Tuesday, October 24, 2006
This one was hard for me to read, so be warned.
So there goes another week. I have been sick now for the last few days, so I have been really bad about getting back to people. I'm sorry. It has been both busy on the floor and I have been too tired to do much of anything else, but get through the work night.
I had a pretty interesting week. We continue to be busy. Our turn around for patients is like no other that I have seen. We keep US soldiers for 12 hours or less before air evacuating them to the next level of care and back to the states. The Iraqi injured are kept a bit longer, but usually they are shipped out to "Medical City" within 24-72 hours. I'm not sure that the Iraqi injured will get the best of care in their medical facilities, but at least they are trying to take care of their own once they have been stabilized here.
Two nights ago we had a difficult night ahead of us. A Unit was hit really badly on a convoy and brought in many casualties through our EMT section. We received 4 of their soldiers. The ICU's were packed along with the wards. We had secondary plans to turn our stepdown unit and PACU into ICU's in order to cope with the influx of wounded. Luckily we didn't have to, but nonetheless it was a crazy night. I was actually working in the PACU that night, but came over to the unit to help out because we essentially turned over half our ICU with new patients in about 10 minutes or so. These guys came in intubated, bleeding, and unstable. We gave more units of blood than I could count and dumped it in as fast as we could. I ran up and down the stairs a bunch of times to go to the lab, the pharmacy. I was picking up medications and blood and requesting more with each pass. Our doc was running between all the patients and giving out orders left and right for each one. I was just helping whomever I could with whatever they needed.
We extubated 3 of the soldiers and they did pretty well once that happened. We then were told that they would all be flying out that night. One of them had to remain intubated because he was not stable enough to breathe on his own.
When we fly these soldiers out we have to complete air evac paperwork. It is a tedious job. Requests for transport get put in by the docs and then it is reviewed by our patient administration people. There is much coordination in the scheduling and transport of these flights and soldiers. As nurses we get the soldiers ready to go which includes copying their chart and any other paperwork that has been filled out for them. We pick up meds they may need, get a litter ready and all equipment essential for them to fly. For example, our intubated pt required a litter on a rickshaw with plenty of sheets/blankets for warmth, a portable, fully charged, and flight approved ventilator, propaq monitor for blood pressure, heart rate, and pulse ox monitoring, and an IV pump. Plus they need a nurse to fly with them too in case they should crash (physiologically) and need CPR/resuscitation or medications.
Basically what happens is you wrap your, hopefully as stable as you can get them, patient on a litter like a burrito/taco with the sheets and blankets trying to make the litter as comfy as possible with an eggcrate type mattress under them. Then you place all their needed equipment on them or on this device that holds it just above them. Keep in mind you don't have too much clearance because you have to fit them on the blackhawk helicopter and the litters are stacked. The helicopter fits 4 litter patients. You have to account for everything: fully charged, flight approved equipment, an oxygen tank that will get you to your destination, an ambu bag in case you have to breath for your pt and their vent stops working, any and all medications that you may need to give them in order to save/sustain their life until you reach your destination. It is a complete nerve racking event. We are trained to know this stuff and often it comes as second nature to you, but it is hard planning for the unknown. Many of the patients you fly with are not stable, but in a sense stable enough to fly out and get back to the states. Plus things can change at any moment. It is up to you to ensure they make it to the next stop in the series of stops they make on their way home. After all they survived the trauma of what happened to them at the point of injury, but trying to keep them surviving is the hard part. You strive to keep them alive so that they can thrive once they get back home.
Many of the patients you fly with are not stable, but in a sense stable enough to fly out and get back to the states. Plus things can change at any moment. It is up to you to ensure they make it to the next stop in the series of stops they make on their way home. After all they survived the trauma of what happened to them at the point of injury, but trying to keep them surviving is the hard part. You strive to keep them alive so that they can thrive once they get back home.
So to make a long story short I got to fly with 2 of our soldiers on the helicopter to Balad. Balad is one of their stops before reaching Germany and then the states. It is approximately a 20 minute flight from here in Baghdad. I was nervous and excited. I haven't gone on any flights where I actually had to take care of patients. It's dark and cramped and I had 2 lives in the palm of my hands. Things could go bad at any time. I put on all my gear on and loaded up my pockets with medications and stuff I may need. We loaded the guys on the bird and we were off. Six soldiers flew out that night.
You work by the light if a blue lens mini maglite flashlite. The glare of the monitors blinking at you as you check over your patients vital signs. "Ok, heart rate- good; Blood pressure- ok; pulse ox (oxygen saturation)- not so good." Your checking your pt to make sure the sensor is on them and that they are breathing ok. You use hand and arm signals and hope they understand you as you try to communicate what you want them to do. The litters are stacked so the first litter is at about chin level and the other about ankle level. I used my hands to check for breathing and pulses. I had the head set on so I could hear the pilots and medics communicating and it was my lifeline, so to speak, in case something went wrong in the back where I was. The flight to Balad seemed long, because you are hoping the whole time that nothing happens to your patients or the aircraft.
We arrived safely and off loaded the patients. They are taken to the EMT section in Balad where the Airforce has a hospital set up there. They are reassessed and I gave report to the accepting nurses and docs. I had to fill out some paperwork explaining what was done for them at our hospital and what kind of injuries they sustained. You have to do this quickly or the helicopter will leave you as they have many other flights and stuff to do. One of our nurses got left behind and stayed overnight in Balad and did not return until the next afternoon when he could catch a flight back during one of first flights out when we arrived here.
We grabbed all our equipment and headed back to the bird. Luckily they had to refuel and the pilots left their flight medics with us so we were guaranteed a ride home. We loaded up and headed back relieved that all 6 of our soldiers made it there. One step closer. The flight was a good experience. Certainly an adrenaline rush, but worth it. I hope to go out on more flights in the future if need be. I was lucky this time with my patients remaining stable while in flight; I hope that I will be next time.
Sunday, October 22, 2006
Those words resonate to this day, and especially this day for me, as it was 2 years ago that my only child, Lt Ken Ballard was buried at Arlington National Cemetery.
When you are deciding where your military family member will be buried, you have up to one year after the death to decide if they will be buried in a military cemetery. For me, waiting 5 months to bury Ken didn't seem strange, although some people thought so. As October drew near, I wondered why I had waited.
Most families want their loved ones buried nearby, whether at a private or a military cemetery. For me, even though I live in California, it was an easy decision. Ken loved being a soldier and I knew he belonged at Arlington National Cemetery. When he was killed in service to this country, he became a part of our national fabric. At Arlington, his gravesite would always be cared for. At Arlington, people would know of Ken's valor and of our families loss and sacrifice.
At Arlington, as all military cemeteries, there is a reverence about it. On national days of remembrance like Memorial Day and Veteran's Day, Ken and all of the people who served this country in the military are honored and remembered.
Ken was the 89th soldier from the wars in Iraq & Afghanistan to be buried at Arlington. When Ken was buried, there were 3 rows in Section 60 for these recent casualties. The last time I visited, there were 4 rows in front of Ken. At each visit, there are new rows, newly turned dirt. If you are ever in Arlington, do stop by and visit Ken and Section 60. You can find his gravesite at SECTION 60 SITE 8006. Stop at the visitors center; they'll help you find the way. I promise you cannot forget a visit to our national cemetery.
For me, October 22 is one of those milestone days that comes up every year, another day to remember how and why my life has changed so much since that awful day on May 30, 2004. As of today 2792 families have had their hearts ripped out since the beginning of the invasion of Iraq 3 1/2 years ago. I am not alone in my grief and while we share this grief, we each have to decide how to get through the rest of our lives living with this pain.
When I decided to speak out against the war, I didn't want another family to hear the words "I regret to inform you" from a uniformed officer standing on their doorstep. I couldn't bear the thought of another family being handed a flag that had just covered their loved one's casket. I did not want this president and his administration to think that my silence would give them permission to continue the wrong course that has been pursued since taking office, not in my name, anyway.
My message to the president is this- Your insistence in "staying the course" is not a sign of strength; it is a sign of ignorance. Your insistence on not listening to the professional military staff is killing our children. While the office of the presidency deserves respect; you as the president have not earned our respect; you do not deserve anyone's respect. You do not have my respect.
My message to Ken is this- Every single day I miss you more than the day before. Every day, I ask myself "now what?" Now, what do I do with my life without you here with me? Every day is a struggle; every day is a reminder of my new normal. What I wouldn't give for just one more of those "take-my-breath-away" bear hugs of yours, just one. I just wanted to let you know that I am thinking of you especially on this day. I love you, buddy!
Saturday, October 21, 2006
What didn't come out in the initial reports were his comments where he raised the possibility that insurgents have intentionally increased their attacks in recent weeks as a way of influencing political events in the United States.
“We also realize that there is a midterm election that’s taking place in the United States and that the extremist elements understand the power of the media; that if they can in fact produce additional casualties, that in fact is recognized and discussed in the press because everybody would like not to see anybody get killed in these operations, but that does occur,” he said.
Oh really? The insurgents are sitting around Tal Afar & Ramadi reading the New York Times telling each other that if they kill more Americans, maybe Lieberman will beat Lamont and Webb is defeated by Allen? Then what?
Yeah, right, sure- just like the release of the "overly friendly emails" from former Rep Mark Foley was a prank perpetuated by the Congressional pages; a prank gone too far.
When is this administration going to tell the truth? We aren't stupid- really! The truth will always come out and it will always win. Some truths take longer than others to stick, but it will always come out. Lucky for us, we are a patient lot. I think our patience wears out in about 2 weeks. How about we convene at the a voting booth nearby on November 7 and send that message loud and clear?
I'm turning this space over to Kevin Tillman today. He hasn't said much in public since his brother was killed back in April 2004. This is posted by my friends at Truthdig and was worth waiting for. Thanks, Kevin.
After Pat’s Birthday
By Kevin Tillman
Editor’s note: Kevin Tillman joined the Army with his brother Pat in 2002, and they served together in Iraq and Afghanistan. Pat was killed in Afghanistan on April 22, 2004. Kevin, who was discharged in 2005, has written a powerful, must-read document.
It is Pat’s birthday on November 6, and elections are the day after. It gets me thinking about a conversation I had with Pat before we joined the military. He spoke about the risks with signing the papers. How once we committed, we were at the mercy of the American leadership and the American people. How we could be thrown in a direction not of our volition. How fighting as a soldier would leave us without a voice… until we get out.
Much has happened since we handed over our voice:
Somehow we were sent to invade a nation because it was a direct threat to the American people, or to the world, or harbored terrorists, or was involved in the September 11 attacks, or received weapons-grade uranium from Niger, or had mobile weapons labs, or WMD, or had a need to be liberated, or we needed to establish a democracy, or stop an insurgency, or stop a civil war we created that can’t be called a civil war even though it is. Something like that.
Somehow America has become a country that projects everything that it is not and condemns everything that it is.
Somehow our elected leaders were subverting international law and humanity by setting up secret prisons around the world, secretly kidnapping people, secretly holding them indefinitely, secretly not charging them with anything, secretly torturing them. Somehow that overt policy of torture became the fault of a few “bad apples” in the military.
Somehow back at home, support for the soldiers meant having a five-year-old kindergartener scribble a picture with crayons and send it overseas, or slapping stickers on cars, or lobbying Congress for an extra pad in a helmet. It’s interesting that a soldier on his third or fourth tour should care about a drawing from a five-year-old; or a faded sticker on a car as his friends die around him; or an extra pad in a helmet, as if it will protect him when an IED throws his vehicle 50 feet into the air as his body comes apart and his skin melts to the seat.
Somehow the more soldiers that die, the more legitimate the illegal invasion becomes.
Somehow American leadership, whose only credit is lying to its people and illegally invading a nation, has been allowed to steal the courage, virtue and honor of its soldiers on the ground.
Somehow those afraid to fight an illegal invasion decades ago are allowed to send soldiers to die for an illegal invasion they started.
Somehow faking character, virtue and strength is tolerated.
Somehow profiting from tragedy and horror is tolerated.
Somehow the death of tens, if not hundreds, of thousands of people is tolerated.
Somehow subversion of the Bill of Rights and The Constitution is tolerated.
Somehow suspension of Habeas Corpus is supposed to keep this country safe.
Somehow torture is tolerated.
Somehow lying is tolerated.
Somehow reason is being discarded for faith, dogma, and nonsense.
Somehow American leadership managed to create a more dangerous world.
Somehow a narrative is more important than reality.
Somehow America has become a country that projects everything that it is not and condemns everything that it is.
Somehow the most reasonable, trusted and respected country in the world has become one of the most irrational, belligerent, feared, and distrusted countries in the world.
Somehow being politically informed, diligent, and skeptical has been replaced by apathy through active ignorance.
Somehow the same incompetent, narcissistic, virtueless, vacuous, malicious criminals are still in charge of this country.
Somehow this is tolerated.
Somehow nobody is accountable for this.
In a democracy, the policy of the leaders is the policy of the people. So don’t be shocked when our grandkids bury much of this generation as traitors to the nation, to the world and to humanity. Most likely, they will come to know that “somehow” was nurtured by fear, insecurity and indifference, leaving the country vulnerable to unchecked, unchallenged parasites.
Luckily this country is still a democracy. People still have a voice. People still can take action. It can start after Pat’s birthday.
Brother and Friend of Pat Tillman,
Posted on Oct 19, 2006 Kevin, who was discharged in 2005, has written a powerful, must-read document.
Photo Courtesy the Tillman Family
Pat Tillman (left) and his brother Kevin stand in front of a Chinook helicopter in Saudi Arabia before their tour of duty as Army Rangers in Iraq in 2003.
hugs to Kevin & Mary
Friday, October 20, 2006
Has not met our expectations? How about it is awful over there? It really sucks and these insurgents are pretty wily. But the overall expectations have not been met. Let's just throw some more soldiers, marines and sailors at the problem; we'll lose a few, but what the heck? OUR expectations haven't been met..... indeed!
Has not met our expectations is a bit of an understatement and it gets me thinking that there has been an awful lot of media attention to the occupation of Iraq lately, more specifically the death toll. 2787 US casualties, 76 in October; that's 3.8 dead American soldiers a day. Take a look around you. Are there even 76 people in your office? Gone, dead, never coming home. How does that feel?
It seems like there is a number that gets to the press and to the people of this country who don't ordinarily have to think about this war. That means there is an acceptable number; like maybe 50 dead Americans is okay in a month. That doesn't seem so bad, it's war afterall, 50 is acceptable, but when it gets to 70, well, maybe that's not a good number. Zero is the only number acceptable to me. 76 families this month will never be the same. That empty seat at the table on Thanksgiving and Christmas, birthdays and just on a regular meatloaf Wednesday night, THAT is the hole in the heart for all of us Gold Star Families.
Cheney says today he's not looking for a way out of Iraq "I know what the president thinks. I know what I think. And we're not looking for an exit strategy. We're looking for victory," Victory? It's past time for those 2 in the White House to start thinking there must be a better course in Iraq because this one isn't it.
And there are tensions between the the United States and the nearly 5-month-old government of Prime Minister Nouri al-Maliki.
Frustration over al-Maliki's failure to crack down on sectarian groups could be exacerbated by revelations that the prime minister ordered U.S. troops to release Mazin al-Sa'edi, a top organizer in western Baghdad for radical Shiite cleric Muqtada al-Sadr. Caldwell said al-Sa'edi was freed after being detained Wednesday with five aides for suspected involvement in Shiite violence. Al-Sadr's al-Mahdi Army has been blamed for sporadic attacks and for inspiring groups kidnapping and killing Sunnis.
If we cannot detain members of the Mahdi army, the biggest thugs and punks around, why are we still in Iraq?
Wednesday, October 11, 2006
Tonight as I write you this email, I am listening to booms from either mortar fire or now after looking at the news an ammo depot that caught fire. It is a bit humbling to hear munitions so close to the hospital. I'm in the International Zone ( AKA the green zone ), but we are no more safe in here behind the walls than outside. Although at least I am not out looking for insurgents or conducting sweeps of the local towns as the other soldiers are doing. I am in the hospital taking care of patients.
Wednesday, October 04, 2006
Of course our US forces should be honored, but George Bush tells us this is going to be a long war. "Our own generation is in a long war against a determined enemy." he said in his 2006 State of the Union speech. A LONG war. A conclusion to this war is far off.
Congress refuses to fund the war properly with regards to training, equipment, staffing levels but they want a party; maybe not this year, but they want a party and they are making sure that they will have one. For $20 million dollars, it will be one heckuva party. Guaranteed!
Conditions in Iraq are nearly out of control with Afghanistan not much better. Last week (Iraq) also saw the highest number of vehicle-borne improvised explosive devices this year," said" Major General William Caldwell, using the military terminology for car bombs. "The number of improvised explosive devices was also at an all time high," he added, referring to home-made bombs used by Iraqi insurgents and militias to target road traffic. A week earlier, Caldwell said the number of suicide attacks in Iraq was at its highest point since the 2003 invasion, citing the Muslim fasting month of Ramadan as a traditional peak for violence in Iraq. And Congress wants a party. Amazing, just amazing.
These people are all drinking double shots of this administration's purple koolaid if they think this celebration will be warranted in the coming year or the next. Until there is a change in this disastrous course, this money should be earmarked for, oh, I don't know, maybe taking care of the veterans and their families as they return? $20 million dollars would go a long way towards healing these veterans and their families. But instead they cut the budget for the vets and they set aside $20 MILLION for a party?
Don't mind the noise; it's just me howling in pain.
The Young dead soldiers do not speak. Nevertheless, they are heard in the still houses: who has not heard them?
Sunday, October 01, 2006
My reply? Some days I just wish people would think about the damned war!
Sad to say, Trent Lott, R-Mississippi, confirmed on Friday that Republican senators and the president don't. He (Bush) doesn't and the real people out in the real world don't for the most part."
President Bush barely mentioned the war in Iraq when he met with Republican senators behind closed doors in the Capitol Thursday morning and was not asked about the course of the war,.Real people in the real world? Mr Lott, let me invite you to spend a day in my real world. Imagine a day without your only child because some incompetent, callous, heartless, ineffectual so called legislators continue to support a war that should never have happened in the first place. Everyone of them should be ashamed of themselves when they look in the mirror each morning.
"No, none of that," Lott told reporters after the session when asked if the Iraq war was discussed. "You're the only ones who obsess on that.
Some days we Gold Star families who are standing up and speaking out feel hopeless. Most days I think this occupation and George Bush's Global War on Terror will last for the rest of my life, but I won't stand by and let it happen without some noise from me. Anyone who listens to me will make no mistake where I stand.
I already gave this country the best of me. What about the rest of this country? What are you doing to stop the war? To stop the madness? Major General R Batiste (Ret) told members of Congress last week that one percent of the population (is) shouldering the burdens (in this war). That one percent are the military families.
I know that members of the Bush administration don't care, but what about the rest of you? How often do you think about the war? Those of you who are reading this have to. I won't NOT let you; it's my job.
Honestly, if George's war was so important to the national interest of the country, wouldn't everyone be willing to sacrifice? Iraq isn't that important. George says it's so, but it's not. REALLY.
The hospital is a fixed facility and was here prior to the war. We just took it over. It is quite different working in these conditions vs the states. I still haven't gotten in to the "conserve all supplies" mode of thinking yet, but I'm sure I will once I run out of needed supplies with no way of re-stocking or obtaining more for a while. I really am learning a lot here thus far. I took care of a patient the other day with 7 different iv medications/fluids running, a trach and ventilator, 4-5 drains, a big belly open wound with every 2 hr dressing changes and a whole lot more. Whew! They kinda throw you into the water and watch and see if you will sink or swim and the occasional life raft offer when you need it.
I'm working night and 12 hour shifts. It's hard right now to settle into a schedule as we have only been here for about 4 days or so. We have also had tons of stuff to do. For those of you non-military types, I get to wear body armor to and from the hospital everyday and if I want to go anywhere inside of our compound (it's surrounded by large concrete walls with checkpoints and guards. I carry my M16 with me everywhere along with a loaded( filled with bullets) magazine.
My living conditions are a little bit... well I'm not in a tent so I guess I can't complain. I live in a suite with 6 other girls. It's surrounded by tall concrete walls and concertina wire. It does need a lot of work though. We need stuff to make it more like home.
The weather here, of course, is warm, but not too bad. They say it gets cold here but the weather hasn't changed yet. Overall I'm well and things are going well. I'm working hard and looking forward to the experience. We haven't been too busy yet, but I'm sure our time will come.
So far all of us are getting along well. It's still early. I'm sure there will be some drama later as we get stressed out. So far we have been slow up in the ICU where I work. We have ICU's ICW's (intermediate care wards), plus our ER, OR, and misc other services. We are located in the Green Zone or International Zone. They say it's not really that much safer here than outside the walls. Actually one of our people got hit by a stray bullet today waiting outside the ER. Very scary. Also last night they had an alert and evacuated some of the living quarter areas for a suspicious package.
I wear body armor and a helmet everyday along with my M16 and a loaded magazine in my pocket. It is surreal being here, but I have friends that all look out for each other. I think it is going to be a good experience. I'm learning alot and trying to roll with the punches.
Meanwhile, this Gold Star Mom is sending good thoughts for all of our military serving our country, and especially those in harm's way.