Sorting through Sunday

Hello all,

It's around noon of a Sunday here in the Horn of Africa, a time when only mad dogs and Englishmen are supposed to be out.  We do have both here - I've met a very nice colonel from London, and our veterinarian quoted me an alarming 60% rabies rate for dogs here in HOA - but neither are in evidence today.

I've been out for a morning run, a triple macchiato at the Green Bean, Sunday brunch, and am settling in for an afternoon of reading and writing.  As to the latter, I thought that with your indulgence I might flip through my little red pocket notebook and share some of my observations in their unpolished state, just so as to clear out last week's slate and start the new one afresh.

First though, a little narrative is in order.  The picture above is from the Internal Medicine wing of Pelletier hospital, the Djiboutian facility here in town.  We had quite a long visit yesterday morning, and like most of Djibouti it was full of startling contrasts that play off on another in fascinating and appaling ways.  The photo above will give the viewer the impression of the dignified decay of a post-colonial nation, groping its way carefully to modernity.  The setting indeed is superb - the facility sits oceanside, looking westward to the more modern part of the city, with the bath-water warm Red Sea lapping at the rocky shore at its feet. Was I to turn the camera right or left by 45 degrees however you would see a mud and rock strewn "plaza", sprinkled liberally with the garbage, construction debris, and the occasional bit of medical waste that would make a Joint Commission inspector weak at the knees.  The interiors of the 15 or so buildings that make up the rest of the walled compound are similarly dichotomous - there are areas of well kept, if quite antiquated, wards, units and medical equipment, a couple of absolutely state of the art modules (a new CT scanner for instance), adjoined to rooms with trash strewn floors and broken furniture that look like the set of some post apocalyptic science fiction movie.

Through this moves the staff - a wonderfully diverse, uniformly polite and solicitous group of caregivers of whom I hope to have much more to report later.  We spent a good deal of the morning with Dr. Said - a Djiboutian born, French trained cardiologist - doing some transthoracic echocardiography.  We also met Dr. Yussuf, the radiologist who has been an invaluable aid to us here with CT scans and ultrasounds; Dr. Elias, the general surgeon with whom a lot of the previous EMF surgeons and Anesthesia folk have worked; the two Cuban ICU physicians who could not have been more welcoming, and and a group of French surgeons from Troyes here on a two week mission.  All were charming and enthusiastic about the possibility of our spending a bit of time helping out.  To some extent our ability to do so will depend on the operational tempo here, as well as our new CO's take on what he would like us to do.  I am hopeful though that we'll get over there on a weekly or biweekly basis.

I must mention in passing that Dr. Said's full name is "Dr. Said Abdillahi A. God", which is followed on his office sign by "Chef de Service de Cardiologie".  The whole looks something like this:

    Dr. Said Abdillahi

A. GOD

Chef de Service

de Cardiologie

"Hmmm", I thought, " I guess cardiologists are the same wherever you go"!  

(Just kidding, Tommy!)

Last night the Captains and Colonels up here in the O-6 housing area, fondly called the White House, got together to watch a movie and share some pizza.  The move "Taking Chance" was supplied by the Joint Task Force Chief of Staff, and the pizza was supplied by...me.  A day or two before, one of my eagle wearing colleagues had e-mailed, in response to to the initial queries about setting up "movie night" that he thought pizza would be a good accompaniment, and that maybe we should get "the Doc" to arrange it.  This was roundly affirmed by all on the string, save one whose identity I bet you can guess.  I gritted my teeth, pursed my lips, fumed and muttered imprecations - why, of all the presumptuous ...if they had any idea what ...idiotic self-absorbed line officers...too damn lazy to get their own...anyway, I went on like this for a while - all to myself of course.  Then I bethought me of a passage from one of the many perfect jewel chapters of  Moby Dick.  Ishmael is reflecting on the occasional indignities of going to sea, as he prefers to do, as an ordinary before the mast sailor, and he says:

 "What of it, if some old hunks of a sea captain orders me to get a broom and sweep down the the decks?  What does that indignity amount to, weighed , I mean , in the scales of the New Testamant?  Do you think the archangel Gabriel thinks anything the less of me because I promptly and respectfully obey that old hunks in that particular instance?  Who aint a slave?  Tell me that.  Well, then, however the old sea-captain may order me about - however they may thump and punch me about, I have the satisfaction of knowing that it is all right; that everybody is one way or other served in much the same way - either in a physical or metaphysical point of view, that is; and so the universal thump is passed round, and all hands should rub each other's shoulder-blades, and be content."

My friends, I ordered the pizza, grabbed the chaplain and headed out the gates to Allo Pizza  to pick it up, oversaw the serving out and collected the funds with the greatest of pleasure, and was sincere when I said it had been no trouble and I'd be happy to set it up again.  And if I silently added "old hunks", well I don't think anyone was the worse for it.  Such is the virtue of literature!

Hmmm, well here I have gotten all this way and not mentioned a thing from the notebook!  I reckon I'll save that for next time.  Many thanks to all of you who have e-mailed.  Special Thanks to Clarissa and Eric for the music recommendations.  

A la prochaine

A synopsis

Greetings all,

It's been an eventful few days, as my last entry indicated.  Our patients of last posting are en route to the US for definitive care, and we are settling down into our normal routine.  I guess to some extent we are figuring out what our normal routine is.  Our picture tonight is of the sun setting over the settlement of Balbalah (sp?) west of Djibouti city, as seen from the Old Cantina - one of the two base watering holes.  Haven't been out that way yet, but we still have a lot of exploring to do.

The folks we came in replacement of have now left, for good and for all and the ball is largely in our court.  One of the recent changes in the manning of the EMF is the staggering of the relief process, such that about one third of the officers - nurses, doctors and administrators remains behind to assure continuity.  They'll leave in July, but bless their hearts, they looked mighty wistful as that 767 lumbered down the runway and banked to the northwest.  For our part, if I may presume to speak for my colleagues, we were happy to see them off.  This is not from any dissatisfaction with our predecessors but more, I think, from an inchoate sense that until we start this tour, we won't really get any closer to being done.  Make no mistake, our eyes followed that chartered bird hungrily too.

We did get out for a couple of superb meals with the last crew before they left.  The first place was a restaurant called Bamfena which had the unlikely twin specialties of ethiopian food and fondue.  At least I think it's unlikely.  Anyway, we all opted for ethiopian fare - the owners being ethiopian this seemed like the better bet (although I was assured the fondue is good).  We split traditional preparation of savory meats and vegetables, served on a large round of bread - the bread more like a crepe - tearing the bread, scooping up the delicacies and popping them in our mouths.  I tried hard to remember to use only the right hand, but only just saved my lap from catastrophe a few times.  The food was delicious, and washed down nicely with St. George beer, imported from Addis Ababa. 

The night before last we took our predecessors out for their last Djiboutian meal, and ended up at a Yemeni fish restaurant, whose name I can't transliterate from the Arabic.  It was lovely - no alcohol as the owners are a bit more traditional then many in this French influenced town - but a fresh lemon beverage too sophisticated to be lemonade more than made up for it.  The fare here is fresh fish - I chose grouper - split, seasoned and roasted over a wood fire.  It is served with, again, a large bread round but the bread here is a flat, sesame seed covered  preparation - something like indian naan, but lighter and a tad crisper.  The fish is flaked off, wrapped in the hot bread and dipped into one of three sauces - cumin, cilantro, maybe tamarind and other exotic spices made the otherwise simple preparation magnificent.  I finished mine and my neighbor's - trying to be careful not to be too obvious about licking my fingers.

I realize that the forgoing will not serve to build a sympathetic and solicitous readership, but folks I gotta call 'em like I see (or taste 'em).  As a culinary stop on your world tour, you could do worse then Djibouti.

Of course, this happened a couple of days ago.  I was walking down the dust and gravel road that leads from our exchange and my CLU to the galley - it was lunch - and I saw an American woman in her early 30's, walking hand in hand with her 6 year old son.  A normal scene where you are, but it floored me.  I choked off an involuntary utterance - somewhere between gasp and sob, and I had to look away lest the hot pressure behind my eyes give way to tears.  I didn't realize, or I had buried deep down, how much I miss kids, children, my child.   Camp Lemonier is like Vulgaria from the Chitty Chitty Bang Bang movie (not Ian Fleming's original book) in that it is a childless world.  Ah!  How arid indeed this place is, and the world would be without the small faces, the sweet voices, the lovely, noisy, busy, joyful chaos that children carry with them as honey bees carry pollen - scattering it heedlessly in their flight. Oh, but I miss my little boy!  Anyway, I have no idea who they were or why on earth they were here and of course I didn't ask.  They walked along, and I turned my eyes to the West and walked on myself.  Do me a favor...hug a kid today.  You can wait until they've had a bath if you're squeamish.

Anyway, perhaps that's enough for today.  I've moved into my new, permanent CLU, bidding adieu to Ahab the crow.  The space is exactly like the one I vacated, save there is no TV, but there is a refrigerator.  All in all a net gain.  I'm off to Pelltier, the Djiboutian hospital tomorrow, having gotten to sit in on a C-section at the French hospital yesterday.  Arabic classes tomorrow night and Sunday.  I'll write more tomorrow.

Au revoir!

A long weekend indeed

I guess some measure of how the blogging habit takes hold of one might be found in the vague sense of unease I've had since the MWR internet portal (through which most of us connect with the outside world) went down for what was supposed 8 hours of maintenance - 3 days ago. In some measure no doubt this reflects the fact that "Skype-ing" as either a video chat or voice-only phone call with family is now impossible, but added to this frustration however is the insistent weight of an agreeable chore left undone. I am accordingly writing this from my work computer - after hours of course - but will perforce be unable to include photos from Djibouti. Quel dommage!

For those of you who have e-mailed, many thanks! I will reply as soon as ever I can, but you are certainly not being taken for granted.



In any event it has been an interesting 24 hours. About a day ago as I write this we were settling into our seats at the all hands club for a Memorial Day ceremony, featuring speeches and invocations by flag officers, master chiefs and chaplains. We (my EMF colleagues and I) planned to head off to a local beach some distance away after the ceremony, and I had sun block, rash guard and snorkel gear all set just inside the door of the CLU. Right after our Command Master Chief (he would be the senior most enlisted man on the base) began a recounting of the history of the Memorial Day holiday, I noticed some of the medical folks getting that startled, quizzical look that people get when their cell phone goes off on "vibrate" in their pocket. They betook themselves to various quiet corners to speak and then nodded and headed for the exits, looking over their shoulders to those of us still sitting with glances that could only mean we were meant to follow. Along we came.



It turned out, as we jogged to catch the folks already headed to medical, that we had casualties inbound by helo: 2 "immediate" and 2 delayed - triage terms for those requiring urgent intervention, and those who are stable enough to wait. I must be circumspect here in respect of both patient privacy and operational security considerations, but will say that both "immediates" are still here and on ventilators - one after surgery here in our OR, one after CT scan in town -and both "delayeds" are doing tolerably well. This is after heroic efforts by our surgeons, by our ER staff, by my anesthesia colleagues, by our nursing support staff and by our friends at the French hospital. We were very fortunate in having two complete crews of anesthesia/surgery folk as the folk we are relieving don't leave until Thursday - this allowed us to have plenty of back up both here and out in town.

And...in the delay between that paragraph and this one the Air Force CCAT team arrived, bundled up and whisked away (well it was a 3 hour "whisking") our 3 most seriously injured folks - one penetrating trauma, one head injury and one thoracic trauma. It was an adventure managing them here on the tip of the spear where we aren't really resourced for critical care management - for those medical folk among you, 18 hours of ventilator management with one expired CO2 monitor, no radiology, no blood gases and one SCD machine for 2 patients. As an interesting secondary issue, in the usual course of things the EMF is mostly a routine walk-in sick call type place - there is no daily, weekly or even monthly exposure to trauma and critical care. Imagine managing the patients mentioned at a mall front Urgent Care and you'll get something of the feel. Whew! That was more work then I had intended to do in 6 months! Anyway it was with both pride and relief that we watched those two ambulances roll off to the flight line and the waiting transport. It came at a good time - we got to experience the capabilities and limits of our little medical shop here at the very beginning of our tour. Next time we'll be even better prepared...or more thoroughly resigned.

I wandered down to the MWR office after dinner this evening to ask if they had any idea when their internet site (which we are supposed to use for personal web surfing) will be back up. They smiled and brightly said "No idea!" They assured me that "top men" were working on it. Top. Men. Sooo... it may be a while before I can post pictures and such as I will need to be on the MWR net to do so. Much news, and many reflections to share - new restaurants, Arabic lessons, a new CLU, and why life at Camp Lemonier is like Chitty Chitty Bang Bang. Coming this week to a blog near you. Pictures to follow, I guess.

Before I sign off, however, let me ask you all as a belated Memorial Day favor to me to whisper a small prayer tonight for the two injured young men we sent off to Germany today. This past 36 hours has brought home to me, in a way the interrupted ceremony might not have, what exactly it is that we pause to reflect on every year in May.

All the best to all of you. More soon

John

We are currently experiencing technical difficulty

Hey Folks!

Sorry not to have posted any thing for the last 48 hours, but the Internet outside of working spaces is down hard (was supposed to be up a day and a half ago). On top of that we've had a couple of critically ill folks that have soaked up most of our time for the past 18 hours or so. I'm writing this discreetly from the corner of our ward turned ICU, where I've been acting as a substitute respiratory therapist, managing ventilator settings on our two most severely ill folks, while the less ill are in the ward that is normally my office. Air Force critical care transport is inbound, reportedly in 4 or 5 hours. Hopefully all will be back to normal by then. Tune in later for all the details (or at least the ones I can share).

Ciao!

John

Selfish Saturday

Just a short post today.  Last night's send off BBQ avec les medecins Francais went a trifle late, and I have promised myself a refreshing nap as recompense for my contribution to international relations (it would hardly be polite to abandon the French general - an avuncular, white haired former anesthesiologist - and his officers).  It was fun, and fortunately their anglais was much better then my french.  They remembered how to use different verb tenses, for instance, while I could only discuss the present.  

The affair was nice, but was held outside in the "Old Cantina" - the camp's original  watering hole.  The air was completely still, 100 degrees despite the darkness and the humidity felt like 90%.  You broke a sweat eating a potato chip!  Anyway, there is some prospect that we'll get together again this long weekend, and that perhaps AC will be involved.  Other then that plans for the weekend are fluid.  I'll keep you posted.

The picture is from the local golf club, looking at the parking lot and the 7th fairway.  Quite a sand trap, eh?  Seriously though, one drives up, hires a Djiboutian caddie, who carries not just your clubs but a small section of green mat from which you can tee off  (there is not now and never has been a blade of grass).  The "greens" are oiled sand, and are reportedly undetectable without your caddies guidance.  I'm told that it has happened that games have had to be terminated when the caddy has abandoned his post on the arrival of the daily khat plane - although this is the merest of hearsay.

And that's it!  A couple of completely self serving notes  and I'll get to exploring the napping possibilities afforded.  Firstly, I figured that blogging would be a great way to let folks know what's going on without e-mailing, and I hope that's true.  I'm certainly enjoying it so far.  It does have the disadvantage however of not providing one with any feedback - one is speaking from a lit stage into a dark theater, unsure if there is any audience at all.  Not that I would stop were that the case - these entries are for me too - but please accept my sincere invitation to all and sundry for commentary either in the blog site itself, or via e-mail at "khufu8it@gmail.com".  Either will be as welcome as the first robin of spring.  

Secondly, one of the things I sort of miss (this from my vast experience of 9 days "boots on ground") is music.  Not that I don't have many gigabytes of stuff on iTunes, but there is no practical way here to sample new music, downloads are prohibitively slow, and radio is nonexistent.  I would love therefore some musical recommendations - I can order CD's from Amazon, or from our exchange.  What are you listening to?  Let me know - and my tastes are very, very broad .  I'd love to learn about some new tunes (or old ) that you all think are interesting, noteworthy and fun.  Thanks!

John

La Terrasse

Looking over my entries so far, one thing becomes clear:  I should avoid reading Melville prior to sitting down to write.  I'm going to try to keep most of these posts a bit shorter in an attempt to ease the burden on myself and my (likely imaginary) readership.  I'll read Hemingway next, I promise!

Today's photo is of the Michaud Medical clinic, in the back of which sits our wee operatory and my "office".  I'll say more about it all in future posts.  The thing on the blue box to the left is the Wet Bulb Thermometer, from which our heat stress readings are taken.  Here it reads 105 degrees Fahrenheit.  :p

Anyway, for those following along, my attempts to photograph Ahab have so far proved futile, but I'll catch that reprobate corvid in pixels yet.  Other current events include my signing up for the Arabic language course and the French language course at the distance learning centers here.

  

My French is the decayed remnant of my high school days, and my Arabic is non-existent.

I have many French resources - among them the Rosetta Stone course lent to me by friends Dave and Mary, and the quirkily enjoyable Coffee Break French podcast (originating from Glasgow) and these have proved helpful.  I want to quickly review some verb conjugations though and I know that unless I have some external driver that laudable goal is likely to go by the wayside.

As to Arabic, well it's not the predominant language here - that would be Somali - but nobody is offering a Somali course, and there are quite a few Arabic speakers around here.  I confess to being interested in the language since my time spent in the formerly Muslim occupied areas of Sicily and Spain, and my reading about the role of medieval Arabic speaking culture in the development of the Western scientific tradition (ever wonder about the origin of the word algebra?).  Anyway it should be edifying.

La Terasse  is the name of a restaurant situated about half way between the entrance to our base and that of the French.  It was recommended by Dave Leivers - he of the Rosetta Stone above - and was roundly aknowledged by the outgoing crew here to have a good reputation  although they had not as yet tried it.  We gathered up 5 hearty souls and a van, headed out the gate and turned right on Somali road (turn left and drive 5 or 6 miles and you're likley to pass the Somali border - unchallenged if it's after dark), right again at "Khat corner" (more another time), and we were there.  I knew right away that the cuisine was likely to be continental when we were invited to sit down and wait until the kitchen opened  - we had arrived at 7 PM.  The AC was anemic, the ceiling fans but faint help, but the meal - after we had been seated at 8 PM was phenomenal.  

I shall not attempt to render the names in French, but as an entree I had local scallops in a richly flavored sauce that would have made Julia Child envious. This was  followed with a local fish in a delicately spiced reduction, with a superb vegetable side dish .  My dinner companions had local squid sauteed to perfection - delicate, flavorful with just a bit of firmness, and chateaubriand with a mushroom  sauce that had us all grabbing for the last bits of the baguettes served with dinner to mop up.  Wow!  The owner, a lovely French lady, had talked us into ordering a couple of chocolate "volcano" cakes after recounting for us her struggles at the market to get her hands on one of the scarce bags of cacao before the other restauranteurs outbid her.  We were not disappointed - it was at once light, rich, intense and delicate.  Not a chocolate fan ordinarily dear readers, but this was a wise investment.

The owner was, as I say, a French ex-pat, who I wish I had had a chance to ask about her life here in Djibouti.  She was very proud of having the only French chef in Djibouti - a claim I could not hope to discern the accuracy of, but which did make me wonder what crimes exactly the chef de cuisine must have committed to be sent hither.  I guess Devil's Island is closed. Anyway, we got back home (odd how quickly one's CLU becomes ones castle!) about 11PM, well sated and grateful for this oasis of gustatory delights here in a harsh land.  Life here shall not be entirely without its charms.

Tonight we'll celebrate the departure of the folks we're replacing, at a BBQ which is to be attended by our French and Djiboutian counterparts.  More on that tomorrow or soon thereafter.

As a counterpoint to the tale of elegance woven above, I'm attaching a story forwarded to me by one of the folks here. It is a frank  account of one chap's exploration of the culture of khat here in Djibouti.  A bit grim, but entertaining.  If the link doesn't make it through, search for Esquire magazine and an article titled "High in hell".  I'll warn you that it is graphic, coarse, explicit and involves the deliberate use of illegal drugs.  If that doesn't make you want to read it, then I've mistaken my audience...

http://www.esquire.com/ESQ0906KHAT_182

Until next time!

Camp and Ahab, the crow.

For the most part the environment outside the door of my CLU has the aspect of a large construction site.  There is heavy machinery rumbling hither and thither down the gravel roads, excavation and industrial clangor aplenty accompanied by the smokes and fumes of diesel and other exhaust, and in every direction people with hard hats and power tools are working away. Superimposed on this construction job site ambience, are the noises and sights of the airstrip 100 yards from where I write - the whine of military and civilian jet turbine engines warming up, the viscerally felt roar as they take off, and the more basso  "thwok thwok" of the rotors of heavy helicopters round out the aural landscape.  

Walking about, the bulk of what one sees is the utilitarian underpinnings of western style life wrung out of the African desert - rows and rows of generators (we produce a third as much electricity as the whole country), reverse osmosis water generators, waste water treatment facilities, truck and heavy machinery maintenance yards, and everywhere antennae and dishes of every shape and description beaming and receiving the constant stream of information that is the sine qua non  of modern military operations.

The gravel "streets" are daily sprayed with water in an attempt to keep down the dust, and are uneasily shared between pedestrians, bicyclists, camp motor vehicles, heavy equipment, and the ubiquitous "gators" - little 6 wheel ATV's that do much of the utilitarian hauling on base.

Much like on a submarine, the living and working spaces are tucked - sometimes artfully, sometimes less so - in and around the industrial skeleton.  We have the galley that I'll someday spend more time on, a "movie theater" where DVDs are projected while popcorn is served, a tiny post office - although a new one complete with ATM is rising in the middle of the former tent city - , and most recently added 11 Degrees North - our all hands club where sailors, airmen, soldiers and marines can go for their 3 beers per night.  The bulk of the rest of the structures are the homes of the 23 tenant commands here on base.  In essence, the camp and its CO - for whom I work - is like the ship's company of an aircraft carrier: here to make sure that the utilities, amenities and services are available for the folks who go further down range to assist with security stuff, humanitarian operations and most recently piracy interdiction.

I'll talk more about who is actually here in a later post, but I wanted to mention Ahab.  The camp has become a haven for several bird species.  One can find sparrows, pigeons, mourning doves, and the occasional ibis is sighted flying overhead, but by far the most omnipresent avian company here is provided by the crows.  The species prevalent hereabouts is mostly similar to its North American brethren, save for being a bit smaller, and having subtly different coloration - the body is actually dark gray while the wings are true black. There are hundreds of them around, raucously  calling to each other, shouting corvid jokes and gossip and vociferously scolding we poor earthbound creatures who must walk the dusty paths.  In any event, one of this multitude, an ancient, disagreeable and ill favored bird with one or two flight primaries missing from his left wing likes to roost on top of my CLU.  As I sit here now I can here the click click of his talons as he skips across the thin aluminum  of the roof.  It seems that he has taken a dislike to human kind as a general proposition and to me (or by report anyone living here in #37) as the specific example of all he objects to in our species.  I am greeted on leaving in the morning and on return in the late afternoon with a harshly croaked commentary on the shortcomings of humanity which is perfectly expressed despite our lack of a mutual language.  Following this diatribe Ahab, for so I have named him, will fly off to a nearby tree to share with the waiting mob of his brethren his latest editorializing, to general and vocal approbation.  If I am not watching him, Ahab will swoop down and buzz me - the wind of his passage seeming to be right by my ear - much as his fictional namesake launched himself at his much larger nemesis.  I don't know if this is counting coups by his lights, or  if as I rather suspect, he is just a disagreeable old bird whose miserable humor is lightened somewhat by the chastisement of the ignorant and unwary.  

I'll try to send along a picture and have been carrying around my camera in hope of doing so.  The evil little blighter has yet proved elusive...but fear not faithful readers for " I'll chase him round Good Hope, and round the Horn, and round the Norway Maelstrom, and round perdition's flames before I give up!"...to quote a more famous Ahab.

Next time dinner at La Terasse.

I finally get a CLU

I know a lot of folks will be waiting for accounts of life "outside the wire", and please be assured that I'll spend a lot of time on the topic.  To this point I've been out about 4 times, most recently to meet our French colleagues at Bouchard - the French military hospital - and it has been interesting each time.  I thought I might start with Camp Lemonier life first though, as it is the area I know best currently.  Write what you know, right?

Well, of course, the most interesting items to any sailor are berthing and food.  I'm happy to report that both are as good as might well be hoped.  I know my colleagues Dave and Krista spent their days here in a camp composed chiefly of tents and few hard structures.  Almost everything here is now based on the "CLU" - the Containerized Living Unit.  I 'll attach a photo of course, but imagine something like the conex  boxes you see hauled around on ships, trucks and trains.  Now add a door on one end, with a window and overpowered air conditioner beside.  Append a bathroom with shower to the other end with a wall and door separating from the main compartment.  Now add white wall panelling - like drywall, but sturdier - and a linoleum floor,  a bed, a desk and a sea chest, throw in about 4 220V outlets and run wires for internet and phone and you have it.  A bit spartan although of course the actual Spartans would think it the height of sybaritic luxury.  Can't complain too much I reckon.

These CLUs form the basis for all the living quarters, and the majority of the office spaces (although those are called "CHUs" - maybe it should be "CHOO"s as they are often pinched and uncomfortable no matter how stylish).  I live in a cluster in a compound affectionately called the "White House", after the original structure on the site when the US forces assumed control of the base.  There is another small cluster not too far away, but by far the majority of our folks live in "Clu-ville", a collection of white metal living boxes that stretches away almost as far as the eye can see to the east of the camp.  It looks like an odd amalgam of those rental storage facilities one sees on the outskirts of many cities, and of an Arizona trailer park.  They present an orderly if charmless vista, baking away there in the noon time sun, but they give our folks a modicum of comfort and privacy, and sure beat staying either in a 40 man tent or even the berthing spaces of most Navy ships.  

As to the food...well as much as I would like to regale you with tales of hardships suffered and miseries endured, it may be the best food I've seen regularly  served in my 20 years in the military.  The dining facility is named the "Bob Hope Galley", and I think that Mr. Hope would be happy to have been associated .  The food is fresh, abundant, diverse, well prepared on balance, and of course free!  It is a common trope that you can either come back from Djibouti bench pressing 300 pounds or weighing 300 pounds.   I'll send a picture in 6 months and we'll see which way I roll.

Tonight we (the medical team) are off for dinner at La Terasse,  a spot frequented by folk from the French base and located about half way between the US and French sites.  Tomorrow (or next posting) more about the city of Djibouti, the French Hospital and events here.

A la prochaine!

First impressions...

After we took off from Bahrain our air crew en route to Djibouti asked us to close our window shades so that those who wanted to watch the in-flight movie could do so - it being the bright morning of another day here in the ancient middle east.  (As an aside, does nobody sit with their heads resting against the plexiglas window of the plane just musing as the world slips by below anymore?  It seems now that plane travel is assumed to be the occasion for watching expurgated versions of movies I either didn't want to see or would like to have viewed in more congenial surroundings.  We are not, it seems, a planet full of contemplative musers  but instead want our experience of the world to have some explicit content...).  Anyway, it was only as the aircraft started to descend that I pulled up my shade and watched the rugged, secretive hills of  Saudi Arabia slipping by underneath.  The Gulf of Aden next leapt into view - a breathtaking aqua blue in the middle of this dry, dry land -  and as we banked, the tan and grey coast of Djibouti and Eritrea.

We continued down into Djibouti from the northwest, details emerging as we dropped lower and lower.  The initial impression I had was of brokenness.  The landscape from the air is brown sand and dirt, scattered with grey and black boulders that seem to have been tumbled off the grey and jagged ridges that march off to the South.  A few trees and shrubs - acacias and other hard-scrabble flora -  traced out the lines of the dry stream beds, and away far south rows of hills  shimmered in the noontime heat as we made our approach.  The image of a broken land was enforced from this less lofty vantage by the endless scattered piles of rusting machinery, buses, trucks and motorcars that seemed to line our approach vector as far as I could see (turns out we came in over the junk yard).  Interspersed with the detritus of mechanical artifice, tucked in dusty crevasses and under the scrubby trees one sees human habitation - from cinder block and tin shacks to crude shelters of bent branches and rags.   The impression one has is of a land so harsh that machines fail and are discarded; where humanity has abandoned its sophisticated material culture as too fragile, relying instead on its own ancient and fierce gift for survival, clinging to life in the face of drought and aridity, as unbowed by its surroundings as a dandelion pushing its stubborn head through the middle of your driveway's asphalt.  As I'll tell in a later post, to some extent this is an artifact of the flight path - there certainly is luxury, vibrant culture and and civilized life to be found here.  The first look however seems unrelievedly post-apocalytic...at least to the kind of person who likes to gaze out the windows of airplanes.

We got off the plane, and boarded a crowded bus that took us the 30 feet to the air terminal.  Passports and military ID's were presented to the Djiboutian immigration authorities, and we piled back on the bus for the 10 minute ride to Camp Lemonier.  The AC units seemed short on coolant, and strained mightily to blow tepid air as we went through the multiple layers of security, along the dirt and gravel road limned by cement walls and concertina wire.  The bus coughed to halt and we were here.

Those of you kind enough to follow along in this journal will rapidly get tired of my description of the heat, so indulge me here and I promise only to mention it in unusual cases from here on.  It is hot.  Silly hot.  Crazy hot.  As I got off the bus I giggled - the wave of steamy, viscid warmth that surrounded me as I stepped down was just so over the top, like a practical joke or some Disney ride effect.  These were of course but the balmy zephyrs of Spring.  We all looked nervously or sympathetically at each other.  Everyone's unspoken thought was of the fiercer days of summer even now slouching toward us, of which the current discomforts were but a foreshadowing.  Hot.

In fairly short order we were met by our sponsors - those folks for whom our arrival signaled that their return could be but a week or two away.   They were the souls of caring, solicitousness and kindness and so sincere that it was impossible to mentally accuse them of gloating.  I hope I am so kind to my eventual replacement.  In any event, after a brief welcome aboard brief in the comfort of "The Oasis" - our movie theater - we were off to our CLU's and left to unpack and collect ourselves.  

More on CLU's and camp in my next.

Our story so far...

Well, it looks as if the blog will work, so I'll send out the links to all and sundry later on today.  I thought I might recap my progress to this point, for anybody who hasn't been following along to date.  Following that - either today or tomorrow - I'll tell you about my interesting day today, including first daytime tours through the city of Djibouti and environs.

I knew that I'd be going on this tax-payer sponsored all expense paid beach excursion (it helps me to think of it as a really big beach), around December of last year.  A couple of folks have asked me if I had to go, and the answer there is no.  As the Chair of a major department at a big teaching hospital I probably could have made a case for staying put, but...the department was where I wanted it to be; I had for the first time a strong cadre of junior, senior and mid-level officers;things at home were favorable - Jack is a well adjusted kid in a school that we love well, and Donna has always been a paragon of self sufficiency.  All these were good reasons to expect I could head out for 6-7 months and not cause upset at the job I love and to the folks I  most care for.  In truth though,  perhaps the most telling motivation for me was the experience of having sat on the comfortable, Captain side of my desk and told officer after officer on the opposite side "You're going". 

In this regard, my role is often as the secondary confirmation of the tidings they will have already heard from detailer or specialty leader - but it is an uncomfortable seat to sit in on either side of that expanse of cherry wood.  

It has been about 18 years since my last tour in an area of active operations, and I frankly felt awkward that I couldn't very well know what it is I was sending my folks to without doing it to some degree myself.  That is not meant to sound noble - it's certainly not.  To do my job and feel comfortable doing so, I needed to do something like this.  So here I am.

The Navy has decided that all of its folks going to the CENTCOM area of operations (and that includes all the interesting stuff from pirates to the Taliban), who are not shipboard, will go through about 3 weeks of what we fondly call "NARMY" training.  This is three weeks of a group of folks ranging from youngish seamen to oldish Captains with all types of skill sets (lawyer, doctor, electrician, dog handler, computer network specialist...you get the idea), learning to wear body armor; carry, shoot and maintain weapons; do some rudimentary land navigation and learn to be a member of a military convoy.  As you'll learn in future postings, for the approximately 20 of us who bound here to HOA, this was perhaps a bit more than is likely to be required, but for my colleagues bound to Iraq and Afghanistan these skills may indeed prove essential.

The training takes place at Camp McCrady - a smaller outpost on the enormous Fort Jackson, just outside Columbia, South Carolina.  The Fort is one of the Army's basic training sites, so was well set up to support us.  We arrived at the end of April.  Within the first day or two  our  gear and weapons  were issued  (M-16 rifle and M-9 pistol in my case) and thenceforth we daily strapped on our 70 odd pounds of armor and weaponry, and learned to aim, shoot, maneuver and the myriad other skills useful to the ground soldier.  Our instructors were Army drill sergeants who were firm but friendly and frankly stood up well in my estimation to the task of ordering about a large and fractious group of older folks (average age 37) often far senior to them and unused to being told the whys and wherefores of their day without a chance for commentary or demurral. 

It was fun in an odd way (and in retrospect).  There is something oddly liberating about surrendering the need to make any decision to someone else, and just having to remember to muster as told, wear the assigned kit, and shoot at what the nice man pointed at.  For all that, I was sore every evening from the unaccustomed weight of kevlar and ballistic shields (Take a moment here to reflect on the uncomplaining service of the tens of thousands of young men and women who right now are standing in the hot sun with this stuff strapped on them - unwelcome armor against an unwelcoming world.  I respect them now more then ever).  In any event, I am now substantially more likely to be able to aim a rifle appropriately, and more importantly less likely to hurt myself doing so!

The net here is pretty slow but I'll try to get a representative photo posted.

In any event, after 3 weeks it was done.  We gratefully packed away our heavy "battle rattle" and boarded a bus headed for Norfolk.  Had a great BBQ sandwich at a roadside lunch place en route, then boarded a 0100 flight and arrived 2 days later in Djibouti.

I think that's enough for today, so I'll sign off here.  I've been here in the Horn of Africa about 4 days now - still jet lagged, although less desparately so, and it will be a fascinating  (if hot) tour with lots of potential for interesting and diverting work.  More of that and of first impressions of our camp and of the surrounding country and people tomorrow.  Apologies to those for whom this prologue is unnecessary but it felt like the the right thing to do.  Picture is of me close to the end of my Camp McCrady training.

Au revoir!

Loomings (with apologies to Melville)

"Call me Ishmael.", is how Melville starts the best American novel ever written, Moby Dick.  I cast about for an equally stirring first line, but calling me Doc, Papa, John or Johnny, or even Gas Passer just didn't seem to answer.  I leave the choice of moniker to you therefore.

In any event, much like Melville's philosophical sojourner I'm off to remote climes and austere circumstances, away from kith and kin and thrown in among a set of charcters of varying degrees of sympathy and interest.  Of course, where Ishmael went to "sail about a bit and see the watery part of the world", I am bound to the dusty shores of Djibouti - by report the hottest continually occupied locale in the world.   I'll be providing anesthesia services and whatever other value I can add here at EMF Djibouti, where we support joint and multinational forces helping to bring assistance to this corner of Africa.

I'm not sure if an account of life here will interest anyone but me, but I thought rather than fill e-mail in-boxes world-wide with intermittent  missives, I'd create a central site where I can make a journal, some photos and who knows what else available to all.  My attempt to do will be charted in the posts that follow.  C'mon along!

As this is my first attempt with this medium, I'll stop here and confirm that it's working well.  Presuming this to be the case, tune in tomorrow for "Our story so far..."