Sorry folks, gonna be a shortish blog tonight. Monday morning in the Al Asad Troop Medical Clinic was pretty busy today. Stomach pains, hematemesis hematochezia (a.k.a. BRBPR), sprained ankles, cellulitis, two new foreign nationals with rashes, back pain, ingrown toenails, boils, all in a day’s work here in the Brown Zone. We had some more (temporary) personnel stuff this weekend, with one of my friends 1LT Coleman being shipped out to another post to help cover another soldier’s leave. Additionally, SGM Dennis came to visit, and to take part in promotion boards for a number of our soldiers. Although I have previously confessed my lack of enthusiasm for travel within a combat zone, there is a part of me which envies soldiers like the SGM, who has been to nearly every military post in theater. It would be interesting to have seen each base out here. They are all a little different: we have the sandstorms, Baghdad has the mortars, Balad has the continually-burning trash pile. Balad also has a Taco Bell (sounds pretty good right about now), and Speicher has an actual Cinnabon. We have a Subway, but I am two-for-two in getting sick when I go there, so right now, I’m sticking with the DFAC, and my two home-”cooked” staples: Simply Asian bowls, and Hormel chicken salad cracker kits. I love both of those, and in spite of eating the chicken salad stuff about half of my days here thus far, I’m still not sick of it. …and I am literally falling asleep as I write this, so will sign off for now, with my apologies for the lame entry; I’ll get a better one up tomorrow. –Erik

I am sitting on my bed, in my ten-foot-by-twenty-foot canister housing unit on Al Asad Forward Operating Base in Iraq. My can is small, but it is cozy, well-organized, and fairly clean. The television set has been strategically placed at the farthest distance possible in my little room, in the opposite corner from where I sit. I am watching a live-via-satellite baseball game on the AFN Sports network (a true rarity here except in the wee hours, but this is a weekend day game), and the Mets are beating up on Andy Pettite and the Yankees. Gotta love that.

The guys in the room next to mine are playing Halo, and the occasional obscenity squeezes its muffled way through our shared plastic wall. I usually put up with this for a few minutes, and if it doesn’t stop, I make a little visit next door, which generally results in the occupants going into radio silence mode for the next few hours, or simply leaving the building altogether.

Not a bad day to be a deployed soldier, all things considered. I had an interesting clinic today, in which I saw the following:

1. A man with cellulitis of his face, only partly responsive to antibiotics. We took a digital photo today, which will be used for comparison tomorrow; if he is not any better, he will be admitted to the hospital for IV antibiotics.
2. Another pregnant soldier. Her 1st SGT came with her to clinic, and pleaded with me to let her stay for the remaining twelve weeks of the unit’s deployment. (No way, dude. She’ll be on a plane within a week.)
3. A 55 year-old department of defense worker with acute gastroenteritis (food poisoning). Imodium didn’t work, so he gets some lomotil, which will shut his guts down, and good.
4. A soldier who broke his fifth (a.k.a. “pinky” toe) doing some kind of martial arts at the gym.
5. A TCN who was doing some welding and had little white itchy splotches all over his chest and arms. Fungus? Or allergic reaction? Because we can’t do the tests here to definitively know the answer to this question, he got treated for both. RTC if no improvement in 2-3 days.
6. A young marine with bruises all over his body, and an abnormal clotting test. Right up the alley of this Hematologist. He got some more tests today. I’ll be discussing the results with his doctor when they are available, but my preliminary feeling is that he got in a fight which he is not admitting (hence the bruises), and the lab was a false positive (it is tricky doing clotting tests, especially in a field environment, and in this case, the test was repeated in the sample sample, with widely varying results). Either way, an interesting case.
7. Lots o’ runny noses. (Allegra, to the rescue!)
8. A couple of insomniacs, hoping to score some Ambien to undo the fifteen Red Bulls they drank earlier in the day. They left, unsatisfied and still pretty wired.
9. A guy with a bad, atypical migraine. I was about to give him some Imitrex (not my favorite drug, for various reasons, the main one being that it doesn’t work as often for atypical migraines), but he fell asleep when I left the room to get his meds, so I backed down a bit and gave him a shot of toradol (a strong NSAID) and sent him home to snooze in his own bed.
10. Finally, a Marine CPT who came in for a bicipital tendonitis. On talking with him, he admitted to taking a whole lot of protein supplements, and a nitric-oxide/caffeine mixture called N.O.-Explode (guess which is the active ingredient). Because of this we got a urinalysis on him, to make sure that he isn’t damaging his kidneys with the protein, and the protein came back normal, but his urine showed some glucose. My immediate feeling was that this was likely to be a lab error, because it did not make any sense for a healthy guy to be spilling sugar into his urine. We did a battery of tests, including a repeat of the UA, and suspicions were confirmed. But his kidney function was about seventy-percent of normal, so he and I had a heart-to-heart, in which we discussed the joys of dialysis. Shortly after our discussion, CPT Marine decided to stop taking the protein supplements and high-dose caffeine jolt.

After clinic, I read through some bits of Lorri’s impending novel (it is excellent!), and sent her my thoughts. A couple friends and I had planned to do two of our bike runs in a row, which would come out to an even 27 miles. We were pretty psyched for our “bicycle marathon,” but the wind picked up, some rare clouds gathered over our post, and for only the 3rd time since I arrived here at Al Asad, it rained. An hour later, it was too late for the marathon, and though the rain subsided, the wind had picked up dramatically, which meant that the Brown Cloud Of Death was swirling around our little dust bowl. Three of us decided to brave the wind and the dust and make at least one loop around the post, and I donned my best goggles and hit the road.

The wind blew so hard against me that every turn of the pedals moved my bike forward just a few feet. It was excruciatingly slow-going at the beginning, but I knew that if we could just make it the few miles to the back stretch, that same wind would be our best friend. One member of our party bailed out after about two miles, so that left just CPT Baker and I (ironically, the oldest guys in our whole company). Baker is one of those sickeningly fit dudes who eats nothing but green things, and has absolutely no discernible fat, and he led the way up the big hill by the reservoir, past the Ugandan guards with the David Ortiz smiles (zham-bo!), and finally, around the corner, onto the back stretch, where we absolutely cruised for the next ten miles.

As we rode effortlessly with the wind at our backs, we talked a bit, looked for hyenas, and noted how we couldn’t see ten yards in front of us. It was like riding in a dense fog, and kind of neat. At one point a very loud military plane took off to our left, with the same incredibly loud screaming noise as usual, but we could not see a thing. Kind of eerie.

We finally made it around the flight line, down the hill and past the guards, and finally back to the cans, where our company was (unbeknownst to us) awaiting our return, with barbecue at the ready. SPC Hert grilled some truly great burgers, and we sat out in the wind, eating our delicious, dusty burgers and talking about home.

[Final: Mets 7, Yankees 4. Woo-hoo!]

We have a new provider in the clinic, a Physician’s assistant (PA) named CPT Hall. CPT Hall specializes in orthopedics, which is great because I prefer seeing the sick people rather than the achy back, knees, ankles, shoulders, etc. Having been on my own for the past two weeks as the only doc in the busiest clinic on Al Asad, it was really nice to have someone else who can see patients, taking a bit of the pressure off.

This afternoon, our company commander called me to thank me for handling the extra load for the past couple of weeks, and to offer me a trip to Qatar for a four-day R and R. Qatar is a small country which extends out from the eastern edge of Saudi Arabia into the Persian Gulf. There is an area there where deployed personnel can go on leave, and visit museums, the beach, and some shopping areas. A few of my medics have been there, and they all liked it a lot.

I thanked CPT Allen for the kind offer, but respectfully declined. First, traveling is one of the least safe activities one can do in theater, and I know that any extracurricular travel would create a whole lot of worry among them. But I have a more selfish reason for not wanting to go anywhere.

If you think traveling by air at home is a hassle, imagine having to go to the airport six hours ahead of your flight, haul all your own luggage yourself (not just around the airport, but actually onto and off of the plane), and sitting on a hammock for the whole flight, while wearing fifty pounds of protective gear. And if your flight doesn’t actually leave because of sand, wind or other issues, you get to stay at the airport, sometimes for days, and wait for the next flight out. And let me tell you, the airports on military bases in Iraq, do NOT have a Starbucks, or a Cinnabon. The Al Asad airport is a pretty sparse affair, having nothing but a few benches and some makeshift offices for the workers there.

I have been a homebody for just about all of my life. I think that somewhere between the fifth and the tenth time I slept over at a friend’s house when I was a kid, I came to the realization that I greatly prefer sleeping in my own bed, with my head on my own pillow. Rightly or not, my little ten-by-twenty-foot tupperware container here on Al Asad has become my home-sweet-home for the moment, and I have to admit, it is pretty cozy. Occasionally, someone will walk by when the door is open, and they’ll see the pictures on my walls, and the carpets I have laid out, the five (yes, five) pillows on my bed, and the general neatness of the place, and they’ll tell me that I am lucky to have the nicest can in the projects.

To which I can only agree.

Okay, time to clear up a couple of misconceptions which I have created. There has been some increase in violence outside of Al Asad, but nothing has happened within the confines of our post. The Army has told me practically nothing about this little gated community on which I am living (they don’t give you a map when you arrive, for example), but globalsecurity.org has some pretty good info, including outdated pictures, and a description of the 21-kilometer buffer zone which surrounds our base. On previous blog entries, I have mentioned the spectacular desert view I get when riding the “perimeter.” Let me clear this up: this “perimeter” is inside the buffer zone, meaning that even at the edge of “the wire” I cannot possibly get closer than 21 km (= 13 miles) from the outer limits of Al Asad. Even if I wanted to (and I do not want to). In fact, I am probably safer out there on the airfield (which is where I ride), because it is heavily guarded to protect the Ospreys and C-130s and other multi-million-dollar flying machines. My biggest threat out there is getting hit by a bus driven by a 17-year-old Marine.

Speaking of the bike loop, I went with three other soldiers yesterday evening and we came across more of the dog-like creatures, and have pretty much decided that they are hyenas. We chased one on our bikes, and he ran straight down the road, never thinking that he could lose us pretty quickly if he just veered off into the desert. We almost caught up to him but he eventually figured it out, and high-tailed it under the wire.

We get some other creatures on post at times, including cats (there have been “outbreaks” of cats to the point that it has become a “general order” not to have any pets of any kind while deployed), dogs, snakes, jackals, and hyenas. When any of these animals is found, it is caught and euthanized. In Iraq, dogs are not considered pets, and are generally wild when found in the streets. There is at least one organization designed to help save some of these creatures, run by the SPCA. I think they are letting the cats fend for themselves, though.

—————

So a bit of good news today. (Again, all of this is rumor mill, but my source is pretty reliable.) I have been told that all of the fighting over the extended weekend was in a single part of Anbar, and that although we had two deaths and a greater number of wounded servicemen, that particular cell has been found and extinguished. I take all info I get here with a grain of salt, as I have often heard one story, and seen it evolve over a week into another story altogether, then printed as a third (and probably correct) version in the Stars and Stripes a week later. Still, my source was a good one, and I am a bit more sanguine about our ongoing security at Al Asad.

Bedtime for bonzo. I owe a few of you e-mail responses, and will get to you soon, so hang in there. Mit, I have only received four boxes from you, but one of them did contain Sees suckers, which I failed to mention in my previous mailbag report. Sorry about that, and thanks for the great Sees Candies, which (as I know with every fiber of my being) are the Only True Lollipops.

I’m not allowed to close this without mentioning that Lorri beat me at yahoo chess today, fair and square. Gotta remedy that with a rematch soon…

There was some more violence around Al Asad over the past 36 hours, including four casualties, one of them another DOA. I know that this was a firefight, but I don’t have any details as to where, who, etc. They don’t tell us much here. I’m not sure whether this new violence represents a trend in the Anbar province, or just a couple of blips on the radar. Let’s hope the latter.

Either way, it has yanked all of us squarely back into reality. It is easy for me to convince myself that I am on a “safe” base in a “safe” war, and I have noted a bit of complacency in the citizens of our Forward Operating Base—seemingly “paranoid” rules like the injunction against any bags in the DFAC are ignored without consequence (until I point it out), and I occasionally see soldiers walking around post without a weapon in tow. But this is, in fact, a war zone, and we are, actually, in real danger here. When I ride my bike around the fourteen-mile loop, I can see places in the road, lots of them, where mortars have hit in the not-too-distant past. Earlier in 2008, there was a bomb set off in a DFAC in Ramadi, and there have been a couple of car bombs on or near Army posts in the last couple of months.

I am blessed to be a Fobbit in a well-protected place, where the flow of patients to my clinic is generally mundane and predictable. I expect that life will continue this way, with a few of these incidents occasionally peppering the landscape. But I am not guaranteed anything, by any stretch, and incidents like the recent ones provide a sobering reminder to each of Al Asad-ians that although we are in a relatively safe location, we’re still surrounded by people who want to kill us.

[Saturday, 10 May, at 2 PM]

As I type this blog entry, the internet is down, but not in the usual way. When I try to get on the net, instead of getting the usual “Internet Explorer cannot access this web page” 404 error, I am getting an ominous black screen with red writing, as so:

The medics tell me that “River City” is a code (could not find anyone today who knows from whence this strange euphemism arose), used on certain posts in Iraq, and it signifies that someone from our post was killed in combat. When this occurs, the Base Commander blocks out the internet (and the phones, mail, etc) until they are able to notify the family. Pretty sad.

By the time you get this, the internet will be back up. I will add more info at that time.

——-

[Sunday, 11 May, 10 PM]

Woke up today, still getting the “River City” page when I tried to get to Yahoo or anywhere else. On my iTunes program (which I keep going all night so that it aggregates the various news and church programs which I listen to when I am working out), I noted that all of my podcasts had been renamed “Radius iCafe OPSEC.” At work, I tried using a DSN line to call home. Lorri left me a message on e-mail right before River City started, about some computer troubles, and would I please call her back right away. Unfortunately, the answer seems to be “no” and I was starting to wonder whether I would be able to talk with her at all on this Mother’s Day.

At church, I learned from one of the hospital workers why River City was in effect. Two servicemen (unclear whether soldiers or marines) had been hit by a sniper shortly after leaving their vehicle in an area of Anbar province not far from Al Asad. The servicemen were stationed here, and had been out on “patrol,” which is a means of maintaining a military presence in the surrounding areas, to let the bad guys know that we are still here, and closely watching their activities. This is a dangerous job, as it requires a frequent presence in area with known insurgent activities. One of the troops received a lethal would (in consideration of privacy, I will forgo details here), and was declared dead on arrival at the Combat Surgical Hospital here on post. A second troop received a serious but non-fatal wound (again, privacy concerns preclude me from revealing more), and is in the hospital, doing well, and will survive to fight another day. The rest of the company on patrol are all safe.

I had to work today, because we are short a provider, which means no day off for me this weekend. Put into perspective, not really a big deal. Or any deal. After work, I went to church, and then came back and checked the internet again. No dice, still River City. Time for a bit of food (Simply Asian thai noodles, microwaved to perfection), and then a serious nap. At about 5:30 I heard voices outside of my room, so I rolled out of bed and walked outside in my classy Calvin PJs. The medics were barbecuing to celebrate the fact that SPC Hert got a bag of smoky wood chips in a care package today. Burgers were tremendous, and I even got a bit of a ribeye steak bought by some kind person. When I walked back into my can a half hour later, I heard the phone ringing, and was happy that River City was over. I talked with the kids, and was not surprised to hear that Maya had been concerned about me since I had been incommunicado for the past 36 hours.

We all take these kind of situations very much to heart. Everyone was down today, knowing that one of our own had fallen. Even at the barbecue, there was a sadness which hung over all of us, and the levity was kept to a certain lowish level. In all of the mess halls I have visited in Iraq, there is a table which is set, with a nice plate, silverware, napkin, etc, and usually a helmet or a soft cap on the seat. It is maintained meticulously, and even if the seats are all taken, that one is left open for the serviceman who gave up his/her life for the cause.

God bless that mother out there, who got some very, very bad news today.

Executive Mansion, Washington, November 21, 1864.

 

Mrs. Bixby, Boston, Massachusetts:

 

Dear Madam: I have been shown in the files of the War Department a statement of the Adjutant-General of Massachusetts that you are the mother of five sons who have died gloriously on the field of battle. I feel how weak and fruitless must be any words of mine which should attempt to beguile you from the grief of a loss so overwhelming. But I cannot refrain from tendering to you the consolation that may be found in the thanks of the Republic they died to save. I pray that our Heavenly Father may assuage the anguish of your bereavement, and leave you only the cherished memory of the loved and lost, and the solemn pride that must be yours to have laid so costly a sacrifice upon the altar of freedom.

 

Yours very sincerely and respectfully,

 

Abraham Lincoln