Nana na na, nana na na, hey hey heeey, good bye!

On the one month and four day anniversary of leaving Rustamiyah, I'll finally blog about it. Plus, since it is no longer ours I can blog about it. The base was on an old Iraqi airforce base so we had quite a few actual buildings (not trailers, tents, or plywood buildings). The first one below is our aid station which previously had been a 300 bed hospital. It was old and there was a lot of damage from the war but it functioned really well for our aid station and lodging along with housing a Green Beans Coffee shop, barber shop, Iraqi restaurant and a couple other shops. Medically, we only used a single large room for our sick call and trauma bay (see previous blog) along with a couple other rooms for ancillary services (dentist, physical therapist, x-ray, lab). From afar, you can't see the boarded up broken windows and huge concrete walls surrounding the first floor so it looks really nice. I bet it used to be a gorgeous facility. I was strangely fascinated with the upside-down pyramid structures.

The front entrance to our building was nicely labeled as both "Emergency".

And, thanks to the translation from my dad, "Outpatient clinic". Basically we functioned as both so the signs were appropriate. Not only did we have our sick call which was what soldiers would come to if they needed to see a doctor, or more frequently if they didn't really need to see a doctor as most people would know how to treat their own colds, but come to see the doctor because it's free, they can, and they might get out of some work. But we also did took take care of a small number of emergencies like a contracted Sri Lankan we resuscitated after he had cardiac arrest from a heart attack, a young soldier who was septic, and a few other less severe emergencies. Because we don't have much more though, we stabalize and send them to the Combat Support Hospital where they have an intensive care unit, critical care docs, CT scanners, and surgeons.

I like to call this entrance, the "Garden View" entrance as to the right of the ramp as you walk in, there is the single patch of vegetation (aside from palm and date trees) on the base.

I don't have any pictures from the entrance to the other side of the building, but I do have what was probably my favorite sign in our building. After you walk in and pass by the shops at the other entrance you would enter a hallway with two ways to turn. I was in room 121...that's to the right. I steared clear from metal and the bundles of wire we would sometimes have to limbo under while walking down the hall...except I did play a couple games of horseshoes (metal) toward the end of my stay. I survived with only a shock to my horseshoe playing ego.

No one had an electrical injury during our time there besides an occasional shock from plugging in a 110 V electrial item into a 220 V outlet. What was more likely to and did happen was a fire. One evening during sick call, we were particularly busy with other docs coming in to help me out so we can get done and get out to dinner (yes, that was our main purpose in finishing up quickly). The fire alarm began ringing and after all our years of fire drills in school, we continued our sick call and just looked around to make sure none of us were on fire. Then one of the docs walked over to the door to the provider hallway (you got it, the hallway where we sleep), slowly opened the door (another what not to do in a fire), turned around and calmly said while kind of laughing "Um, we have a real fire here." As a couple people started moving out, the rest of us watched our pharmacy tech and one of our medics rush to grab fire extinguishers. The medic won the race and put out the fire. That's when it became smokey. A signal we finally took to empty the room. (I think we all need to go back to school.) So what was the culprit? An old light that overheated and caught on fire. According to the fire department (there are American fire-fighters contracted to work on our bases here) there were many more in the past and that was the last of the old lights that would do that. I wasn't too worried even after this as the fire extinguisher was right across from my room :)

As the plans to start closing down the base progressed, the aid station started to get packed up and move out to our new base where we already had some soldiers present. Eventually most of our soldiers and doctors/PAs would move on out leaving just myself and a handful of medics to run the show. We lost everything from the dentist to lab to x-ray, now working out of a minimal pharmacy and one bed. But with the loss of our company, came a quieter more peaceful clinic. The highest ranking enlisted soldier (also called non-commissioned officer) made a schedule for our medics. Everyone was there at the appropriate times, never complained about their job, and was trusted to be an adult...it was a crazy concept for this company to not be treated like Orphan Annie, but it worked. We all were chillin'.

My typical day would be:

-wake up at 0745

-be at the front desk with SPC High (my morning shift medic) to wait for patients

-watch a movie with SPC High in between patients (anywhere from zero to six per day)

-go for a jog around the aid station around 11 AM then shower

-retire to my room to watch a lot of Nip/Tuck

-occasionally be called from my room to see patients

-sleep

-eat meals throughout the day

Eventually even more luxuries would leave. I had already lost the gym (see blog: Eulogy to a gym), and our dining facility was handed over from the contractors to the soldiers. If we didn't go to the dining facility, we would have Meals, Ready-to-Eat (MREs). These were prepackaged meals that were packed with calorically dense and intensely preserved foods. The hot item would come in a plastic bag-like carrier and you would heat it up by placing it in another bag with a heater that would become hot on contact with water. The total instructions are pretty cool and include leaning the final contraption on a "rock or something"--Hmmm..the exothermic reaction might be something Aunt Regina's science class would be interested in ;)--Otherwise, you may get a treat of "taffie snacks" which were Tootsie Rolls, strange cakes that had shiny crystals in them, applesauce, or, my favorite, wheat snack bread made to the shape of a bread-loaf slice. We also had boxes of chips and chocolate muffins. Since the dining facility cooked larger versions of MREs, we progressively went less and less to finally only eating chips, muffins, and MREs.

In our final 5 days, we were threatened with losing our shower trailers. They took away the male trailers so the males would either shower where the Ugandans would shower or in this other building so long as the power was on. The female trailer stayed, but no longer was cleaned and I've noticed a lot of girls here don't respect others by cleaning out their hair..nasty. There was only one shower in our building that I started to use, but with fear of losing power and the trailer, I stopped running. Instead I added a second movie watching session at the front desk with SPC High. We watched a LOT of movies during out time at Rustamiyah.

I think we did a good job of maintaining healthcare for our soldiers while there, but as the days wrapped up, we also got to take care of a couple Iraqi Army soldiers...namely two band members sent over by our Sergeant Major (the highest ranking enlisted title you can get). Since the band was an important part of the ceremony, we needed to make sure they could march and play. First was the trumpet player whose nose was stuffed. We had quite a crowd while I was examining him. I brought him some over-the-counter nasal spray, showed him how to use it, then he took a nice deep breath in through his nose as the medications started to work. Oh, if you could only see his face and the sigh of relief he had! Everyone was grateful I got the trumpet player breathing again...all with a simple spray you can buy at Rite Aid...thanks 4 years of medical school and 3 years of Internal Medicine training! The next soldier had some corns that were rubbing against his other toes from all the marching. I didn't have the proper tools to shave them off, so I had SPC High wrap them up in mole skin and gave him some ibuprofen (yet two more items you can buy at Rite Aid). Despite how simple our intervention was, he was so grateful...more grateful than any US soldier I had taken care of. He didn't speak much English but wanted to show his appreciation. He looked all through his pockets for something to give us. Finally, SPC High and myself were presented each with a piece of gum. As simple as his gift was to us, it made our day! We were thanked for one.

Below is the picture of our aid station on its final day. We had one litter and I brought out one sleeping cot for when a soldier was feeling ill from a stomach bug and needed a place to lay down while getting IV fluids.

With all the pre-planning we were doing for possible attacks on the turn over ceremony, one thing that weighed heavy on our minds was the weather. As mentioned in previous blogs, weather plays a huge impact on how and when patients needing emergency evacuation to higher levels of healthcare can get out. This is what we had the day before. It was really that bad. I'm sure it's still not the worst dust storm out there, but it was the worst I'd seen.

Fortunately that afternoon it rained settling the dust and the next day it was nice and sunny. A turn over ceremony is a huge deal. My parents even heard about it on an Iraqi news network. Since I had to stay back at the aid station, I didn't get much of a view. I kind of laughed at the thought that I am 300 meters away and get the view in the picture below while people thousands of miles away might possibly get to see what actually happened. Fortunately the ceremony went smoothly. It was time to leave. Or I should say, time to wait around for ten hours to leave.

This was my first ride in a military ground vehicle besides what we call the "deuce and a half" which basically is a truck we pile into the back of like sardines...just like the helicopter and plane rides! (see the below picture of me in Texas for some training...pre-LASIK and with our old uniforms...feel free to laugh as I do every time I see it)

These are heavily armored vehicles with seat belts of which I think I may have been the only one wearing.

Well as I was excited to finally hit the road and see Baghdad (take note of the daylight in the above picture), we actually didn't leave for yet a couple more hours...just in time for it to become dark enough that I saw a mosque and an empty open air market then nothing. So much for seeing the home land. But below was the last picture I took of Rustamiyah. I'm still trying to figure out if the port-o-john in the middle snuck in just as a little reminder that we were downwind from a sewage treatment facility. At least it looked pretty. The sky really was that color! It was a nice last picture to have of the base.

The trip to our new base was longer than I thought it would and since it was dark, I just sat with my eyes closed. Our driver (one of our 20 year old female medics) did a great job of avoiding the pot-holes. Once we arrived to the base, our platoon sergeant met us and assisted us with getting room keys and finding our rooms. This took us to about midnight...perfect timing for MIDNIGHT CHOW!!! I have only made it to midnight chow twice. The night we flew in to Rustamiyah, then this day. However, this day had more meaning. After all the MREs we ate, it was time for a real meal and no matter how tired we were, we were going to eat. I will never forget that feeling of seeing, smelling, and eating the baked chicken, mashed potatoes, and green beans....all cooked that day! I went to bed happy that night. I hope all the soldiers who our out on missions sleeping in their vehicles and eating MREs for days get that feeling every time they come back to the base.

That's about it for now. Thanks for stopping by on my picture blog. And thanks to Rustamiyah for not confiscating my camera!