First Day of the Blog

Just a reminder, this is the first blog entry which means that it is the oldest. I reversed the order so it could be read like a book. Think of it as Chapter 1.

Today is the first day of my blog from beautiful Kabul, Afghanistan. I decided to start this blog because I have had such an overwhelming response from all of the wonderful people that have written me through Soldier's Angels and Any Soldier. I have received so many letters and care packages from people back home that I thought that it would be a great way for everyone to keep in touch. I have received mail from class rooms, senior centers, and people young and old throughout the U.S.. I had no idea that there was so many wonderful people out there. I encourage you to post a comment. I would like to know what you think of my site.

I decided to title my blog 6 Months In Kabul for obvious reasons. I actually today I only have 19 weeks, or 137 days, or 3,197 hours or 191,823 minutes left, but who is counting. In case you were wondering what a shazdoc is, I am not sure either. I was told by one of the students that writes to me that being a doctor is the shaz. I thought that it was a really funny word and it gave me a good laugh when I heard it. She guarantees me that it is a good thing.

For those of you that do not already know, I am a Family Practice physician. I was told one fateful day in June, while I was busy with a full schedule of patients, that I needed to pack my bags because I was going to deploy to Kabul, Afghanistan for 6 months. Of course, my initial response was shock, then I have to admit, a small bit of grief, then later I decided that like any other challenge in life, you just have to make the best of it.

My favorite quote of all time was from Richard Nixon's final farewell speech from Aug 8th, 1974:
"It is only a beginning, always. The young must know it; the old must know it. It must always sustain us, because the greatness comes not when things go always good for you, but the greatness comes and you are really tested, when you take some knocks, some disappointments, when sadness comes, because only if you have been in the deepest valley can you ever know how magnificent it is to be on the highest mountain. "

Yes, I was in that deep valley for a short while because, after all, I was going to be away from my family for 6 months and, like everyone else, I had heard of all the really bad things that were going on over here.

I had a week to gather my stuff and fly off to Fort Riley, Kansas where I spent 2 months preparing for my deployment. At Fort Riley I did a lot of Army basic training. I got qualified on a lot of different weapons, I learned to drive a HUMVEE, operate radios, practiced convoy exercises, land navigation and many other combat related activities. I also had a number of Dari classes and "Leader Meets" where we practiced the art of communicating with Afghan nationals through the use of an interpreter. The Army tried to make the training as realistic as possible. We regularly heard Muslim prayer through a loud speakers and we even had a number of exercises where locals from the community were dressed as Afghans. There was also a "Heat Trainer" which is a real HUMVEE that is rigged to spin 360' to prepare us for a rollover.

I arrived in Kabul in Aug after a short stop at Manas Air Base in Kyrgyzstan. I am currently staying at Camp Phoenix. The best way I could describe this base is it is very flat with wall-to-wall concrete. It has a ton of small wooden houses staked in real close (we call them B-huts). It gets very dusty at times especially when helicopters fly in. Outside the base the landscape somewhat reminds me of Phoenix, AZ but with a lot more pollution. Camp Phoenix is actually one of the better bases. It has a lot of very nice amenities. I hesitate to mention all of them because I afraid that everyone will stop sending me care packages when they learn how nice it is over here. : )

I work with 3 other really nice people, one of them is also a doctor and the other 2 work in health care related jobs. Our mission is to open up a new clinic. We recently toured their old clinic. Their current clinic does not even have running water! The clinic will not only be available to the police but also to their family members as well. I know that when it opens it will have a big impact on their lives. I am really proud to be a part of this mission.

I hope you enjoy this blog. Please feel free to add a comment if you like.

Eid

Today was a pretty uneventful day. This morning I ate my typical breakfast of grits with a ton of kiwis. I do not know where I came up with this strange breakfast combination but I seem to have it every morning for the past month.

I spent a good part of the day working on a mass casualty plan for the new clinic. For those of you that do not know, a mass casualty is when a medical facility receives a large number of casualties that exceeds their normal ability to care for them. Patients are brought to a hospital or clinic and they are categorized based on their injury either Immediate, Delayed, Minimal or Expectant. Obviously, the Immediate patients require the most urgent care and so forth down the line. The idea is to focus your care on the people who need it most and are most likely to survive. I am curious how receptive my Afghan counterparts will be to my plan and whether or not it will be implemented. It will also be interesting lecturing with the use of a Dari interpreter. I will keep you posted on how it goes.

The highlight of my day was beating my office rivals in pool. We have a ongoing daily pool match where the winner gets to wear a 1st place medal. So far me and my partner have claimed the prize 2 days in a row. Tonight is poker night. I play twice a week. Last week I finished #1 out of 66. I won a casino PC game. It was pretty exciting. I doubt that I will be able to continue my winning streak. I am just hoping to place in the top 25 tonight. Poker is probably one of the activities that I enjoy the most at Camp Phoenix.

We are still awaiting the end of Ramadan, also called Eid ul-Fitr or just Eid. It typically ends with the next full moon. In case you did not already know, Ramadan is a Muslim holiday where the entire month is spent fasting. I copied a short summery of Eid from Wikapedia in case you are interested in learning more info.

Eid is an Arabic term meaning "festivity" or "celebration" while Fitr means "to break the fast" and can also mean "nature" from the word "fitrat" and therefore symbolizes the breaking of the fasting period. On the day of the celebration, a typical Muslim family is awake very early and then after praying the first normal everyday prayer, is required to eat in a small quantity, symbolizing the end of Ramadan. They then attend special congregational prayers held only for this occasion in mosquess, in large open areas, stadiums or arenas. The prayer is generally short, and is followed by a sermon. Worshippers greet and embrace each other in a spirit of peace and love after the congregational prayer. After the special prayers, festivities and merriment are commonly observed with visits to the homes of relatives and friends to thank God for all blessings.

For Muslims, Eid ul-Fitr is a joyous occasion with important religious significance, celebrating of the achievement of enhanced piety. It is a day of forgiveness, moral victory, peace of congregation, fellowship, brotherhood and unity. Muslims celebrate not only the end of fasting, but also thank God for the help and strength that they believe he gave them throughout the previous month to help them practice self-control. It is a time of giving and sharing, and many Muslims dress in holiday attire.

Happy 25.2% Day!

I read a funny joke this morning:

Radio Command: "I am an admiral with the U.S. Navy. You are in the direct path of a battle ship. Alter your course immediately."

Radio Reply: "No, sir. You must alter your course. I am a lighthouse."

I sometimes feel like that admiral. Aside from today being Eid, today is also 25.2% Day!!! We are 25.2% finished with our deployment.

Fridays are normally our "down day." It is our one day off during the week and we are all in our office working. It helps to pass the time. The locals normally host a bizarre on Fridays. A bizarre is similar to a flea market where you can buy local crafts, rugs, and various other local souvenirs. It was canceled today because it is a Muslim holiday. Next week I will try and post some pictures of the bizarre.

Yesterday, I received the nicest care package from the "Busy Bees" at a Senior Center in Thousand Oaks, California. They sent a very nice picture of all 11 of them. It still comes as a surprise whenever a new care package comes in the mail. I still cannot believe that there are so many nice people out there that are willing to sacrifice their time and effort for all of us over here. The seniors knitted us mittens, caps, and booties. One of our office mates runs very early every morning and he says that the mittens will come in very handy. They also sent us snacks, toiletries, and other goodies.

I also got sent a collection of poems from students from a Marin County Middle School in California. I thought I would post one of the poems that gave me a good laugh this morning:

When I Was Little

When I was little, I ran naked.
Now I play hockey.
When I was little, I crawled.
Now I walk and run.
When I was little, I slept in a crib.
Now I sleep in a bed.
When I was little, I ate baby food.
Now I eat pizza.
When I was little, I cried.
Now I whine.

Isn't that cute. That was written by a fourth grader from San Pedro Elementary in California. I didn't include his name in case he does not want it on the web.

This morning I was working on the formulary for the new clinic. In case you do not know, a formulary is the list of medications that a pharmacy carries in a hospital or clinic. It is very interesting because they use different names for some of our more common medications. Did you know that Tylenol is called paracetamol over here? Also, when developing a new formulary you have to consider a whole different array of common ailments based on the country you are practicing medicine. Parasitic infections are a lot more common over here.

It will be interesting to see what it is like working with the Afghan doctors. One of the other physician mentors at a different base told me that the doctors that he works with treat all "inflammation" with antibiotics. He says that just about everyone that comes through the door receives antibiotics for just about everything. I was also told by a different physician mentor that they use methotrexate to treat asthma. For those of you that do not know, methotrexate is a chemotherapy drug that is also use to treat a lot of rheumatic conditions. It could be very toxic and needs to be monitored closely. Obviously, in the U.S. we have a lot safer medications for asthma. I am not sure if they use it because it is a cost issue or what. For instance, Advair is a common inhaler that we use for asthma and it can cost hundreds of dollars per prescription. Most Afghans do not even make that much in a month so you can see why they have to turn to nontraditional/alternative forms of medicine.

Later this month I plan on participating in 2 CMAs (Community Medical Assistance) programs. I have heard that upwards of 5,000 people come seeking medical care. It will be interesting to see how it goes. I will keep you posted.