Boxer's Fracture

"Fill all thy bones with aches."
-William Shakespeare, "The Tempest", Act 1 scene 2Greatest English dramatist & poet (1564 - 1616)

I like that quote. It should be the theme for this deployment.

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As you can see I am experimenting with some new photo sharing websites. They are kind of fun. For the record, the title picture and the slide show pictures were not taken by me. They were taken by various people during the last VCR trip. Looking at those photos makes you realize that I am having a life changing experience. They are just so moving. My entire perspective of different parts of the world has been chmaged. The pictures also show you that you do not have to give the kids very much make them happy. Bubbles and balloons is all that it took. The photo sharing site that I am using is soooo much better then Picasa. I can not even tell you. The pictures took seconds to load and the slide shows are so much cooler. Let me know what you think.

As you also can see from the short movie below, the gentleman with the hand fracture returned today in the same condition as yesterday. When he showed up to the ER today the ER doc escorted him up to the Orthopedist who then put on a cast. It is kind of interesting because we would have treated him a little differently in the states. We would have put on a larger cast, his last 2 fingers would have been in the flexed position, and we would have told him to keep the cast on for 6 weeks instead of 3. Because I am mentoring an Orthopedist with 20 years of experience under his belt, I try and respectfully tell him how we would do it in the states without insisting that he change the way he treats his patients. After all, what we do may not be entirely correct either.

It was somewhat entertaining to watch the doctor patient interaction between the Orthopedist and the patient with the hand fracture. You have to understand that people in Afghanistan are very stoic. They have endured years of hardship and their pain threshold is a lot different then you and me. For instance, when I sutured the child's lip when we did the high school HA drop I did it with no local anaesthesia (because I did not have any) and he was standing (because there was no where to lay him down). It must have been very painful for him but you could hardly even notice a reaction on his face. So today after the cast material was still soft, the orthopedist decided that he wanted to place a little traction on the broken finger to set it in place. It must have been excruciatingly painful for the patient. The Ortho doc tugged on his finger a few times to get it just right. The one time that the old man decided to display any evidence of pain the Orthopedist looked at him in an irritated manner then, after shaking his head, he turned to me and smiled.

We also had someone come into the ER with really bad abdominal pain. We suspected that he had a kidney stone but we really had no way of confirming it because the lab is not yet up and running. We also do not yet have the ultrasound machine up and running yet. We did not have very strong pain meds to give him so unfortunately we were not able to take care of his pain very well. I learned a very interesting thing the other day regarding the way that they treat kidney stones over here. Typically in the states we do lithotripsy, which is where we send sound waves through water to break up the stones, or we place a stent into the ureter to facilitate the passage of the stone. Over here, when the stones get to be to big to pass naturally, they actually excise them out of the kidney. I never knew that you could even do that. You would think that you would be doing more damage by making an incision into the kidney then by just leaving it alone.

When I came back today I had 3 packages waiting for me. They all were from the same person. One box was toys for the kids.

The other was a big box filled with all of the ingredients to make smores. We have a really big fire pit that people gather around most nights. I will host a smores party some time soon.

Another package was a great big box of cookies.

We had another bombing today. We all are just fine. The secretary of defense also came and left. I did not have a chance to see him. Maybe next time. Hope you enjoy all of the new pictures.

Thanks for reading.