Training

There has never been a nurse with this unit before, and they really do not know what to do with me or what to expect, so I get the enjoyment of defining my own job description. The vast majority of the Corpsmen I'm working with have minimal to no experience with hands-on patient care, and this is a situation I'm going to do my best to remedy. Training is my role right now. I've coordinated with the local military hospital to allow us to do time in the ER, as well as in the lab to get more sticks and one of the STP (Shock Trauma Platoon) Physicians set up time in the OR to more IV sticks and to also observe surgeries.

3 weeks into it and the HMs are motivated, overall being aggressive in getting in the middle of patient care in the ED and getting some decent experience. No trauma yet, but plenty of medical and cardiac patients. They need to crawl before they can run.

Plenty of field ops and ship time coming up in the next 1/2 year, should be fun.

Stay tuned...

I've recently been transferred to a Marine Corps unit for the next three years, and will be deploying within the next 10-12 months. I hope to continue this blog in hopes of repeating the wonderful experience from before through all the people I met and continue to meet through it.

Follow Up

Some articles have been coming out about us since we have left.

Here is a nice article in Reader's Digest

And here is one that I am almost positive is of the dog I had pictured in an earlier post in a CNN article. Here is the Blog for Cpl Lee, Lex's Fallen Handler.

Home at Last

I arrived home this last Thursday evening, and it is hard to express how wonderful it is to be here. The incoming baby was able to wait for me (probable arrival is by next weekend).
It is at this time that I'm going to retire this blog, at least until my next trip 'over there'. Thank you for all the interest that you have shown, I have met many people through this venue that made a tough time a little more bearable.
Again, Thank You.

Back in the U.S.A

We arrived yesterday to North Carolina, hard to say how nice it is to see green stuff. Couple days here, and I'll be on my way home. 110 degrees when we left, 60 when we arrived.

Last Photos of Iraq

We did some tourist type things our last couple days. One of them was to walk a mile or two down the road to where some abandoned 1950's era bombers are laid to rest. They are pretty beat up, apparently weren't even worth bombing in one of our initial ventures into this country.
The last photo is of the American and Iraqi flags flying near where we worked this last half-year.

Tight Berthing

And no one is complaining. It is amazing what we will happily put up with, as long as we are on our way home.

Back in Purgatory

We returned to the lunar landscape that is Kuwait. (ALMOST HOME!!). A couple days here as we wait for our flight, and we'll be on our way to North Carolina.

A Visit to the Dark Tower

LT Vince Johnson and myself at the goodbye meeting with the General and TQ Surgical Officers.

All the Nurses of TQ

Getting Closer

The new group has been here for almost a week, and they have completed their last major hurdle. We staged a mock mass casualty drill for them to demonstrate what they are capable of, and we will soon have our official Replacement in Place - Transfer of Authority (RIP-TOA) ceremony, after which they will officially own the building, and our official job until our plane arrives is to play volleyball. It will still be a couple weeks until I am home, but we are closer than ever.

New Video

*20th Flight*

Very, very busy day yesterday. Started with 2 soldiers in full arrest on arrival, one was able to be revived. He was my flight, and this was by far my most critical patient to date. I'm proud to say he was in as good a condition, if not better, at the end of the flight compared to the beginning. Our staff invested a lot of themselves into this patient, and all were relieved to know he made it to the next level.
Several other groups of patients came in throughout the day. All turned out ok, but made for a constantly busy day, from beginning to end.

(Picture thanks to LT Harrison at TQ Surgical, picture is from my 19th flight)

Closer to the End

We are coming close to the end of our time out here, but it has been a busy week anyway. A couple of notes regarding what we have been seeing (not all-inclusive by any means)

• An Iraqi woman was flown out with one of our nurses after being shot in the chest. Turns out the Bad Guys broke into her house, killed her 4 children, and shot her in retaliation for something they felt her husband did.
• A long night started with 3 Marines whose vehicle was hit by and IED came in, 2 with minor shrapnel injuries and the other required surgery and a flight nurse transport. A 4th in the vehicle did not make it to us. This was immediately followed by a group of 5 Marines, also in a vehicle hit by an IED. All with injuries not requiring a visit to the OR or a flight nurse, but all did fly to a higher level medical facility after initial treatment here. We wrapped up the night around 0430.
  
• I found out that one of the Army soldiers in the recent blackhawk crash that killed 14 service members was an alumnus of my high school, the first alumnus to die in Iraq from our school.
  

More on the FMF Pin

See the link (CLICK ME) for an article on our pinning ceremony in the Marine Corps News...

Read Some of These Links

A couple weeks ago, we were visted by a journalist for several days named Leslie Sabbagh. She writes for a couple magazines, including Popular Mechanics and The Christian Science Monitor. Here are some links and notes about some of her online posts...

This is her blog (CLICK ME) for Popular Mechanics...

This is the entry for TQ Surgical she wrote(CLICK ME), it is worth noting that the two Corpsmen she quotes are both staff from Great Lakes, HM3 Ramirez is on his 3rd deployment to Iraq, and HM3 Smith is my cohort with teaching the EMT class here.

This is a link (CLICK ME) to an excellent article she wrote about the Army medics that we fly with. It is about their flying to point of injury missions, not the interfacility flights they do with us.

Here is her homepage (CLICK ME)

Check Out the Chest Candy

With me is LT Patrick Harrison, we were together in the same Marine Battalion (1/6) a good 12-13 years ago, and were promoted to Petty Officer 3rd Class (E-4) at the same time during our Med float (6 months of floating around the Mediterranean with 2000 other Marines).
The FMF pin I have been talking about is above our left chest pocket, it is now a permanent part of our uniform, whichever one we happen to be wearing.

EMT Iraq

Left to Right - Back Row - SGT Champagne, HM2 Dunkley, HN Russell, HN Rivers, HM2 Hallenbeck - Front Row - Myself, HM3 Smith (co-coordinator)

The other major project I have been working (aside from the completed FMF qualification) is in the process of wrapping up in the next week or two. Around the beginning of May, HM3 Smith and myself decided to see if teaching a traditional EMT-Basic course out here was feasible. Class started the end of May, and has been going strong ever since. There has definitely been some logistical issues to work through (books, tests, equipment, class space), and fitting 120+ hours of class and clinical time into an operational schedule has been a challenge. While they missed out on the traditional ambulance time they would have gotten in a stateside class, I think they more than made up for it with the intensive trauma patients they cared for while here.
The National Registry of EMTs has acknowledged that this is the 1st EMT class taught in Iraq they are aware of.
5 students will be completing the course (4 Corpsmen and 1 Marine), and they have all shown a dedication to this class to be admired. They did all the requirements for this course on top of their normal duties.

19th Flight

Location, Location, Location.
Holds true even in Iraq, as in it is probably not good to live near a police station in Iraq. An Iraqi family of 3 (dad, mom, ~12 year old daughter) were at home, perhaps sitting around in the living room, when a mortar round fired by the bad guys errantly landed in their house. All 3 came to us, the first flight nurse flew with the daughter (intubated due to altered level of consciousness from a head injury) and the father (chest injury and general shrapnel), and after a lengthy surgery to repair a serious abdominal bleed and a very damaged lower leg (without a doubt the surgeons saved her leg - or at least gave her a fighting chance to keep it), I accompanied the mother to one of the level 3 facilities.

Incoming Mail

We found out yesterday that as of yesterday we would no longer be receiving any mail while we are out here, in preparation for our departure next month. Boxes and letters will no longer make it here, and any that were enroute to here are being turned back. I am not sure where these letters will be sent to, maybe they will be waiting for us in Camp Lejeune.

Thank you to everyone who has sent packages and letters, they have brought a little bit of home to this alien landscape (remember... I am from Wisconsin).

18th Flight

We had a few Iraqi Police come in during the day after a firefight with some bad guys. Most had extremity injuries, but one was significantly worse off with a bad pelvis injury and internal bleeding. After he was treated in the OR, I flew with him, and one of the extremity injuries to Al-Asad in a Blackhawk, my first day flight with the army (they used to do only night flights.)

Update

We seem to be stuck on Groundhog's day, every day the same as the one before. We are planning for our relief to arrive soon, and it is nice to be thinking about home (as in 'I'm going home'). we do have a little while yet until that happens, but just planning for it is a nice feeling.

A couple days ago we had several Marines arrive after their vehicle was hit by an IED, most were ok, a couple went to the OR, and one required a nurse to fly with him after the surgery. Many of our staff didn't get any sleep that night. We have been getting injured into our facility much more often than what I mention here, keep in mind that there are several nurses that are in the flight rotation, so for every flight that I go on, there have been several other nurse flights in between.

I am amazed at the night time skies out here. There is hardly ever a cloud in the sky, and it makes for an incredible night time view of the stars. Even in the farmlands of Wisconsin, I do not think I have ever seen such a clear view of the stars.

Someone Thinks I'm Interesting...

Here's a first, I've been interviewed on a blog. Feel free to check it out (CLICK ME), and I encourage you to spend some time looking around the site (CLICK ME), and vote on some of the charities for injured service members.

Please read what VAjoe has to say in his own words:
"I don't know if you've had a chance to look around my site, but VAJoe will be donating $2,000 to military charities. It's called Charity for Charities (http://www.vajoe.com/charity/).

In Charity for Charities, people come to VAJoe and vote for their favorite military charities. They can nominate charities, also. The charities with the most votes and one randomly selected charity share the $2,000. I'm trying to raise awareness of military charities and the work they do in a way that is fun for people."

I Did It!

FMF Pin
Fleet Marine Force Qualified Officer
OPNAV INSTRUCTION 1414.6

"Attainment of the FMFQO designation for a Navy officer signifies an achieved level of excellence and proficiency in Marine Corps operations and indicates a fundamental understanding of a Marine Air Ground Task Force (MAGTF) and its components. The FMFQO insignia signifies additional general knowledge that enhances their understanding of war fighting, mission effectiveness, and command survivability. Officers who wear the FMFQO insignia stand out as significant contributors to the Naval services' ground warfare mission. The FMFQO qualification may only be obtained through the formal qualification program set forth in this instruction."

5 Months of classes and studying, and I completed my oral board last night. Almost all of the officers here have completed the requirements, or will shortly, and we will all put our pins on our uniforms in a ceremony later this month. Pictures to come after that.
This was one of my 2 major projects I've been working on outside of normal duties, more to come on the other project soon.

17th Flight

Had my 17th flight on Monday. Took a Marine to Balad after he was hit by an IED, shrapnel injuries and a belly injury. Flight was very busy, but his condition actually improved over the course of the flight. The trip to Balad, or Al-Asad, isn't nearly as scenic as going to Baghdad, but we prefer the less scenic route if it means less chance being shot at.

A Unique Building in Baghdad

I have seen this building a couple times during the flights to Baghdad, the way it is built out on the water is pretty impressive.

1 Day, 2 Flights, 3 Patients

15th and 16th flights on Monday.
The first flight was a Marine that was shot in the face, but amazingly arrived fully alert and talking. He was intubated to protect his airway and I flew with him to Baghdad, no problems.
The second flight was with 2 Marines, both intubated. They were hit by an IED, one with major damage to one of his legs, the other with a neck injury. I flew with both of them to Al-Asad, no problems. VERY HOT up in the air, no matter how much water you drink, you just can't seem to keep up with all the sweating.
The picture is from the 1st flight, I am in the back of a CH-46. The grey/green strap around my chest is the gunner's belt, it is attached to a length of strap that is secured to the deck. That way I can get up and work with the patient without fear of falling out the back.

News Flash - It's Hot in the Desert

News Article

Please follow the link (CLICK ME) to read about a detachment of 8 of our staff to set up and staff a Mobile Forward Resuscitative Surgical System (FRSS) with one of the Marine units sent out here as part of the surge. Our thoughts and prayers are with them as they forgo the few creature comforts we have here at TQ (warm chow, better berthing, some sort of recreational activities) as they share a tent and eat MREs 3 meals a day.

A Few Things That I Miss..

(Aside from the obvious family and friends... In no particular order, and not all-inclusive)

1. Cold water. The holding tanks for the shower water are next to the bathrooms, outside. The water is heated up enough by the sun that I have not had to touch the hot water spigot in a couple months. I like my showers hot, but the 'cold' water is so hot as to be barely tolerable.
2. A bathroom closer than 100 yards from my can.
3. A tan. Yes I am in the desert, but I am still pasty white. I've had better tans in Wisconsin.
4. Temperatures below 90 degrees. We now comment on 'how cool it was last night - in the low 90's. Positively refreshing'

A few more serious things...

1. The unconditional acceptance of my dog.
2. Sending my oldest off to his 1st day of kindergarten.
3. Feeling our unborn baby kick and move.

For those of you that know LT Lora Martin

She is working 90+ hour, 9 day workweeks.
She single handily saves 50 lives a day.
She has all the collaterals possible, and sits on a minimum of 32 meetings a week (4 separate clipboards required).

(she in no way twisted my arm to write this so that her co-workers at her parent command know that she is actually doing a whole lot of nothing here)

28 weeks, and she's already a looker.

Your Typical Monday Night

Around 11pm we all received a call for 8 incoming Marines, wounds from a VBIED (vehicle borne IED - big). Turns out the bad guys attempted to drive a very large truck filled with explosives into their position, but the Marines were able to hold him off at a distance, where he detonated himself once he realized he couldn't get any closer. Even at a distance, the blast still took out the front of the building the Marines were in, and several of the Marines were thrown around (one said he was thrown 30 feet back). No serious injuries (relatively speaking), mainly shrapnel and ruling out concussions. No nurse flights needed for these guys.
Earlier that day, an 18 month old boy was brought in after a 10 foot fall. Baby was fine overall, but we needed to have a CT scan done to verify that there was no head injury. When I was sent out here, it didn't really occur to me that I would be doing full spinal immobilization on an 18 month old, using blankets, tape, and a CPR board. It worked out remarkably well, he was sent to a higher level facility where the CT scan could be done. I found it remarkable that while we were waiting for the helicopter, the father was very interested in verifying that we were sending him to a military hospital, and not a civilian hospital (he was going to one of our military level 3's). He said (through a translator) that if we sent him to a civilian hospital in the wrong area of the country, "they will kill me and chop the head off my son". He is referring to the Sunni - Shiite issues out here. How accurate he was I can not attest to, but I can tell you that he believed it.

Getting Gas

Usually after dropping a patient off at a level 3 hospital, we will stop for gas prior to returning. This is a picture of 3 different helos, all getting gas. (Enlarge photo for better view). From left to right, An Army Kiowa, Marine Corps Super Cobra (our escort), and an Army Blackhawk. Not pictured - the CH-46 that I was on for this flight.

Follow Up

The 7 year old from last Friday made a return trip through our facility on his way home. Despite a rather impressive head injury initially, he has recovered amazingly. To the point he is likely home already. He was very emotionally fragile, I'd also be a little upset if at one point I'm walking around my home neighborhood, than the next I know I'm surrounded by people speaking a different language. He was able to give his name and other info, so it should not have been to hard for him to get home home with the help of the Marine unit that brought him in.

Aliens in Iraq - Crop Circles

These pictures are a fairly common site while flying over the countryside. I'm guessing that there is a water source in the middle of the circle, and it is easier to water the plants this way. Doesn't stop it from being humorous seeing crop circles everywhere...

14th Flight

Had my 14th flight yesterday. An Iraqi 7 year old boy, with a single, small, hole in his head from a bad guy mortar round (all injury information is from what I could cobble together, I cannot attest to the veracity of what happened prior to his arrival to our facility). According to the person that brought him in, one of the mortar rounds that were directed at the local Marines hit an apartment complex instead. This boy, name unknown, was delivered to those Marines that were targeted, and then brought to us. No name, no family, no history other than guesswork. His age is a guess, which something as simple as guessing the age of these children has proven to be a problem for us, as the children here are smaller than American children of the same age we are used to seeing. A 5 year old child here will often be identified by many of us as a 3 year old, a 9 year old as a 6 year old, etc. I'd imagine that nutrition has a lot to do with this.
The doctors and staff here attempted to stabilize the boy, but there is only so much we can do for these severe head injuries at this facility, he needed specialty care. I flew with him to one of our Level 3 hospitals, and this was one of my busiest flights yet. Didn't even have a chance to look out a window. Vital signs reflected the increasing pressure inside this kids head (not good), and I learned some things about head injuries that I had not heard about previously. The child was intubated, and I ensured he remained unconscious and paralyzed with medications. I'd like to say I delivered him to the facility in the same shape he left TQ in, but I honestly am not sure. His vitals were similar, but time under pressure is more damage to these brains, pressure that can not be relieved until specialty care.
Your prayers are appreciated for this boy.

My postings have been coming a little slower recently, I have really been busy as of late. I will continue to post when something interesting happens, and will also tell you all what has been happening recently that has been filling my time. It is not all patient care related, before I post, I'm looking for the right pictures to go with them.

A New Slideshow - TQ Surgical at Work and Play

13th Flight

Had my 13th flight yesterday (Sunday), took a Marine injured in a firefight to Al Asad. Smooth flight, no problems. Flew in a CH-46 (see photo), and it was a day flight. Kind of a windy day, and there were these mini-tornados (I'm not sure what to call them) everywhere.

Sand Funnels/Dust Devils

As we flew over the desert, you could see these sand funnels, or mini-tornados, everywhere. They seemed about 20 yards wide, and 4-5 stories tall. They would just meander back and forth across the desert. There was always one or two within sight, usually more. I'm afraid the pictures are not very clear, click on the photo for a larger view.

At the Pistol Range

Here is LT Stuart H. with me at the pistol range. I have more junk on my flak vest because it is set up for flights, not because I enjoy the extra weight.
Later on yesterday we had 13 Marines come in after a dumptruck exploded outside the building they were in. None were seriously hurt, very lucky. After this period of downtime, it is good to see that we as a group can 'turn it on' and go from a walk to a sprint immediately. One of the Marines showed me a picture of the crater left behind by the Vehicle borne IED, amazing.

The Great Lakes Crew

Here is the complete crew at TQ from Great Lakes Naval Health Clinic. From left to right, back row: Capt(s) Kane, HM2 Nicholson, HM3 Ramirez, LT Giometti. Front row: Me, HN LaBondano, HM3 Smith. We have 3 other members deployed from Great Lakes in Iraq, all at other locations than here.

12th Flight

Had my 12th flight this morning, a Marine with injuries from and IED. Flight was smooth, rode in a CH-46, which was unusual since most night flights are done in the Blackhawks. Nice to have the extra room.
This was an interesting night (Saturday). Started late, with a TCN (third country national- not Iraqi or American) female who realized she was pregnant as the 1st of 2 children arrived. Regretfully, they were way too premature, and neither were able to survive. At the same time, 2 Marines that were injured by an IED arrived, one with severe (as severe as you can get) leg injuries, and the other with general shrapnel wounds. Both made it through surgery and will make it. Then another patient arrived (I'm going to be purposefully even more vague on this one), who received surgery and joined the 2 Marines and the mother in being flown out in multiple aircraft. Just like that, 3 nurse flights, and one really long night.
I wonder if we will look back as this night being the beginning of our summer surge in business?

Happy Birthday Sarah!!

I know better than to say how old...

More Pictures Available...

Please feel free to check out a blog (CLICK ME) being put together by one of our nurses here, LT Patrick Harrison. He has been sorting through all of our pictures, and organizing them by time taken. Starting with our training in Camp Lejeune up until now. It is still a work in progress, there are an unbelievable amount of pictures he is working through (with the amount of pictures we take, some might think we were more tourists than fighting a war...)

11th Flight

Finally had another flight! Total of 18 days since the last one.
I flew with a Marine with significant injuries, but relatively (relative to what!! - apparently relative to almost dead) stable. The flight was smooth, all issues encountered were easily dealt with. A general directive was passed on to me recently that discouraged being too descriptive about the injuries we talk about on the blogs, so I'll do my best to follow that. I haven't exactly been overly descriptive so far, but will try to generalize more...
It is truly a joy working with the Army flight crews, all but 2 of my flights have been with them in the Blackhawks. Last night's flight was with the Medic from my very first flight, and I am continually amazed by their skills and knowledge. When not carting a nurse around to manage our (relatively) stabilized Patients (usually post-operating room), these are the men and women that are flying to point of injury, into hostile areas, to pick up the patient and stabilize before they ever even get to us.
It is no secret that this last month+ has been slow, and it sounds like traditionally over the last couple years that has been true, but never this slow. For that we are thankful. We also realize that traditionally, the next couple months are much busier compared to the rest of the year. We will see how that goes...

The Best Wheelchair. Ever.

Photos by LT Patrick H.

Pics from the Air

I took this photo during my last trip to Baghdad. It is out of the open tail door of the CH-46 I am riding in, and it is of another 46 that made the trip with us.

Saddam and Me

Bradley Fighting Vehicle

K-9 Flight Gear

This K-9 has been outfitted with his very own goggles for flight.

This picture was taken at a base northwest of here.

Hey, I didn't say it...

Clothes Donations

Last weekend we spent over 8 hours organizing all the clothes donations that we have recieved. What you see here is only a fraction of what we have. When patients (military, civilian, adults and children) are brought to us, their clothes are often already destroyed, or cut off by us. This is so we can quickly evaluate what is wrong and where the injury is. With these donations, we are able to outfit the patients with clothes to wear when they leave us. Along with clothes, we have been recieving toys for the children, who are very appreciative.
We have not been seeing as many civilians as we used to, so we plan on giving any extra clothes we have to some of our military members who have contact with the Iraqis, so all clothes will be used.

Baghdad Mosque

The picture is a little fuzzy, it was taken through a dirty helicopter window. This is a HUGE mosque in Baghdad that is under construction, you can see not all the domes are in place. It is hard to see, but just look at the size of the building in comparison to the other buildings around it. Some of them look to be ~5 stories tall, but they are tiny in comparison...

Iraqi Ambulances

The ambulance below reminds me of the one from "Mother, Jugs and Speed", which only EMT's will understand the reference...

Update on Helicopter Safety in Iraq

Here is an article (CLICK ME) in today's USA Today on the spate of Helicopter incidents when we 1st arrived here, and what has been done to make our flights safer.

Stars and Stripes Photo

Here is a picture that was printed in the Stars and Stripes article in the 1st couple weeks we were here (see March 20th).

All of Us

A penny if you can find me...

Ward Meeting

Each morning the Nurses and Ward Corpsmen meet for patient turnover and to hear whatever may need to be passed. There were no patients on the ward, so we met here versus our normal location in the building
Recently our ward census has been very low, I hope this is a reflection of the improvement in the local area as it becomes more and more controlled by those Iraqis interested in developing their country peacefully.

10th Flight

Had a rather unique transport recently. I escorted an Iraqi VIP with significant recent trauma, in both a helicopter and a large airplane, in order to get him to a neighboring country. This was so he could receive a higher level of care in a civilian hospital. I have few pictures I can share, but the country I took him to looks just like Iraq. All Sand.
The flight involved 4 bases, one helicopter, one C-130 plane, and 7 hours. The picture is from the C-130 enroute to our destination.

NASCAR fan

This is a picture of one of the helicopters here, the pilot is obviously a fan of Dale Earnhardt Jr. Normally the Commanding Officer's helicopter is numbered '00', but when you are in charge, you can change things up. Along with the number, the major sponsors for the car are included, and inside there are chrome kickplates. I have never seen chrome on a helicopter before, it was apparent that the flight crew took great pride in this bird.

Touring a Helicopter

Part of our quest to qualify for the Fleet Marine Force Officer Qualification is to get signed of on being introduced to a helicopter, and being taught how to properly egress in event of emergency. Boy, somewhere in my Flight Nurse Training I think this was covered...
Here I am with LT Stuart H in the back of a CH-46.
We started on the same ward at Portsmouth, Virginia 6 years ago. Small Navy.

And it's still May.....

A Bird's-Eye View of Iraq

I think I'm getting a little better making these things...

9th Flight

Had my 9th flight last night. Took an Iraqi Army guy to Al-Assad. He had a gunshot to both lower legs, the surgeons did a great job restoring circulation to his feet, which the initial injury had interrupted. Flight was smooth, no problems.
The heat has really come to the forefront when planning for how we package out patients for transport. When we first arrived here, we needed to take action to keep our patients warm. Now, just being outside will warm our patients, even in a helicopter with the doors open and strong draft. If you would like to simulate riding in a helicopter, I'd suggest sitting in front of 4-5 hair dryers, and turn them on (on low for a night flight, high for a day flight.) After sitting in front of them for ~30 minutes, you have now simulated a flight.

Yellow Air

About 2 weeks ago we had some high winds during the day, which in the desert means a sandstorm. After the winds died down, this is what it looked like outside. Quite unusual, I have never seen yellow air before. It is around 4:30 in the afternoon, several hours before sunset.

Welcome to the Desert.

And it is only May 6th.

The Nurses of TQ