Update 1

I am here in the Helmand Province of Afghanistan at the British-run Camp Bastion Hospital. Getting here was a several step process. It started all the way back in August with a trip to South Carolina. I spent about 3 weeks in South Carolina, training with to be an Army asset. I am not sure what the real benefit of this training was. They taught us to "Move-Shoot-Communicate" which was a good thing, in a general way. Most of what they taught us falls under the idea of general information. Specific tactics, the way that a unit in the field will move, shoot or communicate, are based in on-site necessity. So general training isn't that useful. It offered familiarization in weapons firing for people who had never had it, but unless things go really, specifically badly here, we won't be using, or indeed in contact with, our weapons. The whole thing is a bit confusing that way. But I suppose it was an opportunity to spend some real, quality time in Fort Jackson, South Carolina. If I could make a suggestion to the travelers among you it would be this: Do not visit Fort Jackson, South Carolina. It is a miserable, hot, humid, ugly place. Also, people there go "Muddin'" a lot. They love them some Muddin'. Don't ask me why. It seems like one of those non-intuitive things. If someone were to suggest Muddin' to me, I wouldn't even have to ask what it is. No, I'd say, no Muddin' for me.

From South Carolina we got a respite. A quick stop-over in the DC area and time with my loving wife. This was a swell time, though it is always difficult when you have to say goodbye again. I don't like it. Others might enjoy such things, but it is not for Margaret and I. The time together, yes please, we like it. The time of parting, not wonderful. But it worked out well and was a nice time.

From there we spent 3 weeks in Strensall, England. This was a pretty nice time. I have to recommend York to everyone. It's a terrific place. It has the old city walls from it's Keep days, the Minster is terrific. The pubs have a wonderful bounty of local brewed ales and the clubs are not as odious as clubs in Cleveland, Ohio. (I know that clubs in Cleveland are not the gold standard for clubbing. They are however pretty much the gold standard as far as I am concerned. I am not a club-guy.) My friends tell me that the strip-clubs in York are rotten. So... you know, if that was your plan, don't bother. The training itself, again, was kind of a waste of time. The Brits have a complete mock-up of the entire hospital that we are in now, in Strensall. It's an impressive bit of simulation, but not really anything like what we have run into since we got here. (For one thing, there is a wildly different climate in Britain than in Afghanistan. I know that will come as a surprise to most of you, but it is really, really true.) Climate is one of the really big issues here, but I am getting ahead of the story. My training-pals and I also popped over and visited London, which I was so prepared to fall in love with. And it was a miserable time. I would love to be able to recommend London, but in fact I suggest you steer clear. Hang out in York, instead. London is so cold and wet, and expensive and touristy and crowded and miserable that I felt kind of like.... Have you ever had a bad girlfriend/boyfriend? One that you just keep trying to make everything good with? You spend more money, try harder, put more time and effort in, only to be continually abused? That is what London was like for us. Not a good scene.


We flew out of London and stopped for about an hour in Cyprus, which has a really lovely landing strip with a duty-free shop. I assume it has other things, but we didn't see them.

Then on to Afghanistan. My first impressions of this place were that it is just like post-apocalyptic, Arnold Schwarzenegger film. There are huge concrete walls that look pockmarked by dust and shrapnel, tons of razor-wire and flashing lights. It is just like something out of an early 90s action-fest. But then you start to realize how much dust is everywhere. No good director would allow it, it is uncinematic. You get off the plane and onto a bus that has not only seen better days, but it forgot about them and now only has that vague memory of better days, like a story it heard once when it was a kid. The roads are everything you've ever heard Third World roads would be. The potholes have pothole and the ditches alongside are more like gradually crumbling hills. The drivers are as cautious as you've heard. At 4 in the morning, with no one else on the road, we almost had a collision with the other bus that was carrying our luggage. You wouldn't have thought it possible, but it happened.

We were taken to our new homes in this dust-filled desert. We live now in tents, we are like the nomads that they have around here. The tents we have are huge, 80 man affairs. There is a huge main corridor, off of which there are 10, 10-man pods. 2 of these pods are not for berthing, they hold showers and latrines. The other 8 have room for 10 people to sleep uncomfortably. We sleep on old-style Army cots. Just canvas stretched over metal frames. Many of us have a sort of mattress, just a long pillow that lies on top of the canvas. It's actually WAY nicer than you'd think. I've slept on the canvas and poles by themselves before and aside from sleeping on a hard plastic floor, they are the worst. (And since a hard plastic floor is the option, even those without the mattresses sleep on the cots.) We string up cord at head height and hang blankets in between our cots, so that we have a modicum of privacy. It isn't perfect, but it's OK. It's home, at any rate, for the next 6 months, so we learn to love it.

The guys in my pod are mostly all guys I trained with. With one exception, I like them all a lot. (There is one kid that I just don't like. He is one of those people that you don't like from the first time you see them. When we were in Strensall, this same group of guys, we all shared a room together. Over the first couple of weeks everyone managed to get pretty annoyed with each other and eventually we all had an "Air Your Grievances" evening. When it came to me, I said, "I am sorry to anyone I offended, I didn't mean to. As far as I am concerned, you're all OK with me. I have no problem with any of you." Then the kid I don't like piped up with some comment and I said, "Except you. I don't like you. I'd like to punch you in the face. Sometimes I find myself just staring at you and thinking about how much I'd like to hit you. Sometimes when this happens, you're asleep. Why don't you shut up." He shut up. Over the next week all the other guys came to me privately and told me that they feel the same way, but that they'd have never said it like that.) They are all pretty good guys, fun to be around, too loud when I am sleeping, but you can't hold that against them.

We're all on different shifts here, which brings me to the role of this Hospital. We're a Role 3 medical facility. Role 1 is the guy in the battle. He's the guy that runs out, puts a tourniquet on and carries the wounded back. Role 2 is a Shock Trauma Platoon or Field Surgical Suite. It is who the Role 1 guy brings the wounded to. Their job is to make the wounded fit to travel to Role 3. We get the wounded, usually off a helicopter, and we make them stable enough, surgically complete the amputation, stabilize the major bleeds, whatever, for the guy to travel on to Germany and a major hospital, who make him ready to go to, usually, Bethesda Naval Medical Center. Now, I work at Bethesda in the role of Liaison for these guys. I see them after here, when I am at home. So this is just a step or two forward in the chain. But what I didn't know, and what you probably don't, is that this hospital is THE trauma hospital. We are the #1 place for victims of trauma in the whole world. There is a 60% better chance of the patient surviving here than anywhere else in the world. And that's just incredible. It is unprecedented. I work here in an Administrative role. That's really what I do for the Navy. I am trained to be that Role 1 guy, but really they always make me Admin. (That's what happens when you know Excel really well. For which, thank you Josh Gottlieb and Auntie Andy.) But many of the guys I live with work in other areas. Some of them work in the Operating Room. Their shifts are 6 hours on, 6 hours off, 7 days a week. If they are in a surgery that takes longer, their shift is longer. It is a punishing life. Some of them work in the Emergency Room, their shifts are 12 on, 12 on call, 12 off. It's better than the OR guys, but still pretty tough. And there hasn't been a day here that the on-call folks haven't been called in. The kid I don't like works on the Wards. They work... not enough, that kid should suffer. No, they work 12 on, 24 off. Not bad.

I work about 10 hours a day, every day. It's easy compared to others. I work at night, so nearly the same time the US is awake. That's a pretty sweet deal. I can call Margaret when I want and talk. I can work on the college classes I am taking. I have it pretty easy.

Now let's talk about the hard part. You know how they keep reporting that this is the worst month on record, X number dead, X number wounded? Well, about 70% of them come through here. It is pretty graphically horrible. Again, movies help out. The trauma we see is painful, but relate able to things we've seen in films. Not all of it. I don't want to get into it, but you see things here that you won't forget any time soon. These young guys are coming in here, double, triple, quadruple amputees. Every day. It wears on a body. I see a little less of it, night-shift doesn't get as many calls. But still, I see enough to keep me awake days. The guys in the Emergency Room and the OR, they have it rougher. (This is why I don't complain if they're noisy while I am trying to sleep.)

But all in all, we are safe. Camp Bastion is surrounded on all sides by miles of Coalition Forces. The last time anything happened here was ages ago and we're pretty lucky for that.

OK, that's tons. I know there are more stories to tell, and like l said, I'll try to get to them all over time.