Honey, I'm home..

OK, not home, home, (56 days, but who's counting?) but back to KAF. Had a little field trip to the East to cover at Camp Leatherneck for a couple of days. It's a wee bit complicated. Eric, who I went through training in Ft. Worth, works in Kuwait, is on R and R. Bill, who is now the PA at Leatherneck went to cover in Kuwait. His wife was going to join him as a mini-vacation, but couldn't get the time off. So Dennis went to cover at LNK. He needed to come to KAF for a couple of days, so I went from KAF to LNK. I flew on what's called "Dyn-air," which is a DASH-7 turboprop airplane. On the way out you do the "milk run'" which goes from here to a bunch of fobs and, 6 hours later, you have completed your trip that usually takes 1 hour. The plane leaves LNK and flies directly to KAF, on the return, so I had that to look forward to on the way back. But nooooo, not this homeboy. There were a bunch of VIPs on this flight, so they reversed the order. They flew KAF to LNK and then, reversed the order so, the milk run on the way back. So 6 hours out and 6 hours back. 12 hours to do a 2 hour flight. And no frequent flyer miles. Also, when we are on the tarmac, we have to wear our helmets and flak jackets. In the heat. Now, no one else is wearing theirs. But it's a rule, and following rules is what we do.
While I was there I had two patients who completely baffled me. So I sent one to London and one to the British hospital. Neither of them has a diagnosis yet. And neither of them is wearing a helmet and flak jacket. It's only 6 hours to London from there. Unless you got to Greece, Italy, Japan and Finland first. That would be my luck...

"Ah, a cuppa tea....hold the cup."

The smartest thing that I've done is to bring my little tea pot with me. Being able to wake up and have a cup of tea before work sets the mood for the day. I'm not a "don't talk to me before my coffee" kind of guy, I just enjoy my morning tea. Many advantages to being a tea drinker. One; you just need hot water. No coffee makers, or espresso machines. A microwave will do.  Two: hard to screw up a cup of tea. It can be done, but rarely. Coffee drinkers are whiners. Too weak, too strong, where's Starbucks? Where's Pete's? blah blah blah. We tea drinkers have our tea bags and we're set. For me, all I need is a little milk and a little sugar. OK, a lot of sugar. And not cream. Cream is for coffee. Trying to convince waitresses of this is a hassle. Usually we have to settle for half and half and a Folgers tea bag. But we tea drinkers don't complain. Except for the time that I was charged 75 cents for a glass of milk that I used 5cc's of. Just wanted a little milk for my tea. And the water has to be hot. It's a coffee drinkers world, I just live in it.
Living in a 10 by 10 box presents it's challenges. Now that I moved the bureau and pushed the chair into the corner, it's like having a new room. Except that yesterday the door fell off and almost killed me. "Closet door attack....closet door attack." No worries, just lean it up against the wall. I constantly knock stuff off of the huge desk in my room. It lands either on the floor or, most often, in my little trash can. This morning I woke up, turned on the tea pot, went to the bathroom, brushed my teeth and went to put my tea bag in my little blue plastic cup. Except no joy. Hmmm? Looked under the desk. Nope. Looked under the bed, no. Looked in the trash can. Nope. So off to the big trash can I went and sure enough I found it. After the second look. With a flashlight. Knocked it into the trash can, then emptied that trash can into the big one. Now, most people would just write it off and go buy another one. Not me. For one, I'm cheap. Two- I want my tea, and Three, buying a new cup requires going to all of the PX's looking for one. Instead, I padded into the bathroom, turned on our super hot water and washed it out with hand soap. Clean as a whistle. Now to add teabags and hot water from the kettle.
Drinking tea takes dedication, laddie .

My kingdom for an "EASY button"

We have many sayings here. The one I use the most is , "nothing is easy here." Getting something shipped here is never easy. US postal service only. And the company has to ship to an APO. Some do, some don't. The funny thing is that a company will say that " that item can't be shipped to an APO," while the next company will pop it into the mail the next day. Hear that Amazon? We have UPS, FEDEX and DHL here. What ever you buy, multiply the cost times three and that will give you the shipping cost.
We have been mandated to do annual physical exams here. Which includes 12 lead EKGs and audiograms and specific labs. We shipped stuff DHL and they lost it. Well kinda lost it. It made it here, but they put it in their yard; outside in 120 degree heat. Sensitive medical equipment. Our supply people went to each of the shippers yards and looked at every package. Sure enough, there was our stuff. We were missing two things. Those were give to somebody to bring with him. We bought him an airline ticket to Dubai and then the stuff was handed to two people coming back from R and R to bring with them to KAF. Very Midnight Express. So we have been planning for months for this. It has been very intense in the past two weeks. It didn't help that I have been sick. I am feeling much better, but every now and then I just run out of energy, still. But we have all of the stuff that we need. Our new fancy lab machine has been calibrated. We have a new exam room, crammed full of ekg and audiogram machines. So we scheduled  5 people for their physicals. How many of them showed up? Zero. Nada. Zilch. Really? Turns out that 4 of them were on R and R and one just didn't care. Oy vey.
Back to the drawing board. I would order an EASY button but it would cost $100 to ship it and FEDEX would lose it.....

"it's alive!!"

I am feeling better, just not 100%. I got a shot of steroids to boost my immune system. I was fine. Until they wore off. OMG was I crabby, it was so weird I could actually feel them wear off. My first and last experience with PMS. Male menopause. Whatever you want to call it, it wasn't fun. It's so strange, I'll feel fine, then all of a sudden just hit the wall and need to sleep. Right now; maybe I have narcolepsy. Induced by a combination of my steroid shot and the poo pond. PMS=Poopond Medicine Syndrome. Makes you feel like shit...
We are trying to gear up to start doing annual physicals. We need more equipment, more people and more space. Guess what we don't have? I'll wait...........you are correct-none of the above. We finally paid for someone to fly here, couriering the equipment we need, and it arrived yesterday. The lab has been struggling to calibrate out new high tech lab machine (the Alera) to work in Afghanistan. Apparently it wants to go home to Texas. It wants Lone Star beer and ribs. Too bad, pal, if we can't have it, you can't either. It's a long story of why it won't work. But it's getting there. We have a disconnect between Indiana, Ft. Worth and here. Too many time zones, too many miles, too many chiefs. Just another day at KAF. Perhaps I should give  the Alera a steroid shot, no, bad idea, it'll just make it more cranky...

and then what happened?

After dealing with the medevac from hell, I just collapsed into bed. I was exhausted and feverish and just plain sick. I woke up hourly to drink water, I noticed that my bedsheets were soaked and my pj's were clinging to me like a cheap, used suit. I woke up in the morning and I could barley walk to the bathroom. I had to hold onto the hand rail. And I had the worst headache of my life. I surely had meningitis, I thought. I had to wear sunglasses to the bathroom because the sun hurt my eyes. More evidence of my impending certain death from Neisseria meningitidis. I had never been this sick in my life. My walk to the bathroom was exhausting. I slept an hour for every 5 feet that I walked. And my headache just got worse. Still bathed in sweat, I realized that I had to go to the clinic.  But, how to get there? Now the obvious thing was to call and have someone come and get me. But that never entered my mind. I knew that I couldn't walk that far, I would have to nap by the poo pond en route. I then spied the keys to the SUV that were still in my room. I had to brush my teeth. They felt like a cat had spent the night in my mouth. Teeth brushed, pair of pants on, socks and my Crocks on, I headed for the car. A slow, exhausting walk. During my walk I wondered if I had malaria. I was planning the labs that I was going to order on myself when I got to the clinic. It took ages but I finally made it to the car. I actually thought,"Please don't fall asleep while you're driving." I've never been so glad to have a 20kph speed limit, it was just my speed. As I  pulled up to the clinic I actually started wondering what I should say when I walked in. I quickly settled on, "I need to be seen." Short, sweet, and to the point. It was noon and the clinic was pretty empty. As I walked in one person started to give me shit about being late until he saw me. Then there was silence, the walking dead had entered the clinic. So Thackery, one of the new Medics took me in, worked me up and ordered the labs that I asked for. Luckily Dr. Sharp was there and took charge. He added an influenza A swab, just to be sure. And sure  enough, I was positive for influenza A. lucky me. The true flu. Son-of-a-bitch. At least I didn't have malaria. They started an IV on me and after a liter of fluid my headache, caused by dehydration not meningitis, started to subside. During the second liter we had a rocket attack. Of course we did. So me and my IV went to the bunker, then back to the treatment room where they covered me up with a blanket and I had a nice nap. After three liters of fluid I began to feel alive and got up and went to my office and read emails. Many pictures were snapped of my stupidity, I mean dedication. They took the IV out and I had a banana and an orange and Karki took me back to my room where I collapsed back into bed. I still didn't pee that much, that's how dehydrated I was.
We have other sick staff, none of them have tested positive for influenza A. Just lucky me. I had a steroid shot that wore off the next day. But thats' a whole 'nother story...

Just listen to the the voices in your head...

If you're a celebrity and you do too many drugs while you're out on a tour date, you get hospitalized for "exhaustion." Everyone believes that you were just singing in too many cities and just got exhausted. Because that's way harder than coal mining or fighting fires or professional wrestling. You get the point. We often say that "we're exhausted" when just tired from doing something or "starving" when just hungry or "burned out" when you're just tired of doing something. I have been exhausted. I was helping a friend bring a sailboat down from Oregon in gale force winds and high seas and had to be at the helm for 4 hours and was using my body weight to steer because my arms quit working because the rest of the crew were exhausted too and were below decks resting. So I say"beat" or "knackered" when I'm tired. But I'm exhausted. And I have a clinical reason for it. There has been a cold going around the clinic, which is one of the benefits of being in healthcare, people share their germs with you. So most of the staff is coughing, some with the garden variety "Kandahar crud,"others with colds donated to them by their patients. I started to feel not so good, so I figured that it was just my turn. I was helping to coordinate two medevacs from outlying hubs, out of country. Turns out that the civilian air ambulance companies will only fly to KAF and not to where these patients are, even though there are airports there. Part of KAF is the "Kandahar International Airport" or, as we call it it, Juliet ramp. Not of "Romeo and Juliet" fame, but Juliet is "J" in the international phonetic, pilot speak, alphabet. It is considered Afghanistan proper. So you can't just stop by and say "hi" or "salaam" in this case. It's just like going to any foreign country. We are not in Afghanistan, we are on a NATO base. Both of these patients were sent to our Role 3 at different times, so it became my responsibility to get them home from here. Working with the air ambulance coordinators in Dubai and their home country, I arranged for them to get to hospitals near where they lived. It just happened that this was  going to happen on Friday for both of them. OK, a challenge, no worries, I can make this work. Of course, there's still a clinic to run and new medics to train, but I have Dr. Sharp here to help me and he can see the sick people at the clinic. Between the staff and the patients, we got a bunch of 'em. Also, we are trying to set up a new part of the clinic to start doing in-country physical exams for people renewing their contracts. Don't have the equipment, paperwork or staff to do it, but hey, doing the impossible with nothing is what we do. Plus of the new Medics, some are doing better than others, so I am doing counseling, remediation, and some ass kicking where appropriate. (Exhausted yet?) So, medevac number one goes relatively smoothly. Our number one goal- keep the aircraft off of Juliet ramp. We want it to go to XXX ramp. Ok not an "x rated" ramp, its OPSEC and I can't tell you the real one. So many emails are sent saying go to XXX not juliet. Plane lands, starts to head for, you guessed it, Juliet, but the tower turns it to XXX. Cell phone rings a lot with updated ETA's and requests for ETA's and "where the f**k is the plane" and "why the F**k is it going to Juliet ramp, we told you not to let it go...blah blah," you get the picture. {Wait, quick break, "Where for art thou Romeo?"} There, got THAT out of my system. Don't tell me that wasn't rattling around in your brain...Anyway, plane goes to correct ramp, patient gets loaded into plane and patient number one is out of here. After that I start to feel like shit. I'm beat. I announce that I have to go lie down. Naps in my office ain't making it. I come back to my room and collapse in bed. I wake up an hour later and my sheets are soaked, I have had a fever and it's broken. I have strategically placed my computer next to my bed and roll over and log into my email. "Air ambulance has been delayed by local government," It says. Of course it has. A call to the Commander S, my liaison at the Role 3 to give him an update. He's cool with it, just keep him advised. I get updates on ETAs and pass them along. I am getting sicker. I am getting a fever. I am dehydrated. But the airplane is on its way. Cool, pass that along to CDR S. "Don't let them go to Juliet," he says. "Roger that, sir." I send frantic emails trying to tell the new air ambulance not to go to you-know-where. I need an aircraft tail number and what ramp they are going to. I get nothing back. My phone keeps ringing, requesting updates. "Dude, I'm trying" I tell the CDR. I get an ETA. The plane will defiantly land at such and such time. I pass that along and they prepare the patient for transport out of the Role 3. I fall asleep. And start to hallucinate, because of my fever. Phone rings. "Where's the plane, Mark?" "Should be there," says I, trying to figure out which one of my hallucinations I'm talking to. "Ain't no plane here," the hallucination answers back, who sounds remarkably like CDR S.  I stagger out of bed, force down two bottles of water and start sending emails. I look at the signature blocks at the bottom of the emails and start calling all over the world. No one answers. "FUCK!" I scream, which I think scared the rest of my hallucinations. Stagger to bathroom to pee. Stagger back, phone ringing. "The plane is at Juliet ramp," the voice at the other end say. Now, I'm sure you have said in your life,"maybe this is all a bad dream and I'll wake up and things will be better." I actually had that conscious thought. Well, when I was conscious, that is. I finally got an email back with a phone number. I called the number of a doctor in India who gave me another number to call. Half conscious I am trying to write down the phone number outside of my room in the dark. I call the number, no answer. Phone rings. Guess who? He has an aircraft tail number, I double check, he has the wrong ai tail number. They are packing up the patient and taking him back to the role 3. I would cry, but I'm too dehydrated for tears. I tell him that they aircraft is on the ground, the correct tail number and that a message is being passed on to the flight crew to move to XXX ramp. Ok, they will pack him up again, and head back to the ramp. My phone rings, it's the aircraft. Ok, the flight crew, it's not like "Cars" with talking airplanes, but with my febrile brain, anything's possible. They want to know where the patient is. I keep asking where they are. "We are at Juliet" the talking plane says. "You need to move to XXX" I tell the voice coming from my phone. "OK," it says. I chug more water. I go pee. I stare longingly at my bed. Phone rings, it's CDR S. He can see the plane. Still at Juliet.  I call the plane. I am pacing outside of my room. "Do you see the ambulance, sir?" I keep saying. The voice doesn't get it. It keeps asking me where the patient is. I try and explain that they can't come to the plane, they have to go get the patient. "We have a stretcher on the plane" another voice says. My febrile, influenza ridden brain wants to say the following," I fucking know that, you fucking idiot. You shouldn't have gone to fucking Juliet ramp, like I fucking told you. If you would of gone to fucking XXX ramp, you and the fucking patient would be out of here, and I would be in bed." CDR S is on the other line. He is calm. I tell him I am talking to the plane trying to get them to come get the patient. He is trying to talk the Afghanis into letting him go to the aircraft. Neither of the people that we are talking to speak very good english. I call the plane back. Calmly, but firmly I try and impress upon them the importance of going to get the patient. "We will move the aircraft" the voice says. I call the CDR back to inform him of the plan. He has talked his way onto Juliet ramp. They are loading the patient on to the plane. I figure that I have probably caused an international incident. I don't care. I just want to go to bed, plus, maybe it was all a hallucination......

a report from the sickbed

I didn't feel good so I dragged myself to the clinic. Turns out I have Influenza A. Honest to God flu. I feel like dog poo. From the dog poo pond. More to tell later. back to bed..

You can go to H.....

The new paid internet and I are not getting along. I think that I've paid for it twice now, just to get on this site to blog. DI has blocked sites like these from the company internet to save band width. Ummmm, not sure how that does that, but what do I know?
We are out of water. Ok, we have water we just can't make it go to the showers and bathrooms in F block. Sounds like being in Alcatraz. This is like prison, just better food and occasional internet. So I put on my Crocs and flip flopped my way down two buildings to H block for showers and other things that require water. I just brush my teeth with bottled water and spit it onto the rocks from my "balcony.". Kinda fun actually. Not so much for the guy below me. Sorry about that, Chief. Hopefully will be fixed soon. Just part of the fun of being in Afghanistan.
I am no longer grumpy. We organized and boxed the 2500 files and put them in storage. Then I bought pizza for the crew. All is forgiven. And the boxes of files are out of my clinic.
One of the Docs is gone from the clinic; off to cover somewhere else for R and R coverage and then it will be his permanent home. So I have the office to myself. 76 days 'till mine, but whose counting.
In every job there's politics, in this one they are on steroids. So may bosses to please. So many rules to follow. I just take it one day at a time. Bill is at Leatherneck, his new permanent home. He has been labeled a "shit magnet" because they have been getting really sick patients in his clinic that need to be medevaced and they are all complicated. One even got me involved and we got the person out but it turned into a "charlie foxtrot" anyway. Because of, you guessed it, politics. I can't even describe the politics involved. You'd have to be here to understand. Maybe if I ever write a book.
My Amazon stuff is starting to arrive. Wore my new socks today. We'll see. There is a line of tinea on the bottom of my left foot that's making me crazy. Lamisil was winning for awhile but now has sounded retreat. No I need to re-treat with something else. Geez, even footcare here involves politics...

Note to self-Pay for the paid internet

I couldn't understand why I couldn't log on. I thought that the new paid internet would automatically renew itself on the credit card on file. Not so much. You have to go online and reenter your credit card info once a month. Live and learn. I have been dubbed special and had my company internet reactivated in my room. DYN has turned it off here at Hicks to improve the band width for the "head shed" aka HQ. So if you want internet in your room, you have to pay for it. But I have been deemed semi-important so mine has been reinstated. Many sites are blocked, not just porn, etc. but also podcasts and blogging sites. Who new that I was a band width eater. {cue man-eater music from the 80's. Get that out of your head}
I was the grumpy PA yesterday. We were given 2500 names of employees no longer working here and we had to pull their medical records. Which sat in boxes on the floor of the clinic outside of my office and no one new what to do with them. Plus at one point, there was 25 people here. Space was tight and I was grumpy. I announced at morning meeting that we were going to do an "all hands" effort to put them in numerical order, box them up and put them in storage. It took all of us working together 4 hours to do it but, mission accomplished. I got yelled at by the CAnadians because I drove through their compound looking for used boxes to put the charts in. They are packing up to leave and I may have driven just a teensy but fast. They have stuff everywhere. Dumpster diving at its best.Now there are "property of the Canadian government" signs on everything. Oops I meant "property of the Canadian government, ay...."

It's a jungle out there, but in a good way

People have told me that folks leave here broke. Hard to imagine making all this money with nothing to spend it on and leaving with nothing. Two words: E Bay. Or, actually, Amazon.com. Point, click, shop, ship. Oh shit, I 'm broke.  Our version of late night retail therapy. The home shopping network of Afghanistan. I have been a shopping fool lately. I bought an autoclave on line but they can't ship it here, so it was sent home. Poor E, she had to shlep this monstrosity to the post office. Some things can come to our APO, some can't. Some people insist on using UPS instead of USPS. What can Brown do for me? Not a damn thing. Unless you want to pay three times the shipping cost.
We love out 5.11  pants here. I had a couple of pairs already from the state disaster team uniform as well as one pair of BDU type pants from the federal team. I like the 5.11 pants better, more pockets. The BDU pants have two big pockets but stuff falls out of them, like my camera, which I have lost. I searched everywhere for it, and came to the conclusion that it had slipped out of my pants. Along with a small pair of glasses. Not to worry, all of the pics had been downloaded to my computer, anyway. I  loved that camera. And it had a large storage card in it. To the internet, Batman. Oh, a hell of a deal on a slightly used one from Amazon. "Sign on to buy this with one click," the website says. "One click Caplin," that's me. And they ship to an APO, sweet. Hmm while I'm here I will order some socks that have been recommended to me for my trench foot feets. And let's see, drink mix and what else...?  Ok some pens and a "remain calm and carry on" poster. That ought to do it.
I was sitting in Karki's room for our nightly debrief and noticed that his dressing cabinet was next to his bed so he can push his desk chair out of the way next to the wall. What a brilliant idea. There are so many reasons that I love that man. I immediately went back to my room and pushed mine closer to my bed and pushed my chair out of the way into it's new "garage space." What a difference. It was like having a brand new room; no more move the chair and move the chair again and go around the chair at night to pee. Had to do some minor rearranging and cleaning up of stuff to make room next to my bed. And what to my eyes did see? My camera. Under the bed, next to my glasses. Yep they fell out of my pocket all right. Zoom back onto Amazon, only to be greeted by a "your order has been shipped" cheerful message. Anyone want to buy a camera? I can only ship parcel post though...

Yes, occasionally it sucks here

Happy August. Happy Ramadan. After 7 attacks in 2 days the rocket attacks have stopped, which is nice. We figured that they were trying to get it all out of their system. Other bases were attacked, some by folks blowing themselves up outside the gate. Or lobbing stuff over the wall. This is a war zone and bad people occasionally so bad things. We are pretty insulated here. The mayor gets killed and we read about it in Stars and Stripes. Just another day in Afghanistan.
Because of the Ramadan fast, there are soldiers at the Boardwalk telling you that you have to take your food to go. No eating in public. No shorts. Long sleeve shirts are preferred. All this for a month. This is a Muslim country. Debate raged at the clinic whether we are on US soil. I reminded them we are on "NATO" soil. Speaking of which, the Canadians have started to pack up to leave, which means they are throwing stuff out. This (Bob) is dumpster diving heaven. Hmmm  what's the Ramadan rule about that?
We came home last night to find that the generators had died. No electricity and no water. Quite warm in the rom with no a/c. So we went to dinner instead as they said it would be fixed in an hour. Wrong! So I set up my MAC outside my room  and put in a bad movie, Bounty Hunter. Hey it has Jennifer Aniston in it. Which I believe, by definition, makes it a bad movie. Everyone was impressed with the clear picture. The power came on, and, no longer starved for entertainment, I shut off the movie. Don't know how it ends. Don't care. No one is THAT starved for entertainment.
I put on my Crocs and my feet hurt. On examination I realized my feet were dry and cracked. Ouch. "Take care of your feet and they'll take care of you" they say. God. "they " are so bossy. But right in this case. I put powder on them and Lamisil on them every day, but now we are moisturizing. I have cracks on my toes. Don't worry, no pics. Even my flip flops hurt. Going barefoot is not an option. Steel grates between me and the shower. Plus snakes. OK, no snakes on the grates, but still, can't be too careful. So walking with toes curled or on the sides of my foot. They are fine with socks on and in my boots. I guess my feet sweat and it's causing trench foot. Charming. Time for some sock research. We get down to the basics here. Hope you're not eating...