Tuesday, May 26, 2009

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


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