Your 16th Update

From a concerned reader:

Owen, given your state of mind this week, I was not surprised you looked back for previous writing.  However, people are interested in and curious about what happens in Afghanistan.  It is getting to be mundane for you, but is not for us.  Except for what you tell us, we haven't got a clue.  We would like to have a clue.  We are depending on you. 

Could you explain a few things in some detail? 

1.)Could you explain the process that brings wounded soldiers in and also the process that brings civilians in. You mentioned it once, but briefly.  I know they get blown up and somehow they end up on a table being repaired.  What happens? 

2.)Is there ever any word after they go off again? 

3.)The people you work with; how do they get there? 

4.)You are at a British hospital; why, and how does command work there? 

5.)Who's in charge and how are decisions made?  I am sure there are strategic matters you cannot relate, but ordinary things are fascinating to us here. 

6.) Do nationals work on the base? 

7.) Is it really so boring for your compatriots that tarot and Ouija boards seem good to fill the time.  Has that passed, yet? 

8.) Who are you working with? 

9.) What kind of people do what you do? 

10.) I note that it raining there this week.  What is the dust like after the rain?  Does it almost solidify like wet cornstarch or is it like mud? 

11.) What animals are there?  Do you see any living things other than humans? 

Seriously, there is so much we don't know and cannot conceive of.  Even comment on something like the article you sent out today - does it connect to what you do?  I imagine it means fewer civilian casualties, at least. 

12.) Am I right? 

13.) Do you ever patch up Taliban? 

14.) What happens to them? 

Consider asking for questions, too. 

So, as Vampire Weekend would say, I Stand Corrected. It's time for another Update.

I will do my best to answer the 14 questions there, and their implications. (Truth be told, both due to seasonal malaise and my innate rebellious nature, I am tempted to make them my grade-school minimums, 1.) Yes, 2.) No… etc. I will not go that route and will use complete sentences and everything. My Mother would be so proud!)

1.) When we were in England and they explained this part to us, I thought that it was really clever. It's and interesting system. There are two different helicopter teams that go and pick people up. One of them is medically extreme, they are fitted to do everything shy of surgery in the air. The other is more militarily extreme, they are set up to do minor medical care, but they are outfitted to go into hairy areas and pick up the wounded while also laying down suppressive fire. The folks that work these areas, both flight crews, are pretty impressive. They get to see some crazy things, as well as more of the Afghan countryside than most other military folks here.

2.) Actually very, very rarely. Believe it or not, once these guys get to where they live, the last thing they want to think about is the time they spent unconscious and miserably in pain in-country. Very rarely we'll get a letter from someone's parents.

3.) The folks coming in to work and those that are airlifted out after treatment here go by fixed wing aircraft. (Planes) There is a flightline on base that is where we flew in, that initial impression I had of Mad Max-style wildness, that's over by the flightline.

4.) The British Hospital is very much owned by the British. There is a Commanding Officer, new now that the new crew of Brits has arrived. And a British, what we would call Executive Officer, or XO. They call him their 2IC. (2^nd In Command) They are pretty nice Officers who have their own agendas and plans for the Hospital. We were specifically warned, before getting over here, that any suggestions we have, as Americans working in with the British, should be posed as questions rather than suggestions. It is a tricky relationship. As far as our detachment is concerned, we have and American Commander (O-5) who is the OIC (Officer In Charge) of our detachment. She is a surgeon and a really good one. I'm going to try to avoid using any names, but she has done some cool things before she came here. She was on the team that helped to design the Mobile Trauma Bay, which was an idea that came out of the initial stages of combat here. It was basically a huge 7-ton truck with a trailer on the back that contained a mobile surgery unit. The plan was that it would be up-armored and travel around, from battle-site to battle-site, dealing out healthcare. It was neat idea, but ultimately unworkable. It was too big and heavy to travel easily and too large to be anything other than a terrific target. One of the nurses that I worked with in Okinawa was an initial designer on the project. That's one of the things that people forget about warfare, there is a great deal of innovation and invention that is part of it. That Mobile Trauma bay is a great concept that we could potentially use one day. It's in the idea-bank and ready for the future. Anyways, Our OIC, then there is a Senior Chief, our Senior Enlisted Leader. He's a good guy.

5.) Well, as far as the Hospital is concerned, it all goes through the British CO. There really isn't a whole lot of decision making for the Americans, and as far as strategic matters are concerned, we are not a strategic asset. We're a support asset.

6.) They do, It's an interesting thing. We have what we call LNs (Local Nationals) all over the place. I think that I mentioned once that the US policy is that anything that is to be purchased, officially, should be purchased from an Afghan source if at all possible. So LNs make and serve our food, they are our cleaners and maintenance folks. Oddly, there is usually an Indian fellow that oversees, but the Afghans are the workers.

7.) The spiritualism phase seems to have more or less passed. I am glad for that. And yes, it is incredibly boring. I probably can't express it adequately, but there is NOTHING to differentiate days. That combined with the 11.5 hour difference with the States puts us in an odd limbo. We work and sleep and watch and re-watch TV shows. Our families are all experiencing yesterday, which makes today feel like it isn't real. The most mundane and minor things become a huge deal. I got a board to put under my sagging cot this week and it has been the source of about half of my conversations.

8.) Hmm, this one I will refer to that photo I posted a few weeks back. I am avoiding names, to protect the innocent, so that'll have to cover that one.

9.) Well, this one is tougher. The people who do what I do are a cross-section of wildly competent and wildly incompetent. I work at nights; I'm the only one here on my particular schedule. This fosters an incredibly alienated feeling. I tend not to be lonely, but I do tend to feel alone. It makes things difficult. I do not share anything with anyone, which means that I feel very, very disconnected and apart. So, the people who do this job are people who are different than I am? Or maybe that is just the nights speaking. I generally like people who work in military medicine, so they are mostly likeable? But then, I mostly like people. Maybe I'll just refer this to that photo, too. The kind of people in that photo, that's who I work with.

10.) This one is kind of interesting, The dust turns into sand. That's what it does when it rains. It's nicer than the sand in Guantanamo Bay, Cuba. Gitmo is the only place I've ever been that smelled really, really bad when it rained. I was always surprised, since it is ocean-surrounded, how bad it managed to smell in a rain storm. But it smells good here when it rains. The air is charged with positive ions and you can generally detect a spring in people's steps. It also gets warmer when it rains. I have no idea how that works. Are there any meteorologists reading this? Can you explain? Can someone forward this to Dick Goddard?

11.) There are no animals at all here. I occasionally see a hawk in the sky, really far away. There are a few feral cats. That's it.

12.) You might be right. It's hard to tell what the cause and effect of strategic planning is when it comes to casualties.

13.) We DO patch up Taliban. But beyond that, I really can't talk about it.

14.) Wow, I REALLY can't talk about that.

Does anyone have specific questions?

For more of the Afghan Updates, please visit: http://dustintheeverything.blogspot.com/?zx=ee6fac97810abcfc