IA, IPF, and insurgents...oh, my!

We had our first fallen angel (deceased active duty member) come thru the hospital yesterday.....talk about having reality smacking you in the face. Hard on all the new staff, especially. When we know an angel is coming in, we line up along the route from the helo pad to the hospital and pay our respects at attention and salute him/her as they are carried down to the SSTP (shock/trauma/casuality receiving area). They sacrificed all for our way of life.....and I felt honored to pay my respects.
We care for a wide variety of patients.....basically it's whoever rolls thru the door. We took a suspected insurgent to surgery two days ago to wash out and I&D some lower extremity wounds. He was behind a door that the patrol couldn't open. They blew it up with a C-4 charge, and he happened to be behind it (they gave him fair warning first). I'm telling my team that first and formost: you are in no position to judge anyone that we are called upon to care for, and that I expect everyone to be treated decently, regardless of nationality or actions that may have brought them there. So far, so good.......
We were also caring for an IPF (Iraqi Police Force, IA: Iraqi Army) member that fell off a ladder and had several burst fractures along his spine. He and his brother stayed with us for several days.....we were lucky to have his brother, who spoke pretty good English! We also have two interpreters on staff.....I can already tell I would be lost without them....
I purposely started off a little somber, that way I could end on a lighter note: I'm also getting some time to explore the base when I'm not at work. One of the departing ERCN's (En Route Care Nurse) showed my buddy Pat and I some of the cooler parts of the base that are within running distance. Yesterday afternoon she showed us the Al Asad Oasis, an old abandoned Russian MIG, and an old Iraqi outpost. A welcome diversion from the hospital to say the least.
As promised, Saddam's Pool story: this base also housed some of the Iraqi Olympic Team, and the indoor pool is quite impressive when contrasted to the simple and utilitarian structures surrounding it. The legend goes that Saddam was here often, and he would tour the air squadrons, soccer team (stadium isn't too far away, either), and swim team progress.....the slowest swimmer was often hung in front of the pool to "motivate" the other swim team members........I don't remember if they won any medals, so I suspect this somehow wasn't the best motivator....anyway, it makes for a great story whether it's true or not.

To Baghdad, adventurous Stranger

Flew my first patient last night with a trauma nurse I am replacing. All of our MEDVAC's are flown by the Army's 45th Aeromedical evacuation squadron based here at Al Asad. We exclusively fly H-60H's (Blackhawks) with the patient carousel in the fuselage, and are sandwiched between the crew chief and the helo medic.
My patient was an Iraqi Policeman that presented unresponsive and was in Diabetic Ketoacidosis (DKA......in other words very high blood sugar levels and acidotic...he had an impressive pH 6.90). We intubated him, started IV's, chest xray, labwork, ect. and then called for a MEDVAC.
Ummmm, I'm not sure exactly how to explain the flight.........don't want to alarm anyone. But flying into Baghdad is a "unique" experience all to itself. For the most part, there isn't much to see in transit.....a lot of desert with scattered homesteads.....fairly routine. But once we start approaching the Army Hospital in the heart of Baghdad, the pilots have a lot to deal with: we are approaching a hostile urban terrain complete with houses, street traffic, towers, antenna, and other low altitude aircraft. Not to mention they are trying to land. Have I mentioned yet that we aren't the only ones flying 1,000 feet off the deck trying to bring casualties to the hospital? So, they had no problems identifying the Army Chinook flying a few hundred feet below us.......it was the second Army Chinook they didn't see until it was almost too late........I'm glad the Blackhawks are much more maneuverable.........but it came with some interesting views of the neighborhood rooftops out my window. I don't think they intended for me to be able to count roof vents like that.
As if that wasn't fun enough, leaving was even more challenging: the new pilot forgot to turn off the landing lights before liftoff.....so about 30 seconds after taking to the air, the hospital ATC radioed them to warn them just as they started seeing tracer rounds.......none to worry: we launched about 6 flares (deflecting heat source and distracting light to throw off the enemy) and didn't gain any new air conditioning ports in the craft. The pilots were laughing about it once we got out of Baghdad (I'm plugged into their communications system while flying, and I'm still trying to decide if that's a good thing or a bad thing)..........I guess it's all fun and games until you leave your lights on in indian territory! Just remember, I get all this and a paycheck to boot.....lets get some.
I'm inspired to quote C.S. Lewis as Digory and Polly come across the mysterious bell in the grand hall in his first book:
Make your choice, adventurous Stranger;
ring the bell and bide the danger.
Or wonder, till it drives you mad, What would have followed if you had.

Disclaimer: apologies to anyone who doesn't speak medicalese or military jargon.....this blog is going out to a broad audience, and I just can't explain it all....however, Google is only a few clicks away.....it will shed light on some of the technical stuff you may have questions about.
Also, I have been taking pictures, but just can't get the internet time to upload them yet....should be within the next week, including panoramic shoots from the roof of Saddam's Olympic Training Pool (story will have to wait for a future post, sorry!).
I finally have an email address:
carl.goforth@acemnf-wiraq.usmc.mil
Also, here is my mailing address:
LT Goforth
CLB-2, HSS/medical
Unit 73655
FPO, AE 09509-3655

God Bless and good night.......

Our first case

First: thank you everyone for your posts and feedback....deeply appreciated!
My team hasn't wasted any time with relieving the current staff: our first case came in last night.....a 6 year old Iraqi girl triggered an IED. She had penetrating abdominal injuries, and broke one of her legs (tib/fib fx). Our general surgeon and ortho surgeon went right to work, and my good friend Pat flew her to Baghdad in the middle of the night.
We met our counterparts yesterday, and they have a mixed look of exhaustion and relief.....they are glad it's over, and are anxious to turn the "watch" over to us. We will spend the next few days working together so they can impart "pearls of wisdom" and lessons learned.

Anbar Province, Al Asad

Arrived in Anbar Province via C-17 a few days ago. Al Asad is a large airbase built by Yugoslavia during the Iran-Iraq war. The perimeter of the base is around 25 miles, and I have only seen a fraction so far.
Still trying to acclimate to this part of the world. Last night was the first night I have slept since I got here, so things are looking up now!

From Kuwait:

I flew over Baghdad last night around 2 AM on my way into Kuwait City. Two observations: It looked like a lively city with a lot of lights, which is a good sign; the lights were not in the form of tracer rounds aimed at the plane----even better sign.
I am at Camp Virginia, Kuwait while I wait for the final leg of the journey: Al Asad. The flight was as long as I thought it would be. We stopped in Newfoundland first. The flight crew said the ice cream was the best, so we ran across the tarmac to the terminal for chocolate ice cream. It was 20 degrees, but I really didn't have anything better planned. The second stop was in Budapest, Hungary, of which there are two districts: Buda and Pest, separated by the River Danube. We weren't allowed off the plane, nor did they bring us any goulash...so we must have been in the Pest district.
The feedback I am getting back on the site is phenomenal! Thanks! Why does it seem like everyone is enjoying the blog more than I am????? .........that's not fair, people.

Imminent departure......

I fly out tomorrow afternoon to begin my long journey to the sandbox.
I finished packing my seabag (king size; 100 pounds) and pick up my weapon on the way to the airfield.......get this for military intelligence: I'll have my weapon for the flight, but I still can't have a knife or mouthwash.........
The trip average is 36-38 hours (including fueling stops/plane turnovers, ect.) and I'm sure I will be offline for a few days. The next post will be either from Kuwait or Al Asad..........thankyou all for your continued support and prayers........

Combat Town

Don't get me wrong, I appreciated the day's worth of squad tactics and clearing buildings of "insurgents". But does the Navy really want surgeons, trauma nurses, and corpsman ridding the world of bad guys? Lets just say if you see me in the news doing this.......that things are definitely not going as well as we had hoped........

En Route Care Training

Finished up the last of three weeks of training friday. Wednesday-Friday the trauma nurses went thru a new course developed by Naval Operational Medicine. It was a mix of classroom instruction on flight physiology and environmental stressors along with equipment familiarization and trauma scenarios. The class culminated friday with a trip to New River Marine Corps Air Station for in-flight training. We split up the class and flew around coastal N. Carolina for the morning with two instructors and a sim-patient along with monitors, IV's, oxygen, ect. I have done simple MEDVACs in the past while I was on a surgical team, but quickly realized this was an entirely different realm of "complicated". Our helos will be flying with all doors and windows open while in theatre, and the prop wash is like a mini jetstream blowing thru the fuselage. The noise prevents us from hearing anything....I'll be lucky if I can hear myself think. Here's the biggest kicker: I will probably be flying at night. The pilots are becoming more adverse to daytime operations, and most flights will be at night in a blacked out cabin.........my instincts will be heavily relied upon.

Helo Dunker

The Navy's infamous Helo Dunker! Here's how this works: swim in and strap into your assigned seat. After everyone is strapped in, the crane operator drops the dunker into the pool and it immediately flips upside down.......once all violent motion stops (their words, not mine), you have to get yourself unbuckled (you are upside down and completely disoriented), locate a window (no, we are not allowed to go out the large hole in the back...), open the window, and climb out. The trick is to figure out which way is up before you run out of oxygen! Two Navy divers enter the dunker as soon as it plunges into the water for safety in case someone can't get out of their harness or can't find their way out.

Desert Flier

Greetings! Welcome to my Desert Blog..................I am deploying to Iraq and will be posting my musings and thoughts as well as lots of pictures (click the link above the photo). This is my first blog, and will be "under construction" until I get a good feel for how I want it to look.......so check back often and leave feedback!

I am a trauma and critical care nurse in the Navy currently stationed in Portsmouth, Virginia. However, I have been attached to a Marine Unit since January 19th, and have almost completed my field and didactic training before deploying to Al Asad, Iraq. My job will be to fly critically injured patients from a forward airbase back to a higher level of care either in Baghdad (Army Hospital) or Balad (Air Force Hospital).