4th Times the Charm?

Dr. William Brydon - the only British survivor of the first Anglo-Afgan war.

For those of you who are unencumbered with the knowledge of history, this is not the first foray of the British to Afghanistan.  In fact, by all accounts, this is the fourth time the English have come to Afghanistan to attempt hold sway over the natives.

The first was from 1839 to 1842.  The 'Cliff Notes' version goes something like this:
   1)  The British already controlled India, but felt the Russians were trying to invade Afghanistan to expand in central Asia.  (Turns out this probably wasn't the case - but, oh well - Colonialism at it's best).
   2)  The British attempted to get the the leader of Afghanistan (Dost Mohammed) to side with them.  All Dost wanted in return was to get back the disputed area of Peshawar from the Persians.  The British said no.  So what did old Dost do?  He asked the Russians for help.  Ooops.
   3)  The British took umbrage and decided that Dost had to go, so they invaded and installed a puppet named Shuja Shaw Durrani.
   4)  Lord Auckland signed a treaty called 'Simla Manifesto', which basically stated that the British were there to protect Durrani and his troops from other territorial disputes.  But, of course Persia had a pro-Russian dictator and things escalated as they are want to do.
   5)  The British invaded with 21,000 troops, led by Sir John Keane, in December 1838, crossing over the now infamous Khyber Pass.  By 1839 they had passed Kabul, took Kandahar and defeated the Afghan forces at the until-then impregnable fortress at Ghanzi.
   6)  Things were going swimmingly, until October 1841.  By that time there only remained 4,500 British troops.  The new commander, William Eliphistone, in an attempt to increase morale, allowed the soldiers to bring in their families.  Now the British numbered 16,000, but this included women, children and Indian laborers and the Afghans thought the British were trying to set up a permanent occupation and now they were pissed.
   7)  The Afghans began to flock to their new leader, the son of Dost Mohammed, Mohammed Akbar Khan.  A series of attacks began on the small, poorly defended British garrison.  The British had not planned very well and all their supplies were actually across a field 300 meters away from their camp.  It became a long 300 meters.
   8)  Finally, at wits end, William Eliphistone reached an agreement with the Afghan fighters to allow safe passage for their garrison and charges.  Unfortunately, he also gave up their guns.  Oops number 2.
   9)  On January 5th 1842 as the garrison was traveling through snow bound passes they were attacked with their own weapons.  A running battle continued thru two feet of snow until only one British survivor reached remained - Dr. William Brydon.

This all led to:

The 2nd Anglo-Afghan war from 1878-1880.  The 'Cliff Notes' version goes something like this:
   1)  See 1st Anglo-Afgan war.  Repeat as necessary for the 3rd.

As a disclaimer, I support the 'War on Terror', however, knowing history allows us not to repeat it - Alexander the Great, Ghenis Khan, Tabur - all great warriors.  What do they have in common - they all failed to conquer Afghanistan.  I would have loved to have been a fly on the wall for this conversation.

Bush:  'We have to invade Afghanistan to ferret all those who would support terrorist organizations'.
Blair:  'I don't know George, maybe just an Air War - no land troops.  We've been there before and it's a rough place'
Bush:  'Don't worry, third times the Charm!'
Blair:  'Wait, what?'

Day 95 BOG, 122 away from home.  All for now.

Hump Day!

Official count down calendar - Circled day at the end is the

very last day I could get home - Dec 23rd.

     The Navy is purposely vague on many things.  I've learned to deal with this, however it continues to be a problem that vexes me.  Currently, the problem lies with the actual duration of our mission here.  When I first got assigned for these orders I was told I would be deploying for six months.  No problem, standard deployment (although there are many, many others who do more - some in upwards of 18 months).  Then I was told that I would have to process for a week in Norfolk.  SOP, got it.  Oh yeah, there will be three to four weeks of training to get you ready for the environment you are going to be working in.  No problem, good idea.  Then there will be 5-7 days of travel to places like Maine, Germany, and Kuwait, where you will acclimate to the 125 degree heat.  Now wait just a minute.
     Anyway, I totaled up the time and it should be around 7 months or 210 days.  Then I picked up my orders and they said:  duration of orders  - 242 days.  WTF!  Where did the extra month come from?  I have no idea and no one else really knows either.  I've come to the conclusion that they build in extra time to have some flexibility for any contingency - or that they hate me for the time I was drunk and did a skit making fun of my chairman at the end of the year awards dinner.   Either way, I'm OK with that, however it's always nice to have a date to hang your hat on, to count down the days you have until you come home.  After running numerous scenarios in my head, I've finally come up with an estimated return home.  And this marks the official (arbitrary) halfway point!  I think.  I'm very non-committal on this statement if you couldn't tell.

In an effort to count down the days of deployments, people use a variety of methods.  I, personally, have a count down calendar (above).  I also have a visual cue from the huge bottle of anti-malarial pills that I was issued (190).  Finally, I've picked a number of dates to 'look forward to', as a way of passing the days.  Here are some examples:

May 1st - Duh, day 1. 
May 21st - Anniversary.
May 28th - Arrive in Kuwait.
June 2nd - Arrive at Bastion.
July 4th - Dress up as a minute man and sing 'Yankee Doodle Dandy' to annoy the Brits.
August 10th - My buddy Jason arrives in Kuwait.
August 25th - My buddies George and Edton get to go home and Dave arrives.  And Hump Day?
September 8th - Opening day of Football Season.
September 16th - Phillies lock up the NL East.
October 15th - Entire British command changes over.
October 23rd - Eagles start season 7 and 0.  And Phillies beat the Red Sox in a sweep in the World Series.
October 31st - Halloween - Dress up as a minute man and sing 'Yankee Doodle Dandy'. Yes it is still funny a second time.
November 10th - Average high temperature in Bastion finally drops below 100 every day.
November 23rd - Marks 180 days Boots on Ground.
December 1st - Marks 8 months of tax free pay.
December 7th - Day 194.  Should be official 'rip out' date of Nobel Eagle number 4608, meaning I should be leaving for Kuwait this day.
December 23rd - Latest day I could return.

As with all things, time will tell.  The only date that I'm positively, absolutely, 100% sure about is.....






The Phillies will crush the Red Sox in the Series.


One last thing - have you ever watched shows like Biggest Loser or Survivor and they have these really dramatic moments where people tell them how much they miss their family and don't know if they can't go on?  Last time I checked, on those shows they are only about 30-45 days long, you can leave at any time, your life is never really in danger and you are actually playing a game.  Quit Winjing!  (That is a British term for complaining).


All for now.

Coordinated Chaos

This is the main receiving trauma bay in the ED (we have 8 of these, although not all this size).  When we get a trauma call (the  so called Catagory A patient), the teams assemble, not unlike any major trauma center in the world.  From left to right:  Team leader (ER physician), runner (for blood and supplies), Radiology tech, Level 1 blood infuser nurse, Radiologist, Nurse leader (with back turned), ER resident and primary surveyer (leaning over bed), nurse (male with back turned to picture), Anesthesiologist and tech (facing toward picture and head down), Medication nurse (standing over yellow box), the three to the far right are two other Level 1 infuser nurses (can infuse a unit of blood or plasma in 30 seconds) and the man with the red cross is the transporter of patients.  Not seen are the three others just beyond the picture which is the Trauma Nurse coordinator who writes all vital information down as it is shouted to them, the Aeromed evac team to start getting ready to fly the patient home and the patient tracker who can contact commands and families to notify them.  

There is always a din of noise with side conversations, until the door swings open and the helocopter team leader comes in to report the patient while the ambulance teams gets them ready for treatment - then it goes silent and you could hear a pin drop.

Again, this isn't too different from any trauma center in the US.  What is different is about ten feet behind the Team Leader where you will find two of each of the Attending level physicians - Trauma Surgeons, Orthopedics, Vascular Surgeon, Plastic Surgeon, Anesthesiologists and the OR nurses - See Below.

Attendings waiting like coiled springs to jump into action.  There is the dreaded yellow line on the floor where we stand behind until called by the team leader to do our part.  In all its there are about 35 people in the trauma bay.

Within about 15 minutes we have stabilized, intubated and resuscitated the patient and they are now in the CT scanner.  Here the attendings are jockeying for position to see what has to be done.

CT scan is done and patient is in the OR.  This case needs Ortho and Trauma surgery - he gets prepped (and a quick bath to get all the dirt and mud off) and away we go.  This happens on average of 2-10 times a day.  (I'm at the head of the bed facing with black and white scrub cap on).

All for now.

The Brits say the damndest things (Part 1)

A popular saying in the British culture is that the English and the Americans are a people separated by a common language.  I have to say, I can't agree more.  The Scottish and Northern Irish notwithstanding (I actually don't even understand what comes from their mouths) the people of the UK (Wales and England) have a distinct, if not flowery language.  I've picked up a few of my favorite sayings in the past few months and would like to take occasion to attempt to describe them.  I would also like to make you aware of several things about the English that you may otherwise not know - all in jest, I assure you.  I do have to admit that most Brits have a very keen sense of humor, but it's a little more low brow than their demeanor might make you believe.

Aside from the obvious distinctions of what they call certain things, there are others that are more perplexing (the loo is a bathroom, as is an ablution, which sounds more like something you do in a Catholic Church while going through confession).  For instance, a theater is not a place to view movies, but rather the operating room.  On a number of occasions as the British attempt to tell a US Marine that they have to operate on them and then go on to say they are going to take them to the theater - well, you can guess what a 19 year old Marine would say to another man offering to take them to the movies and it's not fit for printing on this blog.
One of the terms that has entered my lexicon is 'manky' (pronounced main-key).  It can describe all number of gross things - like an infected wound, a full trash can, or when they wash their work out gear in the sink where I brush my teeth as they do nearly every day.
One of my favorite sayings is - 'You forget yourself, sir'.  This basically translates into F off, but sounds so much more dignified.  From now on when I get any anesthesiologist who back talks me - Bam - 'Why Doctor (fill in the blank), You forget yourself, sir/ma'am'.  I've been using it quite a lot lately.

Here are some other things I have noticed:
 - Their favorite American slang word is.....bullshit.
 - They think being called MF'er is a term of endearment - I have no idea who would tell them such things.
 - Michael Caine is their national hero. He starred in every British movie made from 1961 to 1995.
 - Brits actually make fun of Elton John more than we do.
 - Most of them actually do love the Beatles.
 - They actually like Rowan Atkinson.  Doesn't ring a bell?  Well, he's 'Mr. Bean' of course.  I find him quite annoying, however, apparently he was quite funny back in the day.  He had a show called Black Adder, which is a classic in the UK.  He starred with Hugh Laurie in this sitcom, who plays a dim witted Army soldier in the first world war.  I watched a couple of episodes and I was not impressed, but Hugh Laurie has come a long way.
 - They watch Darts on TV!  No, I'm actually serious.  They will literally sit for 3 hours at a time and watch two fat men throw darts at a wall.
 - One of their favorite movies of all time is Zulu (starring who else, but, you guessed it, Michael Caine). It is their 'Rocky'.  The story is about a small outpost of British soldiers (about 200) in the late 1800's that were attacked by over 3000 Zulu warriors in Africa.  They say the movie shows how valiant and brave their soldiers were and nearly 15 Victoria Crosses were awarded on that day (it is equal to our Medal of Honor).  What I say is that 200 men with rifles and canons will generally defeat 3000 half-dressed men with spears and wooden shields any day of the week and twice on Sunday.  Well played.
 - Although I can't confirm it, I really believe they think that they won WWII single handedly.

    I don't want to make this post too long, so next time I will tackle such things as:  shoewear, why a surgeon is called Mister, tea time, being called a Jack Wet, and of course Cricket.

All for now.

Happy Birthday Mom!

Dr. Poker to OR 4

The lax standards of sterility of OR's in the UK on display

(Yes that is 'near beer' we are drinking - it tastes horrible)

Trying to find things to do in our free time is somewhat difficult with our limited options.  I thought, how better to interact with the Brits than bringing an American game to them - plus a nice way to earn a little extra spending money - (we don't actually play for money, this is not allowed in the AOR).  I have some experience playing poker so I thought it would be a nice way to spend a couple of hours.  The photo above is of one Estonian (he is just behind me, which I'm surprised you can't see him as he is huge and was an Olympic caliber wrestler in Estonia), one Brit and five Americans.  Out of the seven of us, only one had actually played before.  So, I thought to myself, easy money (we don't actually play for money, this is not allowed in the AOR).  Well, this didn't turn out to be the case.  You see, when you first start playing Texas Hold'em you should really only play good starting hands - like Ace-Ace, Ace-King, etc.  Then when someone makes a raise most people know you have some good cards and they won't actually call when they are holding nothing.  However, when you are a beginner you get excited when you have 7-2 off suit and the flop comes and now you have a pair of 2's against my Aces.  I, of course bet big.  They, of course, call - because somehow those 2's in their mind are winning (I don't have time to go into odds of poker, but they are not).  Then the next two cards come and they are 7 and 2 - now giving my beginner friend a full house.  Of course, as some may know 7-2 off suit is the worst starting hand in all of Texas Hold'em, but now they are a full house and I have no way of beating him with Aces.  However, in my mind no one would ever play 7-2 off suit - well, at least no one that knows the rules.  Much to my chagrin, however, the Brits do play 7-2 off suit - all the time it turns out.  So let that be a lesson to you - the Brits cannot be trusted to do anything that makes sense - ever!  So, the most experienced player went out on the second hand and the Brit now think they are Texas Slim!  Thank goodness he's leaving soon, otherwise I would run out of money and patience (we don't actually play for money, this is not allowed in the AOR).

All for now.