Saturday, March 31, 2007

Not your Grandpa's RV...

Check this thing out! We use this armor-plated bus to transport personnel to/from some of the small forward bases near Camp Ramadi. Solid armor plating thoughout (hitting the side is like trying to punch a concrete wall--experience speaking here). Impervious to small arms fire and RPGs, this is travelling in style. Heck, every seat has a weapons port for shooting on the go. All passengers get to join in!
The KBR contractor is kindly pointing out the bullet dents. This thing laughs at small arms fire!
My initial question when looking at this thing is this: who decided not to protect the wheels???? Sure, the bad guys can't penetrate the body, but the wheels seem a little vulnerable to me. The thing would be a sitting duck.
Well, that's my two cents worth.

Friday, March 30, 2007

IED plants

Today, more of the same. Insurgents were caught red-handed planting IED's. The Iraqi Army shot through the vehicle, and brought the casualties to us. We couldn't believe our eyes when one of the insurgents was a 12 year old boy. He sustained a serious GSW to his left foot, and we took him back to the OR for a washout and evaluation. He lost his pedal pulse, but still had posterior tibialis circulation. A good portion of his foot was tore apart---and reconstuction is beyond our capacity. So we placed a cast after the washout, and he will go to the Level III detainee hospital this evening.....the question that begs to be asked is: Why is a child placing IED's!!!!! We will never know his individual story, but the possibilities are both varied and frustrating. Was he coerced by family or friends? Is this something he believes is right? Is he in it to get paid? We are just lucky to catch him before his actions take the lives of those who patrol to keep him and us safe......
Another insurgent had massive thoracic trauma----chest tube placement quickly became a trauma bay thoracotomy with open heart massage----no good, he passed. May whatever God he worships have mercy on his soul.....

Jim Spiri with NPR

"Umm, do you think there's another range nearby that we don't know about?" D-squared said as we share an incredulous look. "Do you hear where that's coming from? Nah, I don't think there 'just so happens to be another shooting range across the river in town'" I said back. We were sitting outside our primitive wooden hut the second day in Ramadi talking about life's deeper issues and pontificating our future, when an eruption of gunfire crackled about a mile away intermixed with the rude outbursts of machinegun fire. That's what makes life so strange out here......Camp Ramadi (where we now live) is itself a veritable fortress only vulnerable to IDF (indirect fire; usually mortars or RPG; no worries.....they have bad aim), but the city lies a short distance away, across the Euphrates River. We can see the famed glass factory (explosion last year caused a 70+ mass casualty) and plentiful housing/businesses from the temporary huts. We can sit outside on a lazy, sunny afternoon and a whole different world is occuring just a few short steps away......mostly what we see day-in and day-out is the aftermath of Ramadi's insurgent encounters. No worries----haven't felt any stray rounds whiz our way yet.

Turns out there was a major joint operation planned a few clicks away from the base entrance between the Iraqi Police and Marines. They are working hard to secure Ramadi "sector by sector". Yesterday's sector was especially close. An Iraqi Police Colonel in charge of Ramadi's 800 IP commanded the operation.
A positive note must be mentioned: there has been a recent fundamental shift in attitude by the local sheiks. They have shown geniune interest in what we are trying to accomplish, and have been given permission to allow their private militias to participate in cleaning up the city of insurgents---time will unveil whether this new change will be effective. The question that always beckons is this: Who do we trust, and where do their true interests lie?

Last night, I just so happened to meet Jim Spiri, a freelance photojournalist with NPR. He was the only journalist covering the operation, and needed some help transferring his digital recorder files to a jumpdrive. I was in the right place at the right time with my laptop, and we spent the evening talking about Ramadi and the region in general. He was a fantastically interesting man with quite the life story, and also shared all of the pictures he took over the past two days including convoying in from Taquaduum, securing parts of Ramadi, a Ramadi city council meeting, buying and giving away fresh fruits and foods to local needy from the Souk (shopping area), and following the Camp Ramadi Civil Affairs personnel on "winning hearts and minds" details throughout the immediate area surrounding Ramadi.

Wednesday, March 28, 2007

Ar Ramadi

Flew to Ar Ramadi last night via CH-53 with everything I own. The flight was uneventful (perfect), and we got settled into some temporary barracks around 2 AM.
We are supplementing a small trauma surgery unit that has been here almost a month. They consist of a surgeon, two other en-route care/trauma nurses, anesthesiologist, and two OR techs. With our orthopeadic team, we add an orthopeadic surgeon, OR nurse (D squared), anesthesiologist, and myself. The team here is small and works well together, and they are happy to get the assistance. We are working with 3 ID 3rd BSB Army medical.
Well, not a lot of time of course. Much more to follow soon!

LT Carl Goforth
CLB-6 (surgical)
Unit 73871
FPO, AE 09509-3871

Desert Flier....

Sunday, March 25, 2007

Ar-Ramadi bound!

Well, I knew I wasn't going to be without a job for long. Actually, we found ourselves gainfully employed the past week cleaning the old hospital and packing up the entire contents. Right down to the last lap sponge!
We used the existing airbase hospital for our operations (the Army built a brand new freestanding modular hospital 50 yards away), and in the basement (affectionately known as the dungeon) are a long series of interconnecting tunnels and secret passageways.....the side entrance is sealed off, but if it was open, I would be able to travel to different parts of the base without ever stepping foot on ground. We were using some of the old entrances for storerooms for our hospital supplies--and we found storerooms we didn't even know we had! When we did turnover with the previous group, apparently they forgot to tell us about all of the supply spaces--and we had to count and account for every piece of medical equipment and/or consumable in our possession! So to make a long story a little shorter, we spent a solid five days accounting for everything we had, hauling every bit of it out of the dungeon to be packed into an endless sea of crates and pallets to be shipped off to another base for future use. No need to go to the gym to find a workout.
Saturday, we squeezed in an Officer vs. Enlisted softball tournament. There was a lot of creative trash talking before the games (we each had two teams) and apparently some bets were made--the losers get their heads shaved by the winners. The officers now are sporting temporary chromedomes--perfect for the desert heat! I have a lot of new pictures to post, and hope to get them on Picasa ASAP.

Tomorrow I fly to Ramadi with a small orthopeadic/trauma "package" consisting of an Ortho physician, OR nurse, OR tech, and myself. We plan to stay in Ramadi for the remainder of the deployment--Ramadi is 1) Urban 2) A direct route from Syria to Baghdad and 3) Busy--we are being told that we are badly needed. I pray the good Lord will continue to guide my hands and feet--there's a lot more work to be done....

New address:
LT Carl Goforth
C Co. 3rd BSB
Camp Ramadi
APO, AE 09396

Many thanks to all those who have sent cards and care packages. And thank you still to those who sent goggles to the swimming pool here at Al Asad. Your acts of kindness touch many that you will never know, yet are actively struggling day and night to protect and fight for what we all believe in......
Signing off until Ar-Ramadi!

Sunday, March 18, 2007

Northwest Herald Article

Many things happening right now:

The Army is having their ribbon cutting ceremony this morning. At noon, they are opening their doors for business. So we are close to having Level III medical capability in Anbar Province.

Our shock/trauma team threw a huge BBQ party last night with the Army staff to celebrate the transition and how well we have been working together. Trust me when I say that getting over inter-service rivalries is not an easy thing to's all about building community.....

There is an article in the Chicagoland Northwest Herald about my father, Carroll, and how he keeps up with my experiences through the blog. I will try to post a link either in this entry or added to my links on the sidebar.

All this, and we still manage to run our shock/trauma unit waiting for the Army to open. We currently have several Iraqi patients that still need treatment and care from IED blast wounds. Our focus continues to be on care rendered "par excellence" despite all the day to day distractors.

Thursday, March 15, 2007

Military medicine in the face of mounting casualties

Walter Reed staff still strong:
With all of the scandal and drama going on at Walter Reed Army Medical Center, it seems to me that many people may forget the soldiers who work there. I was stationed at WRAMC for almost four years and, while I never worked in the main hospital, I got to know many soldiers who did. It has to be difficult for them to rise above all the controversy, but I know they are doing so.
The problems at Walter Reed are not new. However, the problems are not with the wonderful doctors, nurses and enlisted soldiers who get up every morning (or night) to care for our wounded warriors. It’s easy for the American public and even other servicemembers to write off military health care as the worst on Earth, and these stories about WRAMC make it even easier. But I feel obligated to point out that a hospital is much more than a building.
It’s more about people helping people. This concept was demonstrated to great effect by Patch Adams. And, while the facilities at Walter Reed may be run down, the medical staff there certainly is not. That is why they call Walter Reed the premier medical treatment facility in the Department of Defense. Keep up the good work, guys.
Sgt. Benjamin T. Shutt
Camp Hovey, South Korea

Of note: Walter Reed is on the BRAC list for closure. I wonder how much was actually the commanding officer's negligence compared to a general lack of funding. Other than projects that are already ongoing at the time, once a base is slated for closure, that usually means no new contracts for maintenance and/or upgrades. As a military nurse that has worked in a variety of conditions while deployed, I know firsthand what it takes to do more with less.....and I am certain that the staff at Walter Reed have been doing an outstanding job considering the odds stacked against them: eroding facilities, mounting casualties from the war, and staffing shortages from deployments.
Since the start of the war, 7,005 patients wounded in combat have required medical air transport back to Germany or the U.S. The total number of patients requiring transport back to the U.S. since 2003 is 32,544. The figures aren't staggering compared to WWII, but are high enough to be impressive and put a heavy strain on a system that is designed for peacetime patient volumes. After three years of war, we find ourselves all a little surprised at how little progress we have made (think: backwards). The staff at Walter Reed is caught in the middle, and I'm sure it breaks their heart to see their facility dragged thru the mud endlessly over an issue that is beyond their control.

You have enemies? Good. That means you've stood up for something, sometime in your life. Winston Churchill

A hillbilly's letter to Stars and Stripes

A plea to Iraqis
I am an ordinary American citizen known as a hillbilly, not a redneck. There is a difference: A redneck wears his grandma’s Thanksgiving silver platter as a belt buckle and a hillbilly uses his Grandma’s fine imitation crystal glasses, aka Mason jars, for multiple purposes.
I have been in Iraq for 15 months, and I have flown home a couple of times.
[To the] Iraqis: The view of your land from above is beautiful, left me speechless. Then all of that beauty I was seeing is erased by the stories I have read of all the blood that has covered your land. Whether you are Sunnis, Shiites or Kurds, if you could board a plane and see the beauty of your country from above, I believe you would try harder to come together as a nation. I have been told the Sunnis and Shiites have been at war for thousands of years. It would seem, probably easier said than done, that those differences could be set aside in order for your elected government to get your country on its own.
If you keep killing each other at the rate you are, the only Iraqis who are going to be left are the ones living in other countries.
If I were an Iranian or Syrian military adviser, I would be home relaxing, just waiting for a call to let me know “It’s time to move into Iraq, the Iraqis have successfully killed each other off.”
Doesn’t being an Iraqi mean anything to you, or is being a Sunni or Shiite more important than being an Iraqi and having your own country?
Please attempt to make me understand what appears to be your country’s demise.

David H. Thompson Jr.
Camp Anaconda, Iraq

Other than a few technical errors (Islam is only 1400 years old), David isn't too far from the truth....talking to the Iraqis that work on base quickly reveals their frustration with the different sects in Iraq turning against each other. Sunni Muslims used to be in power (Saddam was Sunni), but are the Country's minority. Shiites now have power in the Iraqi government, but it seems the balance of power between the different groups of Muslims in Iraq is something they just can't least not anytime soon.

Army's newest Level III Hospital

Associated Press: The opening ceremony of a new military hospital operated by the 399th Combat Support Hospital (CSH) will take place at 10 a.m., Monday, March 19, 2007, in Al Asad.
This hospital is the first military hospital to be built in the Al Anbar Province. Previous military hospital buildings in that region pre-existed. It will be the primary medical support hospital for the Marine Expeditionary Force, Coalition and Iraqi Forces, including the Iraqi Police, in the Al Anbar province.
The 399th CSH reports directly to TF3 MEDCOM commanded by Maj. Gen. Ronald D. Silverman. TF3 MEDCOM is composed of more than 30 medical units and around 3,000 Soldiers. It is responsible for all medical care for service members throughout the Iraqi theater of operations. TF3 MEDCOM capabilities include combat support hospitals and includes an Air Force theater hospital, multifunctional medical battalions, pathology, dental, combat stress, veterinarian medicine and preventative medicine. TF3 MEDCOM headquarters is based out of Forest Park, Ga.
Forty percent of U.S. casualties come from the Al Anbar Province. The primary benefit of having this hospital in the Al Anbar province is that it will reduce the amount of time before Marines, Coalition and Iraqi Armed Forces receive level III (Surgical and Stabilization) medical care in the region.
The Al Asad hospital will also feature a women's clinic, outpatient specialty clinics, primary sick call, community health, mental health, occupational therapy/physical therapy and ancillary services such as lab, blood bank, X-ray/CT scan and nutritional care.
Other important special care that the hospital will provide include critical nursing care, intermediate care, emergency medicine, trauma surgery, orthopedic surgery, family practice, internal medicine, OB/GYN, pediatrics, psychology, radiology, pulmonology, cardiology, general surgery, vascular surgery, hand surgery, oral/maxo-facial surgery, anesthesia, nutrition and outpatient follow-up care.
The 399th CSH is an Army Reserve unit with its headquarters in Taunton, Mass., and commanded by Col. Bryan Kelly. The top enlisted Soldier in the unit is Command Sgt. Maj. Mitchell Delvalle. The unit is currently staffed with Soldiers from 39 different states and is a multi-composition unit of both Active and Reserve Soldiers. The 399th CSH operates two hospitals; the other being in Tikrit, Iraq

The above article came out today about the Army's 399th Combat Support Hospital. They are opening up on Monday. 40% of Iraq's casualties come from the Arbar Province? I didn't even know that! I think I just discovered my lack of sleep problem....

Thanks to all who quickly offered to send swim goggles. It will go to a very good use. Response has been great, and I think around 15-20 pairs will be shipped. Here is the address to send them:
Cameo Lawrence
KBR Site B-1
Unit 73348
FPO, AE 09333-3348

Tuesday, March 13, 2007

Blast injury update

The lone surviving child from the IED blast last week came back thru our hospital yesterday. He and his father stopped thru from Balad Hospital back to his hometown, Haditha. His entire back and multiple posterior neck/head wounds are stapled. All are healing nicely. He may not have any physical scars after all is said and done with; lets pray the emotional scars are light and quickly adjusted to.
We also had more patients yesterday after an IED blast. One had to be flown to a Level III hospital after an ex-lap and bilateral tib/fib ex-fix. The rest were discharged back to their unit after overnight observation. We have started flying the Army flight nurses with us so they can see the different facilities we can MEDVAC to. Guess it's another sign that the "changing of the guard" will take place soon. Gee, and I just got here....
Other than that, I toured the Army's new Level III hospital today. They still have much preparation left to do. But the facility itself looks great: 12 bed fully capable ICU, and a 20 acute care ward. They plan to have 2 CT scanners (they have one right now, but it needs parts...a lot of parts). Looks like I get to stay a few weeks longer, but still going day to day with a big question mark over my head.

One small request: Would anyone be willing to send out swim goggles? The pool staff here have been incredible, and they are providing a much needed respite to all those at Al Asad. However, they are down to two pair of swim goggles, and are in desperate need of more.

Sunday, March 11, 2007

God's deeper understanding

As I strive to understand the deeper nature of Islam, I will continue to post entries in this vein. I have the priveledged opportunity to have conversations with the Iraqi staff here at the hospital.
Our interpreter is from Baghdad, has a cool alias (Mr. Allen), and plays a crucial role in our ability to communicate with the Iraqi nationals that come thru our doors. He has a deep love and passion for his Country--and his heart is set on a peaceful Iraq. I have gained a much deeper appreciation and affection for the Iraqi people since arriving and going to work. There's nothing like first hand experience to add to wisdom and gain true perspective.
Other than Mecca and Medina, Baghdad has been the cultural center of Islam for most of it's history. The Caliphate (spiritual heart of Islam) was located in Baghdad for over half a millenium. I can attest to the fact that Mr. Allen is torn by what is happening in his Country; he has a family and future generations that hang in the balance....
Vanessa, a great friend from my Marine Corps. days, helped me gain some perspective into God's workings both in Iraq and the world. I'm pasting her email in reference to a book she read about Islam in the past year:
"It's by Christian authors and they gave the history of Islam, ET., one thing I remember them saying quite vividly is that Mohammad prophesied that they would conquer the world, religiously speaking,--and--they are behind schedule at this point and desperate to bring that prophesy to fruition! Thus, the brutal non-stop violence. Thankfully, God in His wisdom has them fight amongst themselves as this slows their progress, sort of like the building of the Tower of Babel! Because they are divided into Shiites/Sunni's and other splinter groups that can't agree with one another, their hampered somewhat in that quest of conquering the world."

Thanks Nessa for keeping me in God's perspective!

Friday, March 9, 2007

Past few days-quiet. A welcome reprieve from the storm.

I've been spending my downtime reading The Crisis of Islam by Bernard Lewis. He mentions some interesting facts about Bid Laden's comments before 9/11. Muslims are, for the most part, acutely aware of their history more than Americans (this is a vague generality, of course). They rarely identify themselves by geographical location as we do, instead refering to geneology.
I mention this, because Osama Bin Laden declared a call to Jihad based on "what has taken place over 80 years ago." Asking any American at that time what the reference was would have resulted in an inability to answer. But Muslims are very aware of the events early in the 20th century: The downfall of the Ottoman Empire in Constantipole. In 1918, the British empire defeated the last Caliphate, leading to a de-centralized Islamic faith. And after three centuries of weakening Muslim influence and stongholds, Christdom and the Western World in general prevailed.
And now the Western World finds itself in what we would like to call a War on Terror. Undoubtedly, we stive to have Muslims on our side to fight a common enemy, the terrorist. But so far, we have been unsuccessful.....and have been losing ground the last few years instead of gaining.
We need to ask ourselves if the Muslim majority is really with us, or does the seemingly sympathetic view of the foreign fighters and Jihadists reflect their true feelings? I feel I am qualified to possibly add one informed comment on Iraq, and the Anbar Province in particular: The U.S. is struggling to police a sectarian civil war.......we are absolutely caught in a wedge that seems impossible to get out of. It wasn't our original intent, but is the paradox we currently find ourselves in.

Tuesday, March 6, 2007

Our dangerous dance

Update: the patient we tried so hard to save quickly died after arriving at Baghdad hospital. He's in a much better place than we are, to be sure.

This brings me to this post's topic: Resource Management. The team has spent a lot of time talking about how to manage trauma over the past few weeks. Taking care of patients in this austere environment is much different than treating the same patient in the United is always a consideration, but out here supplies become downright precious.

Besides dealing with trauma and loss, the next hardest thing we have to face out here is the judicious management of resources.....

We just want to do the right thing: we are trained to save the life....and giving up is the last thing to cross our mind--ever. But we have had some heavy debates over the past few days, and had to set some unfortunate boundaries and limits. When we activate the walking blood bank, we are taking potential future donors out of the picture for two months....activating it twice in one day for the same patient is unheard of. One false move on our part, and a future blast or gunshot victim with very treatable injuries may die weeks from now because of a futile decision we make today.

Deciding who gets the resources and who doesn't forces choices on us that quite frankly we just don't want to has deep and lasting ramifications for a trauma team that just wants to "do good", but especially for the patients and their families and friends back home.......the fact that every decision we make out here has consequences one way or the other is constantly on our thoughts.

Monday, March 5, 2007

Carry on, Old Glory

Pictured in front of our barracks is Jeff, an old acquaintance of mine from Portsmouth Naval Hospital. He's an orthopedic surgeon, and was part of the trauma team we just replaced.

Jeff was the barracks officer, and worked hard at making some improvements, including the addition of a flag pole and a flood light to fly our colors 24/7. I have taken on the responsibility of displaying Old Glory from Jeff......and it's been another welcome diversion from shock/trauma.
The flood light wasn't working when I took over the job, and Jeff and I got that fixed the day before he took the freedom bird home. That night, a wicked sand storm kicked up, and broke my flood light within two hours.....back to square one. I got it fixed again two days far, so good.

Abram's oasis

Al Asad is located just a few short clicks from the Euphrates River about 180 kilometers due West from Baghdad. This base is built on a historically biblical site.......the local population has maintained for thousands of years that Abram, Sarai, and Lot stopped here and camped a short time while travelling from Ur to Haran. This spot is so revered, that it is one of the reasons Saddam Hussein built his premier airbase here. It is well known that he spent a lot of time on this base, and used it to train Iraqi Olymic teams alongside the military.
The oasis is tucked away on a protected area of the base, and is only a two mile run from the barracks. Standing here felt surreal.....what a priviledge to have somewhere quiet to retreat to from time to time that is sacred to Christians, Muslims, and Jewish faiths alike.
The picture can only capture a fraction of how beautiful this spot is.....I can't help but be struck by the beauty of the desert here........the date grove surrounding the oasis is lush, full of color, and bursting with life.

Sunday, March 4, 2007

This is how we roll

My day typically starts in the afternoon, and carries on until the job is done. Our first patient arrived around 3 PM: multiple penetrating trauma from IED blast. By the time we got him off the helo and scrambled to shock/trauma, he was unresponsive......and pulseless. Our first clamshell (cracking the chest open to access great vessels and the heart quickly) of the day....and it was futile.
6 PM: We put the call out for all medical personnel-mass casualty inbound in 15 minutes! Two helos land simultaneously with four patients. Does anyone have to guess IED's at this point? Two more clamshells and 20 minutes later; two more fallen angels. My patient was devestated, but alive. Multiple penetrating trauma to his abdomen with fragments blown out his back.....legs flopping around from shattered femurs. His left hand? Nothing left. He came in initally responsive, and the surgeons wisked him first to surgery within 10 minutes (we already completely exposed, lined (large bore IV's) him, and intubated him within 2-3 minutes). Three hours later, and we had initiated the walking blood bank not once...but twice. For those in the know, I give you the following: He initially got all the packed RBC's we had (10 units). Following that, he received an additional 36 units of whole blood (this is not a typo: 46 total units of blood). We also gave two doses of factor VII (rapid acting clotting factor). In no way can I describe how tenuously he clung to life......our flight nurse just got back from taking the patient to Balad, and said he never worked so hard to keep a patient alive in his life..........
It's 4 AM and winding down. I'll be up at 7 AM for laundry turn-in (of all things). Formation at 8 AM for weapons and flak/kevlar accountability. Then a few hours after that: we roll all over again. Shock/Trauma goes back to work....
Can I just say that nothing, I repeat nothing, would have fully prepared me for this. The chaos, the mayhem, the disorientation of so much devastation pouring in with such regularity.


Luke 14: One Sabbath, when Jesus went to eat in the house of a prominent Pharisee, he was watched carefully. Placed in front of him was an ill man. Jesus asked "Is it lawful to heal on the Sabbath or not?" But they remained silent. Jesus healed the man, then asked "If one of you has a son or an ox that falls into a well on the Sabbath, will you not immediately pull him out?" And they had nothing to say. To paraphrase Jesus' message of Luke 14, He again caught the Pharisees in a paradox.....and blasted and exposed how their strict interpretation of Sabbath and rules couldn't possibly be adhered anyone.
I heard a sermon once on Luke 14, and I quote the pastor saying "religion is one of the most dangerous things in this entire world." He started with this, and immediately had my full attention. I ask you to think about that statement....does it give you the same pause it gave me? His message: religion can be consumed with (and hindered by) sacrament, ritual, traditions, and rules. Now I ask you to think about how religion can be the most dangerous aspect of all mankind. This is when I came to the realization that religion is different than faith. Simultaneously intertwined....yet in a way also exclusive of each other.
I thought about this sermon and Luke 14 yesterday in the middle of trying to save a young school boy's life. The boys took a shortcut home from school, and it just so happened to be a common convoy route......they weren't so lucky. Four died instantly before we could get to them. Two made it to shock/trauma alive. Despite cracking open his chest, we lost another precious child in our arms. And it all makes me wonder why? In what name do the insurgents operate by? And I just keep thinking of Luke 14.....and how religion is playing a role in tearing this Country apart..........because it sure isn't the shared faith that we believe in the same loving God.

Friday, March 2, 2007

Imminent Move

Getting what seems to be a rare chance to add an entry. The hospital has been busy, and the en route care nurses are flying every day. There are five of us, and we take turns being "on call" for 48 hours. It isn't my turn to fly again until next week. Those that are not on standby to fly staff the shock/trauma bay and recovery/ward. When trauma comes in, we get a heads up, and usually it's an "all hands" effort. Every spare pair of hands is needed.
The sad reality is that there are IED blasts every day. I can't go into details due to security concerns, but we have unfortunatly received some high level patients recently.....these men continue to dedicate their lives to the security and wellbeing of Iraqis at the expense of their own health. Inspiring and humbling to all the staff. We are taking in patients every day and the hospital is humming with activity. Everyone is doing a fantastic job, and we are gelling together as a team very quickly.
Also, the Army has almost competed a Level III hospital (we are a level II....less diagnostic capability) right next door to us. They plan to be fully operational soon, and this will shut us down. The plan is to re-distribute us somewhere else in-theatre to "beef up" other Level II camps. Right now, my frontrunners are Ramadi or Falluja, but it's all just a big question mark right now.
Other than working, I have been catching up on my sleep and trying to keep myself healthy. The past few days have been rough, and I've been feeling a little under the weather. Hope to bounce back soon.......

I have updated the photo gallery and made some additions if you haven't taken a look in the past few days.
Also, I always make a little time to read the comments (thank you all!) but may not have time to address everyone individually on the blog itself. I have much better access to my military email account. Please drop a line when you get a chance......especially if you have questions about a post, or just want to say hello.