Sunday, November 13, 2011

Kandahar 13

In regards to Dorie Mattson’s opinion piece, “Military students thrive in, enhance the classroom”. In her essay about teaching for the University of Phoenix, Ms. Mattson says all the right things about our military members, legitimizes herself by pointing to her own family military heritage, quotes St. Colin Powell (the patron saint of the post-9/11 military), and even goes Biblical by quoting St. Peter himself. Well done.


http://www.stripes.com/military-students-thrive-in-enhance-the-classroom-1.160468



Although some of the initial calculations may have been off when the story first broke, the fact remains that for-profit universities are absorbing huge amounts of US tax-payers’ money from the GI Bill; generally, they are not giving our active duty members and veterans very good educations.


No serious employer in a serious profession takes the University of Phoenix, DeVry University, or any of the others of their ilk, seriously. End of story. And that’s bad news for our veterans who are trying, and failing, to find work after finishing service in the military (also a frequent topic in recent news).



http://www.stripes.com/news/senators-blast-rise-in-gi-bill-funds-going-to-for-profit-colleges-1.155864



http://www.stripes.com/news/senate-officials-acknowledge-error-that-inflated-gi-bill-money-to-for-profit-schools-1.160028



http://ap.stripes.com/dynamic/stories/U/US_OBAMA_VETERANS?SITE=DCSAS&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2011-11-12-06-04-45



While Ms. Mattson is ostensibly sincere in her praise for the active duty and former military members she teaches, I still find her essay to be little more than a glorified promotion for for-profit “higher” education. I find it disturbing and a disservice to military members that your newspaper continues to publish such pandering opinion pieces (of garbage) from people associated with these education corporations (particularly the piece by a former general officer who is employed by them). Not to be outdone, allow me to quote St. Matthew as it relates to the topic: “Beware of false prophets, which come to you in sheep’s clothing, but inwardly they are ravening wolves.”






Sunday, November 6, 2011

Kandahar 12

I've discussed, ad infinitum and nauseum, the extensive uniform rules in a previous post. Each of the US services has its unique patterns and patches, and within each service there are multiple other uniforms for whatever purpose, real or imagined, they supposedly need them. It seems there are almost as many reasons for the many uniform variations as their are reasons for fun runs, although I have yet to see a pink camouflage "breast cancer awareness" uniform. But it's coming. Trust me. Everyone loves boobies.




Madam, I salute you!



Each country also has its own unique uniforms. The French, in particular, have “fashionably-cut” uniforms, which flatter some of their female troops’ ass-sets; however, I could do without the “no-secrets” fit on the dudes. “Uh, iz dat a saucisson in your pokette or ahr you zhust happy to see moi?” And their flightline mechanics can wear a variation with shorts, which just looks - and I intend this only with love and no disrespect - totally gay.





Gay or French, you ask? ... Oui!

Brian Montenegro told me about his semester at sea during college when the group went to a bath-house in France somewhere, if I remember correctly. There was a statue of a guy with his junk on full display. The guide at the bath-house tells the group, “Uh, probably you noteeced ‘dere iz a penis on dee wall.” Then proceeded to assure them that, “'Deez iz not pornography ... uh, deez iz art!” It’s funny because they’re French.


One of the flight docs here has a similar problem with his flight suit uniform, which is basically just a onesy with a zipper in the front and some other cargo pockets. His just fits way more snugly than it should. He also wears dark-rimmed glasses and looks like he could be Harry’s long-lost Muggle brother, so Joe and I have decided to call him Henry Potter. Or “Hank” for short. His real name is Jason, but who cares? Not my problem. Henry Potter will just have to do.






The British troops probably have the best uniforms, and they wear them with great aplomb. The Canadian guys call the Brits “the Beatles” because they saunter around with their fashionably-shaggy haircuts, long sideburns, designer sunglasses worn on their heads, and often wear their uniforms without undershirts. These are all acts that go against the Hammurabian code ("eye for an eye, tooth for a tooth") of proper military grooming and uniform wear which most of the rest of us follow, and which would probably result in punishment just as severe if we were caught in defiance of it. There aren’t as many of the British troops who are as “royal family” looking as I suspected, by which I mean to say that they don’t look nearly as inbred nor appear to generally have the poor dental hygiene we Americans typically assume about our English counterparts.

Saturday, October 29, 2011

Kandahar 11

I missed a couple of now-obvious ones in the last update. When describing bathroom noises, I might have mentioned “Colonel Colon” playing his “booty flute.” Also should have added something like “snag yourself in the nostrils when wiping out the hostiles.” And, I should have said that, after my friend’s husband took a hit off his asthma inhaler, they continued make “sweet, wheezy love” instead of “sweet, sweet love.”

It wasn’t Lawrence this time that made the loud booming noise that shook the building and startled all of us a few weeks ago – it was a vehicle-born IED (improvised explosive device), basically a truck with a couple hundred pounds of explosive mixed in a tank, that a couple of insurgents drove up to the outer barrier of the base and set off. It was pretty impressive; shook lots of buildings on base and created a mini-mushroom cloud. No one was actually able to get onto the base, but things locked down for a couple of hours, people had to actually put on their body armor and patrol the compound, and we had to post guards at the entry points to all the buildings.

Later that night, a guy from EOD (Explosive Ordinance Disposal) came to the clinic because of an ingrown toenail. For some reason the power was out, so we were sitting out front, just talking. It actually would have been a nice night to just BS if we weren’t in a combat zone and all. I told him we’d wait a few minutes to see whether the power would come back on, but worst case, we could try removing it by flashlight.

When others inquire what EOD does, he asks whether they’ve ever seen The Hurt Locker (which could be a euphemism for soo many things, e.g., the cramped bathroom stalls in our living quarters). If so, he tells them that it’s sort of like that, but without the Tim-Cruise-in-Top-Gun maverick cowboy antics. In fact, one guy I spoke to told me that any EOD who acted like that probably wouldn’t last very long, either from blowing himself up dead or the other guys in the squad putting an end to that kind of reckless behavior pretty quick. He spoke pretty nonchalantly about having seen and knowing guys who’ve gotten hurt or killed by IEDs. It’s part of the job, I guess. One of those things you just get used to.

The defining feature of this war, really, is the ubiquitous use of IEDs. Sure, there are some complex attacks against bases – coordinated assaults where multiple insurgents try to breach security and hit high-value targets, e.g., like the VBIED the other day - but these tend to be the exception. There was another attack not too long ago on the FOB not far from KAF where they keep fuel supplies. And while there are more than a few of these, most of the attacks on US/coalition forces are by IEDs.

IEDs have become especially effective since troops have been encouraged to patrol on foot. Foot patrols are seen as more compatible with the “winning hearts and minds” strategy than driving around in Humvees, or perched high atop an MRAP (Mine Resistant Ambush Protected) vehicle, looking down on the locals. Unfortunately, the trade-off for trying to win hearts and minds has been the loss of arms, legs, and genitalia; and I’m not being facetious. There was an article in a recent Stars and Stripes (military newspaper that is surprisingly much less biased than I would have imagined) about how kids are getting their testicles blown off, damaged beyond repair, or else having them removed during the resuscitation/stabilization process when they arrive at the surgical units on bases.

I asked a surgical nurse who I recently met about it, and she said that there has been some serious discussion about this specific issue. There’s a question of whether the military should start offering sperm banking services; at the very least, whether they should counsel the kids, who will potentially be going out on patrols and be exposed to IEDs, about whether they have plans to have children, and, if so, giving them information on sperm-banks.

The insurgents come up with all kinds of ways to kill people dead with IEDs. Recently, they’ve put them into turbans and have killed Afghan government officials as well as another very popular and respected leader who many thought could have been instrumental in brokering some new, more peaceful equilibrium in the situation here. They’ve been using young children as well, brainwashing them, which is very not cool.

A few weeks ago, an Afghan woman, apparently legitimately injured in some sort of vehicular accident, was brought onto base and taken to the hospital. When someone noticed wires among her clothing, they did a more thorough search and found she had an explosive vest strapped to her body; fortunately, they were able to disable it safely. I don’t know whether the vehicular accident was opportunistic for some nearby insurgents who happened to be in the vicinity, or whether they caused the accident with the express intent of turning her into a suicide bomber.

The article went on to say that there are a lot of these kids who say they’d rather lose an arm or leg than lose their “third leg”; in 2010 almost 10% of casualties in Afghanistan had genitourinary injuries. It’s become enough of a concern that these kids are being supplied undergarments made from heavy silk (and there’s a design underway that also integrates Kevlar).



Is that an M-16 in your bomb panties or are you just happy to see me?



These ballistic boxers are supposed to provide additional groin and femoral artery protection against IED blasts, and some patrol leaders have started checking to make sure their guys are wearing them before they head out. Some guys apparently call them their “bomb panties.” The tagline for one of the products goes: Protection for your privates, both literally and figuratively.

Wednesday, October 5, 2011

Kandahar 10

Saw another guy from security forces in my clinic the other day, so I asked for an update. He had some interesting stories to tell. He does a bit of traffic-related stuff here and there (says they caught someone doing 65mph and the max speed limit is 40kph, or about 25mph), but tries to avoid that as much as possible; much more interested in doing base security, snagging bad guys and all. As I mentioned previously, there's a lot of contraband, so he catches plenty of people with alcohol, primarily contractors.

There are drugs as well, and he busted a tent full of Army guys one night who were smoking Spice ("They'll let anyone in the Army," in his words). Spice is an umbrella term for various synthetic canniboids, chemicals related to THC, the psychoactive substance in marijuana. It doesn't show up on routine drug screens, and apparently the K9s either can't or are not trained sufficiently to sniff it out. It's garnered quite a bit of attention over the past few years and initially was sold legally in smoke shops, though it has since been ubiquitously controlled and/or banned internationally. He said he found 7-8 lbs of the stuff, which suggested they were probably trying to distribute it.

He randomly goes to the dining facilities where many of the TCNs (third-country nationals) usually eat. They conduct line-ups and random searches at that time in addition to the other more targeted searches they perform based on intel received. Occasionally, they've found TCNs with components to construct IEDs and every so often there are reports of suicide vests; fortunately, none of them have been used. Every now and then they'll confiscate USBs and cell phones, too, which the TCNs are not supposed to have with them. Someone will use a camera to take photos or video of whatever it may be they or others might want to know (the flight line is a definite "no pictures" zone), and then they transfer it to the USB in order to smuggle it off base since it's much easier to hide a USB drive than a camera.

Vehicles go missing at times, usually the Gators, little open-aired gas-powered golf cart like utility vehicles. Whoever steals them will paint them a different color, and although sometimes they find them and return them to their original owners, often they simply disappear. Other larger vehicles - work trucks with hoists and even heavy machinery - have been driven right off base and sold in downtown Kandahar. Some of these vehicles cost over $100,000 and are sold for $10-20,000. Apparently they just drive right through the front gate and no one stops them.

If you know what to look for or who to ask, there is a bustling prostitution industry going on as well. Some of the women who work as vendors at the boardwalk are from the Philippines and Kyrgyzstan, and I guess there are some military women who occasionally offer their services as well. The vendorettes make something like $500 per month, but can pick up an extra couple of hundred bucks a week for a few minutes of extra work, or seconds, depending on the guy's stamina, I guess. As an aside, and speaking of stamina, I had a friend back in Boston who told us that her husband sometimes had to stop and take a couple of hits off his asthma inhaler before he was able to continue with their sweet sweet lovemaking. That should be a scene in an R-rated comedy if it isn't already.

Anyway, he told me that one girl lost her job and had to head back home. Airport security inspected her things and found $50,000 in cash in her luggage. I wonder whether she wasn't transporting money related to other illicit on-goings for other people, but she said it was all from prostituting herself. I'm no mathlete, but even if she was charging $200 per poke (probably a generous estimate), that would be 250 pokes; if she gave any discounts or "Buy 4 Get One Free” coupons, that number goes up even more. That's a lot of pelvic exertion. Hope she's keeping up with her Kegels.

This guy says he loves his job. "It's my favorite deployment by far. It’s like the Wild West out here." I admit that I live in my own head a lot - I'm the guy with his nose stuck in a Kindle, reading while walking to and from the dining facilities, boardwalk, etc. - so I'm usually not up on a lot of the gossip that goes on wherever it is I work. But, that we don't hear about most of this stuff that goes on suggests that these guys are doing their jobs fairly well, and I respect them for it.

I have my own struggle for survival going on every day – me vs. the Taliban flies. I hate those little effers. They sneak into our clinic and seem to congregate in the office I share with Joe. They're not like our American flies, either, and not just because they don't speak any English. American flies are, well, more like Americans - pretty content to just hang around your food, get fat, and then develop diabetes and die. The Taliban flies are wily and wiry. They buzz around your head and bite at you. I swear they've declared jihad on my face and the back of my head. I've become pretty handy with the fly-swatter.

And speaking of pesky bloodsuckers – contractors. I'm not a very big fan. They've been on our compound over the past couple of weeks. The American contractors mostly just stand around and watch while the TCNs do all the work - electrical wiring, new lighting, and cleaning air-conditioning filters. I saw one guy in our computer room for hours many days, drinking coffee and surfing the internet, and it seems they’re always on break. One morning I was "minding my own business" in one of the bathroom stalls and the door opens. Whatever - it's a communal male bathroom, no big deal. Then a female voice asks, "Is anyone in here?" - Um ... yes. - "Oh, well why didn't you say something?" and she headed back out.

Why didn’t I say anything?! Who says anything every time a public bathroom door opens – or ever, for that matter? I don't know how it works in female restrooms, but there are rules when more than one guy is in a male bathroom at the same time: for instance, no using the urinal just adjacent to another guy if it's possible to leave one open (only possible if there are three or more urinals); keep your conversation to a minimum - a simple "Sup?" with a slight head tilt/chin lift will usually more than suffice; and, as with gorillas, use extreme caution with making prolonged direct eye contact as it can be interpreted as a sign of overt aggression. The only people who tend to break these rules are drunks at a bar or club and “anti-homosexual” Republican congressmen in airport bathrooms. Just saying.





Keep direct eye contact to a minimum


And we certainly don't announce ourselves every time someone opens the door. I have to work with these people – I don't want them to know it was me blowing out my bowels on the toilet bowl, and vice versa. I don’t need to know that General Johnson or Colonel Smith was the guy in the stall next to me making noises from his “bum trumpet”, his “stench French horn”, his “ass saxophone” - you get the picture – noises so unearthly that they strain (no pun intended) the limits of what should be physical possibly. Really it comes down to a matter of maintaining proper military respect, bearing, customs, and courtesies.

In college one morning I dreamt about being back home. I was hanging out with Megan (my little sister), who plays the violin. I asked her to play something for me. She at first refused, telling me that she wasn’t any good, but I continued to encourage her to play something, anything. She finally relented, picked up her violin, then proceeded to strum a note on one of the strings. Duh-duh. The string was a little out of tune, so she told me she had to adjust it, and so she kept playing that one note over and over. Duh-duh. Duh-duh. Finally, I came out of my sleep and realized I was a dreaming; I also heard once again the sound of that un-tuned string – duh-duh – and at that time realized that my roommate was farting in his sleep across the room.

So I finished up my "morning chores" and walked out and past this woman, who was standing outside the door, leaning against the railing at the top of the stairs. She is a prime example of a "booty-do." If you don’t know, a booty-do is a woman who's so fat that her stomach sticks out more than her booty-do. The male counterpart is, of course, the dickie-do; not such a rare creature anymore, this species is so fat that he can't look down and see his own wiener (that’s my one allowed wiener reference for this update). I didn't say anything to her as I passed and walked down the stairs, but I heard her say "Hey baby!", and then she must have puckered her lips because I heard her make a kissing sound. Gross.

Since we're talking about the bathroom, the JAG here (his name is Lance), stopped by the other day to ask us some questions about sanitation and hygiene; specifically, they pertained to the implications of someone peeing in a water bottle at night in their room and then throwing those urine-filled bottles away the next morning in the bathroom garbage can. Yes, this is actually happening. And it's not a phenomenon isolated to a single pod. It’s not like our sleeping areas are located a couple of hundred yards away from the toilets, or it's freezing cold outside, or there are rabid animals prowling about (just rabid Taliban flies). Not that any of those situations would make it OK, but I might sympathize a little. Every single row and every single floor of our living pods has its own bathroom and shower room. If you're sleeping at the other end of the pod away from the bathroom, you might have to walk 20 yards to reach it, if that. Joe had to go to the commanders’ meeting and brief them about this. Most of them just started laughing and couldn’t believe it, either.

So accessibility is pretty good, but one problem once you reach the bathrooms is that the stalls are really narrow and short, not leaving a whole lot of room to maneuver. I don't know whether they were made for Chinese people, or just made in China, but it's a very tight fit in there. If I’m in there for more than a few minutes, my patellofemoral syndrome (runner’s knee) starts acting up a little. We usually call it the “theater sign” because your knee will ache if you’re sitting in a cramped movie theater seat, but I think the “Chinese torture chamber sign” works, too.

I’ve never had this particular conversation, but I’m assuming I’m like most people who like a little leg room when casting out one’s digestive demons. Being scrunched up prevents one from being able to relax all those pelvic floor muscles and associated sphincters in order to allow easy passage of one’s “dark passenger” (that’s a Dexter reference for those of you who watch). Tell me if I’m wrong about this, but I don’t think so.

Another problem is that there's very little head room in front of you. This makes maneuvering yourself onto, and off from, the toilet seats a bit challenging. One's natural inclination is to bend forward a bit to counterbalance and control one's downward momentum onto the toilet seat; likewise, it helps to have a little momentum, by throwing your head forward, when you stand up. But, with the door so close, you end up hitting your head on it, or you have to try and dead-lift squat yourself up from the toilet seat. This is especially precarious if you've been sitting there for a while, your leg falls asleep, and isn't back to full functioning.

And forget about it if you have your uniform and weapon with you. It’s a nightmare trying to take off my gun harness and uniform top and hang them up. Listen, I’m trying to take my talents to South Beach, not play a game of Twister. And while I don’t think “pooping dog” is the name for any real yoga pose, I’m pretty sure I’ve performed it and maybe even mastered it by now.

Things become especially dangerous because of hook-hangers on the doors. Not only do you run the risk hitting your head on the door, but also possibly poking out your eye-hole while tidying up your pie-hole; you know, jabbing yourself in the ear-hole while digging around in your rear-hole; hooking yourself in the mouth while cleaning up the dirty South. You get the picture. It does make it easier to maneuver if you leave the door open a bit when you sit, then close it once you get settled, as well as opening it again when you have to stand up to wipe. But, then you run the risk of someone opening the main door and catching you in a somewhat compromising position, which I'm sure violates some of those bathroom rules I mentioned earlier.

Kandahar 9

Manas is the base in Kyrgyzstan through which most troops on their way to and from Afghanistan pass. There are huge sleeping tents, dining facilities, gyms, a few restaurants, and a bar at which you can get your 2 cans of beer or glasses of wine per day. This is kind of a big deal since Afghanistan is a dry country. I’ve heard all kinds of stories about things people try to do to get alcohol to Afghanistan (and I mentioned a few previously). I heard a story about a guy who was having vanilla extract sent because it had just enough alcohol to hold off his withdrawal symptoms. There are similar stories about people drinking mouthwash.

I saw on the History channel one time a show about bootlegging, and they talked about what the “proof” on a liquor bottle means. During British Empire times, sailors were sometimes paid their wages in rum. To make sure that the rum wasn’t watered down, they would prove its potency by sprinkling gunpowder into the rum, then attempt to light it. If the gunpowder ignited, then the rum’s alcohol percent by volume was at least 57% or so. In the US nowadays, the proof is basically just twice the alcohol by volume. In general, any liquor above 40% alcohol by volume should light on fire.


I don't have a lot of experience with lighting alcohol on fire, but one time I thought it’d be an interesting experiment to spray a few pumps of hair spray, which has alcohol in it, on my arm and light it. Do not try this at home. I thought it’d just burn off real quick and no real harm, but I can say that, actually, it burns really hot. I may or may not have ran around the apartment screaming like a little girl and maybe got a little nauseated by the smell of burnt hair. During residency we went without the alcohol gel sanitizer in our exam rooms for a month or so because they originally placed the dispensers near the rooms’ light switches, which turns out is a pretty serious fire hazard. The gel in Purell or other alcohol-based hand sanitizer is about 62% alcohol by volume.

So apparently there was a guy last week, passing through Manas, who doused his hands with hand sanitizer before leaving the building he was in. Usually the alcohol evaporates quickly, especially if you just use the little amount that it usually requires to do the job; if you wave your hands around in the air, it can speed up the evaporation process. This guy didn’t do either and instead went immediately over to a nearby smoke pit where he attempted to light a cigarette; instead, he lit the alcohol on both hands on fire, sustaining 2nd and 3rd degree burns to his appendages. That’s one way to get an immediate ticket back home …. but, I don’t smoke. I think he deserves at least an Honorable Mention nomination for a Darwin Award.

Kandahar 8

Mostly the same old same old here. About 3.5 months to go, which is 3.5 months too many. I did receive a call from my replacement, which was a little bit of a boon to my spirits. My tentative date of departure from here is January 5, 2012. I don’t count down or mark calendars, but I think that puts me at just over a hundred days left. We get 2 weeks of rest and relaxation (R&R) after we return, and I plan on going snowboarding in Austria and/or Switzerland and/or France and/or all of the above for two weeks when I get back. If anyone wants to come to Europe at that time for some serious shredding the pow-gnar, let me know.

I strained my back about two or three weeks ago doing some lunge-reach exercise with kettle bells. Locked me up pretty good. I’d sort of tweaked it a bit before that but was able to continue doing my regular workout stuff, but that didn’t allow it to get better and set me up for pulling a muscle or two a few days later. Joe told me I should rest for a week or two, and I listened a little bit. I mean, I stopped doing any lifting or pushups or pull-ups, but I got on the spin bikes and have been doing that every day for at least an hour or two. My back feels a lot better, and I’ve lost another 4-5 lbs. The upside, my abs stick out a little bit (or my belly sticks out less – same difference in my book); the downside, as my face has gotten a little thinner, my ears stick out even more. Not a good look for me.

I arrived at work the other day and only one other person was there – our supply person, who’s not a medical technician. I asked her where everyone ran off to, and she replied that they had just left for the Canadian gym. Someone ran into the clinic a few minutes earlier asking for medical help. They thought someone at the gym was having a seizure. I missed most of it, but apparently when Joe and the techs arrived, the woman was on the ground, gasping irregularly, and nonresponsive. Joe thought he lost her pulse, so gave her some mouth-to-mouth and they did some chest compressions.

By the time I arrived, the EMTs were there and had placed EKG pads on her. She had a pulse so they were just bagging her as some of the gasping breathing persisted. Joe told me that one of her eyes deviated out to the side. Apparently, the woman is a 33 year old American contract worker. She had diabetes and it hasn’t been well controlled, though she works out regularly. As it turns out, her blood sugar was fine when they checked it. We found out later that she had a hemorrhagic stroke, a brain bleed. I asked someone who works at the hospital and they think she died after they transported her out of here, but that's still unconfirmed.

Speaking of people who have recently died, there was also a soldier who recently died back in the States after he'd just returned from Afghanistan. Rabies will kill you dead without getting treatment. Guaranteed. Apparently, he'd been bitten by an animal while deployed, but apparently didn't tell anyone, which is obviously a bad idea. Now it's a "priority issue" for everyone because, of course, it has to look like we're all taking this very seriously. And it's not that I don't think rabies is serious, but everyone who in-processes here is warned that rabies is endemic to Afghanistan, so don't touch any animals. It seems like common sense. And it's one guy who wasn't very smart, but was very unlucky. That doesn't make it a high-priority issue (I still say that not getting your limbs blown off and/or killed dead by an IED still ranks as the highest priority issue here), but it does make it a seemingly extra-important issue because it was in the press.

Anyway, back to brains bleeding. I remember being in medical school and our team had an 18 year old patient who had a stroke. The kid was 6’5” or so and had a scholarship to play baseball in college – the “All-American” kid, everything going for him. He was working out one day lifting weights, next thing he knows his head hurts and he can’t move half his body. He’d ruptured a congenital aneurysm, or a blood vessel that has weak walls and sort of balloons out until it breaks. Scary to think about, that you might have a ticking time bomb in your head that could go off at any moment. I think that would be a hard thing for anyone, but particularly for people who are especially active.

Griff and I went skiing in Korea last year, and afterwards we were watching a movie called “Murderball”. It’s a documentary about a wheelchair rugby team. As they introduce the team members, they tell each guy’s story about how he became a quadriplegic. Some of the guys had freak accidents while biking or whatever, and in an instant could no longer properly control (to varying degrees) their bodies from the neck down. Well, after less than 15 minutes of hearing those guys tell their stories, and thinking about a few of the accidents I’ve had riding mountain bikes, I had a visceral reaction to it - literally felt sick to my stomach and became so depressed and scared that I had to turn it off. Really.

I remember talking to Mom years ago and she mentioned that she’d taken Maddy to the vet and had her put down. She had those horrible allergies and nothing was really working to relieve her symptoms. I asked her, facetiously, “How would like it if your children put you under for having allergies?” She answered, in Grandma Etta fashion, something like, “If I’m old and as miserable as that dog was, I’d do it myself.”

Old and allergies are one thing, and probably not justifiable reasons for putting your parents to sleep ("probably" being the operative word, though I'm open to debate), but I'm not sure how I would feel about being paralyzed from the neck down. My instant reaction is to say, “Just put me out of my misery.” Don't think I’d want to live like that. I mean, Christopher Reeves was inspiring and all to lots of people, but I don’t think I want to go through all of that. Plus, he was wealthy and famous and probably received extremely exceptional attention because of his celebrity and advocacy. I seriously doubt most quadriplegics have those kinds of resources available to them or get that amount of attention. I guess you can’t really know how you’d feel and respond except in the unfortunate case that it happens to you.

As you may have heard, the military quietly suspended the “Don’t Ask Don’t Tell” policy about homosexuals serving openly in the military. And while I absolutely agree that it was a way overdue policy change, I am still not gay, so this isn’t a coming out announcement. I know, I know. I’m a fabulous, nearly 36 year old male, not horrible looking, smart, fairly athletic, EXTREMELY charming, goes on hiking and camping trips with his buddy with the creepy mustache named “Griff”, hasn’t brought home a woman to meet the family, and is still single. I also know that Bill asked my buddy, Brian, whether he suspected I might be gay as we were traveling through Nebraska and stayed at their place on our way to California to start our respective residencies back when. So I get it. But that doesn't mean I'm gay; it just means that maybe I'm awful and girls don't like me, and that I'm a menace to society.



"USA! USA! US ... HEY there big guy!"


I do, however, find my job has me talking about and touching other men’s genitalia way more than I’d prefer; and I’d prefer not-at-all. I often tell people that my job isn’t all glamour and call-room hookups with naughty nurses. Sometimes I say, when someone asks about what I do, that I stick my fingers in people’s butts. For money. It’s part of my job, and it’s not all that great. Trust me.

Coincidentally, just the other day I had another man's penis in my double-gloved hands, freezing off little cauliflower clusters of genital warts. He explained to me that part of the reason he waited so long to be seen for this issue was that he was nervous and embarrassed that, when at "parade rest", his wiener is kind of small. So I proceeded to reassure him that there are men who are "show-ers" and those who are "grow-ers."

In a cold room, and at their smallest, the "show-ers" would seem to have the longer penises, but the "show-ers" don't get much longer when they get an erection. It’s basically “what you see is what you get.” On the other hand, the "grow-ers" are guys who are smaller when flaccid, but then get considerably larger when they're tumescent, i.e. sometimes big things come in little packages, no pun intended. All the while, I methodically applied a freezing solution to his phallus flower garden. Fortunately, nothing I did to the guy allowed us to find out how much of a "grow-er" he is, although I suppose applying a freezing cold applicator to his genitals might have had some beneficial effect to that end as well, thank goodness.

Also had a guy come in for breast tenderness just under his nipple. I stood behind him, with his shirt off, rubbing both his nipples (cause you have to compare the affected and non-affected side, after all) and said, "I really hope no one barges in on us right now. That would be some awkward explaining to do." Then I had to tell him that, unfortunately, I probably ought to examine his balls (breast masses can sometimes be associated with testicular masses). Sometimes I think I’m way underpaid for the crap I have to do.

And then there was one of the Canadian guys who works at the gym. He came up to me one day while I was on the spin bike, asking what hours I work at the clinic, and if he could stop by to chat. Most of the time when people want to “ask you a question” in private, it really means “I think there’s something wrong with my balls and/or wiener.” In Gono-Korea, we saw a lot of STDs. When guys would come to morning sick call with those types of complaints, the euphemism was “foot problem,” as in “Doc! There’s something wrong with my foot – my wiener is dripping all over it.”

Anyway, the Canadian guy thinks he got herpes from a girl he’s been sleeping with. He was telling me all about these painful bumps/sores that he has on the inside of his foreskin. I sat and answered his questions for the better part of an hour. At the end of our conversation, I told him that was way more time than I ever wanted to spend talking about his junk; and I'd prefer not-at-all. A few days later he gave me one of the better designed t-shirts from the Canadian Air Force run. And as I’ve said before, it’s all about the t-shirts. And donuts.

And then there are all the people with gastrointestinal issues. I admit, after I had those two weeks of diarrhea after returning from Nepal (during which time I was wearing sweatpants to bed in case I farted and shat myself in my sleep), I don’t have a lot of sympathy for people who come in and tell me they’ve had non-bloody, non-fever, non-cramping diarrhea since “this morning.” One guy came in complaining of blood in his stool (from hemorrhoids). He was thoughtful enough to take a picture with his iPhone and show it to me. Um ... thanks? People get pretty freaked out when they see blood in the toilet, so I usually reassure them that even a tiny bit of blood in the toilet bowel can make it look like a battle scene from "Braveheart" in there, or the opening beach scene in "Saving Private Ryan." I sometimes wonder what they do with those pictures afterwards. Hopefully they refrain from posting it to their Facebook page, though I wouldn’t put it past some of them: “Sergeant Johnson … had blood in his poop today! OMG! LOL! BRBPR!!*”

*(BRBPR = bright red blood per rectum)

I saw a girl the other night who was complaining of being really nauseous and vomiting several times before she arrived to see me. We've been seeing a good bit of gastroenteritis lately. I can't say whether it's something going around or not, but when you have lots of people working and eating in close proximity, and who maybe don't wash their hands as diligently as they should, it can obviously be passed around. I had her lay down in order to exam her abdomen (which wasn't overly concerning, though she was a bit tender over her stomach), but I guess that sitting her up made her a little dizzy and ratcheted up her nausea. She told me she needed to throw up, so I grabbed the garbage can. When I got it up by her face, she let go a salvo of yellow-green liquid vomit without any chunks. I held the garbage can and rubbed her back while she let it all out. I asked if she'd eating a yellow piece of candy, and she says she had an apple Jolly Rancher (or a Jolly Rogers, as Dad would say).

After she recovered, she asked, "How can you just stand there so calmly and rub my back while I'm puking right in front of you?" I don't know. It's like lots of other slightly unpleasant things that you just get used to, like changing baby diapers, or eating vegetables. Yeh. Kind of like that. I remember watching a friend get his ingrown toenail cut out in Lithuania, and I almost passed out then, but now I rip out toenails all the time.

I didn't always have even that much fortitude when it comes to vomit. The very first patient I worked with as a medical student had end stage liver disease (drugs and alcohol will do that), and he ended up dying; not a great start to my career. I went in one morning to round on him, and he was more disoriented and out of it than usual. As a brand-new medical student on my rotations, I wanted to be very thorough, so I made sure that I sat him up so that I could really get a good listen to his lungs, though it was probably unnecessary.

He didn't react to all the moving around so well, however, and he started gagging and dry heaving. That can be bad enough to witness as it is, but when you're right next to this guy who already smells sick and you're hearing the gagging amplified through your stethoscope ... ugh. That's when I got grossed out and had to make a quick run for the bathroom. At that time I learned from experience that bananas do indeed taste more or less the same coming back up as they do going down. My friend, Brian, laughed at me when I first told him, but then he was almost offended that it happened. He said something like, "A doctor puking because a patient grosses him out? That makes no sense! That's like a lawyer who doesn't know how to lie." I guess I've grown a little since then, and I don't mean that in the "grow-er" vs. "show-er" sense.

Kandahar 7

Reader response from recent update:

Hey Stupid-

Here's an idea for you. Don't go in the air unless absolutely necessary. Anything in the air is a target. Remember the little story I told you about the bird:

Once upon a time there was a non-conforming sparrow, who decided not to fly south for the winter. However, soon the weather turned so cold that he reluctantly started to fly south. In a short time ice began to form on his wings, and he fell into a barn yard, and almost froze to death.

A cow passed by and crapped on the little bird. The sparrow thought this was his end. But instead, the manure warmed him and defrosted his wings.

Warm and happy, able to breathe he started to sing. Just then a large cat came by and, hearing the chirping, investigated the sound. The cat cleared away the manure, found the chirping bird and promptly ate him up.

The moral of the story:
1. Everyone who shits on you is not necessarily your enemy.
2. Everyone who gets you out of the shit is not necessarily your friend.
3. If you are warm and happy in a pile of shit - keep your mouth shut.

KAF is your little warm and "happy" pile of shit for another 4 months. No need to go flying around.

Thank you Reader X. Sage advice. Got a kick from the “Hey Stupid-“ opening.

I ran a 5k last weekend for something or another cause. I don't know which one. It doesn’t even matter; I just do it for the t-shirts and Tim Horton's donuts at the end. Yes, the Canadians have a Tim Horton's at their compound, which is conveniently located right next to ours. The donuts are delicious, though I only get them on days when I have to work the entire day and feel sorry for myself. I ran an 18.30. In my defense, my legs were really sore from spinning, I couldn’t fall asleep until after 2am the night before, the race started at 6am and I didn’t warm up or anything, and I’m getting old and slow. There’s another one this weekend for wounded Canadian Army midgets. Or something like that. Like I said: t-shirts and donuts.



Oh Canada! ... Oh My! Canada!


So, I'm the clinic OIC here: officer in charge. There are only two of us officers in the clinic. Joe is a Major, so he obviously outranks me, but his duty is sort of the chief medical officer on base for the Air Force (even though Magnum is a LtCol, his duties have him off just working with the flyers). In effect, Joe has really been the OIC of the clinic. He's here in the mornings and early afternoons, when most of the "action" goes on. He also has been seen as the point of contact for leadership since he has to go to meetings with them every day. He occcasionally tells me, "Hey man, you're the OIC. I don't mean to step on our toes or anything." I tell him I appreciate his concern and then nothing really changes. All of that is absolutely fine by me. Every once and I while I order him, in the name of the clinic OIC, to get out of the clinic when his shift is over rather than hanging around, but he doesn't really listen.

Joe’s a nice guy, and we get along. He kind of reminds me of my friend, Brian Montenegro - Latino ancestry, but kind of really “white.” I don’t know, he just eats sandwiches all the time, married a white women, and likes top-40s pop music (don't worry Brian, I won't tell about the time I came home from the hospital and found a Celine Dion CD in the stereo that definitely did not belong to me). SSgt Williams, one of our techs, tells him that he’s qualified to be a school teacher because he has a notebook butt and pencil legs. He has a bit of an angry streak, though, and prefers to nip things in the bud if anyone gives him any attitude; has a little bit of “tough guy” in him.

I end up playing the peacemaker and the one to whom people come to complain or vent their frustrations. It’s not my forte, but I try to seem like I’m listening. I usually give some relatively vague feedback about how I can see some validity in every party’s concern in whatever the dispute might be, give some generic exhortation for patience to see whether things don’t work themselves out, and suggest that different people have different styles of communicating, but we all need to try and communicate better regardless. That kind of stuff. And usually the knots do unravel and things are fine again. We’re not that busy, and there are only eight of us working in the clinic, five of us who are directly involved in patient care. Things are really not all that difficult or stressful, though, and so I don't get why there's any drama in the first place.

It could be worse, though, so I guess I'll shut my mouth now about my pile of shit here.