"I'm a little teapot, short and stout, here is my...rocket attack...rocket attack"

My beloved little travel tea pot has given up the ghost. Well it still makes the water hot but it has developed two problems: 1. It leaks and flooded my computer mouse. Drowned the little bastard. Not pretty. It was on its back kicking its little buttons.. Had to disassemble and dry it out. Which is not hard when it's 100 degrees. 2. Does not automatically shut off. You have to unplug it, which, because we all know that I am a dumb ass, I forget to do sometimes. I come home and hear a "sizzling" noise that I immediately recognise. Thank goodness for my new smoke alarm. The one next door beeps but mine goes "dumb-ass, dumb-ass." Funny how not all of them do that, only mine. But I have a new DesignGO Model 991. Shuts off automatically and gets the water way hot. Which is important for us tea drinkers. It is compact and travel size including two wee cups. Works on 220 and 100. It knows what it is plugged in to. My tea pot is smarter than me. Which ain't saying much. I highly recommend it. You coffee drinkers are on your own. You know who you are. There is always a machine for you in your room, which they expect us to make coffee flavored tea from. The nerve...

The rocket attacks are increasing and it is wearing on my nerves. I am tired. Both physically, mentally, and emotionally. 28 days to go until R and R. I can't wait. I had to have an intervention at the clinic. On myself. Gathered everyone together so we could talk. I feel that my job is to take care of my staff and myself. Now I feel better and I hope that they do to.

Ok, more to follow. Off to the clinic for the crisis of the day..

Why is everything in this country trying to kill me?

Even the cats. This is why I am a dog man. Oh, wait. Those will kill you too. A soldier here died of Rabies. I read on line that he was from Livermore. Apparently he broke up a dog fight. Rule #1 1- Never break up a dog fight, especially in Afghanistan. He even had the treatment started but the dog tested negative for rabies so they stopped the treatment, which was appropriate. But he still died. There have only been three people in history to survive rabies. In medical terms it is what we call "serious shit." I remember when I was a kid and heard stories of the painful shots in the abdomen that you would get if you get rabies. Plus you were afraid of water. No thank you, no rabies for me. Now we have a 5 shot series in the arm, plus one initial shot called IgG that you get at the bite site. I have beefed up our rabies awareness. A guy got scratched by a wild cat that had been trapped and was in a cage. He reached past the cage and got scratched. You don't have to be bitten, just come in contact with saliva. And cats have a tendency to lick their paws. So he flew to KAF to start his treatment. You cannot be too careful. Even though the rabies virus dies easily when it dries out. I don't want another family to have to go through what that poor Livermore mom did.
I have seen a herd of camels. Is a bunch of camels a herd? Nope, {JFGI}it's a flock. A flock of camels. Flying camels? Sopwith camels maybe? Anyway, there was a bunch of camels outside the wire at the end of the runway. Ya don't see that everyday. We were hoping that they weren't Taliban camels. That would suck. How do I explain to my Mum that I was killed by a camel bomb? "I knew camels weren't supposed to have three humps." "No one ever listens to me..." Yes, I would complain even in death. That would be my legacy. "He died doing what he loves, kvetching." Stupid camel. I new I should of never tried to pet it. One pat and BOOM! Hump parts everywhere. Very messy. Never trust a ticking camel. Ya gotta soak 'em in water first. But this is a desert and all we have is the poo pond. Ever try and get a camel into a poo pond? Well, let me tell you, it's no easy task. Try it sometime. They're spitting and kicking and, well, it's ugly. Trust me. First you need a camel, then your own poo pond. People don't like having poo ponds in their neighborhoods because it brings down property values, and the camels are noisy and smelly but not as smelly as the poo pond, then your neighbors complain and call the cops and then you have to try and explain the camel and the poo. Then  you end up yelling "rocket attack" and then you and the camel are on the ground waiting for the English lady to say "all clear" and everyone thinks that you're nuts except for the camel who just wants a drink and then ...you wake up and you're still in Afghanistan waiting 30 days for R and R.
What? Like this never happens to you......

Beeps, bombs and....malaria(?)

I am being tortured and it's not by the Taliban. It's by a smoke detector. In a room next to mine, somwhere. Every thirty seconds I hear "beep." They installed smoke detectors in all of our rooms. OK, I figure that in a 10 by 10 room I will smell smoke. Plus the room's made of metal, so not much to burn. But safety first. Plus I don't smoke in bed. I don't smoke at all. "Do you smoke after sex? I don't know, I've never looked" Old joke, sorry. The beeping bastard is not in the room to my left or right. I thought it was behind me but I complained and they looked and it's not. So someone has this thing in their room and is just ignoring it??!!  Seriously? Wow, no wonder I never see you in the bunker, you must sleep through the rocket attack alarms. They are getting more frequent and they are using bigger boom makers. All part of the charm of KAF.
I had a patient in the clinic last night just at closing time, of course. He had a fever and didn't feel well. We test everyone with a fever for malaria. I wonder how that's going to fly in Berkeley? Knowing the Berkeleyites, they'll thank me. I'll tell them that you can get it from vaccinations. They always believe that. Anyway it came up positive. And for p. falciparum, which is the nasty bug. I called the CDC and they eventually called me back. I had given him some medication and that turned out to be worthless for the kind of malaria that he had. Drat. Bummer. Hmmmmm, off to the Role 3 for a drug deal. I traded the right meds for me not bringing them to the Trauma Bay. Easiest negotiation ever. An honest to God drug deal. A couple of liters of IV fluid and he was good to go, so I drove him to his tent and told him to come to the clinic in the morning. I can see it now at home,"Why does my PA keep driving me home?" "And he keeps testing me for malaria and yelling  'rocket attack' and laying on the floor yelling 'get down, get down" every time a car alarm goes off. But he does make sure I drink a lot of water..."

Medevacs do vex me...

Illegal photo from the flightline. Plane is in the background

What's more annoying? Dailey rocket attacks, medevacs or the fact hat we have new smoke alarms in our rooms that flash a red light and beep every minute. I am the king of the medevac. Medevac Mark, that's me. It took me over twenty four hours to get a guy out of here that had a big heart attack. Basically only 20% of his heart is working. The Role 3 is a trauma center not a cardiac center. They did an amazing job because they have a new Cardiologist there who kicked ass. All I could think was, " this man needs E, worlds greatest CCU nurse. The queen of cardiology." But instead, he got Medevac Mark. He is a subcontractor. My nemesis on the medevac front. No one wants to pay for these guys. Because only the ex-pats get insurance here. And he is Indian. If you work for DYN directly, we've got you covered. But the subs, not so much. But after many emails, his employer stepped up to the plate and paid the bill. Only took me 24 hours of begging and pleading. And they sent a real air ambulance. We took him in our ambulance to the flight line. I was looking for a particular tail number. I spotted a falcon jet on  a taxiway, "Can you see the tail number?" I asked the corpsman who was driving our ambulance. "No sir," she said," but it says 'air ambulance' on the side." Ok, I'm only a dumb PA, but I'm guessing that's our plane. And it was. Of he went to New Delhi. Cool.
Now there is a beeping smoke alarm in the room next to me. Hmmm, we have had a rocket attack a day. Maybe I can aim it at this beeping torture device? Overkill? Sorry, disregard...

36 days and a wake up, but who"s counting? Besides me and E and ...

Every morning I tell a joke at the morning meeting. Here is one of my favorites:
A young couple has just started dating. The young woman asks her new boyfriend to come to dinner at her parent's house. He isn't crazy about the idea but he says that, if he agrees, she would have sex with him.  He, of course agrees, and heads to his local pharmacy to buy condoms. The Pharmacist asks him if he can help and the young man explains the situation and he and the Pharmacist have a long talk about the relative merits of each brand and type of condom before he makes a decision. Pleased with himself, he goes home and the next day goes to his girlfriend's parent's house for dinner. The father asks the young man if he would like to say grace, the young man agrees and prays and prays and prays for about 20 minutes. After he finishes, his girlfriend leans over and says, I didn't realize that you were so religious." "Well", the young man answers. "I didn't realize that your father was a pharmacist."

I was all packed to go out to Leatherneck tonight. Because of some lame brain scheme, we were going to move a bunch of people and then move them back. It was going to disrupt our training schedule and mess up two peoples' R and R. All because of a knee jerk management reaction. It was sprung on me this morning. You can imagine my reaction but it involved the words "---kidding me."  Everyone else thought that  the idea was crazy. This would involve military flights and movement requests and ... just a nightmare. But cooler heads prevailed ( I guess) and I was told to stand down. So I came back and unpacked. I'm alright with dealing with crisis and disasters and emergencies, but not when we make them ourselves. Especially when the crisis is based on a hypothetical solution to a real problem. And when it effects me. 'Cause, as we know, it IS all about me.
Is it time to come home for R and R yet? I'm tired and need a break. I hope that I last that long.
We have new Medics who arrived today and I have to push out the ones that are just finishing up training. The process starts all over again. I think that Karki is tired too. He has two weeks before he leaves on R and R. And he is ready.
We are having a rocket attack a day. Had one today as I was teaching the Medics how to suture by practicing on pieces of chicken. First day, first rocket attack for the new guys. Got it out of the way early. We usually practice on pig's feet but hard to come by in a Muslim country.  "Why did the chicken cross the road?""To get to the bunker..."

Medevacs do curse me..

I know it's all about money here. If we get woking up in the middle of the night by a rocket attack we go back on the clock. "Rocket attack, Rocket attack cha-ching." But attention Taliban-I appreciate the OT you are providing but you can keep the money, really. I'll trade it for sleep. The bunkers have lost their charm, especially the ones that people have pee'd in. We were awoken at one in the morning. I got up looked outside, heard no explosions and looked around, no one else was headed for the bunker, and I hate to be early for a party so, I went back to bed. Through the fog of sleep, I heard the all clear. Cheated death again.
Flash forward to the next night. I am asleep. phone rings, it's the clinic. Steve says, "there's a guy here that needs a medevac, can you come down?" Of course I can, it's what I do. So I get dressed and drive down to the clinic. I meet a man who has an employee in the Role 3. He was admitted 12 hours ago. And now at 11 o'clock at night he wants me to supply him with a Medic to put in his Russian aircraft and fly this person to Uzbekistan. Here'a the thing, none of this surprised me. I drove down to the Role 3 and made rounds on the patient. Then we drove around KAF trying to find a medical crew. Found one at 0100. Job done, back to bed. Just another day (night) at KAF.

I bought Z a birthday earring and necklace set for her birthday at the Bizzare. She lost an earring hitting the dirt during a rocket attack on September 11th standing inline at the Difac waiting for an Outback steak house steak. You know, like this hasn't happened to you.

OK, so you can make this stuff up

We have received DVDs for the show "Combat Hospital." As in most things, I am not going to ask how. I have watched the first 5 episodes. I fear that I will cause the world to implode as I am in Kandahar Afghanistan, watching a show about the Role 3 hospital in Kandahar Afghanistan. And it's not bad, it's no "TRAUMA" (inside joke)  but the re-creation of the Boardwalk is uncanny. They have all of the FOB names correct and the essentials down pretty well. But they are Canadian, after all. The medicine, well...but it's TV and we know how that goes. It takes place a couple of years ago and they are in the old Role 3 when it was still in a tent. I get to go to the new hard building, but we are giving it to people that have seen the old Role 3 so we are getting an accuracy check.
Being Afghanistan, the discs have scratches in them so I have no idea how the episodes end, or I have seen the end but not sure what the hell they're talking about. Oh well. Entertainment is entertainment.
I wonder if they are going to need a new technical advisor around say........February 2012.

Thoughts. Anyone? Anyone? Bueller?

39 days and a wake up. Then home on R and R. I am not counting the days, I am counting the seconds. I am tired and need a break. I am flying Lufthansa. Getting United frequent flyer miles to fly on their new Airbus A380. Dubai->Frankfurt->SFO. Yee hah.

I am back to huntin' and peckin'. But modified. Accuracy counts around here, but I will master this keyboard.

My friend Michelle is here as a new PA. Combined with my friend Dave, a new Medic I get $500 as a recruitment bonus, which is good as California is one of two states that makes you pay taxes, even if you're not living there, not working for a California company, or even if you are in the State for less than 90 days. Their website even defines residency as going to church there like once. So don't eat any California raisons or Jerry Brown will be knocking on your door.

We have new signs in front of the clinic. They are beautiful. Once again they are taped instead of painted, but whatcha gonna do?

In the morning it is about 92 degress. People have sweaters on. I kid you not. I walk outside in the morning and think, "man it's chilly out here." What am I going to do in SF when it's 70? Long underwear is in my future.

Screw United airlines. Lufthansa will let me in their lounge. You can only use United's if your are a domestic traveler. Bastards...

I didn't realize that I had to pay taxes until this paycheck. So I  owe them 6 months. Don't tell anyone.

We are working on an approved medical abbreviation list. It is amazing what some people come up with.

Michelle is raising the bar as far as documentation goes for the Medics. You go girl.

Go Stanford....

fffff jjjjjggg hhh ff jj gg hh

I am teaching myself to type. I am a "hunt and pecker" ( not to be confused with a "pecker checker") from way back. I am starting on the on the "base row" of a qwerty typewriter, sorry, keyboard. Din't lean to type in higschool.The clSSS WAS FULL, SO THEY PUT ME IN BUSSINESS ENGLISH. WHER MISTAKES COUNTED TOWard you grade, ah cap, I hit the caps lock by accident. I went from an A to a B. Plus ther eare all kinds of redlines under words. I am an old an who looks around at the "kids" in my offie typing away at lightenig speed. None of them seem to know how to spell or pays attention to the spell check fearutre. Ok down to a c with typos. But haven't gotten to he part about the row above and below yet, so not soure waht finger to use to type t and y; and b and n yet. I'm msking ot up as i go allng here. Bet you couldn'
even tell. oops that was the enter ey. key, shit.
ok back to hhhfff jjj fff ddd sss aaa kkk ll ;; '''

OHS preschool

The ariel view is of a picnic table that, Larry our Chief Radiology Tech, built and Jamie, the other tech painted white and then got colored paint which we dipped our hands (with gloves on) and then put our hand prints on the table.  Of course it was over a 100, so the paint dried pretty quickly.
The view is from our roof. Karki is on my left.I'm next to him. I look like a Klingon with a flashlight on aimed at my head. That's Gizmo in the front next to Jamie. There are more pics on Facebook. Of course I had to email this to E,  as she doesn't do Facebook. But, due to the magic of Skype, I can share my pics with her. Ain't technology great?
I'm not sure how she got colored paint here. Probably better not to ask. Don't ask, don't tell. That's our attitude.
We are very dependent on the folks back in CONUS (Continental US) not to be confused with POTUS (President of the United States) VPOTUS( Vice President) and my favorite, FLOTUS (First Lady of the United Staes). My call sign? FLATUS.
Anyway, they have to send us stuff. Supplies that are not available from the Army supply system. The problem is they sometimes don't understand how things work here. So we get really frustrated. Things get lost in shipping. You can't mark a box "$20,000 lab equipment" because,  like my new MAC, it will be diverted to the Sopranos. Tony Soprano is now running Lipids and CBCs. Plus watching DVDs on a new MacBook Pro. Who'd a thunk it? "The more I try to leave, the more they pull me back in.."

Rocket attack, smocket attack

September 11 came and went. There were various small ceremonies around the base. I stayed back and took care of the clinic while the staff went to the "flag pole" for a ceremony at 0517 Eastern time. Apparently there were three speakers who talked about what the attacks meant to them. They talked about Jesus and God and played "I'm proud to be an American." Sounds perfectly harmless and patriotic, but the crowd was made up of Hindus, Muslims, and a large portion of non-Americans. Yes we got attacked, but other countries get terrorist attacks all the time. Say, oh I don't know, Afghanistan, for example. Sometimes we Americans just don't get it. There is more to the world than the good ole USA. Don't get me wrong, I AM proud to be an American.  But we have our faults, and one of them is our ability to be culturally insensitive. We don't mean to be. We all know some dumb ass who starts statements with, "I ain't prejudice, but..." And then tells a really bad, really unfunny racist joke. But his also the same guy that   would run into a burning black church in the South to save someone of color, or gives money to feed starving children in a third world country. Or comes to Afghanistan to build a clean water plant. We are a quirky little country, ain't we?
On the 10th we had a band called Goldilocks come and perform. The world is cursed with bad sound men. No different here. All we could hear was the base player. Then we barley heard the singer who was singing her heart out. The show was sponsored by Outback steak house who has gone around and taken over Difacs and cooked big juicy American steaks. Plus chicken and pasta for non-steak eaters. There was also a comedian, but I was tired and went home before his set. Of course there was a rocket attack right in the middle of his set. Apparently nobody "hit the deck" until the Commanding General did. That's leadership for you. On the day, last night, it was our turn for steak. We all loaded into two vehicles, one being our ambulance, and headed off for steak night. There was a huge line, of course, but that's what we do, stand in line for stuff. And guess what happened.  Go ahead, guess, you'll never guess. Wow, good guess, a rocket attack. We hit the deck. We waited, and we got up and were supposed to go to the bunkers. Nobody moved. This was an opportunity to get a better position in line. Two or three people did the right thing. Me, not so much. I am a Caplin, and this is free steak. Good steak. Amazingly good steak. I ain't going nowhere. No siree. Plus there wasn't room for all of us. I will take one for the team. The amazing thing was that they just kept on serving. We had our dinner and half way through they sounded the "all clear."  The crowd erupted in applause. Cheated death again. Man, I am proud to be an American..

An episode of Mad Men-Afghanistan office.

This whole country, it seems, is set up for smokers. It's like being transported back to the 1960's. Ashcans are everywhere. There are  "smoking area" signs everywhere. There isn't one Non-smoking sign anywhere. Except in my vehicle. Turning on my a/c and having used cigar smoke emanate from the vents was most unpleasant. Being a San Franciscan this has taken some getting used to. Most of the folks I work with, at least, try and go down wind, but everyone I talk to lights up a butt. No "mind if I smoke" question. Michele, the new PA here, is a fellow Californian and is shocked by the whole thing. She, too, is violently anti-smoking. Adjust and {cough,cough} overcome. I was enjoying a morning cup of tea, watching the sunrise, a rare treat here, and noticed a water bottle taped to the rail. An ashtray. "This war brought to you by the good folks of Philip Morris." I usually tell all of my patients to quit smoking. I have given up. How do you quit in a stressful war zone, surrounded by smokers? Unless they are going to die if they don't quit, then we have "the talk."
Had another medevac yesterday. Went off without a hitch. My secret? I said all day long, out loud, "this is horrible, nothing is going right. This is so screwed up, I can't believe it, wtf?" A little reverse psychology. Take that Medevac Gods.....

Chief cook and ...litter carrier.

Medevacs are a pain in the butt. They're complicated in the US, let alone from a war zone on a military airfield. Our favorite saying, "It is what it is." Last night I started working on a medevac. With out the benefit of Influenza A this time. I started the ball rolling and went to bed, my cell phone right next to my ear. No calls. Checked my email and everyone was notified that had to be and the process was moving along smoothly. Hmm, I thought, this can't be good. I then received the air ambulance itinerary which stated "the patient will be move tomorrow at 1550" Um, your tomorrow or my tomorrow? These things are coordinated in Virginia. Quick call to VA.They meant my today. Cool beans. Armed with my information I headed off to make morning rounds. I arrived early and briefed the Admin. folks (we usually call them "weenies" but I won't here) and waited in the ward for the docs. They arrived and the presenting Navy Captain said that I was working hard to get him a flight. I interjected "1550 today, sir." He responded, "OK, he worked really hard to get a flight." Score another point for yours truly. Back to the clinic I went, waiting for disaster. Had to be, this is KAF after all. Kept getting updates with the same ETA. Got a call from their dispatch center confirming the flight was coming. I told them that they had to go to a certain ramp and not that "other one." Then I got a call from the coordinating nurse with the aircraft tail number, type of aircraft and the Captain's cell phone number. Listen people, I don't deal with success well, please, I'm begging you, I need some bad news. None forthcoming. Then I got a call from the R-3 asking me to come with the patient to the aircraft. OK, cool. It is a 15 million dollar jet:
http://www.globalair.com/aircraft_for_sale/Business_Jet_Aircraft/Bombardier_Aerospace/Challenger__604_for_sale_59504.html
Me likey. I headed Down to the Role-3 and helped get the patient ready. He had been told that he was going to Germany. That's where all military casualties go. He is going to Dubai, to a civilian hospital, I told him. He had already told his family Germany. I promised that I would call them and straighten them out. I asked him if he had his passport. He told me that yes, he had it and it was in his black bag. The patient was loaded onto a world war two style litter that goes on wheels and taken out to the Navy ambulance, which was ancient. He was loaded onto the litter holder in the back. With me at the head carrying him into the ambulance. I'm a hands on coordinator. We then headed out to the airfield to wait. The aircraft arrived about 10 minutes late but as I looked out the window I saw this huge, beautiful airplane. As it taxied to a stop, the door opened and the ladder came down. "How are we going to get this guy in there?" I thought. Some other people had arrived to help us and everyone disappeared into the airplane to check it out. I was left with the patient in the back of the ambulance. I eventually got out and took his belongings to the aircraft. I had to climb 6 stairs to get inside and take a left at the minibar. The interior is amazing. Gorgeous. Luxurious. But not an air ambulance. There was no stretcher, no medical equipment, nothin'. There were two people in blue jeans who identified themselves as the Doctor and the nurse. Neither were interested in talking to me about the patient. The crowd cleared out I surveyed the situation. A settee had been converted to a bed with a couple of blankets on it. This was their idea of a stretcher. Which is fine if you can walk onto the airplane and kick back with a cocktail provided by the gorgeous flight attendant, but this guy was bed ridden and sick. And I needed an air ambulance. Not a flying palace. Adapt and overcome, that's what I do. I asked the Navy guys if I could keep their stretcher. No problem. I promised I would get it back. So 6 of us carried him up the stairs. The Captain informed us that all we have to do is angle his head into the cockpit. Sure, right. That didn't work. He told us that the handles on the litter retract. Sure enough, they did. I love this guy. He was English. Of course. Stay calm and carry on. It turned out that he and I ended carrying the guy onto the plane. I had to lift the litter up over the seats. I just kept thinking,"don't hurt the $15 million airplane." We got him squared away and I asked him again if he had his passport. He answered in the affirmative again (see where this is going?). I got a ride back to my vehicle and got a water,  I was nackered. I am not used to doing physical labor, after all. So, I headed back to the clinic, slightly pissed.
Just to let you know, I had to stop writing this half way through because my phone rang. The guy had forgotten his passport. It was in our HR department. In his other black bag. The UAE government wants to end him back to KAF. Much negotiations later, they let him in. His passport will be on a plane this morning. He is in the hospital.
I knew things were going too well. Oh, and during all these phone calls, there were two late night emergencies in the clinic. Can I go home now?

Ok, then something cool happened

We have a patient in the Role 3 ICU. He will probably need a medevac out of the country but I wasn't sure, so I went down to talk to his nurse and get some information because he was a military medevac from another FOB. I walked into the ICU as all of the physicians walked in. In the past I was not so welcome and often ignored. There is a new Chief Medical Officer at the Role 3 because the old guard has rotated out. He is a full Navy Captain and very nice. As I saw the herd of doc's walk in I started to slink into the shadows when I saw the Captain at the head of the line. He asked me what I was doing there. "Oh Oh," I thought, her it comes. I told him I was there to check on my patient. He then turned to the crowd, introduced me and told them that I was going to go on rounds with them. The crowd smiled and nodded at me and proceeded on rounds. After the presented my patient and was about to leave, the Cap'n turned to me and asked if there was anything else I deed to know about y patient. "No, sir, thank you." Then they left and the nurse proceeded to give me a report. Just like  real PA. I literally almost cried. I never wanted to leave. After the MPs removed me because I had chained myself to the bed yelling , "I am not an animal, just a contractor, please let me order a test or treatment, anything!" I went back to the clinic, once again marveling about how weird my life is. From stressing about dumbasses taking pictures of my trash can to rounds in the best trauma center in the world. All in 36 hours. Emotional roller-coaster much? Now to get work on that guy medevaced out of here. Just another day at KAF...

How things change

I am much calmer now. To a point. We have a shitty sign in front of the clinic. It is constantly being sandblasted by the wind here. It is a shitty, sandblasted sign. It is not painted. It is made of tape. A taped, shitty, sandblasted sign. We have asked for a real sign. A real, painted sign. I have asked for one for 6 months. We still have out same, sagging, sorry ass  sign. And we have been issued a violation for it. "Poor signage" the violation reads. "No shit," says I. Poor, shitty, sandblasted signage. You're kidding me, right? Nope. But wait it gets better. Really.
It's hard to describe how this all works. Who all these people are and their relationship with us is a two hour lecture. Basically as a subcontractor we fall under "subcontracts." Which is a division of Dyncorp under the LOGCAP IV project. And there is a guy in charge of that department and his second in command. His second in command, lets call him Barney Fife, is the one taking pictures of our clinic, etc. Well, he's gone. We are all part of this subcontractor group, and we are doing a good job. Too good. We are getting praise from the big bosses and demanding that they live up to their side of the contract. In return we are getting this childish BS. Anyone who knows me knows that I have zero tolerance for this crap. I have spent my life fighting injustice. So, sitting on the sidelines is not an option for me, but that is what I was told to do. So, sit I did. And fume.  In the morning I announced that if this "harassment" doesn't stop, I am going home. And driving right to Diane Feinstein's office. Without even taking a shower first. I used the magic words, hostile work environment. That got their attention. We filed an ethics charge, which they had to answer. And they did. The corporate lawyer was here, was briefed on the situation and said in his most lawyerly way, quote,"that's bullshit," unquote. So Barney Fife is out of here. His boss has apologized to us as a company. There is a new person in charge. And our violation for poor signage, revoked. I guess that in itself was worth the fight...

It's not all fun and (scottish) games...

"I've always been crazy, it keeps me from going insane," says Hank Williams, Jr. I don't take anything seriously. Life and death, whatever. Rule #1-don't sweat the small stuff, rule #2-it's all small stuff. My coping mechanism is to try and find the humor in things. Don't get me wrong, I have overcome the juvenile class clown attitude of a 14 year old, and am serious when it is appropriate, but will say something stupid at the (mostly) right time. It is, as they say, how I roll. But lately I am having trouble laughing somethings off. I feel that as a leader I have an obligation to stay professional, lighten the mood when appropriate, and not let little things bother me. And, trust me, there are a lot of little things. "Semper Gumby," my email says. I am new to the contractor world. There is politics and bullshit in every job. Here they are unbelievable. We are a subcontractor to Dyncorp, International. They contract to the US governmet. We are contracted to provide healthcare to their employees and other subcontractors. We kick ass doing that. We are asked to do a lot. We are promised equipment and space, tents, buildings, etc. that doesn't materialize. We adapt and overcome. Move forward, that's our attitude. We are doing physical exams starting at 0500. We are supposed to have a tent to do them in. Nope. So we are doing them before sickcall. They want us to do 20 a day. Right now we are doing 5. That's all we can handle. We could push out 20, but it would kill us and, Dyncorp would say,"you're doing 20, you don't need extra space." We get punished for our success. I announced that we have to fail or we'll never get the stuff we need. We are constantly being praised for our achievements and how well we treat our patients, which has lead to jealousy from other departments, including the manager of our contract. It is freakin' crazy. We are constantly being secretly inspected and told to clean up our clinic. We live in the desert in a shit hole. We are surrounded by people who just throw their garbage on the ground and it blows onto our compund. People walk through our compound smoking and think that the whole base is one big ashtray. We clean up every morning, including policing the grounds and picking up every little piece of trash and cigarette butt, including used toilet paper and water bottles from the port-a-potty in front of the clinic. It is what it is. Not good enough. They wrote us up for "signage." We have asked for a painted sign instead of the sign made from tape that has gotten sandblasted by the desert winds. Did they give us one? No. Did they write us up for a shitty sign? Yes. Please. Every morning they come and empty our garbage cans for us. We generate a lot of garbage. We have asked for a dumpster but have been declined. Ok, we'll deal with it.
Someone came to clinic claiming to be an employee's boss demanding that he be seen at lunch time. The guy had a cyst on his head. Not an emergency I told the "boss." "Yes it is," says he. " No, it's not," says I. Round and around we went.  I finally asked him if he was a doctor. Of course he said no. Then he asked me to define an emergency, which I did. I finally went and got our manager. "You deal with this idiot," I said. We kept telling this idiot to come back at 1600 (4o'clock) for sick call. Karki and I went to lunch. That's how we dealt with the situation. We came back and the Bozo was back at 1400. 200 hours early. OK, I'm not good with military time)
"You're kidding me," I thought. Fine, I went and got the Doc to deal with this guy that had a cyst that we weren't going to remove.
Turns out it was a set up to get us to violate HIPPA, the federal privacy laws. Earlier his boss had come in. Twice. Not at sick call hours. He bandied the big bosses name around. Fine, we'll see you. Then he went back to HQ and claimed that we had refused to see him! Then he came back two days later and did it again. We saw him straight away but he ran back and did the same thing. You are kidding me.
The last straw was two nights ago when we caught the alleged "boss dude" taking pictures of our full garbage cans, This is the underling of the liar. They are all nuts. He jumped into a convoy of three SUV's and sped off into the night with pictures of our trash cans full of...trash. Waiting to be picked up by the trash man. This stuff has got to stop, or I'm going home.
You can't make this shit up...

But think about all of the overtime that we're making...not!

For the first time in over 20 years I will not be at the Scottish games. I am going to find a Scottish regiment and demand that they start tossing cabers, eat haggis, and start playing the pipes. I'll let you know how that works out. "Has anyone seen Mark? Last I saw he was cutting down a telephone pole, blowing into a vacuum cleaner, and asking about sheep. He's been locked up..."
Every medevac here is complicated, last night was a nightmare. And it wasn't even my problem. A patient arrived from the US and was heading to his fob. He became ill on the flight and was dropped off at our medic's. They are out of my AOR so they tried to call their hub but the PA was busy, so they called me. I suggested that they should take the guy to the military to get a chest X-ray, which they did. He ended up getting admitted to the ICU with pneumonia. He's a smoker so he had some additional problems. The CO of the Role 2 that he was admitted to wanted him gone, ASAP. We tried to get him to medevac via the military to KAF so we could get a civilian air ambulance here. It's just easier. No way, Jose. Hmmmm? I tried having our Role 3 call him and offer to take the guy. Nope. "He's Dyncorp's problem," said the Major. Meaning, he's my problem. So to hatch a plan. He needs oxygen, which you can't carry on a commercial airline without certain requirement being met FAR 135.91 to be exact. I remember this from my air ambulance days. Has to be in a hard case. Don't have one. Can be in a soft case as long as it protects the regulator. Nope, don't have one of those either. Just a huge pelican box. Fire department? Not one at this fob. My favorite saying in this case, shit. So my plan, smuggle the guy, a medic and oxygen onto the plane. Seriously. According to the manifest, only room for the patient. Double shit. Some poor bastard is going to get yanked off of the plane. In the mean time his medical records have been emailed to me by the role 2, turns out he has been caught smoking in the bathroom. Of the ICU! You are kidding me! At least he took his oxygen off. His oxygen saturations drop below 88% off of 02. 94% is considered good. Say it with me, "Dumb ass." No wonder they're pissed at him. So, now what? Dennis is covering at the hub that is in charge of this fob, so he is the POC, point of contact. But my phone is the only one that works 24 hours. So at 1100 at night, 2300 in our speak, my phone rings, it's the air ambulance company wanting information. Their dispatch center is in Washington, DC so no problem for them. I talk to their PA and give him the run down. He is very confused. Trying to explain this stuff to people is , well, a challenge. You really can't make this stuff up. He finally gets it and tells me that they will call me back with an update, which they do, at 0400. I am now trying to coordinate a medevac, sneak a guy, a Medic, and a hidden oxygen tank onto a plane in my pajamas from my room. "How the plane got in my pajamas, I'll never know..." We formulate a plane. I have set a Skype conference call from my MAC in my room. I have my cell phone in the other hand. All very high tech. Thank goodness for Skype and messaging. We have come up with a very elaborate plan. James Bond would be proud. We are set to go. 15 minutes until the plane lands. The patient has been kicked out of the Role 2 and is now in our clinic, using up our oxygen. Then my phone rings. This can't be good. But it is good news. They will send a plane to the fob. Excellent news. I tell the crowd on Skype that our prayers have been answered. Then the phone rings again. Oh Oh. No plane landing, disregard, Triple shit. Back to plan A. It is now 0700. Still in PJ's. But I have made myself a cup of tea. I am English, you know. Phone rings again. I am afraid to answer. They have found a helicopter to come up and get the guy. Does it have oxygen, I ask. Yes it does. Cool beans. I alert the Skype crowd. We cancel our plane plan. Meanwhile our medic has caught the guy in the bathroom, smoking. I give him permission to give him a fatal injection. Dennis says just to break his knee caps. He's forgiving that way. Dennis wants to talk to "the asshole." Dennis gets him on the phone. I run and shave and brush my teeth. Apparently Dennis put the fear of God him. Or as the Medic said, "half of his ass is in the tent." I pulled his medical record, under nationality it said, "Native." Hmm, dude you're from Texas. You don't seen Navajo to me. We looked at his dental xrays. His missing about 10 teeth. Getting the picture? While we wait , I dash to the shower and run, literally to the clinic. Takes many hours and many oxygen tanks, but the helicopter finally arrives and takes the guy to KAF. To someone else's clinic.  Yeah, baby. I go over there before the patient arrives to brief them. They have no idea that the guy's even coming. Of course they don't. I leave and monitor the progress. Phone rings. Helicopter can't find patient. Medic can't find helicopter. I finally put them together. Long story short, he got here. Waited and is now in Dubai. Man, I would much rather be at the games...
By the way we don't get overtime for Labor day. Bummer...

Welcome to your physical exam, now go home..

This has been the kick of week for us doing in-country physical exams for people who are overdue on their yearly physicals. The are people who have "re-upped" of have come from another company. We are doing with the same amount of room and staff.  They want us to do 20  day. I told them 5. The process starts at 0500 (5 am for you civilians) I'm all for that. My day doesn't start until 0700. But, I'm there in spirit. You start by getting fasting labs drawn, so nothing t eat after midnight and no breakfast. Or coffee. Could it get any better for them? Ten you get an Xray your hearing tested ad maybe an EKG. Then you see the Doc for your "face to face"and then you can go to breakfast. All before . Karki is a miracle of efficiency. "Be reasonable," I say, "do it Karki's way." The rules are all under "MOD 10." The Army's guidelines for your physical fitness in order to be in theater. We live and die by MOD 10. The joke is ,"don't go to medial, they'll send you home." We call it "DQ" not Dairy Queen, "disqualified." We call Dennis the double D. "DQ Dennis." We bust you for blood pressure and weight. Yesterday I sent 7 people either home or to Dubai for medical consultation. And that's based on only 5 physicals a day. What am I going to do when they build us a tent, get us extra staff and we do 20 a day? We will have to hire someone just to write referrals and send people home. Hm what should we call that position? Oh, I know, "THE TERMINATOR>>>>"