'Viagra lure' for Afghan warlords-- Now this is what makes our country great

"Whatever it takes to make friends and influence people," the Post quoted one agent as saying.

"Whether it's building a school or handing out Viagra."

A Visit from the Pope

Christmas is complete here in Afghanistan and it is back to business as usual. The holiday tone here was quiet, reserved. At a forward operating base, just having a down day is a gift. There isn't much reason to celebrate Christmas here. I was just happy to know that all of my family back home were safe and happy, and enjoying this time of the year.

There were actually a lot of flights coming in and out of the base yesterday. The various commanders make their battlefield circulations, showing their faces and shaking hands. I don't really get this particular hubris of commanders-- officers think that a visit somehow boosts morale. If they drop in for two hours and shake everyone's hand and say "good job, son", then they've done some sort of service for their troops. I love the entourage too-- there always has to be a cadre of pasty-faced Majors and Captains and Sergeant Majors, like the Pope and his Cardinals. Why can't a commander just travel with a small security detail-- two dudes with M-4's-- and that's it. It would make him seem much more down-to-earth, rather than giving the impression that he is an exalted-one. After all, back at home these guys are just mid-level bureaucrats who drive themselves to work just like everyone else. But I think that's it-- out here they get treated like and act like petty tyrants. That must be addictive.

The lower echelon commanders and Soldiers think these visits are a pain in the ass. There are extra details for policing up trash, shooting the dogs, making sure everyone is shaved and uniforms are clean. Having the higher levels of command around just sets everyone on edge, and ruins what would otherwise be a nice casual day. Spare us the sentiment; leaving your cushy office for a quick visit via your dedicated Blackhawk doesn't make you seem more sympathetic.

At the larger bases, units are ordered to serve as instant-audiences, so if the visiting dignitary comes in at 5am for a two hour visit, the audience has to be in place an hour early, just to sit around, then look good for the photo op, cheer and clap when prompted. If they didn't order people to go, then of course no one would come to listen to the Deputy Undersecretary of the Army spew sound bites about how well the war is progressing.

The Things They Sent

I wasn't aware of this before getting here, but there is a massive cottage industry devoted to sending care packages to deployed US service members. There are a variety of organizations that facilitate the connection between giving citizens and receiving deployers. We have been on the receiving end of this generosity and we have personally distributed hundreds of pounds of food, hygiene items, and entertainment to Soldiers across eastern Afghanistan.

This is a cool thing, because there is no easy way to buy any luxury items out here. There is a weekly bazaar and a few small shops run by the Afghans, but you can't get simple American things like a bag of M&Ms, or some deodorant or dental floss, or a pack of gum. You can get plenty of black market DVDs, fake Oakleys, and poorly made Chinese and Pakistani electronics.

Periodically I am touched by the messages that people send with the packages-- they seem motivated because their own children have served in the military, or they themselves served during an earlier conflict. Sometimes they seem to do it out of religious or patriotic obligation. Many people send American flags, prayer books, bibles--- they send baking soda, golf balls, refrigerator magnets, drywall screws, coupons, calendars from 2007, floppy disk drives, half-used pencils, used underwear, and someone sent a smashed sandwich in a Ziploc bag.

People describe their families, their cat, what they did last weekend in Cleveland, what kind of flowers they have in their garden. They tell us about their son who just got his driver's license or their daughter who just joined the Navy, and they send photos of themselves and their kids.

Sometimes children from someplace like Texas, maybe a Mrs. Bailey's class, send a box of Slim Jims and bubble gum. They write about their favorite football teams and video games. They write things like: "I hope you don't die" and "I am just an average kid" and ask "what do you think of the new president? or "do you have a kid or a wife?" "have you ever seen a real polar bear or a jaguar?'

One kid wrote to me that she hopes I don't do drugs: "It's good for you not to do drugs because drugs is bad, for it makes you have a small life." She must have heard something about the Army.

Another kid asked me to solve a math problem: "What is (6-7) x 8 + (5/15)=?" I can do that in my head kid, I think. Is it -7.67?

One child wrote the following: I"m just a kid. My Dad and Brother were in the war. But how are you doing in the war. I beat it is hard fore you and your familey. I want to be in the war when I grow up. I want to help my country. But my dad died in the war a while back I don't know about my brother I have never seen him before. My dad went to the war and I never seen him again."

The kids write simple letters that cut to the quick-- they know they are writing notes to to people who have favorite colors, have pets and kids and wives, people who like pizza and football and don't want to die and just want to come home.

In contrast, many of the adults emphasize their thankfulness for soldiers fighting for our freedom, fighting to protect our country, fighting to protect freedom of speech (?), fighting evil. I have never heard a soldier say that he is fighting for our freedom or fighting to protect the United States. They fight to help sort out the Afghans, fight to kill the bad guy who plants IEDs in the roads, or fight to protect each other. Everyone has a strong sense of accountability to his or her fellow service member, and that in itself can be inspiring because it seems to transcend all the higher meanings that people try to place upon the war.

A few months ago I re-read Hemingway's "A Farewell to Arms" and I marked this passage:

"We won't talk about losing. There is enough talk about losing. What has been done this summer cannot have been done in vain."
I did not say anything. I was always embarrassed by the words sacred, glorious, and sacrifice and the expression in vain. We had heard them, sometimes standing in the rain almost out of earshot, so that only the shouted words came through, and had read them, on proclamations that were slapped up by billposters over other proclamations, now for a long time, and I had seen nothing sacred, and the things that were glorious had no glory and the sacrifices were like the stockyards at Chicago if nothing was done with the meat except to bury it. There were many words that you could not stand to hear and finally only the names had dignity... Abstract words such as glory, honor, courage, or hallow were obscene beside the concrete names of villages, the numbers of roads, the names of the rivers, the numbers of the regiments and the dates."

I'm not sure if I will send packages to Soldiers and Airmen when I'm back, when I'm out of the military. Maybe I will. But if I do I won't write about lofty ideals that they are fighting for, or thank them for their sacrifice or bravery. I'll just tell them that I hope the contents of the package makes the war suck a little less, and wish them a safe return to their family and home and their Ford Mustang.

The quiet in between

Time definitely slows down at the end of a deployment. I have observed this personally and everyone I talk to says that this is a real phenomenon... people don't get excited until they are on the plane or helicopter, actually leaving. When you stay in one place long enough, it becomes your default reality. Everything else is either sentimental reminiscence, or an imagined future. Here it is easy to imagine a different future (i.e. being home) but is difficult to make it feel imminent. It is a really strange feeling and I think it must be related to how the days are so similar, the same people orbiting in the same square mile for days and weeks and months.

As my deployment winds down I am more aware of the slowness of each day, but behind the slowness is that subtle anxiety that I have written about before. The persistent sense that there is something lurking around the corner.

The spring loaded slowness is the worst part-- worse than fouled latrines, worse than the endlessly rotating menu at the chowhall, worse than sleeping on cots, the noise, being dirty, the omnipresent smell of diesel. When there is shit blowing up, the anxiety of expectancy is erased by the adrenalin of the moment. Everything shrinks down to what is going on right now, right at that moment.

I'm not combat arms, so I can't fully articulate or appreciate all of the nuances of anxiety, adrenalin, and combat, but I do know that waiting for the next mortar or rocket to hit is almost as bad as the nervous jump you get from the actual blast. The mind is relieved that the explosion was elsewhere but it also starts calculating the odds of the next one falling closer. Maybe you nervously look at the plywood walls and remember seeing what a 107mm rocket did to a Hesco barrier full of a thousand pounds of dirt and rocks.

In August I was visiting a COP that had been getting attacked with indirect fire fairly frequently. I had settled into my sleeping bag and turned off my headlamp when I realized that I didn't know where the nearest bunker was, so I put my boots on and found it, just meters away, and then I went to bed.

The quiet in between. That's the feeling that keeps people up at night, not the fear of being rocketed in the night, but the agitating background anxiety that is like sand in your sheets.

Improved weather...

Woke up this morning at 0500 and saw a sky full of stars and the partial moon for the first time in almost four full days. The weather system had broken. Last night we knew things were improving because we heard a pair of Blackhawks buzzing the base, coming in for a refuel.

Today the sky is clear and the mountains that enclose the valley are completely snow-covered. The air is cold and hard, and it reminds me of the dry winter mornings in Utah and Colorado. It would be a good day for skiing if I were someplace else.

People are making attempts to bring holiday cheer to everyone at the FOB. There is holiday themed decor in the chowhall and a variety of inflatable cartoon characters in Santa suits here and there. The chapel, which is near my hut, blasts looping Christmas music for about 12 hours a day. It's mixture of Christmas cover tunes by random artists. It really reminds me of outdoor malls in December-- the background music that rises and falls depending on which direction the wind blows, but it's always there. They had mercy and turned it off at about 8pm last night.

Crawling towards Christmas

I'm sure loyal readers are wondering "what's going on over there?". My wife mentioned to me that I hadn't written an entry in a while. Similar to October, I seemed to have stalled out in terms of motivation, mood, and enthusiasm. I thought that December would bring an increase in motivation because the "end" is practically at the doorstep of the new year, but somehow December has slowed down time . With each day that passes, it seems like one day is added to an imagined month of January. This imaginary calendar has days added by snow and endless delays due to weather or other movement problems.

What hasn't helped has been more outside the wire taskings by the Army chain of command here. I've caught the superstitions-- agonizing over the "one last mission" scenario, especially when it's a bullshit mission with very little value, other than keeping the area commander happy. From my perspective, anytime we leave the FOB we should have a clear mission where the needs and risks are assessed and balanced with efficiency. A high risk mission should be a response to high needs, and where the risks are high but the needs are low, maybe I should consider not going. Supposedly I have this autonomy and the mandate from my chain of command (which is located elsewhere) but time and again my independence has been trumped by the local commander. I usually capitulate in the interest of politics-- keeping the climate here user-friendly.

As I have found out, it's hard to fight against the hierarchy even when you are justified in fighting, but that's a story for a different time. The best way to describe the dynamic here is to draw a parallel to an imagined feudal enclave-- you have the local lord who runs and owns everything, his favored lieutenants and their militia who enforce the laws of the lord, and the peasants who labor and suffer abuse at the hands of their betters. It's like I am visiting from a neighboring land, and while I am not treated like a peasant, it is made clear that I will comply with any requests of the local lord. Okay, that's an over-dramatization, but I really do feel compelled to comply with their demands, regardless of whether or not these demands run counter to our own procedures.

That's the situation as we crawl along towards Christmas. I'm trying to convince myself that after the holiday we will be insulated from further missions, because of our short time. I'm hoping that one of these days I will start to feel the calm settling in, but realistically that probably won't happen until I get on a bird and leave for Bagram.

I forgot to mention that it has been snowing here and I haven't seen or heard a helicopter for three days.

I must be losing my mind

One of my latest “projects” is recording the best of the graffiti on the men's bathroom walls. I know it sounds strange, but I wondered what you could tell about a place and it's people by reading what folks write while they sit on the toilet. Maybe if I record enough of it there will be some pattern that will rise out of the chaos? That's anthropology right?

I guess this all started when I first got here. One of the resident Sergeant Majors decided that there was too much graffiti on the bathroom walls so he had all the bathroom stall doors removed. On the surface, the rationale was that people won't write graffiti if they are sitting on a toilet exposed to the world. But I'm sure he just did it to screw with everybody (he has a private bathroom in his quarters). The Army often seems to solve specific problems by making global changes.

Some of the removed doors with the worst of the graffiti were painted over with black spray paint and reinstalled a month or two later. One of my favorite "writings" is on one door where someone scratched into the black paint, exposing the white paint below. The message says: "How will we write on the walls now?"

Another good one is something I had never heard before but has probably been around for a long time: "I love the fucking Army and the Army loves fucking me."

I really enjoy the misspellings-- my favorite misspellings are contained in one sentence: "weman" and "soskwatches", the latter term referring to the former. They were shooting for the plural of “sasquatch”, trying to describe the women of the Army as resembling mythical ape-like creatures.

Most of the writing is on the theme of leaving Afghanistan or "Asscrackistan", opinions about the Army, or what people want to do, drink, smoke when they get back to the US. There is a minor sub theme of questioning the sexuality of the Air Force personnel, but it is half-hearted and not very creative. There is a recurrent theme of real or imagined sexual conquests, naming specific females and their anatomical characteristics, and then there is the obligatory “for a good time, come to this stall at midnight...”. Surprisingly, or not, there is a high percentage of homosexually themed graffiti-- statements about having sex with Afghans, other soldiers...

If there is a coherent pattern in all this, it hasn't fully resolved. I'll keep you posted.

Yes, it can get pretty boring here.

Waiting

Back from what I again hope will be my last mission, I had a nice afternoon doing PT, looking at the sunset between sets of push ups and pull ups and watching the progression of the reds and oranges on the snow covered peaks to the south. It was cold. After an hour my hands were numb and lifeless.

This last mission was a short notice response to a request by the commander of some guys who have been plagued by a streak of run-ins with IEDs. The Army regulations allow for fairly intrusive interventions by commanders (using assets like me) when they have identified significant stressors for certain groups of Soldiers. The name of game is prevention: keeping guys talking about stressors and helping each other cope. Usually I do this in small group debriefs-- nothing touchy-feely-- I take a pragmatic approach with common sense questions and feedback. Response is usually positive or neutral.

I search for meaning here, because so much of my time is spent doing nothing, waiting, occupying myself. I have been astonished by how much of war is characterized by waiting. Soldiers are really good at waiting and I have gotten really good at it too. My missions are characterized by short bursts of work and then long periods of unstructured time. While waiting for clients to drop by at my make-shift office in the camp aid station I watched three seasons of "The Office" over a 72 hour period. The PA who is exiled to that outpost waits too... waits for sick-call patients, hopes that there is no trauma--- again, frenetic activity punctuated by long stretches of waiting. So we waited together, and watched video projected onto a plywood wall.

Now that I'm back and down to a handful of weeks I still wait. As long as there is potential for me to roll out on some unpleasant mission I will have a lingering sense of unease. But at my home base I settle into my routine-- a rigid schedule of workouts, office hours at the clinic, reading and writing. The days are slow but steady.

Distillation

As I round the corner on my last month in Afghanistan I have been thinking about why it has been hard for me. There was a time back in September when I wasn't sure if I could make it, and this was mostly due to my fears that I wouldn't make it. Serving as the regional shrink and de facto confidant of so many people I have gotten a unique perspective into the hearts and minds of these Americans, and I know that my fears do not set me apart.

One thing that many of us share is the grinding repetitiveness of a 7 day work week overlayed with a perpetual sense of malevolent unpredictability. When something unpredictable happens, it is almost always bad. You don't get many "good" surprises here. There is an ever-present sense of the reality that it isn't a matter of "if", it is a matter of "when."

For some of us this is less imminent than it is for others. For those Soldiers who experience this daily or weekly, it changes them. For those who have experienced this four or five times since 2001, it permanently alters things.

If you can, imagine driving to work every day with the knowledge that there is a chance that at any moment a catastrophic explosion could rip through your vehicle, killing or maiming you in an instant. Imagine knowing that even though you realize that this happens to people (you have even pulled blackened bodies out of blasted vehicles and you know the smell of burned human flesh) you still have to make the commute down this road, because it is your job.

If you can really imagine this, then you start to realize that it has the potential to change the way you look at the world, other people, your life. Politics don't matter when you drive down that road.

I think Americans forget about the people who serve in these wars because they get caught up in the politics, the morality, the economics, the symbolism. Our military becomes a monolithic symbol for something-- whether it be a symbol of heroism or a symbol of imperialism. But when it comes down to it the people who make up our armed forces are sons and daughters, fathers, mothers, brothers, and sisters-- normal people who laugh and smile, cry and hurt, people who commit both heroic and atrocious deeds. In short, normal people just like you.

Regardless of why we are all here, it gets complicated for the people who actually are here. No longer about right or wrong, justified or unjustified. It boils down to something different for the people who are actually on the ground, and as the politics and morality evaporate there is nothing left but a substrate of something else.

What that is is difficult to describe, but if you know what I'm talking about, then you know...

Bare Feet

What do you tell a man who shuffles in smelling of dust and diesel, hands shaking, red rimmed eyes, voice quavering as he explains how the children's empty shoes were thrown haphazardly upon the road.
What do you tell a man who beats his fist against the table, once for anger, once for pain, and once for shame because his body and mind went silent when he saw the children's bare feet and small fingers curled and still.
What do you tell a man when he drops his face to the floor, lost in the thought that what was meant for him had turned the children into memories with one hollow thunderclap of combustion and shrapnel.
It is the way of this world. Tomorrow the sun will rise. But I can't say that. Sometimes there is nothing I can say.

Return

I returned from that FOB and it was remarkably uneventful. I was on my fifth day, steeling myself for a seven to eight day stay, when I found out that there was a flight coming in that would be headed to Salerno, a large regional base that is situated right on the Pakistan border. Getting on would be a gamble, because I wouldn't go to my home, but I would be out of that place. I made some phone calls to some people I knew at Salerno (I've been here long enough and traveled enough to actually know people around this country) to try to arrange some lodging and arrange some social interaction. Salerno has a coffee shop and frequent flights to my home FOB, so I figured that I would give it a shot.

I packed my rucksack and geared up about an hour before the flight was due and I went down by the LZ to wait. After two and a half hours of sitting in the dust the Chinook roared in over a ridge. Overhead, an AH-64 Apache circled like a shark, ready to pounce on anyone that tried to lob mortars or RPGs at the lumbering Chinook. Three of us ran through the dust and rotor wash to scramble into the helicopter. I was out of that place and headed someplace new.

To my surprise, the Chinook lifted up out of the valley and swung west, away from where I knew Salerno to be. We flew only a few hundred feet above wooded ridges, the Apache attack helicopter trailing in our wake. Within five minutes I knew that we were headed to my FOB and I started to hope that we were going to stop. The Chinook dropped down into the LZ. It turns out that my bird was waiting to reunite with a second Chinook before heading home to Salerno.

I signaled for the crew chief to let me out and I grabbed my gear and jumped off. I was home and I was happy. I have been very lucky with travel this year...

I'm cautiously hoping that the next time I get on a bird I will be headed to my real home.

Waiting

Still at this FOB, in the middle of nowhere. I completed two days of clinical work when I first got here but this is day five. Might be another three days before I get out. I am able to get some work done from a distance-- phone consultations with my technician and with commanders who's Soldiers I care for. Mostly I try very hard to pass each 24 hour period without getting bored.

Today started off well because they had a few bananas-- that puts my fresh fruit/vegetable count at two kiwis and a banana in the last week. Watched Monday Night Football on Tuesday morning while eating powered eggs and reconstituted hash browns.

Last one?

Is this my final routine mission? I think it might be.

I am at a notorious FOB in the wilds of the Hindu Kush, but it has improved since I was here last. These FOBs are getting these great gyms, I think to get Soldiers through the winter. This place isn't that bad actually.

I probably won't be busy. Out here it is tough-guy territory, so no one is eager to talk to a psychologist because of how it may look. That's okay with me. I brought many hours of video and four books, and I already mentioned the gym. I have a pretty decent room and a concrete bunker nearby. A funny side-note is that I am staying in the same room that a well-known CBS reporter stayed in while she was here for several weeks-- she signed the wall. Maybe I should sign it too when I leave...

Don't Relax

This from Army Times:

"The vice chairman of the Joint Chiefs warned Monday that U.S. troops and their families should not expect to relax if operations in Iraq wrap up soon. Marine Gen. James Cartwright, speaking Monday in Arlington, Va., before a symposium sponsored by the Military Officers Association of America, predicted the situation in Afghanistan won't be resolved as easily or quickly as was the case with creating a semblance of political stability in Iraq. And even if Afghanistan is stabilized, the future is going to be one of military challenges, he said."

What stands out to me is the following phrase: "won't be resolved as easily or quickly as was... Iraq". Did I miss something over the past 5 years? Was Iraq resolved quickly and easily? Has it even been resolved?

The other interesting bit is that he said "even if Afghanistan is stabilized..."

Now here's a nice military story...

"Australia navy off for Christmas"

Most of Australia's navy is to be given two months off over Christmas as part of a new strategy to cope with crew shortages, the defence minister says. Joel Fitzgibbon said the extended break was a way of encouraging sailors to stay in the service... Mr Fitzgibbon said: "We're doing a lot of work trying to find new and innovative ways both to retain skilled people and recruit new people."

I like the idea of finding "new and innovative ways to retain skilled people and recruit new people." Not that taking two months off is an option for our deeply committed military, but the DoD has to come up with something or in five more years of sustained conflict we will have a diluted military.

We will be left with more of this: "U.S. Army and Marine Corps grant more felony waivers" and more waivers in general for people could historically could not join the military.

Quaffing beer and eating sausages

Last year, the German armed forces shipped more than 260,000 gallons of home-brewed suds to its troops serving in northern Afghanistan, as well as more than 18,000 gallons of wine. On a per-soldier basis, that was the equivalent of a ration of 26 ounces of beer a day, all year long.

OK, there is a down side to all that beer:

In March, an armed forces report found that more than 40 percent of soldiers ages 18 to 29 were overweight -- compared with 35 percent of German civilians of the same age. About 70 percent of the soldiers were heavy smokers. Nearly one in 10 was described as clinically obese. The March report concluded that the rank and file quaffed too much beer and ate too many sausages, while avoiding fruit and vegetables.

However, US Soldiers manage to be overweight and smoke heavily, even though they can't have beer, so how could harm a few daily ounces of beer be that much worse? We don't eat much sausage, but people eat burgers and ice cream for lunch here, and that can't be good.

Winter

I haven't posted to the blog in a while, having lost some motivation for doing anything other than the minimum. I'm at day 129 in-country and a general lassitude has set in over the past few weeks. I have been seeing a lot of patients, which keeps me busy, but a new conflict with the local Army chain of command has left me slightly demoralized. I won't get into it in this public forum but this is the third or fourth "conflict" I have had with a group of Army officers and senior enlisted.

At every turn it seems that I am reminded that the culture of the USAF and the US Army are very different. Someone who would know emailed me and said the air cavalry are "all about butt sniffing and dick-measuring". I don't play those games very well, so that puts me at odds with the senior butt-sniffers on this FOB.

Luckily, my true chain of command back at Bagram has my back and they have supported my decisions and the manner in which I have executed the combat stress control and behavioral health mission here in this region of Afghanistan. The Army sees me as just another Captain who is at their disposal, while the Air Force sees me as one of a few psychologists who have specific and clearly defined roles in this theater. I like this about the Air Force—they are more likely to value you based on your skill-set and treat you accordingly, while the Army primarily values you as a body, or a slot-filler, and any treatment you receive is directly proportionate to your rank.

I still feel positive about my ongoing work with Soldiers. There are a lot of good guys here who have very stressful jobs. I do what I can to help them; regardless of whether that is treatment in country or getting the out of here. The ongoing combat in Afghanistan is off the radar screen of American media—there are still firefights and mortar barrages and guys sleeping out in the cold and the dirt. They say the winter is hard on the Afghans but I am observing that combat operations in the cold are hard on anyone. From what I read in the newspapers, the generals want to wage a busy winter campaign here. Winter isn't even here yet, but it is getting cold fast.

Bandwidth

The relative calm for us has continued since early October. In the last 39 days we have done three missions to outlying outposts and two trips to Bagram. We have two more missions scheduled in the latter half of November. Contact with the enemy seems to have quieted down but I'm not sure why.

I have an open invitation to attend daily battle update briefings—these are meetings that review current combat operations and current intel related to our immediate area and adjacent regions. When I first got here I consistently attended these meetings, partially to familiarize everyone with my face, but also because I wanted to know what was going on, as if knowing would make it easier for me to navigate the deployment. Since late September I have avoided them. Everyone now knows me and I no longer want to know what's going on.

By not knowing about every mortar or rocket that falls, and not knowing where every IED is found I am able to peacefully go about my daily business, plan my missions, see our patients and the keep the larger reality of the war at bay. I kind of see it as a way of freeing up bandwidth in my head. Without that daily download of ominous data I can concentrate on my job, and when it is time to relax or focus on myself it is much easier without visions of RPG-toting Taliban or IED-emplacing villagers.

This is a luxury, I know, because I don't need this daily feed of intel to do my job. I think I actually do my job better without it. Some people live immersed in this information and it must make it difficult to find any peace.

Bad Mood

 Election day and I spend it at a small outpost with a bunch of heavily armed deranged racist hillbillies. I wish more people would use birth control.

Good Mood

 It's November 5 now and I am writing from one of the smaller outposts I cover-- one I haven't been to since early September, and I feel pretty good.

It was a quick flight on a Chinook—no more than 30 minutes out of the broad river valley where my home FOB sits and then down into a huge forested canyon system that gouges a path towards Pakistan.

A corner has been turned and I seem to be able to see light through this thicket of months, weeks, days and hours. I've even started to ask myself if it was really that bad… how quickly I forget.

In the spirit of forgetting I have been enjoying my time here at this outpost. I've gotten two workouts in at the luxury gym here. They don't have much cardio equipment (a stair climber and an elliptical) but they have a decent selection of weights and kettle bells and big Afghan rugs on the floor for diabolical sessions of ground work; a painfully large selection of core exercises and push-ups.

As far as real work goes, I still have to brief the medics on managing suicidal patients in theater and I have to see two to three patients. The military doesn't get much bang for the buck by having me here, but I suppose it is better than the Soldier not having any treatment or having the Soldier leave the outpost for a week or more to see a doc at Gardez or Bagram.

The guys here try to make it more interesting for me… Yesterday afternoon I turned down an invitation to go on a mission to the Paki border. The words "fuck that" just popped out of my mouth before the invitation was fully formed by the commander. I had second thoughts afterwards, and I asked myself if I would regret not going on that mission. I silently argued that it would develop some good camaraderie with the platoon, and that it would be pretty cool getting a photo of myself in battle-rattle standing on the Pakistan-Afghanistan border.

 

I believe in luck but I believe that I create my own luck. I'm going to keep my lucky streak going…

November is rolling...

I'm getting ready for the November mission schedule. As it stands we have four scheduled missions and of these four, only two of them fall into the "bad" category. I'm going to get one "bad" mission out of the way this week.

I am strangely light-hearted about this travel. I think it's a combination of decreased "critical incidents" and the fact that it is November. This will be our last full month of missions. December should be a half month, since I won't want to risk either of us going to an isolated FOB after mid-December, getting stuck, and delaying our end of deployment tasks or actually delaying re-deployment.

It has gotten colder. Cold is relative, but we are having daytime highs in the low 60's and nighttime lows in the 30's or high 20's. There's snow in the mountains. When we travel now we have to bring the heavier sleeping bag, fleece, and people are even breaking out the Gore-Tex.

With the colder weather, drop-in traffic in my clinic has slowed somewhat, although it still rare that a day goes by without a customer. Most of my business consists of "back home" issues—relationships, money, family problems. I also get all the blowback from disciplinary issues. I think this unit has inconsistent standards when dealing out war-zone justice, but a generalization is that the lower your rank, the harsher your punishment will be. Unfortunately the lower ranking guys have the poorest coping abilities, the least power, and the most stress. So they end up in my office.

In the non-distressed population, there is definitely a stigma associated with talking to the psychologist, or the combat stress doc. They have good fun yelling at me across the FOB: "Hey doc, I'm stressed! Can I make an appointment?" One of the lieutenants, who works for the commander occasionally comes with a message — he hesitantly knocks, comes part-way through the door. I tell him he can come in but he says, half-joking, that he doesn't want anyone to think he's actually coming to talk to combat stress—"I don't want anyone to think I'm crazy sir."

I tell him that it's too late. "I already know you're crazy because you joined the fucking Army."

That joke gets a lot of mileage here but I don't like to use it much. I don't like the "crazy" jokes because I think it reinforces the persistent idea that you only see a psychologist when everything has fallen apart, when you have no place to turn, when insanity seems imminent. I preach here and at home that it is better to manage problems before they get too bad.

Actually, Soldiers seem generally less concerned about mental health treatment impacting their careers than Airmen. Airmen worry about flying status and security clearances, and in the Air Force there is less acceptance of adjustment problems, meaning that you are more likely to get kicked out. I don't have statistics to back this up, but the Army seems more embracing. I could say that the Army is inspired by a certain Emma Lazarus poem inscribed in Upper New York Bay.

Most of my traction with Soldiers has been via sleep medicine. I conspire with the medics to send sleep complaints to me, and I do my evaluation, educate them, put them on a stimulus control or sleep restriction plan and most of them get better. If I have been thanked for anything here, it has been for helping people sleep better. And that's no small thing in this place.

Quick Update

Things have slowed down in our part of the world, which is fine by me. I know it drives some of the Soldiers nuts. I enjoy the steady and quiet rhythm, the monotonous days. Ramadan (September) was active for the "enemies of peace" in eastern Afghanistan. I don't want to overstate this, because there is still a lot going on in certain places, it's just that our slice has been absent casualties for some time now, which I like very much. There is still a lot of indirect fire and IEDs, but my clinic numbers have dropped. I've also heard that the number of medevac flights have decreased significantly.

 

I think the cooler weather, football season, the World Series, the approach of the holiday season and the end of 2008 has lifted morale to a degree. There is still a lot left to do here (for all of us) but the change of the seasons makes the passage of time more tangible.

BAF was successful...

Back at my FOB after another sleepless night of waiting and waiting and then the Chinook, which is now a very cold ride as we slide into the fall. Flying through the high passes I observed that there is snow on the north facing aspects of the peaks. That's pretty cool. It will be a great ride through the mountains in January on my way out.

 

My BAF visit was successful. I got a brief taste of civilization and a little rest. I mostly enjoyed the bathrooms and showers in the hospital staff dorms, but I also got excited about the coffee shop, the big, open air gym (I would pay to belong to a gym like that), and hanging out with the other docs at the combat stress clinic at the hospital. Let me tell you, the Air Force really knows how to put together some nice living facilities in the war zone.

 

Other news: I found out that I have a replacement in the pipeline-- the person is going to the lovely Army Combat Skills Training in November and then will be joining us after the new year starts. I'm not 100% sure that they will be replacing me, but I was the earliest provider, so it would make sense that the first replacement takes my billet... That isn't notable news in itself, but it does mean that the end is approaching, and that's encouraging.

 

Being back with the USAF retarded my acculturation process-- just as I was getting acclimated to the Army and its mysterious ways, I spent four days with my Air Force brethren and got a shot of nicotine-and-obscenity-free air. OK, there was a little Army-bashing going on, which is unfair, but there is a big culture divide between certain elements of the two services. I am deployed with mostly scouts and infantry and I don't know much about the Army, but apparently that says it all. The fact that I am a member of the not-very-high-speed medical corps doesn't help either...

 

Don't get me wrong, these are good guys, tough guys, who do stuff I would never volunteer to do, but the charm of living with them has worn off. Jeez-- I just wish they would flush the toilet once in a while and maybe write some bathroom graffiti that consists of something more than: "I WUNT TO F^@K GERLS"

 

That was a slight exaggeration. Slight.

 

Keeping my spirits up and waiting for the snow!

More BAF...

Day two accounting:

 

11 hours of sleep

1 triple latte while reading Harpers

1 casual breakfast while watching Sportscenter

2 hours at the gym

1 clean, hot shower

1 hour on fast internet

2 James Bond movies at the "theater"

0 hours of work

 

A little respite

Ahh... back at Bagram Air Field (BAF) for a few days. I left my home FOB at 1am and arrived at Bagram at 4am after a freezing cold Chinook flight through the dark. I walked a few miles from the rotary terminal to my temporary lodging, and then drank myself silly with coffee. I had three cups of Air Force coffee (marginally better than Army coffee) and then went to the Green Bean (an actual coffee shop) and had a $4 mocha latte. Pretty good. Actually, just being in a coffee shop (imagine a faux Starbucks) was nice.

 

I watched one quarter of Monday Night Football (nice treat, but bad loss for the Broncos) and spent an hour or so talking with the other members of my unit who are posted here at the Bagram hospital. Wow! Being around Air Force people is great! I haven't heard the word "fuck" for about 15 hours now!

 

Being at BAF is great too! The internet speed is 10 times faster, the DSN phones don't have a 10 second lag, I have my choice of dining facilities and the bathrooms are clean. I think today I'll do some shopping, get a workout in, make some phone calls and then catch up on sleep.

 

My sleeping arrangements are adequate. I'm in a dorm room, taking up a bed by the door in a four person room. It's hot and stuffy in there but it's a clean, safe place to sleep for a few nights-- and there are non shit-stained toilets and non moldy showers for a change. It's the samll things in life...

It's enjoyable to walk around on pavement and concrete instead of dirt and crushed rocks.

 

I remember bitching about BAF when I got here in July. Now it's less crowded and cooler, and my perspective has been warped by living in Paktya province for the last three and a half months. I'm going to enjoy Bagram while I can and when I leave this time I will be reassured that I have the minority of my deployment left before me.

APA LETTER TO BUSH: NEW POLICY LIMITS PSYCHOLOGIST INVOLVEMENT IN INTERROGATIONS

Finally, my professional organization joined the rest of the medical community. It will be interesting to see how the DoD adjusts to this. I don't see how psychologists could have been that helpful anyway...


WASHINGTON—The American Psychological Association sent a letter today to President Bush, informing him of a significant change in the association's policy that limits the roles of psychologists in certain unlawful detention settings where the human rights of detainees are violated, such as has occurred at the U.S. naval base at Guantanamo Bay, Cuba, and at so-called CIA black sites around the world.

"The effect of this new policy is to prohibit psychologists from any involvement in interrogations or any other operational procedures at detention sites that are in violation of the U.S. Constitution or international law (e.g., the Geneva Conventions and the U.N. Convention Against Torture)," says the letter, from APA President Alan E. Kazdin, PhD. "In such unlawful detention settings, persons are deprived of basic human rights and legal protections, including the right to independent judicial review of their detention."

The roles of psychologists at such sites would now be limited to working directly for the people being detained or for an independent third party working to protect human rights, or to providing treatment to military personnel. The new policy was voted on by APA members and is in the process of being implemented.

For the past 20 years, APA policy has unequivocally condemned torture and cruel, inhuman or degrading treatment or punishment, which can arise from interrogation procedures or conditions of confinement. APA's previous policies had expressed grave concerns about settings where people are deprived of human rights and had offered support to psychologists who refused to work in such settings.

Noting that there have been credible reports of torture and cruel, inhuman or degrading treatment of detainees during Bush's presidency, APA called on the administration to investigate these alleged abuses. "We further call on you to establish policies and procedures to ensure the independent judicial review of these detentions and to afford the persons being detained all rights guaranteed to them under the Geneva Conventions and the U.N. Convention Against Torture," Kazdin wrote.

Army meatballs and red wine

I joked with Colleen that this blog should become a wine and beer tasting blog in January... I know that's potentially a bad joke give the association between redeployment and alcohol abuse, but I have to admit that a glass of some big juicy Cabernet sounds amazing-- especially Mondays, which is pasta and meatball night here.

This is good news if you like red wine and you're a smoker:

A study from Kaiser Permanente researchers published today found a strong link between red wine consumption and a decreased risk of lung cancer in men. The researchers studied 84,170 men ages 45 to 69 who were part of the California Men's Health Study. They found lung cancer risk is lowered an average of 2% for each glass of red wine consumed per month. The greatest risk reduction was found among men who smoked and who drank one or two glasses of red wine per day. They had a whopping 60% reduced risk.

The only things I've had in the last three months that have been remotely alcoholic have been one overripe banana and one can of non-alcoholic Heineken. However, I know that Army personnel occasionally get busted on the FOB for alcohol possession-- they get vodka from the Afghans who work on the post. This is a Muslim country, but apparently in addition to opium, heroin, and marijuana, there is readily available alcohol as well. Maybe I'm naive but I've been surprised that both drug and alcohol use is as common as it is here.

What's funny (and vaguely related to the rest of this entry) is that if you smoke opium and get caught you will be sent home faster than you will if you charge your rifle and shoot it at another Soldier (and miss). Is that funny?

Yes, sometimes I feel like I am stuck in a penal colony.

That could lead to another entry about Army recruiting, but I'll stop now.

Beautiful Children

Back from another mission to the south. This trip reinforced my secret opinion that I am a wasted resource being deployed to these far-flung outposts. I spent three days doing absolutely nothing, apart from walking around making small-talk, advertising that I was there and available. It was a small outpost and the medics had a few Soldiers in mind when they thought of who might benefit from seeing me, but no one sought me out for consultation.

On the fourth day of doing nothing productive I hitched a ride on a convoy that was headed back to my home FOB. As usual for this country, it was painfully slow and bumpy, banging along at 10mph over terrible roads. Driving slowly through villages I am astounded by the beautiful children here. Most of them are dark haired and dark eyed, but some are light or red haired and blue-eyed. The little girls are clothed in brightly colored gauzy clothing, the boys in plain white, tan, or brown loose fitting shirts and pants.

At one point in a small village a dented Toyota sedan pulled onto the road and inserted itself between our gun-truck and the 5 ton truck behind us. Our gunner called out that a car had pulled into the convoy, which is an unacceptable breach of security. A crowd of school-aged girls minding two or three toddlers were standing around off to the side of the road, giving us thumbs-up and staring up at the huge armored vehicles. Our driver braked hard and slammed the truck in reverse, suddenly accelerating backwards to force the car off the road and out of the convoy. I watched the dark eyes of the nearest child widen and her mouth tighten in fear as she picked up the small toddler at her feet and twisted around, shielding the child from imminent threat. I was struck by both her obvious fear and her beauty. She was absolutely beautiful in a way that seemed so familiar.

When the Toyota pulled off the road, intimidated by several thousand pounds of armor and the matte black barrel of a heavy machine gun, we reversed direction and proceeded to crawl up the road. The girl relaxed slightly and placed the child back in the dust. As she disappeared behind us, her face remained in my mind and I wondered what her voice sounded like, whether or not she went to school, if she had ever danced to music, if her parents hugged her and told her they loved her. I thought of my daughter.

Later, in Gardez City, a small black-eyed boy ran alongside the truck, waving to us and holding his thumb up. In his left hand he delicately grasped a kite made from sticks and discarded thin blue plastic. The surface of the kite was ragged with holes and it was small, maybe 12 inches across. But I could tell by the way that he carefully held the kite that it was precious to him. For a kid in the US it would have been nothing more than a piece of trash. I couldn't help but see my son running after us, his small hand holding a favorite toy.

Seeing beauty and echoes of familiarity in the Afghans keeps my mood and outlook moderated to some degree. The anger and fear fades when I look at those kids. This seems to last only as long as the relative calm and mundane progress of days is uninterrupted by death and destruction. When the loud and messy reality of war reasserts itself into my life, those darker emotions roll over me. By virtue of being confessor and psychologist for dozens and dozens of Soldiers, I know I am not alone in this.

Being able to maintain a consistently rational and humanistic perspective is, I think, impossible for me. To completely rise above prejudice and irrational anger I would need to let go of my fear of death, and let go of my attachment to my life and my hypothetical future-- become some kind of selfless warrior.

This darkness that overwhelms rational thought is something I didn't understand before this year, even though I am getting only a small taste. I think this may be one aspect of what separates combat veterans from everyone else. There is something visceral and crude that crawls up your spine and sits on your soul.

Earthquake

Last night I woke after 3am to my room shaking. I came out of a deep sleep and wondered what was causing the movement. It moved the building, wood creaking, and rocked my cot back and forth. My sleepy mind slowly ruled out wind, someone shaking the building, and a rocket attack. It was kind of soothing and surreal, and then it stopped and I fell back asleep. Here's the link.

Football

Another convoy, another five day trip to a different camp. I rode with the route clearing package-- a huge convoy of vehicles led by specially designed vehicles that find and either safely detonate or deactivate IEDs. These are National Guard guys and I like them. The huge convoy rolled for three hours to the next FOB and then stopped on the road while my vehicle drove a side road to drop me off inside the perimeter of the FOB. Not VIP treatment but as close as it gets for me...

This is my second trip here, so they know me. I get to stay in the same room, the same cot. Not much happens. I'll make myself known, walk around and be social, give the people who need or want to speak with me the chance to come out of the woodwork before I leave.

This afternoon I sat down in the MWR in an overstuffed chair and watched 45 minutes of the Colorado Buffaloes getting beaten by Texas (recorded and re-broadcast on the Armed Forces Network) and then I watched Sportscenter. It was nice. It felt "normal" but it left me feeling a little sad, a little wistful for October back home and watching football on Saturdays or Sundays.

I brought two novels, a non-fiction book on parenting, a stack of magazines, and a handful of movies. I should be able to settle into a schedule of sleeping in until 7am, drinking coffee (I also brought a pound of coffee), working out, and cleaning up by late morning. My "business hours" will run from lunch to late afternoon and then I might sneak in another workout, eat dinner, and retire to a night of reading and DVDs.

Not bad work if you can get it eh?

Am I turning into a bigot?

September is gone and that's a good thing. It was a bad month around here for everyone. Ramadan left a foul taste in my mouth. Sometimes I worry that my experience in this Islamic country will permanently bias my view of Muslim people. Killing in the name of Allah seems so barbaric and primitive, but then if you look around here you can't tell what century it is anyway.

It's easy to just give up cognitively and emotionally, and take a position that we should just leave them to cut each other's head's off the way they have always done. I go back and forth between this perspective and something more fitting of an educated child of the West. Even so, I have a new understanding of where the old stereotype of the crusty Vietnam vet who hates Asians comes from. It's illogical, but hatred finds good purchase in the frightened mind.

Being here has made me more forgiving of my own country. For all of our faults and our war-mongering ways, there are cultures out here that are darker and much more brutal. Yes, we are greedy, wasteful, and slightly imperialistic. We are arrogant too. But some of these people (Mullah Omar, Jalaluddin Haqqani for example) are way scarier than Sarah Palin or even Dick Cheney. The way females are treated, the whole beheading thing, the rate at which blood is spilled in these countries, the extreme and absolute interpretation of religion. Evil is relative.

I'll kiss the ground of the good old USA when I get back (metaphorically—airports are unclean) and I'm sure this experience will have changed my civic and political perspective. A conglomeration of anger, pride, and renewed patriotism. I know that this service will have made me a better citizen.

That said, I'm getting out of the military in about 270 days. I'll throw a party.

Which one is the real Left Captain????

Transcendence... for an hour

I'm back at home, returned from the south of Afghanistan. I managed to catch a ride on a Blackhawk where I was the only passenger. I buckled in, gave a thumbs up to the door gunner, and we lifted off the earth. We flew through Ghazni and Sharana across the miles of open desert. I didn't want the flight to end-- I was at peace, the thrumming of the rotors and the rush of the air insulated me from the war and all my attendant emotional lows. That hour on the helicopter was a warm, detached dream, watching villages, sand, and dry hills slide below the aircraft, and I felt nothing, which was nice for a change.

Exile!

The rumors of this being the end of the world are true. Everyone here joked that I was stuck for a good two weeks once I got off the helo. Today was my theoretical departure day but there is no flight scheduled. I've already settled into a sustainable rhythm, so it doesn't really matter how long I'm here. I have what I need: books, my laptop, a comfortable place to sleep, food, a small gym. I've seen a few patients which justifies my visit, but there really isn't much work for me to do.

 

I'm afraid to admit this, but it's nice to be compartmentalized from any potential work that there might be in the north. Work makes the time go by, and travel makes the time go by, but being stuck here at least keeps me away from places that are less pleasant. Not that this place is "pleasant", but so far it has been relatively benign.

 

Here there is more a sense of isolation and a sense of being somewhere foreign. There is just a small village, a small market, the small base, and miles of trackless desert. At night you look up directly into the wheel of the galaxy, undimmed by any light pollution, the nearest city being hundreds of kilometers away. In the quiet at night I listen to chanted prayers from the village.

 

The tempo here is slower an the war seems further away and that's okay.

 

Down South

Writing from southern Afghanistan. I wrote in my journal that the area is just a sun-blasted desert (southern Nevada) dotted with small villages. I don't know how people survive here. This area is much more remote than the north-- very small mud villages with roads that are nothing more than two-tracks through the desert. I flew here with a layover at a huge base to the northwest of my location. I stayed in transient tents from about 3am until 7am, ate breakfast, and then sat around at the air terminal for about 5 hours. I didn't even go to the main part of base because I would have had to drag around my weapons, body armor and two small packs-- about 80 pounds of gear. Better to just sit and wait, so I read a bad novel.

 

The FOB I am at now isn't bad. Let me enumerate the positives: there isn't much direct or indirect combat in this area (the area is so vast that the Taliban just avoid US forces), I am quartered in a concrete building, the base has an observation blimp, I am away from my Army commander and his command sergeant major, I have lots of free time, the gym isn't bad.

 

The negatives are minor-- pee tubes instead of urinals (I don't mind them except they stink), and burnout cans instead of plumbed toilets. The medic here also annoys me.

 

I am scheduled to leave in a few days but everyone says I will be here longer because flights are always canceled to this place. We will see. I do know that I will not have to come down here again.

 

For now I'm just practicing keeping it day-to-day. I am finding that if I can find contentment in the moment, regardless of where I am or what I'm doing, it makes the day go by smoothly and I don't feel the worst effects of sadness, fear, or despair gnawing at me. I can keep that stuff at bay by just finding ways to enjoy the moment, even here in this horrible corner of southwest Asia.

 

OK. Now I'm off to find something else to enjoy!

 

Living in the Future

I'm getting a new battle rhythm, based on the needs of our commander. It looks like we will be expected to try to visit each of the FOBs or COPs in our area of responsibility at least once per month or sooner. This isn't out of necessity, but is driven by some Army policy that is enforced by some Army Colonel somewhere, and is reinforced by the commander here. We were shooting for a six week interval or for an as-needed schedule, which is what was done by the last team. Oh well, things change.

 

I am making peace with this by trying to control the mode of my travel as much as possible. Flying is the preffered way to travel. Not only is it more comfortable but it is faster and you have a decreased chance of experiencing an ambush, and a zero chance of experiencing an IED. I suppose you take on the statistical chance of an aircraft mishap, but there are always risks with every mode of travel. Even staying in one place has its risks.

 

Anyway, I've resolved to tell myself that I am quite capable of enduring any hardship. The hardships that are projected ahead for me include a few more trips to places that are "OK", and at least one more trip to a place that is "not OK". That's not bad. The good thing about each mission is that when it's over I feel very relieved-- like checking off an unpleasant and difficult task. We've been to all of our locations over a period of almost three months, so theoretically that only leaves time for one more rotation. In between these missions there is my standard clinic work and a fair number of quiet days and nights. I really don't mind the missions because time flies by rapidly, even when I'm not doing much.

 

I have an upcoming mission to a smaller FOB to the south but I have to fly through one of the larger regional FOBs to get there. I will spend at least one night at this large base. I think they have a coffee shop and an air strip! There is another combat stress team there, so I'll visit with them, get in some internet time, read some books, wait for my flight the following day.

 

This trip should eat up the rest of September, bringing me into October. If I time things right I will be able to take some R&R at Bagram in mid-October and be back in Gardez by the third week in October for the home-stretch of the deployment.

 

I feel like I'm breaking the rules of "how to live right" by being obsessed with the future. What ever happened to living in the present? Maybe I'll keep giving that a shot, but it's challenging under the circumstances. My everyday life isn't bad-- my routine at my home FOB. It's comfortable, safe, productive. Even missions to most of our locations turn out pretty mundane. The most difficult part is finding a room to stay in and getting adjusted to new people and a new place. By the time you get a sense of the place, you get a flight or a convoy out. Not so bad.

 

Looking back, the time has gone fast. I got in country on July 11, left home on July 7. It flew by. Looking back even further-- I left for training on April 28, and that was about five months ago. It seems like just a few weeks ago. Five months from now I will be relaxing in Vegas, wondering how time went by so quickly.

 

 

Psychologists Vote to End Interrogation Consultations

The vote, 8,792 to 6,157 in a mail-in balloting concluded Monday, may help to settle a long debate within the profession over the ethics of such work. Psychologists have helped military and C.I.A. interrogators evaluate detainees, plan questioning strategy and judge its psychological costs. The association's ethics code, while condemning a list of coercive techniques adopted in the Bush administration's antiterrorism campaign, has allowed some consultation "for national security-related purposes."

This is far from being binding; it has to first be put into the APA Ethics Code and then adopted into state licensing statutes. But it's a first step, following the physicians of the American Psychiatric Association.

I have seen first hand the value of what we get from interrogation-- it's an important part of war-- but I don't think licensed health care professionals should be involved.

Introduction to the short story "In a Far Country" by Jack London

"When a man journeys into a far country, he must be prepared to forget many of the things he has learned, and to acquire such customs as are inherent with existence in the new land; he must abandon the old ideals and the old gods, and oftentimes he must reverse the very codes by which his conduct has hitherto been shaped. To those who have the protean faculty of adaptability, the novelty of such change may even be a source of pleasure; but to those who happen to be hardened to the ruts in which they were created, the pressure of the altered environment is unbearable, and they chafe in body and in spirit under the new restrictions which they do not understand. This chafing is bound to act and react, producing divers evils and leading to various misfortunes. It were better for the man who cannot fit himself to the new groove to return to his own country; if he delay too long, he will surely die."


My job: helping people (myself included) develop that "protean faculty of adaptability"

Temporary Break

I just got back from another mission and I am now at my FOB, hopefully for a few weeks at least. I have now visited every FOB and combat outpost in my area of responsibility.

 

I am going to take a temporary break from blogging, until I sort some things out in my head. I'm going to keep writing, just not publish for a while, maybe a week, maybe more, maybe less.

 

I am walking a thin line between sharing information and descriptions that need to be shared and also sharing too much of myself right as this all happens. It really comes down to the fact that I can't write about what I am experiencing without writing about grief and fear and I don't want my family and friends to go on the grief and fear ride with me.

 

Suddenly this past week it all seemed to get more serious-- maybe it was just a switch that was thrown, maybe it was a combination of seeing shot-up guys, this last mission, being pissed off at the Army. It's not like it wasn't serious before, but I passed through some portal this week.

 

As I told my NCO, I don't have acute stress disorder or anything. I just had a few nights where I would have quit if I could. I would have dropped all my shit in the dust and walked away, back to my family and I would have never looked back to this place.

 

But then I woke up in the morning and, since everything looks better in the morning, I realized that I need to keep going.

 

I don't want people to worry about me because my job is pretty damn safe compared to ther people's jobs, it's just that I am going through my own struggles with my job and its tasks and duties. I'm pretty durable and I just need some time-off from the blog. I'm going to write and see what happens-- post some stuff when I'm ready.

 

I'm closing down on the halfway mark-- about one month away-- I need to focus on getting to that mark and then re-orient myself to finishing the second half of this.

 

Thanks for all your support. People have been great and I appreciate hearing from you via email and on the blog. Thank you!

 

 

Getting Up Close

Sometimes it's easy to forget that I am in Afghanistan. I can lose myself in talk about my children, plans for the future, favorite pizza places… You do that to disassociate and feel a little normal.

Inevitably the reverie is broken up by the dull thud of an explosion, near or far, or cracking sounds of gunfire. Mostly those sounds are not immediately meaningful—it means that violence is taking place somewhere else: an Afghan checkpoint is being attacked, the Taliban are randomly and inaccurately lobbing ordnance at Afghan or US posts, someone is test-firing or engaging in target practice, so on and so forth.

I have developed the standard hyperawareness of those sounds. I hear something and suddenly focus all my attention on identifying the source. Was that a mortar? Was that the coffee maker? Was that the next door neighbor slamming his door? I get mildly anxious and I have this strong desire to classify the sound as benign or otherwise. I think that's pretty standard, and I see people jump all the time at loud sounds—from rookies like me to battle-hardened vets.

I got a lot of dirty looks the other day when I accidentally slammed the cooler door in the chow hall.

Football season has started now and that means Autumn and Ramadan. Cooler temperatures are starting to prevail. People are staring to wear jackets in the evening and early morning.

I'm back from a four day mission—a visit to a combat outpost in a small town that is known as a Taliban stronghold. I didn't post to the blog because there were only four public computers at the outpost and a constant queue—I used my 20-30 minutes on the computer to check my fantasy football lineup, read the NY Times and check my personal email. It was a busy trip and I'm tired, but not from being a combat stress doc.

The second morning of my trip started off nice—coffee and conversation with the medic. We were talking primary care medicine and discussing how to motivate people to make lifestyle changes that are so important in the management of chronic disease when our talk was broken up by a distant explosion.

Fifteen minutes later Afghan police roll up to the medical facility in a Toyota Hi Lux. A badly bleeding Afghan soldier is sitting up in the back of the truck--- he had been blown up while attempting to disarm an explosive device at the base of a cellular phone tower. His face is a mask of dirt and blood. His eyes are piercing and intense but he seems to look right through as I carried him on a litter into the aid station, a trail of blood leading up the ramp and across the floor, splashing on combat boots and the plywood walls.

I'm not much of a blood and guts guy—not at all interested—but I saw a bit more than I wanted. The man had been pulverized by an exploding anti-tank mine. Despite the carnage wreaked upon his body he was remarkably calm. It was bloody, organized chaos, the US medical team doing great work to stabilize and package the guy for a medevac. I was drafted into the medical team just because I was there… and everyone pitches in.

After the medevac we were left with cleaning up the chaos—the detritus of a medical emergency, trash and blood everywhere, the heavy smell of body odor and blood in the small room.

Had a nice lunch and I was able to easily eat a hot dog with ketchup, and two peanut butter cookies. I went to the MWR for some emails… thought about maybe taking a nap or watching a DVD…

A boom and then another but these were closer than the morning explosion. Soldiers in the MWR room were playing "Medal of Honor" on the Xbox.

No one really moved until the machine-gun fire started, but then things moved rapidly.

I quickly decided to log out of my email account (!) while next to me a guy was madly trying to finish an email—typing while standing up and pushing his chair away. Small explosions and an increasingly loud staccato of gunfire ratcheted up my heart rate.

I trotted out, not liking the sounds I was hearing outside the walls of the outpost. Not a hard decision to put on my Kevlar and my body armor and, yes, at that moment I was happy I could sling the M16 rather than just having the M9.

What the hell was going on? Were we being attacked? Outside of my hut people were running around, donning armor.

I couldn't decide where to go—the bunker? command center?—so I went to the medical aid station and decided I would just follow their cue…

They were happy to see me at the aid station. "Hey Doc—get some gloves on we've got casualties coming in."

Before long, wounded Afghan soldiers started rolling in—gunshot wounds, shrapnel (the booms were RPGs in the village). I fell into a catch-all role of fetching things, assisting with movement of stretchers and patients, keeping armed Afghans out of the aid station. I saw what an AK 47 round does to a man's abdomen when it enters one side and goes out the other. One guy took a round to the stomach but it didn't come out—the PA explored the hole with a gloved finger but quickly retracted his digit when he touched intestines.

The scene was played out to a soundtrack of machine-gun fire. Again, bloody but organized chaos followed by a Blackhawk medevac.

I kept my body armor on for at least twenty minutes after the gunfire stopped… I figured my wife would have approved of that, and I didn't care what people thought.

For the second time in the day I cleaned blood off the floor, picked up empty morphine auto-injectors, wrappers from Israeli bandages, and bloody latex gloves. Tracked all around the floor were bloody imprints of lugged Vibram boot soles.

I won't get into the details, but suffice to say that we (US personnel on the outpost) had nothing to do with the firefight. The storyline was something out of a classic western—two gangs having a shootout in the town square while the innocents hide, trying to avoid stray bullets.

Forgive me this statement; I'm shooting from the hip but sometimes I can't help but think that it's their country; let's just give it all back to them, every dusty, fly-covered, Islamic inch of it.

Driving back to my FOB we pass through multiple villages. It's later afternoon and there are small children everywhere along the road. The littlest children are dressed in bright, sequined fabrics. Big brothers carry little sisters and watch as our armored vehicles rumble down the road. I watch a little girl, maybe 3 or 4 years old, wave at us, give us a thumbs up. She spins in a circle and dances by the side of the dirt road and then waves at the next US truck that passes. I see another dark haired boy come out of a hut, he's about the age of my son and he waves and gives us a thumbs up, a smile lighting his dirty face.

It breaks my heart. I see my children's faces.

If we must stay here, to build schools and bridges, grow businesses, train police, kill Taliban and Al Qaeda. If we sacrifice under Afghan skies, let it be for these small children who dance in the streets in the eye of a hurricane of violence and poverty.

Enemy Dogs

Apparently the FOB dogs qualify as "America's Enemies". There are the two usual suspects, my officially named "FOB Dog" and another, smaller, scruffier, short-legged white dog. Yesterday a new dog made an appearance. He looked like a combination of a wolfhound and a greyhound. He was light brown, rail-thin, with prominent ribs. He had a slight limp-- something was wrong with one his back legs. I noticed him as I walked out for my afternoon PT. I came close to getting my camera but was too lazy to walk back.

He watched me closely and moved off to one side. At about the same time I arrived a senior NCO walked over and was scrutinizing the dog. The dog eyed both of us. The NCO fingered his 9mm and said "I gotta get close enough for a good shot."
I said, "You're going to shoot him?"

I had a sinking feeling in my gut and I had to walk away. I didn't want to see and hear the poor dog being shot. Another NCO with an M4 walked over and charged the weapon. The dog had apparently been shot at before because as soon as he heard the the bolt rack a round into the NCO's gun he started running.

The dog wasn't dumb. I guess you don't survive long as a dumb dog in Afghanistan but about 15 minutes later I saw a group of Soldiers walking towards the corner of the FOB where the dog had disappeared. Shortly after that I heard three shots. Apparently whoever did the deed wasn't a very good shot.

I don't know why that dog was executed but the others are tolerated. He was larger and more haggard looking, maybe that was it. I dont know why they don't just seal up the holes and keep the dogs from getting into the FOB. They do cause problems-- they knock over trash cans and spread garbage around.

Most people don't seem to care about shooting dogs so I don't know what makes me different. I have observed that Soldiers seem eager to shoot the dogs-- like they want to kill something and jump at the opportunity for sanctioned killing.

A Soldier's job is to be prepared to kill, so it isn't too bizarre to imagine that they are eager to kill. Maybe I idealize the concept of the warrior who loathes killing and only uses lethal force when truly necessary. I wonder if it is true that first person shooter games numb a person's sensitivity to violence-- a lot of these guys go on missions all day and then come back and play Xbox 360 all night. Ready to shoot all day and then virtual shooting all night. It must be exciting for them to shoot a dog. I'm serious.

It's like maybe they are titillated by the potential to unleash lethal force, which makes them eager to charge their weapon and get clearance to destroy. At some level I understand that but my understanding is still hampered by own goal of avoiding any situation that would involve me even thinking about firing my weapon. I'll do it if it comes up, but as a non-combatant I will make every effort to minimize my chances...

This all taps into one aspect of my job here-- that we take anger seriously, whether it is towards the self or others, because lethal force is always two quick movements away.

Odd Combination of Pride and Frustration

Kind of a second lowpoint in the deployment for me the past day, although I can't put a finger on why. I'm only at around two months here at the FOB but when I look back at the spring and summer I realize that all of May and parts of April, June and July were eaten up by training and preparation for deployment. It seems like it has been a long time since I last lived my normal life-- Deployment has been dominating my thoughts and daily life for most of this year and will continue to for the rest of the year. Mostly I'm fine, but I really have to avoid looking at pictures of my family...

I find it interesting that a not insignificant number of people here really like the deployment, or at least don't mind it. These young men and women like their jobs, aren't married, don't have kids, don't pay rent or pay for food and they make extra pay while they are here. Not a bad deal for a 20 year old. This is why a professional, volunteer Army works-- there are people who want these jobs and are willing to do what it takes to get through 12 and 15 month deployments (although there seems to be universal agreement that 15 month deployments are not good for anyone).

This is an important point, because people continue to join the Army and re-enlist knowing that these one year deployments are now standard fare. Frankly I'm impressed that people do it, but also thankful that there are people who want to serve in this manner. It isn't for everyone and some people know this ahead of time and thus avoid joining any branch of the military, other people find out that it isn't for them half way through their first deployment...

Nevertheless I am constantly surprised when I hear the statistic that only 1% of the US population serves in the military. I'm not sure how accurate that is, but it causes a combination of pride and frustration; I'm proud that I am one of those few and frustrated that more people do not volunteer.

That sums up my experience of military service though: an odd combination of pride and frustration. Half the time I rue the day I raised my right hand and the other half I feel confident that I will be proud of my service for the rest of my life.

Great Climbing?

It's a shame that there are people who like to dismember Westerners here, because this place has some spectacular geography-- of course there is the Hindu Kush but there is great rock everywhere here. It would make for a great climbing destination.

Naps

Our security detail waiting for us to be done with the visit. This is a true demonstration of the flexibility of a Soldier: if you get downtime you take advantage, even if it means sleeping in the dirt under your truck. The shade is nice and cool.

Tera Pass

The road over the Tera pass connects Paktia and Logar provinces. It was recently paved during the reconstruction effort here in Afghanistan. It's pretty nice pavement and seemingly unscarred by IEDs, unlike the new highway between Kandahar and Kabul that is apparently just a mess, constantly bombed by the Taliban and company. The top of the pass is around 9000 ft. The traffic going over was pretty light. You'll notice that terrain looks bone dry. Despite this there are multiple springs dotting in this area-- fresh water just popping out of dry rocks.

Road Trip Photos

Outside of Gardez City. The roads here are terrible, in general, but local drivers are very respectful of the convoys.



Driving through Gardez City reminded me of my few visits to Mexican border towns. Lots of garbage, open air shops, clusters of people sitting around, rundown buildings and beater vehicles.

More Photos on the Way

The upload time is too long this afternoon-- I'll need to try later. One thing I really miss is fast internet. I'm starting to think that a 45 second page load is pretty damn fast.

Another Mission

My second mission this week came and went uneventfully. It was short notice and the commander specifically requested my presence on the trip—a quick visit to a nearby FOB, up towards Logar Province. It is a small outpost out in the desert at the bottom of Tera Pass (which we drove over).

I rode in the relatively bombproof confines of an RG31 MRAP, second truck in a four vehicle convoy. It is an uncomfortable ride, even on pavement, so I can’t imagine a few hours on nasty dirt roads. That said, I will always celebrate the MRAP over the Humvee.

In contrast with my ride with the engineers we were heavily armed this time. These guys roll on trips loaded for bear: every vehicle has a 50 cal or a Mark 19 grenade launcher and these are backed up by squad automatic weapons and personal weapons. On this subject, I've taken to bringing my M16 on trips with me, using the following logic: if I am in the unlikely situation of actually needing a weapon, I will want the rifle over the pistol in pretty much every scenario.

When we got there we met the FOB commander and the platoon leader and were briefed on the state of things, and then went out and mixed with his platoon. I did my combat stress officer duty and talked with the guys, checked in with the platoon sergeant, talked with the medics, talked with the FOB commander. Everything seemed to be going well other than boredom, and problems getting flights in and out.

On the way back I had a perspective shifting conversation with an interpreter who was riding in with me. I asked him about himself and he shared that he had a wife and two small sons in another city. He talked about growing up during the Soviet-Afghan war and how he wants his sons to grow up in peace. “I don’t care about my life, I do everything for my sons.”

Maybe I’ll post more on that later, but it put a human face on the war for me. Sometimes I feel myself slipping into an uncaring place, just wanting to get the hell out of here and leave this place behind. Listening to people’s stories gives color and meaning to the mission again. Don’t get me wrong, I’m not getting all idealistic, but talking with him made me care.

Leaving Jaji

The Left Captain at the LZ-- hoping the Chinook crew chief lets him on!

Deliverance

The bird that came to fly me back to my FOB-- it was delivering a few guys and a generator from BAF. It was almost full but they let me on!



The cushion of air that these things create with their dual rotors is impressive. It pushes you around and throws up heat, rocks and sand.

Rules and Easy Step By Step Instructions

I thought this was amusing-- very specific guidelines on how to use the latrine. These are posted inside each toilet stall. This was taken seriously too-- no one wants to mess with the first sergeant there. He means business.