Folks, it has been a long one today. For the past few days, Al Asad has been one big sandstorm, which has grounded many of our planes and created some other problems. Weather was especially bad today, with the rsult being that our clinic power was out most of the day. Because of this, I ended up seeing my last fourteen patients in the 100-plus-degree heat and considerable darkness inside of our clinic. Thankfully the lights are back on now, and the little A/C unit in my can is currently cranking non-stop. It is 9:30 PM, and I just arrived back home from the clinic an hour ago. Therefore, gonna keep it short/sweet tonight, but I do have a few thoughts to share.

Packing My Mental Baggage

For two years back in the late 1980s, I was an LDS missionary—you know, the young, clean-cut guys in suit-and-tie who ride around the city on bikes. We missionaries had a term for the peculiar behavior of those among us who were nearing completion of their 24 months, and occasionally showed the signs of being mentally “home” even before they physically left the mission field. The term was “trunky,” as in “Elder Johnson is a bit trunky, and therefore was not really excited about doing that service project.” I think that the term originally came from the mental image of a missionary sitting on his already-packed trunk, waiting for the ride to the airport. We generally forgave a bit of trunkiness—after all, it’s hard not to daydream a bit about sleeping in your own bed again after being away for a couple of years. Most missionaries fought off the trunkiness pretty well, and kept their eyes focused on the work at hand as much as possible.

I hereby admit to you that I am currently a bit “trunky” about getting back to the green green grass of home (not to mention my wife and kids, the pool, the uninterrupted power grid, etc), though I think I am mostly containing my restlessness. On days in which the lights go out, the sand slaps painfully against my skin every time I walk outside, and the heat is oppressive and uncomfortable, it is easy to dream about better days to come. The other provider in my clinic right now is CPT Daphne Sims, a pediatrician out of Ft Bragg. (And you thought I was practicing outside of my specialty!) CPT Sims and I came to Iraq at the same time, and it looks like we will leave at the same time—may even be on the same “freedom flight” home. So, we are both perhaps a bit on the trunky side. We’ve been keeping each other honest, though, and putting in a solid day’s work every day. But we occasionally talk across our shared desk of the places we’ll go, and the things we’ll be doing this time next month. Our “Calgon moment” is almost invariably interrupted by a medic telling us the sad, sad story of the patient in room three, who has “this thing” on his foot (or some other Al Asad-specific malady). Oh well, it was nice while it lasted.

Becky Anundsen, the Anti-Adkins

A few weeks ago, a study came out in the New England Journal of Medicine which demonstrated fairly clearly that the food pyramid which we have been taught for decades (the one with wheat, grains, breads and cereals as the “base” of the pyramid) is all wrong. In fact, an “Adkins”-style diet consisting of very few carbs, increased protein, and moderate fat intake appears to have superior health benefits on nearly all parameters when compared with even calorie-restricted, carbohydrate-neutral diets. When I read the study, I talked to my TMC staff about it, and the end result was that about half of us have been on a low-carb diet since the beginning of July.

That is, until last Saturday.

That was the day that two boxes sent by one Becky Anundsen (”little sis” to me, “Beckles” to everyone else) arrived via the Army Post Office. As mentioned previously in these pages, Becky’s package consisted of five boxes of cookies (sugar, peanut butter, white chocolate macadamia, and pecan choco chip), and the Al Asad TMC staff have been living off of the things ever since. All of the cookies are good, but those sugar cookies are un-be-stinkin’-lievable. They have that slightly doughy taste that all good sugar cookies must have, and they just spontaneously crumble on the tongue, as if on cue. I have not been able to stay away from that particular ziploc container. Unfortunately, I do not believe that Beckles cookies qualify as “low carb.” In fact, I have it on fairly good authority (two witnesses: my tongue and my stomach) that they are not even “medium carb.” But I simply cannot stay away, and neither can my medics.

So thanks for the cookies, Becky. Trust me, they are well worth the extra few (say 20) hours I’ll have to do on the treadmill this week to negate their nefarious effects. Well worth it, indeed.

I have spoken often of the people with whom I work on a daily basis. Here, then, a few more introductions for you, via pix of the weekend’s barbecue.

Pictured here in the obligatory card game are, from left, Staff Sargeant Carla Cano-Perez (C-P to all of us), 5′4 and with an “Hecho en Mexico” tattoo on the back of her neck, is in charge of the medics; SPC Cordero, whom you already know; SFC Catherine Langer, the Non-Commissioned Officer-In-Charge of our clinic. SFC Langer is the powerful, maternal figure who keeps our clinic together. She is a Wii-fitness fanatic, and has truly excellent taste in music, books, and movies (i.e., she agrees with me on most things).

SGT Stephen Evans, chillin'.

SGT Stephen Evans of Asheville, NC, who just got back from leave in Vegas. SGT Evans is another one of my favorite kids. A solid medic, and one of the best schmoozers I have ever known, which has served him (and us) well in Al Asad, where he has been able to finagle and trade for the things we so desperately need, from air conditioner parts to entire vehicles.

SGT Castulo Vera

And sauntering up the row of cans is one SGT Castulo Vera, known is our clinic as the World’s Tallest Mexican. Fortunately, SGT Vera is not standing sideways, or you would not be able to see him. Vera is a fine medic, and one of the few natural athletes in our company. A soft-spoken guy who doesn’t put much money in the “swear jar.”

SGT Ernest Hert and CPT Joshua Baker

SGT Ernest Hert of San Diego, CA is on the left. He is NOT soft-spoken like Vera, but is a good guy who would take a bullet for any one of his comrades, and one heck of a barbecue chef—the man of a million seasoning salts. SGT Hert will be heading to Ft Carson in a few months, but he doesn’t want to stay there; Hert loves to be where the action is, and will probably be in Afghan sometime next year, heading up a team of medics somewhere.

To SGT Hert’s right is my closest friend here, CPT Joshua Baker, who is our clinic’s optometrist (and the only one on Al Asad or any of the surrounding posts). CPT Baker is originally from upstate NY and currently from Alaska. He has been the personal fitness trainer for our entire company. He’ll be heading to Germany when he gets out of Iraq. I have publicly predicted that Baker will be the top Optometrist in the Army within 10 years. Not a tough call, really, as he is the epitome of “squared-away”: smart, in good shape, and with unimpeachable integrity. (Also, note the pre-formed beef patties on the grill.)

SGT Andres Villareal

This is another one of my favorite kids, SPC (p) Andres Villareal, who will be a SGT in one short week, and has given me the honor of “pinning” him (i.e., putting the rank on his uniform for the first time in a ceremony). SPC Villa is another one of those quiet, reliable, solid medics, who does whatever he is asked to, quickly and efficiently, with no complaining or excuses. One of my work-out buddies along with Baker, though he doesn’t look too tough here with his pink-hued leukemia water. Villa plans to get his nursing degree and become an officer.

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Finally, this little guy did not attend our barbecue (at least, not that I know of), but Maya made me promise that I would post a picture of the lizard we caught in clinic a month back (a cute little dude, and well-behaved), so here it is:

Lizard in the Al Asad TMC

Barbie

Last night we had a farewell barbecue for SPC Cordero who has, by the time you read this, already arrived at another base. Though it was sad to lose a member of our little group, the party was fun anyway. The PX here sells a very limited selection of frozen meats, including some pre-formed burgers with Vidalia onions mixed in. Combine these with the amazing assortment of spices (up to and including Montreal Steak mix) which the medics have accumulated, and the occasional (sort of) fresh buns available at the PX, and you have a pretty good barbie.

1000 Words

Our resident Marine Corps pilot, CPT Deb Turley, brought her camera last Sunday, and sent me this picture, which will give you an idea of what our humble church meetings look like. You’ll notice that all services (Army, Navy, Air Force, Marines) are represented here (note the different uniforms). Front left is Sister Turley, middle is Brother Lloyd, the second assistant to Brother Manny Diaz (second from left in the back row), who is our group leader. The woman who appears to be glowing is Sister Lott, who is wearing a night-reflective badge. This sacrament meeting starts at 8 PM, and most of the congregants walk or ride bikes to church.

Rupard Mailbag

Have I mentioned how very much American soldiers love to see those red, white (mostly), and blue priority mail boxes? They are like manna from heaven, sometimes literally.

On Monday of this week, my Norelco razor bought the farm, which is very bad news for me, as I use it to groom not only my face, but also my expansive & bald noggin. Having to physically shave my head with razor & cream is a huge pain, and usually results in a few nicks and/or not-quite-baby-smooth areas. So, I needed a new Norelco, stat.

Lorri Rupard to the rescue! I called Lorri on Monday, she went to Target (her favorite store), scored me a nice inexpensive rotary, and put it in the mail with a bunch of other goodies (Batman Pez dispensers, peanut butter M&Ms, rice krispy treats). Unbelievably, I received the package on Saturday, just 5 days later, which means that I had a nice smooth head for church today. Thanks, Lorri!

I also received two priority mail boxes from the Anundsens of Reading, PA. Beckles & Company filled those boxes with ziploc bins full of cookies, including sugar cookies, chocolate chip with nuts (woo-hoo!), peanut butter, and white chocolate macadamia. These were delivered just before the aforementioned barbecue, and were heartily enjoyed by my whole company of soldiers during said party. I have to confess, though, that one box of the choco chips remained in my trailer. I will be working through that one over the next 27 days. Thanks, Beckles!

I have to admit it: though I like all of the soldiers who work in my clinic, Specialist Maria Cordero is probably my favorite. The reasons for this are multiple. First, she is originally from Stamford, Connecticut, just down the Merritt Parkway from my home town of Cheshire. Amazingly, of the 15 people in my clinic, three of us are originally from CT.

Additionally, SPC Cordero is only a few years older than Madeline (my oldest daughter), and she looks even younger than Maddy, so she has been sort of a surrogate kid for me.

But the best thing about Cordero is her very laid-back, self-deprecating sense of humor, which has served our whole clinic well when we needed to lighten up a bit. She has also been a consistently interesting medical case for me, as she has had four or five mysterious illnesses while I have been here, one of which landed her in the hospital for a couple of days before completely disappearing as fast as it came. This propensity to catch any virus, bacteria, or fungus brought in by our patients resulted in the medics referring to Cordero as the “outbreak monkey,” and that was eventually combined with her last name resulting in her current nickname, as per the title of this post.

Since I arrived here, SPC Cordero has been our front desk staff. Though she is a trained laboratory technician, we are currently without a lab, so SPC Cordero’s job description had to be modified a bit. Unfortunately, she will be leaving us in the not-too-distant future for another undisclosed location, which is a real bummer, as she has been an important part of our team, and an even more important part of our deployed family. Earlier today, I talked with SPC Cordero, and here are a few of the highlights:

You were raised in a rich community in Stamford, CT. Not too many kids from Stamford end up in the Army. When did you join the Army, and why?

I joined in November 2003. I honestly was too lazy to apply to college. I was offered scholarships, I had good grades, but I was so stressed-out with the idea of having to apply to colleges, that the Army just seemed like an easier thing to do. One day I saw the recruiter at lunch, and he told me to just take the ASVAB test, see what happens. I took it, and in my mind I decided that whoever calls me first, I’m gonna join. The Marines called me first, and I thought to myself “Hell, no! Whoever calls me second is who I’m gonna join.” And it was the Army.

Did you get to pick your MOS [military occupational specialty]?

Yeah, I wanted to be something in the medical field. Medic and x-ray didn’t sound very exciting, but when I heard about lab and all of the gross stuff that has to do with it, I though that was pretty cool. So I picked it.

Have any of your family members been in the Army?

My dad was in from ‘84 to ‘91. He got out right after desert shield, desert storm. He deployed a good three or four times. I remember my mom crying when he left.

You are part of a small group of soldiers in this war who ended up with a 15-month deployment. Did you know before you came out here that you’d be here for that long? What did you think about it?

I knew I’d be in Iraq for fifteen months. I thought “this sucks,” but I knew what I was getting myself into, and I was prepared for it.

Do you like being deployed?

Overall I like it. The only thing that sucks is being away from the family, missing out on everything that is going on with my daughter, Lola, who is two years old. My husband is in Afghanistan right now, and he’s a fifteen-monther too, and he left seven months after I did, so I won’t see him until seven months after I get back.

What experiences out here will you remember?

I haven’t been shot at or had to fear for my life at all, which is good. The only thing that really stands out is the people I have worked with. Even though I’ve reached the point in my deployment where I can’t stand most of them, I know I’ll never forget them. It’s one of those things that you’re gonna remember for the rest of your life.

So, you were trained in the lab, but the Army has made you our front desk staff for now. What do you think about your current job?

I love it. I wish I had known about this job before I picked lab. Being able to work with the medics, and bother the docs, and hear all of the funny things that the patients come in with…

Plus, you have your own office, which I don’t even have.

[Laughs] I know! And my own computer, my own desk. It’s nice.

What do you do to pass the boring time here?

I watch a lot of TV. If I’m not lazy, I go to the gym. I hate running so I do put it off as much as I can. I read a lot. I’ve been studying, taking online classes from George Washington University, trying to get my Associates in laboratory medicine. I’m six credits shy of that degree.

Are you considering a four year degree?

I’m definitely going to do a four year degree. My husband and I have been talking about me getting out, and now that the GI bill is such an awesome thing, the way they changed it around, we are definitely going to use it. I’m going to go to school first, get my four years, and then we’ll switch. Once I have a good steady job, then he’ll go to school for four years.

Will either of you stay in for twenty?

I’m still considering it, but my husband is pushing me to get out, and with the baby I’m really leaning towards that, too. I would love to put in the twenty years, maybe take a break, go to school, come back as an officer. That’s still an option.

Have you re-enlisted?

I re-enlisted last summer, and got a bonus of 8500 for an extra two years. It’s all in savings.

Who are you going to remember out here?

Bits and pieces of everybody. The two people that I’ve incredibly bonded with are Villa [SPC (p) Andres Villareal] and Vera [SPC (p) Castulo Vera]. Villa because he’s got kids and he understands what I’m going through, and Vera’s just a crazy awkward Mexican, and he’s like a brother to me.

Okay, perhaps a bit too much info on my last entry (at least that is the consensus of all the Rupards who commented). So, we’ll keep this one perhaps a bit less revealing.

Days continue to fly by, as evidenced by my little countdown timer at the upper left of your screen, which will likely have gone below the one-month mark by the time you read this. Still, thirty-one days to go (Darn you July, for having that extra day!). I have been able to learn a bit about what my re-deployment (Army lingo for “return home”) will be like from various sources including my friend John Zaugg, who returned a few days before I deployed. John tells me that after I catch that fabled “Freedom Flight,” I will eventually arrive at Fort Benning from whence I departed six months ago. There, I will get a chance to see Lorri, though she won’t be able to see me get off of the plane, like in the movies. They have a waiting area in the military airport for the family members, and we will walk off the plane and into that area. Next, we’ll have some briefings (death by PowerPoint), and will be released for the night, with orders to show up at oh-dark-thirty the following day. At that point, we will go through many of the same equipment lines which I went through during CRC, but with an obvious difference: this time, I’ll be giving stuff back.

Some of the items which the Army wants back are sort of obvious, e.g. my Beretta M9, my body armor, specialized and expensive equipment like my gas masks. Some of the things they want back are simply weird. What are they gonna do with my raggedy, dusty, sweaty old uniforms? I was issued four of these, and told that I will be required to give three of them back. Some of the people here have suggested that they actually do not ask for them back, especially if they are well-used, so we’ll see what happens. There are a few other useful things I get to keep (boots, “under armour” t-shirts, some of my cold weather gear), and a few which I truly hope I can keep (my Camelbak).

Unbelievable as it is to me, it is true: as of this writing, I have only three Sundays left in Iraq. Exactly five weeks from this moment, I will be at Ft. Benning, GA, reunited with my sweetheart Lorri, completing the CRC redeployment process. Yet, as I watch the days tick down on my little desktop counter thingie, that date seems a long long way off, and I can’t quite feel it. That may be a good thing at this point; I’m guessing that once I am close enough that I can almost taste the clean, dust and/or diesel-free air, the seconds will start to drag a bit. Right now, I am still (mostly) enjoying the ride.

This week’s Saturday-to-Sunday routine was fairly typical. On Saturday night, my neighbors and I had our usual get-together, in this case to watch Band of Brothers just outside of our cans on CPT Baker’s ridiculously oversized big-screen laptop. After two episodes, a few of us hopped into Barney and headed to the DFAC for “midnight rats,” the half-dinner-half-breakfast meal served for those workers who can’t get to the regular meals because of work. I had a nice omelet, a couple of waffles, and grabbed some cereal for Sunday morning. Back home around 11:30, at which point I caught the remainder of the (crummy) Red Sox game versus the Angels on AFN. I usually stay up late on Saturday nights, because I don’t have to be anywhere on Sunday until 1 PM (first church meeting of the day). So, on Sunday morning, I attempted to catch up on my sleep.

I choose my words carefully here, because the reality is that, though I attempt to sleep late every single Sunday, I rarely succeed. This failure is, in itself, remarkable, as it is truly difficult to conceive of a more sleep-friendly scenario than mine on Saturday nights in Al Asad. To wit:

• I have no work to get to in the morning, since I’m generally off on Sundays.
• My family is out and about doing their own Saturday stuff thousands of miles away, and they generally do not call me after 11 PM (often, due to my spotty internet access, physically cannot do so). I’m like a doctor without a pager.
• I stay up late on Saturday nights, surfing the net, watching Saturday-afternoon baseball, blogging, etcetera, which means that I should be very tired by the time I hit the hay.
• I eat breakfast at midnight, stuffing myself to the gills with high-protein foods. (Mmm, L-tryptophan.)
• I have a small personal living area with entirely user-modifiable temperatures, and a nice, cozy bed, inside a hermetically-sealed plastic container. It is like I am in a sensory deprivation tank. Eerily like that, in fact.
• I am “The Major,” so none of my co-workers dare to knock on my door, barring emergencies. (This is not because I am mean; it’s just how my very professional soldiers have always treated me.)
• There is not much else to do except sleep.

In spite of all of this, my attempts to crash past about 0730 have generally been unsuccessful. I have diligently attempted to ascertain the reasons for this, so that I can eliminate them. One possible explanation was that I am awakened and stripped of melatonin by the very bright light that comes shining into my window starting at around 0430 (Iraq does not follow daylight savings time). I have eliminated this as a possibility by hanging my thick green army blanket over the window on Saturday night. Didn’t help.

Another possibility is the noise. I do, in fact, live not only near, but actually inside the confines of the airport. Planes, helicopters, and strange creatures which are combinations of the two (true story, that) constantly fly over my tin can, rattling the walls in attempt to find the harmonic frequency and bust me open like Joshua at Jericho. This kept me up a bit initially, but now I hardly notice it; the machinery sounds are simply a part of the aural landscape, and they block out the Halo sounds next door. At this point, I’m pretty well convinced that when I finally get home, in order to get any rest I’ll probably have to go and buy one of those “soundscapes” alarm clocks, but one with a “Combat” setting (perhaps right in between “Ocean” and “Rainforest”). So, I don’t think it’s the noise.

So what gives?

Unfortunately, I and many (all?) of my family members are blighted with the “Rupard Curse.” This is a multi-functional curse, including (but not limited to) the following items:

• Male members get receding hairlines at an astonishingly early age. Want proof? Check out my yearbook picture. My high school yearbook picture.
• Multiple chins, again at an early age, and even when the rest of the body is at ideal weight.
• The “John Travolta” syndrome, in which approximately five-sixths of all weight gained at any given time goes directly to the noggin. Rupard men all have big heads, but when we get a bit overweight, they become medium-sized planetoids. I swear, some of my med school pix look like I had just moments before discovered my latent peanut allergy. (By the way, this is also known as the “Barry Bonds Phenomenon.”)
• Proctalgia fugax. I’m not even gonna tell you what this is, or link to it; you’ll just have to look it up yourself. (If you don’t have it, you won’t understand it.)
• A retentiveness which (let’s face it, compadres), occasionally crosses that fine line into the nether reaches of OCD.
• And finally, the raison d’etre of this particular digression: Rupardian Insomnia. This is not quite like regular insomnia, in which the poor sucker has to wade through two post-Letterman infomercials before finally dropping off to abbreviated-but-productive sleep. The Rupardian variant renders the protagonist willing and often able to fall asleep, but unable to remain out for more than about 45 minutes at a time. He/she is constantly waking up, looking at the alarm clock (”Crap! Only 2:45″), and laying there in the dark for 5 to 500 minutes or so, before eventually drifting back to sleep for another 45 minutes. I like to think of this as “Reverse Narcolepsy” and I have been suffering for years, as have all of the rest of us. It wasn’t until I was married and able to enviously watch my wife as she slept, on-and-on, with no alarm-clock-checks and no full-body-pillow-reshufflings, that I figured out my sleep behavior was not that of a normal hunam being.

So, I conclude that my inability to sleep beyond 7:30 is multifactorial, with my sleep genetics being the primary culprit. Ah well, at least I’m good looking…

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Rupard Mailbag

About two weeks ago, I sent a true desperado of an e-mail to mom and dad, asking for a few items which were completely, entirely NOT essential, but which would make my time here a wee bit nicer. They responded, as they always do, by sending not one, but two packages just a few short days later. Unfortunately, when the United States Army and the United States Postal Service meet, as they do here in Iraq, the vaunted efficiency of both organizations dwindles just a bit.

So, although my parents sent the two packages quite literally at the same time, I received one last Saturday the 12th (included baby wipes, almond butter, Propel flavor packets, and the all-important Jelly Bellies), and spent the rest of the week expecting but not receiving package #2. After Monday and Tuesday passed, my hopes dropped a bit, and by Friday, I had given #2 up for lost. On Saturday, however, SGT Hert gave me hope when he told me that his wife’s boxes regularly got delivered a week or more apart from one another, and yesterday (Sunday), SPC Penkert knocked on my door and delivered said package #2 (more almond butter, much-needed black socks, more flavor packets, more baby wipes). Thanks very much, LymeRupards!

This bodes well for my post-office-happiness this week, as I am expecting a couple of packages from my sweet wife, who has an uncanny knack for sending me exactly what I need.