As The Sparks Fly Upward

Time keeps on slipping (slipping, slipping) into the future…

  • You have reached a 2008 blog…

    ...about the day-to-day adventures of MAJ Erik Rupard, working as a physician in a Troop Medical Clinic in Iraq, during 2008. It is presented as a diary, in chronological order, but feel free to start anywhere.

    I'd like to express my gratitude and appreciation to the fine soldiers of the 581st ASMC who kept me alive, happy, and well-fed throughout my time in Al Asad.

    If you are a former or current 581st member and you want to reach out to me or any of the others, head on over to Facebook, and search for Erik Rupard. Talk with you soon!

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Archive for April, 2008

Will Rogers’ Neighborhood

Posted by Erik Rupard on 22nd April 2008

I went to a late dinner today, after a long bike ride. As I sat in the DFAC, eating some pretty darned good stuffed peppers with three of my co-workers, I had a moment of clarity.

“What do you like about being deployed?” I asked of SGT Evans, a fresh-faced, multiply-tattooed 22-year old, who by the end of 2008 will have spent well over two-thirds of his life in Iraq since turning 20 years old. I have always suspected that Evans enjoys being deployed, and he confirmed this today, citing as deployment’s positives the general freedom, the opportunity to do the job for which he was trained (medic) and the fact that he saves money while he is overseas (there is little to spend it on here).

“But,” he added, after finishing the list above, “the best thing about deployment by far is the people that you meet. What other situation allows you to meet and become friendly with Ugandans, Indians, Iraqis, Pakistanians, Australians, Brits, Canadians, and Americans from every state? And during deployment, you really get to know and bond with the people who are actually working with you every day, like you guys.”

It was at this point that I realized that being deployed here in Iraq is a lot like Boy Scout camp, albeit with the notable exceptions that deployment lasts a lot longer, and there are people just outside of our “camp” who are trying to kill us. Most of us have had the experience of going to scout camp (or Brownies, Girl Scouts, young women’s camp, whatever), and not really wanting to go, not knowing anyone there very well, and possibly even not liking very much the people who are stuck there with you. But then stuff happens that brings you together: your canoe overturns and everybody has a good laugh, or someone gets injured and the others come together to help them out, or you just talk around the fire; all of these experiences bind the group together. It’s been my experience that it is very hard to truly dislike any person whom I get to know beyond just a superficial level. And it is easy to like them, to admire some aspect of their personality, to empathize with their unique story.

And then, there are the shared experiences. Today, as I rode my bike out on the flight line with a couple of my colleagues, one of them slowed down and pointed backwards, in the direction from which we had just come. Behind us was a breathtaking sight: the sun had acquired an enlarged, sort-of wavy appearance as it sank low behind a bank of clouds, with the mysterious Al Asad “pyramids” in the foreground, along with some signal towers and some large, beautiful planes. That is a sight which could not be seen anywhere else but on a military base in Iraq. This particular military base, in fact.

I do not imagine that there will be a time after I get home when I will sit and pine for my deployed days. There is much about being here which is unenjoyable, or simply not distinctive in any way, and therefore not memorable. But I will remember moments like that one, and I will remember the people with whom I have shared those moments.

Posted in Iraq | 3 Comments »

things are gonna change, I can feel it

Posted by Erik Rupard on 21st April 2008

At the end of a long (but fruitful) day, I offer you the following random bits o’ Iraq:

  1. This weekend I borrowed SFC Langer’s legendary vacuum in attempt to thoroughly clean my canister. Unfortunately, the 500 watt transformer I own was not quite up to snuff, and sometime during the process, it started to emit some fine smoke. I did not notice this (just thought that funny burnt popcorn smell was coming from the vacuum, and “normal”) until it got pretty smoky in the room, and then I quickly switched everything off and ventilated the place. Now, my entire living area smells like toasted electronics. The smoke seems to have gotten everything. I Febrezed the living daylights out of every item in the room, but it is still a transistor meltdown in here.
  2. I received an e-mail from my Georgia Bishop today, letting me know that I have been released as Elders Quorum President of the Martinez Georgia Ward. Good thing, too, since I was probably going to miss the Presidency meeting this week (again).
  3. I jogged, ran, biked, walked, and ellipticalled today. Plus, I lifted weights for an hour. In other words, I have “disposable time” for the first time in my life since about summer vacation, fifth grade. At this rate, I may have time to find those pecs after all.
  4. There were rumors floating around that the mess hall had some real (as opposed to powdered) eggs, so I made a rare breakfast appearance today. Indeed, there were actual, factual, bona fide eggs, and I had a couple, over easy, with some bacon, and a bowl of Special K with berries. Best meal I have had in Al Asad, hands down.
  5. The dust level has declined precipitously, and so has the heat. Very strange, as a few days ago all was brown and boiling. I’ll take what I can get…
  6. As I am about to lay down to sleep, I can’t help but wonder: is unannounced Iraq visitor Condeleeza Rice sleeping in a “can” tonight? If so, does her trailer sport the lovely fragrance eau de burnt transformer?
  7. The Red Sox have already won their game today, third in a row against the Rangers. Woo-hoo!
  8. 132 days to go…

Later, skaters.

Posted in Iraq | 31 Comments »

Title Schmitle

Posted by Erik Rupard on 20th April 2008

I’ve backlogged a couple of days since my last (real) entry, and will catch up on those in time. But first, it is time, high time, in fact, to address some [begin loud, echoey voice, like the announcer at a stadium]

BLOG (log, log, log)

HOUSEKEEPING (eeping, eeping, eeping)

STUFF (tuff, uff, uff)

Often, people ask questions in the “comments” part of the blog. I really like this, because it gives me a chance to answer specifics right on the site itself, which serves to enrich this “document” of my trip. I think that in many years (or maybe not so many), my September 2008-ish printout of this blog will be a precious document to me, sort of like having a personal journal of my time here, but with the timely commentary of those who have read the passages. I am honestly very grateful for your participation in this, and I hope that anyone out there (Rupard family member, Rupard friend, or interested third party) feels free to comment, and not necessarily to agree with everything stated. As I’ve said before, my only requirement is to keep it clean.

Having said that, I don’t always respond to questions within the comments section, as sometimes by the time I wake up the day after I’ve posted something, there are multiple questions from multiple people, and it would be hard to answer them and keep any sort of reasonable “flow.” In those cases, I will e-mail the questioner directly if they left their e-mail address—which is safe to do, as I am the only one who can see it and of course I won’t give it to anyone else. Or, I will respond on a later blog post (see below). Occasionally, a question or comment will get buried after a couple of days, and I will not respond at all. I apologize for this, and can only explain that I have limited hours per day with a stiflingly slow internet connection, but I also have to admit that I sometimes just plain forget. But again, please accept my sincere thanks for “playing.” If you ask me something and I don’t get back to you, by all means ping me again (either on the blog or by e-mail) and I’ll eventually be shamed into getting back to you…

So then, some shout-outs (as the kids say):

Travis Richardson , a friend from residency days at good old Wallyworld, and it looks like you are there now. Glad to hear from you, but I’m sorry to learn that you are headed to the brown zone. Hopefully, just for six months. It’s a very small world out here, but one with very limited transport, which means that I’ll either never once see you out here (likely), or I’ll see you constantly (if you are stationed on Al Asad). Once you know where you’re going, let me know. If you have a choice, this is a good place (safer than most, but also dustier and less friendly); Balad and Liberty are both as cushy as it gets. Baghdad is less safe, but (so I hear) has better internet, more stuff to do, and more medical types (which means you’ll probably know a few people who are there). Either way, I wish you a safe and quick trip here and back.

Beth Brown and family: It is so nice to hear from you, and I hope you like my silly ramblings here. Thanks for thinking of our clinic; although I will be leaving in September (hopefully), the TMC will be here as long as the troops are, so keep them in the back of your mind for any future projects. Al Asad is a safe base (the most important thing), but kind of a deprived one—not much entertainment outside of the gym, and the food is good but very samey most of the time, so contributions are greatly appreciated.

Dad: Funny that you mention it, the second I read Mamet’s essay, I felt the pangs to read “Masks In A Pageant.” So I e-bayed it and Amazon-ed it, and the prices were outrageous (likely because of Mamet’s essay). So, I figure I’ll check it out via interlibrary loan when I get home. Please don’t spend thirty bucks on a copy for me. Glad to hear that it is good, though. If you feel so inclined, copy your favorite chapter, and put it in the next package or letter that you send me, and I’ll read it.

and last but not least

Christian: You have been one of the more prolific writers to my blog, and as I look over the past weeks, I have been pretty slow and/or negligent in responding to you. Sorry about that. Got your e-mail today, and I really like both songs, especially the Brendan Benson tune. When you write about music on my blog and on e-mails, you sound like a rock critic—maybe you have a bit of the writer’s bug in you like Grampa Rupard, your mom, Your Unkie Erik, and your Aunt Lorri. Rock critics have a great job (get free CDs in mail before anyone else gets them, listen, write about how crappy they are). But before you start to think that’s the coolest job ever, remember what David Lee Roth (Van Halen’s singer) said about rock critics. When he was asked “Why do all music critics like Elvis Costello?” he answered “Because all music critics look like Elvis Costello.”

EC circa 1977

THE RUPARD MAILBAG

The brown-out-edness of this week led to very few days (two, actually) in which mail was delivered. Thankfully, I scored each time. I’ve already mentioned the box of Chex mix, candies, and “calf slobbers” (Confused? Google is your friend.) which I received from mom and dad. On Saturday, just in time for our big Saturday Night Movie which shows regularly under the stars (or dusty mosquito nets, as the case may be) in the alley between our cans. The Tompkins family sent me lots of books for the clinic (thanks–we have a regular Carnegie library in the makings here), along with some middle-east rarities such as Oreos and Chips Ahoys. When some of my sergeants saw those double-stuffed peanut butter Oreos, they practically bloodied each other trying to get at them. Thanks, Melissa and family for your generous donations to the cause. You’ve done your part to make your soldiers happier (and a bit fatter).

Christian sent me a Matt Costa disk and some music magazines, which I’ll be digging into later. But the crowning jewel of this packages is a 1970 Mad Magazine paperback, “A Mad Scramble.” Now THAT is literature, and will bring me back to the days of “Spy vs. Spy” and those ke-razzy Don Martin comics. Plus it has one of my (seriously) favorite smells, that of an old book. If they made a cologne called “Old Paperback,” well, all I can say is “Watch out ladies!” So thanks, C-dog! May be the best package yet. (Wait, now that I think about that more clearly, I am pretty sure that it is exactly tied with all of the other packages I have received to-date. Yeah, that’s it…)

Finally, the always-anticipated Lorri package, which contained a special item which is almost never available here in Al Asad. I am speaking of bread. Good, old-fashioned bread. We do have hot dog buns and the occasional loaf of white bread in the PX on occasion. I don’t want to suggest that these buns are dried out and perhaps a bit hard, but there is a sign above them that says “You break it, you bought it.” And I did cut my foot on a shattered piece of Wonder bread the first week I was here. So Lorri sent me some bona-fide, Pepperidge Farm bread, which actually squishes in a bit when I push on it (rather than hitting me back). Fascinating. Also, some donuts, which lasted about 12.3 seconds after I opened the box last night (I made the mistake of opening in the clinic).

At any rate, thanks to each/all of you for the chow and other stuff.

I still owe you some travelogue from the past two days, but you’re sick of me already, so I’ll catch you later on that front (maybe after church today).

Posted in Iraq | 3 Comments »

Quick and/or Dirty

Posted by Erik Rupard on 19th April 2008

Sorry folks, long couple of days on the old dirt farm, days that have seen us without electricity intermittently and often, and (on a related note) with an even more constant swell of sand swirling about than usual.

Been a couple of eventful days, too, but it is 0048 hrs military time here, so you’ll have to wait until tomorrow for a longer message. Got a few new pix for you, so I’ll try to get those up tomorrow as well.

In the meantime: some food for thought: when I get back in the states, I think Lorri and I (along with some local focals from Georgia) will be heading to the Austin City Limits Festival. Why? One-word answer: Neko. (But also: Conor Oberst [Cassadega = best album of 2007], Iron & Wine, Jose Gonzalez, Okkervil River, and Silversun Pickups.)

Wanna come? ‘Cause you are invited…

Posted in Iraq | 1 Comment »

Brownian Motion

Posted by Erik Rupard on 16th April 2008

My sleep last night was constantly interrupted by the sound of wind whooshing past my mansion o’ plastic. Now I have indeed previously documented that it gets pretty windy here in the not-so-fruited plains of hill-country Iraq. However, my swank bachelor pad in scenic Al Asad (motto: “the ultimate gated community”), is completely surrounded by 25-foot-tall concrete barricades, and therefore the fact that a good amount of this air was bashing my walls all through the night was a bit troubling. On a couple of occasions, I could feel the canister straining at its foundation, threatening to break away. I thought about looking out of the window to see what was going on, but was too lazy to get up. (Also, I was a bit afraid that I’d see Toto flying by.)

When I got up around 7, it seemed to be very dark outside, and the wind was still whipping fiercely. I looked out the window and saw…well, pretty much nothing. There was a serious brown-out going on, with the dust nearly obscuring the front door of the can directly across from me (maybe ten feet away). I hopped on the internet, as I always do in the AM, to check out what you guys have been saying about me all night, and noted that the OIFnet service was down. A few minutes later, the TV went down as well. You can probably guess what would fall next.

As I was getting dressed, one of my medics came by and said that he had been sent in the truck to pick up my neighbors and I (the non-breakfast-going bunch) and drive us to the clinique. I declined his offer, as I wanted to ride my bike around and check out the damage. The ride in was fun, with faster winds than I have previously experienced forcing me to lean heavily to one side, just to keep my old Huffy aloft. By the time I made it to the clinic (only a quarter mile away), I (or rather the right side of me) was covered in highly refined brown silica, a.k.a. Iraqi dust.

When I opened the door to the clinic, I noted that the electricity had gone down yet again, but this time I had an ominous feeling that it would not rebound quite as quickly as before. This feeling proved correct, as the power did not go back on for the entire day, and phone lines, internet, LAN, all were down as well. Our clinic is in a building that (per rumor) was previously a bath-house, and hence has no windows except for some of those transom-types about 14 feet above ground level. This means that when the electricity goes out, it is very very dark. All of us have these little white LED lights on our keychains (Al Asad, like all bases in theater, is blacked out at night, so those little babies are essential), so we used these to get around, and saw what patients we could see, but not many showed up due to the cloud of dust. So, most of the day was spent sitting in the hallway where the open door gave us a little light, coughing and talking about the usual subjects (home, clinic, dust, the upcoming PT test).

Lunch was Cordon Bleu (again, no animal specified) and then I slipped back to the canister to see if the internet had come up there yet. No dice. For afternoon clinic I saw a few patients, listened to a book on my iPod, and had a little nap on one of the exam tables. I figured that I’d be awakened, sooner or later, by the lights going back on, but it never happened. A few of the medics, and my nurse practitioner were given the opportunity to go home after about 2:30, as it seemed that the lack of light and the paucity of patients would result in an exceptionally slow clinic, but not a single person on the medical side left. If some of us were sitting in the dark, than all of us would sit in the dark. Army people are unselfish that way.

At about 4 PM I accompanied SPC Penkert to get the mail, and I was rewarded for my efforts with a package from mom and dad (thanks for the Chex mix–woo-hoo!). Then, since the brown miasma was still hovering over Al Asad like Pigpen, and therefore no exercising outside could be done, I went to the gym with CPT Baker.

If you have never been in a smallish gymnasium which is

  • full of sweaty marines lifting weights
  • in the middle of the desert
  • during a dust storm
  • when all of the electricity is out
  • with no air-conditioning or any other kind of ventilation system
  • and silly you, you completely forgot to bring your toxic gas mask

then I am here to tell you my friend, you have simply NOT LIVED. However (and I say this as one who has experienced the above and managed to escape with just enough strength in my festering lungs to tell the tale), there just may be some things worse than not living. To (just slightly) paraphrase Patrick Henry: “Give me liberty or give me death. But please, PLEASE give me death before you make me go back into the Al Asad Gymnasium when the A/C is out.”

Fortunately, the lights came back on at 5:35 PM. When they came on, I could see clearly that the brownish haze was actually inside of the building as well as outside. I rode my bike back at around 6 PM, with the Pigpen miasma still keeping things real, and eventually got home to (finally) functioning internet. Lorri and I spoke for a bit, I had some delicious Hormel something-or-other, and then I settled down to watch that fabulous Mormon talent show “American Idol.”

Posted in Iraq | 11 Comments »

Improvised Explosive Devices Are Bad

Posted by Erik Rupard on 15th April 2008

Another interesting day in the Brown Zone.

The first step out of my door on each day this week has reminded me that, the mild weather of my first month notwithstanding, it is going to be very, very hot this summer. The overwhelming heat pounds me the second I go outside of my air-conditioned, 22 degrees Celsius cocoon. By midday, the weather is intolerable. I keep reminding myself that this is April, and that the peak temperatures (July-August) are still months away.

In the middle of our morning clinic, we had another blackout, and had to finish up with our patients in the dark. The TMC ended up being out of commission for about an hour, during which we sent SGT Evans over to make arrangements for a backup generator to be installed in our building. When, in the military, one makes a huge request like this, there are four possible things that will happen:

  1. The person to whom the request is directed will laugh or nod politely. Either way the message is clear: Not Gonna Happen.
  2. The requestee will actually get angry (either at the audacity, or the waste of time).
  3. The requestor will be told, blithely, that the request has been granted, and will be given the usual reams of paperwork to fill out. He/she will complete said paperwork, and turn it in. About three months and 180 phone calls later, all hope will be abandoned.
  4. The item will show up on the requestor’s doorstep, as if by miracle, within a few days of the request.

SGT Evans is our own Radar O’Reilly (although he sadly has no idea whatsoever who Radar is), and so he may just pull this one off, but right now, we really don’t know whether option #3 or #4 is in play.

In the afternoon, we had a huge group of patients who needed “LOD” assessments to be done. These amounts to a lot of medical paperwork which is done to document for a given soldier that he developed a medical problem during (and perhaps as a consequence of) his deployment. All well and good, you say, and I agree with you: a soldier who is injured in the course of his/her soldiering should, indeed, get medical and/or financial recompense from the government. Sadly, a few soldiers (a great minority, and almost never active duty personnel) use these LODs to try to extract every last dime out of Uncle Sam. I have had people request LODs for (I kid you not) hemorrhoids, heartburn, rashes that just popped up the week before, etcetera. One proud fellow claimed eight different issues (mostly musculoskeletal) which just happened to pop up during his six months of deployment, and of course had nothing whasoever to do with the fact that he is 54 years old and 50 pounds overweight. I am waiting for a soldier to attempt to claim an STD as a compensable medical problem; I’m sure it’s coming soon.

After seeing twenty-four of these LODs, my afternoon was capped off with a sadly interesting case: a very young kid who had driven his vehicle over an IED during a convoy two days before, and had been knocked out by the force of the explosion, which destroyed his vehicle. Happily, he had no penetrating trauma (thanks in great part, I am sure to the new-fangled protective devices built into many of our armoured trucks). He had been assessed elsewhere initially, and was sent home with Tylenol and the knowledge that his CT scan was negative.

He came to our clinic today complaining that he has had a headache since the event, and just did not feel right. On my exam, he had lost the ability to furrow his brow on the right side (sounds funny when I say it like that, but this is one of the tests for damage to a cranial nerve, or to the organ from which those nerves originate, the brain). He also had a slight but definite ptosis (drooping of the eyelids), also on the right side only. Finally, he had a very flattened affect, fancy doctor way of saying that he spoke in a monotone and barely looked up, as if he were hung over or morbidly depressed. These findings combined with the history of head trauma and the lack of resolution of his headache led me to believe that something more serious may be going on. We have no lab or x-rays in our clinic, and so we asked the ambulance people to help us out, and I personally delivered him to the Emergency Room at the CSH, and when our trauma guy took a look at him, he made the immediate decision to air-evac him out of theater, to get an MRI tonight.

Traumatic brain injuries (or TBIs) are a leading cause of evacuation out of theater, and often it is the lesser injuries that end up causing more long-term problems. This is because if a CT scan shows a massive subdural hematoma, it will be properly managed, and the patient carefully followed until resolution of the problem. But some of the mild injuries, which do not show up on CT, but cause persistent symptoms, can go un-diagnosed for a long time. The military has taken an aggressive stance on TBIs (and NTBIs, as well) and we all attempt to be very proactive. I would rather that this ends up being much ado about nothing and that his symptoms are simply from post-traumatic muscle spasm which will resolve neatly on its own. But there is a saying in medicine: if a doctor has positive findings every time he orders a brain MRI, he isn’t ordering nearly enough of them.

Post-script: I made another rare trip to dinner tonight (I usually eat a PB and crackers or Hormel chicken salad at home, to spare a few calories and give me some time to write). So, guess what those aforementioned, evil, money-grubbing-Cheney-hugging faceless corporate fatcats at KBR fed your Multinational Forces tonight?

WRONG AGAIN! The crab legs were last week!

Tonight, we had surf-and-turf: a t-bone steak (a good one, medium rare, just right), plus tempura shrimp, but wait for the clincher. To top it all off, we were served

(duh duh duh DUH)

Martinelli’s Sparkling Cider!

Again, I would not joke a joker (nor a smoker, nor even a midnight toker). We had Martinelli’s Sparkling Cockamamie Cider! The grape kind! All you can slurp! And, apparently, all I can exclamate!

Admit, don’t you sorta wish you were here right now, living in a plastic Barbie house surrounded by dust, insects with teeth, and people who are actively trying to kill you? It’s worth it, if only for the sparkling cider, don’t you think?!? Bet you can’t find that in your local Safeway. (By the way: if you do find it in your local Safeway, can you send me some more? I don’t think I can go back to the Saudi cola now.)

Posted in Iraq | 3 Comments »