Day 153: New Year's Rockin' Eve

I'm not a fan of Dick Clark's New Year's Rockin' Eve or even a hard core fan of video games (there was a time...). Most New Year celebrations have typically been spent with friends, family, a glass of Martinelli's finest, a peak at the ball dropping into Time's Square, and a quick chorus of Auld Lang Syne to herald in the new year...actually it's more of a hum as I have no clue what the words are.

Happy New Year from Afghanistan!

Well here in Afghanistan, we can party just as hard. To bring in the new year, I hung out with some avid fans of the video game Rock Band on Playstation 3. Our "concert venue" was staged in the dining facility and we were generous enough to offer free admission. We had a great time! There has always been a small part of me that has wanted to bang on some drums, but there has always been a part of me that has always been uncoordinated. Well, for a few hours my little fantasy came true...

Camp Clark Rock Band

After several hours of imaginary play I was beat! The whole experience was indeed a very effective method to unwind. Well, it's just past midnight (Afghan time)...HAPPY NEW YEAR everyone...the year that I come home!!!

Day 151: Connection

FINALLY...after waiting patiently for our internet service to be up and running, I was finally able to return to the world of webcam. For the first time in over 2 months, I was able to see my beautiful Gemma, Maxwell, and Maya face-to-face! We had a great time. Maya has really filled out, great job nursing honey! Maxwell was talking in phrases and singing his favorite songs, he is really turning into a little boy. And Gemma...you look as gorgeous as ever:)


I can only say that by the grace of God have I been able to press on out here in Afghanistan. Not only as a soldier simply surviving but thriving! Blessings such as functional internet, free phone calls home, and time in the Word have allowed me to stay connected to my most valuable sources of strength. In hindsight, although 2008 has brought it's share of disappointments (big ONES!), I can only say that there was someone much higher than myself who had remained more involved in my life that I had realized.

"From the end of the Earth will I cry unto thee, when my heart is overwhelmed: lead me to the rock that is higher than I."
Psalms 61:2 KJV

Day 150: Bad Day

Today was a bad day. I really have no other descriptor other than "bad" to summarize the events of the last 24 hours. Unfortunately, my criteria for rating this day as "bad" had nothing to do with my clinical responsibilities or the food in our dining facility or lack of hot water in the shower.


As I was returning from an Afghan Army meeting this morning, I just happened to be walking in the direction of a loud BOOM which was promptly followed by an all-to-familiar mushroom-shaped cloud (see pic above, off in the distance). Come to find out, it was an SUV rigged with explosives and a suicide driver who was targeting a local government meeting in the Mandozai District of Khowst Province only a few miles from our base. The saddest thing is that the bomber detonated the vehicle in the vicinity of a school which took the lives of 14 local Afghan children who could have very well been children that have been seen in our free clinic.

Such a vivid and painful reminder of the realities of war. An image that will be forever etched in my memory. My heart goes out to the people of Afghanistan and the families of those children. During a spare moment, please take the time to lift up the people of Afghanistan in prayer as they continue to live, essentially, as casualties of war.

"He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away." Revelation 21:4 NASB

Day 148: Letters

I had mentioned in my previous blog that I had spent a significant part of my Christmas sorting through a bunch of letters and greeting cards from kids all around the country. It's amazing to see that so many children, of a variety of ages, have taken the time to remember the troops that are out here in Afghanistan. I couldn't help but share some of the letters that really put a smile on my face.

Merry Christmas to all. I hope that you are safe where you are. If you are ever unhopeful, say to yourself "I think I can" over and over again. Don't give up. Be Safe! Go in peace to love and serve the Lord. Thanks be to God! -- Cate

Dear Soldier, Merry Christmas! I wish you could be with your family. I hope you get some presents. Be safe and come home soon! I want an X-box. --From Grant

Check out all the letters and cards!

Dear Soldier, Thank you so much for your selfless sacrifice in defending our country. I just wanted to take the time to tell you that we all appreciate what ya'll are doing over there. Your actions in defending our country helps all of us sleep at night knowing that you are here to protect us. Thank you again for everything you have done for this country. God bless. --Anonymous

Dear Service Person, I'd like to thank you for defending my freedom. That's a wonderful gift you're giving me this Christmas: freedom. It really means a lot to me. You know, Jesus suffered for us to. I hope you have a Merry Christmas and a Happy New Year. --Mary

Dear Service Person, Thanks for your service to our nation! As a high school senior, I sometimes get caught up in the stresses of life--searching for colleges, doing well on tests...but then I'll see something as simple as an American flag bumper sticker and realize how much I have for which to be thankful. People will always find something about which to complain -- the economy, the President -- but you guys are out there risking your lives every day for our opportunity to complain. THANK YOU! --Sincerely, Sara

It's amazing to read the maturity in perspective that some of these children have. I hope that in reading these sincere expressions of appreciation, please take every minute of freedom that you have and make the most of it because you will never realize how valuable it is until it is taken away.

Day 147: Christmas

Merry Christmas everyone! Although I am spending this holiday season away from Gemma, Maxwell, and Maya without the joy of opening gift-wrapped goodies, singing Christmas carols, or enjoying a Christmas service at church, I can still say that I had a very memorable holiday experience. Here are some highlights...

DFAC at X-mas

As you can see, a very festive dining facility (DFAC) with a wood-carved sleigh in the center and our senior enlisted advisor, Santa "Clauss" (his real last name) giving out presents. We had great food and had a wonderful time of Christmas feasting and fellowship.

Santa's Little British Helpers

Navy team on one side, Santa's Little Helpers on the other. Actually that's me sitting with our British allies who have been helping us with the Afghan mentoring mission as well. Great guys to work with, and they definitely know how to get into the holiday spirit!

A Christmas visit to the ANA clinic

Even though Afghans do not celebrate Christmas, they are familiar with the popular holiday and the traditions that come with it. They have seen the red Santa hats, the giving of gifts, and the mention of Jesus' birth. When I went to give them a box of Christmas goodies it was so nice to receive such warm Christmas greetings...one of the Afghan medics said to me, "I wish for you a Happy Christmas and Congratulations!" I thought that was pretty cool, especially coming from someone of an Muslim background.

Well to cap off the rest of my day, I spent time on the phone with mi familia, won a Christmas ping pong tournament, watched some home DVD footage courtesy of my brother-in-law George, and rummaged through a plethora of letters/cards from elementary school kids all around the US wishing troops a Merry Christmas and Happy New Year. I even wrote some of them back! I thought it was definitely a Christmas day to remember!

Merry Christmas everyone and may we continue to live the gift of Jesus every day.

"And she shall bring forth a son, and thou shalt call his name JESUS: for he shall save his people from their sins." Matthew 1:21

Day 146: One

"One Team, One Fight!" or "Army of One"...catchy, motivating cliches coined to foster a sense of unity in the war against terrorism. Over the last couple of months, our Navy Garrison support team has made a concerted effort to find unity amidst a diverse group of individuals in order to be a team of true "force multipliers" (another clever little phrase from the Army). And what better time to celebrate and reflect on the milestones that we, as a unified Navy team, have achieved than during the holiday season. Everyone gets along at Christmas! So here is a rare photo op of all Navy personnel aboard the Camp Clark quarterdeck looking happy as ever...we practically look like family!


Also, in the spirit of unity, we shared our Christmas traditions with our Afghan Army Garrison counterparts. We introduced them to traditions such as gift giving and the consumption of yummy care package cookies. I especially had a wonderful time expressing my appreciation for the hard work that my counterpart, Colonel Shah Zadgull, was putting into the clinic. I think he really liked my Christmas gift box with special mention to the bright blue fuzzy pillow!

"For as the body is one and has many members, but all the members of that one body, being many, are one body,
so also is Christ." I Corinthians 12:12 NKJV

Day 145: Powerless

In the eyes of the Afghan people, we Americans are perceived as a country with unlimited resources. Despite the repeated requests for village elders to limit the amount of patients that are sent to the free clinic to 30-40 patients per week...well today, close to 300 showed up at the front gate!! Yes, I said 300!!! Unfortunately, we had no choice but to turn the vast majority of them away. We still ended up taking care of 45 patients which was 15 more than what we had prepped for, but I couldn't help but feel powerless as I wish I had the resources available to take care of all 300 of those patients.

Hanging out in the waiting room!

Of the 45 patients seen at the free clinic today, one particular patient stuck out in my mind. He was a 19 y/o male who was cachectic, bedridden, and had multiple painful pressure ulcers on his lower back and arms with some sores eroding down to muscle and even bone. Apparently, his family was not aware of the need to turn him regularly. When I saw him, he was in so much pain that his family couldn't take him out of the car seat so I could evaluate him. I attempted to obtain what ended up being a very convoluted and broken-up history regarding his medical condition which, in the end, still rendered me clueless as to what was going with him. Wow, if there was ever a time in my medical career that I felt so powerless...it was now. As I talked with him and painfully took down his old dressings, I could sense the hope that his family had in me as the "American doctor" who can do anything and everything.


In the world of medicine that I'm most familiar with...this patient would have been admitted to an inpatient facility and a multidisciplinary medical team would have been involved with his care. But, in the world of medicine that I am currently working out of...I had some gauze, sterile water, tape and my own 2 hands working out of the front seat of a beat-up Toyota Corolla for a hospital bed.


After painstakingly cleaning his wounds, replacing his dressings, and telling his family that the liklihood of finding him specialty care was highly improbable...I couldn't help but feel like I was letting them down. But, as I reflected on the deeds of the day, I realized that in my simple acts of "powerless" medicine, in the eyes of the Afghan people, I was still seen as powerful...not because of the uniform I was wearing, but because of the character I was displaying.

"But a certain Samaritan, as he journeyed, came where he was: and when he saw him, he had compassion on him. And went with him and bound up his wounds..." Luke 10:33,34 KJV

Day 144: Exchange

The other day, we had a Christmas party as a show of appreciation for our hard-working interpreters. It was a great time to be able to exchange gifts, introduce them to Christmas music, and enjoy a nice, hot cup of tea.

Our Garrison Commander with our Christmas gifts

The most intriguing part of our get-together was not the exchange of gifts, but our exchange of ideas. Our interpreters were very open to a discussion of Christmas and it's Christian origin as well as how Christianity relates to Islam. It was explained to me that Muslims believe the Bible to be a holy book and Jesus was viewed to be an important prophet. In response, I had the opportunity to explain basic Christian beliefs which was met with open ears. I only hope that there will be more chances to share in the future.

Me and the Interpreter Posse

"...be ready always to give an answer to every man that asketh you a reason for the hope that is in you with meekness and fear." I Peter 3:15 KJV

Day 143: Jingle Truck

Here in Afghanistan, there is a propensity for those who own large cargo trucks to "customize" them. Just like the prototypical, trendy Honda VTec-powered "rice rocket" that we see in the US or the vehicle transformations that can be witnessed on MTV's "Pimp My Ride", in Afghanistan we have the "Jingle Truck". It's purely coincidental that I am choosing to blog about this near Christmas time! You know...Jingle Bells...Jingle Truck...Jingle all the way...(I know...that wasn't that funny).


"Jingle Trucks" can be seen all over Afghanistan, and they come with all sorts of colors, designs, and dangling decor. Here is a prime example of one.


In the spirit of Christmas and in celebration of living in the land of the Jingle Truck, some troops decided to put their creative skills to work and design a US version. It's amazing what people can do with some Christmas lights, a HUMVEE, and a lot of free time.

As you all experience your very own Christmas celebrations amongst family and friends, please take a brief moment to pray for the many troops that will be spending their Christmas away from their loved ones this year.

Day 142: Male Bonding

As an Afghan medical mentor, one of the things I have learned about their culture is the high value that they place on social relationships. Friendships represent trust, promises are never empty, and bonds are rarely, if ever, broken. Today, our medical mentor team decided to strengthen the relationships that we have built over the past couple of months by inviting our Afghan counterparts for a meal in our dining facility.


They came to visit on a rather festive night...Mexican! I think they really enjoyed fajitas, tacos, and salsa. Hopefully, they didn't think it was too spicy...nothing a little ice cream didn't cure. As much as they enthusiastically mentioned how delicious the food was, you couldn't tell from their facial expressions.


After, dinner we escorted our visitors around the base and stopped over into the Troop Medical Clinic. The interpreters and I got them to loosen up and they finally cracked a brief smile just long enough to be caught on camera!


Major Probus, my fellow medical mentor, convinced Doctor Sami to try on the traditional Santa hat. We considered getting him to say, "Ho Ho Ho..." but that would be asking for a bit much.

I thought the evening went very well as they were all especially grateful for the unique cuisine. We're making plans to invite them over for breakfast some time to see how they handle french toast sticks, pancakes, and cheesy omelets. I'm sure that will add some flare to their usual morning chai time!

Day 137: Service

We had another successful free local national clinic today. The clinic served about 30 patients, mostly children, and we were able to give out vitamins, medicines, toys, blankets, shoes, school supplies, and jackets. Also, the proactive involvement of the Afghan medics and soldiers have made the local clinic a true joint coalition effort. Here are some highlights of our clinic day.

Hello in there! Hmmm...looks like a mild middle ear infection.

As you can see, some of the children leave the clinic with great outfits allowing them to be cozy for winter. Here is the cutest little Afghan girl modeling her new wardrobe.


At the end of the day, to see such impoverished people leave with their huge smiles and gestures of thanks reminds me that there is hope, even in Afghanistan.


For many of you who may be following my blog, I am asking for your help. I know that, financially and economically, times are tough. I'm sure you are stressing about Christmas budgets, wish lists, and traveling plans...I know how the holidays can be. But, being out here on the front lines of war and poverty, we honestly have it pretty good...actually very good. So how can you be of service? Well, the clinic is strictly run through the generous donation of supplies from individuals, families, and organizations back home. Anything from coloring books, crayons, shoes, jackets, sweaters, blankets, travel-sized personal hygiene products, and toys would be much appreciated. If anyone is interested in sending a box or 2 or 3...please e-mail me at LTMercadoMD@hotmail.com and I can send you a more detailed flyer. Please consider the opportunity to make an enormous difference in the lives of those much less fortunate that ourselves.

"Let nothing be done through strife or vainglory; but in lowliness of mind let each esteem others better than themselves." Philippians 2:3 KJV

Day 136: CME

Continuing medical education or CME is an inevitability for us medical professionals which often requires us to attend expensive conferences or read not-so-interesting journals. Out here in Afghanistan, my job as the sole physician on base is to ensure that our troops also maintain their basic first aid skills through regular retraining. Today, the medics and I decided to conduct an IV placement and bandaging refresher course for some of our non-medical troops. I think medical training provides an invaluable contribution to mission readiness, and affords an opportunity for my medics to find the joy in educating others.

Class is in session!

Here I am obtaining "CME credits" as I stick my medic, Sr Airman Snyder, with an IV catheter. As opposed to my numerous attempts at Fort Riley, I avoided some embarrassment and nailed it on the first try! Good for me...great for Snyder.


Apparently, I've been shot in the groin and Captain Randall, with the assistance of Master Sergeant Davis is expertly placing a wound dressing to stop the bleeding. Just behind me, my medic is just being weird. Another typical day at the office:)

Day 135: Study

When I first arrived to Camp Clark I discovered that there was a Bible study being held on base. I decided to show up and realized that they were needing someone to lead out, so I volunteered. Since then, I have had the privilege of sharing the Word with some really great guys. Our group is a mix of active duty Army and civilian contractors, all with a willingness to share their personal struggles and triumphs, as well as the desire to find peace and comfort in the Word of God. For many of us, including myself, living in this country can bring about feelings of fear and anxiety. Having an outlet to share my knowledge and spiritual journey, especially in Afghanistan, has enabled me to quell those fears, stay rooted in the Word, and has allowed me to grow in ways I hadn't thought possible.

For those of you that are tuning in, I want to encourage you all to continue your diligent study in the Word of God. In closing, I will simply leave you with the words of Christ...

"Search the Scriptures, for in them you think you have eternal life; and these are they which testify of me." John 5:39 NKJV

Day 133: Responsibility

It's been a bummer to have the internet down for the last 4 days, although this week has been very busy. Today is my first day as the only physician on the FOB. I now have inherited both the TMC (Troop Medical Clinic), which serves the American troops, as well as the Afghan clinic. That translates into more meetings and administrative tasks, both which I detest immensely:(

The TMC Crew

The upside is that I get to run my own "shop", which is something I have never done before. I oversee 3 medics who help me maintain an appropriate amount of medical supplies, pharmaceuticals, and sanity. They also help me put together tactical first aid classes which are then given to the non-medical troops, the classes emphasize placement of IVs, tourniquets, and basic wound care. It's a good time!

Historically, my current job description has been a 2-person gig, but with such a shortage in medical manpower, I am temporarily forced to fly solo. I'm looking forward to the challenges that lie ahead as I am putting everything in the hands of someone whose ways are much higher than mine.

"For as the heavens are higher than the Earth, so are My ways higher than your ways, and my thoughts than your thoughts."
Isaiah 55:9 NASB

Day 128: Runner Up

I remember when my parents bought me my first ping pong table. My friends and I would play on it for hours, perfecting my repertoire of serves, spins, and slams. For a while I was getting very competitive at ping pong and it soon became a most enjoyable sport (I consider it a sport...some of you may disagree). Then college came, then medical school, then marriage, then...my paddle was forced into retirement! Until I came to Afghanistan...


Apparently, ping pong is pretty big on the base. There is always someone playing on the ping pong table, and the competition is always intense. What makes it fun is the variety of styles that come as result of players coming from different countries of origin including South Africa, Great Britain, Kosovo, Ukraine, and India.


Last night, we had a Camp Clark ping pong tournament. It was a great time! I must admit, it got my competitive juices flowing. Not to toot my own horn, but I thought I had a solid chance of winning, especially after the reigning champion was eliminated in the first round. Here is the first round matchup between Mentor, the reigning champ (from Kosovo) and Max (from Ukraine).


As you can see, I didn't win, but I definitely gave the champ a run for his money (score was 18 to 21). Here is a picture of the new Camp Clark Table Tennis Champion and his sidekicks. Don't worry Max, I'll get you next time!

Day 126: My Space

My living space is on a forward operating base (FOB) named Camp Clark. We are situated in the eastern region of Afghanistan in the province of Khowst, bordered by Pakistan to the East and extensions of the Hindu Kush mountain range to the West. Khowst is a very volatile province as many of the Taliban insurgents cross the border from Pakistan through Khowst. Also, the infamous Khowst-Gardez pass, or "KG pass", which winds through the treacherous mountain ranges and is notorious for countless insurgent ambushes and improvised explosives, is the only road that connects the Khowst province to the rest of Afghanistan. To put it bluntly, it's a bit dangerous in this part of an already dangerous country. Well, enough of the geography lesson...

Beautiful view of the Hindu Kush mountain ranges to the west

Many of you have asked me, "How are your living conditions?". I myself had my own preconceived notions that I would have to "rough it", perhaps live out of a sleeping bag, build campfires with 2 sticks, and hunt for my food...essentially I was mentally preparing myself for a year long camping trip. Well, I was pleasantly surprised.

Our "B-Hut" Village

We live in small wooden cottages called "B-huts" or "Bee-Huts", the name comes from the fact that the first B-huts were built without any organizational symmetry with respect to how the rooms were partitioned off. Given the random, honeycomb-like pattern of the huts' interior design...Voila!...the term "Bee-Hut" was coined. After years of trial & error and a small dose of common sense, "B-huts" have now been built with cozy and efficiency in mind:)

Come on in!

I was lucky enough to have a generous amount of living space as you will soon see. I don't know the exact dimensions of my room, but it reminded me of my dorm room in college except I don't have to deal with a roommate. The sign on the door is a memento that is passed down as base docs come and go.


Here is a view of the room as you walk through the door. I think the designers of HGTV would be proud. My favorite part of the room, in this picture, is the Superman-themed bedding:) It adds a playful yet powerful touch to the room...


Along the wall next to the door is where I have pinned up some cards from family and friends. Also, note the wooden stand which displays my body armor and helmet indicating that I am always ready for action!


Here is a view of the opposite side of my room. This picture shows some of the various touches that have added extra personality to the room such as, the authentic Afghan rug and the official flag of the United States Navy. Also, I have been blessed with a great personal office space to include a custom-built table with plexi-glass top, wall mounted shelving which houses my computer speakers, a bulletin board, some organizational trays, and a cozy office chair...our tax dollars at work.


This is my all-time favorite part of the room. On the wall, next to my bed, are about 32 different reasons for living. Each morning I have the privelege of waking up to some of the most precious people in my life, they give me the strength to get through the day.

Well, I hope you've enjoyed this brief tour of my humble living space. It's no Ritz Carlton, but for now...it's home:)

"In My Father’s house are many mansions; if it were not so, I would have told you. I go to prepare a place for you. And if I go and prepare a place for you, I will come again and receive you to Myself; that where I am, there you may be also."
John 14:2,3 NKJV

Day 124: Doctor

From the Latin word docere which means to teach.

One of the greatest joys as a physician, for me, comes from being able to impart medical knowledge to others. Whether it's in the setting of a lecture hall, rounds, on a radio station, or in the patient exam room, I have always made a point to seize every opportunity to mentor and teach others. Maybe it comes from years of seeing too many physicians and not enough physician-teachers. Today, providers, such as myself, work in an environment that does not afford us the time, or resources, to mentor and teach up-and-coming health care professionals. We often find ourselves wishing that our fledgling young interns or medical assistants would just "get it" in hopes that the work simply gets done faster, and when things don't go as planned we chalk it up to "inefficiency" when the true problem lies in our own inability to simply take the time to teach, or to be a doctor.

A bear hug for the teacher, I would have preferred an apple

I guess that's why I have really enjoyed my time out here. In exchange for long white coats, clinic days, and call nights, I get to devote my time to mentoring and teaching. No charts, no paperwork, no lab results, no telephone messages...just the opportunity to teach medicine to a group of people who are willing to learn. I get to be, in every sense of the word, a doctor!

Most of my teaching opportunities for the past month have come from daily patient rounds and other various brief teaching moments. Today, we had our first lecture in our new training classroom. This is a big deal because for the longest time, the Afghan medics have been very disinterested in any kind of training.

My team of medics going over a trauma scenario with me

Since I was able to observe the medics in a real-life trauma scenario several weeks ago, I decided to review the basic concepts of triage, and how to manage a multi-trauma situation since I did notice some things that needed to be worked on. I'm no trauma surgeon, but out here in Afghanistan...I'm all they've got:)

Medic Ayub doing a great job training his fellow medics

The class went very well and they were very engaged. Also, one of my medics even took it upon himself to take part in the teaching which is part of my master plan. Hopefully, they will begin to see the value of teaching each other...then the mission will be complete.

"Give instruction to a wise man and he will be still wiser, teach a righteous man and he will increase his learning."
Proverbs 9:9 NASB

Day 123: Happy Feet

Today was once again Community Clinic Day which is definitely the highlight of my week. But, today was not just any Community Clinic Day, it was Community Clinic SHOE Day!! An added blessing is that every clinic has continued to flow better and more efficiently as the the Afghan Army medical team grow towards taking more ownership over how the clinic is run. That leaves me with more opportunities to shoot some pictures!

Check it out, matching head gear!

My Interpreter, Latif, manning the pharmacy

Waiting patiently to be seen

Personal Hygiene Tips with medic Nazim Gul

Today was especially fun because we were able to fit the kiddos for shoes. I went ahead at put the "Brits" in charge of the shoes. They have been on our base to help us out with various training missions for the Afghan Army. They love interacting with the kids, and I get a kick out of their British accents...it's a win-win situation for us all!

Our shoe-fitting friends from Great Britain

These families walk miles to come to our clinic, many of them walking through harsh gravel terrain in their flip-flops or bare feet. Not to mention that there is always a chance that they can trip over a newly planted bomb courtesy of the Taliban. I couldn't help but think about the things we take for granted...even such simple possessions as shoes, which for many people in this country are a rarity.


Thankfully, with the help of our Afghan counterparts and comrades from England, we were able to make some people very happy...feet included.

"Because of the tender mercy of our God, with which the sunrise from on high will visit us, to shine upon those who sit in darkness and the shadow of death, To guide our feet into the way of peace."
Luke 1:78-80 NASB