Author: Frederick (Fritz) Karrer, MD
The OPTEMPO (operations tempo) has remained high in the region this week. We had casualties every day last weekend, including several multiple casualty events (4 or more). One of the MASCALs (mass casualties) was a suicide bombing at the Khost Police Station on Saturday that wounded over 20 and killed 3, including the commander of their QRF (Quick Reaction Force). We received 7 of the wounded from that blast, including a 12 year-old boy who took some shrapnel
through his flank and lost his right kidney as a result. Sadly, May was the deadliest month for civilians in Afghanistan since 2007, according to the UN’s Afghan mission (UNAMA). They documented 368 civilian deaths and 593 injuries in May due to the ongoing conflict. June doesn’t seem to be any better.
But enough of the gruesome side of our work here. I have managed to get into more of a routine lately. I get up at 0430, and the sun’s already up by then. I go to the gym, put in 30 minutes of aerobic (treadmill, elliptical, stationary bike, stair climber or rowing machine) and 30 minutes of weights. Then hit the showers, breakfast at the DIFAC (dining facility) and get to rounds by 0700. We usually have a couple of scheduled cases; dressing changes, wound wash outs, lots of extremity procedures (rods, pins, screws, etc). We usually help each other out (since there are no residents). I like helping the pod (orthopedic surgeon), COL Jimmy Swanson. He’s a high speed, low drag former West Pointer. Very knowledgeable and a good teacher about how to fix broken stuff. I’ve attached a photo of our patient from the first week, who was run over by a local truck and sustained a femur fracture. We call him “Hot Rod” because he is always zipping around the ward in his wheelchair.
During the day, we see patients in the LNC (Local National Clinic), mostly follow ups but occasionally new consults. I usually get asked to see the kids. One was a 10 year-old boy with congenital exstrophy of the bladder (basically an open, inside out bladder just above the pubis). This is a condition that normally is repaired in infancy in the US, but this 10 year-old has lived with his bladder open, dribbling urine his whole life. They have no diapers for him, so he just walks around with his pants wet constantly. He was refused by the school because he smells of urine. We are trying to find a way to help him, but with our high optempo, we can’t afford to tie up a bed. I got some good advice from our pediatric urologist at Children’s Colorado, Duncan Wilcox. We may be able to send him to Bagram, a bigger base and has the regional hospital there, with more capacity, more equipment and a urologist.
Later, barring additional events, we usually watch a movie, hit the computers for email or Skype or read. Thankfully, the nights are relatively quiet, trauma-wise, so being on-call is not overly
Scrub tech, SFC Sharke, on pasta night
burdensome. Even though the DIFAC is decent and has a good variety, it tends to be pretty tasteless and repetitive.
On Thursday night’s, one of the scrub techs, SFC Sharke, does pasta night. She sets up her little kitchen in the hallway outside the OR and has made some amazing meals. Most of the ingredients are sent to us from friends back home. This week, she made chicken alfredo, garlic bread, italian salad and for dessert, cupcakes. Very yummy and a welcome change from the DIFAC.
This week, one of our surgeons, Stuart Johnston, redeployed (that’s Army-speak for went home). Some of the more senior faculty will probably remember him. He was a CU surgery resident, finished in 1997. He’s currently on the Baylor faculty, practicing in a north Dallas suburb. Great guy and an excellent surgeon. Sorry to see him go so soon, but happy for him and his family.
Well, enough for this week. I’m going to show the new surgeon, Deepak Deshmukh (a vascular surgeon from Norfolk, VA) around the FOB. One last thing for the Cornhuskers, a picture of our back hallway (note the Black Shirts flag). Go Big Red!