Busier...

I’ve been busier lately… less so with prevention and more with actual pathology. Depression, suicidal ideation, anger, marital problems, sleepwalking. My practice here is less intense than at home, with less documentation, less overall work, but I think it’s harder to actually help people here, just due to ongoing, unremitting stressors.

I also have fewer options. The options basically consist of: “keep going to work” or “let’s get you out of here.” There’s very little in-between.

We have a small variety of medication options and I am the only game in town for psychotherapy. Most minor to moderate problems resolve on their own, or if they don’t resolve, they at least become manageable with time. Many times I just see people in the acute phase, and when the pain dulls after a few days, they find that they’re okay.

As time wears on I have become more known on the FOB and I see more and more patients in more places—chowhall, the showers, the gym… It’s a small town here. I find that I have a good feel for the pulse of the FOB—I know who the bad NCO’s are, I know about the stressful operations, I hear the rumors and the myths.

Now that my NCO has returned we have to plan our next mission (outreach to other outposts) and it’s my turn. I may leave very soon, but I’m not holding my breath due to all the problems flying. Truthfully, I’m comfortable here and I wish that I wasn’t expected to travel (make them come to me!). Luckily there have been relatively few emergent situations where our skills are needed, and if that luck holds we will have a light travel schedule into the autumn.

The sounds of war are usually distant here at our FOB—and that’s the way I like it. One thing about war is that sound is a major factor. Explosions and gunfire are loud, and loud sound carries far. Your brain tries to sort out the difference between benign and threatening sounds. Many things blow up in this country, whether it be unexploded Soviet ordnance going off on its own, a donkey stepping on a landmine, NATO aircraft dropping bombs, Taliban shooting mortars, FOBs shooting training rounds.

Yesterday, I was eating dinner with several people when a horribly loud screaming sound came out of nowhere, it rose to a crescendo within 2-3 seconds. Everyone stood up, dinners dropped, wide-eyed, poised to run for cover, when the sound rapidly formed into the familiar sound of a jet engine. A US Navy F18 Superhornet (from a carrier in the Indian Ocean) had buzzed the FOB at about 500 feet.

At his speed and altitude, the roar of the aircraft came suddenly, without warning, frightening everyone on the FOB. The jet made a second pass, just as low, and received many middle-fingers.

I can say that I am much more keyed into loud sounds here… I’m always listening. Once or twice a week it keeps me from falling asleep, but I comfort myself with the laws of probability, and a good book.

Irony: (1) incongruity between the actual result of a sequence of events and the normal or expected result (2): an event or result marked by such incongruity*

Article in today's Wall Street Journal-- "Taliban Is Seizing, Destroying More NATO Supplies". Maybe it's just the way it is worded...

"About 90% of U.S. goods destined for Bagram, the main U.S. military base in Afghanistan, make an eight-day journey from Pakistan's Karachi port through the Torkham border crossing into Afghanistan, according to U.S. officials. Weapons and ammunition are flown into Afghanistan.

The majority of NATO supplies transported through Pakistan continue to reach their destinations, say Western diplomats and army officials. The U.S. government estimates it has lost only about 1% of its cargo going from Karachi to Afghanistan.

Still, the targeting of supply chains marks a new and troubling development. The militants' tactics appear designed to bog down foreign forces and wait them out, the same strategy adopted successfully by Afghan insurgents against the Soviet Union in the 1980s.

In response, NATO forces are adopting some of the Soviets' tactics. They are paying more money to local warlords to guarantee safe passage over roads and importing more fuel from central Asia, across Afghanistan's northern borders with Uzbekistan and Tajikistan, where roads are still safe. That presents logistical challenges and drives up the cost of the war."

*http://www.merriam-webster.com/dictionary

Slower Days and a Quick Brief on the RG-31 (Military Trivia That is Not So Trivial)

My posting has been slow lately, perhaps a reflection that not much is going on here. Combat has been slightly less frequent and there have been no casualties (well, some of our guys surprised some "bad" guys planting an IED and the encounter was a bit one sided, if you know what I mean). Slow is good, from my perspective.

Part of the slowness is that I'm still waiting for my Staff Sergeant to return from the south. He has been stuck for two weeks now, safe and sound, but stuck. It's really hard to move around in this country. Mostly the delays are due to weather in the mountains. The Chinooks need to fly through a number of passes to get anywhere, and if there are high winds or thunderstorms they don't fly. People get stuck places for weeks, and all you can do is sit around and wait for the next scheduled flight. Luckily, he will have visited our two furthest outposts and we will be unlikely to return.

As soon as he gets back I'm going to make the rounds to the outposts that are in the north section of our area. I'll let him stay here for a while and enjoy "civilization" and I'll go to a few other outposts. I'll consider hitching a ride in a convoy as long as I can get a seat in a $500,000 v-bottomed RG31. They are pretty much safer than the flat-bottomed Humvee M-1114.

US Forces are getting a lot of the RG31's (somewhere between 500k and 1 million per unit, courtesy of the US taxpayer credit card, thank you very much) because the Humvees just don't cut it anymore here in the world's biggest ammo dump. I read on the internet that the Humvee is close to ground, wide, and flat-bottomed, which means that the vehicle will absorb a relatively high percentage of a blast from beneath, transferring that force to the occupants and making the vehicle more likely to be breached. The RG31 is a high-riding vehicle that is v-bottomed like a boat, which deflects the blast out and up, rather than just absorbing it. Poor Afghan Army guys drive around in older Toyota HiLux trucks, which are really cool looking but definitely not IED resistant.

That said, I'll be happy to wait around for at least a little while to catch a flight.

FOB Dog Update

Our FOB dog is still alive but they haven't fixed the wall where he gets in. I got a few photos of him yesterday when I found him hanging out in the mortar pit. I currently can't post any photos because the public computer network is down and I can't access Blogspot from my work computer. I can post text entries remotely, by email, but I don't know how to post photos remotely. I can't check comments either, so if you've posted a comment and I haven't responded-- I don't when I will be able to...

The Blues, the FOB dog (update), and Please Send Hallucinogenic Gas Dispensers

I haven't posted in a day or two. I've been here one month and I think I'm experiencing a brief period of "adjustment disorder with depressed mood". As I told my brother-in-law, I am finding that the Army and I are very different. The honeymoon period is over, so now I have to adjust to the reality of this relationship. It's not a match made in heaven-- more a union of convenience (for the Army) or an arranged marriage, which is appropriate for this part of the world.

I said this before, but I'll expand on it. I have observed that I have a few external "strikes" against me, as I am considered to be a medic (actually, worse than a medic-- a shrink) and I am Air Force. Even the Army medics are somewhat marginalized, especially the doctors. They are possibly seen as being coddled or soft, whereas the actual "medics"-- enlisted Soldiers who go on missions and rub elbows with Soldiers in the dirt-- are more accepted and even appreciated, which makes sense.

The Air Force thing is mostly a barrier because there is constant griping that USAF deployments are shorter. They will point out that they will go through a third USAF psychologist before they even leave next year. I understand this, it sucks, and I don't think it's fair. But I consistently counter this by asking who was dumb enough to join the Army in the first place. Usually this goes over well because I think while Soldiers complain about the length of deployments, they also hold this as a point of pride-- it's one thing that sets them apart from other service members. To be honest, I didn't use that counter on the squadron commander when he said, "Six months? I could do six months standing on my head." I just smiled. Good thing he can't read minds.

It's an ebb and flow. Things have been mostly up, so it is reasonable to expect to have a few down days or weeks.

Moving on...

The FOB dog came up at the Battle Update Brief today. The squadron commander observed the location on the perimeter wall where the FOB dog infiltrates into and exfiltrates out of the FOB. The dog somehow gets in... It's remarkable. In the brief, he asked the First Sergeant to make sure that the breach is addressed. I'm not sure why it's a big deal. Maybe there are concerns that the little dog will one day wear a suicide vest, or come over at night with an AK47?

The First Sergeant grumbled an assent and said, "I was planning on shooting the dog anyway." I knew he was at least partially serious (I know the guy casually, but I have him profiled).

So after the meeting I grabbed him on the way out:

I said, "Sergeant "X", don't shoot that dog-- you better not shoot that dog."

He said, "You mean the pretty little dog? That dog craps in my horseshoe pit and when I play horseshoes I don't want to step in dog crap."

I said, "You're just a sick bastard and you want to kill something don't you."

Another NCO chimed in, confirming my suspicions, "Sergeant "X" if you need that dog killed, you let me know."

I said, "Just fix the wall so he can't get in. Don't you like dogs?"

There was a little more banter but I hope that I appealed to his humane side. I like the FOB dog. Reminds me of my dog.

If he kills it or has it killed, I will TORMENT him until I leave (a la Doctor Faustus).

Do you know about Dr. Faustus? The supervillain psychiatrist (of course) associated with Captain America?

Faustus has no superhuman powers but has a genius intellect, and is extremely charismatic and can modulate his voice in a highly persuasive manner. He has a Ph. D in psychiatry.

Faustus regularly employs hologram projectors, hallucinogenic gas dispensers, androids, and elaborate props. He also hires henchmen to impersonate various people as a part of his scheme to drive victims insane.

I gotta figure out how to get a hold of some hallucinogenic gas dispensers.

"I will be home and showered and probably three beers in by the time Carmichael makes it in."

My "distraction of the moment" is following Armstrong at the Leadville 100. Yes, I know he's degenerated into a womanizing tabloid figure (what was up with the whole Olsen twin thing?), and I have been reminded that I should be following the Olympics, but I'm curious to see how much of a bad-ass Lance still is on the bike-- and a mountain bike no less. The race is Aug 9, by the way--- www.leadville100.com

Pushed to predict his finish time for Saturday's race, Armstrong said he thinks he'll come in in the neighborhood of eight hours, or about an hour behind the winner — which at Leadville equates to about fifth place...

"I fully expect to get beat up," he said.

He did, however, engage in a little trash talk with coach Chris Carmichael, a Leadville veteran who will compete again this year.

"I know I can beat Carmichael. I will be home and showered and probably three beers in by the time Carmichael makes it in."

Photographs and Afghan Naan

I haven't taken photos lately but I should probably start again, post them for everyone to see.

I saw a HUGE spider in the gym the other day when I was doing sit-ups and I wished I had my camera then. It was as big and hairy as a small tarantula but it was light brown.

I'll get a photo of the sewage truck-- the tank is hand painted in blues and reds and yellows and it's quite pretty. They love to decorate their trucks here and the Soldiers call them "jingle trucks" because they have bells and chains and all kinds of decorations hanging off the sides, jingling as the trucks rock their way over the pot-holed roads.

I'm still trying to photograph that FOB dog-- she's a little grey and black mutt, about 40 pounds, with a curled tail and pointy ears. She gets into the FOB by climbing up the Hesco barriers and sandbags and squirming her way through the barbs of the concertina wire. I guess she eats garbage on the FOB. Americans have the best garbage in all of Asia, every Afghan dog knows that. People ignore her and she keeps her distance, always on the move. She's scared the crap out of me at night when she streaks through the beam of my flashlight.

I haven't seen her for a few days. I also haven't seen cats for a few weeks. There used to be a lot of cats that lived inside one of the qalats-- I thought it would be good to have cats around-- keep the rodent population in check. I heard that the commander put a contract on the cats and the Afghan laborers took care of them.

Which reminds me, the medics here provide aid for local national workers on the FOBs, mostly "terps" but also laborers and the guys who pull security on our walls (picture bearded guys with AK47s in dark green camo and white sneakers-- actually there is interesting story about those guys but I'll get to that later...) Anyway, the Afghans will bring food for the medics as a gift for services rendered.

They usually bring garlic naan and kabob wrapped in old Afghan newsprint. It looks and smells great, and the guys who bring it are smiling and expressing genuine respect and thanks. I find it vaguely sad-- impoverished people offering gifts of food to Americans. The food is usually dumped. Diarrhea, otherwise known as a "leaky o-ring", is prolific here, and eating local food may contribute to this? Most of the meat is supposedly lamb but the only livestock I have seen has been thousands of goats, some camels, and a few skinny cows. I haven't seen any sheep. Lots of dogs though.

I admit to some amount of paranoia. I have yet to eat local food and my guts have nevertheless been populated by some southwest Asian organism (I also have yet to go to the local bazaar due to my vaguely irrational notions about the stereotypical suicide bombers' affinity for markets and bazaars). To go to the market you have to be armed, but body armor is optional!

There's a bakery on the FOB-- the guy makes cinnamon and garlic naan. I gotta go check it out. Take a photo of that too...

Talking about Censorship

This book sounds disturbing enough by itself, but it's just plain Orwellian-creepy that civilian and military officials would want to censor a text like this and keep it from the public. Based on this read, elements within the Army fought to keep it as an open source.


Kevin C. Kiley, a retired lieutenant general who was the Army's surgeon general when the book was being prepared, said some higher-ups in the military had been worried that the pictures "could be spun politically to show the horrors of war."


So, what's worse, political spin to show that war is not that bad, or political spin to show "the horrors of war"? The underlying implication is that if citizens really know that war is horrible (um, is that still up for debate?), then they will be less likely to support war. Expanding that, the implication is that if citizens see maimed Soldiers then they will lose the will to send more Soldiers into harm's way. Is it really that simple? However the thought process went for the would-be censors, it is clear that they thought it best for the general public to remain ignorant.

I guess this is just an extension of the same line of thinking that led to barring photos of Soldier's coffins and other images of US casualties (anyone follow the recent Zoriah Miller controversy?) I don't think there are easy answers to this stuff, and I can see how immediately published after-action photos could have security and intel implications, but I do think too much censorship diminishes the contributions of American sons and daughters and cheats the voting US citizens.

Half of the time I can see the purpose of this mission and half of the time I can't, but when I do see the purpose it is always informed by a consideration of the human cost. I can't make good decisions as a citizen without being aware of certain realities.

But, I have a different view of war because much of what I do is listen to Soldier's narratives. They tell stories about what keeps them up at night and I try to synthesize science and good old fashioned empathy into a salve to get them a measure of respite.

I admit that there is a part of me that wants all Americans to be respectful, thankful, and empathic towards our servicemen and servicewomen who are on the front lines. This is not respect just because they are "heroes", but also because for every five of these men and women who come back from combat, there is one or two who will have jarring, anxiogenic memories that will live on with unerring clarity for the rest of their lives.

Somehow I like to think that if the rest of us understand what they went through, then it will easier for them to make it.

There-- that's my circuitous and obliquely psychological argument against censorship.

I had better get to sleep.

Maybe tomorrow I'll write about the clever little FOB dog. But I won't tell you about what they did with the cats!

Same Week-- Ramadan and NFL!

There is constant action in Afghanistan these days. The Taliban (and their friends) are either targeting the Afghan Army, Afghans who transport goods for NATO, or NATO forces. Typically they will avoid direct confrontation with NATO patrols unless they have elevated positions and a quick avenue of escape, or caves. The Taliban love caves.

It seems like the most frequent attacks against NATO forces are IEDs (pressure plates or command-wired) or indirect fire (Chinese-made mortars or rockets). These guys are resourceful. Most of the trigger mechanisms are basically made out of trash and stuff that they find laying around in the dirt. I have been shown a number of IED trigger devices that were made from trash that was discarded by US forces: water bottles, batteries, copper wire, calling cards. There's terrible irony that people from this medieval culture take the refuse of the industrial age and fashion it into weapons that have the potential to crack open the most advanced vehicles we field. Of course we counter this with more technology.

The word on the street is that we probably have one more month of intense fighting and then Ramadan eats up most of September (that was a bad joke, ya get it?). Typically Ramadan means less fighting, or so I hear, but I would speculate that maybe that time would be ripe for suicide bombers? A rich combination of religious fervor and grumpiness from fasting-- that promise of 70 virgins. Lots more female suicide bombers these days.

Do the female martyrs get 70 male virgins? Probably not. But that might not be such an incentive anyway.

After Ramadan it will start getting cold here. Once the ground freezes at night it becomes harder to dig holes for IEDs, but because they lack good cold weather gear they also lose their motivation to sit around in prepared fighting positions waiting to ambush NATO patrols.

So, the start of the NFL season roughly coincides with the start of Ramadan. I am looking forward to both.

With luck I will be back home in time for the AFC and NFC championship games!

Not a Comfortable Viewpoint to Consider...

"We only want a stable country, whether with the Taliban or the foreigners." But he said that the level of violence made him realize that the foreign forces could not bring security... His father, brother and a daughter were among those killed. "You cannot take revenge against a plane," he said. "But I will not forgive the foreigners for this crime."


These poor people. I can't imagine the pain. I'm reminding myself to not take anything for granted in the US, not even $5 a gallon gasoline.

Technology, Hellfire, and Guilt

I've been impressed with the capabilities of our technology. As an Air Force guy, I'm surprised that the Army doesn't give the Air Force more credit. The grunts rely on the availability of close air support and all operations are run with either a B1, an A10, an F15 or an MQ9 close at hand. The UCAVs (Unmanned Combat Aerial Vehicles: the MQ9 and the MQ1) have these high resolution cameras on them and they fly really slow, so they can literally focus in on what someone is doing with their hands. They can see at night, they can see through things (infrared), and you never know one is around because they are little and quiet. They also remind me of home, because the UCAV missions are flown by remote control by miserable people in little metal boxes in Las Vegas, Nevada.

Anyway, I watch these video feeds and I'm impressed. Even the F15 has great cameras that scan the ground with really high resolution. They can literally see a bad guy with a gun from miles up in the air.

Highlight footage recorded by these aircraft cameras is distributed via thumbdrives (probably illegally), and it's used for inspirational purposes when put to a soundtrack-- like showing a reel of a football team's best plays before a big game. I'll give you an example of highlight footage: an unmanned aerial vehicle spots four guys who are lobbing mortars at a FOB in the middle of the night. The UCAV circles and waits until the four guys are clustered together around the mortar tube. You can see them talking and gesturing to each other. You can see their clothing move, see them scratch themselves, see the small pile of unfired ammunition on the ground. Then suddenly there is a flash and they all disappear in a cloud of dust... the UCAV has released its single AGM-114 Hellfire missile. As the dust clears, there is just a hole in the ground where the mortar crew was before, but one man manages to crawl out of the dust cloud, then gets up on his feet and tries to run, staggers, then falls, kicking up a small cloud of dust.

The UCAV footage is tame compared to the A10 footage. The A10's 30mm cannon shoots huge depleted uranium shells at 70 rounds per second. I was shown video of an A10 hitting a truck full of bad guys and then chasing down the survivors on three subsequent strafing runs.

A month ago that stuff would have disgusted me, but somehow I now take guilty comfort in those images. It's not pleasure-- I still think the images are disturbing-- but when I see those feeds at the TOC or hear a report that a bomb-maker a few miles from here blew himself up while preparing an IED made out of Italian anti-tank mines-- well I have to admit that I reflexively feel satisfied. Maybe it's just the tenor of war, that when you feel threatened you take incremental comfort in any damage to whose whom you perceive as your antagonists.

It's not vindictive. I think it's a natural response to fear. I think that's why the idea of "turning the other cheek" is indeed Christlike. What normal human can really live that creed in both thought and deed?

The Daily Smoke Session...

Since there's not much going on (that I can prudently write about :) I'll go ahead and share one thing that's really helping me get through deployment: smoke sessions.

Not that kind of smoke session-- the Army kind-- intense physical activity-- only without a Drill Sergeant standing over me yelling obscenities.

Before I got here I was planning on working out a lot while I was serving my time here, but I didn't really have a plan. I suppose I vaguely thought I was just going to run regularly, lift some weights, do some push ups. I didn't know--

I have to give a lot of credit to this guy I met here-- he's been here four months and has a routine that mostly stays the same. He's 40 years old and can pretty much crush me on any measure of physical fitness. He attributes much of his discipline to recovering from a broken hip a few years back. I'm not copying him, well, maybe I am kind of copying him. I'm using him as an inspiration and I'll share the inspiration here.

The first inspiration: do two-a-days as often as possible. I used to do these when I was crazy about triathlon, but they always seemed excessive and luxurious, especially if you had to work, be a parent, those kind of things. I'm sold on two-a-days here, because I have the time, and also because once I start doing them I realize that I can actually sustain them. For most people it's hard to get a two hour block for exercise during a typical day, but if you split it into two, one hour blocks, or even two 30-45 minute blocks, it is much more feasible and it can double your exercise volume in a week, making it easier to gain or maintain fitness or lose weight.

The second inspiration: do regular abdominal work. I've always been half-assed about working my abs even though EVERYONE knows it's good for your back, good for stabilizing hips and knees, and generally complements any physical activity. I now do a 10 minute ab workout six days a week. It goes like this: 1 min bicycle crunches, 1 min traditional crunches, 1 minute vertical leg crunches, 1 minute traditional sit ups, 1 minute boat pose (with bent knees) and then you do it all over again, no rest between exercises, for a total of 10 minutes. The first day I did this I almost died. It goes by in a flash.

The third inspiration: do more than I think I can. If I can run for 30 minutes, why not run for 40 or 45? I'm typically a 45 minute guy if I'm just out for a quick run but I've been doing at least 60 here, just slowing down if I fatigue. Also, I thought the stationary bike would be torture (it's so not like riding a bicycle) but it gives me enough of an approximation of a real bike that I'll chug out 30 or 40k, imagining I'm somewhere else. I ignore the clock and have found that if I think I can do more, I do it easily.

The fourth inspiration: keep it simple. I can do almost everything I need to stay fit without any equipment, just some shorts and shoes and a shirt. The art of the sit-up, push-up, the pull up, and the dip-- body weight exercises that work the major muscle groups of the upper body. The body weight workout to failure is fast and can be done almost anywhere (well, push-ups at least). It takes about 20-30 minutes of constant motion and I'm cooked. (See: An Enduring Measure of Fitness: The Simple Push-up). This year I've become a huge fan of the push-up.

And the last inspiration is actually Michael Pollan's well known mantra: Eat food. Not too much. Mostly plants.

Okay. Indulgent self help session is over.

I'll get back to war-blogging tomorrow, maybe.

Note to Self: No More Hitching Rides with the Engineers

I finally got to leave the FOB—my first view in two weeks of something other than the inside of this FOB. It was a short-notice request by medical personnel at our sister FOB due to two mysterious incidents that resulted in serious medical problems and medevac to Germany for two Soldiers. I wasn't sure why I was going but I went anyway.

 

By networking and talking to people I managed to hitch a ride on an early morning convoy—they had an extra seat in the trailing vehicle of a four truck operation.

 

I stuffed all 77 inches of myself into the backseat of the Humvee. This was made more difficult by body armor, Kevlar helmet, pack, and sidearm. Wedged in, combat door locks locked, we rolled out and I got my first view of "outside the wire".

 

I felt pretty secure, gazing out at the trash-littered moonscape through 2 inches of ballistic glass set in a 500 pound steel door. Giant feral dogs casually walking down the side of road, kids just standing around, watching. Six men with chest length beards sat stuffed into a Toyota Corolla, all on cell phones, staring.

 

A coalition convoy basically bulls its way through traffic, all cars pull off to the side of the road and the US vehicles swing wide to avoid them, across both sides of the road, alternating their speed; fast then slow, slow, fast, faster, slow, a tactic to throw off the timing of command-detonated IEDs that rely on precise timing to trigger the charge at the center of the vehicle.

 

We drove down about a half mile of unmaintained pavement and then rumbled down several miles of rutted, washed out dirt road, through a small village, past walled compounds before reaching the entry control point for the FOB. It was uneventful, still early in the morning, but I was happy to drive into the US compound.

 

I spent the day at the FOB, seeing a few patients who were referred by the medics and I did a one hour debrief with a small unit that was affected by one of the incidents. They were appreciative and I prepared for the second unit, feeling like I was doing a good job.

 

The commander of the second unit basically blew me off and said, "My guys don't really talk about their feelings." I said, "Do you know what a debrief is?" He said "no" and walked away.  I didn't take it personally, but I felt bad for his troops. This young, dim Captain had made up his mind. I didn't pursue the issue further.

 

I was expecting to stay the night but I was done by 3:30pm and I started to look around for a ride back to my FOB. Someone told me that the engineers go over at 4:30. The Mayor still didn't have a place for me to stay anyway…

 

I found the engineers office and I asked a guy at the desk if they were going back to the other FOB and if so, could I get a ride. He said "Sure." Right at 4:30, five guys strode out of the office in full battle rattle. There were two Soldiers and three civilians.

 

Well, it turned out that the "convoy" back consisted of a Ford Excursion and a Humvee. The Master Sergeant waved me over to the Humvee (whew) and I got into the  left rear seat (rear right is over the fuel tank, by the way). I quickly noted that there was no gunner, the gunners hatch sealed up. Maybe we will hook up with a few more vehicles before we leave the ECP? I thought as we pulled away. I was under the impression that the current standing order was that there was a four vehicle minimum in this area. "Ya, there is", the Master Sergeant said, "...but we're special."

 

As we rolled out of the ECP there were no other vehicles. I observed that there were two guys in the Excursion. One of them was armed with a 9mm pistol. There were four in our vehicle; one guy with an M-4 and me with my 9mm (I had left my M-16 locked up in my hut in the interest of traveling light). I noted our degree of armament not because I am a gun enthusiast, but because I suddenly found myself considering all sorts of possible extenuating circumstances, and in Afghanistan unfortunately, guns can be helpful when extricating oneself from extenuating circumstances.

 

(Again, I was struck by the strangeness of being concerned about something like not having enough automatic weapons-- am I dreaming this? What a striking shift in reality, that I think about stuff like that.)

 

Late in the afternoon there were more people out; swarms of children. Little boys and little sandy haired girls in colorful clothing rushing out of what looked like ancient Anasazi ruins—mud buildings in disrepair, surrounded by trash, broken TVs, piles of firewood (where they get that, I have no idea).

 

Our two vehicle convoy banged over the dirt roads. There was no conversation, no after-work banter. Was there anxiety in the truck or was it just me? I was sure anxious, especially after coming over in the morning with four gun-trucks and 20 heavily armed infantrymen.

 

There were more huge dogs (the biggest dogs I have ever seen) and men just standing around (never saw a woman). Some kids gave thumbs up and an equal number threw trash and rocks.

 

One child, about 10 years old, held to his shoulder a toy RPG launcher made out of white Styrofoam, and aimed it at our Humvee, popping it up and down with make-believe recoil as he fired make-believe explosive rounds at our two trucks.

 

It was a little disconcerting, for various reasons, not the least of which is because real RPGs get shot at our guys everyday. I know that kid doesn't watch too much violent TV, but he was born under Taliban rule and has grown up during the NATO occupation of Afghanistan. I wondered what his future holds, what the future of all those little kids holds.

 

I pointed the RPG kid out to the guys in my truck and they looked over. One dead-panned, "Ya, they love us."

Two Good Things and One Bad Thing In Afghanistan...

Walking back from the latrines the FOB is completely blacked out and I had to let my eyes adjust for a moment and switch off my blue LED. The moon is gone and the wind was relatively calm today, keeping the clouds of dust out of the sky.  I looked up and saw, for the first time here, the big white streak of the Milky Way.  

 

Completely clear and beautiful, all those stars. I've missed seeing them with as much clarity as I remember them from all those nights at 10000ft in the Sierra Nevada.

 

That's one good thing about being in Afghanistan.

 

Another good thing is that I survived my first two convoys (although one was much more unsettling than the other) but I'll need to post that story tomorrow.

 

A bad thing is that I've got a touch of "Osama's Revenge", if you know what I mean.

 

That's what's called "too much self disclosure".

 

I'll stop now.

 

To bed.

 

The Important Things in Life...

The final stage near San Diego will actually be a mountain top finish, a first for the race. "The final stage is planned to be a mountain stage up Mt. Palomar. Whoever wins the race will have to have legs on the final day!"

Since our family is leaving southern Nevada in 2009 this will be my final chance to easily spectate at the one of the premier stage races (the premier?) in the US. What a combination... San Diego, staying at Coronado, a mountain-top finish at the Tour of California, the end of my freakin' deployment!!!

 

Anyone want to meet me there?

 

 

Invisible People

This is something that doesn't get a enough play in the media:

 

According to a January Defense Department report, despite significant efforts, the number of suicides continued to rise. And an earlier report showed us that an increasing number of troops were killing themselves while in Iraq or Afghanistan.

 

There has been one completed suicide here since I arrived (it wasn't at one of my locations). In the last few months, the guys I replaced had responded to one other suicide completion and several attempts and gestures. It is no secret that people here suffer under the stressors associated with combat duty.

 

I sit in on a commander's briefing every morning and one of the reports is a medical situation report on patients seen at medical aid stations in the last 24 hours-- combat stress patients are one category but the number is always zero-- meaning that people are presenting to aid stations with other symptoms like headaches, sleep problems, vague aches and pains, fatigue but they aren't reporting combat stress, or the medics aren't asking.

 

Based on those numbers, no one has combat stress. The commander looks at my numbers once a week, which says to me that it isn't much of a concern. (He gets a daily update on when the next mail delivery is coming).
 

BUT... the Army completed the 2007-2008 MHAT V (Mental Health Assessment Team) report this year and concluded that depressive and acute stress symptoms were worsening in Afghanistan, catching up to rates in Iraq. This was before the death rate in Afghanistan passed Iraq. Post-deployment surveys of service-members consistently confirm that up to 25% of returnees experience significant psychological symptoms, and the VA is under-resourced and overwhelmed with OIF and OEF vets seeking services-- with people looking at the lack of services as being possibly associated with vet suicides.

 

So there are these people out here who are really struggling, but they are mostly invisible to me.

 

A related task for me is to get the NCOs and officers to be able to better recognize Soldiers in distress, but also to get them to do something to help. It's hard in an environment where almost everyone is experiencing some degree of distress, stress, discomfort. Everyone has risk factors so how do you sort out the severe cases? I need to get them to ask that question. No one asks that question.

 

Anyway, word came down this morning from another FOB that they need a psychologist ASAP. So much for prevention.

 

I hear the chow is better over there... KBR food.

 

 

 

Negligent Discharges

A notable thing about the war zone is that everyone carries around a loaded weapon; everything from 9mm pistols to big SAWs (squad automatic weapons). Most places that aren't under some sort of imminent threat (real or imagined) keep people in "green" status, which means that they carry an unloaded weapon and have a magazine elsewhere (back in their room or on their person, just not in the weapon).

 

Here at our FOB we are in "amber" status, which means that we carry weapons with a loaded magazine inserted into the magazine well, fire selector on safe, without having a round chambered. Loading and charging a weapon is the two step process that is widely known as the "lock and load", the result of which is a weapon that is ready to fire.

 

Whenever people venture outside of the wire on ground transportation you always lock and load, but keep your weapons on safe (which means if you pull the trigger, nothing happens). If you are locked and loaded, all you need to do to fire the weapon is to move the selector from safe to fire.

 

When you venture back into the wire you are supposed to go through the process of clearing the weapon; that is you drop the magazine, clear the round from the chamber and ensure your selector is on safe, not fire.

 

You can probably tell where I'm going with this...

 

People forget stuff.

 

Since I've been here there have been two incidents known as "negligent discharges". One was an Afghan guy who let off several rounds from his AK-47 into the ground BETWEEN THE LEGS of one of his buddies. Another was by a medic who somehow squeezed off a round from her M-4, also going into the ground. That both of these incidents did not cause harm illustrates the importance of what is known as "muzzle discipline", or always keeping your weapon pointed at the ground unless you intend to shoot something. If the rules about keeping your weapon on safe and keeping your finger away from the trigger don't work, hopefully you abide by the third rule and keep the thing pointed in a safe direction.

 

Now the really crazy story... There was a medic who was treating a leg injury for someone and was joking around, saying something like "I know what will fix that leg" while taking out his pistol to pretend to shoot the guy's leg. But instead of pretending, he somehow actually shot the guy in the leg.

 

It gets better...

 

He is still in Afghanistan working as a medic.

 

Ya gotta love the Army. They are so forgiving and tolerant... quite the liberal organization. Shoot someone? That's okay. Beat your wife? That's okay too. Problems with cocaine? Get your ass to Iraq Soldier!

 

Now if you're gay...

 

Cheers from lovely Paktia Province!

 

TLC

Quiet

Not much to report from here. SSgt R left for our first mission down to the south of our territory. It is expected to be uneventful, other than dealing with delays in air travel. I maintain a presence here and wait for the local operations to calm down, and then I'll be headed east to another outpost. My goal is for us to visit all of our FOBs by the end of September. This will effectively split our time here, with the first half (July-September) being spent establishing a presence, and then we'll come up with some kind of plan for the second half (October-December).

A current excitement on the FOB is related to the upcoming football season. There's a TV in the chow-hall, so people are dreaming of 2am football parties. I'm sure I'll be there.

The Lament of a Non Soldier in a Soldier's World

Big operation out of the FOB… lots of soldiers, helicopters, big guns, Afghan National Army troops, massing for a mission and then gone. There is always a mission going out each day, but this was my first experience with a big one. A specter of tension hangs over the FOB and it gets verbalized at the medical aid station. Every time the phone rings (and it doesn't ring often) it might mean a KIA or a WIA notification. This fear is born out when the phone rings this morning—an IED strike—no injuries.

Along with this news is word that several bad guys were killed by an F15 that was prowling ahead of the US insertion—SSgt R, my NCO, was talking with the airborne infantrymen and he said they were joking about getting guts on their boots as they get out of the helos—gallows humor as they stand on the brink. Enemy deaths are subtly celebrated, representing one less guy who might kill one of our guys.

Early in the morning I ran for an hour, making loops past the ECP where a large convoy of MRAPs was lined up waiting for orders to leave, guys sitting in body armor and Kevlar helmets behind deadly looking 50 cals and Mk 19s. I had a vague sense of guilt that I stay at the FOB, working on my PT, while they prepare to look for IEDs, get shot at and shoot back. I wonder if I will be more useful to them if I have experienced what they have…

I've seen about 20 different people since I've been here, and my combat experience (or lack thereof) has not been an issue. Part of me thinks that I would need my own services if I was rolling out in convoys—which would render me pretty ineffective in my primary duty here.

To make myself feel better I remind myself that I'm not a Soldier—I'm an Airman, I'm a health care professional inserted into this environment so that Soldiers have easy access to me, not so that I can do what they do. By default I may experience my share of exposure to these stressors, but experiencing the stressors is not a task I need to check off in order to get my job done.

Lately, planning missions, I've felt jealous of other USAF folks who stay at Bagram or are assigned to places like Kuwait, or Qatar. They don't have to even consider riding in convoys or flying out to 20 man combat outposts on the Paki border. Why couldn't I have been so lucky?

I think some of this comes from something the battalion commander said to me a week back, he said "I need you forward deployed, so that the guys can see you doing the things they do, get mortared with them… so you know what they know." I see his point, and I see how getting the "street cred" will possibly make things easier, but then again… I don't need to have experienced a panic attack or a major depressive episode to help someone manage the symptoms.

I vacillate back and forth, trying to sort out what it will take to do a good job here, how to minimize our risks but still get the job done, how to create a balance between heroically going anywhere for the mission, but still maximizing our chances of getting back home safely.

Ugh. I guess that's part of the burden of leadership. If you make a decision you need to be willing to live with the consequences. Risking the guilt of being too conservative, versus the consequences of dismissing risk.

One thing that helps… this may sound strange… is that I remind myself of how "bombproof" those bunkers really are, and MRAPs are pretty damn tough. That seems like such a screwed up thing for ME to be thinking about… I should be thinking about getting home early for dinner, finding a new job, playing with the kids… (then the Voice comes in and says "what the HELL was I thinking?")

Pointless direction to go down at this point.

I just need to break the seal on these missions, get a few done, and hope that with experience will come clarity.

 

Disneyland for Terrorists?

So far I feel pretty lucky, given the nature of our location in Afghanistan. Based on history, our base has been a safe haven, receiving scant attacks from the forces that are collectively known as "AAF" or Anti Afghan Forces. This term includes the TB, AQ, and the drug lords. We have a sister base that is attacked much more frequently, and we have an outpost that is a short drive from here (up in the mountains) that is aggressively attacked on a regular basis. You can glean most of this info from the news, but I'll repeat it here... that much of the resurgence in fighting here is related to a new influx of foreign fighters. People come from all of the "stans", Chechnya, and the Middle-East to get an opportunity to fight Americans, British, Canadians, Germans, and the hapless Afghans. It's like a vacation spot for Islamic guerilla fighters-- like college boys go to Cabo to score with drunk chicks, Islamic fighters come here to fight infidels.

 

I think morale here is high but the more I talk with people about the future of this war the more I uncover confusion. I guess it's not our role to understand the big picture, but no one I speak with really sees how more soldiers will make a difference. More money maybe, but a lot of money disappears into corrupt networks (from the news, not my opinion). People generally believe in their mission, want to do a good job. I have always heard the argument from soldiers-- "let's just leave them to kill each other, instead of them killing us." I know where that comes from-- it's not a very sophisticated viewpoint but it's one that becomes understandable if you drive out of the gates everyday wondering if you will make it back home alive.

 

I have yet to go on a mission, but already I can understand... I can understand how soldiers just want to do the job of the day, get themselves and their friends back safely, and count down the days until they can go home and forget about what can seem like a forsaken, medieval wilderness.

 

What we do...

Our mission has several functional areas, as defined by the US Army (remember, I'm in the Air Force).

Primarily, I serve as consultant to the commander of this region. I'm a doc in the traditional sense (being attached to the medical component and being available for "patients") but we are also the de facto experts on the assessment, prevention and management of combat operational stress reactions (COSR). This is basically defined as the physical and emotional responses to acute or chronic stressors associated with war and living conditions associated with war.

The first part is assessment, prevention and education services, which is mostly walking around, talking to people, asking questions about morale, stressors, etc., We will also offer briefings and classes for different units-- smoking cessation, anger management...

The second part, which is more time consuming, is basic behavioral health services. In conjunction with the medics, we are the only game in town for management of depression, anxiety, chronic pain, insomnia, interpersonal problems, anger, etc. Basically we do everything we do back at home, just in a more informal environment.

The third part is traumatic event management. When something bad happens, we roll in two to three days later and, in small groups, debrief the people involved. Nothing complicated, just an opportunity to let those affected normalize their responses (maybe grief, anger, fear), get some brief peer support and guidance about how to move on. The Army has a specific way they want this done, and we've been trained up on those techniques.

So far the days are usually comprised of a few hours of walk-abouts on the FOB and three to four walk-ins to the clinic. It's light duty compared to back at home.

On the horizon are several trips to outlying FOBs-- to basically offer the same services in the form of a traveling road show.

Captain America Visiting

I heard that Toby Keith came to this FOB earlier this year-- I'm impressed. Although he probably flew in and out on the same day.

Captain America visited the Combat Stress Control hut today...



Told stories about the Cold War and showed us a photo of him with the Reagans... Believe it or not he told me that he voted for Clinton in the '92 election.

"Kabul in Transition" from the NY Times

Brief but interesting slideshow-- be sure to turn on the sound so you can get the narration. The photo of the mom and kid on the street just kills me. I can't look at pictures of kids!

Sensations

The smells: diesel exhaust from the generators that run 24/7, plywood, sewage from the make-shift latrines, mold in the make-shift showers, sweat, dirt, and body odor mixed together, smoke from the burn cans, cafeteria food smell from the chow hall, rotting garbage from the jingle trucks parked by the west wall, alcohol in the hand-sanitizer. There’s nothing that smells good here.

The sounds: the diesel generators that run 24/7, wind rattling the aluminum shingles on the hut, B-hut doors slamming, the heavy beating of Chinook rotors, hip-hop music from the chow hall kitchen, F15’s roaring over the province, power tools, mortar fire, the diesel generators, the diesel generators, the diesel generators. The iPod is a sweet haven.

The tastes: endless bottled water, boxes of unsweetened grapefruit juice, dust, the chow hall, raisin bran, bad coffee, sweat, plywood.

The touches: constant ride of a weapon sling on your shoulder or hip, uneven rocks under desert boots, heat under the non-breathable uniform, slippery cool of constant hand washing with soap, scratchy sheets at the end of the day, hot water of a shower pouring down to wash away the smells and the tastes. Laying down at the end of the day...

The sights: razor wire, plywood, weapons, armored vehicles, uniforms, immense blue sky, dry hills, Afghans and beards, dust, dirt, sweat, stacks of water bottles, rocks, Hesco barriers, Chinooks. I try to take note of the morning and evening sky, the clouds, the stars. Beauty is a scarce commodity around here...

Looking into the past

This view caught me—sunset over the mountains, framed in razor wire and Hesco barriers. I ran to grab my camera and watched the sun drop to the west. I realized that as it was just falling away from us here in Afghanistan it was just rising for my sweet children, my wife, my family, on the west coast of America. My July 22 was over as theirs was just starting. A bittersweet moment, imagining them stirring and waking for a new day while realizing that I can’t get much further away than I am right now.

Scenes from around base...

Our Wal Mart is on the right and Target is on the left. The red target sign is just out of the picture. These shops are run by locals and they sell a bunch of crap from India and Pakistan-- lost of knock-off electronics and pirated DVDs.



A few klicks off base is a wide open plain dotted with tents and wagons. This is a summer settlement of nomads. They pretty much live like they did 1000 years ago-- herding sheep and cows, living out of tents.

An old Russian motorcycle with side-car-- from the Soviet occupation. An American bought it from some guy and is arranging to ship it back home and rebuild it...

The cardio gym... I've spent several hours here already, but try to run outside.

Our post exchange-- the AAFES motto is "We go where you go". I''ll never complain about the Nellis BX again. There are about six shelves that are stocked with chewing tobacco, cigarettes, candy bars, Mountain Dew, coffee filters and two issues of "Smooth Girl".

The Afghan tailor who works on the base...

Two Blackhawks doing medevac, headed to BAF. The helos always travel in pairs.

Domestic Violence?

I found this interesting commentary on Afghanistan-- a quick slant on the conflict and culture here. I don't spend too much time thinking about it, but if the TB are so bad, why are they so resilient here? You would think that bad dudes who use indiscriminate violence would be rejected by a population that is so torn by centuries of war. The TB kill far more Afghans than NATO does via collateral damage and we literally pour money into local economies. I guess it's a case of "better the devil you know"-- the same reason abused spouses remain with the abuser.

And then there's that whole "infidel" thing...

"The problems in Afghanistan for the most part, do not stem from within its borders, but from Pakistan. This is another bizarre example of the alliances that the United States forges. Pakistan and Saudi Arabia are dangerous places with almost no equity for the treatment of women. Iran on the other hand is at peace and has a large number of women in professional roles, in college, and holding political office."

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Adaptation

Good news. My first mission, visiting two firebases and one FOB, is to a region that is quiet right now. No safety concerns. Nothing is firmly scheduled yet but it should happen within a week or so.

 

Our hottest area is nearby here-- a firebase in the mountains that takes mortars and rockets nightly. The Taliban/Al Qaeda/whoever target the bases with indirect fire, but it is largely ineffective and much of it misses anything of improtance. Even if it does come close, the bunkers on each base can sustain practically a direct hit and leave the residents with nothing more than a headache from the noise and overpressure. The bad guys more frequently target the locals who drive supply trucks to and from the bases or work on road projects or other construction projects. They make good money but the insurgents target them as collaborators. Many Afghans are killed or wounded on a regular basis.

 

Listening to the mortar crew at our sister FOB shooting illumination rounds 5k in the distance last night, I realized that you never really fully relax here. There is a mild but insidious anxitety that permeates every experience. The sounds, the smells, the sights. Even laying in your bed, drifting into sleep, you devote brain bandwidth to monitoring sounds. But today I re-learned some things I already knew.

 

You see, I've made a friend, and I've started working out relentlessly. The guy I am becoming friends with is an Army doctor, who I network/consult with as one of three medical officers on this base. He's a cyclist, lives in Washington, and has three kids about the same age as mine. Most people here are young men and women, roughnecked warriors, good old boys, kids. There are a handful of Army officers-- Captains and Majors, but they make up their own cadre and while some are very pleasant, we live and work in different worlds. So, it was a relief to make a friend. 

 

He took me on a long run through the FOB, making multiple loops and circles on the gravel and rock roads. When I was running I felt at peace and got lost in the physical experience, and the not insignificant pain from the elevation and several weeks of sedentary travel. The next morning I spent almost an hour on a dusty stationary bike, spun my way through 18 stationary miles. I listened to music and stared at the canvas wall of the tent but I was somewhere else too-- I was on my bike back home, I could feel the wind on my face and the heat in my legs.

 

A friend and a re-focusing on fitness; two things that are helping me adapt.

 

Brain Rangers: Finding the Core of it...

The team I replaced is now gone—on their way to the States to their great relief. Getting them out was significant, not only because I can now fully own COSC here, but also because their presence reminded me that I just got here!!! I can now make my own legacy and wait for my replacement (poor bastard). My Staff Sergeant showed up at 6am. He had been traveling all night, getting to the BAF air terminal at 8pm the night before. Such is the nature of travel here. The "air bridge" that connects these bases is tenuous and unpredictable, forcing long waits that stretch from hours to days to weeks.

 

Things are suddenly rolling at the combat operational stress control hut. My four days of aggressive marketing is paying off with multiple referrals from the Army medics, self referrals, and a meeting with the commander.  Our clinic was busy with walk-ins from 1030am through 6pm. In three days I have seen mostly combat and operational stress clients with a handful of people with pre-existing issues like chronic insomnia and anxiety.

 

The commander is fully supportive of "brain rangers" and our services, acknowledging that we have an important part of the mission, and he wants us to play an active role.

He paused when we were talking and said that the first thing he wanted to do was "Pantherize" us before we forward deploy: make us less obvious as USAF personnel (our uniforms are a rough approximation of the Army's, but theirs are much cooler and fireproof). After the meeting, per his instruction,  I made a quick trip to the logistics area and got two new Army Aircrew Combat Uniforms… made out of Nomex! The sergeant stuck Airborne patches on the sleeves and the Sergeant Major gave me an ACU hat (took it to the Afghan tailor to sew on rank). With a slung M16 I'll fit right in.

 

This leads to what will be my first mission away from our FOB: a unit behavioral health needs assessment in one of the far-flung companies. I guess I'm talking the talk, so I need to get ready to walk the walk. Making a trip forward, circulating with the guys on the front line and meeting some of the company commanders should garner a few inches of acceptance here in the battalion, which in the long run will make my job both easier and more fulfilling.

 

I've decided that we will do our traveling separately, to maintain a constant presence here at our main location. We already have an active sleep medicine service and we will stand up a smoking cessation service within a week or two. My sergeant is really motivated to provide services for soldiers and do outreach here on base, so when I'm gone he can keep our services active.

 

As the days progress I'm moving towards a rapprochement with my deployment and the anxiety it generates. I'm going to work hard to make it the kind of experience that, when I look back six months from now, I will be glad it is over but proud that I have served in this capacity. Proud that I dug deep to do the right thing for these people who go into harm's way at the behest of our elected officials. That right there, that's at the core of it for me.

 

Like I told my family, if I am going to go to the trouble of being 7000 miles away from my heart and soul, I am going to make sure that the journey is worthwhile and make sure that my accomplishments represent something that my family and friends can be proud of.

Long night

Saturday-- my NCO was supposed to arrive at some point that day. I checked at the TOC for pending flights into the FOB and they had one incoming flight at 2230 Zulu (0130am). As the sun set there was a huge storm cell scouring the mountains on the Afghan/Pakistan border, lightning illuminating the boiling clouds from within. Wind had picked up and flags were snapping on post. I was sure the flight would be canceled. The team I had replaced 3 days ago was waiting at the LZ with their bags, hoping the Chinook would come in, bringing my guy and carrying them back to BAF, then on to Manas, then home.

 

I struggled to stay awake until 0130am and I heard rotors beating the air. I rushed out into the dark to the LZ but it was a pair of Blackhawks on a medevac run to BAF. The Chinook was delayed. I went back to my hut and dozed. At 0330am the heavier, deeper thrum of a Chinook shook the FOB. Again, I rushed to the LZ, the night lit up under the full moon. Two huge Chinooks had dropped into the LZ and were disgorging passengers and cargo under the moonlight, but no NCO for me. The Chinooks left a few minutes later, one following the other, engine pods glowing red, powering into the sky.

 

The doc and tech waiting to get out were standing on the edge of tthe dark field patiently-- they told me the helos were coming back after a quick run to another FOB and then they would go to BAF. They waited with the patience of two men who were but a few days from being back with their families. I know I'll be willing to wait all night when it's my turn... I shook their hands and said "goodbye", closing the door on their tour and symbolically beginning mine. I went to bed. The sun was coming up. It was 0415am.

More photos...

View to the west from the walls of the FOB. In the center of the valley you can barely see the ruins of an ancient fortress on a hilltop.

View to the south across the LZ. Those walled compounds are everywhere here...

Mud walled compound inside the FOB. Not sure how old it is, but it looks old.





Wall of Heroes...

Afghan graveyard inside the perimeter of the FOB. Some of the graves look hundred of years old. I'm not sure of the significance of flags in the foreground. The base comm tower is in the background.

Anysoldier.com

At our Combat Stress Control clinic we have a large set of shelves with various items sent by www.anysoldier.com. You can find my name here. This explains how it works. I am trying to beef up our stock so that I can spread the news on base that people can stop by, pick up some snacks, candy, DVDs, or razors, and maybe chat a bit with me or my technician (lots of women here too-- not sure what women like to have out here. Lotion?). I'm also going to bring stuff out to the FOBs when I travel. Mail hasn't reached this FOB for some time, so I'm not sure when stuff will come. I'd really like to set the clinic up with a TV and a DVD player and some benches or couches, but a lot of people have TVs here (some flat panel TVs in some of the hooches). I think the food and other free stuff will be my lure-- feel free to check out the website and pass the link!

My New Small, Small Town...

I made it to the FOB after another long day of travel. The only way to travel around here is by helicopter, so I rode a Chinook out of BAF, touching down at the LZs in a network of firebases and combat outposts spread throughout the mountains. I felt pretty safe because the Chinook bristles with guns: two door gunners and a tail gunner. I would not want to risk shooting at one of these from the ground if I were Taliban—you would be sure to get a face full of 7.62mm from at least one door gunner and the tail gunner as they flew by. Sorry, but yes I had that thought. The helocopter flies through high passes only a few hundred feet above the forest, I suppose due to elevation. It is a little unnerving.

In flight on Chinook:


The trip was long and cramped but I can now say that I’ve been in Kabul and have been right on the Pakistan border (it looks just like Afghanistan, which looks just like southern Nevada, so really, if you’ve been to southern Nevada, you’ve pretty much seen what central Afghanistan and western Pakistan look like.

Upon arrival, one other passenger (a USAF personellist) and I madly dragged three or four hundred pounds of gear off the bird while the Chinook idled on the ground. The rotor wash and the heat of the exhaust is impressive, blasting you with superheated gas every time you get into the rear of the aircraft. We got a few hundred feet from the two Chinooks and they left—on the ground for no more than three or four minutes. The helo LZ is just a big open area covered with fist sized stones and weeds.

The air terminal is a small wooden building on the edge of the field, and I stood in line to sign in my arrival behind a few Afghan men who had just come in on a Jingle Air helo—they fly cargo and locals in big Russian helicopters (unarmed) from place to place, and make easy targets for Taliban or Al Qaeda with RPGs, as they fly low and slow through the mountain passes.

The base is very small in terms of both size and population and is structured around two small forts, complete with towers, six foot thick walls, and small outbuildings that hug the inner walls. It’s very rough and tumble, nothing fancy. One of the forts was built and used by the British in the 1800’s and was subsequently used by US Army Special Forces during Operation Anaconda. For a good read on the recent military history of the area, pick up “Not a Good Day to Die” by Sean Naylor. It gives a good overview of our initial involvement in this province and details the drama of Anaconda, which played out in the mountains that I look out on to the south.

The mission here is diverse in that the Provincial Reconstruction Team (PRT) is based here for this province. They build schools, improve roads, mentor locals in agriculture, construction, medicine. They funnel money into local infrastructure. It is run by the military but only because the security situation is too poor for civilian organizations to come here alone. Civilian aid workers would be kidnapped, beheaded, or just shot and blown up. The military provides these services under the relative safety of military accoutrements such as body armor, armored vehicles, and heavy weapons. I feel for these guys because they go out to help the locals but constantly worry about IEDs, ambushes, or getting assassinated during meetings.

The place has the feel of a small town, with a nice mixture of civilians, Army, and Air Force. I think it would be rough with just Army, as they are generally an uncivilized lot, but that’s as it should be. There are a lot of Afghans who work on the base, mostly as laborers, but there are also interpreters, ANA soldiers, and a few small shops run out of cargo containers, selling local rugs and jewelry and a lot of other crap that is probably from sweat shops in Pakistan. While walking around the base perimeter yesterday I was invited for tea in one of their hooch’s, but I declined (at least I think that’s what he wanted). I need some time to get comfortable here before I break bread with the locals. I’m still at the point that I have a vague but controllable anxiety when I am near the Entry Control Point (ECP). Just need some time…

New OIC of Combat Stress Clinic:

The views are pretty good, with mountains on all sides, and I can see the ruins of an old fortress on a hill top, supposedly built or conquered by Alexander the Great when he attempted to conquer this area.

Combat Stress Clinic:

I’ve met a nice mixture of people so far and it has everything I need—so I think I’ll be okay. I think I can make this feel like home for six months.

What Lies Underneath

While eating lunch, several soldiers sat down at my table. I zoned out for a while on my food and idly watched day old coverage of the Tour de France on the big screen TV in the back of the room. I was too far away to see what was going on in the race and it made me homesick so I struck up a conversation with the soldiers. They were E-6’s in an Army Airborne unit finishing up 14.5 months in the eastern part of the country, waiting for a flight to Manas and then home. This was their second tour to the same region in Afghanistan, and they said that things were getting worse. Their take on the problem was mostly related to low numbers of troops and not enough air cover and transport from helicopters.

They asked what I did, and I said that I was a combat stress control psychologist being forward deployed-- that I would travel around to several FOBs in the eastern part of the country. They laughed and pretended to get up, saying “why are we talking to you!?” They said they had been schooled from early on to avoid speaking with mental health personnel.

I eventually asked them to give me some advice—what I could do that would be helpful or useful when I go visit the FOBs and COPs---

Soldier Number One: “Don’t go. We don’t need you there. Maybe we need you back at home but not out there.”

Me: “But I have to go, that’s my job, so what should I do when I go?”

Soldier Number Two: “Sir, you should bring cigarettes and Copenhagen, they would love you.”

Soldier Number One: “Sir, when I get back from a mission the last thing I want to do is talk to some combat stress guy. I just want to take a shower, jerk off, and go to sleep. If I have to listen to some guy talk about combat stress I won’t be listening.”

The second soldier suddenly started to relate a story about coming home from his last deployment, how he lost friends in Afghanistan and when he came back he was paranoid and short-tempered, got divorced, drank too much. His somber confession seemed to catch his friend off guard as he moved the conversation into what sounded like a pretty dark time in his life. He said, “I don’t think it was PTSD but it was a weird time.” He knew that those experiences were related to his combat tour but he didn’t know what to make of it. He paused and seemed thoughtful, and I imagined that he was wondering what it would be like to go back after this tour, if the anxiety and anger was still inside him, dormant.

I just listened, and suddenly the spell was broken, the voices and the noise in the dining facility intruded, and we were done. I wished them both “good luck”, and wished them a good trip home, not without a twinge of jealousy.

Standby

I’m on standby for another 24 hours. At some point I’ll go to the rotary terminal and sit around for three or four hours sequestered, waiting for the flight. Understandably, the flight schedule is classified and seemingly random and unpredictable. Based on my briefings yesterday I have gathered that I will be a frequent flier on helos during this tour, making it unlikely that I will convoy anywhere beyond my immediate area (I think I am responsible for a FOB that is 1 or 2 miles away). I’ve been told that much of my territory is not easily accessed by vehicles, so I have to fly.

That cheered me up. In the last three months I have seen hours of Taliban video of US vehicles being hit by VBEDs and IEDs and being ambushed with RPGs and small arms (available on the public domain, as they video many of their attacks and then post them on the internet—www.ogrish.com-- but be warned that much of it is not for the faint of heart so don’t look for it if there are some things you would rather not see). It’s good for me to see that stuff, given my job, and it would probably be good for me to experience a convoy or two for that same reason, but I will not go out of my way to seek that particular experience.

I learned more about my job yesterday during several hours of briefing. One element will be a traditional role as a military psychologist, seeing clients/patients who walk in to our little clinic and doing psychiatric evaluations for commanders and other health care providers in my particular area of responsibility. This will probably be a small part of the job, given the size of my FOB.

The more prominent role will be doing outreach and “walkabouts”. This is comprised of just walking around, introducing myself, talking to the Chaplains and the leadership and keeping my face familiar. This will probably be the most challenging for me because I don’t think of myself as being a spontaneously social person. It will probably be easy at our small FOB—because we’ll know everyone pretty quickly—but this will be challenging when I travel to the outlying FOBs. Not only will I will be a stranger, but I’ll have three marks against me from the start: I’m an officer, I’m Air Force, and I’m a shrink. I’ll guess I’ll have to redefine myself a bit.

The third element will be doing Traumatic Event Management, or TEM. This is basically a structured debriefing procedure that Army behavioral health uses when there is some sort of traumatic event, which usually means death/injury of someone in a platoon or company. The debriefing is flexible and context dependent and can take a variety of forms. It is not empirically supported as being helpful, but there is a small amount of recent Army research that has suggested that it isn’t harmful, which has been the big controversy about debriefing in recent years. It serves as an opportunity for a third party to check in with soldiers 24-48 hours after they have experienced a severe stressor. Even if they don’t talk much, we have at least educated them about signs/symptoms of COSR (Combat Operational Stress Reactions), given them some ideas about coping, and maybe, just maybe, that one guy who is having trouble will talk to us later…

On today’s agenda is final packing, and getting a set of ACU’s (the Army Combat Uniform). We are required to wear ACU’s or a flight suit if we fly in helicopters because those uniforms are flame retardant, wear as the USAF in all it’s wisdom made our brand new ABU uniform flammable.

Some photos from around BAF:

The B-Huts I’m staying in, built by the ROK Army Engineering Group. There are 8 people per hut and each person has about 40 sq feet of space, partitioned off with 6 ft high plywood walls. They get pretty hot in the afternoon.

A French Renault APC. Yes the French have a compound here, and this group had just come back from sort of mission.

This is what we drink here—thousands of bottles of water. It is stacked on pallets all over base and is bottled in the town of Bagram. If you like to drink bottled water, then this is the place for you. You just walk up and grab a bottle. It’s free and plentiful. They incinerate all of the bottles, along with the rest of the trash that BAF generates.

This is the bunker outside my hut. They are positioned all over base but are rarely used here at BAF. It’s basically a concrete tube with open ends on each side, surrounded by sandbags.
Looks just like Vegas. The pink bus is shuttling local workers to some location on base.
Typical early morning scene on Disney Drive—the main drag on BAF.

These are those hell tents I mentioned in an earlier post, right by a fuel depot. Trust me, they are disgusting inside.

The vehicle in the front is an MRAP; a V-bottomed vehicle that is resistant to all but the largest IEDs. There are quite a few around here. This is what I would hope to ride in if I had to convoy somewhere.

The Pat Tillman USO. You gotta respect Pat Tillman for what he did. It’s a shame the Army covered up the circumstances of his death but it doesn’t detract from the meaning of his life’s story.

The Left Captain

I’m going to revisit the “Left Captain” theme, as it’s been a while since I’ve made any partisan comments, and I find myself in a dynamic process of justifying to myself why I am here, but this is normal for me. I want to think that I am a part of a honorable war effort, part of a force that is doing good things. Most soldiers/airmen who talk about justifying the war put it simple terms: we are killing terrorists who want to kill us, and that’s good enough. Simple, elegant, but it doesn’t completely work for me. Those simple terms will likely work well for me in the event that I experience 102mm Chinese rockets, or drive in a convoy anywhere near the Pakistan border, but I need more than bad guy/good guy.

I believe that NATO is justified in ousting the Taliban and has a responsibility to begin to rebuild the country, support a new government, and help keep the Taliban out (by training Afghan security forces). I think this is part of being good world citizens. The US has a special part in this, as we ignited the hottest part of the Soviet-Afghan war and then walked away, sowing the seeds of our current harvest here in Afghanistan.

Our biggest failure since 2002 has been alienating our allies. Bush is politically toxic for everyone, making it hard for nations to give blood and treasure to support what has been branded as Bush’s “War on Terror”. I get angry when I think that our leaders will not do more to develop a true coalition, using diplomacy and compromise to bring in additional reconstruction and military support from other countries. Instead they are willing to lay the burden upon the shoulders of America’s sons and daughters.

This war should be fought by international soldiers, shoulder to shoulder. It is, to a degree, but we carry the heaviest load. I don’t really blame any one person (!) and I don’t blame Europe. I’m hopeful that a leadership change in the US will lead to changes in foreign policy strategy and tactics.

But to come full circle with this, I know for sure that the vast majority of our soldiers, airmen and sailors are here meaning to do good things—leaving their homes and families and friends, risking their lives, but doing so because they believe they are doing something positive, whether it be hunting down suicide bombers, vaccinating kids, building schools and footbridges, or training Afghan doctors in Kabul.

It’s important to remember that our people are here with the intention to do something good and from what I hear, a lot of good things happen. The politics of war seem very distant and irrelevant to me, sitting over here. This is about people.
Now the contractors, they’re just here to make money, but that’s a different story.