A blog/journal about my life and the stuff I like. Popular subjects include music, guitars, gear, books, movies, video games, technology, humor.
Just a follow up post on our favorite freezer bag wearing local national. Or should I say, local ninjanal. Here he is getting his sutures removed, obviously in great distress and in fear for his life. I wish all kids were like this.
Here's a closeup of his laceration, well healed after about 8 days.
or ninjas, or firewalkers, or whatever other badass pain insensate icon you can compare to these kids. Here’s a couple more of our stalwart local patients.
The little boy with the interesting headgear and gator (it was raining and we needed to keep the dressing dry) was hit on the top of the head with an axe, according to the story we got. Luckily, it must have been a very lightweight axe as it only penetrated the skin and didn’t reach the bone. He was completely lucid and not showing any neurological defects during the hour he was with us. I threw some stitches in and off he went. He got the gator because he sat there as stoic as a supreme court judge the whole time without complaining or moving. Yeah, these kids are tough. We still get the occasional hysterical screaming kid, but we get more of these kids with zen like patience and bearing.
The little girl behind the old man lost her right eye and suffered shrapnel wounds to her face and leg. I treated and stabilized her initially and then we evacuated her to the forward surgical team where she stayed for a few days. She is on a list to get a replacement eye prosthetic (glass, I think) which will probably be performed in Kabul when it eventually happens. She was another monk like patient; she cried a little bit but otherwise didn’t squirm or fidget during the whole process of cleaning up her wounds and bandaging them. Normally we would have sedated her, but since she had head trauma, we couldn’t give her anything that would cloud her clinical picture.
She’s too young to realize the magnitude of her loss, but the day this picture was taken (about 10 days after the event) she was smiling and playing with her sister and responding to me when I talked to her.
These children in Afghanistan have a very hard life by any standard, especially by Western standards. Almost daily we are seeing children with significant burns, blunt and penetrating trauma, or infections that have progressed much farther than they would in the US. This little girl is about 3 years old and she was burnt when she apparently knocked over a boiling tea kettle. She was brought in about 12 hours after it happened. We sedated her and cleaned up her burn and dressed it. We arranged for her transfer to a burn center in Kabul and she flew out yesterday. She'll probably do okay in the long run, but it's hard to see these kids going through all the suffering they do when some simple safety measures could prevent these accidents.
Here are some more pics. The first is a view from our flagpoles out into the Korengal valley below. The second picture is of our trauma treatment room. The third is a little girl who suffered arm and hand burns after turning over a pot of boiling liquid.
This is a picture of the front door to the aid station at Camp Blessing.
I’ve been in Afghanistan for about five weeks now, the last two at a new base with a different battalion after one of my peers had to be replaced. I was moved to one of the infantry battalions at Camp Blessing, which is in a more remote and contentious area in A-stan. I actually find the life here much preferable to the last place I was at (Jalalabad). The weather here is a bit cooler, the aid station we occupy is a permanent cement structure that keeps the temperature cooler and more stable around the clock, and everything that I would need to do is within about 300 meters walking distance (aid station, dining facility, gym, laundry, bathroom). We see mostly local national children here and we get to do surgical procedures mostly on a daily basis. Lots of abscesses and skin infections with the occasional trauma thrown in. In the two weeks I have been here, we have had two mascals (more patients than we can treat at one time) although in both cases there were only two “serious” patients so both the doc and myself were able to manage them within our scope. We’ve intubated four patients, and put in four chest tubes (one guy got two). We’ve seen everything from shrapnel, to GSW (gunshot wounds) to MVAs (motor vehicle accidents).
We also see alot of kids with burns and other questionable blunt trauma injuries. It’s not uncommon for children here to be running around open fires with cookpots full of boiling water and other dangerous substances. Safety practices are essentially non existent so we see alot of stuff you wouldn’t see in the states. Personal hygiene is also not a priority here so we see alot of infections that wouldn’t normally occur in the US. I wouldn’t have thought it, but I find the work here quite agreeable. I normally prefer the steadiness of occupational medicine but there is definitely a different vibe to seeing people with true objective illness and injury as opposed to the typical sick call patient we see in the US. When you see a 6 month old kid with an eyelid full of pus the size of a golfball, it’s not even a question as to whether or not they deserve your attention. So many of the problems here are correctable with an intervention or two so it’s much more satisfying when you treat them and then see them get better. And they are almost universally appreciative for the help.
This is opposed to the typical soldier on sick call who has some sort of minor musculoskeletal issue that will only get better with time and a small amount of effort/common sense on the soldier’s part (which is often lacking). There are plans to get a new PA to replace the one that left and theoretically that would mean I get sent back where I was, but I am beginning to think it would be better to remain here. The work is real, the living is better, and time is going by faster while I’m here. Time will tell.
are now gone by. I am currently in Jalalabad, Afghanistan working out of a consolidated treatment facility colocated with a forward surgical team. We have moved two different times already, and are due to move again when they finish building new housing and a clinic. That’s due to happen in Sep/Oct but I will probably miss it as I am getting ready to backfill for a provider from an infantry unit that is being sent back to the states. Hopefully I will still have connectivity where I’m going, but I won’t know until I get there. I intend to upload some photos and video when I get the chance.
