Duke Duke Duke, Duke of KAF KAF KAF...

TO:        Elizabeth, Queen II

From:     Caplin, Mark PA-C

Subj:        Knighthood


Your Majesty,

As you seem to be in a very good mood after your Grandson, William was married yesterday and you are throwing out titles like smarties candies, I was wondering if you have any spare titles rattling around at Buckingham palace that you are not using. As a former loyal subject (ok, I was 4 not sure how loyal I was) I feel that I have been a good representative of the Empire {insert snooty accent here} in "the colonies" low these many years. Perhaps a marquesses, earl, or viscount. (or is that French? Par-don) I mean I could buy a Lordship and be in the Lords but that is so last century. And tacky. Maybe a Knight of Kate's garter? Ok, that was really tacky. I'm not asking for much, ma'am. We have a Cambridge Dfac here, does that count? I'm just saying. Perhaps Prince Philip could spare one of those metals that you gave him. He had a bunch. He could of spared a couple to loan to his Grandson. It's not like he earned them or anything. That one paltry medal that he was wearing looked quite lonely. By the way, you were rocking that yellow hat. You go, girlfriend. Anyway, back to me. I think Sir Mark has a nice ring. Or Mark the Earl of nottnghamshire-on-toast or something. I ain't asking for much. Throw a brotha a bone here.

I remain  your most humble servant (ask anyone),


M Caplin PA-C

This is your Captain speaking, ok, not really...

The Army has a service that I found out about at the last Role 1 meeting. It is a specialist consulatation service via email for deployed personnel both military and civilian. I sent my patient's chest xray out on it and got a pulmonary consult and a read from a radiologist. How cool is that? The cooler thing was that both emails started with "Dear Captain Caplin....." Hear that honey? The Army says I'm a Captain. I'd rather be a Navy Captain, but hey, I'll take it. I sent a dental consult out with a great bad tooth pic. (tooth pic, get it?) [sound of E groaning] And that came back, "Dear Dr. Caplin." Forget college and military acadamies,  just send out emails! I hear that they need a new director of the CIA...



MALARIA UNDER THE MICROSCOPE



any thoughts on this? This is a real pt





Definiton of a real friend, a friend that will help you move...and without beer!

Hello from F203, my new digs. Didn't want to move from my beloved two-two-niner but being a team player and all I thought,"How bad could it be?" Let's set the stage, shall we. This room has been a transient room for 18 months. No one has been permantly assigned to it. So nobody cared about it. Everyone that stayed here accidently left some piece of clothing or other belonging here. With a desk, chair, bed and armour, the room gets crowded. Here's a solution-break the chair in half, move the desk to the end of the bed, wedge half the chair under the desk and wedge the desk between the bed and wall. Then break the thing that keeps the door closed. Perfect. Really? I walked in after sick call to this mess. And, this was AFTER two people had cleaned it and took all the crap out of it. "Oh no I'm not" said I. Off to the billeting office I went. They want a room, they can have this one. I'll stay put and all will be right with the universe. Ok, the obvious "you're in Afghanistan" comment goes here. But a boy can dream can't he? No the billeting nazi (nazette?) says the big boss wants it this way. And this way it shall be. She will send a crew to fix stuff. Fine, I will make this the best room in KAF. Let the furniture wrestling commence. Editors note-it is now 102 outside. After sweeping and mopping the exposed areas I proceeded to make it just like 229, just the mirror image. How the hell they got the desk wedged in there I'll never know, but hell hath no furry like a PA scorned, room wise. After much grunting, groaning and bad words that I didn't even know that I knew, I got stuff moved to the other side of the room. More sweeping and swabbing, then set up the way I want. The a/c hasn't been working. I found out why, the filters were burried under the desk. Then Laura another Medic, came and helped me move stuff from room to room. They are right across from each other, we were wishing that we had a rope pulley system so we didn't have to go up and down two sets of stairs. But three hours later hot, sweaty and exhausted I had been officially relocated. Got the filters in the a/c so it works. It's noisy as hell and this room has had so much air freshner sprayed in it over the years I may die of Gladeitis."He's dead but  he smells like a forest glenn"
With a touch of Poo Pond.




A boy, a bad haircut and new room





The view from across the way.Pining for the fjords

Hello my name's Noah and I'll be your PA...

When I was growing up I had a best of Bill Cosby album and one of the tracks was called,"Noah and the arc." Google or youtube it. I'll wait......
Anyway, I was called to clinic this morning at 0545 for a patient having chest pain. Women have what's called an atypical presentation. Which is medical speak for "it ain't like men." So the medic and I were both concerned that she may be having a heart attack so we loaded her in our ambulance and took her to the role 3. Things look good so far but she has to go home for more tests.  After lunch time I was called again for another woman having chest pain. We were going to load her in the ambulance, but it wouldn't start.  The environment is tough on vehicles and our ambulance doesn't get drivien a lot. No problem we just loaded her with her IV into the SUV and cardiac moniter and drove her to the role 3. Adapt and overcome. That's our creed. "Semper Gumby." Always flexible.
I am waiting for a malaria patient to come down from a FOB. Along with another malaria patient from another FOB. We also saw a patient with an inguinal hernia that needs surgery. But don't confuse him with the inguinal hernia patient that needs surgery. Starting to see a pattern here? "Lord, what's a cubit?"
There are big changes on the horizon for the KAF clinic. We are expanding and adding staff and adding capabilities. We are getting a doctor and will be doing reenlistment type physicals. All this will start happening while I am on R and R and finish while Dennis is on R and R. No idea where we are going to put these people. Information comes out in trickles. I was told today that we are giving up 4 rooms at Camp Hicks, location of my beloved two two niner. I am being moved across the way to F203. Almost moved me to a tent but Steve stepped up and saved us. There's no cool way to say F203. It is the room that I look at when I look out of my front door. It is the mirror image of my room. I will probably run into the wall and get lost going to the shower for awhile, but it's all good. Attention Tailban: No rocket attacks until I get my bearings. I can just hear it now,"Rocket...attack...Rocket...atta...bang. ouch, son of a bitch....."[scene of Mark hobbling to the bunker, mumbling to himself...]

I think your bitmap just ate my jpeg...

As we know, technology hates me. Teach a class, projector won't work. Computer crashes. Email won't work. Bill Gates spits at me. Just on and on. Caplin's rule #135: Technology will fail you when you need it the most. Case in point-We have xray. We don't have a Radiologist to read them; we are supposed to read them.  A radiology link will be set up later over the internet. However our IT department says that we will wipe out most of Southern Afghanistan's internet with our first chest xray. This, I believe, is a problem. More prisoners will tunnel out of jail. As the guards are cursing in Pashtu at Facebook. Really? A tunnel? No wonder they were out of "Great Escape" DVD's at the Bazaar. Gitmo ain't looking so bad now, is it? "Why is this tunnel so wet? I hear the ocean. Dig, we get to Florida, drive taxi." Anyway back to technology. I burned a cd of the chest xray that I really needed to be read and took it to the Role 3 radiologist to read. I went back and because of political reasons he couldn't do an official read but he would do an unofficial "wet read." So he pops in the DVD and ...nothing. "Read error; you must download a viewer." What's the word I'm looking for? Oh yea, shit. Moment lost. I go back to Larry, our xray dude and he pops it back in the computer and gets the same error messege. I must of pissed off a microchip in a previous life. Now what? I got this guy who may have TB and I have no way to prove or disprove it. Maybe those escaped prisoners need a PA. But wait I just went to a lecture on resources for deployed medical personnel. Wait, I'm a deployed medical personnel. I read the follow up email and there is a way to get a read on xrays if your a ship at sea. Hmmm, Ok I'm in the desert. Deserts have camels. Camels are ships of the dessert. Perfect. The nice man in Dallas sends me the info on converting xrays to jpegs. I am not the guy to do this. Larry, you're on. Of course, because I'm standing in the room we fail miserably. He sends me to the google to find a solution. Really, me? Ok to the internets and beyond...Microsoft paint can convert it by holding down the print page button while convertng the file to a jpeg and attaching to a html based webserver. Ok I have no idea what I just said but what the heck. We try it and we don't have paint. But we click on the file and somehow by hocus pocus, Mark try and focus, it converts to a paint file. Holy smokes! Now we have to email it. Of course that don't work from the xray computer. But, wait I have a large thumb drive in my desk. We can save it to that then transfer it to my computer and email from there. Genus I tells you. And it worked. Another crisis solved, or partially solved. Just part of my day. Who knew that I was computer savvy? Definately not my computer. So it has been emailed from the USS Landlocked. Will wait and see.

The xray in question

Happy Easter, two tacos please..

Some of you will be enjoying an Easter dinner of ham and scalloped potatoes. Maybe apple pie with ice cream. Some of you not. If you're Jewish, maybe not so much. But as it is Sunday here I decided to find me an Easter dinner. I figured that the American Dfac should be doing it up right. So, I piled Kharki and our new South African Medic, "Z" into the SUV and headed accross the base to Independence Dfac. Doesn't get any more american than that. And they were having, wait for it, tacos. Tacos!!?? On Easter. Seriously??!! So much for showing my new international friends a little anglo saxon (read WAP) Easter lunch. The peach cobbler was good though.
One thing that I cannot shake from my former paramedic life is paramedic superstition. I am not a superstitiuous person. But if you talk about it, it will happen. E says that I am crazy and that it is a silly "tradition." But, ladies and gentlemen, all the way from Kandahar, Afghanistan is proof of said superstiton AKA "Just another day at KAF."  Dennis is writing a malaria policy. I have been proofreading it. Yes, the blind proofreading the blind. Anyway, he gets it finished, sends it in for approval and sends it out. I read it a realize that it still has typos; so as I am reading the policy and making notes my Skype beeps. It's a fob Medic. He has a guy with recurrent fever. Run a malaria test, I say. He does and it comes up positive. Wait there's another Medic from another fob on my skype. He has a guy with a fever of a103 that comes and goes. Can he do a malaria test, he asks? Sure why not. Place your bets. And Yachtzee, a positive test. Two tacos, two malaria cases. Do they have the drugs recommended in our new policy? Of course not, we haven't sent them out yet. Send them to KAF. OK, in three days, when the next helicopter leaves. Cool. Ok treat their fevers and keep me advised. In the middle of all of this, one of the KAF medics comes to get me for a guy with a cough and weight loss for a month. I listen to his lungs and decide to fire up our  Xray machine. I look at the film and it looks very suspicous for TB. Shit. I take the films down to the Role 3 but the Radiologist is off having his Easter dinner. He'll read the films in the morning. After tacos. Not much I can do until morning. At least it ain't malaria. Give him a breathing treatment, start him on antibiotics in case it's pneumonia, and send him on his way. Ok, enough crisis for one day. I want my Easter dinner still so I go to the closer Dfac and have chicken and mashed potatoes with apple pie. Not bad. But then I look at the menu from lunch and they had Turkey, mashed potatoes, stuffing and green beans. My favorite dinner. Seriously??!! Oy vey...

TGIFriday, Ok so it was Saturday..

To celebrate my 2 month anniversary here  I treated myself to TGIF Fridays. Yep, that's our expensive "treat" restaurant. Had a chicken fajita with guacamole. Yum. They have fake margaritas and mojitos. I had a strawberry lemonade and watched "Batman Returns" on the big screen TV. All in all a nice lunch. I started my day by being sent on a house call for a patient that I had seen in clinic. Kharki called and sent me to room E2XX I went to room E2xx, and the poor guy  was totally surprised to see me. I called him back and finally got him to tell me it was B 2XX. Got to teach that man the phonetic alphabet. He said B but with a Nepalese accent it sounded like "E." So I called the EMS ambulance instead of ours, because of political reasons and the time. It is all very complicated. The weird thing was that the dispatcher didn't know my location. We live at Camp Hicks but that is not the official name. I don't know the official name. We call it Camp Hicks. The sign says, "Camp Hicks" so I kinda thought that they should know that. But I had to direct them from the Poo pond. There is a system that directs emergency responders but the map is in my office. And I was in my room. Our ambulance crew would of known exactly where to go. Oh well just another day at KAF.
I followed up on my patient and it turns out that he only has one kidney. He didn't know that and he drinks 15 bottles of water a day. He told me that but no one drinks 15 bottles of water a day. Everyone "overestimates" their water intake, so I didn't believe him. Well, he gave himself hyponatremia, aka water poisoning. And he didn't know that he had only one kidney. All righty then. No more water for him.
I have watched two movies on my computer since I've been here. 127 Hours and Casino Jack. Recommend both of them.

Kharki, in my office,  helps me look up hyponatremia

I have an office phone number. Our internet goes to Germany. Google is in the UAE and our Internet based phone goes through Dallas. So either my search terms come up in German or Arabic. Phone number is 817-567-4420. 1900 to 0700 California time. Just in case. If our internet goes down we are incommunicado Or no communicado. Plus no powerinado. It's a pain the buttinanado...

Two months down. 17 days 'till home

We live simply here. You appreciate the little things, like the fact that I was able to hook my ipod up to the computer speakers in my room and can enjoy some music without accidently ripping the earbuds out of my ears by turning my head the wrong way. Or a nice cup of tea. Sitting here sipping tea and reading my book. Ahhhhh.
The bad thing, besides the whole rocket attack thing, is the fact that I am totally reliant on the internet. Our printer is via the net, our phones are internet based and I answer 15 emails a day. All of the notes that the Medics write from the FOBs are sent to me to review. I sign them electronically and send them back. Computers hate me and I them. We tolerate each other. Barely. If there is anyone that technology is planning to bite in the butt, it's me. But here I am looking at excel and OWAs and VOIP phones... Oh, the humanity. Especially when it goes down. And it does. Then things come to an abrupt halt. Then the power goes out. And, well we just go with it. Open the doors. Then close the doors because of the flys. We have many fly swatters in our clinic and  I am becoming a triple Ace. Many kills to my credit. The bloody Red Baron of Kan da har...
It was a beautiful night to walk home. The sun was setting behind our surveillance balloon. Big blimp outside the gate with sneaky cameras and stuff. Not a secret, everybody can see it. It's not like, "There's cameras in there? I thought it was a sale at crazy Ali- Mohammad's  used car sales." Had the ipod in and just cruised home.  Have to look for scorpions and listen for the rocket attack lady, but it was quite enjoyable anyway. You have to plan your route in case you have to hit the dirt in case of in-coming. When I walk past the Pooh pond I think about where to hit the dirt. Hmmmm. Pooh pond dirt or rocket? Hmmmm.
There are new signs there  My new favorite is, "Brown trout, limit 6."

I knew I shouldn't have slept through PA school...

Sir, PA Caplin reporting that all TB patients are gone, sir. Ok crisis over, what looms on the horizon, Leftenant? Maybe the guy that got thrown off of the top story of a housing unit after drinking illegal alcohol and being caught by the husband of the woman he was doing the nasty with that  got I a desperate call about this morning. Or not. Just my daily trip to the Role 3. Still waiting for that typical day to tell you all about.
My morning routine is to walk down to Green Beans, our Starbucks equivilant, and get a strawberrybananamango smoothie and a hot milk granola. Ok,  it's not a smoothie, it's ice and chemicals. But a boy can dream. I am addicted to Jamba Juice, after all. Yesterday I knocked it off of my desk, into my computer case and all over my sweatshirt. Smooth move, Exlax. So it was an excuse to mop the floor of my office. With my sweatshirt. Ok, not all of it. Just the puddle under my desk. Yuck. Now my office smells like Pinesol. Pine trees, mangos and bananas. Oh my.
Mailed off my Mother's day card. Never know how long it will take. Or should I say that I tried to mail the card. We have a new outgoing mailbox. But the opening is too small to accept letters. I tried folding it over. Didn't fit and I can't send Joan a wrinkled card. So I went to the real post office. Tried to open the big blue gate thingy in front. It had been welded shut. Hmmmmm why doesn't God and Uncle Sam want me to mail this card? Then I noticed a jagged opening in the front. Large enough for my card. Uh Huh! Of course, the  opening is the perfect size for a bomb.  Man, if they blow up my card my mum will be pissed! The Taliban is no match for an elderly angry english woman. Who they won't be able to understand...
My job is to teach the new medics stuff, including procedures. So we had a plantars wart that I got to carve on and zap with liquid nitrogen. And someone came in with a laceration on his arm so we had suturing class. Tony got to throw a couple of stitches. Here's his handy work:

don't go all HIPAA on me, I have his permission

Not bad for  a rookie. That's a bruise next to his cut where he fell. I thought we should of made the word "Mom," Tony talked me out of it...

A cup of tea, a CAC card and thou

The email that we all wait for around here is the one that is delivered to your personal email that says "your CAC card is waiting to be picked up." Your CAC card, Common Access Card, is a military ID for civilians. Lets you fly on military aircraft and makes life generally easier. And mine is waiting for me. Hot damn. Of course it needs a picture and mine will have the dork look on it. No, you can't see it. Just a reminder of my stay here. I could show you but I'd have to kill you...
So I strolled into work yesterday and the place was crawling with cops. I tried to scram, see  but the screws found me, see. It was the IMPs, internatioanl military police. They had cordoned off the area and were searching the tents behind the clinic and we were caught up in their net. People were none too happy I couldn't help thinking that if we were back in the US people would be bitchin and moaning and calling their Congressmen. Here we just go, "OK, can I go pee?" People stood outside for 7 hours while they searched. My theory is that we have had 35 people killed in theater in this year from folks coming on bases in uniforms or acting like workers and either blowing themselves up or shooting people. There were no dogs so I don't think that they were looking for drugs. So I think that they were looking for uniforms and other paraphanalia. Now, me being me, asked the officer in charge what we were going to do about sick call. After a conference they decided we could see our patients if they were really sick. If not, send them away and have them come back in the afternoon. And we had to stay in the clinic. And, of course, it is me you know, I had to make the Canadian Sergeant Major a cup of tea. With milk. None of this American with a lemon nonsense. Wow, my English heritage has finally paid off. Me mum will be so proud....

A key, aqui

I sucked it up and confessed my key loss. Actually no big deal, just wrote out a statement of being not so bright, which they totally believed, and they changed my lock and issued a new key. The keys come on a key tab for hanging on a little hook in a key cabinet so they are kind of easy to lose.  I have put mine on a bigger key chain so as not to repeat my error. We'll see how THAT goes.

Now I can lose my key, a whistle and a flashlight. I keep blowing the whistle but so far no cabs have come...
David left for his new assignment yesterday. Off to the C-130 terminal. We'll see, he may show up at the morning meeting. Although it is pretty hard to be bumped from a Hercules. Ya never know.
The big boss was supposed to come in from Indiana via Dubai on Saturday, but he got bumped. All that cleaning for nothing. It was actually good, nothing makes you clean like having company coming over. We could invite my parents over then I'd really be in a cleaning frenzy. Good thing they used to visit me in college every now and then or my apartment would of never gotten cleaned.
Today is Divisor Dance day back in the real world. E has gone and then off to Chevy's afterward. What I wouldn't give for chips and salsa. And a pena colada with dark rum. Wait, I don't drink. Never mind. Ok, once a year. Usually on a sailboat or in Hawaii, I treat myself. And a sailboat in Hawaii? Fo-get-about-it. It's funny, everyone going on R and R here talks about how drunk they're going to  be on the flight home. I have to remind them that, after all this time, one beer in the airport and they'll be fast asleep. Sort of born again light weights.
I sent my Casio watch off to be repaired and they sent it back to me here. That was cool of them but what am I going to do with two watches? Guess I could set one to San Francisco time. But I'm confused enough. Plus I already look like a dork with my "groovy" haircut, so two watches may push me over the edge dork wise. The dorkinator. The dorkmeister. Dork'o rama. Oh man now I'm having High School flashbacks...

Thoughts, random, one each. Open with caution..

Look, no more "testicle talk"...

I lost my room key. I've looked everywhere. Now, do I admit it and risk the humiliation or do I leave my room unlocked and risk getting my stuff stolen or do I do what everybody else does and lock it and open the door with a knife?

Today David, the new PA and my running buddy, leaves for training at his new assignment at another base. I'll miss him. I guess there's always Skype...

I'm so glad that I brought my iPod here. Nice to listen to going to and from work. Makes the "morning commute" so much nicer. I was listening to Reel of Seven and was doing a strathspey past the Poo pond. The Poo Pond Strathspey, good dance? No, it stinks. Hard to do in boots.

Attention Muslims: Quit killing people over the dumb ass in Florida. Enough already. Yes he burned the Koran, but our constitution allows people to do stupid shit. Over react much? Your religion doesn't allow you to kill innocent people who had nothing to do with it.  Knock it the hell off. Makes you look bad.

Attention American forces: Quit killing Innocent Muslims and Afghans that are minding there own bussiness, just having a picnic. If you're eating and praying by the side of the road is no reason to send predators and A-10s to kill families and children to "neutralize the threat." What threat? "Blue leader looks like chapli kebab but could be an IED, going to guns." Makes you and us, look bad. Knock it the hell off.

I changed the F word to hell. Made me look bad.

I shoulda taken the reds, man...

If you are old and a child of the 70’s, like me, you grew up with Cheech and Chong. Smokin’ dope and listening to “Big Bamboo”. On the big black CD that required a needle to play. Phonograph needle, that is. They had a bit called, “let’s make a drug deal,” a parody of the TV show “Let’s make a deal.”  Anyone who has been in the military knows that there is an official way of doing things and then there’s the unofficial way of getting stuff done. Here we call those Drug Deals. One problem here is that some drug deals have been done that should have been done the official way and I have spent a considerable amount of time and energy undoing those deals and crossing my T’s and dotting the I’s so that there is a paper trail and making amends to officials who were none too happy after they found out about the transaction in question. However, that doesn’t mean that the deal de drug is still not happening. Yesterday was just such a day. I have talked about all the rules that we have to follow. One rule is that you have to wear a reflective belt after sundown. Makes sense, we don’t have a lot of street lights here. Kind of an easy way to adjust your aim, if you know what I mean. Also, you have to wash your hands before going to the Dfac to eat. Not ridiculous rules by any means. But they set up a sting and they checked everybody’s IDs and made sure that you had a belt on. If not you got busted. Karki, the Chief Medic, headed out without his belt to dinner and got busted by The Man. Calls of “Karki got arrested” rang out throughout the clinic. Panic ensued until he walked in, none too happy. Also someone was driving our black pickup truck and backed into someone who was also backing up. Two objects cannot occupy the same place in space, I think that is like Fig Newton physics or something, and smash. So we had a “safety stand down.” Which means we had a lecture on backing and belt wearing. Or I think we did. I signed a paper saying I went to a lecture on it. Musta been the world’s shortest lecture because afterwards someone mentioned that they forgot to do the lecture part. Oh well. I will definitely back up wearing my reflective belt from now on.

Yesterday was the Role one meeting. It was at a different spot, the Canadian House and we had Tim Horton donuts, yum. Amazing the information that you learn after the meeting ends. Two quick conversations later, I was off doing deals and solved two patients’ problems that have been going on for awhile. One, a patient that we have been trying to get out of country and the other that walked in in the morning that had baffled us. Problem 1 solved with a color copier. Problem 2 solved with a consult by a Doc who just happened to be hanging around and was the specialty that I was looking for. A free donut and two medevacs. Now that’s a drug deal…

He who lives by the LOA dies by the LOA..

First, thanks to all of you who sent snail-mail. Also thanks all for the cookies and tea. The staff loves the cookies. They all drink coffee so the tea is all mine. I am set for life for tea. Really. Thanks. No kidding...no more tea...please...man, I have to pee..
Living on a military base, nae a NATO base requires the following of certain rules. Driving at 20kph is one example. Another is the fact that you don't leave "the house" without a least 4 forms of identification. Seriously. If you look at our pictures we all have these things hanging around our neck or hanging on our arms. I gave up the armband for the neck version. Just don't have the guns for it. They contain our KAF cards. ID for KAF. Our Dynacorp company ID. My new meal card so I can eat, possibly a CAC card. That card means you have passed a background check and can go to "special places." You also have your passport and shot record and, most importantly, copies of your LOA. Letter of Authorization. This tells you what you are entitled to. From food to transportation to medical care. Every time you want to do something someone wants to see your LOA. Mucho importante. If I have to take you to Role 3 hospital for medical treatment they check your LOA to make sure that you are eligible for care. Which leads me to my crisis of the night. Last night, just I was leaving a man came in with severe testicle pain. Gizmo ran up and said, Sir, there is a man out there just like me." Of course there is. Sure enough this poor man had bad pain in his testicle traveling up to his groin area. In this case your first concern is testicular torsion {I'll wait while you look that up on wikipedia} The way to rule this out is with an ultrasound. Where is the ultrasound? Yup, you guessed it, the role 3. I asked the gentleman for his LOA; turns out that he has applied but has not yet received his LOA. What's the word I'm looking for? Oh yeah, Shit. I gather his paperwork and drive down there to plead may case. No LOA, no treatment unless he's been shot. Bad ball not included. I wonder over to the urgent care part and find a Doc. I explain my situation to him and he agrees with my treatment so far. He says the testicle feels hot so it's getting blood and probably not a torsion. His last piece of advice,"ice his nuts." Ice his nuts, aye, sir. It is a Navy hospital, after all. I return to the clinic, start him on antibiotics, give him pain pills and
break out the ice packs. He leaves with stern orders to return in the morning and to call me if things get worse. If it becomes an emergency then I'll figure some way of getting an ultrasound.
He returns later the next morning feeling much better. The magic of the tablets. And ice pack. I am able to do a better exam and diagnose epididymitis. Treatable with antibiotics. Ladies, you may have more complex plumbing, but sometimes it sucks to be a boy...

My ID card holder. The LOA is tucked into one of the pockets
There is a new challenge coin in the middle. One of the FOB medics gave that to me.

Shave-and-a-haircut... 5 bits.....or, in this case, $7.

I hate getting my haircut. I think it stems from my Dad taking me to the barber college when I was a kid. Cheaper, you know. Plus I have semi-curly hair, so it's hard to cut. I've had one cut here that wasn't bad, but 6 weeks have passed and off I went for haircut #2. I went looking for the guy who did it before, but to my horror, he wasn't there! And as luck would have it, I was next. "Wash and hair cut," I said, having learned my lesson from last time. "This much off?" the woman asked, holding up about 1/2 inch of semi-curly locks. Yes, please. She then proceeded to engage in a conversation with the woman next to her. Must of been quite the hot topic 'cause she kinda forgot about that 1/2 inch that I wanted taken off. There was an occasional "nice hair" comment to me as she cut and cut and cut. So now it's former nice hair, as most of it is now on the floor of the salon. And I use that term loosely. Not only is it too short, the hair cut sucks. I haven't had a bad haircut in a awhile, and, surprisingly, I really don't care. Everyone has a short haircut here. None quite as bad as mine, though. The reason that I got the cut in the first place was, like an English sheepdog, my hair kept falling in my eyes. And, of course, she kept that part long. Jeez oh man. But fear not, I will be home in 30 days and will make a bee-line to Al, my hair guy, who will fix this mess that has cropped up upon my head. Hey what do you want do you want for 7 bucks? It's bad, but at least it's cheap. Moo reese will be so proud....

Hello, my name's Mark and I'll be sending you out of the country...

One day I'll tell you all about my typical day. Just as soon as I have one. First the crisis du jour update. One gone, two to go. One should be easy, the other... who the hell knows. Not my problem, it has been kicked "upstairs."
I sent one of our medics out of theater to get fixed. His problem is fixed and he's coming back. In the mean time out clerk, who we call Gizmo, has a problem. He could not tell me or David so he told one of the Medics who told me. He has a problem with his little boy parts. His little Gizmo is broken. I know, I know, don't get him wet. So I examined him and couldn't figure out what was wrong with him so I had David examine  him. He couldn't figure it out either. He was in big time pain. We have broken Gizmo, shit. So off I go to the Role 3 to plead my case. Luckily there was a nice female Australian doctor on duty who agreed to see Giz. She wanted him premedicated, so I drugged him up and drove him down to Urgent care. She examined him. It was cute, he is Indian and couldn't stop shaking.  She kept saying,"you're alright mate." I kept expecting her to order him a Fosters. I had to leave him while he got t tests. Tests on his testes. Turns out he has a hernia and will be sent home for surgery. Meanwhile I have given him more narcotics, so I am his best friend. Poor guy, he can hardly walk and his right leg kind of swings out funny when he does. Last night we had two rocket attacks and I could just imagine poor Giz hobbling down the stairs only to hear the "all clear," then hobbling back up, getting into bed then the second alarm sounds and off he goes again. Or maybe he took two tablets and slept through the whole thing. No one was hurt because of really bad aim. Let's just say that they miscalculated.
We had to do our monthly narcotic count today. I dropped 9 vials on the floor  and David dropped one. All of mine didn't break but his did. Our floor now has slurred speech. When we came back the Medics had put a big "Retard" sign on our office door.

I'm the one on the left.....

Crisis Du Jour

On my return to KAF, crisis completed, I settled into my comfy chair in my comfy office to enjoy my comfy KAF job. That lasted exactly 4 hours. Then a patient presented back to the clinic that we had been treating for many things,. Then he developed a cough. And night sweats and we diagnosed him with {dramatic music}TB. OK, David diagnosed him. I just arranged a chest Xray. Miliary TB for you medical fans following along at home. Shit. Double shit. Launch the alert 5.  Anyway time to go to  crisis control stations, again. I went to the Role 3 to try and put him in isolation, Not so much. He is my problem, I was told. Alrighty then. We have made an isolation room. Now we gotta figure out what to do with him. Arrange an air ambulance and get him out of here.  He's not military so we need the civilian version. Hey, I know that stuff. That's how E and I met. In the back of a MU-2. Stop with the mile high club jokes...Lots of bids for our patient. Untill they heard "TB" then it seems that everyone has to wash their airplane that day.
 We have been trying to get Xray set up here at the clinic. Now we have to do chest xrays on his tent mates and we get all kinds of clearances to crank it up. Way cool. We find three guys and take their Xray and, sure as shit, one has active TB. Triple shit?  If getting one Air ambulance for a TB patient was tough then getting two is twice as tough. (Like how I did the math there?) So I said put them together on the same plane, they're going to the same place. Seems like a no brainer. Oh wait, I forgot that I'm in Afghanistan.......
Upon my return I promised the staff a pizza dinner on me. So after crisis management 101 and 102 we set off for our local pizza parlor for pizza and fake beer. Here we are, with table cloths and everything...

Steve and Dennis, I'm in the back across from Kharki behind Andrew, in the hat

Goldylocks, a C-130, and thou...

Well kids, I'm back in KAF. The adventure ends and then yet another was waiting for me.
At LNK as we call Leatherneck, had to flip flop down to the shower on rocky road. I couldn't understand why my foot hurt. I was about to buy new flipflops when I found this "arrowhead" in my flipflop:

This picture is actual size.............I do have big feet.....Ok, not so much. Remember, never let the facts get in the way of a good story. Hey it hurt, ok and felt that big. Moving on...
When is was in  the military no matter where I had to go I ended up in a C-130. Well, the streak continues. I was promised a C-17 and sure enough, they sent a  C-130 for my ride up and back to LNK. Marines up, Air Force back. Just get on, crank up and off we go. No "Life jackets are located..." Stuff. Just turn and burn, baby. Also no bathroom. Not a problem for a short flight but add waiting time and then bus rides and "stay hydrated," this becomes an issue. It was the longest bus ride of my life after we landed. Then the Air Force Airman wanted to give me a "Welcome to KAF" lecture. Sorry, dude, I gotta pee. I lapped an F-18 on a take off roll as I headed to the porta potty. It truly is the pause that refreshes.
So what was I doing at LNK? Covering for a PA who fell victim to "reply all" email hell. Said the wrong thing in an email and sent it to the wrong folks. Had to fly to KAF and pay the piper. Piper properly paid, proceed LNK. So we passed at the flight line and homeward bound I was. After arriving home to my beloved 229 I found that someone had been sleeping in my bed [enter dramatic music]!! Who would dare?! Well turns out that nobody would. They thought that someone might, so Kharki my Lead Medic, put my stuff in the closet to protect it. Mystery solved...

Me outside the LNK clinic during firefighting training

The morning blah blah blog..

I am sitting in my temporary, very nice, office having my morning cup of tea. I am surrounded by coffee drinkers and smokers. Or tobacco chewers. It's like being in a scene from "Deliverance."  0600 here, no shower, unshaved, teeth unbrushed just enjoying the quiet morning. This is usually when I skype with E but she is just back from Hawaii, so we'll talk later.
Went out and about on the base yesterday. Went over to Bastion, the RAF base {sound of Bob doing Wing Commander impression} in the clinic pick up truck. It's a big American Toyota with left hand drive so, of course I did the "windshield wiper for turn signal"  trick. Great, when it get back to KAF I'll be doing that for a couple of days. My poor Exporer will be so confused by me when I get home."Why is he sitting in my passenger seat? And leave the damn windshield wipers alone, it ain't raining, dumbass." Dissed by my own beloved vehicle, what a drag. Plus I'll be doing 20mph on the roads. While out I bought a new coffe mug and the Lonely Planet Afghanistan tour book. It was funny, they are not allowed to sell it in Dubai. There is an official guide for UAE but I searched everywhere for the Lonely planet guide, they had them for everywhere but for here and there. Not that I'm interested in being a tourist. Actually I am. It sucks that we don't get to go to town. I wanted to look up the local birds. I asked about a bird book and they just stared at me. I know that there are "bird nerds" as I call them here. They're just hiding. I think maybe we sent them to the Taliban so that  they would bore them to death. "Please Sir, please, please  stop arguing about the plummage of the Ruddy vs. Common Shelduck..." Anyway I'm off to the shower. Cheers.......

It's just like summer camp...but with out going silkworm missles.

Nothing like a good night's sleep on my new mattress. My little saga/crisis continues and I hope it ends in a couple of days. I have had to send one of the key players out of the country because of a gallbladder attack. Wasn't expecting that.....but wait...I am in Afghanistan. So here I am at Camp Leatherneck, due West of KAF. Sleeping in a tent with it's own, very clean outhouse. Have to flipflop down the street in the morning for my shower. Luckily, I'm next to the clinic so I sneak in and make myself a cup of tea first.
It's very quiet here. No poo pond smell and no one fires rockets at us. Probably 'cause the Marines routinely fire rockets randomly out into the desert. "Disinsentiveizing" I believe they call that in the business world. Apparently homey don't play that "rocket.attack.rocket.attack" game here.
Yesterday was another adventure. We had heard that the secret base-within-the-base was having steak and lobster. We are not supposed to go there. So, of course, we went there. It is called "Tombstone." No really. I could tell you about it but I'd have to kill you. Or, eat your steak and lobster. So off we went into the night, through gates that are verboten and well I can't tell you anymore, but I did see a goat. Whole other story. Anyway, sure enough, they were serving steak and lobster. And Miss Kitty  was behind the bar. OK, I made that part up. It was sooooo good. In a small dfac that was like a cozy restaurant. They had root beer and ice cream and I made myself a rootbeer float. I thought that I had died and gone to heaven. Or was it boot hill? Anyway, I actually said out loud,"I am sooo happy right now." Of course, we got busted. But the guy that busted us wasn't supposed to be there either, so he couldn't say nuthin'. Sweet! I said  thatI would gladly go to jail for this meal. What are they going to do, send me to Afghanistan???

Like a scene from M*A*S*H maybe...

If you remember a few years ago there was a garbage scow from New Jersey that couldn't find a home. It went up and down the East Coast trying to dump its load. Now I know how it feels. I am on temp. duty at Camp Leatherneck. Due West from KAF on a Marine Base. What I'm doing here? Well, more about that later. But I have given up the comforts of 229 to live in a tent. A tent with old mattresses that have springs sticking out of them. Now E will tell you that she calls me "the princess and the pea" when it comes to my bed. I am not one of those "sleep anywhere" people. I likes my comfy bed, so this stuff ain't happening. So we requisition some new mattress for the tent, which also houses the Medics, and am told the next day that they are ready for pickup. So we take out the old mattresses, pile them in the back of the clinic pick up truck and head out to get our new mattresses and dispose of the old ones. Simple right? I forgot that I was in Afghanistan. First we go to the burn pit. That's where all trash goes. Nope, can't take them here because they contain metal, so off to metal disposal depot. No worries, off we go, of course they are doing construction on the roads so we get lost and end up at the hazmat dump. Nope, they don't want them, not hazardous enough. They send us to the right place. We get them there and, yes you guessed it, they don't want them because of the fabric. Germs you know. So, take 'em back to the burn pit and burn the stuffing off, then bring the metal back. Roger that, back to the burn pit. Nope, the burning material will cause air pollution.The we're told to cut them up and burn the material and take the metal to DRSM, the metal place. But it's the fabric that causes the air pol...wait, sorry forgot where I was. So we decide, let's just take them back to where we started. Sure enough they said to just leave them there and they would take care of it. One and a half hours later we pick up our new mattresses. Ah a good nights sleep. Well, I was exhausted from driving around looking for a places to dump these mattresses..........

Politics and controversy Oh my........WTF?

I know that in your job you have office politics, and here it's no different. Oh, wait, yeah it kinda is. I am dealing with two. One is solved. One is evolving.
First the solved one. The other, stay tuned..
Here in acronymville a Difac is a "dining facility;" mostly staffed by foreign nationals. I am in charge of FOB medics who have to send me there charts  to review and sign each day and call me if there is a problem. So one on them had a guy with a fever and jaundice. "Hmmm," I thought,"sounds like Hepatitis." So, I sent him home. He works in a Difac,hmm. A week later a second Difac guy shows up with similar symptoms. This ain't good. I notify the appropriate folks and we stop a bunch of these guys from cooking food. Turns out a bunch of them test positive for some liver aliment. Not sure what it is but we test their liver enzymes and there are notsogood. So, the Difac gets closed and the workers get put in quarantine. 10 here, 50 there. The place gets scrubbed, we do more testing and they come up negative for Hepatitis A. WTF? Hep A is the food borne type most common in food handlers and third world citizens. Hmmmmmmmmm. Joint head scratching occurs. Meanwhile I am the chief babysitter, heath care worker, spokesman, and all around nice guy to ur 10 shall we say "POWs"  We gt them their own bathroom and shower and they are brought their meals but they can't leave the classroom they we have them housed in. We buy them cards and I bring them newspapers and rig a TV for them. They are super nice guys. They are the victims of their company not doing adequate screening. So, after two weeks of captivity, they are going home. I shook their hands and they thanked me for my kindness. I tried to get them other jobs here because they are the most medically screened workers on the planet. They could work at NASA. On the International Space Station. Cooking with TANG (old guy reference).
Turns out they have Hepatitis E. And they are having a paper written about them. So they are headed for India and the Philippines.  So crisis over, but I am at a base called Leatherneck, temporarily.
Stand by for that story..........