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.

The Macarena

Today I am very excited because I had a great idea. I was thinking about the large number of hits that my blog has been getting over the past few days (over 100 to date!!!) and I thought that it would be a great idea to start a children's clothing drive (emphasis on warm weather cloths since it will be getting very cold over here very soon). We could even expand it to include toiletries and toys. I have been told that families over here share a single tooth brush per household. I do not know about you, but if I had to share a tooth brush with my brothers growing up I might not have ever brushed my teeth.

There are a number of opportunities for me to distribute the contributions that I receive, although I have not yet worked out any of the details. As I previously mentioned, I will be participating in CMAs (Community Medical Assistance) projects. We also will have our clinic which has a peds department. There is also something called Operation Not Forgotten which is a collection drive for children done by Camp Phoenix. I believe they go out to rural towns to distribute their donations. Believe it or not, there is also the Pul-e-Charkhi prison that is just down the street. I learned from an article that I read that children have to stay with their mothers when they get imprisoned because they have no where else to go. It is really sad. I encourage you to read the article online. I posted some pics from the article.

The article is titled: AFGHANISTAN: Children share deprivations of imprisoned mothers. Cut and past this title into google. It should be the first or second result to pop up. For some reason I tried to include the link and it would not work. It is from irinnews.org

I do have to mention that the success of my site also brings with it somewhat of a bittersweet feeling. I am concerned that the more people that visit my site then more people that will send us care packages which is not my intention. As I mentioned in my 1st posting, I earn decent income and we are very well taken care of over here at Camp Phoenix. There are some soldiers in Afghanistan that are on a 15 month "camping trip." They eat MREs (meals ready to eat) for every meal, they basically live in small Afghan villages, literally "embedded" with their Afghan counterparts, without any access to internet or phones. I included a number of soldier support links where you can send care packages at the bottom of my blog. Here is my recommendation, find out which ones live on a small FOB (a FOB is a Forward Operating Base). Those are usually the ones with the fewest amenities. Also, bases in Afghanistan that are in the southern region are usually a more hazardous place to live. They get more rocket and motor attacks then in the northern regions. This is a generalization of course. We have our own share of dangers in Kabul such suicide bombers and VBIEDs (vehicle borne IEDs) .

For those of you that still want to send us stuff we would love to receive it. I just wanted to set the record straight so I could have a clear conscious.

Last night I did my boxing class. I dragged my friend along- we call him "Puffy." We call him that because his last name is Combs. Parents, ask your kids for further explanation. I did not warn him how rigorous the class was going to be. I got a good laugh watching him struggle to do some of the ab exercises. The best was watching him bob and weave. He made the instructor crack up. The instructor said that it looked like he was doing the Macarena.

We should be getting actual boxing equipment in soon, like punching bags and gloves. I still need to order tape and a mouth guard online. I am not sure how far I will go with this. I may need to stop once the sparing starts. I do not want to get hurt. After boxing they had salsa dancing. I usually go just to watch them dance. Tonight they have Karaoke over at the Coffee Bean (yes, we have a coffee shop on our FOB, you see what I mean about all of our amenities). I am trying to get my team to participate. Maybe in the future I can learn how to post short video clips. It should give everyone a good laugh watching us try to sing.

Today we worked on the clinic layout. We have a copy of the floor plan on the computer and we were mixing and matching who should go into which room. I have been calling the new clinic a clinic but that really is not accurate, it is more like a small hospital. It has just about every subspeciality, including neurosurgery. One of the first things we will need to do before the clinic opens is give the doctors training on all of the new equipment. Most of the equipment is state of the art, and therefore, very foreign to them. I have started to contact some U.S. doctors in the area in an attempt to get them to provide some teaching for things like the optometry equipment. So far everyone has been really nice and has enthusiastically agreed to help out.

I am posting our address in case you would like to participate in my drive. Don't forget, you can send children's cloths, toys, toiletries, and anything else you think would be helpful. Used clothing is encouraged. Don't go spending a lot of money. Just send me the old stuff that you already have and want to get rid of. You know all of that stuff that it is just collecting dust in your garage or attic.

Thanks again for visiting. Now don't just log off- post a comment!! I would love to hear what you think. : )

Pesky Flys

Good afternoon. Or for most of you I should say, good middle of the night. Everyone that reads this is probably fast asleep right now. That actually works to my advantage because usually the first and second drafts that I write have the most spelling and grammatical errors. By the time people are actually awake to read them they have been proof read a few times. By that time I have changed all of my macaranas to macarenas. I am sure plenty of errors still slip through the cracks.

I am beginning to learn a lot more about the world of blogging. My knowledge has been growing by leaps and bounds. My first accomplishment was to install a site counter. For those of you that do not know, it involves cutting and pasting HTML. I really know nothing about HTML but I do know how to cut and paste. Here is a good tip you can take with you- holding down the Ctrl and C key at the same time is a short cut to copy and holding down Ctrl and V key is a short cut to paste. The second slightly challenging thing I did is I created a photo album as you can see on the right column. I plan to add pictures daily so be sure to check it regularly. I plan on taking pictures of all of the major Phoenix events. For instance, there is a body building competition taking place in early Nov. That should be interesting. I also will try and showcase all of the various activities around Phoenix even though I do not participate in them, like Cigar Night which takes place 3 times a week (they actually give away free cigars!).

I anticipate that there will be many people logging on searching for info on Kabul and Camp Phoenix since they will be deploying here in the near future (like I did at Fort Riley). Hopefully, I can give them a taste of what it is like over here and somewhat put their mind at ease. I have a really funny thought, we could take it even further if we wanted to and we could really simulate what it is like over here. First, after blindfolding a person, you can burn a bunch of tires near them to recreate the smell. I have been told that tires are part of the ingredient that they use to make bricks and that is why they are always burning them. Next, you will need to add the occasional low flying airplane, a lot of dust and dirt in the air, and pesky flys buzzing in your face (but only when you are in your office typing on the computer). You also will need to add the sound of Muslim prayer in the distance 5 times a day along with Revele and Taps played over the loud speaker every morning at 06:00am and 21:00. If you recreate all of these sounds and smells then it will prepare you for Camp Phoenix. Maybe I should contact Fort Riley and let them know.

I think that the idea of a locations having unique scents and sounds is very interesting. If you can think of any other place that has an undeniable and distinctive ambiance then write them in the comment section. It would be fun to read them all.

Today I also came across a site called milblogs. It is a site that lists all of the military blogs listed on military.com. I registered mine. Here is a link, I hope it works:

http://www.milblogging.com/

It is fun but kind but overwhelming to see all of the different blogs that are out there. I think that I am going to favorite a few of them and read them on a regular basis. I should probably mention the blog that actually introduced me to and got me interested in blogging which was A*W*A*C. by Capt Traversa. He was also deployed to Camp Phoenix and he had a great way of describing his experience in a fun and entertaining way. Here is the web link:

http://traversa.typepad.com/

Surfing all of the blogs also inspired me to create a goal for myself. I would like to try and get 50,000 hits on my site and win the Air Force Milblogs Blog of the Year Award. Hey, if you are going to try for something you may as well go big. I think I can do it. After all, I have 6 months and plenty of time on my hands. Here is the award that I would like to win.
I hope you all got inspired by yesterdays blog. I expect to get a lot of children's cloth very soon in the mail. When I get a good amount I will deliver them and take plenty of pictures.

Thanks for reading.

Forgotten Heros

There is a marine phrase that is commonly used, "Semper gumby." It basically means that you need to remain flexible because plans change. I was told by many people prior to deploying to Afghanistan that I needed to "remain flexible." I did not know quite what they meant but I am quickly learning. My job over here may be changing soon. I will keep you posted.

For some reason the new information that I recently learned got me thinking of the day that I was first told that I was going to be deployed. You have to understand the context, normally the Air Force deploys its people for 4 month missions and they are usually sent to relatively safe locations, especially if you are a doctor. It was the middle of the day and I was in the thick of a busy patient schedule. Both of my bosses came to my office looking very solemn. You could tell that they had something significant to tell me. In those 5 seconds before they said anything I thought to myself, "OK, what can it be?...did someone die?..No that can't be it....Noooooo, they are going to deploy me!!" During the short conversation I was told that I was going to Kabul, Afghanistan for an yet to be determined time period. I later learned that I would be filling an army deployment spot and that the entire deployment was going to last 8.5 months. Talk about a surprise.

I was told on a Friday afternoon that I needed to be at Fort Riley, Kansas for training on Sunday!! Fortunately, I was able to get my report date extended by a week. I tell you what, I have never wanted time to slow down like I did that week before my deployment. It was truly a wonderful week. Every second I spent with my wife and kids was invaluable. I could remember being at the park with my family and just wanting time to stop. They always say you should live for the day and I really was. When I get back home I would definitely like to recreate that week indefinitely.

I have to say, I do have a bit of guilt about having left my family. My children were 4 month-old and 3 years-old when I left and I feel guilty about having my wife carry the load. Before I left I taught my wife all of the little jobs around the house that only I knew how to do. I showed her how to change the air filters in the AC, how to shut off the main gas and water, where the circuit breaker was, how to work the automatic sprinklers, and a bunch of other things. I was a little worried that now that she knew how to do everything that I would become irrelevant when I came back home. I even found someone to take care of our dog, good 'ole Huckleberry. My wife said that it would be too much for her to handle so I found an incredible coworker that was able to adopt Huck and she eventually found him a really good home. While I was at Fort Riley I even had a home alarm installed.

I am looking forward to tomorrow morning because I will be seeing my family via my web cam. I recommend bringing a web cam if any of you reading this are scheduled to deploy to Camp Phoenix. The internet costs $35.00 a month but it is worth every penny. I deployed with the Navy to Iraq in 2003 and it took 2 months just receive a letter. Now you can talk and see each other in real time. It is absolutely amazing.

I have to mention before I get off of the subject that wives are truly the forgotten heroes of this whole Iraq/Afghanistan campaign. We get all of the attention and concern and wives are left to carry on a very hard and lonely job back home with very little appreciation. The next time you see a spouse of a deployed soldier be sure to thank her for her sacrifice as well.

Thanks for reading.

Power Point

We had a very interesting time today giving the power point presentation that was both in English and Dari to our Afghan physician counterparts. LtCol Johnson did a very good job with the help of our interpreter. Maybe I could enlighten you on some of the interesting challenges we face in opening up a medical clinic in Afghanistan. Men and women can not wait in the same waiting room so we have to create different waiting areas (I do not endorse the customs I just follow them). It is important to take into consideration the religious customs when creating a clinic, for instance, the urinals should not face towards mecca. It is also very important that the Afghans have a way to wash a body right after someone dies, I am not sure why. Never the less, we need to construct a body washing area in the new clinic. There needs to be a place to pray in the new clinic so a prayer room needs to be constructed. It is traditional to sacrifice a goat at the opening ceremony to bless the facility (we are still working out those details). Some other interesting Afghan customs is that it is common for a man to kiss another man on the cheek as a form of greeting and hold hands. It is also customary to enjoy a nice cup of chai and talk about each others family prior to discussing business.

We had a lot of cultural awareness training at Fort Riley, they called it "Leader Meets." We actually had actors that dressed and acted as if they did not know any English and it took place in a traditional Afghan surrounding. We were presented with challenging scenarios that we had to work through all with the help of an interpreter. Let me share just a few cultural taboos with you. You should never sit with your legs crossed where the bottom of your feet are showing, this is considered rude. You should never place your hat on the ground (I am not sure why) but it is common for Afghans to kiss their hat after it falls on the ground. You should not give the A-OK sign because it is considered offensive.

Everyone seemed to be pleased with our layout of the floor plan so we do not need to make any major changes. Our next step is to start training the staff of how to use the new equipment. We also will be giving lectures on mass casualty and emergency procedures, and infection control. I am looking forward to it.

I learned yesterday the origin of the word blog. I believe that it comes from the combination of the words web and log. I found that to be interesting.

Thanks for reading.