Florence Nightingale's December Update

more news directly from Baghdad-

Well this has been a long overdue update. There really has not been too much going on here. I have to say that luckily it has been slow and quiet. Usually that means that American soldiers are not being injured, at least in my general area of Baghdad. We still have many Iraqi patients to care for in spite of the relative calmness.

There has been a 6 year old little boy that has been a patient in our ICU for the past few weeks. He came to us in respiratory distress and had to be intubated. Let’s just say that this little boy gave me a run for my money the night he was admitted. I was in charge and I took on this little boy as my patient. He had this terrible habit of turning blue, which is never very good for kids. So there I was with 2 doctors giving me orders and I’m trying to tread water to keep up with their multiple orders in between trying to get better IV access and resuscitate this kid back to acceptable oxygen saturation. Luckily my battle buddy, was there to lend me a hand and write out all my orders for me and help keep me on track.

It is amazing how an adult patient can roll up on the floor covered in blood and have no blood pressure to speak of, but as soon as a kid rolls up I loose all my color. I’ve decided that it has to be because there is much more of a margin for error in an adult than with a child. I have to quadruple check every medication, and calculate every safe medication range. I check and recheck the ETT, the vital signs, and countless other things.

I have calmed down over these last few weeks working with him. I haven’t gotten as nervous about having to “breath” for him as I use the ambu bag to bring his color back and bring his oxygenation back above ninety. I actually have the confidence to take care of him without being a nervous wreck. It is honestly sink or swim here sometimes. The great thing about having your patient for more than one day at a time is that you can learn from your mistakes and do it better next time. You can also learn from your patient too, in order to better prepare yourself for the incidentals that come up.

I also got to fly again this past month. This time however, I didn’t have a ride home. I had to spend the night in Balad. The Air force facility is very different from our hospital. The hospital is set up in a tent or depmeds. Depmeds are deployable medical equipment and tentage. They have the same sections as we do at Ibn Sina, but there seem to be more. I think they had 3-4 ICU’s, 4 ICW/MCW, EMT, and Pad. They also have a pharmacy, radiology, and lab sections. They have a MWR section with phones, computers, and a TV in the hospital. There is also a small dfac.

Patients sleep on cots and they have to go outside to the portable latrines when they need to use the bathroom and don’t have a catheter. Imagine you have broken bones or got blown up in an IED blast and you have to go OUTSIDE to use a bathroom! Everything is covered in a fine powdery dust like here, but it’s more of a problem in the tents.

This facility is how I thought we would be operating here in Baghdad when I was deployed. I have trained in these tents before with other CSH. I realized that I have things pretty good here being in a fixed facility with running water and latrines. We don’t have all the things that we would like to have like back in the states, but you quickly learn to adapt and overcome the challenges that being deployed raises. Our patients here at least have real electronic beds versus cots!

I was able to get a “ride” back “home” the next evening. “home” being wherever I lay my head at night and for now it is in Baghdad, Iraq in my room with my battle buddy Kim. I had the night off, so it worked out that I could get back to my room and rest. I wish I could describe how exciting and scary it is to fly in those helicopters. The countryside or Iraq can seem so peaceful and beautiful as you are flying overhead looking out at the twinkling scattering of lights and feel the cool crisp air streaming in from the window. Then you think about the potential danger you’re in by being in a combat zone. The bird lands and it’s time to snap back into reality and get back into work. I didn’t have any patients on my flight back so I could just enjoy the scenery and think. The rotors are spinning and you are greeted by soldiers awaiting the patient on board. Stooping low to avoid the rotors they pull the patient off and carry them to the Gator. Equipment in hand I walked up the small stretch of street to the hospital from the landing zone and check in with the TOC (Tactical Operating Center). It is almost like your breath is caught when you get on that helicopter and given back to you once you’re walking back on the home stretch. It is a rush.

I’m hoping that I will continue to get the opportunities to fly with our patients. Right now only the ICU trained or identified nurses are able to fly unless the Head nurse approves. Keep your fingers crossed that things will change for me. It is always a good feeling to be sending our patients on their way back home. Granted they don’t want to be going and they feel terrible about leaving their buddies, but they all have a new journey to embark on. I’m just glad that I can be a part of that sometimes.

I want to wish everyone a Merry Christmas and Happy New Year. Christmas this year was certainly different and was challenging. The dfac was highly decorated and they had a Christmas dinner. My battle buddy and I opted for pizza instead. Our unit had a small pizza party and exchanged secret Santa gifts. I got a little massager and some other cute items! Other than working that sums up my Christmas. My battle buddy and I opened presents on our day off which was the 26th. Her family sent us a real Christmas tree which we decorated and put up in our common area a few days before. It smelled wonderful. We did the best we could as for keeping spirits high. The command group along with the Chaplin and some of the other CSH (Combat Support Hospital) soldiers went around on Christmas Eve and sang carols on the units. I guess you don’t really realize just how much the holidays mean until you are away. I’m hoping that next year will be a different sort of holiday season. I hope that all soldiers are home for the holidays next year.

I am challenged everyday. I am so thankful to have all of you to lean on when I need to vent and to share my experiences with. I hope these updates help to shed some light on the things that I do here. I will be in touch and be sending out some new pictures soon. Until the next update, have a safe and happy holiday season. I think of you often and look forward to seeing everyone again soon. Keep in touch!

I couldn't make this up

I get some unusual correspondence sometimes. Someone sent me this in an email on Christmas Day (not edited for spelling or grammar):

I do not know how you can say: I stand by what Ken stood for, and in the same breath. Put down our military. If you have forgotten The War in Viet-Nam. About the time the North was about to give up...due to the hard pounding they received under Operation Rolling Thunder and Operation Line Backer. A woman by the name of Jane Fonda.....Lovingly known by the G.I.'s as Hanoi Jane. Was photographed with the North Vietnamese on an Anti-Aircraft Gun smiling. Along with the protests in the streets here at home. The VC say that our government was at odds with the people. This gave the VC a second wind and the war escalated for another 5 years.

Freedom is yours to do with what you wish. You stand hand in hand with Cindy Shehan protesting and diminishing our troops accomplishments, not to mention encouraging the insurgents to fight on through your actions. Shouting (as it is translated to the insurgents) Our govt is full of infidels, we all deserve to be killed. So more die, in your name (actions) called freedom of speech. That is in no way helping or supporting our troops.

I wonder what the writer is doing to support the troops? How many CARE packages or letters sent to Iraq or Afghanistan? How many VA hospital visits? How many pieces of body armor purchased? How many legislators has the writer worked with to improve conditions for our troops? Blindly supporting the president and his failed policy is NOT supporting the troops no matter how misguided you are.

I could easily refute the so-called facts of the email, but I won't bother; it's more fun to let the writer think I actually would consider the sage advice being offered. I kind of think I'm being compared to Jane Fonda. Hasn't the writer seen the movie, "Sir, No Sir"? Probably not; don't think it's on their Netflix list.

And I don't really think the writer has heard me speak- "we all deserve to be killed"? naaaaah, I don't. But no more soldiers or marines need to be killed either and neither do any more Iraqi civilians. I do support the troops and the peace work I do will bring the troops home sooner than if we don't speak up.

Ken would say "go for it, ma!" And for Ken and the other 2980 US military troops who have died in Bush's war, I think I will do just that!

Oh and, bartender? Another cup of purple koolaid for the writer of the email! With Bush's approval numbers in the mid 30's, the president needs all the support he can get.

Perhaps they are not stars

Perhaps they are not stars

but rather openings in Heaven

where the love of our lost ones shines down

to let us know they are happy

~~~~~~~~~

Just before dawn, I sat under the glorious star-filled sky over the Sea of Cortez on the coast of Mexico and watched the Geminid meteor showers last week.

I knew that those dancing stars were our loved ones letting me know that they are always with us.

.

with love to all my Gold Star Family friends

.

an Eskimo legend

Shame on Rep. Virgil Goode (R-VA)

This letter was recently sent to hundreds of constituents by the office of Republican Rep. Virgil Goode Jr. of Virginia:

Thank you for your recent communication. When I raise my hand to take the oath on Swearing In Day, I will have the Bible in my other hand. I do not subscribe to using the Koran in any way. The Muslim Representative from Minnesota was elected by the voters of that district and if American citizens don't wake up and adopt the Virgil Goode position on immigration there will likely be many more Muslims elected to office and demanding the use of the Koran. We need to stop illegal immigration totally and reduce legal immigration and end the diversity visas policy pushed hard by President Clinton and allowing many persons from the Middle East to come to this country. I fear that in the next century we will have many more Muslims in the United States if we do not adopt the strict immigration policies that I believe are necessary to preserve the values and beliefs traditional to the United States of America and to prevent our resources from being swamped.

The Ten Commandments and "In God We Trust" are on the wall in my office. A Muslim student came by the office and asked why I did not have anything on my wall about the Koran. My response was clear, "As long as I have the honor of representing the citizens of the 5th District of Virginia in the United States House of Representatives, The Koran is not going to be on the wall of my office." Thank you again for your email and thoughts.

And I'm going to include his address in case you are so inclined to get ahold of this idiot and give him a piece of your mind.

Virgil H. Goode, Jr.
70 E. Court St., Suite 215
Rocky Mount, Va. 24151

They asked my son, Lt Ken Ballard for his religion when he enlisted in the Army, so it could be embossed on his Army dogtags; dogtags that were given to me with his body when it was returned to me after he was killed in Bush's war in Iraq, and that I now where around my neck. They didn't care what religion he was when he enlisted in the military and they didn't care what religion he was when he was sent to war. And lastly, they didn't care what religion he was when I had to determine the verbiage on his headstone that sits in Arlington National Cemetery.

If the Un-honorable Virgil Cooke doesn't know his history, the United States was founded on the premise of religious freedom.

I am ashamed that he represents any district in this country.

Congress is tired

I'm sorry that Congress is tired. The average annual pay for a member of congress is around $160K . They should earn their wages. This "Do Nothing" Congress, the 109th has worked less than any since 1948 .

The House of Representatives is projected to meet for only 99 days this session, nine days less than the Congress of 1947-48. The Senate is projected to meet for 129 days, tying the sixth fewest days a Senate session has met since 1948.

The average pay for a soldier fighting in Iraq & Afghanistan is $7.50 per day. How's that for supporting the troops? Yes, I'm talking to you folks out there who slap a yellow ribbon on the back of your SUV. $7.50 a day! So, I'm not feeling too bad for those members of the 109th session of Congress.

"There is a lot of battle fatigue among members, probably on both sides of the aisle," said Rep. Mike Pence (R-Ind.), usually a reliable conservative firebrand. "Contrary to popular belief, members of Congress are human beings. They have a certain shelf life and a certain amount of energy to be drawn on. We're tired."

Rep Pence** should not dare to use the words "battle fatigue" unless he is referring to the troops in Iraq & Afghanistan. You know, those men & women who are being deployed for multiple trips into a war zone and who are being stop lossed because "they volunteered" to serve their country. Members of Congress do not have a clue, not one inkling what battle fatigue is. Back in the day, battle fatigue or "shell shock" was what soldiers suffered from when they returned from WWII or the Korean conflict or Viet Nam; now they call it Post Traumatic Stress Disorder.

If you dare, go to the PTSD Timeline and read a little bit about some of the PTSD cases in the past 3 years.

Read about Tony Garcia, a 24-year veteran of the military who suffers from post-traumatic stress disorder.

Or Corey Small, a 20-year old Army private first class based out of Fort Polk, LA committed suicide while serving in Iraq with the 502nd Military Intelligence Company, 2nd Armored Cavalry Regiment. " [A]n account published by the Gettysburg Times tells of a soldier, who shot himself July 3 after calling the USA. The suicide took place in front of other troops waiting to use the telephone."

Or James Curtis Coons, a 36-year old Army Master Sgt., who'd been evacuated from Kuwait weeks earlier following an overdose, hung himself while getting treatment for PTSD. He told doctors he was seeing the shattered face of a dead soldier in the mirror. They diagnosed him with post-traumatic stress disorder, sent him to a hospital in Germany and then to their premier treatment facility, Walter Reed Army Medical Center in northwest Washington. By July 4 he was dead, hanging from a bed sheet in his room at Mologne House, a hotel for outpatients and families on the grounds of Walter Reed. The soldier had served for 17 years in the Army, earning an OIF Bronze Star. His family is fighting to get his suicide listed as KIA.

Or my friends, Joyce & Kevin Lucey, the parents of Jeffrey Lucey, a 23-year old Marine Reserve who fought in the battle of Nasiriyah and who hung himself a year after returning home from military duty in Iraq. In late May 2004, his parents had involuntarily committed him to a military veteran's hospital after he ignored pleas to seek help. The hospital discharged him after a few days. Three weeks later, he was dead -- the dog tags of two Iraqi prisoners he said he was forced to shoot unarmed, lay on his bed.

So don't talk to me about battle fatigue and DO NOT tell me you are tired unless you are a soldier who has done one, two or three tours in Iraq of Afghanistan. And finally DO NOT tell me you "support the troops" unless you are doing something about bringing them home NOW and are taking care of our son's and daughter's when they return home. If you aren't doing either of those, you are not supporting the troops.

** Rep Pence of Indiana is still drinking the purple koolaid that this administration is serving. In June 2006, he issued a press release saying that WE ARE WINNING THE WAR IN IRAQ. We weren't winning the so-called war, this occupation in June 2006 and we aren't winning anything now. Even the nominee for US Secretary of Defense, Robert Gates, was asked at the Senate Armed Services Committee confirmation hearing today, "Do you believe that we are currently winning in Iraq?" Gates was equally blunt in responding. "No, sir," he said simply.

No sir, indeed.