Wednesday, March 30, 2011

Don't mess...



Today's features team member is HM3 (FMF) Todd Cecil. Cecil is a Fleet Marine Corspman, a former member of the US Navy Marksmanship team, and an all around good guy. Here at the FST he works on trauma team one and has been my go to guy for help with ortho patients. (Mainly because he's the biggest guy on the team! What can I say, we knuckle draggers have to hang together!)

Cecil also manages to stay popular by picking up mail and keeping the guys in the mail room working so that we actually GET mail. He recently re-enlisted and honored me with the privilege of administering his re-enlistment oath. I hope you all enjoy learning a little more about HM3 Cecil!


SSSS: What’s your full name?

Todd Russell Cecil

SSSS: Code name?

El Diablo also known as the fightin’rooster!

SSSS: Why that one?

Shake and bake

SSSS: Where were you born?

Lubbock, TX. God’s great state in the republic of Texas!

SSSS: Married or single?

Married

SSSS: Any kids?

Daughter age 1 yr, Caralee

SSSS: How long have you been in the military?

3 years

SSSS: Any tattoos?

Fourteen. My favorite is the one in Arabic on my calf. It means “Sons of Abraham”

SSSS: What’s food do you miss most being here on the FOB?

Bangers and mash

SSSS: What’s your favorite food that they serve here?

Omelets

SSSS: Any food that you absolutely won’t eat?

I have yet to find something I won’t eat. I’ll try anything at least 3 times.

SSSS: What’s your favorite movie of all time?

Cool Hand Luke

SSSS: Team Edward or Team Jacob?

I know the reference but I’ve never seen the movie. I don’t even know who any of them are. I’d say team Edward because Jacob just sounds like a wussy.

SSSS: Star Wars or Star Trek?

Real men like Star Wars

SSSS: Mac or PC?

PC

SSSS: Tupac or Biggie?

Not a real big fan of either one

SSSS: Astrological sign?

Cancer

SSSS: Briefs or boxers?

Boxer-breiefs

SSSS: If you could teleport from here to anywhere in the world for 6 hours where would you go?

My wife’s bosum.

SSSS: Lowenbrau, Becks, St Pauli, or O’Douls?

Lowenbrau

SSSS: Are you a little bit country or a little bit rock-n-roll?

Country

SSSS: Did you get that last reference?

Yeah

SSSS: What’s your favorite thing you’ve gotten in a care package?

Only got one. Protein was the only thing in it.

SSSS: What message do you want to share with everyone reading?

Don’t mess with Texas!

Tuesday, March 29, 2011

The Team... Medinareyes Edition!


Many of you have asked me about all the folks I work with here at the FST. I can honestly say that, without exception, we have a amazing group of men and women here! It is really impressive that so many people from such varied backgrounds can come together as a true team and make miracles happen. I wish I could introduce every one of you to every one of them, in person, but, given the fact that we are spread out all across the country and many of you don't even live near me, that would be an impossible feat. The next best thing is to introduce them all here. To that end, over the course of the next couple of months, I'm going to (try to) feature three team members a week on the blog including a photo or two and an interview with each one.

My first "victim" is the guy who, aside from being a super corpsman, makes all our administration run smoothly. Of all of us, he probably spends the most time of all actually in the FST answering telephones, typing memos, and keeping things flowing smoothly. HM2 Medinareyes is our admin corpsman extraordinaire, and the first team member to be interviewed for this new feature!

So here goes...

SSSS: What’s your full name?

Luis Enrique Medinareyes

SSSS: Code name?

Giggles

SSSS: Why that one?

Because I giggle. Actually it's "giggles" or the "mean queen". Both were given by Venegas and Simpson. Mean queen because I use lots of hair products.

SSSS: Where were you born?

Morelia, MX

SSSS: Married or single?

Single

SSSS: Any kids?

No

SSSS: How long have you been in the military?

6 years

SSSS: Any tattoos?

No

SSSS: What’s food do you miss most being here on the FOB?

Bar food. Chicken wings especially. These traditional buffalo wings I had at a bar on Bourbon St. in New Orleans are the best I've ever had!

SSSS: What’s your favorite food that they serve here?

I look forward to the herbed potatoes they serve at breakfast

SSSS: Any food that you absolutely won’t eat?

No

SSSS: What’s your favorite movie of all time?

Kill Bill Vol. 1

SSSS: Team Edward or Team Jacob?

Jacob because he’s Hispanic or Indian... or something...

SSSS: Star Wars or Star Trek?

Star Wars

SSSS: Mac or PC?

Mac but because of the military I have to use a PC.

SSSS: Tupac or Biggie?

Tupac

SSSS: Astrological sign?

Capricorn

SSSS: Briefs or boxers?

Boxer-briefs

SSSS: If you could teleport from here to anywhere in the world for 6 hours where would you go?

Okinawa

SSSS: Lowenbrau, Becks, St Pauli, or O’Douls?

Corona

SSSS: Are you a little bit country or a little bit rock-n-roll?

Little bit country

SSSS: Did you get that last reference?

No

SSSS: What’s your favorite thing you’ve gotten in a care package?

Cinco de Mayo decorations!

SSSS: Is that really your favorite thing or is it just the best one you can mention?

Really!

SSSS: What message do you want to share with everyone reading?

Keep praying for those of us that need it. Wish luck for those of us who don’t need it. I look forward to seeing you all six months from now.


So there you have it. HM2 Medinareyes (Giggles) in a nutshell! Hope you all enjoyed the introduction!

Until next time...

Saturday, March 26, 2011

All work and no play...





On the wall just next to the door in my room, a few of the former occupants have channelled Jack Torrance from The Shining and crystallized FOB life into a single sentence. A typical day here can be truly boring if you fail to create little distractions for yourself. In general, a typical day goes something like this:


Wake up, get dressed, eat breakfast, go to muster, go to the gym, eat lunch, take a nap, read a book or watch a movie, go to dinner, Skype with family, go to bed.

Interspersed through the day we try to place little diversions... just to mix it up! The unscheduled "diversion" of a trauma call definitely takes up some time. That said, patching up another Afghan national who rolled his vehicle or ran over an IED is less than pleasant. These poor people live in unimaginable conditions and deal with terribly unpleasant "neighbors", (spelled T-A-L-I-B-A-N), on a constant basis. Worse yet is the constant nagging thought that the 14 year old boy you're working on who "blew his hand up with unexploded ordinance" was actually being trained by the surly "uncle" accompanying him to build more IED's... But alas, ours is not to reason why...





More fun than trauma calls are the bits of tomfoolery we engage in throughout the day... Recently, a couple friends
sent me a teen mag full of awesome posters! Not wanting to
hog all that adolescent cuteness for my self, we decided to share with Dr. Ortiz.












The funny thing is, he liked the posters SO MUCH that, rather than leave them on his door, he decided to give them a place of honor at the head of his bed. Now they are the last thing he looks at before he goes to bed each night!




Monday, March 21, 2011

Mail Call!




Today we got mail. A LOT of mail! It seems that the guys in the mail office are somewhat selective about which days they sort mail (work) so no one got mail for the last three days. Several of us knew for a fact that mail was on the way if not overdue and there was some grumpiness beginning to blossom. Fortunately, the coin flip in the mail room came up heads, (or maybe it was tails), today so we got mail!
It was like Christmas opening all our packages and letters! Some of it was stuff we ordered...












Gardening equipment...













...Grow light for Wade's "special plants"


















Zero gravity chairs...














...equipment for "game night"















New hobby...



But the best packages are always the ones our families and friends send! My AMAZING wife sent me everything from Bacon Salt to goose liver pate'! Chocolate to avocados! Olive oil to coffee! With occasional deliveries like this, I might just survive 6 months of DFAC food...




Thanks to everyone who is thinking about us out here in the dirt!

Saturday, March 19, 2011

Week one down...




Yesterday marked the end of our first week of responsibilities here on FOB Lagman. Despite a painful start, the rest of the week wasn't too bad. Dr. Corwin did 2 appendectomies, we had a couple more relatively minor traumas, and I saw a few ortho patients, only one of whom needed surgery. The weather this week was still beautiful but cooled off a little and the wind has started picking up. The mountains to the east, that were covered in snow when we got here, have nearly shed their winter coats and, when the dust isn't up, are now just a long brown ridge line in the distance.


Day to day living includes time in the gym, three square meals, naps, and lots of reading, movies, and internet. I'm glad to be somewhat bored because it means people aren't getting hurt. That said, time seems to have slowed significantly the last few days and I really hope that doesn't persist. Today is Haley's first real horse show and missing it makes me sad. Sure I'll get some pictures and hear all about it on Skype, but it just isn't the same.


One of the good things about the FOB that I'm planning to implement once I get back home is the full service laundry...













I drop my dirty laundry off here...













The next day I bring my little slip by this window...










...and, Presto! My laundry is presented to me clean, folded, and socks even matched up! It's a great system and I look forward to the same system at home!

Wednesday, March 16, 2011

Settling in...





We've been here on the FOB (Forward Operating Base) for a little over a week now. The outgoing group have all departed and we have begun to settle into our own routine.


Each day we gather at 8:30 for accountability and then tend to our supply and equipment checks. Training for the morning consists of basic skills and then usually a trauma drill as we continue to sharpen the team for real patients. We break at lunchtime and then spend the remainder of the day doing more training and waiting for patients to roll in.
As the sole orthopaedic surgeon, I hold clinic for coalition forces as well as Afghan National Army and Afghan National Police patients two days a week. The diagnoses I see in clinic are really no different from those we see in general ortho clinic back home. The only real difference is that if someone needs surgery they always have to get sent out. For US service members whose injury prevents them from being combat ready that means an end to their deployment and a trip to one of our MTF's outside of the theater of operations.


Our accommodations here are not fancy but, for the next six months anyway, they are home. Four of us (three surgeons and our anesthesiologist) live in an old jail cell block left over from the Soviet occupation years ago. We share a common area which has been equipped with a small table we use for friendly poker games, a television connected to armed forces network, and a couple of cheap fake Persian rugs which you have to pay a dollar to walk on in shoes. Everything is dusty and no matter how hard you clean it doesn't take long for things to be dirty again.



The individual "cells" that the four of us live in are about 8'x12' and have plywood furniture and standard issue wall closets in various states of disrepair. Cheap "tapestry" type material bought from a local vendor covers many surfaces to make things more cozy. The good news is that we all have Internet in our individual rooms. We have to pay top dollar for it or else use the SPAWAR computers in MWR which are crowded and have a time limit so the expense is certainly worth it!







The ability to chat with the folks back home is priceless and, honestly, most people here would sleep in the mud for a year as long as they had a solid Internet connection. Internet access is truly a major morale booster! Thank you Edge City!




Despite being in the middle of nowhere in a third world country, there is certainly beauty to be seen. Each evening, as the sun begins to set, I like to walk up to the "Front Porch" with my camp chair and just sit. The sunsets are beautiful (thanks to all the dust in the air) and the camaraderie enjoyed while sitting "above it all" drinking near beer and smoking cigars is one of the little pleasures we have out here on the FOB.






This deployment is like a marathon and those quiet moments of beauty are like water stations along the way.




Saturday, March 12, 2011

Trial By Fire

Yesterday afternoon, in a brief informal ceremony, we took over responsibilities as the Forward Surgical Team for FOB Lagman. Afterward, we moved into the quarters we'll be living in for the next 6 months. It was nice to unpack knowing it will be the last move for a while. We had a quiet evening with plans for a single team trauma drill this morning and a Sunday without any responsibilities.

This morning we awoke, ate breakfast, and met at the FST to perform morning equipment checks and have our trauma training for the day. It's a beautiful day with not a cloud in the sky and the temps around the mid-seventies. We made it through a small portion of the scenario when we were informed that we had incoming patients from an IED blast. We quickly ended our training and began to prepare for our first patients to arrive.

The initial report we received was that an IED blast had killed two Afghan nationals and wounded several more. We would be getting four patients with varying injuries. After the story changed several times ranging from us actually being bypassed and getting no casualties to us getting four, the MEDEVAC helicopter landed and the truth began to spill out. In total, we received, and cared for, seven patients. Our first trauma call was officially a mass casualty.

The first patient through the door was a badly injured young teenage boy. His elder brother was accompanying him and waited outside while we worked to save him. We gave him what would be considered the "full court press" in the States but, in the end, his injuries were more severe than we could correct. He died from massive hemorrhage and, most likely, a severe closed head injury. We cleaned his body and he, along with his brother, were provided transportation back to their village. Welcome to war.

In addition to the teenage boy we cared for a 2 month old infant, two women, and three men. All were Afghan nationals. By the time we loaded the last patient on a helicopter, cleaned the FST, and debriefed it was 3:30 PM.

Today's events brought the reason that we are here into sharp focus. Before today, all the training, talk, and supposition about what FOB Lagman would be like was an abstract idea individualized to each of us. Now, just over 24 hours into the real job, it's become a harsh, ugly, shared reality.

Wednesday, March 9, 2011

Touchdown on Lagman... finally!

It’s been quite some time since my last post and much has happened. The main reason I haven’t updated has been that getting online has gotten more and more difficult as we have moved into the theatre of operations coupled with concerns for operational security. So to those of you anxiously awaiting the next installment in the Adventures of the Surfing Surgeon, I apologize.

With that disclaimer out of the way, let me try to update you with the condensed version.

Time home was awesome! Putting all the training behind us, and leaving straight from home with only a short stop back at Dix prior to heading over was a real morale booster.

The trip from San Diego to Dix was challenging and involved planes, trains ,and automobiles, as well as multiple unexpected stops and a not so fortuitous extra long layover that fortuitously allowed Rocha and me dinner in the piano bar at Harris’ Steakhouse on Nob Hill listening to live Jazz and enjoying foie gras, bone in ribeye, and Fladgate 20 year tawny before heading back to SFO for our flight.

We arrived at Dix just in time to head out to Bordentown, NJ with the rest of the guys for lunch. We stumbled across an amazing Italian place called Marcello’s. Our server made great suggestions and we had a very nice “Last Supper” of sorts. The tomato pie was amazing as was the papardelle with short rib. I finished my meal with crème brulee’ and a snifter of Grand Marnier. It was delightful! To make the experience even better, when our lovely server presented us with the check she informed us that her parents, visiting her from out of town and seated across the restaurant, had overheard that we were headed for Afghanistan and had paid a substantial portion of the bill. People like that are becoming fewer and further between. But it sure is nice to feel appreciated.

After our requisite 48 hours confined to Fort Dix prior to leaving the country, we boarded buses and headed for Baltimore. We enjoyed a last minute frosty brew pop in the airport and then hopped on the aircraft. Following a long layover in German, made longer by some aircraft mechanical problems, we finally arrived at Kuwait international airport just after midnight.

Following a tiring transport and check-in process at Ali Al Salem Airbase we finally arrived at Camp Virginia for our final training prior to entering Afghanistan. The folks at Virginia rolled us over in simulated MRAPs, collected our travel claims, and, two days later, put us back on buses bound for Ali Al Salem and our second to last flight before reaching our goal.

Now, Ali Al Salem is kind of the crossroads or the war. Almost everyone going into or out of Afghanistan or Iraq passes through there. I am convinced it is an undescribed circle of Hell. It is, of course, dusty as can be, and filled with bad attitudes, vicious rumors, and no reliable place to hang your hat when you get stuck there for days (as we did) because the Air Force can’t rummage up a plane. The internet sucks, the phone centers are packed and no one seems to care that you’re stuck and miserable.

BUT!!!

IF you are a member of the greatest military service the USA has ever produced. (That’s the Navy in case your deluding yourself otherwise) and happen to chat up the right Seabee, you may just be able to get a free pass into what we came to know as Shangri La! So here’s the story…

Christian and I were walking around Ali the morning they dropped us off taking note of the sour attitudes and glad that we were scheduled for a flight that evening when we noticed a sharp looking sailor in desert camo approaching. He looked completely out of place because he seemed to be smiling. He fired off a crisp salute and Christian commented to him that it was nice to see a squared away sailor amongst all the Army. A quick conversation took place and once he discovered we were currently housed in miserable transient tents he told us to cross the road to the Seabee compound and ask on the quarterdeck if they had any lodging available. “They’ll definitely hook you up!”, he told us. “We take care of our fellow sailors!” Well, we thanked him for the offer but since we “knew” we were going to be on the midnight flight it wouldn’t be necessary.

Just before midnight it became necessary. Surprise, surprise, we got bumped from the flight and sent back to the transient tents which were already occupied by other poor souls traversing Ali Hell. Ken Ortiz and I threw our rucks on our backs and marched over to the Seabee camp. On the quarterdeck, Chief Brancatelli welcomed us and woke the duty CS who quickly located an empty 16 man SWA hut for us replete with lights, climate control, fitted sheets, pillows and blankets, and very little dust! The Seabees were all friendly and welcoming. They even invited us for cake at the Seabee birthday party that just happened to be that day. Many of you know that my buddy Kent was a Seabee so I’ve always kinda liked those guys, but after this experience they move to the top of the list! Their can do attitude and the way they welcomed us was a breath of fresh air! So to all you Seabees out there; A hearty thank you from a bunch of (formerly) tired and grumpy docs!

Our second night at Ali we actually made it onto a C-17 bound for Kandahar. Three and a half hours later we got off the plane and were met by a Role III Chief who got us check into our temporary tent and told us we’d we leaving the next day. We ate, hit the exchange for last minute items, and went to the hospital for a few briefs. This was Sunday. After the briefs we were informed that we wouldn’t actually have transport to our FOB until THURSDAY! AAAARRRRGGGHHHHH! Why so upset? Because as bad as Ali was, I think KAF is worse. KAF looks like something out of a post-apocalyptic nightmare. It stinks, there is dust or mud everywhere, they get frequent rocket attacks, and there are MRAPs driven by a bunch of maniacs constantly about to run you over everywhere you walk. Oh, and the food is terrible. Oh, and the Army has PT right outside the transient tent we were in at 0530. The only good thing I found was the British coffee shop and MWR. If you get stuck at KAF, I highly recommend you seek that place out.

So as bad as it was going to be, the next morning as we returned to the tent from breakfast and a walkabout, the plan changed. As we approached “home”, Captain Raheb told us we had about ten minutes to pack our stuff as they had found us a ride to Qalat! We threw all our stuff together, drove to the flight line, and by lunchtime were stepping off the helicopters into the clean cool air of our home for the next six and a half months.

Hallelujah! We’re finally here!

More to come!