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...