Saturday, November 27, 2010

Thanksgiving Day Entertainment for the Troops

In the tradition of Bob Hope we had some pre-holiday entertainment when a Country & Western Performer called Aaron Tippin arrived on Tuesday, November 22 to entertain us. I've never heard of Aaron Tippin but apparently many soldiers did and there was certianly a core group that were over the top thrilled. Tippin felt right at home with the troops at COB (combined operations base) Adder and he's had a tradition of traveling to military bases to entertain the troops during the holiday seasons. Tippin also stated that when he first started doing these trips, about 20 years ago, he traveled with Bob Hope so he's a living link to Bob Hope's tradition of entertaining troops during World War II.

I doubt I would ever go somewhere on my own to hear a Country & Western Performance but I do like the music and this was a great setting to watch the performance and we didn't have anywhere else to go anyway, Most of my TMC (troop medical clinic) unit went and we did enjoy it.

If you want to know more about Assron Tippin click here.

Major Marty

These Thanksgiving Day Displays were set up outside our DFAC (Dining Facility)

Monday, November 22, 2010

Major Marty's Newest Pictures!

Click "Read More" to see all the new photos!

In case you we wondering, THIS IS WHERE I LIVE

This is my CHU, or Containerized Housing Unit. Notice the size of each of the three units. Mine is the one on your left. Amenities include bomb shelter and blast walls.

Earlier in the blog I described first going to CONUS (Continental United States) Replacement Center at Fort Benning, Georgia and I included two pictures of myself along with my three bunkmates.  This is a permanent structure and we were staying in a real building aka a "hard building" which means a permanently constructed building.  When I got to Kuwait that base has probably been open a few years and maybe after the mission in Iraq is over it will be closed. So for the time being the set up is a large tent built over a concrete floor.

I'm not completely sure why but at my base in Iraq a few years ago, they decided to stop using tents and they brought in what are basically small sub-divided trailer parks called "Containerized Housing Units" call CHUs (pronounced chew). They are basically shipping containers roughly divided into thirds with connected electrical wiring and a built in heater & air conditioner.  The enlisted personnel and the officers below the rank of Major live in CHUs built for two single beds and do not have water and these are called dry CHUs) so the occupants have to go outside to a bathroom/shower that's been installed in either a big trailer or in two separate trailers that are joined together. 

The officers from the rank of Major (which includes me) and up are given the courtesy of a private but even smaller CHU that is only big enough for one person but it does contain a bathroom and a shower and it's called a wet CHU.  The shower is okay but the water pressure is so poor that I try not to use the bathroom and instead I prefer the outside latrines.

If you'd like to see an actual tour of a Chu at Adder I found one on youtube:

If you’d rather skip the Youtube tour I’ll describe it and it won’t take long because there’s not much to say.  There are electric lights with outlets, a small single bed, a single chair and a small wardrobe closet plus a very small bathroom.  There are obviously no cooking facilities since we go to mess halls, which are now known as the DFAC , which is short for Dining Facility.  It’s a generic room for one and if you had a guest it would be a challenge for both of you not to become claustrophobic.  

Officially we are allowed to have guests in our CHU but only of the same sex and the army doesn't mess around with this.  We have been told repeatedly and emphatically that we will be severely punished and prosecuted under the Uniform Code of Military Justice if any member of the opposite sex is allowed in your CHU. It's uncanny but these are the army rules. (The army also has very strict rules about officers "fraternizing" with enlisted personnel and because of a scandal involving drill sergeants several years ago they have zero tolerance for sexual harassment.)


In the previous posting "This is where I Live" CHU was listed as an abbreviation for "Compact Housing Unit"
This was an error.  CHU is actually an abbreviation for "Containerized Housing Unit.  The correction has already been applied.

Tuesday, November 9, 2010

Sick Call At The TMC (Troop Medical Clinic)

The soldiers were waiting for me in great numbers as soon as I arrived.  Of course not for me personally, they are waiting for the "doc" and trying to take advantage of their down time.  In return for joining the military and agreeing to serve wherever they are sent soldiers are assured that they will be provided with all their basic necessities including medical care.  Getting it to them is the responsibility of their officers while in this case they simply have to show up.  Once they've checked in they can take advantage of their down time.  Soldiers often have to work extremely hard but they are also accustomed to being asked to wait and almost no one is worried about how long the wait is going to be.  They've been accounted for and it's all out of their hands. 
Sick call means you show up and wait to be seen since the TMC (Troop Medical Center) doesn't make appointments.  Military medicine is now highly computerized and it's gone from being a backwater medical service to among the most advanced and highly computerized medical services anywhere but at this location everyone is urged to come at 8am when we first start seeing patient because it's first come first served. It's all very similar to how most things are done in the army and nobody is surprised.


I'm staffing what's known as a Level 1 Battalion Aid Station (BAS)  but in this setting it's also referred to as the TMC .  This is the entry level medical facility and there is also a small army hospital, know as a level 2 in the vicinity

During a war when the front is actually changing the entire facility is packed up in trucks and can be on the move rapidly.  During hostilities you don't wait until the wounded arrive you anticipate it.  Ideally the the medical command is briefed as to when an offensive is going to take place and they should try to set up their BAS as close to the front as possible so that you're fully staffed and waiting for the first wounded to arrive.  Fortunately, even though there are explosive devices and some firefights on the roads daily, Camp Adder & Tallil Air Force Base has a very secure perimeter and we only have to infrequently worry about rockets and mortars.  

There is a lot of history associated with my base.  The building I'm in was part an Iraqi Air Force complex and was reportedly part of the operations center for Sadaam Hussein's cousin and henchman, Ali Hassan al-Majid, the notorious Chemical Ali.  The planes that dropped poisonous gas on the Kurds as well as on Iranian targets during the 1980 - 88 Iraqi-Iranian War took of from Tallil.  What a terrible history but at least this section is now a health care facility.

At enormous expense all building including our housing units have been surrounded with 20-25 foot high reinforced concrete walls known as T walls, which are lifted and positioned by cranes to protect against rockets and mortars.  In addition to the T walls all structures have nearby bomb shelters utilizing the reinforced concrete that are also covered with layers of sandbags.

My Aid Station (or TMC) like many facilities is understaffed.  The doctor I relieved actually got on the same military plane to leave Iraq that I arrived on so we never got to even speak to each other much less sign off.  There's supposed to be a physician plus at least two Physician Assistants but for now I'm it. 

On the day I did arrive I was very pleased to learn that the army hospital has assigned one of their physicians, Dr Findlay, to staff the TMC until I got set up. When I met Dr Findlay I could immediately see that she is simply a class act and a great physician.  She's an experienced army physician and one of those very special people.  She has three young children including an infant and her husband is also an army physician.  She has several more months at Adder but says when that's over she'll be leaving the army so she can spend more time with her children.

Given that they're so short of medical providers I'm surprised that they're allowing so much time for my orientation until I discover what I believe is the answer is.  The answer is computers & technology.  I soon learn that in order to start seeing patients I need to be up and running with either four or five different computer systems each with it's own user ID and passwords.  I've also never seen such requirements for user names & passwords. My main password has to be entered twice for each individual patient and it has 16 separate key entries, which must include several upper case and lower case letters plus several additional symbols.  Only the army could create such a monstrosity.

The soldiers are waiting for their doctor to get ready and I'm over ripe to finally get started.  I've gone through all the years of my medical training and went on to run my own practice for eighteen years.  I turned eighteen in 1969 while the Viet Nam war was escalating but Uncle Sam left me alone because I was registered at City College of New York. 

Even though I was at best a fair student who consistently underachieve the student deferment held and I was never drafted.   Long after the Viet Nam war ended I somehow completed my undergraduate education and went on to become a physician and three months ago I recertified in Family Medicine for the third time.  Six years after 9/11 I crossed paths with a National Guard medical recruiter who looks me in the eye and tells me that the army desperately needs physicians like me. The deal is one weekend a month, two weeks a year and 120 days of active duty with 90 days in theatre if there's a national emergency and I'm called up.  Yes, there is a national emergency now, the same one that started on 9/11.

The army would still take a full year to process my application and slowly things start to move.  I'm sworn in and I go to my drills for almost a year and I'm scheduled for my four weeks of basic training.  The weekend drills do not seem significant and my life really hasn't changed one bit until months later when I'm given a deployment date and then it all changes rapidly.  The past was all an abstraction with privileges, then preparation and now it's show time.  I'm pretty good with the first three computer systems, the fourth I'm still sketchy with and I'm not going to get oriented on the fifth one until the following day.  I'm now in "theatre" and I've decided that I'm going to start in the morning and everything else I'll learn on the job.  

There are four medics who will be working with me and they are the greatest.  They've been in the infantry and some of them have worked in the convoy escort vehicles. They couldn't be more welcoming and seem so glad that there's a physician for this TMC.  Meanwhile I'm trying to express to them how honored I feel to be able to work with them and contribute something to this war which will have lasted ten years before my enlistment is over.  This will be my first day treating patients in a war zone and for the moment everything has come together to make this a first day for me unlike any other first day of my career.  I want to give thanks that I have been allowed to treat our soldiers and I pray that I will meet their needs.

The day has flown by and I hardly realized that I should be taking breaks. Every day is similar and if it wasn't for all these computers and the passwords that take forever to enter I would be even more productive.  Now I understand why it's called An Army of One".     

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