, when directed, rapidly deploy by air, land, or sea to conduct full spectrum operations in support of the Regional Combatant Commander's Requirements.

The 506th Parachute Infantry Regiment was activated on 20 July 1942 at Mount Currahee, Camp Toccoa, Georgia, as part of the newly formed 101st Airborne Division. Currahee was a Cherokee Indian word meaning "Stands Alone," a phrase which later became the Regiment's motto. Led by their Regimental Commander, COL Robert F. Sink, the Regiment conducted a 137-mile forced march from Camp Toccoa to Fort Benning to begin Airborne training. They were the first Parachute Infantry Regiment to complete Airborne training as a unit. The 506th Infantry was the sixth parachute regiment constituted in the US Army.

The 506th Infantry Regiment motto: "CURRAHEE STANDS ALONE"

Their training continued in England until 5 June, 1944 when the 506th suited up for a different kind of parachute jump. At 0100 hours, 6 June 1944, the Regiment jumped into the skies over France as the lead element of the massive Allied D-Day invasion. Their objective was to seize the high ground immediately behind the Normandy beach. By the evening of 6 June 1944, the Regiment had secured its objectives, and had linked up with other elements of the invasion force who had established a beachhead at Normandy. For its exploits at Normandy, the 506th Infantry Regiment received a Presidential Unit Citation, and 25 of its members received the Distinguished Service Cross.

Currahee is also well known for the book and HBO miniseries “Band of Brothers”, the story of Easy Company in the 506th Infantry Regiment during D-Day and battles afterward. So the Army division here definitely has a rich tradition.

These are the guys who go "outside the wire" everyday risking their lives. This is about as close as I can get to the edge of the FOB.

Beyond this fence line you no longer have the protection of the base. Sometimes I feel a little guilty that I am not one of the ones venturing out into the mountains, that I always have the protection of the base and therefore a lot less risk. In fact there is a slang term for people like me who never leave the FOB: "Fobbitt."

As an Air Force person living on base, you just don't feel quite as tough as those Army guys leaving the base in their armored vehicles with top mounted 50 cals.

It's all good though; we understand our role is critical, and our being here and ready 24/7 gives those guys security when bad things happen.

Colonel M and Capt G (anesthesia CRNA's-the two left) prepare to intubate a person with a severely burned face from combat.

Trauma sustained to armpit. Femoral vein was grafted to brachial artery to save the arm.

We are also here to take care of emergencies in the local civilian population. I can show this cute baby because her story has already been published in the US media. She is a 9 month old who came in with 3rd degree burns to her legs and feet. We took skin grafts from her thighs and transferred to the burned areas. She recovered well after 3 weeks and went home with her mom.

That's all for this post, I'll try not to wait so long before I post again. Thanks for visiting!

Down Time in the Desert

2009-02-07T14:43:00.010+04:30

What I will try to do here is give a little tour of Salerno. These are some of our rooms. I walk past this tree every morning going to the shower, which is about 200 feet from my room. I call it the bird tree, because I swear at least 200 birds live in it. I guess there's not that much choice of good trees around, so they can't be picky.

Here is the chapel. They have different style services (Catholic, Protestant, LDS, etc) here at various times during the week.

Trevor and Jerry are standing on a volleyball court in front of the gym in the background. The gym is in that big tent and has a good selection of free weights, machines, and cardio equipment.

These are the docs at the hospital from left: orthopedic surgeon, (me--anesthesiologist), general surgeon, general surgeon, internal medicine.

This is looking over towards where a patient would be wheeled on a litter from where the helicopters land.

Being the capitalists we are, we have a bazaar set up on base and let the local nationals come and sell their goods. While there are a lot of neat places selling afghans, rugs, scarfs, and stones, not everything is genuine Afghan product. You can see the Blockbuster sign in this photo where pirated movies are sold. These are all made here in Asia and almost anything can be found for around $2. I'm not really into that, but some people are.

You can also get a nice cup of hot tea at the bazaar in your down time.

Speaking of hot drinks, why not have some coffee and read out in the sun, something you definitely don't get enough of in England!

And while we're killing time, why not do a hand stand. I mean what else are you going to do for 12 hours of sitting around?

After we're done doing handstands, we head off to the gym to start lifting as much weight as we possibly can until our bodies hurt.

This is my crew I always work out with, Jerry and Trevor, and Robyn, the ortho surgeon.

This particular night was pizza night......in the operating room. Here you can see our buffet line where you can pick your toppings before you cook you pizza.

After you are done picking your toppings for your pizza, you hand it to the chef (one of our scrub techs) and get it cooked. Now, we don't exactly have ovens in the hospital, but we do have intrument sterilizers! Through trial and error, 350 degrees at 20 PSI pressure for 15 minutes seems to get the job done.

Yes the last couple of weeks have pretty low key and relaxed here. Life has been pretty good, but is getting a little interesting in the last few days. Bagram Air Base, the large AF base in country here, has only 1 runway, and this runway serves the military for the entire country, at least for the big cargo jets. Last week the runway was down because this C-17 Globemaster crash landed with no landing gears. They had to fly in a crane from the US to lift it. Therefore, all the mail going out to the FOB's stopped. No mail!

Otherwise, everything is good, and until the weather warms up, the action might be a little slow around here. So I'll just keep drinking coffee, enjoying the sun, and waiting for the next adventure. I will post again soon, seeya later!

The First Two Weeks

2009-01-24T17:57:00.005+04:30

Well I’m settled in here at Salerno. Week 1 was pretty low key. We received an inservice on loading patients onto the Blackhawk helicopters. These helicopters will fly out to where soldiers have been injured and pick them up to bring back to our hospital. We also use them to medivac patients out to the bigger hospital at Bagram Air Field west of here.

These are two of the guys I work out/hang out with in our down time. Trevor is a radiology tech and Jerry is a scrub tech. In the first few days we have not been too busy. On the 3rd day we did receive patients from an IED blast. One went to surgery with extensive injuries. Other than that in the 1st week we have had lots of gym time and movie time. There is a lounge in the hospital with a big TV where we hang out sometimes. We also often get the chance to do humanitarian surgery on the locals who live here, time permitting. We take out lots of thyroids and the other day cut off a huge skin cancer that was growing out of this guy’s chest. Here is a picture of the trauma bay where injured patients come in off the helicopters.

The “No Photos Allowed” means no public posting of patients.

Here is my office, the OR.

This room actually serves as 2 OR’s, and we are frequently using both tables at the same time. After a few days of down time and not much going on, week 2 has seen a sudden increase in the action. Monday a car bomb exploded just off base. We felt the blast in the hospital. 6 adults and 5 children came in injured and 4 of them went to surgery. Tuesday we received a gunshot wound through the liver and stomach. We heard more blasts and learned that rockets were being fired into a city close to our base from somewhere. For a while we all had to where body armor if going outside. That was a little anxiety provoking but being in the hospital provides a pretty safe structure should anything go unplanned.

Wednesday an IED blast brought in 5 more victims, 2 of which required surgery. The thing that is different about doing these surgeries as opposed to what I am used to doing is that every hole represents a piece of metal that is lodged in the body somewhere, and after one of these blasts, there are holes everywhere.

Wednesday night I think I had gotten a little dehydrated. I was working out with my friends in the gym and started to feel like I was going to vomit. That sounds like I am in terrible shape but that never happens to me. I got into bed hoping for a good night’s rest after drinking lots of water. Around 2:00 am I was suddenly awoken from sleep by the sound of an explosion. I lay in bed in my pitch black room not knowing what was happening, but I was pretty sure it was not a dream. Then it happened again. It sounded kinda like someone was standing in your living room and shooting a shotgun, or maybe like when the thunder hits right over the top of your house shaking all the windows, except several times louder than that. And it happened again, and again, and again. So at this point I started to freak out just a little, wondering if these were mortars coming in. One of my roommates is an Army Colonel, and was in Iraq when Desert Storm started, and here when all this started, and many places in between. He was obviously awake because no one could sleep through that, so I said “is that incoming fire?” He said “no that’s outgoing fire, just try to go back to sleep.”

Oh, my bad, I just thought my room was about to explode into a fireball, sorry about that! I guess it’s routine and maybe not even a big deal to some veterans of this stuff, but it’s a new experience for me. It turns out that one of our huge cannons here was shooting over the base into the hills close by --- and I don’t think they were practicing.

Thursday morning the work continued. We got the call for traumas coming in around 10:00 am. This time was different, they were enemy prisoners who had severe burns and shrapnel injuries, survivors from what appeared to be large artillery blasts several hours earlier. It really didn’t seem much different taking care of these people, even though they were probably Taliban or Al Qaeda and trying to kill us, they just seemed like regular patients clinging to life. It was a little weird to think back on it later in the day though, and I’m sure there will be many more…

Friday provided some relief and rest, no cases, no explosions, a good day to chill. And then today (Saturday), we were back at it with 4 people coming in from an IED blast, surgery on one of them, and a skin graft on a 9 month old baby who came in the other day with burns.

That's all for now. Stay tuned for another edition of my vacation here in Salerno!

One of our Blackhawk pilot's helmets

The Road to Salerno

2009-01-15T18:21:00.001+04:30

I am settling in my first week here in Afghanistan. My journey began January 2nd at 4:00 am. I had to take a taxi to the base to pick up my 9mm handgun and then take me down to London to get on a commercial flight. At Heathrow I reported my weapon and they checked it like a piece of luggage. I then met up with 4 or 5 other people headed the same direction with a variety of weapons, and we all filled out our paperwork in a group and stuck together. I took off on British Airways to Frankfurt International Airport, picked up my pistol, and took a taxi up to Ramstein Air Force Base to spend the night. German taxi drivers are interesting. We were driving almost 100 mph (while it was snowing) on the autobahn listening to "danger zone" on the stereo. It was pretty fun. That night I ate at Chili's on the base, and enjoyed the last good food for a long time to come.

The next morning I got up early, headed to the PAX terminal on the base, and checked in for the flight. Our itenerary was taking us to Incirlik Air Base Turkey, and then continuing to Manas Air Base in Kyrgyzstan. We boarded a commercial airplane (I was surprised it wasnt military) and headed towards Turkey. Most of the people on the plane looked like me, wearing a military uniform, but there were some civilians and also children on board. As it was getting dark in the skies on the was to Turkey, I looked down and saw some huge mountains with snow all over--very impressive. After it was completely dark, looking out the window I kinda had a feeling of anxiety by not knowing what was waiting for me at the end of my journey, only that the plane was taking me there and there was no turning back. The flight to Turkey lasted around 4 hours. We landed, deplaned, and walked into a terminal and all sat there for about 3 or 4 hours. The military is famous for "hurry up and wait," and this was no different. Fortunately there was a little grill making hamburgers. I had just eaten on the plane but decided to eat again out of sheer boredom. After the hours had gone by we all walked back to the same plane and sat in the seats we had before to continue our journey. This flight had no civilians and no children. We were in the air for another 4 hours heading out of Eastern Europe and into Asia. We made it to Kygyzstan around 6:00 am local time, landing on a snow covered runway.

We all headed into a room where we received a briefing. Some of us would spend a night or 2 here, and some of us would quickly be moving on. I was selected as one of the people who would be flying on to Afghanistan that day.

We spent the entire morning receiving more issued items such as cold weather gear, chemical warfare gear, and body armor. Afterwards we piled up all of our bags on pallets to be loaded onto the next airplane.

The airplane taking us to Afghanistan was a C-17 military aircraft. We were traveling with a large group of Army soldiers heading to various places in Afghanistan. We were packed onto that plane like sardines.

We didnt take off until the early evening, I was already really tired from traveling the entire night before. I was hoping I could find a bed sometime in the near future. What was supposed to be a 90 minute flight down to Bagram Air Field Afghanistan turned out to be much more. The pilot tried 2 or 3 times to land at Bagram, but dense fog kept him from seeing the runway even though he was 400 feet above the ground. So we diverted to Kandahar, Afghanistan. Once we arrived, we deplaned, checked in at the terminal and were taken to some tents at around 2:00 am to sleep.

The next morning, about 6:00 am, we walked back to the terminal to start waiting on a flight out to Bagram. With all the Army people stuck there though, it took all day to get a seat. Finally, around 5:00 pm, we received word there was a C-130 we could fit on to go to Bagram. We rode on the C-130 to Bagram and arrived around 9:00 pm. After we checked in and filled out a bunch of paperwork, we eventually made it to a tent, a pretty large tent with about 50 transient people in it, and slept on a cot.

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Surely this would be the first good night of sleep in a few days. No---it is very cold at Bagram and was below freezing. The large tents have heater ducts blowing warm air into the tents at night. Well ours malfunctioned somehow and was pumping in cold air, causing it to be around 45 degrees in the tent. It’s hard to sleep while shivering… The next day I completed a checklist of things to do, including picking up ammunition for my weapon. The funny thing about this was that since I am medical, I picked up my ammo in the hospital. As an anesthesiologist, not only can I check out a bag full of narcotics, I am now able to check out 45 rounds of ammo for my handgun!

We were informed that we had a C-130 going to Salerno leaving at guess what time…2:00 am. At 10:00 pm I showed up with the other people heading out to Salerno, carrying all 4 of my bags of issued gear plus backpack plus handgun, and began waiting. Finally we boarded the C-130 and took off for Salerno. These military airplanes have no windows, but you can kinda tell when you are about to land based on how things feel and sound. Going into Salerno was a different experience. In a forward location such as this, you don’t want a long smooth approach just over the enemy’s heads. So there was quite a bit of wild maneuvering getting down to the runway—which is all gravel by the way. You had no idea when the landing was coming, and suddenly SLAM there it was, not smooth, not graceful, just getting down to the ground quickly. In fact one of our guys happened to stand up to reach for a bag or something when we slammed the ground, and he got thrown about 5 feet over a few people—pretty funny. We did a hot offload of the plane, meaning they lowered the ramp in the back of the plane and you get off with the engines running. The C-130’s never stay at Salerno, they just unload, load, and take off. Walking out of the back of that plane we entered the darkness. Salerno is a very, very dark place at night. There is a strict blackout policy here, and the only lights that can be used are red, green, or blue flashlights. We were met by hospital people and taken to our rooms to sleep.

This is my new home, my little corner of the room. Beautiful isn't it! At least it's not a tent...