Tuesday, June 26, 2007

Anbar Waffle House opens for business

A dear friend whipped up a fantastic idea: surgical team waffles! She send out a waffle iron, pancack mix, maple syrup, buttermilk powder, and a can of pumpkin.

All I had to do was "procure" some milk and eggs. Grocery stores, or "Souks" are off-limits. Haven't found any Wa-Wa's or 7-11's yet. No easy task; this took a coalition of the willing and some smooth talking at the chow hall. Worth it. Along with some freshly ground Starbucks, this was the finest "homecooked" meal I've had in months!
Surgical Team says: Thanks Missy!

Sunday, June 24, 2007

Slave to the System

"Dude, you're not on the nine-line!"

"What, your kidding me! I'm going to have to go on this one! Either that, or the patient stays on the deck, and we re-submit another request."

"I already have a monitor." The flight medic yells above the roar of the rotors 20 yards away.

I shrug my shoulders, as if to say "What now?"

The flight medic yanks a thumb with a resigned "get in" to the blacked-out helo silhouetted against the soft glow of green landing lights. I grab my flight bag, run ahead, and jump in. The Army evac team, on my heels, carries my patient up alongside, and I help them guide the litter along the carousel skids.

Patient settled in, and vital signs stable. Struggling to quickly get my 5-point harness on before take off. I wasn't fast enough to get buckled in, but no matter: takeoff was soft as butter. Besides, as soon as we are in the air, I have to hop up and start assessing our casualty.
VBIED attack: I follow my patient from the trauma bay to the operating room, and coordinate getting him to the Baghdad CSH just as Martin, Tim, and RH finish repairing abdominal wounds, a blown out knee, and a gaping right shoulder injury.
Anytime a patient is critically ill, and is either unstable or needs to remain ventilated, a flight nurse goes on the mission. We bring along specialized ventilators and monitors, and unless the flight medic happens to be infinitely familiar with our equipment, can become a complicated mess in flight.
Hence, the need for me to be included on the "nine-line", which is essentially a mission tracker that includes casualty identification, flight route, and crew. If I go on the mission, all coordinating services need to know I am on that helo, similar to any flight manifest throughout the rest of the world. Otherwise, if something happens during the mission, the Tactical Recovery of Aircraft and Personnel (TRAP) team won't have any idea who I am or why I'm near a crash site. Wrong assumptions would put me at high risk. Not to mention if I somehow get separated from the aircraft: they won't know to look for me, if they never knew I was on the mission to begin with. I ended up running into complications, but it wasn't anything worse than getting stranded at another base while trying to figure out how to get back to Ramadi.

The patient did well. Stable for the flight, I busied myself with watching his oxygen status, changing out oxygen tanks, and giving IV fluids and some pain medications. Flight medic taps me on the shoulder and signals "two mikes out". I have just enough time to clamp and store his IV fluids back into the "hot pocket" and check the oxygen tank one more time. Once we touch down, it's too late for housekeeping. We count tasks in seconds, and have precious few to spare. Flashes of light off to my right as our Blackhawk launches countermeasure flares. In all reality, I'm too busy with my patient to care. It registers in the back of my mind "Hmm, wonder why we're launching chaffe?" I hear the pilots and crew chief talking over the "comms", and they don't know why it launched either. Our countermeasure flares can be triggered manually, but are always on sensors, too. The helo computer sensed some sort of heat threat, but none of the crew saw anything. Safe assumption it was just excess heat from a roof vent. Sixty seconds later, and the Blackhawk touches down in Baghdad. We carry the patient to a 4X4 "gator" and drive 25 yards to the ED entrance. Patient care is transferred to the Army ED physician, and the medic and I grab flight equipment and monitors for the dash back to the helo.
Here is where my return to Ramadi gets a monkey wrench thrown into the mix. The Blackhawk crew had no idea they were going to have to go back to Ramadi that night, and were caught unprepared. Visibility was closing in to around 2 miles in Anbar Province, so they broke the bad news to me: I was going to Taquaddum with them, and would have to find my own way back. They offered to drop me off at TQ surgical.

Small consolation...and here's where the "it's not just a job, it's an adventure" part kicks in:
Random thoughts as we were targeted with a volley of RPG fire on our appoach to TQ:
"How long can a Blackhawk hold a hard bank at 90 degrees to the Earth?" as the pilot violently pulled the helo left, right, and left again to avoid being hit.
"Can my heart really go this fast?"
"I can't believe I'm not on the friggin nine-line; they'll have no idea who I am if this thing goes down...$%*! figures!"
Sandwiched in between the flight medic (primary job when not taking care of patients: the pilot's eyes on the left, or port, side of the Blackhawk) and the crew chief (starboard eyes), I'm totally reliant on theirs' and the pilots' skill at evasive maneuvers. I'm not sure what I was doing during that wild forty five seconds, but my thighs were burning sore for three days after this one. If there's a way for humans to actually make diamonds, this has to be one of the fastest methods.
We hauled tail to the TQ flight line, pilots cursing and creating new explitives along the way, Cobra gunship straining to keep up, and were met by the ground crew. Spotlights were hastily set up right on the flight line, and aircrew crawled all over the craft to assess for damage. Lead pilot jumps out and says "Whew! There's one to write home about, Doc!"
Truth be told, I'm getting to the point where I would rather write about how many days (82) I have left...

I spent two days trying to figure out how to get a flight back to Ramadi. It normally takes two or three days minimum to reserve a seat for a flight. For instance, an Assault Support Request (ASR) requires on average a three day wait. So I tried to get on a routine medical run the next night. The "milk" run consists of a few H-46 helicopters that fly patients back to their units every so often. They made two passes through Taquaddum that night. The first time, I was bumped by a patient and their escort going to Balad. "No problem" they said. "We'll get you when we come back later tonight". Around 2 AM, five hours later, they touched down at TQ surgical again. I was on the flight line standing with 100 lbs. worth of flight equipment and monitors waiting for the signal to hop on. Never happened. They briefly stopped, a Marine ran out of the back (he was returning to his unit), and they kept right on rolling through. I was stood up like an ugly prom date as I watched the helo quickly disappear into the ink black sky.

The next night was equally as frustrating, but a little more fruitful: the Army was able to put in an emergency ASR, and told me to be at the Taquaddum flight terminal at 8:30 PM for a 10:30 PM flight. Caught a ride to the terminal and lugged all my crap to the manifest check in. They had no idea who I was, and couldn't find my flight number anywhere. "Sorry, Sir, but you aren't in our system. If you want, you can go to the billeting tent and we can put you on standby." Completely torqued, I started calling everyone and their brother to find out how I got into this mess. I called Charlie Medical and the Ramadi air terminal: no luck. I disappeared from the system. Great. I called the Ramadi air tracker next, and they found an open seat on a Blackhawk later that night, but it was going to the TQ medical pad. Stranded in the wrong place again! I called TQ surgical and asked if anyone could come back out to the terminal and give me a ride. "But we just dropped you off!" an exasperated corspman defeatedly states into the phone.
"Yeah, yeah, I know. Just a slave to the system."

Monday, June 11, 2007

I may be off-line for a few weeks, and hope to return soon. Your support and readership is appreciated........

Friday, June 8, 2007

Meet Suhad

After two surgeries to repair her liver, diaphragm, and stomach, Suhad finally made it back to Charlie Medical last night. She is the girl that was accidentally shot with an AK-47 a few days ago. Her surgical incisions are healing well, and I found her this morning eating breakfast with her brother, Towad, in patient hold. She had follow-up surgery the day after I flew her to Al Asad, and quickly recovered. Within days, she is ready to be united with family.

With no sign of pain or discomfort, she and her brother talk while she plays with some of the toys and stuffed animals donated this morning. We took some pictures, and her brother asked me if I could print some out for them to take home. They both seemed to like the picture printouts more than the toys!

Their stay with us will be short. After lunch, the Iraqi Police will swing by and pick them up to take them back home. We hope that the care they receive and the genuine concern for their well being will leave a lasting positive impression..........