Mark's Afghanistan Adventure

having fun at home

2010-03-22T21:59:00.000-07:00

I apologize that I have been absent from the blog scene for some time. I have been enjoying my past life with family and friends. There really is no more purpose for a blog on Afghanistan (unless of course the military invites me back). I have really enjoyed writing a blog while away. It was somewhat therapuetic and at times enlightening. If I get an itch and feel like I really have something valuable to say on a somewhat routine basis (that is a lot to hope for) then maybe I will start another blog for that purpose. For now I am going to go on blog hiatus and prefer to instead talk to you in person.

Mark

hurry up and wait

2010-03-10T00:36:00.001-08:00

All you previous military will appreciate this titled blog. I am finished with leg three of my journey back home. I had to show up at customs more than 24 hours ago to start my second leg yesterday. From there we are marched into a room (with chairs this time) to wait for four hours which of course becomes more like eight with the obligatory delays. We finally took off after standing in the rain wiating to board and landed in Germany 8 hours later. Another three hours of waiting. Though this time we were allowed to partake in a German beer if deisred. I desired. I also wolfed down a couple of their bratwurst. Next we flew 7 more hours to Bangor, Maine where I am currently. We were supposed to have a 2 hour layover which is now announced to be 4-7 hours. It is 3 AM local time, however, there were still some retirees here to shake our hand when we stepped off the plan and they opened the coffee shop for some warm drink and food. God bless them!
Okay, next time I blog (if ever again) it will be from my home turf in San Diego. Thanks again for all the support these past few months.
Mark

pete's place

2010-03-08T05:04:00.000-08:00

Here in Manas we are allowed to have 2 beers in a 24 hour period if our command is game. Well everyone is interested in having that cold one after 6 months in the desert. Problem is, how do you assure that everyone is safe and behaving. Well, you have the officers and staff NCOs do shifts in the pub to make sure everyone is good. So that is where I am this minute. The pictures I just published are already obsolete as about 30 military members just walked through the door. The music is blaring, the smoke arising and the beer is flowing. I can't wait until my 2 hour shift is done so I can partake.

pedicure

2010-03-07T19:41:00.000-08:00

Many of you would say that getting a pedicure is not manly, and you're right. That being the case, I got a pedicure yesterday. There are few reasons why:
1) I have never had a pedicure before
2) There is very limited activities to do while in Manas, Kyrgystan
3) It was a bargain at $10
Let me take you through my experience. First I got my pleasant foot bath. After the clipping and trimming of my nails and cuticles she broke out this razor blade contraption. She grabs my foot and tells me to be steady. I give a quizical look? She explains that she is not intending to shave my toe hair (yeah I got some, so what?), but instead is planning on paring down the skin on the bottom of my foot. I asked if it was ticklish and is that why she wants me to be still so as to not cut me. She replies, yes it is ticklish and that she is not worried for my foot, but for cutting her hand if I were to withdraw my foot. Now that we scrapped away all the old tissue she takes out a paddle, she says emory, and proceeds to scrap away on the sole of my foot. At last she was done and the best part came. I got a foot rubdown with moisterizer. Now that made the whole experience right there.
I know you are all asking yourselves this question now. The answer is no. I did not get them painted.

You could start an IV on that foot!

first leg home

2010-03-06T23:28:00.001-08:00

So, yesterday was a looonnggg day. We loaded up ourselves on a bus at 2200 (10 PM) to go to the terminal for a flight out of Afghanistan at 0200. Things did not look good from the beginning as we encountered the worst sand storm of our deployment that evening. It was a complete brownout. However, it rained soon therafter which abated the dust.

At around 0100 in the morning we were told that our flight was delayed an hour which became 2 hours which became 13 hours. All the while we had to stay pretty much in this huge hanger. None of us planned for this and thus none of us had our warmest clothes on, sleeping bags or pillows. We had to make due sleeping on the plywood floor.

The good news is that we finally hoped on board a C-130 and took the 2.5 hour journey to Manas air field in Kyrgystan. It is in Bishkek, here is a link .... http://en.wikipedia.org/wiki/Bishtek. By the time we did all the formations, gear checks, weapons check, briefs....it was near midnight local time. However, I was still on an adrenaline high so I went to the only place on base that serves alcohol to get me a little sedation in a bottle. We are limited to 2 beers in a 24 hour period for safety reasons. I have not had a beer in 6 months and for 2 bucks I got this 16 ounce beer called 9. Why is it called 9 you ask, because it is 8.6% alcohol and they round up. So I drank maybe 40% of the beer to be on the safe side and it did the trick. I woke up feeling almost like a minor hangover between the lack of sleep over past 2 days and my out of shape liver being exposed to alcohol again.

So anyhow, things are better here in Manas. I got a big gym, a big chow hall with midrats (that's midnight rations for all you non-military folk) and my room has wireless internet. I will be back in the States next week. See you all very soon.

Air traffic control.

Trying to get comfy.

Staging area for flight.

Marines can sleep anywhere.

hectic days

2010-03-04T00:49:00.001-08:00

These have been hectic days indeed. We are in our last weeks here in Afghanistan which means that we have to turnover with the new crew, pack our bags and get last minute missions done. For medical it means having to do a final screen of all 470 Marines in our squadron. We also have to go through all their records to make dure complete. This has occupied most of my last week.
I also finally got to pin on my FMF last week. We were waiting until both medical officers and the chaplain had a chance to finish up so we could all pin on together. I have included pictures below. I am hoping ot blog more soon.
Mark

CO doing the pinning

The three of us post pinning.

my health care manifesto

2010-02-25T00:06:00.000-08:00

So, I posted a story about a Canadian Premiere coming to the U.S. for his health care the other day. When talking to a colleague about health care reform he asked me ‘well, what would you do to fix it?’ I thought that was a fair question. So here are my thoughts about what is broke and some ideas on how to fix it.

The first question to ask is whether health care is a right? I do not think so. However, when you are in a country with the means to do so, I think that you need to be able to delivery some form of basic health care. Now you have to define who you want to cover when you talk about ‘universal health care’. I think that if you are a citizen, that you should qualify for basic health care. Next, you have to decide what type of health care coverage. I think that everyone should have a base level of health care that covers you for emergencies and for preventative medicine. After that, I think that you should have options, either through work plans or personally financed, to increase your coverage.

It is easy enough to say ‘everyone should have health care’. However, how will one pay for it? Another thing to contemplate is, just who is going to see the patients? We are in a time when we are short primary care providers in this country. If we increase the patient pool without increasing the number of primary care providers (which takes years to accomplish) then we overwhelm the system. I have some ideas of how we can address these issues.

The very first thing that must be done is medical tort reform. You need to limit how much in damages one can get through legit or perceived medical malpractice. Medicine is not an exact science and there will always be the chance of adverse outcomes and there will always be mistakes. However, people like John Edwards have made far too much money through ambulance chasing. The days of channeling dead babies in the courtroom should end. This is a tough one since most congressmen are lawyers, but it is a must, because once you cap medical malpractice payments it has more positive impacts.

If malpractice is limited, then malpractice insurance goes down as well which means that physicians do not have to charge as much (kind of a reverse trickle down effect). Some medical specialties have obscene monthly medical malpractice insurance rates.

Also, when there is a fear of malpractice suits then a primary care provider will quickly refer patients to a subspecialist to make sure they are not missing anything. Let me give you an example. A family practice doctor hears a murmur which he thinks is benign (okay). However, he does not want to miss something and get sued so he refers the patient to a cardiologist. The cardiologist says ‘well if he sends this patient to me, then I should do a full workup’. So the cardiologist gets a chest x-ray, EKG, echocardiogram for a full cardiologist evaluation. Most likely, the patient is told that their murmur is benign. So the cost for this patient just went up exponentially. This patient could have been followed by the family physician to see if any changes or symptoms developed prior to sending to a specialist. However, they did not because of the fear of being sued.

Let me now talk about health care insurance. We need to open up competition between insurance companies. In many states there are near monopolies for health insurance. There may only be two companies to choose from. If you allow competition of insurance companies between state lines then you have more companies competing for your business. It is a basic principle of supply and demand that if more companies are allowed to do business then the price of insurance will go down.

We also need programs like Medicare to pay out better. They basically dictate how much they will pay for a procedure or a doctor visit. Many times the doctor gets 70% what he or she bills. So what happens next? The doctor will have to see more patients and do more procedures to try and get enough compensation to account for what he or she is not reimbursed by Medicare. This leads to unnecessary procedures. It also means less time per patient by the doctor.

When a primary provider is getting slammed seeing more patients (to make enough money) they get frustrated that a) they are working overly hard b) they are not practicing the medicine they envisioned. Most primary care providers went into that area of medicine to spend time with their patients and do preventative and anticipatory care. That is one of the reasons I got out of pediatrics. I wanted to spend time with the family to develop a bond. I wanted to help with preventative counseling. It is impossible to do in a 10-15 minute appointment. So, what happens? They become a sub-specialist like I did. Why do you think we have a lack of primary care providers in this country?

So we have established that doctors get driven out of primary specialties due to fear of malpractice, dissatisfaction with compensation and frustration about type of medicine they are doing. I think that there is another reason as well. Most civilian doctors have a huge debt after medical school. You are talking hundreds of thousands of dollars in debt. They become doctors when they are about 26. Then they do internship for a year where they make probably 35 thousand. Then they go into residency for 2-4 years where they make maybe 40 thousand a year. So they are now in their 30’s, have a doctorate degree, have a huge debt still and have not yet made any money. So they go into fellowship to become a specialist because they know they will get paid better. Besides they have talked to enough primary care providers to know they do not want to go that route. Maybe we should subsidize some of medical school costs and pay residents a bit more money so they do not have such financial pressures. They work 80-100 hours a week when a resident, I think they deserve it.

Well, there you have it, my thoughts, whether you wanted them or not. I am happy as a military physician. I had a good time being a pediatrician and I am glad that I did an allergy/immunology fellowship. If I were to do it all again (and that is a huge if) then the only way I would do it would to go through the military again. I am really struggling with whether I would want to practice medicine as a civilian post my military career.

health care

2010-02-23T21:29:00.000-08:00

So we are heading to socialized medicine (actually socialized everything) in this country. We all know that Canada is one of those nations who already have socialized medicine. One of the key arguments against a system like theirs is the discontent among their citizens of their medical system. Many will cross the border to come in the U.S. to get key procedures done and pay out of pocket.
Well it gets better as a Canadian Premier went to Mt Sinai (in the U.S.) to get his heart procedure instead of utilizing his 'free' health care up north. Why? Because he values his health! Here is the link ... http://www.google.com/hostednews/canadianpress/article/ALeqM5h0QC7bditrEb3wYz_6_b-gsGGDxA

reflection

2010-02-22T22:00:00.000-08:00

So it is getting close to the end of my deployment and I thought that I would give some reflection. I could complain about being in the middle of a third (is there a forth) world country being underutilized as I am separated from family and friends. I asseverate that there has more good than bad and that there is a proverbial ‘silver lining’ to my six months in the desert.
For one thing, I am in the best shape of my life. I have done my best to give Liz that prison body that she deserves. I have actually shed a few pounds despite engaging in gluttony. All the while I have increased the amount of weight I can lift. I have been pounding out sit-ups, pull-ups, dips and push-ups daily. I run most days of the week. This coming from someone who is accustomed to running 30 miles a year, not 30 miles a week. As an apogee of my running I have entered into the Rock ‘n’ Roll marathon in San Diego this June.

Even though I have not been challenged professionally, I have had time to read. I have read three textbooks and numerous articles to keep up with my specialty. Usually, these reading assignments sit on my desk for months. Despite the medicine here in my BAS being rather remedial, it is appreciated by the Marines.

I have been fortunate to have the chapel be next door to our BAS. I have been further blessed to have had our chaplain be a Catholic priest. It is uncanny that my faith has been able to grow in a country that is intolerant to other religions.

I was ecstatic when I found that the chaplain brought a couple of guitars with him for the chapel. One of the guitars was rarely claimed and thus I was able to keep it hostage at the BAS. His religious assistant plays guitar and was able to teach me some new material. I will let you be the judge when I get back as to whether I got any better.

I have always been proud to serve my country. However, most of the time I have served, it has been in a clinic/hospital taking care of military and their dependants. I definitely serve a purpose back home, but here it is a different kind of medicine taking care of those fighting for our country and way of life. One may question why we are here and what exactly our mission is at this point. However, the soldiers here are fulfilling the mission that has been directed to them by our government and they do so with honor and with purpose. Having now been deployed in a combat environment I can hold my head a bit higher knowing that I was supporting the Marine on the ground.

Speaking of Marines, I am so happy that I got attached to a Marine squadron instead of an augment to an Army unit. Not to piss any Army lovers off, but they are sometimes really backwards. The Marines are just more professional from top to bottom. I can further appreciate the Marines now since earning my FMF (fleet Marine force) device. I will be able to wear this device, as well as a few ribbons from this deployment to add some ‘bling bling’ to my uniform.
I have been able to meet many different people from many walks of life. They not only come from the U.S., but from many countries abroad. I have been able to taste different foods, hear a variety of languages and be exposed to other cultures. Some people can get on your nerves after 6 months of close interaction, but for the most part everyone was civil. There will be a few who I have felt a stronger bond and will look forward to keeping in contact in the future.
Lastly, despite being separated from my family, I have never felt more aware of just how important they are to me. I truly appreciate my family and my love has only grown. I think our bonds will only be strengthened by this experience. I am really proud that my wife and kids have done such a great job in my absence. (actually it kind of pisses me off since I do not feel as irreplaceable now :)

So there are some of the positives from this deployment. That being said, I am really looking for some old food favorites, any alcoholic beverage, a comfortable bed and the warmth and love of my family and friends when I close this chapter in my life.

Peace

Chief and HM1 posing in front of Camp Viking.

British vehicles lined up to go out to the fight.

okay

2010-02-15T02:21:00.000-08:00

I have been a bit tardy in my blogging of late. Mainly this is due to communications being up and down. You all see the news and understand why this may be the case. Anyhow, I am very safe so don't fret.

Today we are doing post deployment health screens. All the Marines and Sailors in my unit has to do it. It takes about 30-60 minutes for each individual and each person has to see myself or my partner before it is considered complete. Talk about a headache. I guess I should not complain because the fact that we started them is a reminder that I will soon be home.

I fiished reading the State of Fear. Though it is a fiction book, it is heavily footnoted with actual articles. The author has some great comments in the back of the book that ring very true to me with our current obsession with global warming. I would recommend the read. The story is fun as well.

I also finished reading Left to Tell by Immaculee Ilibagiza. She survived the Rwanda holocaust by staying in a 4' x 2' bathroom with 7 other women for 3 months. It is a story about faith. Incredible story.

Will talk to you soon.

I have a picture, pinned to my wall

2010-02-10T21:37:00.000-08:00

I have started my Spring cleaning early since I will be redeploying in the Spring. I have sent some packages home and have asked that no further packages be sent out (thanks to all who have sent packages to me over the months). I am starting to take down the numerous pictures and drawings that have been sent my way. I took a picture of my plywood wall in my hooch (tent) before I took them down.

I also took a picture of a bookmark that Anna Custodio made for me. It is a beautiful bookmark that I have definitely used, but I thought that the back of the bookmark deserved special mention and a picture so others could appreciate.

I realized that I never put anything in my blog about the Super Bowl. This is probably because I still had some resentment that my Chargers have yet again blown a great season with an early exit. Maybe it was better that they went out when they did instead of teasing me a little longer to just intensify my pain with a loss in the Super Bowl. Anyhow, the Super Bowl was shown on AFN without the commercials at 0400 (that is 4AM)! We still had about 12 people in the BAS watching (what else you going to do out here?). Since they did not show the commercials that you all were seeing, they showed commercial skits that DoD schools put together. HORRIBLE!!! Well the good news is that the Saints won. I say this because, well Indy already won a Super Bowl and more importantly one of my corpsmen is a huge Saints fan and would have been dejected for the rest of the deployment had they lost.

It has been very windy and cold here lately. No more hail which is good. I am supposed to run a half marathon on Sunday, but I am definitely a fair weather runner and if it is cold then I am a no go. I have already paid my entrance fee so I will show up to collect my shirt. That's right I will wear it even if I don’t run!

Headline of the day .... "First Lady Links Childhood Obesity to National Security in Launch of ‘Let’s Move’ Campaign". Really? Obesity and national security. I suppose that is like how the record snow falls are really caused by global warming like some are stating in the news. First rule of politics, spin current events somehow into your agenda no matter how absurd. If you keep saying it is true it is, right?

Everyone take care,
Mark

My art collection.

Handy bookmark.

Step back!

Trying to stay warm and awake for the Super Bowl.

One happy fan and more importantly one happy corpsman.

hail

2010-02-07T01:42:00.000-08:00

Yesterday we got a lot of rain over the course of a few hours. It even hailed for about an hour. The sound of the hail hitting the tents and metal containers was intense and deafening. I included pictures below.

The problem with rain here is that the ground is not porous at all. Thus, I can expect to waddle amongst big muddle puddles for the next week. The bizarre thing is that the puddles will start to recede about a day after the rain, but only to grow to their previous size the next day. I think the ground initially absorbs it, but then the water is drawn back out when the weather permits.
Nothing exciting is going on this week. We are starting to prep for a move next month since our lease on this British base is up when our unit redeploys home. Thankfully, we have not had a lot of patients, at least nothing exciting enough to report here in my blog.

I read another couple of books since last post. I read one called Ghost Map about the great cholera outbreak in Victorian London in 1850’s. It gave a very vivid picture of how people lived in a densely (over 2 million people) populated London at that time. It was the first time that someone actually attributed the disease to contaminated water. The prevalent theory of the day was that of miasma. Miasma was thought to be a bad humor that would settle over areas of filth and which blamed disease on poor air or putrid smells. Anyhow, the first half of the book was good, then the author started to try and parallel to a lot of modern day problems which lost my interest.

The second book was by James Patterson called Double Cross. I read this book because I had never read this popular author, but also because he sent us a huge shipment of free books in support of the military. It was a quick read (which for me is saying something, because I am as slow as it goes). It was a ‘who done it’ serial murder book. It was satisfying.

Today I am going to start State of Fear by Michael Crichton. I understand that he started this as a book to help educate about global warming, but ended up being a book about how it is all a shame. Right up my alley. It will be a very contemporary book to read since more is in the news every day about how the governing bodies for global warming had been taking suspicious studies and unqualified research and presenting it as real. Also, we are seeing record snow storms this winter in many states. I have not heard an explanation from Al Gore.

I saw in a headline that Tomlinson will not be back next year. Unfortunately, two years too late. Had we cut him loose, kept Turner and suffered the public sentiment backlash, we would probably have a Super Bowl trophy. The guy was great, but it is a business and we kept him too long. Now we have to hope that there is a quality running back in the draft that will be able to start next year.

Okay, you know that I am bored if I have rambled on for this long. Enough of me, get back to your lives already. Love you all,
Mark

Corpsmen reeling in the flag during hail storm.

Well I guess we now have ice. Probably more palatable than the water we drink.

Hail collection between tents.

Happy Birthday Madeline

2010-02-03T21:45:00.001-08:00

February 4th, my daughter’s special day,
And I am unfortunately far away.
What kind of gift should I buy,
That would capture my girl’s eye.

How then the solution came to me,
My daughter’s love of poetry.
Perhaps I could write an ode to thee.
But could I, being so such an anomoly?

For this is the problem you will note,
My literary skills are quit remote.
My views are often very obtuse,
And thus I sound much like Dr. Suess.

So here I am trying to ponder,
The best message to my girl over yonder.
When it comes to me, just to say,
I love you so, happy birthday!

Madeline and I climbed Diamond Head. She is 5.

Madeline in China at age 7.

Madeline, you are becoming a woman, but I will always remember you as the little girl in the pictures above.

Love ya!

Dad

February at last

2010-02-02T00:49:00.000-08:00

So the computers are back on and I can once again get in contact with the outside world. I am doing fine now that we are in February. I am due back probably sometime in March which would be great. Now that I am done with my FMF pin, I started to pleasure read again. I am currently reading a book called ‘Three Cups of Tea’ about a man named Greg Mortenson who goes around the most remote areas of Afghanistan and Pakistan and builds schools mostly for girls to assure they get proper education. It is a very engrossing book. If you are looking for an inspirational story, I recommend this book. My next read will be about a great cholera outbreak in Europe.

I am also watching the complete 6 seasons of the Sopranos. I just finished season 4. It is entertaining, but it is starting to get a little old. This guy back stabs that guy because he is sleeping with this woman and so that guy shoots the other guy….Sounds a lot like past turmoil of Afghanistan. I have access to Heros, Lost, Dexter and 24. Any recommendations on which I should start watching next?

One of the allergy associations wants me to write a little blurb about what Navy allergists are doing out here in Afghanistan. I think that they are mistaken that we are actually doing allergy. Hopefully they will not be too disappointed to find out I am taking care of turned ankles, dry skin and runny noses. I included below the picture of myself and my allergy colleague from Bethesda. I am sending this picture into the allergy society. He is in a different uniform because he got augmented to the Army since the Army now depends on other services to do their medical job for them. So he showed up to a battalion with over 800 soldiers and no doctor, no PA, no nurse, just 2 medical techs (less experience than corpsmen). He has since had another 500-700 soldiers come in under the buildup with no further medical support. On top of that a bunch of them are reservists which means medically they are broke. He is much busier than I. He told me the other day that his unit has 3 Army doctors who are all at a bigger base and together see about a third of the patients that he sees. Injustice if you ask me. You have to ask the Navy for docs and you do not even work your organic Army docs as hard.
Okay, that is enough for today. I am going to force myself into a run. I have a half marathon coming up here in 2 weeks and Liz just signed me up for the Rock ‘n’ Roll marathon in June.
Take care

Tactical allergists.

FMF

2010-01-29T00:44:00.000-08:00

Last night I was in a tent with 2 other Navy officers sitting across the table from 3 FMF board members getting drilled for nearly 2 hours on all aspects of the Marine Corps. Why you ask? It was the final step for me to get my Fleet Marine Force (FMF) designator pin. You want to know who the first Marine Corps pilot was, I got your answer. You need to know the date and birthplace of the Marine Corps, no problem. Who is the 13th commandant of the Marine Corps, lets just say there is a camp on the East Coast named after him. You having trouble with your SALUTE reports or or SMEAC orders, I got your back. Maybe you need to know the distance the M16 is accurate to for a point target, 550 meters, that was easy!

Anyhow, I had already done the physical fitness test and the hump with a loaded ruck sack so this was the acme of the program and.............I passed. Yeah me! Three of us entered, but only two survived. Now the commanding general signs the order and I get to wear a shinny pin on my chest and have yet one more thing on my uniform that can catch on the seat belt.

The real reward is that I get to throw away all the notes and now concentrate on pleasure reading and videos. Maybe a little patient care.

I included a picture of the main hallway of a tent hospital behind the British hospital. This tent hospital seems to go on forever. At each junction between the subsequent tents in series (in line) there are 2 tents that jut out to each side to form different wards (lab, radiology, surgical, ICU....). It occupies a good piece of realestate. It serves two purposes. If something happened to the current hospital the they could theoretically move resorces into the tent hospital. It also serves as an overflow in case business picks up with operational tempo.

Tired of pictures of me yet? Or maybe you do not see me, I am camouflaged.

one of those days

2010-01-27T00:30:00.000-08:00

Last night I decided to put away my all too efficient sleeping bag. It has been very warm in our tent with the heater on all night and I was getting a little baked in the sleeping bag. So I got under my sheets and blanket and went to sleep. Only to awaken in the wee hours freezing. I tried to get comfortable, but kept waking up due to the chill on my head and feet. I then realized that I did not hear any sounds from the heater. It broke. The one night I decide to go without the sleeping and that is the night the heater breaks. So here is the dilemma; I had another hour before I had to awaken. Do I get in a fetal position and pull blanket over my head or do I get out of what little warmth I have, get sleeping bag, and get back into the rack in the dark without waking anyone? I pulled the wool over my eyes.

So then I am getting ready to go to mass and I am asked if I wanted to go across base to breakfast. The breakfast is a lot better where they were going and so I was tempted to put my oatmeal aside, ditch mass and go for the good chow. Alas, I decided to stay and go to mass....only to find out it was canceled 5 minutes prior. Arrgghhhh!

So I go back to the BAS and get on my e-mail. Well, I need to open up a file, but for some unknown reason my Adobe does not work anymore. So I have to forward the e-mail to another account so I can look up that separate e-mail on a completely different computer. I was able to thus open up the document, but for some other unknown reason the printer is no longer recognized on that computer. I just cannot win. I seem to recall a book I use to read to the kids about a kid that had a very weird day on a Wednesday. Well it is Wednesday today and that is the only explanation I have.

I guess I should stop blogging and get back to studying. I have my oral board for my FMF (fleet Marine force) pin tomorrow. I therefore have been doing eveything I can to procrastinate and avoid studying.

Hey thanks to the Custodio family for the 2 board games they sent to the BAS for us to play.

Despite my bad day, the sun still came up.

another day in another week

2010-01-25T01:22:00.000-08:00

I am starting to run out of topics to write about. I mean there is only so much life in the middle of an Afghanistan desert to talk about. I don't (and you wouldn't want) me to get too philisophical and I know there is only so much medicine I can write about without boring you to death.

We do get brillant stars at night out here since there is not much big city (actually no city) lights to obscure one's view. I have a star chart that I reference. You know you have been here too long when you can start to name the stars (Rigel, Betelgeuse, Sirius....). We also get some good sunsets and sunrises. Nature has a way of coming out beautiful no matter where you are.

We had 5 corpsmen with birthdays this month and 3 of them are here at the main BAS. We had a little birthday celebration for them. MWSS supports the MAG (Marine Air Group) with messing (cooking). We have befriended the cooks and they hooked us up with a cake made from scratch as well as some quesadillas. They will spot us in the chow line and give us some extra food (sometimes good food not necessarily on the menu that night). I am finding out more and more that it is who you know and what you have to trade that gets you places while deployed.

I do not know what it is with Filipinos and duct tape. I have a few Filipino corpsmen in out BAS and one of them did a fine fix it with duct tape. The picture is below and it is in honor of my father-in-law.

My mom wanted to know what they did with recycling and my daughter is a huge environmental citizen so I thought I would submit a picture of the local nationals picking up cardboard. The downside is to the best of my knowledge they are picking out all the cardboard because they burn that in a separate burn pit form the rest of the trash.

Me up close.

That is a rice cooker with the electrical duct taped to the side.
Notice the New Orleans spice next to it.

Recycling?

Tasty cake.

more interesting cases

2010-01-22T00:13:00.000-08:00

So we have had a couple of interesting cases this week. We had a military fire truck crash into a drainage ditch (I am working on getting pictures) when trying to avoid a local cutting them off. This resulted in one of the Marines smashing his left orbit into the dashboard. He was seen at the hospital and sutured up, but followed up to me the next day. His left eye was swollen shut except for a slit and was a deep purple. That was not the interesting part. He had hypesthesia (decreased or lack of sensation) of his left cheek, left upper lip and left gum. He also had a ptosis (drooping) of left upper lip. This was worrisome for a possible orbital fracture with infrorbital nerve entrapment. So I sent him to the hospital for an orbital CT and sure enough he has 3 orbital fractures.

The second case was a female Marine complaining of constipation and feeling of gurgling in stomach. She had also had some nausea some weeks prior. She has been working out like crazy out here and had been on a supplement allowing her to lose 35 pounds. She was convinced that she had worms. She does have a parasite of sorts…..a baby! When I palpated her belly the belly started to palpate me back. She has a fundal height (way of measuring the pregnant uterus) of 20cm. I figure her to be about 20+ weeks pregnant. Oh, she had a positive pregnancy test too. In case you are wondering, we have been gone about 18 weeks, so her pregnancy is legit.

I also had a pediatric consult today. I got a call from a satellite base about a local national 3 day infant boy who has not yet urinated. Feeding fine, no jaundice, consolable, but no pee-pee. I am worried about kidney problems (not making pee-pee) or posterior urethral valves (blocking pee-pee). Anyhow, we arranged for a helicopter to transport the kiddo to an Afghanistan referral hospital. I was about to instruct the GMO over the phone on how to do a suprapubic tap (sticking a needle through the lower belly into the bladder) had we not been able to get the transport.

Transport vehicle for the squadron. Yes, it is an old school bus.

My swing is looking good. I found 3 golf clubs. My mom and Liz sent out a peice of carpet and practice balls.

I was happy to see this small patch of greenery. This is the first green I have seen out here besides the color of uniforms.

helicopter support team

2010-01-20T01:18:00.000-08:00

So yesterday I got to participate on an HST (helicopter support team). Basically, we netted up some water bladders filled with drinking water (1000’s of pounds each) to be flown to another forward operating base. After you net them up and put on a huge D ring, a helicopter comes down to have it latched to its underside and then fly away with the goods.

In this case, it was 2 53s that flew in. So when they approach you have to brace yourself due to the immense winds they generate. I literally had to be in a crouch position leaning into the wind with my hands over my face. Even in that position, I was being pushed back along the rocks. You then rush under the helicopter and one individual holds a grounding rod to the hook from the underbelly of the helicopter while another individual (me in this case) hooks the D ring on the hook. Then we all skeedattle to the periphery, brace ourselves once again as the helicopter increases its collective (power) to lift off. When it flies away you see a brilliant electrical current on the edges of the rotor blades (only 175,000 volts or so…). Very motivating experience, great leg work out! Pictures limited due to being night time.

I am shocked that Scott Brown won the election for senate seat for Mass. It is an amazing story. He is a republican running for a seat that was held by the most democratic family (Kennedy's) in probably the most democratic state after being behind 35 points in the polls weeks ago....and he wins! This is a warning sign to those in Congress that people are fed up. Maybe this will turn the tide. I think it is a foreshadowing of waht is to come in Nov elections.

Forklift lifts the heavy water bladders onto the net.

Marines secure the net around bladders.

Guy with grounding rod is on left and just released. I am far right backing up after I hook the load to the helicopter.

Go Chargers!

2010-01-17T01:25:00.000-08:00

I requested at the last minute that Liz send me some Charger gear to wear for the playoffs. Amazingly she sent this jersey of mine just 7 days ago and it is here. I have to wake up at 2AM Monday morning to watch the game, but that is what being a fan is all about. If the Chargers lose you may next see a picture of this jersey being burned.

I took some motivating pictures of a couple of British troops about to go on patrol. They follow below.

Here is the brillant quote of the day by a wonderful liberal voice from Hollywood. Actor Danny Glover says the following about Haiti earthquake...“When we see what we did at the climate summit in Copenhagen, this is the response, this is what happens, you know what I’m sayin’?” Absolute idiot! I think he is officially worse than Sean Penn on my list of ignorant Hollywood types.

bucket list

2010-01-15T22:07:00.000-08:00

So I got a copy of the movie The Bucket List. I have not yet watched it, but understand it to be a list of things one wants to do during their lifetime. I was in a particularly mundane meeting the other day and decided to make my own bucket list. Here are some things I would like to accomplish before I am too grey and arthritic. Top ten are:

1) Run a marathon – Planning on trying to do the Rock ‘n’ Roll marathon in 2010. Anyone want to join me?
2) Jump out of a perfectly good plane – I was going to do this on my 40th, but since I will be in Afghanistan I will push back a little bit. Again, if you want someone to jump out of a plane with, I am your man. As a side note, I actually had orders to jump school during medical school but they got pulled at the last minute for another group that was more in need. Bummer.
3) Bungee jump off bridge – Preferable in Australia.
4) Go to Australia – a) to accomplish #3 b) my dad always wanted to go to Australia and never had the chance c) it would be great trip for family
5) Go to Manchu Picchu – This is probably what I want to do most and would want to go within next 2-3 years. Anyone game?
6) Visit the Vatican – Of course would have to explore Italy at same time.
7) Go to Carnival in Rio de Janeiro – I just don’t know if Madis Gras in New Orleans would be enough.
8) See Christ the Redeemer statue – Hoping to parlay this with Carnival.
9) See the Pyramids of Egypt – Who wouldn’t?
10)I am leaving this slot open for now. There are some other places I would like to go (like Alaska and many places in Europe), there are other sites to see (like Mt Rushmore, Niagra Falls) or possibly trekking down to the bottom of Grand Canyon. Maybe I go wild and get a tattoo, I just don’t know yet. Any ideas?

My favorite quote of the week is from Vladamir Putin when he said ... “In addition to the global warming challenges, we need to address'global cooling' effects and to do so promptly,”. You got to wonder about some of the world's leaders.

Dug this picture up from my Okinawa days. I made this halloween costume from scratch. I spent entirely too much time and money in this project and this is the only picture I took of it.

kaboom

2010-01-13T00:56:00.000-08:00

We had another extended blackout of computers and phones. We get these when bad news needs to be relayed to families in the U.S. Even though it is frustrating not having access to communications to talk to our friends and families, everyone understands why the blackouts must occur and that we are lucky to be on a secure base and not fighting on the front lines. I imagine that there will be many more times for the remainder of the deployment where communications will be down for varying periods of time.

So, the other day I was in my room talking to the chaplain (my roomie) when all of a sudden there was a loud BOOM and the ground literally shook. Chaplain nearly dove under his bunk much like we were taught in elementary school for earthquakes. We ran outside and saw this big plumb of smoke arising from just outside the perimeter wall.

About 2 minutes later, there was an announcement over the loudspeaker system stating it was a controlled explosion. Usually, they will make the announcement before the controlled explosion such that we will be prepared and not freak out. Anyhow, the ground has not shook like that for me since….ah better stop there since the kids may be reading, and my mother-in-law, and my mom….

Speaking of loudspeaker announcements, you may remember that my squadron is pretty much the only Americans actually residing on a British base. Therefore, we get British announcements. Now, when I am sitting right next to some of these chaps I often cannot make out a darn thing they say due to their thick accents (it would interesting to know if they have the same problem listening to us, then again, English is getting pretty hard to understand in America even for me). So imagine what this same chap must sound like on a loudspeaker that is 50 feet in the air and about 100 yards away. A message like “There will be a controlled explosion at 1100” might sound like “Aerial bye uh enralled splashin aught oven and red”. It is sort of a game making it out.

Presto!

Typical bunkers around camp in case of need.

my friend

2010-01-10T03:03:00.000-08:00

Nice to be back on the computer. The power to the computer tent has been out for a couple of days.

So whenever I go somewhere for a substantial amount of time, I like to get some nice momentos to remember my experience. We have decked out our home with interesting pieces of furniture from our time in Asia, my office has plaques and knick knacks for me to remember my past commands. Unfortunately, my choices here on a base in Afghanistan are limited. I can chose from copy infringed DVDs, knockoff sunglasses, hookahs, or carpets.

I bought a couple of nice carpets for Liz earlier in the deployment (Take into account that I am a military man with no fashion sense picking out carpets). You can buy wool, silk or a wool silk combo. In a nutshell, the wool ones are more wear resistant and are meant to be on the floor for use, the silk ones are for hanging on the wall (and are usually from Iran, not Afghanistan) and the wool/silk blend is somewhere in between. I have learned to look at the carpets closely to assure not machine made, to look for single versus double knots and approximately how many knots per square inch.

So, I guess that I did okay with the first batch of carpets, because Liz has requested a runner for the hallway. Problem is that she has been a bit tardy telling me what color or size to get. Today I came across a new bazaar and came across a vendor of carpets. I decided to go ahead and look at what carpets he had and ended up doing a impulsive buy of a runner. Anyone who has traveled has a story about haggling for a price. I thought that I would give you a rundown of how my encounter with this carpet vendor went.

Vendor (V) “Hello my friend (even though we just met), how I help you”
Mark (M) “uhm, I am looking for a carpet, a runner, you know what I mean”
V “I give you good price, just for you (we now have known each other for 90 seconds), come here, look, hah, good carpet”
M “I like this one, how much?”
V “You pick good carpet, very good, see, look, feel, see, very good carpet, last forever”
M “How much is good carpet?”
V “$320, is good price, just for you”
M “Sorry too expensive”
V “Wait, how much you want to spend?”
M “A lot less than that…….how about $100?”
V “Ahhh, ohhh (look of horror), ahhh, nooo, this good carpet, take one year to make, feel”
M “I can see it is good carpet. What is your best price?”
V “Since you good customer, I give you special price, $260”
M “I can stretch to $120, but that is still more than I want to pay”
V “I go down $60 and you just go up $20”
M “Maybe we are too far apart, I will think about it, thanks”
V “Wait, $250, good price, lets shake” He holds out his hand. I do not shake because I do not like the price and I cannot remember which hand is used for eating and which for the bathroom.
M “Still too much, thanks”
V “What is your best price?”
M “$140”
V More cacophonous sounds “ahhh, ohhh, nooo, this too good carpet, take one year to make, feel”

Anyhow, this keeps back and forth until we are like $150 versus $180 and making no ground. I pull out $150 cash and say he can take it or leave it. He accepts and everyone happy. “You come back and buy more carpets” are his last words. This carpet is from Herat which is along the Iranian border and is made of wool. Hopefully Liz likes the carpet as well.

One last bargain story. I needed some cheap sunglasses and I picked up a pair and asked how much. Vendor says “$15”, “how much???”, “$10”, I hold up 5 fingers and he says “yeh yeh okay”. Quickest negotiations I have ever had.

Shopping at Camp Leatherneck

Runner purchase

Up close design

Previous buys

wearing thin

2010-01-07T01:37:00.000-08:00

It is getting to that point of the deployment where I am like 'I am done already'. The fact is that I am only here for emergencies, which thankfully there have been few. Thus, I am not really challenged medically and I feel like my skills are dwindling. I have had plenty of time to read medical resources, but there is only so much of that one can tolerate.

You add the lack of professional stimulation to an environment that is cold, sandy and flat and then you mix in the fact that I have no privacy and you get one demotivated allergist. Of course, I could have gone to the Army as an augment as did one of my allergist colleagues. He is getting killed with patients because it is him and one Army medical tech to care for over 800 individuals. On top of that, a bunch of his unit are Army reservists who were not properly medically pre-screened. He has had to send home quite a few (incontinence, neuralgias, long history of GI bleed...). At least he has a pseudo office. I get a third of a picnic table as a desk and get to share a phone and computer with 14 corpsmen.

Let me pause for a second, because I am almost wishing that I was back at NMCSD seeing patients and that would cut into my workouts and my guitar practice that I do enjoy here.

Naahhhh, I am still going to complain. We get taskings to send corpsmen to different places and usually this requires that we send someone who is up to speed and motivated. Thus, we have sent off most of our good corpsmen. The ones we have left in the BAS are either anti-social (for instance you say hi shipmate and you get back a blank stare with no vocalization) or they move like a slug, or they are under investigation (can't divulge details).

Lastly, I want to give you an example of the types of people/situations that make my day entertaining. Yesterday I had an urgent message that a SSGT needed to know particular information about a Marine being flown out. I got back to him that I had already briefed the CO on the situation hours ago. He responded that he needed an e-mail telling him the information so he could brief the CO. I echoed again that I had already briefed the CO. However, he was going on protocol that he needed an e-mail and he intended to brief the CO on the matter. It did not matter that I verbally told the CO more info than I had e-mailed to the SSGT, he needed to brief the CO, it was his job. Kind of a small example of how government runs anything.

exchange

2010-01-04T21:24:00.000-08:00

Today I am going to talk about the exchanges here in Afghanistan. There are 2 American exchanges that have either an American military or civilian at the head and with third country nationals (TCNs) running the shop. We have the basics, but shelves go bare quickly when a new shipment comes in or when it is payday. Prices are about the same as in the States. The smaller exchange is about a hundred yards down from my BAS. The larger is a 5 minute drive. The larger one is always packed since it is on the main American base. Basically, the soilders have nothing better to do with their free time and so go there to loiter about and buy anything of interest.

There are also Dannish and British exchanges which offer a different variety of goods, but often the prices are a bit steep. I like to look at the food items because the labels are often amusing. An example would be 'digestives' crackers.

All the exchanges use the U.S. dollar as currency. You do not get coins as change though. Instead, you get 'pogs' which are silver dollar size cardboard cutouts with denominations written on one side and some sort of motivating picture on the other. You can actually use the pogs in American excahnges back in the States. I have been sending them in letters to the kids for souvenirs.

I had mentioned prior that it was getting colder here, but really the weather has been better than expected for this time of year. We have not yet had snow and the rains have been tolerable. I can only hope that this pattern holds through the winter. In other news, the U.S. is on target for coldest winter in 25 years (tell that to Al Gore).

Getting tired of seeing me in pictures yet?

Welcome to Camp Barber exchange.

happy birthday Liz

2010-01-01T21:13:00.000-08:00

Today (at least it is the 2nd here in Afghanistan) is Liz’s birthday. I will not disclose her age, but will remind everyone that she reached a milestone last year! I love this part of the year because for the next 2 months she is 2 years older than me. As we get older it is not as big of a deal. Now when she was 21 and I was 19, there was cause for a lot of ribbing that she was a cradle robber. The only thing I can rib her about now is that we are in two entirely different decades of life (oops did I give another hint about her age?).

This, I believe, is the first birthday of hers that I will have missed since 1990 (we met 1989). I have helped her to celebrate her birthday while she was in college, while studying in nursing school, on both sides of this continent and even overseas. This will be the first from a war zone.

My birthday present to Liz is that I will refrain from making another video on my blog. This will help stave off some of the embarrassment that I have caused her in the past and that which I am sure to cause in the future. Honey, I have nothing to toast you with except for orange-squash or black currant juices (actual drinks in the chow hall…yuck). So I raise my lemon lime Gatorade bottle up and toast you on your special day. I love you.

I do not have my drive with all my pictures on it, but was able to find a few pics of Liz over the years on my hard drive which are below. As opposed to the kids and I, she appears to remain ageless in her pictures.

Club Med, Ishikaki (spelling?) in Japan around 2003. I include this picture a) because the bunny ears and b) because Liz absolutely hated this shirt of mine.

Liz and Madeline at a 'tea' a few years ago.

Liz and Kyle at Liz's BDay party last year.

Liz and Timmy in Okinawa circa 2003.

Maybe my all-time favorite Okinawa picture at peace park. Liz's wind blown hair, Timmy's look of terror, Kyle doing a superhero pose and Madeline giving her flower child peace sign. Classic!

funny headline

2010-01-01T05:10:00.000-08:00

Snowstorm squelches climate change protest

By Judy Fahys
The Salt Lake Tribune
Updated: 12/30/2009 06:36:58 PM MST

A downtown protest of the climate change talks in Copenhagen became a victim of Wednesday's snowstorm.
"Not many people showed up because of the blizzard conditions," said organizer Clea Major, an international studies student at the University of Utah.
It didn't take long for the six friends to pack up a bullhorn and posters they'd planned to use for their "scream-in," an outlet for their frustration about the failure of the Copenhagen climate talks earlier this month to curb the pollution blamed for climate change.
Still, they chatted with a few passers-by during the commuter-hour protest near the Gateway, and explained that, blizzard aside, climate change is expected to bring chaos to the global climate, said Major.
She called Wednesday evening's effort a success and possibly the first in a series. As for the snow, it's not entirely new; a protest she attended last year in Washington, D.C., suffered a similar fate.
"There is always the irony element," Major said.

Happy New Year!

2009-12-31T11:55:00.000-08:00

Well, I stayed up to ring in the new year. We spent the night playing spades and drinking virgin margaritas. I heard a couple of cannons fire off to signal the new year. Otherwise nothing too exciting about today. I am measuring my remaining days off of birthdays (Liz, Madeline, and mine). In fact I am going to change my countdown to days until my birthday, because it is approaching faster than my departure date.

I hope you all have a wonderful new year. I cannot wait to see you all again. Peace.

Recent sunset. Just so you know that the sun does actually shine over this austere place.

Recent sunrise. Yes, you can find beauty anywhere.

plywood

2009-12-29T00:43:00.001-08:00

It is amazing what can be done with some 2x4’s and plywood. One can find scraps of wood lying around if they are industrious enough. Our chief in particular likes to build things. He secured some tools when we first got out here and started to go to work. Someone (usually me) will say ‘it would be nice to have a bookcase here’ and next thing you know he has recruited a couple of corpsmen and the saw blades come to life out back. He has made a TV stand, bookcases, CD case, porch, haircut booth, and wardrobe closets all from scraps.

The engineers in our unit also do a great job building things. They are working on putting a plywood floor in our BAS and have just completed doing the same at the chapel. Basically the ground gets saturated with water quickly from the rains and it will literally soak through the tent floor leaving puddles everywhere. What they do is take 2x4’s or 2x6’s and build frames with cross supports every 2 feet. They then place plywood on top and tack it down. This raises the floor off the ground and allows for a dryer environment. The floors actually look kind of nice when finished. What do you think of a cheap wood floor alternative Liz?

I have found a poker game over at the British hospital. They play Texas hold ‘em. I figured that since I am the only one who has ever been to Texas that I may have held an advantage. I have played 4 times and won twice. I'm so money! I am thinking Vegas baby, Vegas!

Wrap around desks and TV hutch all from scraps.

Bookcases

Front porch to Med Ops (code for staff NCO office space)

New church floor. Benches all made from 2x4's

New haircut hut complete with lighting.

2009-12-27T06:01:00.000-08:00

I just finished reading the book ‘The 5000 Year Leap’ by Cleon Skousen. This is a book that I have been meaning to read for some time, but have put off because I thought that it was going to require a lot of mental energy. Instead, I found it to be a very insightful and educational page turner. Basically the author goes about explaining the constitution and the founding principles in America through the writings of our founders of this country…Washington, Jefferson, Franklin, Madison, Adams… It also goes through some of the primary sources for their thinking like John Locke and Cicero… I think that this is an essential resource because, let’s face it, we do not get any proper grounding in our history and our constitution in our current education system. I also fear that most of our politicians do not fully understand the intent of our constitution and through reading this book you will see that our country is going down the road that our founding fathers had warned us against. I highly recommend reading this book. I think that you will appreciate just how thoughtful our founding fathers were in setting up this country for success.

Below I posted some pictures that I have taken over the past few days. I have included the welcome sign to Camp Leatherneck which is currently going under a huge expansion in anticipation of future troops. I have a picture of a couple of Brits dressing up for the day after Christmas. This is called Boxing day (you can read about it at http://en.wikipedia.org/wiki/Boxing_Day). I have also included a picture of me in a beret I just secured from probably the only Filipino in the British armed forces. He is a nurse and the beret is an officer nurse corps beret.

Cheers

Either me a) mocking a sign b) heart broken that I am away from my love or c) dancing to achy breaky heart

Must see landmark in Afghanistan

Brits on Boxing day. They apparently had raced in this garb earlier in the day

Tucker...Mark Tucker

Merry Christmas

2009-12-24T13:13:00.000-08:00

Well it is Christmas here. I just got back from midnight mass (actually at midnight). It is pretty amazing if you think of it. We are in the middle of a backwards country where you would probably be beheaded for being a Christian if it were not for us being in an enclosed compound.

It was an interesting Christmas Eve. I was called away from an officer dinner holiday celebration due to a sailor having shortness of breath and lightheadedness. It turns out that she was having most likely a run of atrial fibrillation secondary to recent supplement that she started (has 3 sympathomimetics in it like caffeine and ephedrine related drugs). The next patient came in during our gift exchange after having a bar with over 200lbs on it fall on his chest during bench press in the gym. He ended up having a disruption of his costochondral joint at the fifth rib.

We were able to have our gift exchange as well as a dirty Santa exchange. I think that it helped with the morale. We are pretty much at the half way point which is exciting, but at the same time you realize that you basically have to repeat the same time span again. Regardless, I am still thankful for what I have. What do I have you ask? I have friends and family like you back home to support me, I have my health, I have my faith and I am doing a job that has a purpose.

Peace be with you all.

Some of the corpsmen.

Christmas Eve dinner.

HM1

Christmas jester.

Just before Christmas midnight mass. It was a packed house.

frocking

2009-12-23T05:33:00.000-08:00

The other day we had a frocking of a couple of our corpsmen. Frocking is a process where someone is promoted in rank such that they can wear the rank and have the responsibility, but they are not yet getting paid in their new rank. Basically, it is a way for the military to get more out of you and delay paying you for your work.

Last week the results came out for the corpsmen as to whether they made rank and 2 of my HM2s got selected to HM1. So we had a frocking ceremony (pic below). Just so you know, they no longer frock Navy officers so I am indeed getting paid as a Commander.

I finished reading David Baldacci’s ‘Divine Justice’. It was the sequel to the last book I read ‘Stone Cold’. I liked both books.

I am also reading 5000 year leap which I think should be required reading for all high school students. It is amazing what the intent of our founding fathers was and how it is being mis-interpreted in our current political process. I came across a proverbs 29:2 quote today ‘When the righteous are in authority, the people rejoice; but when the wicked beareth rule, the people mourn’. A lot of mourning going on in the news these days.

Newly Frock HM1s

Who is that handsome devil in the middle?

setback

2009-12-21T08:18:00.000-08:00

So I got some bad news today. We have a computer tent for which we can use for personal use and e-mail and such. When we arrived the few headsets and video cameras they had were lousy. Therefore, most of us bought our own through Amazon or had family send them forward. Well now, we are told we can only use the few sets available at the tent. This means that you have to be lucky as to whether a set will be available to you should you want to Skype your family/friends. That is only half of it. You also can no longer use thumb drives or other plug and play devices into the computer. This has been the case for the government computers, but not for the ones for personal use. Unfortunately, many of the computers do not have DVD drives and if they do they often do not work. So now it will be nearly impossible to send pictures back home through the internet.

This is what I had to do to post today’s pictures on my blog. I first downloaded the pictures from my camera to my computer. I then burned them onto a CD. I took the CD to the computer in the BAS and downloaded the images. I then sent an e-mail from my military account to my gmail account with the pictures attached. I then walked to the computer tent, waited for a computer, opened my e-mail, downloaded the pictures and then attached them to my blog. Basically, you will be seeing fewer pictures in the future because this is a pain in the butt.

Yesterday was a nice clear day. The day before was rainy all day. The bad news was that there are big puddles everywhere because this ground does not absorb moisture at all. The good news is the dust is all matted down today and you can see a great distance. I could see more mountains behind the nearest and they were snow capped.

I finished reading 'The Men Who Stare at Goats' by Jon Ronson. He wrote about the use of psychics and other paranormal specialists in the government and the military. Is is surreal to think that any part of this could be true. Entertaining quick read if you want something different.

This is an actual Christmas tree that we procured.

This is an Afghan ambulance. They must have really short patients!

happy anniversary to me

2009-12-17T19:54:00.000-08:00

Today is my wedding anniversary. We have been married 16 years on Dec 18th. I know it is hard to believe that a) Liz agreed to marry me and b) she has stayed married to me. What can I say except that we have far outpaced the general population as far as time served in matrimony? Liz has been a wonderful wife and a tremendous mother. I am truly blessed to have found her.

I thought that I would use this opportunity to tell you how I proposed to Liz. I recalled this event because Liz sent me some candy coal with an anniversary gift which brought back this memory.

I decided on the evening of the 23rd of December 1992 that I would propose to Liz after Christmas mass on the 24th. I had found the ring and was frantically running around to get the best deal and to pool all the money I had to pay for this diamond. So I am literally running out the door the morning of the 24th with like an hour to go before the bank is going to close for the holiday and I have maybe another hour after that to get to the jeweler to get the ring for that night. Liz calls and is quite perturbed with me because she thought we were going to go to Costco to get her mom her bread maker for Christmas. I told her to give me a couple of hours and then we could get it. Well that did not sit well and I got an @#$ chewing about how important it was to get the bread maker right then and how I was being selfish. (Now that I think about it, maybe she was seeing me only for my Costco membership). Anyhow, I covered the phone and whispered to my mom ‘if she only knew what I was trying to do right now’.

So I told her that the bread maker would have to wait. Now I was a little disgruntled that I am spending my life savings on a ring for the woman I plan on asking me to marry me in about 8 hours and all I got for my trouble was the silent treatment. I decided right then to play a joke on my love.

After mass we went to open presents at her house. She opened the box that I had wrapped and when she finally got to the contents she pulled out a piece of coal and gave me a look like I was crazy (which many of you have learned over the years to be an accurate assessment). I told her that I had told Santa about her bad behavior and bad children usually will then receive coal. I further explained that there was an upside because with the proper conditions and with lots of love coal can turn into something special. I then got down on my knee and proposed with ring in hand.

I know that this is not the most amazing proposal story, but it is my story and it was good enough to win us a bottle of champagne on our honeymoon cruise!

Happy Anniversary Love!

birthday message for Timothy

2009-12-16T00:54:00.000-08:00

Today is Timothy's 8th BDay. He was born December 16th, 2001. I am trying to load this video, but a 30 second video on these computers with this bandwidth takes like 30-60 minutes.

I will tell you a brief story about Timothy's birth. I was a pediatric resident at the time and was on call in the NICU (neonatal intensive care unit). Liz came rolling into the labor deck in the early morning hours. She was stable and I was trying to juggle taking care of the neonates in the NICU and checking on my wife on the labor deck. Well the other resident on the ward called the NICU staff and the staff came in at 0400 to relieve me to be with my wife. He also brought me a coffee to help me stay awake. As anyone knows who has been a resident, you usually get no sleep at night and that coffee just could not hold me. So at mid-morning with Liz stable I sauntered (good descritpive work isn't it?) down to the coffee cart to reload on my caffeine. Right when I was about to get that cup of joe, an overhead page was sent for me to return to the labor deck. Let me tell you, that page was better than any coffee in waking me up. Thankfully, for me, I got back in time for the birth of my third child.

So, I need a volunteer to 'gently' swat Timmy's gluteus maximus eight times to properly indoctrinate him to his new age.

I love you son!. Happy Birthday buddy!

Slamming mat

2009-12-14T02:40:00.000-08:00

Our squadron does many tasks to support the Marine air group. One task is to build runways. This entails prepping the land and making sure it is level and compact. The last step is to lay the mats of tarmac down. Kyle would like this task because it involves locking rectangular pieces together as if one was building a massive sheet of Legos. The problem is that these Lego pieces weigh up to 155 lbs each. They call it 'slamming mat'.

Due to necessity and for motivation the staff NCOs and officers have been doing some night shifts laying matting. I recently went out to do my part (and bring my medical bag for the inevitable crushed toe or finger. It is a rather good workout throwing this matting around. Unfortunately, some of the pieces have been used prior and thus they do not always want to fit together easily. During the deployment out squadron will lay 100's of thousands of feet of this matting.

Heave ho, lets go

There are 6 foot and 12 foot sections that are locked together in a pattern.

My partner carrying a 6 foot section of mat

The exciting world of mat laying

Getting ready to 'slam mat'

cranes

2009-12-11T06:29:00.000-08:00

Hey, I am back. It has been nearly impossible to blog lately due to extremely slow computers. Can you say 5 minutes to load a page! It still took about 20 minutes to load these pictures tonight and that was while I awaited the swirling Skype sign to try and contact the family back home (it is still trying to connect as we speak).

I am attaching some pictures and hopefully a short clip of these cranes out here that move around these huge containers. They can stack them or set them side by side with incredible precision. They are very wide across and when they travel on the roads it is intimidating (especially if they are traveling with a container in the air. I figured that the kids back home would be impressed.

I am finding that being in charge of a BAS is like running a high school or raising teenagers. Most of my corpsmen are not that far removed from school and they act the part for sure. I am having to see clicks, childish fights, possible romances, temper tantrums.... I guess it will prepare me for my kids one day. I really do not envy chief since it really is his bowl of wax to deal with. Now I know why so many chiefs drink and smoke....to deal with the stress of 'guiding' these young sailors.

I finished a Daniel Silva book ' the Assassin' and a David Baldacci book 'Stone Cold'. I like them both. I am now reading a 5000 year leap (great book so far) and the follow on to Stone Cold. I figure I will give Dean Koontz another try next since someone commented on past blog that I did not give him a fair shake.

Should I be concerned that Obama has a higher popularity rating in Europe than in the United States? I read that his below 50% rating at home is the lowest for any president 10 months into term.

Up up and away

Putting it back

relaxing

2009-12-07T03:17:00.001-08:00

I was caught napping last night when I was supposedly studying for my FMF pin (pic below). The flash woke me up (following pic). I have been doing a lot of reading, but not necessarily all medical or military related. There is just so much one can tolerate. I finished a Bill O’ Reily book yesterday ‘fresh bold piece of humanity’ I think the title was. I liked the book overall. It gave insight into his upbringing and life experiences that have molded his opinions and style of work. There were some funny stories. He is definitely an egomaniac, but I kind of knew that going into the book. I am now reading Daniel Silva’s ‘the mark of the assassin’, I will let you know.

I have been playing a lot of card games at night. A favorite is spades with the Marines. They like to trash talk a lot, but you know me, I will handle my own. Last night was a game called phase 10 which was entertaining. It is kind of like a combo of Uno and Gin Rummy. I won. I just felt like I had to tell you that :) The staff NCO’s (senior enlisted) will have PMEs or professional military education sessions at night (wink wink). That’s right, it is just poker. Unfortunately, I have not been able to convince enough officers to engage in this sort of extra-curricular education. Though, I hear that there is a poker game at the British hospital. I may have to set up a ‘symposium’ with them.

I am putting in a picture of a recent Marine injury. It may not be appropriate for minors due to particualr offensive finger gestures. Although, the Marine is not technically able to perform the aforementioned figure gestures (see below)

So, I see that the global warming extremists are on the defensive from the leaked e-mails showing that they were trying to suppress any science to dispel their claims. Now you have the few conservative voices in Hollywood trying to take away Al Gore’s Oscar for his documentary about the planet having a fever. Of course, the White House is trying to defend that there really is a global warming crisis so they can hammer through the cap and trade bill on CO2 emissions (errr big tax hike on the population for more wasteful government spending).

I will tell you one thing. No global warming here in Afghanistan. We don’t have any fevers (maybe chills). Looks like many places around the world are the same way. All I hear about is record snow falls.

Studying?

Waking up to a flash photo.

Which way is up?

Ouch.

quick story

2009-12-05T01:11:00.000-08:00

One of my corpsmen had to go to Germany for an evaluation for symptoms he was having. When in Germany he was evaluated by a doctor who asked him who he worked for in Afghanistan. He responded 'I work for the greatest allergist in the Navy'. The doctor than stated 'oh, you work for Dr. Tucker?'

When my corpsman called back to tell me this story I was cracking up. Now, I would never claim to be the greatest allergist in the Navy. However, I am pretty confident that I could be the greatest allergist in Afghanistan! In fact, at the moment I am probably the only allergist in Afghanistan.

Hope all is well back home.

2009-12-03T01:32:00.000-08:00

Just the other day my grandmother wrote that I should fire whoever is cutting my hair. I posted my haircut that I received by one of our Master Sergeants previously. I am still staying motivated with my high speed, low drag coif. I am just doing the chore myself these days (sorry grandma). We have a haircut hut that is next to the BAS. Usually what happens is someone goes out there to cut their hair or their friend's hair and next thing you know there is a line of people asking if they can get their haircut as well. I have not yet had the courage to butcher anyone else’s haircut.

I have found a few advantages keeping my hair short. 1) Less gray showing 2) No bed head 3) Spend less on shampoo 4) Can visualize that I still have hair at the acme of my noggin 5) It feels so cool to rub my scalp :)

I just finished another book. This time it is Dan Kootz. The book is called Frankenstein and is the third in a series. It is about Dr. Frankenstein 200+ years later making a 'new race' for a better world order and is bruoght down ultimately by the help of his original monster creation. yeah, not very realistic, but a quick read. Ultimately, I do not recommend.

Most recent movie was 'Righteous Kill' with Robert DeNiro and Al Pacino. Good cop movie with a twist.

Latest series is 'Flight of the Concords' about 2 New Zelanders trying to make it big as a music act in New York. Perfect for Greg and Cissy.

Haircut hut.

Oh the fun we have in Afghanistan.

cool cases

2009-11-30T20:02:00.000-08:00

We had a really interesting week of patients. It all started simply enough. We had a case of a vesicular rash on a Marine’s neck that was causing a burning sensation. It was in a dermatome distribution. He was diagnosed with herpes zoster (shingles), started on acyclovir and is doing much better. (pic below)

Next up was a young Marine who sustained a foot injury as a child. Being that his family was poor and lived far from health care his father latched a 2x4 to his foot for a couple of weeks in an attempt to set it. You can see below the repercussions.

Soon after we got a call about a Marine having a seizure on the flight line. He was noted to have a fever and thus thought to have possible meningitis. He had to be medivac to the hospital where he had a normal head CT and normal lumbar puncture (thus not meningitis). He is now getting evaluation in Germany.

Right after that fellow, we had a fellow get a superior dislocation of his shoulder. I can relate to his pain and suffering as I too have had a shoulder dislocation. At least I can give him good info on rehab.

The past few days have been even better. We had someone show up with chest pain and a history of congenital dilated cardiomyopathy. He was quickly treated and evacuated to the hospital for possible early myocardial infarction. He is doing well, but will soon be in Germany as well for a catheterization.

Then there was the guy who has been impotent for the past 26 months. I know it is common, but not at my age (I hope not) which he happens to be. Apparently he has had this problem since completing a 100 mile long bike race. He had 6 weeks of bilateral lower extremity numbness for 6 weeks after the bike ride as well. He has some subtle neurological changes on exam. So he probably will end up in Germany as well.

But my favorite is the guy with right sided chest pain. Usually, this is not as concerning, unless your heart is on the right side. That’s right, he has situs inversus which means your heart and stomach are on the right side of your body instead of on your left. There is a condition called Kartagener’s that is associated with some of these individuals where you get recurrent sinus and pulmonary infections (due to ciliary defect) and also have high chance of infertility (same defect). Anyhow, he does not have Kartagener’s and thankfully had normal EKG. He instead had a history of recent chest trauma and on CxR I found a cracked rib. If the CxR was able to load, then you can see for yourself below.

I am going to rest my noggin now.

I included a picure of the clouds after a morning rain here. It just goes to show that you can even find beauty in a dustbowl.

Nice party trick.

I itch just looking at it.

Aaaahhhh.

hump

2009-11-29T03:43:00.000-08:00

So yesterday I did a hump. Now even though it involved more than one person, let me assure you that it is not the type of hump you may be thinking. This one requires not only clothes, but a 50 lbs pack load. As I mentioned in previous blog, I am striving to get my FMF pin and part of the requirement is doing a 6 mile hump. This is a waved requirement while in a combat zone, but I am a motivator.

So my partner and I decided to do this hump 24 hours prior and we let some of the Marine officers know our intentions. We got 6 of them actually wanting to go along and another few bummed out that their schedules would not permit. That’s the Marine Corps for you (BTW in TBS which is their officer school they do plenty of humps that culminates with a 15 mile hump with near 100 lbs load).

I paced off a route with our vehicle which encompassed the perimeters of both British bases. We had to wear our uniform, our flak, our weapon and have a 45 lbs pack with our Kevlar attached. The rules were that we had to stop for a gear check and for a 10 minute break midway through and we had to complete the 6 miles in less than 2 hours.

Eight of us left on our mission. Everyone did pretty well through first half. At 4 miles I looked at my watch and made a decision that we would split into 2 units since time was pressing and Mike and I needed to finish within the 2 hours. My group finished with plenty of time to spare. I had been told through the grapevine that one particular Marine 1st LT boldly stated that he was going to drive the Navy officers into the ground. Let’s just say that he was marching off my pace all afternoon and he was a bit more sweaty than I :)

All smiles before the hump.

Leader of the pack.

Madatory break.

black friday

2009-11-27T04:44:00.000-08:00

Well today I got up early to see what kind of 'black Friday' deals I could get. Unfortunately, there are just 2 places I can go to shop the MCX (Marine Corps Exchange) and the local Afghanistan market. I put a couple picture below of some of our finds. Of course at the little market they always have 'a special price for you'. I did price out those swanky suits that I blogged about earlier. I just might have to buy one for future events.

We have recieved a lot of boxes from AnySailor.com recently and have been able to give a lot of the Marines snacks, toiletries, blankets... We also received a lot of Christmas decor. A few of our corpsmen had any evidence of Thanksgiving down and all the Christmas decorations up before I was up this morning. It should be festive.

You will notice a hat theme below.

Got your hokas here.

LT Crandall, Chief and I with an assortment of hats. I especially like the leopard hand warmer.

Tactical Santa.

Psycho.

Thanksgiving

2009-11-26T03:13:00.000-08:00

So today is our Thanksgiving. It is still in essence a workday around here, but we had part of the morning off. I was able to go to Thanksgiving mass followed by the obligatory meeting. I got a chance to run my clothes over to Sadish the laundry guy. Then it was time for football.

Yes we got this idea in our heads that there needed to be a staff NCO and officer football game. I was ‘volunteered’ to play. I suppose it should be a complement that they wanted me to play. I showed them the error in their ability to judge talent by throwing the game deciding interception that was returned for a touchdown.

When we play football, or any other sport, on this field, you are just hoping to come out alive. We have had numerous strains from sliding along the gravel in running shoes as well as many skinned knees, hands, name your body part. I had the further disadvantage having participated in the Marine PFT the previous day which has left my back a little stiff.

I took the Marine physical fitness test yesterday as part of my FMF pin. The fleet Marine force pin consists of being attached with the Marines for a set amount of time, pistol qualification, PFT, 6 mile hump with all your gear on and an oral board about the Marine Corps. The PFT is actually waved while in a combat zone, but we decided to do it anyhow. The PFT is not that difficult. It consists of pull-ups (20 to max points), situps (100 to max points) and a 3 mile run (18 minutes to max points). You are judged on a 300 point total and there are 3 different categories. The most difficult part was the run because we are having some rather fierce winds currently and on certain legs of the run I felt as if I were running in place. You will be happy to know that I got a first class score. If I were to take the test 4 months from now, I would be in a different age category (40+) and would have had to put in a lot less work to get the same class score.

Things that I am thankful for today….

- My health
- My family
- My friends
- My ability to serve my fellow man and my country as both a Navy officer and as a physician
- My faith
- The Marines that keep me safe
- Skype
- Peanut Butter
- Warm clothes
- The fact that this deployment is finite and thus there will be a day soon where I will be able to see all your faces and share laughs with you once again.

May peace and happiness find you and your family. Happy Thanksgiving!

I am in this picture, can you tell which one?

Running a route.

Da Players.

The food resembled and tasted like a Thanksgiving dinner (despite the pumpkin pie being frozen).

updates

2009-11-22T00:08:00.000-08:00

So, I thought today I would just update you on some things.

The British chow hall turned over their contract to an independent contractor. This has resulted in much less authentic British food and rather bland menu choices. It has also resulted in a lot of people behind the counter who cannot speak English. On the flip side, my young corpsmen and their novice taste buds actually prefer the more Americanized menu.

I am still doing yoga 1-2 times a week. Rodney Yee is still my man :) However, I have branched out a bit and now am trying some pilates. So far, I have only done abdominal pilates by Ana Cabana and she kicks my butt! I do not have the flexibility or control of my balance to get into the positions that that girl does. It mixes up my routine though and for that I am grateful. Namaste.

I had read the ‘The girl with the dragon tattoo’ by Stieg Larsson which I really liked. I just finished the sequel ‘The girl who played with fire’. It was also good, but not as good as the first. Next book is ‘A bold fresh piece of humanity’ by Bill O’Reilly.

This past Friday, we had our first inaugural cigar club meeting. Gil would appreciate the fact that Marines like their cigars and it is no exception out in the field. One of them has been ordering interesting cigars online. Another Marine has made his own humidor. So a pay $10 for 3 cigars and presto I am in the club. I got quite an education about how cigars are made and how they come by their names. Now, I do not condone smoking, but I figure that if I am in an area where I get ‘hazardous duty pay’ and ‘imminent danger pay’ then I should be able to justify smoking a cigar once a week.

Speaking of smoking, my mom asked what they did with all the trash here. Well, they burn it. In fact they burn everything including plastics (sorry Madeline). Heck, in the outlying areas they even burn their @#$%. They have big incinerators on base for the burning. Below is a picture of the BAS with the smoke rising behind it from afar.

Lastly, I mentioned prior that I was asked to play guitar in church despite only knowing pink panther and bluebird at the time. I had been practicing, but had not been able to get a hold of a guitar this week to ‘fine tune’ (like the pun) my strumming. I was stoked today that I was not going to be able to play guitar and thus avoid embarrassment at mass. Only to be tasked to be the Eucharistic minister. My only qualification is that I am probably the most consistent mass attendant at this camp. So I doled out the Blood of Christ today. I can only imagine Ellie beaming with pride and tears welling up in Liz’s eyes at the thought of me at the altar. I can also imagine Cissy thinking ‘he is only doing it because he gets to drain the cup at the end of communion’.

Till next time…

Lot of hot air in this club.

The roof, the roof, the roof is on fire. Naaahh, just them burning stuff behind the BAS.

The last 2 books I read. Overall, I recommend for both.

research

2009-11-18T04:15:00.000-08:00

So, one would think that you would not need too many allergists in Afghanistan (or even one for that matter). That being said, my first two patients were seasonal allergic rhinitis and asthma. There has been a good amount of asthma exacerbations due to the irritant effect of the constant dust. Maybe this is why we will have 3 of the Navy’s 5 allergists serving in Afghanistan by February (which leaves 2 allergists to cover 3 major hospitals).

I have also had some other interesting cases such as food-associated, exercise-induced anaphylaxis to oatmeal. We have had numerous interesting skin cases which my partner is salivating over since he wants to do dermatology one day. Urticaria (hives) is always present as well. I have been able to do some drug challenges to rule out drug allergies and even considered desensitizing a patient to doxycycline for malaria prophylaxis needs.

I was due to go to the American College of Allergy, Asthma and Immunology this month, but could not due to my vacation to Afghanistan. I had 3 abstracts accepted. We had a poster presentation on the ‘evaluation of FeNO and the subsequent diagnosis of asthma in military basic trainees’. We had a poster presentation on ‘anaphylaxis to neoprene’. Lastly, I had one accepted for oral presentation and luckily one of the co-authors was able to present the ‘diagnostic value of limited skin prick test panels’. She did an awesome job and the presentation was well received.

I have brought research to work on out here, but finding more interest in pleasure reading and guitar at the moment. I did read the first volume of the new Middleton Allergist text (pic attached). This was only 700+ pages (unfortunately, volume II is 1000+ pages). I currently am reading a chapter of vol II in Middleton’s and a chapter out of a contact and occupational dermatology book each day. Another favorite professional read has been the new edition of the Red Book on infectious diseases. Hey it helps with insomnia!

I know that this blog was not quit as exciting, but once-in-a-while Mark can be a dull boy. Hopefully it will portray me as being somewhat intellectual…..naaahhh!

I would like to point out that this blog entry was spell checked. Liz was quit perturbed at the fact that I misspelled ambulance in recent blog entry. I told her that I am more interested in what arrives in the ambulance and not being able to spell it correctly. Nonetheless, grammar and spelling should be at least above that for a graduating high school senior which is not saying much these days.

Volume I is in the books so to speak.

Vol II of an allergy text and a book on contact dermatitis. Who needs ambien for sleep?

This is me strumming the guitar with new hat in tow.

Helicopters on the flight line.

Pacquiao

2009-11-15T01:08:00.000-08:00

Is Pacquiao the man or what? I found out that we would get an AFN (armed forces network) broadcast of this HBO match last night. The whole BAS plus some Marines huddled around a TV to see this boxing master pick apart Cotto. I am not a boxing afficiando, but I can appreciate that this man is a bad#$%. It just made my Filipino-in-law pride swell.

We had some Marines playing softball on our wonderful rock field that is surrounded by barbwire. Below are some pictures of what happens when you reach through the wire to try and retrieve a softball. This Marine must have not donw well in the game 'operation' as a child.

We did our H1N1 shot exercise this week. Everything went well. Below is a picture of me getting my vaccine.

I put in a picture of an ambulence that was in front of our BAS recently. With all the IED blasts occurring they have really up-armored all vehicles. This ambulence is no exception. They all V the bottoms of many of these vehicles to help deflect a lot of the blast. These beasts get very low gas mileage, but are probably going to be exempt from the newer mileage regulations that our current government is demanding for the future :)

Last picture is a new tailor shop that opened with the other vendors in past few weeks. I am soooo tempted to get one of these suits with a felt hat. I could be the pimp daddy of them all!

Before.

After.

HN Stein (or Stein-o-mite as we call him) giving me my H1N1.

An ambulence that even Rambo would love.

Style in Afghanistan.

Marines 234th Birthday

2009-11-11T19:53:00.000-08:00

So yesterday we had a birthday celebration for the Marine Corps. They were officially born on November 10th, 1775 at Tun Tavern in Philadelphia where 2 battalions of Marines were raised under the Capt Samuel Nicholas. Their mission was defined in the National Security Act of 147 (amended 1952). Today the Marine Corps is 234 years old. We celebrated yesterday, the 11th, to correspond with it being the 10th in the U.S.

Other important dates one should remember are that the Marines came under the Department of the Navy in 1834. Marines will retort that they are part of the ‘men’s department’. I will often remind them that the men’s department is often found in the basement.

In the Battle of Belleau Woods in France during WWII the Germans were so impressed with the tenacity of fighting from the Marines that they called them Teufelhunden which translates to ‘Devil Dogs’. Marines use to hear this name with pride and call each other ‘devil’. Now in our politically correct society Marines are encouraged to refrain from using this nickname in case some may find it derogatory. I don’t know about you, but I like our Marines to have an edge.
So, they have a very formal cake cutting ceremony followed by a BBQ. Some of us had cigars, some participated in pull up contest and yet others participated in football. It was a very important occasion with the Marines with everyone going around wishing each other ‘happy birthday’.

Semper Fidelis!

Happy Veteran's Day!

BBQ setup.

Having a cigar with some Marines.

Participating in the pull-up competition.

Taking a break from festivities.

Marines playing football on dirt lot.

HiMARS

2009-11-10T23:46:00.000-08:00

Yesterday I went over to look at the HiMARS attachment that is adjacent to our camp. We often see their Marines in our BAS. HiMARS stands for High Mobility Artillery Rocket System. They use to be an artillery company that shot 155mm Howitzers (M198). I know this because I was a GMO with 1/11 from 1998-2000. 1/11 is an artillery battalion and we use to go to 29 Palms to shoot our very loud and impressive artillery. Back then this company was also traditional artillery, but in the past few years has switched to the HiMARS role.

HiMARS are a rather impressive weapon. They are constantly on standby waiting for calls to provide artillery support for troops engaged in combat or to target buildings. The rockets they shoot can travel up to 80-100 Km (50-60 miles) and are very accurate in their impact zone. They are obnoxiously loud when they launch, but apparently are silent as they approach the target. They can carry various munitions rounds that serve various roles.

We were able to talk to the command element of this company, tour their command center, and look over the vehicles. Their training sergeant decided to have them demonstrate a dry run for us and roused up the ready crew. They basically get geared up and roll the vehicles just out the gate to a firing position. Pictures below.

Movie Reviews:

Kingdom of Heaven - would highly recommend. Good acting, get a little history, decent battles.
Taken - would also recommend. Lots of good violence.
Gamer – don’t waste your time.
Currently watching season 2 of Seinfeld. It is so funny looking at the hairstyles and clothing from the early 90’s.

Book Review:

The Girl with the Dragon Tattoo by Stieg Larsson. Kind of like a Silence of the Lambs who done it. I thoroughly enjoyed and have since bought the sequel The Girl Who Played With Fire.

LT Crandall, HMC Stubbs, Myself, HN Stein posing in back of HiMAR vehicle.

LT Crandall and HMC Stubbs taking pictures of HiMARS outside gate.

In firing position.

Looking down a missle tube.

food for thought

2009-11-09T02:35:00.001-08:00

I thought that I would talk about food today. I have promoted the British chow hall in past blog entries, but I have new distressing news. They turned over the chow hall to KBR which is a contractor through Russia. Now we have a lot of foreign nationals (Indian and many different Asian countries) who are trying to mimic the British cooking techniques. There has been a slight noticeable difference thus far. The main problem currently is proper communication. In other words, there is a lot of finger gesturing at food to try and relay what entrée you would like. Time will tell.

One of my favorite lunch dishes has been the ‘dream’ sandwich which is ham and tasty cheese which is dipped in egg and then fried. I have had it with jam on top ala Monte Cristo and have also lathered it in ketchup and Tobasco when I am feeling a little adventurous.

One of my favorite food activities is to look at the shelves at the Danish and English PXs. I have attached some pictures of interesting foods or interesting names.

It is starting to get cold here and very windy. I know that it is cold because when I pee in the urinal of the port-a-potty there is steam coming off of it. Unfortunately, the cold is not suppressing the stench in there. The wind is kicking up a lot of dust which is affecting visibility at times as well. I am often wearing my sunglasses in these conditions whether it is sunny or not to avoid the crust that develops in your eyes.

I did want to say something about current news. You probably have gathered that I am more a conservative thinker. I am also, as you know a physician. This may skew my opinions on health care a bit. I do believe that health care in this country can be modified for the better. However, I do not like how it is being addressed by this Congress and administration. When you are talking about a big issue like one’s health and an industry that is about one sixth of the GNP, you should not try to bulrush an outrageously large bill through on a Saturday night vote. You should also not be able to pass this type of legislation with a simple majority vote. I think that big change like this should require a super majority vote or a vote to the people (since Congress rarely represent the people these days). I hate the fact that there was limited time for Representatives to look at this bill, I think it is bull**** that the public had even less time to look at this behemoth document and I hate that the vote was almost purely partisan. I can only hope that it collapses in the Senate so we can really have a long healthy debate about what would properly help Americans and also be fiscally responsible. Lastly, I want a health bill that has health as the main topic and not have other agendas as its main driving force as I think is currently happening.

Thanks for tolerating my ranting.

Look, its got milk in it, it is good for them. Besides, he looks happy.

Monster Menthos packs. But look at the people it attracks!

A perfect snack for an old sailor.

The name says it all!

The Dream.

job description

2009-11-06T02:11:00.001-08:00

So I was asked by my son today ‘dad what is your job there?’ I thought that I would answer this in three parts, why our unit is here, what my job description is, and then what I actually do.

I am an augment to MWSS-372. They are a support squadron out of Camp Pendleton. Our job is to make and maintain runways, give fire rescue support to aircraft, give medical and logistical support, provide messing (food) support, and do all kinds of other projects for the Marine Air Group. We are really focused on the airfields during this deployment.

My job is that of senior medical officer (SMO) of the battalion aid station (BAS). I inherited this job because I have the most gray hair and a higher rank than anyone else at the BAS. I ensure that everyone else in the BAS are doing their jobs. I do see patients, but for the most part they are not very complex. My most important job seems to be making power point slides for daily briefs to the CO. Words just cannot describe the excitement and intellectual challenge this brings me. Lastly, I have to deal with local politics of other medical officers. Thankfully, I usually only have to introduce myself with my rank and this resolves most situations since they are mostly LTs.

To really give you an idea of what daddy does at work in Afghanistan, I will describe my day yesterday.

0630 – wake up
0630 – 0700 – brush teeth, make oatmeal and tea (switched from coffee recently)
0700 – 0730 – Talk to family back home
0730 – 0800 – Take 30 minutes on our computer to check about 3 e-mails
0800 – 0815 – Go to daily mass (got to feed the soul too)
0815 – 0830 – Make power point slide for brief
0830 – 0845 – See a couple of patients (maybe it was one patient with 2 diagnosis)
0845 – 1000 – Read medical text, journal articles
1000 – 1030 – Battle Update Brief or BUB (that is really the acronym they picked for brief)
1030 – 1130 – Work out (sit-ups, push-ups, pull-ups, dips, chest and triceps)
1130 – 1200 – Chill / light reading
1200 – 1330 – Lunch (10 min walk, 20 minutes to eat, 50 minutes chat, 10 min walk back)
1330 – 1400 – Patient (possible food-associate, exercise-induced anaphylaxis)
1400 – 1530 – Read, write letter, eat M&Ms
1530 – 1615 – Yoga
1615 – 1645 – Run to other base to play basketball
1645 – 1800 – Play basketball on a court that Brits made from material used for air strip
1830 – 1845 – Shower
1845 – 2000 – Dinner
2000 – 2100 – Sit around and talk smack about people
2100 – 2345 – Watch ‘Conspiracy’. Horrible movie. Name one good Val Kilmer movie other than ‘Top Gun’ or ‘The Saint’. That’s right, you can’t.
2345 – Sleep

I wanted to give a shout out to Greg Utz, former neighbor and Navy colleague who is going to take over as CO for Navy Health Research Center. Lily, we know that this is more from your hard work than his :) I also give Liz all the credit for my current position and stature…………in Afghanistan.

V-22 Osprey have arrived.

Warrior pose(er)?

This one is for you uncle Greg!

gym

2009-11-03T22:28:00.000-08:00

Today I thought that I would talk about our local gym. The Marines usually have decent gym equipment on their bases (of course never as nice as that which the Air Force bases will have…different blog). Our gym is about a hundred yards from the BAS which is definitely an advantage. However, it is, like everything else, housed in a tent with a plastic floor. I am sure that at one time (i.e. first month of use) the gym was great. Now the weights are mismatched, the pulleys on machines non-functional, and the pins needed for the machines non-existent. That is not even the worst of it. I have included a picture of the bench which is now more duct tape than fabric (remind you of anyone Liz?). I also added a picture of the treadmills. The treadmills only occupy space at this juncture as they do not work. All they do is collect sand. If you look closely, you will see that a lot of the ‘tread’ from the treadmills has been removed by some industrious Marine.

Mostly my routine these days is series of situps, pushups, dips and pull-ups. I am really starting to pump out some numbers. I have taken up running while out here. I use to run about 5 times a year. Now I am running 5 days a week, 4 miles a day. My goal is to get my weekly miles up and hopefully run the Rock N Roll marathon in June 2010. Anyone want to run with me? That’s right I threw down the gauntlet!
Talk to you all later.

Side notes:
1) I was a bit perturbed when I heard it reported that Obama would not decide on possible troop increases in Afghanistan until after November elections. Goes to show you where politician priorities are these days. They are more interested in political clout (winning local elections for their party) then they are about the welfare and safety of U.S. troops. Maybe we will have an answer after the next poll results are in.
2) I found it interesting that it is speculated that the first eco-billionaire could be Al Gore. He is sure profiting from his agenda. His financial interests stand to make millions off us common folk when things like cap-and-trade programs go into effect.

Just like Venice beach.

Where's the beef?

Yet another use for duct tape.

Slightly used treadmills. Actually never used because they no longer have tread...or monitors....or electricity to run on.

promotion

2009-10-31T22:50:00.000-07:00

So today, November 1st, was my promotion day. It was unique in a couple of ways. 1) We are in a war zone in the middle of Afghanistan. 2) I was promoted by the Marine colonel CO of MWSS-372 who happens to be the only officer higher rank than I (actually same rank now, but he is more time in service and my CO). 3) Everyone in the States will get promoted on Monday the 2nd since it is the first workday of the month. I got promoted on Sunday the 1st because we work every day in the field.

Really, all the promotion means is that I stuck around long enough and I have started to get gray. However, there are a couple of advantages I would like to point out. First advantage is that I will get some extra income each month. I am sure that if I do not find use for this that my family will :) Second, the higher the rank the fewer people I have to salute! I am also just one rank away from getting those prime 0-6 parking spots at the commissary and the golf course. Have a belated Happy Halloween.

Mark Tucker
CDR MC USN

Pinning.

Oath.

Handshake.

Officers of MWSS in front of BAS.

laundry

2009-10-30T05:01:00.001-07:00

I was asked about how laundry is done here. Everyone has a net like laundry bag for which they put their dirty laundry. You bring your laundry to an Indian national working for a British contract through Russia, Sadish, in the morning. You then come back the next day to pick up your bag. What they do is tie up the bag and throw it in a big washing machine amongst similar bags. When done they pull the bag out and throw it in the dryer. Simple, right?

There are a few caveats that one learns about. 1) Do not overload your bag (meaning more than a few items) otherwise it comes back wet. 2) Do not buy a white laundry bag. Most Marines bought theirs here and they all look alike. I, thankfully, bought a black one and thus easy for Sadish to find my bag. 3) If you need something back the same day then tip the guy a couple bucks. This will get your items fully dried and folded. 4) Do not get upset if somehow women’s underwear/bras end up in your bag. There is no message here; it is just not a perfect science. I personally have not lost any garments or gained any garments, but others have. Usually it is the women finding that their underwear is missing!

The other service that the laundry guy offers is bracelets. He makes them out of different military cords and weaves in names or patterns. Pictures below.

Cheerio

p.s. you will find humor in that the chaplin tracked me down after mass today (that's right they do have mass on the weekdays too). Apparently he heard that I was learning the guitar and he wants me to strum along the hymms on Sundays. That should be wild. Only advantage is that everyone else will have their horrible singing drowned out by my grinding guitar sounds mimicking a cat being skinned. More news of this in future blogs.

Handicrafts of the laundry man. Making good use of that 550 cord.

Laundry complex.

Laundry in a box.

Sadish.

water

2009-10-28T21:13:00.000-07:00

I was asked about the prevalence of water at our establishment here in Afghanistan. There is no evidence of any water anywhere near here. There is not a green anything here except on Marines. Apparently one of the reasons that this base was built here is that it sits on a huge underground aquifer. The water we drink is actually ‘bottled in Camp Bastion’ which is scary enough. That being said, we have plenty of available water. There are wood huts situated throughout the base that has pallets of water that anyone can take. In the chow halls there are refrigerators full of water (which oddly enough always seems to be warm?). Our CO had a huge walk in refrigerator placed next to the BAS to store cold water for the Marines/Sailors. It was just placed in time for our oncoming winter.
Speaking of water, I should see plenty of it soon. There are a few months of the ‘rainy’ season. When it rains that water just sits on the ground as the ground is not porous at all. The BAS, and all other tents, will get flooded. We were told that there was a stream of water that flowed through the BAS in the past. The ground becomes a sticky mud (remember, all we have is dirt around here) that gets over everything. Should be tons of fun!

I am going to go get a cold one now. That would be water for me 

Typical water storage area.

Bottles actually tell you to keep out of direct sunlight! How about out of the sand!

The master of the water locker,

Is bottled in Bastion a good thing?

Camp Leatherneck Resort and Spa

2009-10-27T06:30:00.000-07:00

I just got sent this. If you to see something really funny and get a taste of what are daily lives are like, then go to following site at youtube for a laugh http://www.youtube.com/watch?v=9-ro9zLSb2s

Mark

blackouts

2009-10-26T06:27:00.001-07:00

Hello,
In case you are wondering why I am not always consistent in my blogging, it is really three reasons. 1) I am lazy 2) It is a lot of pressure to think of new interesting topics coming from a very uninteresting individual and 3) Blackouts.
We have communication blackouts when there is an U.S. casualty. This is so no news of the event gets out before the family members can be appropriately notified. Sometimes this is within hours, sometimes days. Therefore, there are times I just plain cannot get on the computer to blog.
Today I am going to write about the Gurkhas from Nepal. They are part of the 'Queen's Gurkha force' which is part of the British forces here in Afghanistan. They are known as fierce warriors in the past. I will refer you to a wikipedia link http://en.wikipedia.org/wiki/Gurkha. I was able to purchase one of their traditional knives that are handmade. I also got some replica letter openers. The money raised by the sale of these items and shirts and such goes to a charity fund for those who have served in the Gurkha forces serving Britain pre-1997. They apparently do not get any pension and thus need added assitance. So below are some pictures for you to peruse. Cheers!

Knife has layer of oil on it to preserve. There are 2 smaller knives in the hilt that are used for skinning game.

Letter openers and signature patches.

Me outside Gurkha headquarters.

smok'n

2009-10-23T06:25:00.000-07:00

Hello again,
So I have had some requests on topics to talk about in the future...is there enough water there?....how do you do your laundry?.....what happens to all the trash? I will get to work on these questions.
For today, I will talk about the smoke pit. It is conveniently located just feet from the BAS door. Who in their right mind would put the smoking area next to a medical clinic is a mystery to me. Of course we also have the port-a-potties and the haircut shed next to us as well. Now my corpsmen claim that it is a benefit as they go and socialize with the Marine and British smokers to, you know, make sure that they are feeling okay. Are they dispensing advice about quitting smoking...no! No, they actually are smoking themselves (about 5 of them). Not exactly the message I want to be sending.
I thought that I would take a shot at the smoke pit for your enjoyment.

We have continued to get lots of packages from AnySailor.com. We have truely felt blessed at the supplies and support they have sent. I have decided to post a package of the week. This week's winner is a tie. I received 3 boxes (one shown below) from a federal credit union in Florida of pure M&Ms. We also received about 40 boxes of Girlscout cookies from a troop of 18 girls in Misssissippi (I had to sing that to spell it).

I could play James Dean or maybe John Wayne.

We have been bartering with our Girlscout cookies.

MMMMMMMMMMmmmmmmmmmmm.

hideout

2009-10-21T01:35:00.000-07:00

Today I thought that I would talk a little about privacy or better yet the lack thereof. Here in the field there really is no such thing as privacy. I am constantly around people at work, play, chow, and even sleep. It is not that I do not like social interaction (most of you would probably state that I need attention), it is just that sometimes you like to have a little peace and quiet. About the only place you can have that quality time to yourself for reflection is when you go to the head (bathroom for non-Navy types). The problem is you do not want that much time in that situation because you are either sitting in a space that is smaller than an airplane bathroom (previous blog) or your olfactory system is insulted while you steam away in a port-a-potty
My original living quarters was with the younger, more hip, Marine lieutenants and captains. When it was realized that I am actually a field grade (04 or above) officer I was told that I must move to the hooch (tent) where the CO, the XO, the operations officer and now the Chaplin all reside. The Chaplin and I share the front third of the tent; I call it the parlor or ante-room if you will. The nice thing is that there is somewhat of a plywood partition that separates us from the other officers, but the negative is that everyone must walk through my space to get to theirs and the door opens right into sight of my rack (bed). Therefore, I had to find a way for a little, that’s right, privacy. I have included some pictures to give you an idea of how I can engage myself with different layers of privacy.

Open air.

Is he sleeping?

The man wants to be left alone!

technical difficulties

2009-10-18T03:00:00.001-07:00

I waited in line for use of a computer and excitedly sat down to update my blog, but there seems to be some technical difficulties today. Thus, no pictures today. Felt like I should at least say hello. I will continue to bring you the news of the day here at Camp Barber in the middle of nowhere errrrr.....Afghanistan.

I was told by multiple sources that my 'feeling sorry for Mark' stock took a hit when I published the pictures with the celebs on last blog. Well at the risk of having my stock further plummet, I have new news. Apparently, we will have our evening meal provided by Outback Steakhouse. That being said, I would trade a steak for a good carne asada burrito anyday!

Yesterday we played a basketball game with the British engineers. They built this rec area with sand volleyball and a basketball court with a wood-like matting. It was fun hanging out with them, but their version of basketball is more towards rugby. I am a bit sore today. Maybe volleyball next time as there will at least be a net between us.

Thanks everyone for your continued encouragement. I enjoy hearing from you all. Nanette, you get bonus points for your use of the word shenanigans (and spelling it correctly at that).

celebs

2009-10-15T03:04:00.000-07:00

So, today we had our first celebrities at our compound. I was a bit cynical when first hearing about this event. The celebs that were to come were Kelly Carlson (The Marine), DW Moffett (theater), DeAnna Pappas (Bachelor / Bachelorette), Greg Germann (Ally McBeal) and Vanessa Branch (Orbit gum girl). Since none of them were going to be performing for our entertainment, I figured that they were getting the most benefit from the appearance. Well, overall, I believe they were sincere in their intent. The Marines and Sailors seemed happy to see them and they stayed back to take pictures with the troops. So I give the experience a B+.
I did get a picture with the crew. When I went up and introduced myself, the women asked ‘sir, can we put our arms around you for the picture?’. My response…….’make my wife jealous’.
I also got a picture with DeAnna for two reasons. One, she was the only woman who did not look anorexic. Second, she knew my rank by my insignia because her father is a LCDR in the Navy.

I signed our BAS up on a site called AnySailor.com when we arrived. I received a box of goodies 2 weeks ago from a family in Northern CA. Today I received 9 boxes from 2 families in FL. Nice to know that there are people out there that try to do their part in making military members lives more bearable while away.

Really, who is the real star of this picture?

Probably broke her heart when I told her that I am not a bachelor!

haircut

2009-10-13T23:53:00.000-07:00

So what happens when you start to cut your hair in view of motivated Marines? You get plenty of volunteers willing to cut your hair for you. The negative is that you have little control over how short your hair becomes. Such was my experience yesterday. A Master Sergeant decided that he needed to cut my hair and now I am quit bald as you can see below. The good news is that I now have no gray hair showing. The negative is that it is starting to get chilly around here and now I have no hair buffer to warm my noggin.
For the kids I am attaching a picture of a Finland infantry troop carrier. I also put in a picture of a trench digger that was outside our BAS digging a trench to lay telephone wire for our phone.

I finished my book on the history of Afghanistan. It was a dry read. Cliffnote version is that they have a long history of hardships and war. Now I am in the middle of watching Band of Brothers. I have owned this series for the longest time, but just now watching for the first time. I highly recommend.

Who is that sexy man?

Sides smooth as a baby's butt!

Finland troop carriers.

Can you dig it?

say what?

2009-10-11T01:45:00.000-07:00

Hello all once again. So it is hard to get all the recent news over here since we get limited time on the computers and when we do get on them they take about 5 minutes to load a page. I did see one headline that I wanted to comment on….
What does Desmond Tutu, the Dalai Lama, and Mother Theresa have in common with Jimmy Carter, Al Gore and Barak Obama? They are all Nobel peace prize winners. That would be the only common thing they share! It is my opinion that the Nobel prize has lost a lot of its merit over the years and now serves more a political agenda than an honored award going to an exceptional human being.
Lets look at the latter three I listed. Jimmy Carter has does more harm every time he opens his mouth the past five years than he every did good to warrant the prize in the first place. Al Gore took questionable science (if you can call it that) on global warming and made a movie to earn his award. BTW, did I read that Colorado snowed out their baseball game this week….in early October! Now Obama is being applauded for his outreach to the Middle East….based on one speech?......or was it based on his bowing to the Saudi king?

Okay, okay, I know that at times I can get political, sorry. So for your picture of the day I have an image of one of the more popular Pringle flavors sold at the British exchange. Enjoy!
I will also include a picture of my trivia team, ‘The Bloody Yanks’. We participated in a charity trivia game with the British and Dane medical support. We were the only Americans there which was interesting on many fronts. First of all, not all the questions fully translate into terms an American may understand. Second, we were jested in a friendly fashion all night long. When we would verbalize a good score on a section, we were uniformly booed. When we did poorly we were cheered. I think that we would have been in serious danger had we won, but instead we finished in the middle of the pack. Cheers!

Yummy!

Yankees representing.

what to do with the sand

2009-10-09T01:47:00.001-07:00

So lets talk about sand today. Not the sand you make sand castles at the beach with (that would require water silly). Not the sand you put in the back yard for the kids to play with (that is too fine and comfortable on your feet. No we will talk about Afghanistan sand. When one first tries to establish a base here he/she realized that the dust is horrible. Walking in the sand is like walking in moon dust with billows of dust clouds forming about your knees as if you were walking about in powdered sugar. So what is the solution? Scrap off top layer and then put down different sand with small to large rocks in it to keep the dust down. This works to an extent, but my lungs are probably caked at this point as if I were a 30 year smoker. Also, any piece of equipment anywhere on base has a layer of dust upon it.
There is however, one ingenious use of the sand and that is for walls. HESCO (do not know what acronym stands for) is the way they build walls around here. Basically you take a wire shape and stick a fibrous board material bucket inside and then fill with what the primary resource of the land happens to be......sand! Pictures below. Cheers :)

I finished Liberty and Tyranny by Mark Levin. Really enjoyed the history lessons in the book and it scared me to death of what we may be led to expect to occur in this country (U.S.) if we do not wake up.

Now I am reading a history of Afghanistan. In a nutshell, lots of war, lots of betrayal, lots of brothers killing each other and/or blinding each other and lots of kids with many wives. Favorite quote so far is from one of the monarchs of the past who was forced into exile into British India. He said in autobiography 'I would rather tend to a blade of grass at British camp rather than rule all of Afghanistan'. Wonder why with all the sand and all?

church

2009-10-06T03:41:00.001-07:00

We have a chapel that sits next to the BAS. It looks remarkably similar to the BAS from the outside. The pews are benches that are made from old pallets, it too is dusty, but still serves its purpose. I am lucky that our Chaplin is a Catholic priest since I am also Catholic. He is from Philly and is number 5 of 9 kids and has 46 nephews and nieces. The chapel service on Sunday reminds me of Little House on the Prarie because we are never more than 15 and we have to sing without music which does not bring out the best in me.
I have started to go to daily mass when he is around and not visiting the Marines and Sailors out at the outlying operating bases. The disadvantage of going to daily mass is that I am often the only one there and thus have the responsibility of doing the first reading and responsorial. I also need to independantly remember when to stand, sit, kneel and what prayer or response is next. The pressure is starting to get to me! The positives of daily mass is that it is never longer than 15 minutes, the homily is never longer than 1 minute and it is the only place out here to get a drink :) Here are some pictures to enjoy.

injury report

2009-10-04T02:14:00.000-07:00

Well hello again. Did not know what to talk about today, so decided to showcase some typical injuries that we see during the course of the week.

This guy was playing with his new knife. It works!

This guy had his sutures removed at appropriate time, but it reopened like a zipper 2 hours later.

This guy had secondary cellulitis of a lesion on his knee.

This guy dislocated his PIP joint of 5th finger. I have great picture of him giving an hang ten sign, but it shows his face so I cannot publish here.

Trauma to ear from wrestling caused this seroma to develop. I lanced it and pulled out serosanguinous yellow fluid.

I want to give congrats to my son Kyle who accomplished after four lesions what I have yet to accomplish in four decades. He got a hole-in-one on his 3rd ever played par 3 hole. Way to show up your old man Kyle. I hope that you continue to show me up in many avenues in life.

Today's readings in church were about matrimony. It reminds me of the importance of a strong loving marriage for the rearing of our children (I sure could use many aspects of that 'love' in our marriage right about now ;). I think that one of the great fractures of our society is that marriage has been trivialized and redefined to the point that it has led to many broken homes and a troubled youth.

battalion aid station (BAS)

2009-10-01T01:55:00.000-07:00

Today I thought that I would write about my beloved BAS. We have two tents that are back to back that form our BAS. We have a few make shift treatment rooms, a decent formulary, no running water and no bathroom. We do have an air conditioning system that is a big tube that hangs from the ceiling that has multiple holes that you can velcro open or shut. The air con usually works, but we anticipate a power outage about once a day from our generator. There is a good layer of dust on the floor, computer, desk, phone, me.....
We have corpsmen from different walks of life and different areas of medicine which makes for an interesting crew. We wear our battle dress uniform every day as well as our weapons. Conveniently the smoking pit is just across the gravel from us (who made that decision). Luckily I have a chief and a few corpsmen that are addicted and can sit there and disseminate useful information to the smoking troops about preventative medicine :)
I have gone from an office with a phone, internet, e-mail, scanner, desk space, file cabinets and a window to a three foot carved out area on a picnic bench that serves as our admin space. We have a computer that could compete with the best machines ever produced .... in the 80's. We have one phone that serves 20 people.
Most of what I see is very general medicine and my pediatric and allergy talents are not going to be adequately used, but my mission is to serve the Marines and I am willing and able to provide that service. Though the BAS is primitive, it is actually better than I envisioned and the corpsmen I work with are great.

<-----Our crew

BAS

Welcome to my world!

BAS cont...

2009-10-01T01:51:00.000-07:00

thoughts about food

2009-09-29T02:53:00.000-07:00

So Today's picture is of our change of command ceremony which has now left us in charge of the dirt and dust rather than our sister squadron.

However, I wanted to say a few words about food with observations I have had over the past 2 weeks. First, good food leads to good morale and I am happy to say that I have not had to have a complete MRE or T rat meal since being deployed.

I have mentioned that we have been mainly eating at the British chow hall. The negative to this is that it is very poorly air conditioned, the food is not always salted enough and the milk and water tend to be warm. It is hard to find any other criticism. I really think that the Brits get a bad rap about their food. We usually have 4 different entrees to choose from and I have as of yet not been disappointed. Actually the food is pretty flavorable. I especially like the currys that they make.

I have gone to the American chow hall on three occassions. Now, many of the Marines prefer this chow hall, but I think that it has to do more with the better airconditioning, the cold drinks and the familiarity of fried foods. Since I have been partaking in the British chow hall, I now have been reminded just how calorie rich our fried foods can be. Could it be that this is an alimentary awakening for me?

Last point about food. Here the meals are really a social event. We walk together in small groups to the chow hall, we sit together and we talk. It is not unusual for us to be there an hour. Then we walk back. What a concept...build up an appetite, eat slowly with good company and then digest while walking back to camp. Another concept lost on American routines when we are more interested in eating fast to get to the next place we need to be. I just wish that more people could sit and eat as families as we get the chance to eat as comrades.

So in the past 24 hours I have finished the last Harry Potter (victory over Voldemort at last) and I have started Liberty and Tyranny by Mark Levine (a great read). I have also watched the hangover (a bootleg at that) which was pretty funny.

another sandy day in paradise

2009-09-28T01:53:00.000-07:00

So I had to move yesterday. Apparently, it was not appropriate for me to stay in the company grade quarters being that I am a field grade officer currently and will be promoted in the coming weeks. Thus, I was shuttled across the gravel to the tent housing the CO the XO and other brass. True, there is a bit more wiggle room in my new corner of the tent, but it just is not as lax. There certainly is not the same humor quality (or lack thereof) that there is in the junior officer quarters.
It is still hot here. There is plenty of water to go around, but usually the bottles are in big piles stationed outside buildings and therefore the water is as hot as the day. Refrigerators are sparse in these parts and ice is unheard of. When you go to the chow hall for lunch you sweat and it is not because of any spice in the food.
I have included some more photos for your enjoyment. You can appreciate the nice little dust storms we get daily. I also included a sunset, because it is the first time I have seen a cloud in these parts. The car, a Tata, is a common vehicle seen on base. We call them Tic Tacs. The last picture I included is a bazaar that they have on base. I doubt that many of the objects are real, but it killed 10 minutes of my deployment so worth the perusing.

toilets

2009-09-23T23:30:00.000-07:00

I thought that I would write about the toilets today. So we have two choices for using the head (bathroom). We can use port-a-potty or use the bathrooms that are made from big steel boxes. The advantage of port-a-potties is that they are everywhere and are a bit more roomy. They are cleaned twice a day including a powerwash. However, they tend to have a stench to them that is intensified in the heat.
I prefer the conex boxes. So basically they put these boxes together with a couple for women, a couple for officers and staff NCOs and then others for lower ranking enlisted and lastly for the local contractors. Each conex box (for males) has a urinal that lines part of one wall that reminds me of my teenage days in TJ (all it needs is someone to dump ice in the bottom of the trough). There are three sinks and three showers and three stalls. Now space is at a premium in here. If you were over six feet tall you would be miserable. My head clears the shower by about a half inch. The toilets are even worse. Your knees touch the walls when you sit down and getting off the head and trying to pull up your pants is quite the task. It would probably resemble a Benny Hill skit. When you shower, you have to push a button on the wall in order for water to come out. If you let go of the button it stops. If you continue to hold the button it will stop after 10 seconds. Thus, you have to get creative with your showers.
The good news is that I just fit in the conex boxes at 6 feet and therefore I am avoiding the port-a-potties for any activity that requires me to sit down. Also, hot water does routinely come from the faucets (how scolding hot is a different matter).
I find it ironic that one of our goals in Afghanistan is to promote individual freedoms and every time I get to log on and look at the news we are gravitating to giving up the same freedoms at home in the U.S.

The conex boxes ...errrrr... bathrooms.

Shower.

Urinal and sinks.

No porcelin here only stainless for good reason.

the company car

2009-09-22T19:09:00.001-07:00

We have a vehicle to drive around base for medical needs. It sure is not an ambulence. We are separated from most American forces and other medical assets by enough distance and roads that it requires us to drive for those matters. We drive on the right side of road, but also sit on the right. It is stick and thus you have to stick with your left hand which takes some getting use to. I hopped right in at first opportunity and was surprised to be able to drive rather easily. That being said, it is old and bumpy and the sounds that come from the steering does not give you much confidence in it's future.

Company car.

Left stick shift.

Still functional Hummer with door falling off.

Many of the local trucks have drapes inside and have these medal chimes dangling form front bumper.

first days at Camp Barber

2009-09-21T01:33:00.000-07:00

Dust would be the one word to describe Camp Barber which is the British part of Camp Bastion. Sand and dust is everywhere and on everything. There is no green. No grass, no weeds, no trees, just sand and rock. It is hot right now about 105. Supposedly it will start to get cold in next two weeks.
I live in a tent with about 8 others. We have showers in a box that will allow water to flow for 10 seconds at a time. The toilets are sparse and really tight such that you can hardly pull up or down your pants (I will take picture another day). Internet is limited to 30 minutes at a time and must use their computers, not your own.
The BAS (Battalion Aid Station) is relatively well put together in a separate tent. Lots of plastic matting and plywood, all with a layer of dust.
The one benefit so far is the chow. We eat at the British chow hall and it is quite good. This chow hall not only serves us and the Brits, but also the Danes. I have not branched out and tried the blood pudding yet, but it is probably a matter of time since I am here for 7 months.

Chargers killing me! I did not see or hear the game, but common it is suppose to be their year!

Our BAS. We need to change sign to 372.

Me and the Chaplan. Nice that he is Catholic, wife and mother-in-law should be happy about that. To top things off, the chapel is next door to the BAS.

Camp Barber entry.

flight to Afghanistan

2009-09-21T01:27:00.001-07:00

So our flight finally took place. We again had to hurry up and wait. We literally crammed our way onto some old white school buses and then we boarded a C-17. I sat on a jump seat next to our pallets of gear. Interesting flight in that you have little sense of where you are since no windows. Bizarre to feel a drop on approach, but not able to fully anticipate landing until…bam!
Whe we landed and the back opened up I knew I was not in Kansas or any part of civilization anymore…

Just so you know, I have limited access to internet and thus posts will be fewer. Also, I cannot get my normal e-mail, so if you want to get a hold of me contact Liz and she can give you alternative e-mails.

Me on the bus with the fellas

Two of my corpsmen

View from my seat

the Marine

2009-09-18T06:16:00.001-07:00

The past few days I have been able to observe Marine, Air Force and Army units go about their business on this base. I have been reminded in just how professional the Marines are when compared with their sister services. It is not even close. The Army and Air Force do not salute each other (and certainly not a Navy officer) and they wear their PT gear everywhere. The Marine wears the proper uniform, renders the proper greeting and walks around as if he/she has a purpose in life. The Marine also tends to fit in their uniform with a bit more ease ;) I certainly feel blessed that I was attached to a Marine unit for this deployment instead of say the Army. The Marines will definitely take care of me.

Remember that this Saturday is talk like a pirate day arrrrrrrrrrrrrrrrgh!

rainy day

2009-09-16T23:14:00.000-07:00

Picture today is me wearing Russian military hat purchased at base in Manas. It is a little colder and raining today. Not all was lost as I found out that AAFES contracts out massage services in a trailer. I happily got a 20 dollar 1 hour massage from Tatiana. Liz will be happy to know that there was no 'happy ending' to this massage! Tatiana tells me that she is Russian and that Russians make up less than 10% of local population. Most of the those living in Kygystan are Kyrgystanies (spelling?) who also speak Russian (since once part of Soviet Union), however look very Asian in their features. The nearest city is also the capital and most contractors from both Kyrgystan and those form America live out in town and commute. I will most likely be leaving this base in coming days and go onward to Camp Bastion to hang with the British. More to come....

I was ecstatic to see that ACORN is finally being outed. I see that one of the primary sting videos was from San Diego (National City). Unfortunately, the major networks will still not report much on it. Journalism is not well these days and certainly not non-partisan (my opinion).

FIrst full day at Manas

2009-09-16T07:06:00.001-07:00

So I just wanted to tell you about my first full day at Manas. I am sleeping in a huge tent that has like 120 Marines in it. We are in bunkbeds with so-so mattresses. Chowhall is decent and free which is good. I must say that the gym is impressive for where we are and complete with weights, machines, and basketball court. We played a little baseketball today. I visited the permanent medical clinic here and it was sufficient. They actually have capacity for surgeries. There is a Px here and behind it a place called AAFES town where locals can sell some gifts. There is also a coffee shop of sorts and a trailer where they sell pizza hut pizzas (must be frozen pizzas they cook). They have self service laundry and showers nearby the hut where I live which definitely helps my morale. Below are some more pics.

I just watched some TV in chowhall during dinner and saw that the House of Representatives spent taxpayer money to waste a day condemning Rep Wilson for his outburst of the President. Then I saw that Jimmy Carter says these things are due to racism. Are you kidding me!!! First off it took the majority white vote to carry Obama into office. Second, no one called out racism when democrats would heckle Bush (by the way, I am not the biggest fan of Bush either) and compare him to some rather deplorable things/people. It is sad that racism is brought into the discussion so easily. Maybe some people like Rep Wilson jsut do not like Obama's policies or the fact that he is bullish in his nationally televised speeches (how many have there been already?). Sorry just had to get that off my chest. Now back to the pictures....

Me posing in front of AAFES town.

Our tent where we sleep. Lots of gravel everywhere.

Representative shot of our bunks.

First leg

2009-09-15T05:31:00.000-07:00

Okay, soooo I am really tired after my recent journey halfway around the world. I left Camp Pendleton on Sunday morning, went to March Air Force Base by bus, hung out in a hangor all day before boarding a flight to Bangor Maine. We arrived in Bangor in wee hours of the morning (people there still to shake our hands). We then flew to Germany where we waited for a flight to Kyrgistan. I arrived in Kyrgistan on Tuesday afternoon. Currently I am 12 hours ahead of PST. I have attached a few pics for people to see.

Mike (other doc) and me at Camp Pendleton prior to launch

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Waiting in hangor at March AFB. Mmmmm MREs

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Random soldier in Russian garb at airport in Manas. Could not resist taking picture with the man in the big green hat.