They shall grow not old, as we that are left grow old:
Age shall not weary them, nor the years condemn.
At the going down of the sun and in the morning
We will remember them.

The Coming of the Ship

Almustafa, the chosen and the beloved, who was a dawn unto his own day, had waited twelve years in the city of Orphalese for his ship that was to return and bear him back to the isle of his birth.
      And in the twelfth year, on the seventh day of Ielool, the month of reaping, he climbed the hill without the city walls and looked seaward; and he beheld the ship coming with the mist.
      Then the gates of his heart were flung open, and his joy flew far over the sea. And he closed his eyes and prayed in the silences of his soul.
      But he descended the hill, a sadness came upon him, and he thought in his heart: How shall I go in peace and without sorrow? Nay, not without a wound in the spirit shall I leave this city.
      Long were the days of pain I have spent within its walls, and long were the nights of aloneness; and who can depart from his pain and his aloneness without regret?
      Too many fragments of the spirit have I scattered in these streets, and too many are the children of my longing that walk naked among these hills, and I cannot withdraw from them without a burden and an ache.
      It is not a garment I cast off this day, but a skin that I tear with my own hands. Nor is it a thought I leave behind me, but a heart made sweet with hunger and with thirst….

The PROPHET, by Kahlil Gibran

Bastion Role 3

Bastion Role 3 Hospital. When we were doing our WTP as we were heading out we had one of those touchy feely sessions and one of the questions that was asked was how would you rate your deployment on a scale of 1-10.  There were a lot of 5s and 6s, some 7 and eights but when it came to me I said without hesitation: 10/10. All the badness of the deployment: away from home, family, and the ugliness of war, couldn’t take away from what was done at BR3 and being able to be part of that experience. 

There was and still is a lot of criticism of how things were done at Bastion, mostly by the other American MTFs (Medical Treatment Facilities) in Afghanistan.  Mostly this was centered around “ oh that must be the way the British do it”, and especially the way we handled the multiple lower extremity amputation from IED blasts.  In the 7 months that I was there we saw thousands of trauma casualties and others and did a phenomenal number of operative cases, transfusing thousands of units of blood products. I said in one of my earlier posts that some called BR3 the busiest trauma center in the world.  In my time there, that was probably a true statement. We did close to 300 IED amputation casualties which amounted to probably well over 700 amputated limbs:  clearly the largest cohort of any MTF in the world.   In a time frame before me and during my time, a best practice approach was developed for the handling of these casualties which yielded results that were as good as or better than any other facility and with reduced blood loss.  Perhaps rather than criticize BR3, the other MTFs should look on how things were done there.  This was all done in an environment where no one really had any personal agendas. It was just a group of people with one common goal: BEST CARE.

This brings me to the real reason it was the experience it was.  I took over 2000 pictures while I was at Bastion and a sampling of the results is shown below.  The theme I think is evident: An extraordinary place doing extra ordinary work by a group of amazing people: A 10 out of 10.

The Gibleteers

I know I have talked a little about the "3 Gibleteers" but not in a way that relates the true meaning of this group of 3.  Given the nickname by a British Orthopod (I think affectionately) it comprised myself and the two other general surgeons of the 4608.  Myself (middle), Chris on left and John on the right, and between the 3 greater than 150 years of experience (ouch that sounds so bad). I got to spend the greater part of 9 months with these two and it was truly an honor to serve with them.
John was the steadfast of the group, and although not a trauma surgeon, he used his experience to become one of the most solid surgeon at Bastion. Even under the worst circumstances it was  great to be with John at the OR table. 
Chris I have talked about: my Battle Buddy and the person who seemed to keep me centered.  He could sense when I would head towards one of my moods and just never allowed me to go there.  We were "surgical paired" for a good portion of the deployment and I couldn't have asked for a better partner at the OR table. 
It will be hard to go back home now and not have that experience across the table when operating.  It is one of those rare adult events to be able to develop these close bonds.  I am thankful that I could do that this late in my life.

In All This Rain

(written on plane ride from Kuwait to US and home)

Sitting on a plane heading home I am having trouble trying to put this whole experience into perspective.  A large part of the experience was horrific. It was and is a brutal war.  We all will somehow have to deal with that part and come to terms with it.  There are however, much more important images and memories that already are solidifying the experience in a more positive way.  The one that will stand out for me and I think for many of the caregivers at Bastion R3, is the treatment of the casualties and the positive impact we all had on their lives.  It was definitely true for the Afghan local nationals, but even more so for the wounded and injured Brits and US Marines; especially for us, the Navy contingent here, the US Marines.  In my 20- years of trauma care I have gotten somewhat use to seeing and dealing with civilian trauma; still the children and innocent  civilian casualties were difficult but it was  the British and US Marine injured combatants  which raised the situation to a whole different level. 

There is a general consensus that goes around the medical field that you should not get attached emotionally to your patient.  This is a canard, a lie.  It is simply an excuse not to give 110% to the care of the patient.  We got to see the US Marines and the British soldiers in their most noble state, and witness this incredible sacrifice and honorable commitment.  It made you feel that you could not fail these noble souls.  Everyone at Bastion returned that commitment. You cannot have witnessed their sacrifice and not be changed.

(Picture is of note written by 3/5 Commander to our Navy OIC when presenting their Battalion with US flag flown over Bastion)

In Perspective: The 4608

There will be many memories, good and bad from this deployment. But clearly the one that probablly will stand out as being one of the most positive is our unit NE # 4608.  It is hard to put into words and sum up The 4608. We were in many ways the orphans of Afghanastan.  What is clear though is the pretty much perfect performance of every single member regardless of where they were.  From the start at Ft Dix Training, to EMEDS, to Afghanistan the unit set the bar for performance and mission accomplishment.  It was/is truly an amazing group. It was so great to be part of it, and will be something I will always remember. The picture shows our 4608 flag which the Corpsman made and then everyone signed and I will keep.  As it is a symbol of this group, it will be something that will remind me off all the good of this deployment.

WTP = Warrior Transition Program

We are just about finishing our WTP.  It is most great to have the entire unit back together again and we have talked a lot about our different experiences.  The WTP program itself is pretty neat...kind of nice base (but not home) and a bunch of R&R as we set to head home. 

My New MRAP

So I don't know whether you remember a post quite awhile ago about my MRAP I was taking home.  Well I decided to trade it in on a new model which was availabel at KAF!!!..more a family type, seats 8 in fact....the best part about this one is a new option only available this year: An automatic targeting weapons system in the turret...it is all the rage. I opted only for the 30 CAL model not the 50 CAL model since that seemed a little too much.
This will be so great in the BRONX!!!!!

The Journey Home: Last Stop!

Finally in Kuwait after like a 30+ hour military journey. It was so bad it was actually comical, having to lug bags all over the middle east about 100 times, but we are finally here on the last on the last leg of journey home. Pic is of tired crew on C130 on last leg to Kuwait. As usual through all the crap they performed great! The whole DET and especially the Corpsman have set the bar everywhere we have been.

 

The 4608: Back Together!

Well we are all here back in KAF (what a zoo) and for the first time all of the 4608 is back together and on our way home and it feels great to see everyone again!!!!  The pic is of all our corpsman united for the first time in 6+ months

The 4608 at Bastion

Our unit the 4608 has been divided up since we arrived at Bastion.  We are about to all get back together as we head home!  This is our group here at Bastion.  It was a very intense and hard time here for all of us but everyone did such amazing work in such a professional way.  It truly was an honor to serve with them.

The 3 Gibletteers

The 3 surgeons from my unit the 4608 also know as the 3 Gibletteers, getting ready to RIP OUT hopefully VERY soon.

A Last British Vigil

Attended what hopfully will be my last British Vigil here at Bastion for 3 British Soldiers.  It has been a very bad week for the British, and also for the USMC and the Gorgians. It would be nice if this were the last vigil period. But I think that won't be the case
After 7 months it is very much time for our DET to head home.

Heroic Efforts for a Hero

Again kind of violating my basic blog rule to talk about one particular casualty but it was the one mentioned in the previous post and it is such an extraordinary set of events for a hero and has played so on everyone's emotions here.  Its hard to put in this blog since it would not be right to put down the details, but as stated just such an amazing effort to save this one hero, from the Medivac in the field to the FOB he first went to, to the unbelievable efforts here at Bastion by everyone, to the Special Critical Care Team that flew in from Germany to get him back home. I know for us here at Bastion it was so much more than just giving the best medical care possible. It was an outpouring of love and caring and prayers: a total commitment. At the end of our tour this really crystallized why we are here, and of our young heroes that get injured, but also of the medical heroes here at Bastion and all over Afghanistan that give their all to provide the best care that these injured deserve. In the midst of all the devastation to see the outpouring of good and caring reaffirms the height of the human spirit.

Bastion R3 in Perspective: BLOOD

About 5 more days and our DET is about to RIP OUT!  Hard to believe it has been about 7 months here. It is hard to put things into perspective but I count myself extremely lucky to have been stationed here.  In the overall scheme of trauma combat care in Afghanistan, this unique hospital has afforded its practitioners the materials and environment to take care of the casualties pretty much as needed, with not really any tacked on "agendas".  In my very limited view of combat care this seems to be a somewhat unique thing.

In the time that  our unit has been here we have taken care of close to 1000 casualties and to put things really into perspective, transfused well over 5000 units of blood products. That blood figure alone is truly amazing when you think about it.  We basically don't have to think about blood, and assume that there always will be basically an unlimited and instantaneous availability of blood products for our wounded.  If one had to put your finger on one thing that stands out and probably allowed us to save more lives it is that fact.  It seems that it is pretty much possible here to keep up with any blood loss when we are operating, giving the surgeons that precious time needed to control the bleeding. We have just treated one ISAF casualty that has gotten over 70 units of prbcs and 70 of FFP in a 36 hour period. What a phenomenal accomplishment for a combat hospital in the middle of an Afghan desert.  And credit goes to the blood bank/lab here and to all the surrounding logistics both US and UK that keeps that supply of blood going. Oh and yes to our walking blood back too.  For the first time we started to run short of blood products (platelets mostly which seems to be the most precious) and word got out and we have had 100s from both UK and US camps come to get tested and get into the "walking pool", just to make sure we never do really run out!

Battle Buddy

So in combat everyone is suppose to have a battle buddy. Kind of someone you are attached to at the "hip" basically keeping an eye on each other, watching their back etc etc.
Well this is kind of my battle buddy, my co-surgeon partner, roommate and well yes...my battle buddy.

Bastion R3 and CT Scanners

Well it is hard to believe but our DET is getting ready to leave so I am thinking of things I haven't covered here. One is definitely the CT Scanners. Two 64 slice CT scanners with fancy software packages. They are very amazing.  The injection protocols are basically set up for multiphase so it is possible to see the "basic stuff" plus pretty much a whole body arteriogram, including run off to the extremities which we need alot. I am going to see if I can pack one of these scanners in my sea bag and take it home.
Pic is of 3D reconstruct and demonstrates another interesting topic: Proximal Vascular Control. Clamps are on the Common Iliac Arteries but the interesting part is how quickly and how well the external and internal iliac arteries reconstitute. This data and pictures is not available any where else in the world, simply because we are the only place that does this control and then CT.

Casualties and a "Tea"

Our hospital here was the proud "recipient" of being chosen as the "sister hospital" for an American Tea 2011.  As you can see in the flyer volunteers (many from my home hospital!) put together at special "Tea" for people and wounded at one of the military hospitals in the US and they choose a sister hospital in combat to also have a "Tea".

We got a TON of boxes and special teas and cookies and set yesterday as our official TEA day at 3pm. A very proper British tradition.  Everything was set to go, our admim were set to distribute the cookies and have tea. The British CO and others were kind of excited (well the are British after all and  afternoon tea seems to be a tradition.) Unfortunately the war didn't want to cooperate. We had a s**tload of casualties come in at around midday and it didn’t stop. I lost count of how many.  But in all the chaos we did have our tea, and maybe it was even better since it was so welcome under such bad conditions. Thanks to ALL that made it happen and made a bad day a little better.
Pics are of everyone having some homemade cookies and tea in the midst of taking care of all the casualties.
First pic below is in ICU (ITU as the Brits call it)...notice the "goodies" set up in forground and taking care of business in the background.

Passing of a Gentle Giant

We had the saddest news yesterday just to add to all the badness around us. One of the orthopedic surgeons that had worked with us not more than 3 months ago collapsed and passed away at home. It has been shocking news to all who knew him and we can't image what his family must be feeling. Our thoughts are with them. He was truly a gentle giant. One of God's better creations! He made us all better people.

Requests Have Their Price

I had a request to post a picture from awhile ago during our rainy season (again seems like another life ago). It was pretty weird as we were walking to Leatherneck seeing this dust and rain storm moving towards us. It was a pretty serious storm too, and a pretty neat picture.

But now come the fun part: the price for the requester is putting up some pics of him (again violating my primary blog rule): our star pediatric surgeon. They are two of my favorite pics of my 1500 or so.....one of his "first" meal at Leatherneck (long story on this one but he was nicknamed "The Special Forces Surgeon" after that episode a title he shares with the esteemed and legendary Capt Tuttle), and the other during pancake day..and yes that is a smiley face

Have amended the post since I forgot to put the most important pic and what he is best at!

.

Another Brit Vigil

We had another vigil for another British Solider killed over here.  It has been a change, since it use to be that many of the US Navy contingent went, but it was pretty much only me going tonight. I have attended all but one since I have been here, missing one because we were operating.  They are always very moving, with the whole of Camp Bastion assembling on the parade ground.  For me I think, it is a time to reflect on all of those that have died or have been badly injured, Americans and Brits. It is very sad and weighs the heart, but somehow it does seem to help.

One More Leaving

One of the things I have not done on this thing is put a lot of posts on the people here mostly to respect privacy but in looking back that may have not been so good, since the people who have been here are such an integral part of the experience.
One of those is Capt Ed! He is one of the Navy ER docs and has been here since Aug of 2010!!!!! He has been a big part of the backbone not only of the Navy unit here but to Bastion R3 as a whole. Had a big sendoff as he is getting to rip out. As always glad to see him head home...but sad to say goodbye.

The 4608: Starting to Wind Down

Ok so as we wind down our deployment I am probably going to start to get real sappy!  It is hard to believe that the 4608...,my unit (that sounds weird)  which is the smaller unit of the Navy contingent here,  is winding down and will be leaving soon! We have been here now over 6 months and by the time we leave it will be 7 months. The unit itself has been split between TK, KAF and Bastion, with the majority coming here.  It has been one of the trials of by deployment to try and lead and keep together all the members of this unit and to see that they are taken care of. Next to taking care of the wounded it is the thing I have worked on the hardest. They all have performed in an such an exemplary way!.I will talk more about them as we work our way home!
This picture is of the whole unit at EMEDS training in Texas before we came out (since we did not do Hospecks).  I am sure to all of us it seems so like another life ago!

SD News Article on Bastion R3

This group has written several articles on the 3/5 Marines as they are stationed at Cmp Pendelton. This one relates to the hospital. I have reprinted prertty much it in its entirety which probably isn't kosher. But what the heck. All rights are reserved to the original site!

The original article is at :

http://www.signonsandiego.com/news/2011/may/14/trauma-surgeons-fight-to-keep-troops-alive/

Trauma surgeons fight to keep troops alive

By Gretel C. Kovach

Saturday, May 14, 2011 at 6 p.m.

Photo by Nelvin C. Cepeda

A British soldier who was wounded from a bomb blast is comforted by the grip of a fellow soldier at the Bastion Hospital in Helmand province Afghanistan.

Photo by Nelvin C. Cepeda

U.S. Navy Cmdr. Angela Earley (center, facing camera) is the lead surgeon, as she and two other doctors operate on an wounded Afghan soldier.

Photo by Nelvin C. Cepeda

A surgeon prepares a wounded soldier's hand for surgery as three orthopedic surgeons work on the soldier's badly injured leg.

CAMP BASTION, Afghanistan — Flags for the international fighting force were flying at half-staff outside the military trauma hospital the morning of our visit, in remembrance of the latest troops killed in the war.
Some die here on the operating tables, despite the best efforts of British and American surgeons. Others succumb to their injuries before arrival. What surprised me, given the horrendous wounds inflicted in combat, is that so many sent to Bastion hospital live.
Quantum leaps in battlefield medicine made during a decade at war have contributed to a more than 90 percent survival rate at the British-run facility, which includes a rotation of U.S. Navy doctors among its international staff. The hospital is on the British base in Helmand province adjoining Camp Leatherneck — headquarters for 20,000 U.S. Marines who make up the bulk of the NATO coalition in southwestern Afghanistan.
Many Camp Pendleton Marines have gotten their last look at Helmand from Bastion hospital, which is the busiest trauma hospital in Afghanistan.
Union-Tribune photographer Nelvin C. Cepeda and I spent the final reporting day of our recent six-week trip to Afghanistan at Bastion hospital. Warm spring weather had ushered in another fighting season, and a dust storm the day before gave insurgents cover to hide homemade bombs.
It turned out to be the hospital’s busiest day in months.
First thing that morning, medical evacuation helicopters flew in four Afghan policemen ripped apart by gunshot wounds, then a British soldier with his leg shredded by a grenade blast.
Wave after wave of patients arrived after that. By the afternoon, their scrubs were soaked in sweat and the night shift nurses had been rousted from bed to help. A Navy doctor dozed off sitting against the wall, stealing a few winks until the thump of rotors or the shout of “five minutes!” signaled the next helicopter load of patients.
I don’t know how the Bastion staff find the stamina to maintain their concentration and composure amid this daily onslaught of gravely wounded men, women and children.
U.S. Navy Cmdr. Angela Earley, who finished her general surgery training in 2002 at San Diego Naval Medical Center, took over in October as officer in charge of a new American team at Bastion. The portly Afghan officer she operated on that morning was lucky.
One bullet shot into his belly and exited without penetrating his guts, while another exploded out the side of his leg. Such girth is “unusual for an Afghan,” Earley said. She cauterized the wound to stop the bleeding, sending a contrail of smoke and the smell of burning flesh wafting toward her huge blue eyes. “It probably saved his life.”
Dr. Mansoor Khan, a British medical resident who helped treat the policeman, said “The trauma you see here is unlike trauma anywhere else. If a military-grade bullet hits bone, it blasts out the other side, destroying everything around it.”
On the neighboring operating table, the British soldier’s mangled leg appeared to my untrained eye to be unsalvageable. Three orthopedic surgeons worked on the leg while a plastic surgeon reconstructed his hand and a clutch of nurses and technicians orbited the periphery.
The commanding officer of the hospital, British Army Col. Mark Pemberton, watched over the controlled chaos of his staff rushing to and fro, the blood sloshing on the floor, the sweet smell of plasma and disinfectants, and the hushed voices under fluorescent lights. “Each day is a herculean effort — impossible injuries, impossible conditions, and yet remarkable results,” he said.
Many of these patients would have died in earlier conflicts, before improvements in body armor, evacuation procedures and combat medicine.
Today, life-saving treatments begin instantly on the front lines. Each Marine carries four tourniquets and knows how to use them. Navy hospital corpsmen, medevac flight personnel and forward surgical teams at battalion aid stations all help resuscitate patients, so that breathing is restored and blood loss stops as soon as possible within the “golden hour” of effective trauma care.
As the U.S. military was ramping up in Afghanistan two years ago, Defense Secretary Robert Gates promised troops stationed there that medical providers would be pushed closer to the point of injury so they could administer critical care within an hour, as they were in Iraq.

Today Pentagon officials say that “golden hour” standard has been achieved in Afghanistan, where patients are transported to advanced stateside military hospitals in as little as three days, versus a month or more on average during the Vietnam War.
At Bastion, fresher blood products administered in a one-to-one ratio to replace lost blood reduce the risk of lung problems associated with using saline. Two powerful 64-slice CT scanners produce three-dimensional images of the organs, bones and vascular system, helping doctors pinpoint the most severe injuries rapidly.
Earley and her American team began their deployment at Bastion in October the same month that Camp Pendleton’s 3rd Battalion, 5th Marine Regiment took command in Sangin, an intensely violent area of Helmand province.
They performed about 60 leg amputations and more than a dozen to the arm, hand or groin in October. “We had trial by fire very quickly,” Earley recalled. “We had to step it up … to get over the shell shock of what we were seeing and try to save these guys’ lives.”
Earley worked in Iraq in 2007 treating Marines, when it wasn’t as common for those with double or triple limb amputations to survive, she said. (Last year, the San Diego Naval Medical Center treated 31 patients who had lost extremities, three times as many as the previous year.)
But the tissue trauma and contamination caused by insurgent bombs in Afghanistan, which result in wounds embedded with mud and bolts used as makeshift shrapnel, is more severe than she encountered in Iraq; and none of the other doctors on the American team had served in either war zone.
For them, the perseverance of the 3/5 Marines despite heavy casualties was heroic inspiration. “It kept us motivated to keep going,” Earley said. “No one should have to lose so many.”
The international medical team was sponging blood off the policeman’s skin when Earley’s beeper sounded with another trauma call. Six more patients were on the way, including several more British soldiers, a U.S. Marine and a child all hit by insurgent bomb blasts.
The Marine rolled off the ambulance had a deep gash in his arm that had been partially stitched. He was keyed up still from the attack, and belligerent. The British soldier Earley evaluated was in a morphine-induced calm. They cut away his blood-soaked uniform and checked for swelling and shrapnel. Afterward, another soldier leaned over the injured trooper, gripping his fist and talking softly to him for a long time.
The exchange was touching, a private moment between two brothers-in-arms that unfolded while the buzz of medical care moved off to more seriously wounded patients.
When staff got word of several injured Afghan civilians who drove over a roadside bomb, they scrambled to form an all female-unit to treat a woman in the group. Last year an Afghan man murdered his wife after she was treated because foreign men touched her, a British nurse said.
They ended up operating on 18 patients that day, for a total of 38 hours of surgery in four operating theatres.
Two killed in action were flown home from “Rose Cottage,” the hospital mortuary, but Bastion medical staff were grateful that the chaplain didn’t have to say a prayer in the operating room that day for a patient who died under their care. “Sometimes I think it’s as much for us as it is for the soul of the person,” Earley said.
Earley and the others kept working past midnight, some until 3 a.m. They amputated the legs of a British soldier that night, and the first trauma alert beeped the next morning at 7:30 a.m. for another double amputation — on an American Marine.
The U.S. medical team at Bastion was fortified during their tour that ended two weeks ago with the knowledge that they saved lives and improved battlefield care each day they served in Afghanistan, when they helped rewrite treatment guidelines.

gretel.kovach@uniontrib.com; (619) 293-1293

Keeping Cool at Bastion R3

Well it is getting closer to summer here and the temperature is rising just a little.

Note the bottom number which is 50.9 and that is Celsius. About 124 deg F in the shade. Oh wait THERE IS NO SHADE IN THE AFGHAN DESERT!

Vanderbilt Dept Surgery Division at Helmand Prov Afghan

Seems like Vanderbilt has taken over the trauma surgery here in Helmand Prov! Turns out the new OIC has recently finished his Trauma/Critical Care Fellowship at Vanderbilt.

Then earlier I got to work with another surgeon who trained and did his residency at Vanderbilt

Jason is on the right, and then of course there is me.  I think Dr. Tarp and Dr. Morris would be proud!!!

On Commandants and Kids

s

We had a visit from the Commandant of the Marine Corps James F. Amos last night. Was a little complicated visit since we were having another Kids Shot in Afghan day and had two young children in the OR with pretty bad GSWs. We did have a pretty injured marine too who he visited. Still as far as 4 stars go, this one is high on my I was glad I meet him list.  But I still rank our meeting with the Commander of the 3/5 higher. Just goes to show you stars don't necessarily mean everything.

Helmand River Fly Tying Club

This has to go along with the Bastion R3 Tennis and Racket Club; the Helmand River Fly Tying Club. Yes I think they are sister clubs. There is a big membership as you can see.  Now all we have to do is figure out how to get to the Helmand River..or maybe not.

The Poppies

Well it has been uncharacteristically not busy here. Something to do with the poppy harvest…hummm…seems that the powers that be want the Taliban to pay the growers for the poppies then take that from the Taliban. The implication I guess that it will get VERY busy once the poppy harvest is over…which unfortunately for our Det will be before we leave.

Interesting there is a poppy field supposedly right outside the wire here. I will try and get a picture of it. It all seems very confusing.

Meanwhile we are kindof resting waiting for the onslaught to start.
The picture above is from the URL below. Very recent articel

http://www.dawn.com/2011/04/25/afghan-farmers-hooked-on-poppies-10-years-on.html

The Camp Bastion Role 3 Cricket and Racquet Club

We went out and played tennis on center court at the Bastion r3 Cricket and Racket Club yesterday. Pretty nice court actually! I am in the far side. Had lines and everything including imaginary net.
Of course we know who won!!!!

Skype Again

Looking over blog there are alot of postings about dogs. Hummmm..........Guess they are pretty special here. Some normaliacy in a very abi-normal enviornment.
Anyway...got up early for now what if a usual Sunday morning thing...walking Skype. He recognizes me now and goes pretty crasy when I go to get him out of his pen. Strong as hell (he is a Beligian Melinois) but a total push over, and just rolls over when you pet him. I REALLY think I am packing him in my seabag when I go home!

Weddings, VIPs, and Explosives

Yesterday was Wedding Day..got to watch the wedding with the Brits...wow!!! lol
Also had visit from a bunch a VIPS which is always lots of fun (not) ..see pic. Also something about suicide bomber explosives etc at Leathreneck...hummm...time to get weapon out of storage i think

The Luckiest Person in Afghanistan

Ok so we have this list: The Luckiest Person in Afghanistan. It has grown pretty big and there are alot of entries on it. However one does stand out.
This one particular person was shot in right side of chest with...yes rifle bullet...it went thru his chest and into his mediastinum. It managed to miss EVERYTHING, heart, great vessels, trachea, esophagus. It came to lie less then 1mm from the aorta!

Bad Days and Tennis and Dog Walking

It has been some very bad days here. Sat was especially bad for the USMC, we had numerous deaths and 3 very badly injured marines come in, and to top the day off had a VIGIL for Capt Lisa Jade Head, a female EOD officer. She did come to Cmp Bastion and then was flow home and died after getting back home to Britain. http://www.bbc.co.uk/news/world-13139980
Sunday we had 8 local nationals come in and yesterday several children with bad injuries from IEDs including two with lower extremity amputations.
But things go on here. Today I got to hit some tennis balls with my "partner" fellow Brit Surgeon on our "clay court"...well actually our Afgan dust court. . And for Easter Sunday several of us got up early and had a "dog walk". Pic is of my British partner surgeon taking a with his "pup". I got to walk Skype again. I wonder if I can pack him in my seabag when I am going home!!!The dogs are great therapy.

HAPPY EASTER!!! and...OUR NEW MOTO

Well I hope everyone at home is having a most excellent Easter with family and friends. It hasn't been a great weekend here; yesterday was really bad and today not so good either. But rather than focus on that I want to introduce our new Camp Bastion Role 3 Hospital Moto: STRENGTH THRU REST!!!!