Sunday, March 25, 2007

Priorities

On Monday, the military will release the results of the 5th investigation into the death of Army Ranger Pat Tillman. They will also reveal the results of a related investigation Army Criminal Investigation Command.

Also on Monday, the results of the autopsy of Anna Nicole Smith will be released.

If I was a betting woman, and I am; I would bet that the lead story on the Monday evening news will be Anna Nicole Smith.

wanna bet?

Friday, March 23, 2007

Missteps & Oversights

On Monday, the Army will release the results of the 5th investigation into the circumstances of death of Cpl Pat Tillman. Although it took the Army 5 weeks to reveal that they knew Pat's death was caused by "friendly fire"; we now know the Army knew the truth from the beginning.

Until now, the Army has punished seven people for the Tillman killing, but no one was court-martialed. Four soldiers received relatively minor punishments under military law, ranging from written reprimands to expulsion from the Rangers. One had his pay reduced and was effectively forced out of the Army.

A Pentagon investigation will recommend that nine officers, including up to four generals, be held accountable for missteps in the aftermath of the friendly fire death of Army Ranger Pat Tillman in Afghanistan, senior defense officials said Friday. Missteps? How about incompetence? How about collusion?

The Defense Department inspector general will cite a range of errors and inappropriate conduct as the military probed the former football star's death on the battlefront in 2004. Pat's dead and they call the conduct "inappropriate"?

It appears the inspector general will not conclude there was an orchestrated cover-up in the investigation. There probably wasn't a Pat Tillman plan in case he was killed; we'll do this. But an orchestrated cover-up? Of course there was. I'm pretty sure there was plenty of "We're screwed" and WTF? and "No one must know" kinds of conversations. Pat's brother. Kevin, was nearby when Pat was killed and he wasn't told the truth either, so we know the cover up started immediately. The soldiers involved burned and destroyed Pat's uniform; they said it was a biohazard. Since when did evidence become a biohazard unless you are hiding something. Might it have been because an analysis of the body armor would reveal who shot Pat Tillman?

The Tillman family was notified last week that the report would be released to the public on March 26, but the family could review it ahead of time IF they promised not to say anything until Monday. With the way the Tillman family has been treated, I would have had the fax machine on speed dial ready to send the report to my favorite media contacts. Respect during these investigations seems to go only one way and the families deserve better. The officials who leaked the story today requested anonymity because the Army has not publicly released the information. That anonymous source didn't give any thoughts to the family.

Having walked in the "Delayed truth" shoes, I can tell you that I was lucky that the Army pretty much showed up on doorstep 15 months after my son, Lt Ken Ballard, was killed in Iraq, and told me the truth about how my son died. They called it an "oversight", I called it incompetence. I had no inkling that what they told me when he was killed was not true; I had accepted the truth. Because the media didn't know ahead of time, there was no feeding frenzy to talk to me until after the news had been released. Once the news of the Army's oversight was released, everything changed. Reporters invited themselves to the next meeting with the Army; I refused them. Reporters called me and stopped by incessantly.

My friend, Nadia McCaffrey, mother of Sgt Patrick McCaffrey, was told the truth 2 years after Patrick was killed that he was not killed in an ambush as the family had been told; he was murdered by Iraqi soldiers that the Americans were training. Nadia knew that the Army was going to give her very bad news when they called to schedule a meeting at her house; she had spoken to some of soldiers in Patrick's unit. Another anonymous source leaked the news 2 days prior to the meeting and her life was hell dealing with the media for those next 2 days before her meeting.

Most people have a voyeuristic curiosity about the details of the inquiry and the death; the who, when, who knew, what time details. Most people are outraged that it took so long for the truth to be revealed. Some people are outraged that the families want to know the truth and those people can just shut their mouths and sit down. None of us could predict how we would react, what we would do if we got that knock on the door; you wake up the next morning and try to figure out what your new life means. As the headlines announce the new findings, people must know and they must remember that we mother's are hearing details of the last minutes of our son's life. Some of us have seen autopsy photographs with every, single bullet wound; I was told my son's last words. We have to find the balance of processing the technical and analytical details, and at the same time, wonder about the fear and terror our son's faced in those last minutes of their precious lives.

So 3 years after Pat's death, the Army will gather the family and tell them the results of their inquiry again. It's taken too many months with too many players involved to believe that the whole truth will ever come out. A family just wants to know the truth at the soonest possible time and 3 years isn't the soonest time.

Tuesday, March 20, 2007

4 years for what?

It is unbelievable that our young men and women have been fighting for 4 years in Iraq. As the sun rises this morning we see the start of the 5th year of George Bush's occupation in Iraq. This morning, 5 families are waking up to what they think is their normal life. They will make coffee and go through their mental to-do list, and they don't know how one knock on their door will change their lives forever. These 5 families don't know that when they open the door, they will be faced with someone in official military dress. Their loved ones are dead and they are never coming home.

The president begs us for patience and gave a stark warning against the temptation “to pack up and go home.” George Bush just wants a do-over because 4 years of fighting and killing has not gotten him that victory that he promised and he will stop at nothing until he gets it. The problem is, his definition of victory is not clear. He wants to stay the deadly course. Of course he didn't use that phrase because it's been replaced by the newer and more hip term, "surge" It's all the same.

Tony Snow, the mouthpiece for the White House says It would also force failure of the mission in Iraq and forfeit the sacrifices made by our troops.”

A CNN poll shows that 35 percent of Americans are confident about the war. When the war began, 83 percent of Americans expressed confidence in the invasion. The Iraqi people are seeing hope slip away and see conditions worse for availability of electricity, jobs, medical care, security as compared to 2005.

And I am just weary. Ken's gone and he's never coming home. When I lost only child Iraq in May 2004, I lost my future. 3218 US soldiers have been sacrificed in George's folly.

Tony Snow or anyone else should not tell us "The sacrifice of our troops would have been for nothing if we don't continue this war". How can anyone possibly think that one more dead soldier would get us closer to that elusive “victory”? Every day you neglect to end this war you are also condemning 3 more US troops to death. My son and the 3200+ other troops whose lives were sacrificed and wasted by George Bush will be best honored by a nation and a Congress with the courage to end this war. I urge you to have the same courage that my son and his fellow troops exhibited when their Commander in Chief gave orders to invade Iraq. You must have the courage to stand up to that same Commander in Chief and say NO escalation, NO more troops, NO more funding for this hideous war.

Members of Congress can stop saying that they "voted against the war". That is no longer enough. That vote was more than 4 years ago; what have they done for the troops lately?

With the right leadership, the US can stop the occupation in Iraq, improve education and health care for all of us including returning veterans, really do something about improving the environment and even regain our world standing. Is the 110th Congress up to this challenge? We will see.

Let's just get the hell out of Iraq, bring the troops home and take very good care of them when they get here.

Friday, March 16, 2007

Iraq Veterans Memorial

We are proud and honored to present to you the Iraq Veterans Memorial.

This memorial was conceived as a place to honor the servicemembers who lost their lives over the past four years during the Iraq War. By watching the videos, you will have the opportunity to learn about these heroes from those who knew them best -- their family, friends, and fellow servicemembers. Each man and woman represented in the memorial had attributes and qualities that made them unique, but they all have one thing in common - they were truly loved and are deeply missed.

http://www.iraqmemorial.org/

Sunday, March 11, 2007

The Army is ordering injured troops to go to Iraq

If you are a parent, you have probably had this kind of conversation when you knew your child had done something wrong and they just weren't ready to admit it. "If you don't tell me everything NOW, it will only get worse".

George Bush is that recalcitrant child and he's not telling us anything. No one should be surprised by this. This administration doesn't know how to tell the truth and further, since George Bush told us he is the decider (of what we should know, how we should act and so on) it's apparent that he thinks we don't need to know anything.

Bush loyalists will have to throw their cards in one day and come to the side of full disclosure. At this point, I'd ask for half disclosure because even if you only look at the egregious behavior of the Bush administration in the past 30 days, you'd have to wonder what other stories we don't know about. The thing that surprises me is that the president doesn't seem to understand the magnitude and the effects that his administration has on this country and further the effects on troops that he supposedly supports.

The desolate conditions and treatment of patients/troops at Walter Reed and other VA hospitals; the revelation that the FBI has been violating the Patriot Act right an left; discussion of a pardon for Irving Scooter Libby after being found guilty of 4, count 'em, FOUR felonies related to lying to a grand jury. I could go on, but it's been a busy week for bad news and I don't think I can take anymore.

Salon.com reports The Army is ordering injured troops to go to Iraq. This shouldn't be a surprise with the increased number of troops required to fill the surge of troops being sent to Iraq for added security. Let me add that these troops are from the 3rd Infantry Division out of Ft Benning, GA many of whom are heading to Iraq for the 3rd deployment to hell. It's no wonder many of them have injuries whose doctors have classified them as "unfit for battle". Many of these soldiers are medically restricted to lifting less than 15 pounds or wearing their helmet for less than one hour. I think this is part of Rumsfeld's "you go to war with the Army you've got" policy. These soldiers needn't worry about getting the medical care they need when we finally get them out of there; I'm betting there will be only cosmetic changes to the conditions that we know about at Walter Reed even after the commission makes it's recommendations.

With everything else that has happened under the watch of this administration, I am certain of this, things are going to get a lot worse before they get worse.

Saturday, March 10, 2007

Waking up Los Gatos

Los Gatos, CA is a relatively small town in the South Bay part of the San Francisco Bay Area. Population about 28,000, with an median income of $94,ooo. Average age? about 41. 83.3% of the folks in this little burb are white.

I tell you this because Mike, one of the members of Mountain View Voices for Peace (we're up the road about 20 miles) thought that we should take a walk down Santa Cruz Avenue, the main drag in Los Gatos this evening with signs for impeachment and for ending the war in uraq. Tien, of course, had his "Mend your Fuelish Ways" sign, too. Close your eyes and think about the street in your town with all the cute$t and coole$t boutiques. Don't forget the fully stocked Lamboroghini dealership on the corner. Yeah, it's that kind of street in that kind of town.

Los Gatos has not been a hotbed of protest about this war and I was afraid that that we would find that no one from this part of the Bay area even knew that the good old U of S A was involved in a war over there in Iraq. They have not suffered any casualties, so I wondered if they had been touched by this 4 year old war.

There is good news and bad news. While we found the town to be a little sleepy, especially for a Saturday night, we were able to raise some voices and garner some reactions to our signs demanding IMPEACH & OUT OF IRAQ. The reactions were mostly positive, but Los Gatos, I have to tell you that you have a couple of real mean eggs in your town. A middle aged woman was strolling down the street chatting with her friend. She couldn't miss us, all 11 of us, as she approached. With the closest thing to a Snidely Whiplash sneer, she suggested that we all be put in jail and then that we should GET A LIFE! I told her that I would like my son's life back and she told me WHO CARES? Our people were surprised, perhaps horrifed at what she said to me. Her son was killed in Iraq, they told her. WHO CARES? she repeated. Who cares, indeed? It's really kind of sad.

We decided to walk over to the overpass over Highway 17/880 to assess the situation. YES!! The road was filled with vehicles with people returning from a great sunny day at the beach over the hill in Santa Cruz. Heavy traffic was at a slow crawl when we hoisted our signs. The honking began immediately! What a great reaction! Full disclosure, there were a few people who didn't like our signs, but overwhelminglly they were in support of Impeachment and ending the war.

Trip summary? Yeah, it was a good evening. We got our point across and made people in Los Gatos realize that they aren't alone in their disatisfaction towards this president and his war and that it is okay to raise your voice.

We think we're on to something. What town nearby needs a wake up call? Los Altos, we're on the way! Campbell? you're on the list, too.

Note to readers: Proper etiquette when one passes by a demonstration or protest that you agree with would be to HONK and honk wildly in support of the cause. Don't be shy! Roll down your window and flash a Peace sign! Your honks energize the marchers and makes us feel one with you and we appreciate it!

Friday, March 09, 2007

Iraq War Veteran's Memorial Trailer




A place to come together to honor the US serviceman and woman
who have lost their lives.

Through the voics of their family and friends.
We remember those who have fallen.

Unveiling the Iraq Veteran's Memorial in this space on March 17, 2007.

Thursday, March 01, 2007

Florence Nightingale's Winter update

This is part of an ongoing series of updates from the military hospital in the Green Zone of Baghdad. Our Florence Nightingale is halfway through her year long deployment. This is an intimate perspective of the war that we don't necessarily hear.
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Hello Everyone!

It has been a long time since I last wrote and many of you have sent along messages checking in to make sure that I was okay. Thank you so much for caring. I am doing okay. I have been having trouble finding restful sleep and am usually very over tired. The months of January and February have been extremely busy as well. I have also come to a point where I am having a difficult time taking care of my patients and the demands of this deployment. You don't realize how much a deployment like this can take out of you until you are knee deep and trudging through the muck. I am almost at the half way point and looking forward to leave. I am hoping to become refreshed and refocused after leave so that I can finish this final sprint to deployment end.

I experienced many new things these last two months. First, I "coded" my first American patient. By "coded," I mean that I had to do CPR and give medications to try and save his life. It was a sad case. The patient was an American contractor and only 30 years old. He suffered from a massive heart attack and was transferred to us after he was found unresponsive on the scene. The pieces to the puzzle were a bit confusing to put together, but essentially this patient was admitted to my ICU and a fellow co worker and I were the nurses caring for him. He came up intubated/vented and we began our normal routine admission procedures. Soon enough things started to turn around. We noticed some EKG changes (electrical changes in the heart) and we got a 12 lead EKG to get a better picture of what was going on. He was having another heart attack. Our doc started the normal protocol for our heart attack/chest pain patients. I actually had many firsts on this day. I gave TKnase, a medication given to bust up clots. I have never given this medication before and there are so many precautions you want to be aware of. It is weight based and can cause massive bleeding because it is able to bust up any clots in your system as well as make your blood extremely slippery and prone to bleeding. We gave him the typical ACLS (Advanced Cardiac Life Support) medications as well during the times when his heart rate dropped and his blood pressure became nonexistent. He was a complex case. There were multiple doctors coming up to see him. Our cardiologist did an echo (ultrasound of the heart to evaluate the valves and blood flow through the heart as well as possibly identify the area causing the heart attack). We had our vascular doc come and evaluate his leg because an IO(bone) needle was placed and his leg below the needle was blue and pulseless. It was one thing after another. I was so glad that both Tammy and I were working on this patient. We had to start CPR eventually. We were doing chest compression's and I was giving medications through the available IV lines. He started bleeding from every place he had an IV and started to bruise all over his body from the clot busting medication I had given. We ended up doing 2 rounds of CPR and was not able to save him. We tried everything. It was so upsetting. We got him back after that first round but we couldn't getting him stabilized and he crashed again. It was a code type situation for like 4 hours. It only seemed like minutes while we were going through it though. You are so busy and focused on assessing the patient and giving meds and CPR and reevaluating for the next planned intervention that time flies by without you even blinking to notice.

I got to experience the American morgue for the first time that day. Usually we put the Iraqi deceased in a very large refrigerated container. It really looks just like a very large box like one of those storage pods but larger. It is also refrigerated and the patients are stacked 3 on each side. Nothing fancy just the basics. The American morgue however is just the opposite and rightly so. It is in a building and there are long "trays" that pull out where you place the person. They are 3 people across. There is no stacking here. It has an illuminated American flag framed in glass and a poem on the wall paying tribute to the sacrifices of the American soldier. I had to hold back the tears as I entered this room. I was amazed and stunned. I was touched that at least the American Heroes were placed into a room that held an air of the utmost respect. It was a humbling experience.

Unfortunately I was hoping that this would be the only American that I would have to put here. If only that were true because a few days later an American soldier was placed here. He was admitted to the ICU and had a lethal gun shot wound to the head. This posed a serious ethical dilemma on the floor for many of us. We were fortunate enough to have a visiting neurosurgeon at the CSH when this soldier came in. He made the determination that he was not going to operate on this man because he essentially would have no quality of life ever again. He would not be able to speak or comprehend words/speech or conduct any of his basic needs. He would be a vegetable as most people would call it. It was a most difficult decision for the doctor to make and then when the soldier arrived on the floor and I was assigned to him I was tortured by the principle of sitting back and easing this man, this Hero into death. I have taken care of many dying patients in my career, but not like this. This was completely new. I was here in Iraq and I was taking care of my brother in arms, but I wasn't taking care of him and fighting for his life. I was making his remaining moments more comfortable. I also had to face his unit. I had to tell them what had happened and the damage that was done. The doctor of course also explained everything to them and conferred with them to ensure that they agreed to his decision to withdraw care.

The doctor made this decision and his wife later agreed to the course of action that was taken. It posed many questions among the soldiers on the unit that day. There was discussion amongst the doctors and nurses to help understand why we weren't doing everything in our power to save this soldier. Being a medical professional can be a difficult place to be sometimes in a situation like this. For example I can understand the doctors point in that the soldier would have no quality of life and that he would be potentially in a coma for the rest of his living years. On the other hand I have seen the other side where heroic measures have been performed to save a soldiers life. I have taken care of the brain injured and wounded of this war back at Walter Reed. Yes, these soldiers lives are irreversibly changed forever and they can become burdensome to their family, but how do you decide which is the better outcome. Is it better to have your loved one die in combat or from wounds in combat or be saved to potentially die later from complications of injuries or live a life with more challenges than ever dreamed? It is a tough call to make. I still don't know how I feel about the whole situation.

My deputy chief of nursing came up to speak with my battle buddy and I about the situation and to get our thoughts. She said that she could see in our faces that the situation had hit a nerve and wanted to be assured that we were okay and coping with what had happened with this soldier. It was nice that someone in our chain of command took notice and allowed us to verbalize our feeling without repercussion.

As I mentioned before the months passed were very busy. We were lucky in not seeing many wounded soldiers but many host nation civilians, Iraqi Police and Iraqi Army. The bombings seem to have picked up and there are more and more everyday. I just don't understand how the people of this country think. I wonder if the people setting up these IEDs and VBIEDs or even the suicide bombers realize that they are killing their own people. It is just so sad that a child cannot play with their sibling in their back yard without fear of being blown up. A family or an individual cannot go to the market place without the potential threat staring them in the face. I cannot tell you the numbers of children that I have cared for and those cared for by the other ICU and the wards that are changed forever. Their subtle innocence is gone. They are wounded by not only their injuries but in their spirit. Yes, there is medical care here in this country but it is nothing like the United States. There are now children without parents and siblings from the effects of this war. There are people who will never be the same again because of their injuries. It just doesn't make any sense to me.
I have also been experiencing what has been termed compassion fatigue. The research team has been looking at the effects of seeing trauma everyday on the medical professional providing care to these individuals and if their empathy/simpathy is affected. The challenges that I face everyday includes trying to overcome communication and language barriers as well as cultural constraints. If there is a female patient, we need to try and pair her up with a female nurse. You need to ensure that she is covered and not exposed for people to see. This isn't as easy as it may sound when your staffing is limited. The other part is that some of these people act like you should be at their beckon call. It is in the culture that when a loved one is sick all their needs be tended to on a 24hr/7day a week basis. Now when you have only one patient that may be possible, but with the days we have had lately it is not an option. I had a patient banging on the side rails for my attention and demanding his pain medicine this instant. I knew this through the interpreter who I called to help me figure out what was wrong with my clearly agitated patient. Even after an explanation that pain medicine was given to him and that I cannot make his pain go away completely, he continued this behavior. You find yourself doing things that you would never do back home. I had the interpreter explain that his behavior was unacceptable and that if he continued he would not get anything form the nurse. I had her tell him that he would be given pain medicine at every opportunity that was available with in the restrictions of the doctors orders. I really just wanted to tell this man that he needed to stop acting like a child and chill out. Now I really couldn't say that since my Arabic can only get me so far. You tend to ignore the ones that treat you badly. You care for them, but when they are pinching/hitting you and disrespecting you at every moment the challenge to care for them is magnified.

I face situations like this often. It seems like the people here are never satisfied. You try to do the best for them with the best that you have and it's not enough. You start harboring some resentment. You think to yourself, "hey, I didn't shoot this guy or try to blow him; all I'm trying to do is take care of him and get him back home. Why is he behaving so badly toward me?"

You also find yourself comparing injuries. You look at the guy that has burns all over his body with limbs amputated and loose your compassion for the guy that had an open fracture of an extremity that was fixed surgically and screaming in pain. You think to yourself, "what are you complaining about it's just a broken arm and now it's fixed. Look at that guy over there with the burns and no legs." It is so difficult when you feel so under appreciated by those you care for. Granted nursing has always and probably will always be a thankless job. We are the worker bees. We tie all the loose ends together. We carry out the doctors orders and tell them when their patient isn't doing so well. We are by their side 24 hours a day, 7 day a week. We are there in their worst moments and sometimes their greatest triumphs. It is a job that I love to do, but can also be a trying job to continue to do.

It has been the months of new challenges and experiences. I'm sure there are many more to come. I am trying to find quiet moments to myself to reflect and find peace. I have learned so much in this deployment, not only about nursing but about myself. I am looking forward to my upcoming R&R and hope that it will help push me through the remaining months of my deployment.

I want to again thank you all for your continued support. I could not have made it this far without you. Please forgive me for not writing sooner and being lax with my communications these last two months. I have chosen extra moments of sleep and relaxation to help keep my mind in the game and focus on the mission I need to complete. I think of you more often than you know. I miss you all and look forward to seeing everyone soon.
Lots of love,

No Apology Necessary

Barack Obama said it a few weeks back "We ended up launching a war that should have never been authorized, and should never been waged, and on which we have now spent $400 billion, and have seen over 3,000 lives of the bravest young Americans wasted."

John McCain said it last night on The Late Show We wasted a lot of our most precious treasure, which is American lives over there." I heard him make that comment, but frankly, there was no blip on my radar.

Our bravest young Americans, our most precious treasure "wasted". How can you fault anyone and demand an apology when one is speaking truth? Obama apologized immediately, "It is not at all what I intended to say, and I would absolutely apologize if any (military families) felt that in some ways it had diminished the enormous courage and sacrifice that they'd shown." saying he was upset with himself for using that word. McCain backpedaled saying he regrets the comment, “I should have used the word, sacrificed, as I have in the past,”

I don't know why the Democratic National Committee is howling about McCain's use of the word. Is sacrifice a better word? According to dictionary.com sacrifice means Forfeiture of something highly valued for the sake of one considered to have a greater value or claim. Wasted means to be consumed, spent, or employed uselessly or without giving full value or being fully utilized or appreciated.

Using the apparently preferred word sacrifice implies that this hideous war has more value than the life of my son, Lt Ken Ballard and the 3164 casualties from Iraq and that his death was for the greater good. I disagree, as do many of the members of Gold Star Families Speak Out. And I think this media maelstrom is a bit overdone. When you have these kinds of disagreements about semantics; you are taking your eye off what really counts. And when you have these kinds of disagreements about simple words, you are buying into the Bush administration who is excellent at hiding the true cost of this war. They want us to believe that there is a better outcome ahead and that our loved ones lives were not wasted. But, these lives were wasted. Any life cut short is wasted, but a death because of this war is a huge waste to the family, friends, and this nation. This war will never have been a greater value than the lives of our loved ones.

I'd rather we work on the plan to get our troops out of Iraq, and how we can take good care of them when they get home. I'd rather worry about the condition of the Veteran's Administration as it related to the care given to our troops. I'd rather work on providing these soldiers on the ground in Iraq & Afghanistan with the proper training, and supplies that are necessary to keep them safe until we can get them home. There are so many other things to worry about. This argument is irrelevant.

And I really don't need or want an apology when someone is speaking the truth.