Day 58: Communication

I remember my first painful few days as a medical student as it sounded something like this...

"I have Mr. Smith who is in his 80s. He has heart problems, kidney failure, diabetes. He has a wife...did I mention he was on was on blood pressure medications. He had breakfast this morning. He had labs done today...I have them here somewhere. Oh did I mention that surgery was consulted. And by the way, I almost forgot to mention he had chest pain this morning, and also a fever..."

I remember my first few days as a convoy commander on the radio as it sounded something like this...

"Umm...hello this is Boxkicker 1 (our call sign) I heard an explosion. I think it's an explosive ...maybe. Oh, did I say there was also gun fire. Not sure from which side...possibly both. Oh yeah...I also think we will need some help since our vehicle is blown up, and we are ambushed. I almost forgot we also have several wounded...this is Boxkicker 1 out, roger, noted, thanks. "

It now sounds something like this...

"All Boxkicker elements this is Boxkicker 1, received contact right, IED and small arms fire. Requesting vehicle recovery. We have 1 wounded, CLS in progress. 9-line medevac initiated and QRF requested. 1 out."

If there is one thing that I have taken from this training it would be understanding the importance of clear,concise, and frequent communication. Not only in the context of demonstrating proficiency using a radio, but also in the context of interacting with people. Poor communication causes relationships to fall, rumors to start, wars to be lost, and soldiers to be dead. Let's work on avoiding that...

"A soothing tongue is a tree of life, But perversion in it crushes the spirit."
Proverbs 15:4 NASB

"I'd like fries with that...over"

Day 55: Capstone

This past week has been very busy, stressful, and at times frustrating. We have come towards the tail end of training which the Army dubs as the "capstone" exercise which signifies the culmination of our training experience. All of the knowledge gained from class work and mild-mannered training exercises these past 6 weeks have now come together into a series of "missions" which our team will be required to complete. At the same time, the concept of TEAM will be tested as many of us are growing weary of being away from our families, and being forced to live in the same room together!

Using a computer simulator as a planning tool for our upcoming missions...what a nerd am I!

This past week our "mission" was to investigate terrorist activity in a nearby village and to apprehend a HVT or "high value target" who has been responsible for multiple attacks on US forces. This "mission" was to be completed alongside our Afghan Army counterparts as we were merely an advisor team. This "mission" evaluated our team's ability to effectively plan and execute a "cordon & search" operation, and coordinate a raid operation. I once again found myself asking, "What in the world does all of this have to do with me?".

The cool thing is that the whole training exercise required a large number of Dari speaking actors playing the various roles of villagers, terrorists, and Afghan counterparts. There was a real-life Afghan village where we conducted our "mission". There was some pyrotechnics to mimic the sound of indirect gunfire which added a little stress to the situation. Different villagers and Afghan soldiers ended up "wounded" so I was able to perform some combat life saver skills. I wish I had some cool action pictures to share, but there was never an opportunity for a decent photo op...sorry!

At the end of it all we somehow made it through our exercise, not necessarily with flying colors, but with enough flare to hold our heads up high! What our instructors had emphasized as a strength was that we not only worked well within our own team, but we also worked well alongside our host nation counterparts during the scenarios.

To answer my question, "What in the world does all of this have to do with me?". Even though I won't be kicking down doors and catching the bad guys...my mission as a physician will not be any different than a supply officer, infantry soldier, artillery soldier, tanker, nurse, clinic administrator, pharmacist, or pilot. To leave behind an Afghanistan that is better than when I first found it.

"You are the light of the world. A city set on a hill cannot be hidden; nor does anyone light a lamp and put it under a basket, but on the lamp stand, and it gives light to all that are in the house." Matthew 5:14,15 NASB

Day 50: Happy Birthday Max!

Happy Birthday to you, Happy Birthday to you! Happy Birthday dear Maxwell!! Happy Birthday to you...

Max's Very First Birthday!

Today is Maxwell's 2nd birthday! Being away from my son especially on his birthday has been tough. He is really growing up so quickly! He is such a special boy as he has really been a fairly low maintenance toddler. Yes, he has tantrums from time to time, but overall he is such a kind, cheerful, attentive, helpful, and smart little boy. He doesn't need expensive toys...just throw him any kind of ball and he is good to go. What has been most amazing is the love and care that he openly displays for his baby sister. He is always requesting to hold her little hand, stroke her head, or attentively watch as Gemma nurses her. I am so truly blessed! I can't wait to see him again!

Super Max
(13 months)

A Day at the Park
(20 months)

Dearest Maxwell,

Happy Birthday son! I miss you so much, and I am sorry that I can't be with you on your birthday. I really enjoy talking to you on the web cam, and I have especially enjoyed watching you play with your baby sister. Even though the web cam is fun to use I would much rather see you in person because I want to give you a big hug. I will be home soon, and I can't wait to play you one-on-one basketball!! Take care of mommy and Maya for me. I love you...

...Daddy

Day 49: Medal of Honor

I am of the opinion that all men and women who serve in the military are heroes, but there are a very select few who have gone "above and beyond the call of duty." The medal of honor is the highest military award awarded by the US government. It is bestowed on a member of the United States armed forces who distinguishes himself "conspicuously by gallantry and intrepidity at the risk of his life above and beyond the call of duty while engaged in an action against an enemy of the United States". Because of the criteria of the award, it is often given after the recipient has died in battle.

Desmond Doss: "War Hero Without a Gun"

Private First Class Desmond T. Doss is one such recipient who is an inspiration to me both as a fellow Seventh-Day Adventist Christian and fellow medical provider. Over the weekend I was able to watch a documentary on DVD entitled "The Conscientious Objector" which told his miraculous story. The citation for his award tells the story...

Rank and organization: Private First Class, U.S. Army, Medical Detachment, 307th Infantry, 77th Infantry Division.
Place and date: Near Urasoe Mura, Okinawa, Ryukyu Islands, 29 April-21 May 1945.
Entered service at: Lynchburg, Va.
Birth: Lynchburg, Va.
G.O. No.: 97, 1 November 1945.
Citation: He was a company aid man when the 1st Battalion assaulted a jagged escarpment 400 feet high As our troops gained the summit, a heavy concentration of artillery, mortar and machinegun fire crashed into them, inflicting approximately 75 casualties and driving the others back. Pfc. Doss refused to seek cover and remained in the fire-swept area with the many stricken, carrying them 1 by 1 to the edge of the escarpment and there lowering them on a rope-supported litter down the face of a cliff to friendly hands. On 2 May, he exposed himself to heavy rifle and mortar fire in rescuing a wounded man 200 yards forward of the lines on the same escarpment; and 2 days later he treated 4 men who had been cut down while assaulting a strongly defended cave, advancing through a shower of grenades to within 8 yards of enemy forces in a cave's mouth, where he dressed his comrades' wounds before making 4 separate trips under fire to evacuate them to safety. On 5 May, he unhesitatingly braved enemy shelling and small arms fire to assist an artillery officer. He applied bandages, moved his patient to a spot that offered protection from small arms fire and, while artillery and mortar shells fell close by, painstakingly administered plasma. Later that day, when an American was severely wounded by fire from a cave, Pfc. Doss crawled to him where he had fallen 25 feet from the enemy position, rendered aid, and carried him 100 yards to safety while continually exposed to enemy fire. On 21 May, in a night attack on high ground near Shuri, he remained in exposed territory while the rest of his company took cover, fearlessly risking the chance that he would be mistaken for an infiltrating Japanese and giving aid to the injured until he was himself seriously wounded in the legs by the explosion of a grenade. Rather than call another aid man from cover, he cared for his own injuries and waited 5 hours before litter bearers reached him and started carrying him to cover. The trio was caught in an enemy tank attack and Pfc. Doss, seeing a more critically wounded man nearby, crawled off the litter; and directed the bearers to give their first attention to the other man. Awaiting the litter bearers' return, he was again struck, this time suffering a compound fracture of 1 arm. With magnificent fortitude he bound a rifle stock to his shattered arm as a splint and then crawled 300 yards over rough terrain to the aid station. Through his outstanding bravery and unflinching determination in the face of desperately dangerous conditions Pfc. Doss saved the lives of many soldiers. His name became a symbol throughout the 77th Infantry Division for outstanding gallantry far above and beyond the call of duty.

The citation only mentions part of the story. When he first joined the Army he was ridiculed and even physically assaulted for his strong convictions of not wanting to carry a weapon (he is the only conscientious objector to be awarded the medal of honor), and his convictions on keeping his seventh-day Sabbath holy. His commanding officers made several attempts to kick him out of the US Army. The same people that treated him so unfairly were some of the very men that he saved on the battlefield.

The citation mentions that he saved 75 men...yes 75 men! He dragged them several hundred yards one or two at a time then lowered down the escarpment to safety...mind you that PFC Doss was only about 150 pounds! Also, every time a soldier was on top of that escarpment that soldier would be wounded or worse in a matter of minutes. PFC Doss was unharmed while saving all 75 men on top of that escarpment. Years later, a Japanese soldier reported that he had Doss in his sites, but his rifle jammed every time he attempted to pull the trigger!

After that miraculous act of heroism his infantry company received orders to take over the escarpment several days later...which landed on Sabbath. Doss was the only medic left and his company knew his convictions. Doss made only one request...he asked to have some time to read his Bible prior to battle! His request was granted by the Brigade General!! Can you believe it...the war was put on hold for a combat medic whose faith and "sword" was thought of as of vital importance in attaining victory. They won the battle that day.

This man was truly a man who stood for truth, courage, and obedience to God even to the point of death. What has been even most inspiring is that through all the earthly praise and honor that he received he still remained a man of quiet humility...a man who I know will be counted with the meek who will inherit the earth.

Desmond Doss: A Man of Honor, A Man of God

"And they overcame him by the blood of the Lamb and by the word of their testimony, and they did not love their lives to the death."
Revelation 12:11 NKJV

Day 47: Direction

Today was a rather interesting class as I learned how to use basic navigational tools (binoculars, protractors, and topographical maps) to be able to assess where a target is located. I also learned how to radio in for reinforcements if my team is pinned down by enemy fire using grid coordinates on a rather complicated topographical map (if I find myself in such a situation...it's a bad day). In other words, the training theme of the day was understanding the importance of having a sense of direction! From a combat perspective, without direction one is lost and probably doomed. Is it any different spiritually? This world provides us with so much distraction that it is too easy to find ourselves way off the "straight and narrow", sometimes when we don't even realize it. Won't you stop and consider if you are living the right direction today?

"If can of Myself do nothing...because I do not seek my own will , but the will
of the Father who sent Me." John 5:30

"Many are the plans in a man's heart, but it is the Lord's purpose that prevails."
Proverbs 19:21

Day 45: Teachability

It has been a busy week as we have had multiple "range days" where we would essentially spend all day (and night) shooting at plastic targets in the middle of an open field. Looking back at the past week, I can't believe that I have intimately acquainted myself with pistols, rifles, machine guns, grenade launchers, and night vision technology (to the point of ad nauseum!!) which have now taken the place of my stethoscope, reflex hammer, tongue blades, pens, and pocket pharmacopoeia. Being a Christian physician has made these educational endeavors especially difficult since I am around people who seem to enjoy shooting at things and blowing things up.

In hopes of finding a life lesson from a week of seemingly meaningless target practice... I would have to say that I have learned about the invaluable virtue of being teachable. Out of all the military members in my group I am the least experienced when it comes to deployments & weapons familiarization. In other words, much of the military stuff that I have been learning has been way over my head. This has been extremely humbling considering that I'm used to being the mentor rather than the mentee. But, in allowing myself to remain teachable I have been reminded of several things:

(1) being teachable starts with being humble
(2) being teachable means respecting the knowledge and background of those who are teaching
(3) being teachable means realizing there is no shame in saying " I don't know"
(4) being teachable is an exercise in listening
(5) being teachable is an exercise in being patient
(6) being teachable opens yourself up for unparalleled opportunity and growth...remember Jesus' use of a seemingly random mix of disciples who ended up changing the world?

Hitting plastic tanks with a grenade launcher (mounted on the HUMVEE).
Try to spot the tanks off in the distance.

Check out the night vision goggles...FYI, don't look into the sun with them on...

Learning how to assemble and disassemble the "50 cal" machine gun with
Petty Officer Hemcher

"Make your ear attentive to wisdom. Incline your heart to understanding."
Proverbs 2:2 NASB

Day 40: Home on the Range

This week was a bit more challenging as we spent almost 30 consecutive hours on a shooting range familiarizing ourselves with a variety of HUMVEE-mounted machine guns and foreign rifles (none of which I will be using when I get to Afghanistan). While many soldiers seemed to be getting a rush out of firing the machine guns...I cringed at the thought of handling them let alone learning how to assemble, disassemble, clean, and operate them. As a naval officer and someone who's last "weapon" was a Super Soaker...this is totally weapons overload!! I will spare you the painful details of a typical range day and leave you with a few pictures...

A view of "the Range"

Team Navy/Air Force patiently waiting our turn

MREs...Meals Ready to Eat or Meals Refusing to Exit?

"Then David said the Philistine, 'You come to me with a sword, with a spear, and with a javelin. But I come to you in the name of the Lord of hosts, the God of the armies of Israel'..."
I Samuel 17:45 NKJV

Day 39: We Will Never Forget

Today was a long day...we have been on the "range" for the last 2 days with minimal sleep and just got back this morning. I was going to add an entry about that experience, but I will save that entry for later...

When I applied for my military medical scholarship it was sold to me as an "easy" way to pay for medical school. Why not...free money...no school loans! My hopes of a "easy" military obligation all changed after 9.11.2001. At the time, I had no idea what the attack on NYC meant, nor did I have the time to ponder the implications it had on my future military career. Honestly, I was simply trying to get through medical school. It's now seven years later and the call to duty is in no way an "easy" one. In preparing for this deployment I have often caught myself complaining about how I would NOT have taken the scholarship if I knew the cost would include a year-long excursion into the dangerous "sandbox". How selfish am I? After reflecting back at what our country has been fighting for, and the sacrifices that have been made in the name of freedom...I find it an honor to serve in the United States Navy. May we never forget the freedoms that we have been blessed with, and for the bravery of those who have given their lives to grant us those freedoms.

Day 35: Better Living

Today marks the halfway point of this whole training experience. Living in the same room with 40 other people is starting to take its toll on some of us. It has "wielded its ugly head" in the form of increased irritability, fatigue, and apathy to the training mission. This is to be expected as we are all away from our families and for most us...out of the "comfort zone" of our respective permanent duty stations and individual job descriptions. But, we have done things to keep life here a positive one...

We all scream for...

Team Barbecue with Sr. Chief Manla, Petty Officer Thompson
Chief Pornan, Chief Fickens, and Chief Ciapponi
(I took the picture and had tofu for dinner!)

Similar to my pre-deployment experience, I have found that my Christian walk has seen it's difficult times. There have been times when my journey has been impeded by doubt, complacency, apathy, and being just plain busy. What I have found is that when these obstacles have "wielded their ugly head", it has been during those times when I have lost focus on the One who is the giver and sustainer of life...a better life. My prayer for today is that we all continually seek and live that better life that only Christ can give.

"I have come that they may have life, and that they may have it more abundantly."

John 10:10 NKJV

Day 33: Combat Medic

This week has been dedicated to Advanced CLS (see day 26 for Basic CLS details) which is for medical folks including doctors, medics, nurses, PAs or anyone else interested in advanced combat medicine training. It started out with the usual parade of powerpoint slides followed by some laid back, hands-on training in wound packing, splinting, and advanced emergency procedures for airway and vascular access then the real fun began!

Wound packing practice

The advanced CLS course incorporates simulated battlefield conditions (rifle-fire, being shot at by paintballs, smoke grenades, and high tech dummies that have pulses and even bleed!) while being required to perform a variety of emergency procedures. These procedures include securing airways (using a "nose hose", combitube, and/or cricothyroidotomy), placing sternal interosseous (IO) catheters (shoving a large needle into the sternum to administer IV fluids...any volunteers?), performing proper tourniquet placement, placing and starting IVs, and performing needle decompression for a pneumothorax (collapsed lung). I had to perform all of these procedures in 15 minutes or less wearing 35 pounds of body armor, in a pitch dark room full of smoke, with multiple instructors yelling ?*@!?** and pointing out how my patient was dying! It makes for a more stressful yet delightful learning experience.

Practicing sternal IO access

Sternal IO access obtained!

I am humbled by this experience as this type of medicine is a whole new level of patient care. The combat medics and navy corpsman who are saving lives at the expense of their own have my deepest respect. Although my chances of being in a direct, live-fire combat situation are small...I hope that I will be able to answer the call of duty with the same courage as my medics.

"Greater love has no one than this, that one lay down his life for his friends."
John 15:13 NASB

Day 31: Daddy's Little Girl & Boy

Last week I was talking to one of my junior sailors who himself is a proud father of two. He told me, "...having a son is like having a best friend, but a daughter...she is my heart." After this past weekend I now know what he was talking about. There is just something about a bond between a father and daughter that is beyond description so I will let the pictures do the talking...enjoy!

It may seem that Baby Maya was the main event, but I also spent some quality time with Maxwell. I was promptly reintroduced to my fatherly responsibilities including diaper duty, culinary duty, and clothing detail (subtle military terminology...sorry). But through those simple "labors of love" I was quickly reminded how blessed I am to have such a beautiful son.

Pool Time with Daddy!

Max's partner in crime, Kuya Josiah

Got Milk?

And where would I be without my better half. Behind this gentle, sweet, kind soul is the toughness and strength that surpasses even the most fearless soldier. Hoorah honey!

Max supervising Maya's feeding...strong work!