Whew!

Hello All,

Well it's been a busy few days here at Camp Lemonnier (an aerial view of which appears above). It's a bit odd that, as time grows shorter, we seem to have accelerated our pace here at the best little EMF in Djibouti, but the additional work has been welcome. This is especially true as we had expected a bit of a lull while our point of contact at Hôpital Général Peltier - Dr. Elias - is away in Mecca on the Hajj. We've been preparing for some coalition military exercises, for which we will share medical duties with our French colleagues, so our drills have have taken on a new intensity (we've been working on our "walking" blood bank - that being the pool of folks walking around with blood of various types in their veins who might consent to bring it along to us in case we needed a bit extra in an emergency). The lab bit is a challenge, but it's really the administrative bit that's a nightmare - getting folks in, screened, and processed. Good practice though. Speaking of good practice, we've had a lot of practice with Medevacs and critical care patients. We've seen that big Air Force bird with a Critical Care Transport team in its belly touch down 3 times in the last week for a patient with heart trouble, a pharyngeal abcess and what we thought might be a case of acute meningitis. The former two were on ventilators, and as the de facto respiratory therapists my pal Herman and I spent a couple of long nights doing ventilator management. The weekend was dedicated to taking it easy and catching up on sleep.

Juxtaposed on all this is the ongoing H1N1 vaccination process. As an underemployed anesthesiologist, I ended up with "Public Health Emergency Officer", and as you can imagine I've been busy this past couple of months. With extremely able assistance (and extremely able assistants) however, we're almost done with the military folks here on Camp, and will start in on our contractors and other employees soon. We've been relatively spared so far, so that has been a blessing.

I did get my 11 mile run done this past Sunday though. My friend Kevin was kind enough to send along a book on treadmill training for runners, which has some helpful techniques, but most of the credit for not losing my mind must go to The Teaching Company, and to Professor J. Rufus Fears' absolutely engrossing series on Famous Romans. Having gotten to Marcus Aurelius, and the end of the series, I confess to being at a loss for next weekend's 12 miler.

Came back to a bit of sad news, as poor old Hektor, our long time patient Djiboutian military working dog, passed away. He had developed severe anemia and despite transfusions, and every other intervention we (and an international coalition of e-mail advisors) could think of, we could never get his bone marrow to restart production of blood cells. He had become a favorite of all of us at the EMF, and we were saddened to hear that he had passed on, albeit peacefully, last night. I will say that Hektor helped us all to become familiar with working around military dogs, and as that turns out to be part of the "expeditionary" mission, I would say he left us better than when we first met him - no mean accomplishment for anyone.

On a happier note, it now seems fairly certain that Mark, my replacement will arrive here on Thanksgiving day. It's an appropriate enough occasion: I shall of course be glad to see him, and - after a 30 hour flight - he'll be glad to get off the plane! Presuming that all then proceeds as scheduled, that'll put me home around the 14th of December - in plenty of time for Christmas, and with a bit of time to try to acclimatize in 70 degree San Diego before heading to Tahoe for our annual post-Christmas ski trip. I can't even imagine what 10 degrees is going to feel like on top of Heavenly. Brrrrr.

Other than that, not so much to report. With drills and critically ill patients we've been pretty close to base for the last couple of weeks. Weather is gorgeous, and it would be quite pleasant outdoors save for an explosion in the fly population - we're actually a few weeks into it now. The flies, which seem like ordinary house flies, have a discomforting tendency to land on one and ti refuse to take a hint. They aim for ears and eyes and noses and are thus a nuisance out of all proportion to their size or number. They also are sort of slow and not too agile, which doesn't work out that well for them - but it can make the outdoors a bit of a trial.

Anyway, reckon I'll sign off here. My CO pointed out to me the other day that Camp Lemonnier now has its own cool website. Should the mood take you, you can check it out at "https://www.cnic.navy.mil/cldj/index.htm"

Ciao!