30 SEP I get around

30 SEP I get around.

Hi folks. I don't know how long I can talk because we have a troop on the way in who was shot in the chest. He is a trained member of a special forces team, so you can guess that he is pretty tough. Those guys seem to be able to get through anything. I hope we get him through this all right. If he makes it to our door, he has a 98% chance of surviving, if you go by past experience. We are pretty proud of that and we are working hard to keep it up or perhaps even make it better.

I also have a patient on the table in OR 2, but before I can finish, I have to wait for Neurosurgeon J. and Ophthalmologist B. to finish their work on her skull and left eye. She was peppered with shrapnel from an IED explosion. Surgeon M. and I checked her belly because one of the fragments of metal had entered her liver. Fortunately there was no serious injury in her belly and we could close her up. When the team finishes work on her head we will turn her over to lay on her stomach and take out the fragments that entered from the back and wash the wounds. This is how many of the injuries go. There is work to do from head to toe.


This morning I started out with a "Lazy Sunday" and staggered out of bed late. I poked around the hooch for a while, changed out my laundry and then went for lunch. I checked in at the hospital, but the SOD had things under control. I went to Air Force gym to work out, and after that for three laps in the pool. Mind you, the pool is 50 meters long so it isn't as wimpy as it sounds!

All in all, I covered about eight miles today, and it was a lot easier on my trusty steed: a black and purple Huffy mountain bike! It is covered in dust, the front tire has a slow leak, and last night I broke off half of the front sprocket guard when I derailed on the way to the DFAC. Still, with regular bathings in WD-40, it gets me where I want to go, no questions asked. I inheirited it from plastic surgeon M. when he left; he got it from another surgeon before him. If it doesn't get crushed under a HMMWV, I'll pass it on when my time comes to leave.

I've included a picture of my old red Fischer from the last time I was here. That bike was in the nutritionist lineage; I'll have to see if nutritionist S. has gotten it handed down to her. I'll admit that I was a little embarassed to be riding a Fischer in Team Huffy Balad, but no doubt that Fischer never failed me!

Being on two wheels again reminds me of being a kid growing up in Madison. Everywhere we went we went there on bike. We roamed the streets like a gang of nomad budding preppies. There weren't too many places to go. We could cut off horsepond onto the Rt. 95 truck stop to play Space Invaders. We could go to the high school to see a game. There was the Ben Franklin five and dime to get candy or baseball cards. But more often than not, the destination was the beach. Everyone was at the beach at some point. We could hang out with the kids from my Catholic school and the local school kids. There were the kids with Sunfish sailboats at the sailboat beach and we would try to hitch a ride. Our parents would have cookouts at the town beach. Sometimes we would crash the dances at the Beach Club where the rich kids were. To be honest, no one in Madison had it bad, but everywhere has tiers. There was almost no worry that couldn't be made better by going to the beach. It was just about the best place in the world to grow up.

Well I don't have a beach here, but biking around gets me through the day and eases some of the worries. Just now, there's the trauma call to the ER over the loudspeakers. Take care for now. I'll be seeing you all later at the beach.


Love, Chris

P.S.

Here's a pic of my front door. Yard of the month, baby!

Love Never Loses Its Way Home

I got an email from a dear wonderful longtime friend today. She told me that a cousin of a friend of mine had died last month in Iraq. He was only 20-years-old. It has been so hard on his family. Those words don't express it and I know I can't even imagine how hard it has been. I read his obituary and the young man's face did not seem old enough to be that of one who had gone to war. There are so many things that his life could have held and they were stolen away here.

They come to us every day, hurt, bleeding, still brave, and some even joking as they lay strapped to a Nato gurney. They are so young and it practically never happens that I see an injured troop even close to my age. I do however see the old Iraqi men and women who come to us, dazed, wrapped in dusty, perforated, and blood-stained robes, their bare feet calloused and dirty. I suppose I have to be thankful for the ones who make it to our doors because others who didn't survive the blast still lay out there and don't get a helicopter ride to our hospital.

As I passed through one of the military airports on the way here, I was given a care package by a member of the USO. There were the usual snacks: candy bars, some tasty beef jerky. I got a mini tube of toothpaste, a toothbrush and some lip balm. At the bottom was a sweet card from a gradeschooler "Kristin" who had drawn a picture of her class and offered words of support. There also was a MIA remembrance card for Matt Maupin.

Keith Matthew "Matt" Maupin was captured while on convoy in Iraq in 2004. Last time I was here I saw his face on posters in the DFAC. His was a young full face with a quizzical smile and calm eyes. His parents continue to search for him and maintain a website where I got the picture of Matt below. When I saw his face at the bottom of my care package I knew that things were the same in Iraq. The hospital still needed surgeons and Matt was still missing. The remembrance card was marked "Love Never Loses Its Way Home." The Wikipedia site dedicated to Matt reveals that it is a South African proverb. Don't forget Matt. Don't for get any of them. Get them home. That's all I got.

27 SEP Dogs of War

27 SEP Dogs of War

I arrived at the PLX a few days ago, and was surprised to find a German shepard sniffing around. He was calm and methodical, moved from desk to desk, checked our gun locker and moved onto the boxes of food under the back table. He sniffed over beef jerky, salami, twinkies, and pringles and smoothly moved onto the file cabinet. His handler was a young troop who stood in the center of our area and pivoted to watch the dog sweep the full circle of the PLX. I asked "What is he looking for?" The soldier answered "He is just checking the area." I'm just glad he wasn't looking for jerky, he would have had a fight on his hands. There are many working military dogs in the AOR (Area of Responsibility) and they help the troops in various ways. They can sniff out explosives, drugs, or hiding humans. They are also a non-lethal method of stopping an aggressor.

There is a housing facility on our base for the "Dogs of War" where they have air conditioned quarters, regular meals, and a fenced-in play and training area. They are well cared for, but still there is much danger in their lives. There was a training exercise in which a dog had to locate a small amount of C4 explosive. Unfortunately, the dog consumed a small amount of the explosive. C4 is poisonous and the dog could not be saved. His handler was unconsolable. Recently, we had to manifest one of the dogs of war on an air evacuation mission. He had suffered a stroke, as occasionally occurs with the breed. His handler requested and received permission to accompany him on his journey back to the United States. It is very unlikely that the dog could return to duty. His handler made it known that he wanted to adopt the dog and care for him now that he could no longer serve.

The other night we had a trauma code. When we reported to the ED, there was a troop in one bed, and a military working dog in the next. Both of them had minor shrapnel injures and were resting comfortably. The dog had a bandage wrapped loosly around a wound on his neck. He lay calmly and obediently, allowing himself to be examined. The injured handler seemed oblivious to his own wounds and remained attentive to his canine, asking for updates and explanations of necessary treatment. They will both return to duty.

These loyal animals question not the reasons or motivations for this war. They have been trained, and they serve true to their training. They can pay a great price for their service and we owe it to them to value their lives and devotion.

All this talk of dogs makes me miss my pooch back home. His greatest skill seems to be passing toys through his digestive system, but I miss the fuzzball all the same!

Woof woof,

Chris

A ride through Balad in the moonlight.

A ride through Balad in the moonlight., originally uploaded by ccoppola@pol.net.

Here's a picture I took under a eucalyptus tree biking home from the post
exchange. Cosmo's moon was so big and bright that I had to bring it to you.

25 SEP 2007 There goes the neighborhood

25 SEP 2007

There goes the neighborhood

I'm living in the same barrio I infested the last time I visited Mesopotamia. It is a
trailer park with duplexes and triplexes nestled in a maze of sandbag walls and concrete
barriers. I've moved on up, to the east side, to a deluxe wet trailer, on the side. My new
digs are in the F pod, and I've left the rabble of the A pod behind. This is because I
pinned on rank since my last visit to the litter box. The trailer looks exactly the same,
but it is a major advance in luxury because now I am permitted to pee indoors, rather than
hoof it through the dust to a port-a-potty in the middle of the night. I share a tiny
bathroom in the middle of the trailer with another officer. This one room efficiency with
shared bathroom may seem spartan, but you have to consider that it is more luxurious than
the domiciles of 99.9% of the troops camped out over her. The lucky ones are in bunk beds in
quarters, and others are in tents or shelters of opportunity. I face one annoyance:
sometimes I'm kept awake by the noises from the wacker that I can hear through my wall. The wacker is a self-contained gas-burning generator and street lamp that voiciferously lights the roadway next to my trailer.

Since I inherited a creaky mountain bike from departing plastic surgeon, M., I have been on
mounted patrol again. I took the opportunity to take a roll down memory lane and cruised
through the A pod. I passed my old haunts, trailer A9. the place looked the same. Sun
decroded sandbags leaked cascades of dusty earth around its perimeter. The dented air
conditioning unit hummed continuously, and fronds of dust lined its louvers. The plywood
steps were more splintered at the edges, layers of coarse wood separating and a deeper sag
in the middle.

Only one change disturbed me. When I left there had been a proud row of sunflowers adorning
the eastern exposure. Now the broad footprint of a 12 foot tall concrete barrier was
squarely planted across the length of the flowerbed. True, the safer the better, but it will
be a happier day when a row of flowers is more valuable than a wall to intercept rockets and
mortars. Perhaps the base will be a station for families when that day arrives.

23 SEP We dine as a family

Hi, Friends!

I hope that this letter finds you happy and well fed. Those who know me for any length of time learn fast how big a part food plays in my life. I am happiest at the family dinner table, laughing and stuffing my face. Among the many things that are difficult for me over here, missing that daily communion with my family, sharing a meal and discussing the days events, ranks way up there.

Our band tries to keep some society centered around dinnertime. There is a certain rhythm to our lives. We surgeons all report to the hospital in the morning. There are usually some maintenance operations to do on our existing patients. These are short trips back to the operating room for the injured men, women, and children that remain in our care. In this war, many of the wounds are caused by fragments scattered at high velocity from improvised bombs. These fragments create multiple dirty wounds with dead tissue along their edges. The first time we meet a patient, we try to stop the bleeding and save their lives. If we are successful, these patients often need more operations to gradually clean out all the foreign material contaminating their wounds and eventually get their skin back to gether.

This morning I reported to work and took care of two individuals who needed exactly this type of operation. One with clean healthy gunshot wound was ready to have his skin closed and should be able to return to his home shortly. The other, a middle-aged woman, still had some dead and contaminated muscle in her wound. I cleaned what I could and got her back to the intensive care unit safely. She will be back in the operating room in a few days for more work, but she is a far cry better than the day she came to us, her life threatened by bleeding in her chest.

We take turns as the surgeon on duty, and this surgeon must remain in the hospital for 24 hours, ready to handle emergencies. The rest of us, even though we are available if a surge of wounded arrives, must find some way to occupy ourselves. After I completed my duties, I went to work out and then stopped by the Post Exchange for a shelf check. They had the same stuff I had seen two days ago. I moved on to the pool without buying anything.

The rhythm of the day brings us together again at 18:30. We convene at the surgeons' desk in the hospital, pick up our weapons, and head to dinner together. This evening ritual is one of the most comforting and enjoyable parts of my day. I'm sad to be far from my family, but to share a meal with my surrogate family briefly dulls the pain of the great distance from M. and the boys.

We load into the "Czar Car", a pick-up designated for use by the trauma czar. Since we are finishing the crossover training period with two teams present, we fill that pick-up soundly. It brings many a stare to cross the byways of LSA Anaconda with a pick-up bed full of majors and colonels!

Tonight we went to our usual eatery, DFAC (dining facility) 3, also known as the Camelot. In the cafeteria, dining is, of course, family style, on long tables. We stake out a sizable chunk of real estate, with our many surgeons, but we always neighbor other airmen and soldiers. It is always a pleasure to meet troops, learn from what state they hail, and to hear about the many varied jobs in the military.

We don't always go to DFAC3. A few days ago, we made the evening special by visiting Balad's very own Turkish Cafe. The restaurant is in the Army recreation complex, bordered by the Army gymnasium, outdoor pool, and Sustainer Theater. You have to pass a checkpoint manned by Ugandan Army guards who check both sides of your ID and verify that you don't have a clip in your weapon. A short walk down a gravel path lined by 12-foot blast barriers brings you to a nondescript sand-colored building. It is marked only by a small vinyl sign with red block letters reading "Balad Sami's Turkish Restaurant".

Once you pass the doors, you are transported to an exotic world of simmering spices. The walls are adorned with tooled brass platters and Turkish-themed murals. Actually, there is a cement floor and plywood walls, but just the feel of walking into a neighborhood restaurant makes the locale special. At the counter, you order from the swarthy smiling proprieter. The Turkish pizza with spicy ground meat, thick with cheese is tasty. I opted for the Chicken Tava, a dish served in an earthen casserole where diced chicken simmered in a salty tomato broth and was cloaked in a tasty raclette.
(e.g.: http://www.cdkitchen.com/recipes/recs/284/Chicken_Tava42952.shtml , but definitely add the cheese on top!) This was well accompanied by a minty green smoothy with mystery fruit ingredients. I think the touch that made the meal special was that after ordering, we sat to whet our appetites with conversation until the counterman's younger assistant came to us, one by one, calling out our numbers and delivered our food. This simple act of bringing food to the table briefly took me away from the suffering that continued in the hospital. The dinner was a special occasion because it was a slow goodbye for some of the surgeons who had completed their tour and were fixing to fly.

Thus fed, we returned to the hospital. Some surgeons went to the roof to continue the dinnertime discussion under stars that winked to let helicopters pass by. Others joined the surgeon on duty, delivering him his doggy bag of Turkish pizza and pitching in to help care for the arriving helicopter's payload of injured men.

It isn't home, it isn't my family, but I have broken bread with these dear friends and I will carry that with me always. I guess we are a family of sorts.

Eat well, eat with the ones you love.

Chris

Meeting coalition friends

22 SEP 2007 I just got off of a wild night on call. We admitted (redacted) patients, which isn't the record, or even a mass casualty event, but it makes for a night of constant surgery, I operated until about 3am and then collapsed on a couch. I got up to change an order in ICU; I was gone for a minute, and when I got back another member of the crew had passed out on my couch! Among our patients were a group of detainees who were having their injuries checked, a group of Iraqis injured in a car crash, and toughest of all, most of a patrol of Romanian coalition troops who had been burned after an IED exploded next to their armored personnel carrier. One didn't make it, but we recieved the other (redacted) troops, all of whom had full thickness or third degree burns. They were really tough and answered our questions calmly. If I grab the frying pan the wrong way, I'm screaming like a baby so I can't imagine how horrible they felt. In groups of two, we got them all to the operating room to clean their burns, ensure that they had blood flow through their burned extremities, and checked for burns in their breathing tubes. The all did well and were evacuated out of theater to (redacted) in stable condition. They were accompanied by a very concerned company surgeon and a young officer who served as a translator. They tended to their men attentively, reassured them and helped us whenever they could. I think it was good for the injured men to have some of their contrymen around and it was good for us to work with other coalition partners. I think the more we can make this drive for peace in Iraq an international effort, the better. After the casualties had been evacuated, the doctor and translator were kind enough to snap a picture with me, and we exchanged emails so we might be able to help each other in the future.

As for me, I'm bushed. I'm going to catch up on some shuteye, as soon as I find the guy who borrowed my hooch key last night! I'm off for now, but I'm sure that this war will provide more injured for some time yet.

Take care, and most importantly, Happy B'Day, G ! I love you!

All the best,

Chris
----------------------------------------
LTC Christopher P. Coppola, USAF
332 AEW/EMDG/OR
APO AE 09315-9997
ccoppola@pol.net
christopher.coppola@blab.centaf.af.mil
DSN 318-443-2925

http://www.madeadifference.blogspot.com/

----------------------------------------

Assuming Command

When a new group takes over the hospital, there is a period of overlap. I arrived a few days ago, and later tonight the surgeon I am replacing is headed out. Additionally, the staff replacement takes place in stages over the course of a few weeks. The wisdom in this is that there is never a point in time when the hospital is completely staffed by a brand new crew. The overlap does make for a bit of a burden back home because for those few weeks, there are two chunks of personnel missing from our home station. Our hospital back home is responsible for a heavy share of the hospital staff here in Iraq, so the crew left back home has to hustle to take care of business with a thin staff.

It is a feeling of accomplishment to be able to send the departing crew home to their families. In the past 24 hours, the hospital has been abuzz with announcements of departing flights and lists of manifested passengers. The halls are full of troops laden heavy with equipment and baggage, their faces alight with the promise of embracing family after a few short days' journey.

I've had a great time hanging out with my roommate for the past few days. He was gracious enough to let me bunk in until he left, rather than rack it in a crowded barracks. He is an experienced trauma physician assistant, and we had the good fortune to take care of a few patients together in the past week. I could tell right away that he is a skillful, caring worker and we would have had a blast working together for a full rotation. But he has the good fortune to have a seat on a plane home. I helped him pack up his bags and truck them out to the rally point. He was a chalk facilitator and had to start gathering his flock to transport them to the flight line. I wished him well and told him clearly how jealous I was that he was rotating back to the world! We took a picture together, and I know we are going to have a good time someday in the future when we can get our families together. I wish him a fast, safe journey home to his loving family.

I enjoyed a fake beer with a few remaining members of the departing crew. We went up on the roof of the hospital and watched helocopters and bats alike flutter through the air. The beams from the floodlights filtered through silty Iraqi dust and smoke from the burning garbage. We reclined on beach chairs and laughed at nicknames and jokes, and asked what everyone's first meal would be when they made it home. We were a happy community of doctors, nurses, techs, and visiting pilots. Again I was jealous of those who would be headed home shortly. But I do know that our little family in the hospital will support each other, come what may.

I don't know much, but I do know this: you can't stop the clock. One day soon it will be my chalk headed out to the flight line.

Sleep easy, friends.

Chris

19 SEP 2007 Surge and Sustain

Hi, All!

Hope that you all are doing well. I haven't had much of chance to write lately. First we had a surge in wounded patients, then the Morale, Welfare, and Recreation Internet connection went down. In spite of this, morale is good. We are working hard, but getting good results, and it is rewarding to be part of an effective team.

Yesterday, I was hanging around the PLX desk: that is the pharmacy, laboratory, and X-ray desk. This is a name that carried over from the old tent hospital, because the surgeons used to hang out at the intersection of these three areas. Now, in the new brick and mortar hospital, these areas are more spread out, but the surgeons desk has kept the same name, PLX. As I mentioned, it's also the unoffical information desk of the hospital because everyone comes up to us and asks where the bathroom is.

We heard the announcment: "Seven incoming wounded from an IED attack". And IED is an Improvised Explosive Device, and the term refers to any variety of bundled explosives and dangerous fragments that are buried, thrown, or even carried into an area by a suicide bomber. The medical team began to gather in the Emergency Room. There were troops from the outgoing staff mixed with new members like myself. There was quite a crowd of nearly fifty people. ER doctor J. divided the crew into teams and assigned them to the different beds around the emergency room.

The helicopters started landing and unloading patiets. The first dropped off two elderly women covered head to toe in black gowns called burkas. Both had bandages on their face where shrapnel had cut their skin and eyes. I started examining one of the women with surgeon M. who had just arrived the night before. She struggled to keep us from uncovering her as we looked for injuries. Our translator, a woman from the U.S., assured her that she was okay.  Besides the injuries to her face, she was peppered with small fragments of metal up and down her body. There was a large open wound on her leg and we could feel no pulse in her foot. We were concerned that one of the metal fragments had injured the artery that supplied blood to her leg. After some medications for pain and some x-rays, M. and I took her to the operating room as the other teams cared for an additional six patients arriving from the scene of the attack.

We set to work on her leg while orthopedic surgeon S. repaired another wound on her hand. Back home, M. is a vascular surgeon and was well prepared to find and examine the artery in her leg. The wound in her thigh was a small crater, and we found the artery at its base. The artery was not injured, but when we checked the blood flow, it was sluggish and slow. Using a video x-ray, we checked the blood flow to her foot, and there was no blockage. But when we injected the fluid that filled the artery up to her belly, we saw on the screen a small fragment of metal and a blockage in the artery high up in her groin. We opened her skin at the groin and found the artery at that location. The metal fragment had nearly cut the artery in half, and a blood clot was blocking the vessel. The fragment had entered the skin at her knee and had traveled all the way up her leg to the groin. We repaired the damage to her blood vessel with a small patch of her own vein. As our ophthalmologist began to repair her eye, I felt her foot and detected that a normal pulse had returned.

It was a relief that we were able to help her. The new hospital staff had responded strongly to their first challenge. Of the eight patients who had come to us, six of them needed operations. As evening came, we finished the last of the operations. The wounded men and women were brought to the intensive care unit to begin a slow recovery. It is offensive that civilians, and old women at that, should have to bear the risk and pain of these injuries. War has no care or respect for the wisdom of our elders. I think of my grandmother at home, whom I miss very much, and I can't bear the thought of her having to experience such a thing. No one's grandmother should.

I had missed the departure for team dinner. That just meant there was a little more room in the trauma chief's truck on the way to the dining facility. I grabbed a big plate of mystery meatloaf and chicken cordon bleu to make up for a missed lunch. I wandered over to the physical training facility for a workout. During my lunges, the Alarm Red sounded and we all hit the deck. I heard the attack helicopters thunder off to investigate. We waited a while but heard no impact. Fortunately these alarms are rare, and it is even more rare for anything to get hit. We are a strong and well defended base, and one would be more likely to get a sports injury than anything else.

That day ended and a new one came. I'm still here. This morning I visited the woman on whom we had operated. I felt her foot and there was a strong full pulse that seemed like it was there to stay.

LTC Christopher P. Coppola, USAF
332 AEW/EMDG/OR
APO AE 09315-9997

Christopher.coppola@blab.centaf.af.mil

DSN 318-443-2925

First Night: Made It!

Whew, I must be getting old! It just isn't as easy to make it through a call night. Last night was my first time as the SOD, surgeon on duty. I was lucky to be following around surgeon J. who has been at it for four months straight so I had an easy reintroduction to Balad surgery. Yesterday morning I got up early. I was jittery because I was nervous about my first night on call, even though I had made it through so many nights on my last deployment. The injuries we see here are so far beyond anything I have treated in hospitals in the United States. The new hospital at Balad is in a building, so it doesn't have the familiar muddy, dusty, noisy tent feel. (This is actually a good thing, but it made me feel like I'd never worked here before.)

Very quickly we were in the operating room taking care of a man who had been shot in the back, shattering his pelvis and causing internal bleeding. Having something to do with my hands quickly dispelled any uncertanty. Surgeon J. and I cleaned his wounds, and we were pleased to find that he didn't have any major internal injuries. After a few more procedures and some rehabilitation, he has a good chance of recovery and being able to walk.

It didn't let up after that. We were in and out of the operating room until after midnight. Some of our patients could have been rolling into an emergency room in Texas: motor vehicle crashes, a man burned by lighter fluid at a barbecue. Others suffered the severe injuries that I only had seen in a war zone: rocket propelled grenade injury to the head, multiple AK-47 rounds shattering the bones and arteries of the leg. Surgeon J. and I called in our colleagues: the ophthalmologist, the orthpedic surgeon, the neurosurgeon, and many others as the need arose. The team worked quickly, getting the patients in and out of the operating room as fast as we could close them up.

Around two in the morning, I was limping on swollen ankles, my throat was sore, and I could barely keep my stinging eyes open. Back in the day, I could go months spending every other night in the hospital, and still somehow manage to drive home! The years have softened me. I will definitely have to get my endurance up for the months to come. I grabbed some snacks from midnight chow in the hospital cafeteria and napped through the wee hours during a merciful lull in the action. At six, the loudspeakers called us back to the emergency room to care for two detainees who had been stopped trying to plant an explosive device.

I am relieved to have the first night past me. My partners came to the hospital and I was free to head back to my hooch for some rest and a shower. My patients are recovering in the intensive care unit or on their way out of the country. Another day down and another day closer to home.

Y'all take care,

Chris

Take a look at Saturday

Here I am on the main drag. Behind me is our housing area, surrounded by 12 ft tall concrete barriers. The hooches are the white trailers, laid out in rows of rank and file. They're all made out of ticky-tacky and they all look just the same.









































I thought B. might like to see this Humvee box truck.


































I miss you all and we will talk again soon. Time for me to head to the border!

Love,

Chris

15 SEP 2007 Air Force Theater Hospital, New shell, same nut.

15 SEP 2007 Air Force Theater Hospital, New shell, same nut

Hi Friends,

It is a sunny Saturday afternoon here in Balad. This morning I had to ask what day it was. I have already fallen prey to the sand-blind confusion in which one day blends into the next. Every day seems the same and this deployment has picked up just where the last one left off. It has been a very therapeutic morning. I got up around three in the morning, but since I’m bunking in with a friend for a few days, I left the lights off and stayed in my cot, drifting in and out of waking dreams until it was six. I’m staying with B., a trauma PA from the Midwest. He is a great guy, and has been working day in, day out for the past four months taking care of wounded warriors in the intensive care unit. He’s headed back home to the world in a few days and we’re sharing a hooch until I take it over from him. Our hooch is like a small trailer. We have one half of it; another troop has the other half. In between, we share is a small bathroom. I consider the conditions that most of the troops are facing and I know I’m in the lap of luxury.
B. needed his sleep because he had been run ragged in the intensive care unit the night before. We were taking care of a little boy with serious burns. He came to the hospital after he had pulled a pot of boiling water over on himself. Even in a war zone, the dangers on the kitchen can bring misery in the blink of an eye. The crew here had been working tirelessly to keep him alive and had operated on him three times. He was struggling to live in the intensive care unit. He was swollen from head to toe, and his breathing was labored. As his vital signs worsened, the team put in one artificial breathing tube, but it was too small. They asked me to replace it with another, and I was just able to see past the swelling to get the larger tube in. I called for a translator, and J. came to help me talk to the boy’s grandmother. She was tearful, and thanked us. I could see that the team had worked so hard on him and had put so much heart into his care. This was the first day I had seen him, but I could tell it didn’t look good. Sometimes it is harder to see big picture when you have been pouring your heart into fighting for someone’s life. As the night became morning, he worsened. His vital signs failed and he passed away near noon.
It was so hard on us. I felt the same raw feeling as when I lost a little girl in a similar situation two years ago. I may grow numb to the long hours, the horrible wounds, but no amount of time will ever find any sense or reason in the death of a child. It was a shocking reminder of the high stakes at play in our hospital. There had been no joy that night. Around midnight a pregnant woman had been brought to the ER after being shot with an AK-47 in her belly. She was rushed to an emergency operation. Surgeon M. found that the bullet had injured her intestines and then went on to kill the baby growing inside her. If her pregnant womb hadn’t been there, the course of the bullet would have taken it through the large artery in her belly. She would have bled to death in minutes. She will live, and maybe even bear another child. There is no joy in war. I feel myself bracing for worse in the months that come.
So today, I reported to the hospital. When there was no work for me, I set out to clear my mind. I wandered the dusty, gravelly streets I had been over before. I checked the shelves at the Base Exchange and dropped off some uniforms to have my new rank sewn on. I went to the gymnasium. The generator was out, and we exercised in near darkness, shafts of light crossing from the doors propped open with buckets. I lifted weights, counting repetitions, measuring time, calculating how many push-ups I could do before my time here is up. I was pumping iron in the yard. I did my fencing stretches. As I flowed through cycles of sun salutations and watched myself dimly in the mirror, I felt like I could make it. Tomorrow is my first night on call and I hope I’m ready. Balad hasn’t changed much but I’m not sure that I have either.

I got to talk to M. yesterday. Her voice was so sweet in my ears. Closing my eyes, letting her words wash over me, she could have been next to me, her hand on my shoulder. That is enough to carry me through anything.

Until the next phone call,
Chris

14 SEP 2007 A visit from star athletes

Yesterday, we were graced by a visit from a team of well trained and highly skilled athletes. It is always a privilege to see a performance from those who have honed their endurance and skill until they are able to rise to the pinnacle of their field. I'm talking of course of the Dallas Cowboys Cheerleaders. These young athletes were brave and generous enough to get on a plane and risk their tails to visit troops in the war zone. It emphasizes the spirit of our hospital battle cry: "Bustin' ours to save yours." These friendly ambassadors of all-American good will were only 18 to 23 years old - such babies! Young enough they could be my children. But after all, that's the age of most of the injured troops whom travel down the hero's highway from the helipad to our emergency room. We visited with the cheerleaders in the physical therapy suite, which seems appropriate as they were excellent demonstrators of range of motion exercises. Their escort then saw them off to the Sustainer Theater for their show. I've remained behind to help the team tend to a patient. I've never had the Dallas Cowboys Cheerleaders visit me in Wilford Hall! I think some really good ideas can come out of our hospital practices here in Balad. You all take care and be well.

Warm regards,

Chris

sweating in the cargo bay

sweating in the cargo bay, originally uploaded by ccoppola@pol.net.

Here are some views in the cargo bay after a long morning of lugging gear.

Liberty Island (corrected)

Liberty Island (corrected), originally uploaded by ccoppola@pol.net.

From one of our last visits to Manhatten when we could still see the World Trade
Center. I don't think that wool coat has come out of mothballs in Texas.

Liberty Island

Liberty Island, originally uploaded by ccoppola@pol.net.

One of our last visits to Manhatten while the towers were still standing. I don't
think that wool coat has come out of mothballs in Texas.

Our 7th grade Class

Our 7th grade Class, originally uploaded by ccoppola@pol.net.

Here is our 7th grade class photo. Notice Peter and me down in front, both
wearing matching navy blue Izod shirts. Ah, the eighties.

11 SEP 2007 Wish you were still around, Peter

11 SEP 2007 Wish you were still around, Peter, originally uploaded by ccoppola@pol.net.

Wish you were still around, Peter.

11 SEP 2007

11 SEP 2007 Wish you were still around, Peter

We haven’t moved, but there is promise of a flight north to the hospital soon. It has been boring and subdued, stuck here in a military Limbo. I spent most of the night up, wandering, reading, and hydrating. After morning chow, (more eggs and hash browns, yeah!) I visited the barber. The haircuts cost only four dollars and are worth every cent! A little surprise comes at the end when the barber rubs alcohol into your scalp, ala Bugs Bunny working Elmer Fudd to the tune of The Marriage of Figaro. With the heat, it is actually quite pleasant. After the sun came up, it wasn’t much fun to be alive and out of doors so I racked most of the day. At least they keep the barracks cool.

September 11^th brings several thoughts. First off, Happy Birthday, A.! I miss you and can’t wait to see you again! I think you and I are the disaster twins since Katrina struck on my birthday. It is just a little reminder that a good day for one might not be a good day for another. Do you remember where you were on September 11^th? I was in DC Children’s hospital fixing a two-year-old boy’s hernia. My attending surgeon, Dr. N., checked CNN and saw the towers burning. What a pointless and cruel theft of lives. We will survive it; I have no doubt of that.

I also think of Peter Gelinas. He was my next door neighbor growing up. When I was four and we moved to Connecticut , we encountered each other exploring the woods between our homes. We staked out whose territory was whose, and were friends from that point on. We attended Our Lady of Mercy Country Day School together and both went to Becket in the Berkshires summer camp. Peter was eternally happy and enthusiastic. He was an avid athlete and a natural leader so it was no surprise that he was the star of the Xavier High School football team. He married a beautiful woman and had two boys, whom he took camping when they were still toddlers. He worked for Cantor Fitzgerald and was in the World Trade Center when it was attacked.

I wish Peter was still around. In the years before he was murdered, we didn’t see each other much, but whenever we did, it was like no time had passed. A giant smile would immediately spread across his broad face, and he would laugh heartily. We talked about our boys, and by chance had even chosen the same name for one of them. We talked about the neighborhood and how things were for our parents back home. I remember once when there was a fight behind the bleachers between kids from our Catholic school and the kids from the public school. Peter came along, and all animosity just dissolved from the crowd. You see, he was friends with just about everyone in both school. We ended up on a double date with two of the girls from the public school. I don’t think Peter would have seen the point in this war; it wouldn’t have seemed like much fun to him. He would have rather had a bonfire on the beach. The people who killed him could never understand that.

I hope I can love life the way you did, Peter.

See you on the beach,

Chris

Maine troop greeters

Maine troop greeters, originally uploaded by ccoppola@pol.net.

Some of the contingent giving us a warm loving
welcome.

What I look like

What I look like, originally uploaded by ccoppola@pol.net.

10 SEP 2007 Stick with your chalk

10 SEP 2007 Stick with your chalk.

(Spanning Western to Eastern Hemispheres)

Anyone’s journey is like anyone else’s. There is a start and a finish, and any number of disasters and successes before the ending. So I will try not to bore you too terribly with the details of my journey over the past 36 hours. Of course some of the details are best not to reveal as they provide a bit of specificity that someone intent on mischief could use to their advantage, so I’ve dropped a few of the proper names. Just imagine someone you know in a similar place, and I’m sure the image you land on will be pretty close to the truth. Also, I find it is very hard not to phrase any experience today without considering “how it compared to last time”. It always annoys me a bit to hear medical colleagues say how much better it was at the Mecca where they trained, so I resist that urge too, though it may slip out. On first impression, most of it seems the same anyway, except, perhaps for me.

The trip started much like it did last time. We reported at God-awful o’clock in the morning and made formation. I watched people kiss their babies and cry. My errant deployment paperwork showed up, sealed and completed, with the help of some dedicated friends. (redacted) mingles with us and we strike up a conversation. He extols the virtues of the new hospital, so much better than the tents. I ask him if he has visited. He hasn’t but he has seen a similar one just opened in (redacted). I’m pleased that we are less likely to have rivers of mud running through the wards when the rains come.

M. has sent me with a delicious bundle of nearly two pounds of delicious butterscotch-cinnamon bars. I share with friends. I have also brought a shopping bag full of Halloween candy from our early celebration last week. A day and a half later, I have consumed nearly all of the butterscotch bars, and I am sure that the dense sugar and butter calories have been responsible for keeping the engine going this long. Most of the candy remains and is tucked away in my contractor’s trunk for the flight to Balad.

I had little to do the long hours we were sequestered, so I gave in to the urge to call. I’m sorry my phone call woke you, it was still too early to call, but I was happy to hear your voice nonetheless. Especially since a combination of morale call limitations and a parent-teacher conference have conspired to keep me from hearing it tonight. It did make me very happy to speak with B.

Friends from the hospital visited to say goodbye and good luck. It was sweet of them to come, and it reinforced the feeling of family among our medical unit. They say that I will be missed, and even as a nicety it pleases me because if you aren’t missed you aren’t useful. I have worked with a large percentage of this deploying group, and I know that they will work hard to take good care of the people we encounter. Public Affairs pays me the compliment if asking if I would be willing to speak to the press. By the time the photographer gets to me, I am racking against the wall in a metal chair and he gets a wonderful photograph of a napping officer. It is good to be captured doing what I do best.

The announcement comes that family must clear out. The conversation in the classroom had reached a warm reassuring buzz, but it immediately takes on a more frantic and pained tone. New kisses and tears follow. I see one boy who is about seven shake his head at his stoic teenage older brother and say “you’re not very emotional, are you?” When relations are hustled out, we take roll and learn our itinerary. We have a day’s journey to the east coast, north, across to Europe, and then a rest in an Air Base in (redacted) before the military flight hopping to . A long line of well-wishers forms in the hot sun on the tarmac to see us off.

The day rolls on, punctuated by butterscotch bars. We shuffle from bus to bus. There is a strange dance of busses as they switch places in the parking lot, apparently to keep us from lingering behind on a bus and missing a briefing. It reminds me of the way prisoners switch busses when they go through a checkpoint to guard against stowaways and contraband. We shuffle from airport to airport. The seats are small. A chief assigned to command sits next to me. She describes how she has seen civilian aircraft reconfigured for military troop transport. Where two rows of seats have been removed, three are installed in their place. I read Huckleberry Finn and The Emperor of the Air. We watch movies and I note funny lines to tell M.

Along the way, volunteers from the USO feed us and tell us to stay safe. Once, there is a DJ, but nobody dances. In Maine , close to midnight, a long line of veterans and retirees greets us with smiles and hugs. I think I have seen some of them in patriotic videos set to music in slow motion and circulated through email. After we pass, they meet to discuss who is staying for the 2am arrival. Many are octogenarians. A friend and I take the opportunity to order a fresh Maine lobster roll. You can taste the cold water in the crisp tail meat. I miss family in Texas and the east coast greatly. As we fly over, I pick out city after city to which I want to move. In we are sequestered in a terminal that feels like a cage that is only slightly larger than the airplane. A military tourist trap sells sodas for three dollars and certified pieces of the Berlin Wall for $20.

With new fuel and a new air crew we make the final jump to the Middle East . A comedy plays on the video screen. When the final credits finish, the trip computer comes on screen and shows that we are in the airspace over Tikrit, . It is a sobering vision and laughter about the movie quietly dies down. As I disembark, I’m overwhelmed with the feeling that this place looks, smells, and feels the same. Even near midnight, the air is heavy and hot, and a halo of suspended dust blurs the flood lamps. What a dump. We form a bucket brigade to tuck our gear away and are given bunks in barracks that hold around 60 troops each. We are separated into groups called “chalks” and are told to await announcements of flights to Balad. We are wide awake with travel stiffened joints, sweaty kits, and jet lag. We scatter to find the morale telephones, Cadillac shower trailers, and beer garden. I settle into biscuits and gravy with potatoes, sausage, and bacon at midnight chow. I watch Fox on the big screen TV as Bill O’Reilly marginalizes MoveOn.org. It is the first of many visits to midnight chow.

You must be as tired of this journey as I am. I hope I’m not stuck at this waypoint for too many days. There is a crew in Balad that is waiting for us to spell them. I miss you greatly. It’s time to take a shower and rack. One day down.

Love,

Chris

http://www.madeadifference.blogspot.com/

Happy Holidays!

Hope that you are all well. It has been a whirlwind of a week, but fortunately much of it spent with family. Since I have turned over care of my patients, so my only duties on the base are administrative, it has been a stark illustration of the parts of my job I like and do not like. Guess which part I don’t like!

To tell you what I have been up to this week, I think it is going to sound a bit like a “Dear Diary” entry, but the week has been an extraordinary one in that I’m so focused on preparing for deployment. I suppose the summation would read: attempting to squeeze out as much life as possible without becoming frantic. I think it was on Monday, Labor Day, we celebrated Thanksgiving. The kitchen had just been finished. We finally replaced the contractor grade (meaning, crap) yellowed and cracked countertops with a beautiful Black Canyon Silastone and scrapped the sallow pink pickled imitation wood cabinets with a cherry tone resurfacing. Mmm, it was a delight to see it before leaving, but it did make the time crazy. Since it was just us, we only cooked up a turkey breast, but it turned out to be more than enough for plates and plates of leftovers for turkey and cranberry dressing sandwiches. Our other favorites are cornbread stuffing with apples and raisins, sweet potatoes with caramelized marshmallows and broccoli with Velveeta and Ritz! (Don’t knock it, I’ve eaten about two pounds of it this week and I’m ready for more!) I had no problem enjoying Thanksgiving in September because it is a food based celebration (all the good ones are.) I didn’t do my usual deep fried turkey because the peanut oil is so expensive. Around real Thanksgiving they have it on special, but they were not offering any bargains on two gallons of peanut oil for me. Didn’t matter: M’s apple butter and sage glaze fulfilled its patented guarantee to lock in moisture as well as my mink-oiled desert boots lock in sweat. (Hmmm, sorry.)

Then we celebrated Halloween last night and the boys had friends over for a costume party. Sure, the pirate costume was easy, but what matters is to make an effort and get in the party mood. The boys were happy for an excuse for unanticipated excesses of candy. I wonder what my neighbors think about our jack-o-lantern lights around the doors and glowing skeleton hands along the front walk. As early as we are, they were selling the stuff at Walgreen’s! I think I even saw a pile of Christmas stuff ready to go. Unfortunately, they had only put out the girl’s costumes so far at Target so we had to get creative. The boys weren’t interested in being Barbies or pirate princesses. Our dear friends took the boys for a sleepover so M and I could have an evening watching our favorite movies.

I may seem frantic with this slapdash tour of holidays, but at the base, they were wild like a mound of fire ants that had just been kicked over. You from Texas will understand. I think I had nearly twenty phone calls about my vaccination paperwork this week. The calls went something like this:

“We need you to come in and complete your vaccination paperwork.”
“I dropped that off during the deployment exercise six weeks ago.”
“Was the record sealed?”
“No, they said that if they sealed it before I had my last appointment at Immunization clinic, the base would get a discrepancy.”
“Did you get the appointment?”
“Yes but they didn’t have the oral version of the vaccine I needed.”
“Then we need a letter stating that.”
“I know, I faxed it in to your office yesterday. Do you have it?”
“No, it isn’t here.”
“Okay, I’ll fax it in again.”
“But we don’t have your medical record.”
“You had it when I visited Friday. Where did it go?”
“We sent it back to your doctor. We are not allowed to hold onto it because of HIPPA rules.”
“I don’t have a doctor, what happens if I go to (redacted) without my medical record?”
“The base will get a discrepancy.”
“But, you’ll still let me on the plane?”
“Yes, but the base will get a discrepancy.”

Hmm. That, of course, told me all I needed to know. However I can tell you with pride and happiness that I have a complete and sealed record ready to travel the globe with me. (And even if I didn’t, I have a photocopy of every sheet in the thing: 17 years of dealing with the military has taught me this: never give away your last copy. It will be lost.)

So last minute preparations and festivities continue. We got the dog to swim in the lake with us today! He was paddling in circles and was happy to climb up on my back when he caught up to me. Once safely out of the water, he resisted all calls for a second dive. I’ve picked a pack of movies to bring with me. Please note these are not my (only) favorites!! They are the ones I didn’t think would be missed too much at home and I could afford to leave in the sand without shedding a tear. Don’t get me wrong, I’m not disowning these guilty pleasures: I’ll admit to watching each at least ten times.

Kill Bill 1 and 2
From Dusk to Dawn
South Park, Bigger, Longer, and Uncut
Family Guy, Freakin Sweet Collection
Fight Club
Jay and Silent Bob Strike Back
Pulp Fiction
Die Hard
Blade Runner
Borat
New Jack City
Casablanca
Amelie
Fifth Element

I challenge you to find a theme!

Warm regards,
Chris

For those of you who have asked for my address:
LTC Christopher Coppola, USAF

332 AEW/EMDG APO AE 09315-9997

I'm tired of fighting, It must be my age.

The title above is stolen, it is a line from Shichinin no samurai (the Seven Samurai) by Kurosawa. I've seen so many films inspired by it, but tonight I got to see the original. For those of you who haven't seen it, a village beset by bandits, employs several out-of-work samurai for their defense. The seven starts with one aging master who plays the leader and recruits the others. The true salvation of the village comes as the farmers are transformed not only to fight for themselves, but also to forgo guarding their own individual interests and join for the good of the whole. I can tell you without revealing too much that the samurai wisely note that even though they have survived, they are defeated in comparison to the richness of the communal family life of the farmers.
As I prepare to leave with my band, I wonder who will be the leader of men? Who will be the jokester? When I am again among Iraqis, how will we find each other? I can only hope that I do more good than trouble I stir up.
M and I are making the most of our time by going on many dates. We have never been in such need of babysitters! We are quite simple in our likes: movies and food. Sometimes, we even go in for good movies and good food! Last night was a wonderful meal at the Lodge of Castle Hills. It was a delight but did not dislodge La Reve from our hearts. Since Friday, I have turned over care of my patients to a trusted colleague, so I was even able to partake of the wine pairings for a rare occasion. Since no alcohol is allowed in the area of responsibility, I best get my taste before I am banished to the land of near-beer and brown stuff and rice.
On one final note, our book will be featured on CSPAN-2 Book TV tonight at 11:05PM when they will air in interview we did at the Twig Bookshop. I hope it gets some attention for Fisher House.
Hope to see you all soon,
Chris