Our own little 4th of July

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

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

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

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!