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.

Thanksgiving in Baghdad from Florence Nightingale

Hello!

Another week has gone by. This week went by a little quicker than the last. Our census has finally dropped in the ICU and we were given some extra time for ourselves. It was nice to say the least and much needed. I feel like we have been working hard and trying to keep pace with our demanding patients. They are demanding in their needs and medical problems not necessarily in their wants.

I have seen deaths door too often since I have been here. It is again an unfortunate reality to the situation we are in. There is such trauma sustained to the body from IED blasts, GSWs, and everything else that the fact that the body can withstand some of that torment is incredible. It is even harder for some reason to see a child affected in this way by this war. It is not everyday that I get to care for sick and injured children, but here in Baghdad it is an everyday reality. Small children as young as 3 years old have crossed my path. They have suffered from gun shot wounds, IED blasts, and vehicle crashes just like the adults I care for. There is no differentiating between who the blast will affect and where the bullets will land. Their little bodies withstanding all that torture of injury and surgery to recovery and rehab. Some of them don’t survive and perhaps their deaths hurt more because they are too young; too young to have really lived and enjoyed life. They may simply be in the wrong place at the wrong time or caught in the cross fire. We had a family of 8 injured in the cross fire this week. Two children died on the scene, two were admitted to our ICUs, one was flown to Balad for a head injury, the father was cared for in the Step Down unit, and the pregnant mother was cared for on the ward.

How do you care for each of these injured souls? It is difficult enough trying to get better for yourself, but when your very support system is pulled out from under you how do you heal a broken heart?

So today on Thanksgiving, I am thankful for my family, my friends, my fellow soldiers, and the gift of being a nurse. I may not always give myself the credit I deserve as I have been reminded so often by those that know me all too well, but I am a good nurse. It has taken this deployment for me to realize that. I have a gift of connecting with people when they are down and out and helping them get to the best place for them. It may not always be better or healed where they walk out of those hospital doors from where they first entered. It may be to die with ease and comfort or to find a place where they feel safe. I have my doubts that I may not always accomplish what I set out to do, but the fact is that I try.

On a different note, I took care of another fellow soldier tonight. I have a difficult time trying to explain the difference between taking care of soldiers than taking care of other types of patients. I was told once that soldiers fight harder, take more risks, and accomplish great things because they know that we (the medical assets) are here to take good care of them if they get hurt. I know tonight my patient must have thought I was crazy when I wanted to turn him and check his backside. Keep in mind he had multiple fractures and wounds from being in an IED blast. I gave him the rationale why and we screamed and fought through the pain to get him to move so I could check his wounds and his skin to assure he wasn’t going to “bleed out” without me knowing about it. He forgave me later when I let him brush his teeth and helped him wash up this morning. He told me that this was so embarrassing for him. He looked at me strangely as I offered him my explanation that “this” was my favorite part of my job. I told him that I love to help people and if helping them brush their teeth and washing them up is going to make them feel better then hand over the wash cloth and soap!

He may not even realize that even his bed bath is part of his recovery. He brushed his teeth today with his one good arm (2pts). He washed his face and torso (5pts). He washed his hair with a shampoo cap (2pts). He rolled in bed so much better the second time around so I could wash his backside and change his sheets (10pts). My point is all these little things add up. They double as physical therapy, they count as exercise and assist the blood to flow to those injured parts to facilitate healing, and they give him control over a seemingly uncontrollable situation. Everything I do has a purpose; they may not know that or ever learn that, but it is to help them reach a goal. That goal would be to walk out of Walter Reed or some other Army facility a stronger man or woman than when they came in. Beat up and broken initially, but stronger and wiser later.

This is how I fight this war. This is my part in making a difference during this deployment. I may not always know why I am here or agree with what we are doing, but I know that my mission is to take care of soldiers and this is what I will do.

I will end this here. I am well and in good spirits despite that the holidays are here and I’m without all of you. Again, I cannot thank you all enough for sending the wonderful packages, letters, and support on such a daily basis.

I wasn’t able to get any Thanksgiving cards this time and most of you know that I keep Hallmark in business by sending greetings for all the holidays. I want to wish everyone a very HAPPY THANKSGIVING! I hope that this season helps us all to reflect on what we have to be truly thankful for. Plus how can you go wrong with turkey and all the fixings!

Wishing you all well. Thinking of you often and missing you more! I’ll be in touch.

With Love~

It's Thanksgiving

Any holiday these days is bittersweet. I try to be mindful of other's joy in celebrating, but there is so much emptiness in my heart. I can't say "Happy* Thanksgiving or *Happy* Holidays or *happy* anything.

Of course there are better days, and there are many good memories my son, but any holiday is a reminder of what shining light is missing from my life.

3 years ago in 2003, Ken & I had set up a time for us to chat on the internet; he being in Sadr City, Iraq and we being in California. For these purposes *we* means my parents, 2 sisters, 2 nieces, my nieces fiance', and the fiance's family. We had a houseful of love and food, too. We were all looking forward to sharing a meal of thanksgiving and chatting with Ken. We were thankful he was alive and well, albeit 11 time zones removed from our family gathering.

I was nervous about making sure we had a connection- what if Ken came online and we weren't there? What if he thought we weren't thinking of him? This was the year that George Bush flew to Baghdad, and served turkey dinner to the troops safe within the Green Zone, wearing a 1st Armored Division jacket. Of course it was dangerous and how could the President of our country, the man who started this ugly war go beyond the safety of the Green Zone? For those outside the Green Zone, one day is like the rest; no respite from the daily mortar rounds, the ied's (improvised explosive devices) and the war.

Ken did not appear at the appointed time and I started to panic. I thought it was the internet connection, or maybe he popped on while we were eating. Finally, the instant message noise on the computer rang and Ken was with all of us for just a little while that Thanksgiving day. The delay in meeting us was a result of an extended firefight and unlike the women in some of the September 2006 Doonesbury comics, I always knew that our meetings online could be delayed.

Ken got to chat with everyone, mostly it was back and forth trivialities, but we were together that day and that was good enough for me.

As I raised Ken, I wanted him to be the kind of man that other women would tell their partners- Why can't you treat me like Ken treats his woman? I wanted him to be able to be as comfortable in the kitchen as he was driving a 65 ton tank. He should be able to do his own laundry and be able to balance a check book. When he got married I wanted it to be because of the woman and his commitment to her and the relationship, NOT because he needed someone to do his laundry or fix a meal.

Ken did feel comfortable in the kitchen from a very young age. Every Thanksgiving from the time he was about 4 years old, Ken made the cranberry sauce for our family dinner. Yep, from scratch, real cranberries and real sugar. He loved stirring the pot while the cranberries popped and released the juicy pulp. Look at that face, how happy he was to be part of our families tradition. As I continued Ken's tradition of making the cranberry sauce last night, I know that Ken was with me; always in my heart.

Over the years, Ken spent many Thanksgivings with friend's families and with his Army buddies and always, the families told me what good company he was.

So, this week, while our president yuks it up at the White House with the traditional pardoning of the National Thanksgiving Turkey and a gratuitous nod to the military, my thoughts are of Thanksgivings gone by.

He also commended U.S. military personnel, whom he said "have set aside their own comfort and convenience and safety to protect the rest of us." "Their courage keeps us free. Their sacrifice makes us grateful. And their character makes us proud," Bush said. "Especially during the holidays, our whole nation keeps them and their families in our thoughts and prayers."

Most people in this country are detached from the war, including our president. They won't have to, don't have to think about the 140,000 troops currently serving in Iraq who are so far from their families and another 18,000 in Afghanistan on this national holiday. There is no impact, no rationing, no personal commitment to this war, except for the military families.

While happiness is a distant memory for me, I *am* grateful for many things and many people. I am grateful for my fellow Gold Star families at Gold Star Families Speak Out and the other 2871 Gold Star families, who know this bereavement. I am grateful for my new friends that I have met along the way and of course my old friends, my dear friends; the hugs that are freely given when people find out I am a Gold Star Mom; and my family, who has been supportive of this journey we are taking. I am grateful for the relatively good health of my family and that I will share Thanksgiving with my 2 favorite sisters, my favorite parents, my favorite niece and her new puppy. I am grateful for my 3 favorite brothers and 2 other favorite sisters and ALL of my favorite nieces and nephews, who are with their families this holiday. I am grateful for Ken's friends who stay in touch, who let me know that he will always be remembered. I am grateful that the voter's finally understood the futility of this occupation in Iraq and I hope the newly elected Congress responds in kind. I am grateful for ALL members of the military past and present, who made a commitment to serve their country; and to their families & friends who know the cost of this war.

I hope you are spending the day with those you love, as I am, and that there is comfort and gratitude in your heart. I do wish you a HAPPY Thanksgiving!

Poppa Bush is drinking the koolaid

And I thought George HW Bush was onto his son.

I had heard that it was this president's father who suggested a few months back that Rumsfeld should leave. That's when his son came out and told us he was the "decider"; But I'm the decider, and I decide what is best. And what's best is for Don Rumsfeld to remain as the secretary of defense." George W said in April 2006 when 6 retired generals spoke out against the Secretary of Defense.

The International Herald Tribune tells us that the retired president was speaking in the United Arab Emirates and had just finished a folksy address on leadership by telling the audience how deeply hurt he feels when his son the president is criticized.

"This son is not going to back away," Bush said, his voice quivering. "He's not going to change his view because some poll says this or some poll says that, or some heartfelt comments from the lady who feels deeply in her heart about something. You can't be president of the United States and conduct yourself if you're going to cut and run. This is going to work out in Iraq. I understand the anxiety. It's not easy."

This is going to work out in Iraq? FOR WHOM??? He hasn't a clue about the anxiety of a loved one at war and he never will. It's not easy? AndI'm guessing that 41 did not get the message that "cut and run" is no longer the message. He can be forgiven for that, well, maybe not; but he cannot be forgiven for this comment:

"When your son's under attack, it hurts. You're determined to be at his side and help him any way you possibly can."

When the son's and daughters of this country were sent to Bush's war, there was nothing we could do to be on their side and to help them in any way possible. This administration sent our son's and daughters into this war with inadequate training, inadequate equipment and inadequate numbers and an undefined mission. And while we raised our voices in protest, very few in Washington listened until election day a few weeks back. They got the message that the war is wrong and it is time to bring them home, but did they listen? We will make sure they listened. We said that people would not get elected if Iraq was not on their platform and we were right.

Finally, back in in the UAE

Another hostile audience member, a college student in Abu Dhabi, told Bush that U.S. wars were aimed at opening markets for American companies. He said globalization was contrived for America's benefit at the expense of the rest of the world. Bush was having none of it.

"I think that's weird and it's nuts," Bush said. "To suggest that everything we do is because we're hungry for money, I think that's crazy. I think you need to go back to school."

Someone needs to go back to school and it isn't the college student who made those accusations.

Florence Nightingale reporting In

My favorite Army nurse is checking in...

I must tell you that it has been a busy week for me. I have not been able to write or email as much as I would like. I have gone through a variety of emotions this week from happy to sad to upset and stressed. Everyday can be a challenge here because you never know what will come through the doors. Never mind, the constant challenges you constantly face in the ICU as you take care of your patients. Often though it feels like Ground hog day, like in the movie. I wake up every afternoon around 1600 or so. My battle buddy usually gets in the shower before me and I get the extra 10-15 minutes of sleep. We put all our gear on and walk over to the hospital before dropping our stuff off and heading to dinner. Dinner of course has turned into eating the same thing every night; it just has a different name. Then we sit for a few minutes before we “assault the mail room”. We head up stairs, change into our scrubs and our night begins. We hit the gym in the morning and then race to go to bed. Then it starts all over again.

I don’t even know where to start now. I learned an important lesson this week about the interaction of people you work with. It is always a difficult test to throw a whole bunch of people together who have never worked with each other before, send them to a place where no one speaks the language, take away the pieces of their life like family and friends and expect them to perform. I think most of you who have ever heard me talk about nursing know that I have very high standards. I like my patients and work area neat, clean and organized. I always feel that if you keep the area you work in organized that when stuff goes wrong you know where everything is and can act fast. I also always put my patients’ needs before my own. That includes going to the bathroom, eating, or anything else. I also have high expectations of the people I work with too.

I have learned that not everyone will share the same ideals you have. Not everyone will work as hard as you do to do the right thing. Not everyone will know what they did wrong or where they can improve if you don’t tell them. I have always had a difficult time correcting people. I hate the confrontation, especially with being in the military. Being here throws an interesting twist on things. Here, you can never get away. There is no place to go. There is no real escape. We all live, sleep, eat, and work together all the time; 24 hours a day 7 days a week. It’s not like you put in your time and head home and become distracted by your life. This is your life here.

I have learned that regardless of how I feel about confrontation, I owe it to myself and the person I have issues with to tell them about it. Perhaps it was a misunderstanding. Maybe they didn’t know that what they were doing was wrong or not the right thing to do. I have learned that not only am I an officer, I am a leader, a registered nurse, a teacher, an advocate. I will need to work on this idea while I am here.

My goal for the next year will be to take the CCRN (Critical Care Registered Nurse) exam while I am here. They are conducting a review course for the exam and they plan to give in the spring. I don’t yet feel like an ICU nurse even though I am told on a daily basis that I am now. I’m hoping to pass this exam so I can finally feel like I know something. I think that it will be helpful on my resume or my curriculum vitae for the military.

I have been taking care of an Iraqi burn patient all of this week. Whenever I am working I will get assigned to this patient. He requires so much care and I have taken on the difficult task of it. I have come to the conclusion that I don’t necessarily enjoy taking care of this type of patient, but I am probably good at it due to my OCD (Obsessive Compulsive Disorder) tendencies. There are multiple dressing changes to be done throughout the day and night. He also requires the same regular care that you would provide for every patient anyway which include oral care and bathing, hourly monitor and vital signs, medication and pain management. I did get a compliment from one of our docs though; He said that the patient was getting better and that I should take care of the patient each night. The sad reality is I don’t think that he will. If it wasn’t for the medication we are giving him he would never be able to maintain his blood pressure or breathe on his own. A harsh reality. Perhaps if he were back in the states he would make it, but one never knows.

A little over a week ago our area was hit by a rocket. It impacted just behind our building where I sleep and near the trailers where some of my fellow co workers sleep. The blast wave from its impact broke most of the windows in our whole building. It apparently shook up the trailers next to us as well. My buddy and I had just finished dinner and were sitting out on the smoke bench ( she smokes, not me) waiting to do our daily assault of the mail room and all of a sudden we heard this loud boom followed by some fire like sparks over in front of the hospital. The smoke bench is located on the back side of the hospital by the EMT entrance. We both just sat there and stared at each other. It was like we couldn’t move. I was frozen. Finally I just said “run” and we sprinted to the hospital.

Everyone was obviously shaken and there were people putting on the IBA (individual body armor) and moving toward the front of the hospital. My buddy and I reported upstairs to the ICU and everyone was talking about what had just happened. Inside my heart was beating a mile a minute. I was trying to control my breathing and think clearly. I took report on my patient but I really wasn’t listening. I was numb. It took a couple of hours before I was back to myself. Our roommates and fellow co workers were coming in periodically from other places to let us know what was going on and that they were okay. One of my roommates was in the shower when the rocket hit and was attacked by the fan in the window that blew out with the blast. She also was greeted half naked as she was trying to pull on her clothes and get out of the building by someone barging in and telling her to get out.

When we returned in the morning, we found broken glass and were thankful that we have heavy curtains covering all the windows. We also have very tall concrete barriers around our building with concertina wire on top. It was at this time that I realized I’m really in a combat zone. I hear gunfire all the time. There are “booms” every now and again. I know that I am lucky though. I am not listening or engaging the enemy on a daily basis. I am not living in a tent or out conducting convoys or patrols. I am not a combat arms soldier who faces this danger every moment of everyday they spend here in Iraq or Afghanistan.

Well I should probably end this here as it seems like it is already 3 pages long. I tend to get a bit long winded. Sorry about that. I hope you all are enjoying my updates and that I am not boring you.

I’m hoping everyone is doing well. I am still taking it one day at a time. I appreciate all the support, emails, letters, and packages. Thank you so much. I will be in touch
With love

Happy Blogday to me!

One year ago I made the first entry here. I didn't know what I would say, but I knew I had plenty on my mind. I've heard from enough people who make me feel that I am making a difference; maybe what I say does matter.

I've had visitors from .mil and .gov addresses. I hope they are taking notes. (The war is wrong and you know it!) I've had visitors from all over the world. I have regular visitors and accidental visitors; anyone who stops by is welcome. Don't be shy- do leave a comment; I appreciate a bit of dialog.

I've learned a lot from some fellow bloggers, Chancelucky, Brainhell, pogblog, and the Nemesis of Evil to name a few. Thanks for standing by me- it means a lot.

I hope I have made you laugh a little and I hope we've shared some tears. I wouldn't wish my life as a Gold Star mom on anyone. That is why I speak out and share my thoughts.

There have been some victories and there've been days when I wondered what kind of people were running this joint we call America. There have been days of darkness and a few days where we found out that this country really does belong to "we, the people" and that maybe it will get back on the right track.

Always, this blog has been a place of late night solace for me; where I could say what I really feel once the door to the outside world is closed.

I think Ken would have liked knowing my thoughts. I don't know if I would have been inclined to keep a blog had my life not changed so much on 5.30.04. The thing that I cannot express well enough is just how much I miss Ken; every day, every hour, every minute. We got gypped, whether you knew him in life or you just got to know him here; we were all gypped! I hope you got to know a little bit more about my blonde kid.

So, what do you say? Shall we try for another year?

RUMSFAILED

It's been a good day in America.

2 years ago as I listened to George W Bush give his "victory" speech after the election, I sat at my desk and cried. I couldn't understand how so many people could trust the administration that had failed this country. For our group of Gold Star families, the run up to November 7, 2006 was days filled with sadness, depression, nervousness. What would our fellow citizens do when they showed up to vote? Who ARE these people?

For all of Bush's protests, the election on Tuesday was a referendum on the war in Iraq, corruption, morality and everything else that defines this administration and the Republican Congress. To be sure, many of the Democrats do not deserve a second look, but every elected official, regardless of affiliation, got the message loud and clear- it is time for a change in this country NOW! There is hope for better tomorrows and that makes today a very good day.

How can you top a Democratic sweep of both houses of Congress? I could barely supress the grins. I could have been happy with just that news- there was hope and validation for all we have been saying for so long. And just before 10 this morning, I received a quick email from a friend

AP: Rumsfeld stepping down
Thought that might make you smile.

He did not, however, send a link. Of course it made me smile, but I need details! Was he just messing with me? Not this friend, but still. Within moments, my brother who works at a TV station in Cincinnati, called with news, literally hot off the wire. I'm feeling downright perky now. A call from another Gold Star Mom, a post on a Gold Star family message board, more phone calls, lots of emails. What's not to like? Rusmfeld is out and I don't care why.

Rumsfeld never supported the military; either the troops at ground level or the highest of the high at the Pentagon. His arrogance and patronizing was horrifying to hear and watch, as if the troops were little green army men to be moved around at his will with no regard to their value.

People will analyze and discuss the nominee to replace Rumsfeld in the days to come; but he's not looking good, this longtime friend of the Bush family, former CIA director, Robert Gates. Let's not say "anything is better than Rumsfeld", let's be smart about it as this new Congress should be. It's time to be smart for our military, their families and our country.

As we bid good bye to the Secretary of Defense, I will heed my brother's advise, to not pull a muscle while I am doing the Happy Dance. If anyone feels an ounce of sympathy for Donald Rumsfeld, Reuters reminds us of some of Rumsfeld's words of wisdom.

"Reports that say that something hasn't happened are always interesting to me, because as we know, there are known knowns. There are things we know we know. We also know there are known unknowns. That is to say we know there are some things we do not know. But there are also unknown unknown's, the ones we don't know we don't know. And if one looks throughout the history of our country and other free countries, it is the latter category that tend to be the difficult ones," Rumsfeld said on Feb. 12, 2002.

"Stuff happens," Rumsfeld said on April 11, 2003, when asked about rampant lawlessness in Baghdad after U.S. troops captured the capital. "It's untidy, and freedom's untidy, and free people are free to make mistakes and commit crimes and do bad things."

"You go to war with the Army you have, not the Army you might want or wish to have at a later time," Rumsfeld on Dec. 8, 2004 told a U.S. soldier in Kuwait who asked him why U.S. troops had to dig through local landfills for pieces of rusted scrap metal and glass to provide armor for their vehicles before driving into Iraq.

"His regime has large, unaccounted for stockpiles of chemical and biological weapons, including VX, sarin, mustard gas, anthrax, botulism and possibly smallpox. And he has an active program to acquire and develop nuclear weapons," Rumsfeld said on Jan. 20, 2003. Before the Iraq war, Rumsfeld often warned of President Saddam Hussein's arsenal of weapons of mass destruction. None of these were found.

"We know where they are," Rumsfeld said on March 30, 2003 in the days after the Iraq invasion, when asked whether he found it curious U.S. forces had not yet found weapons of mass destruction. They're in the area around Tikrit and Baghdad and east, west, south and north somewhat."

"The Gulf War in the 1990s lasted five days on the ground. I can't tell you if the use of force in Iraq today would last five days, or five weeks or five months. But it certainly isn't going to last any longer than that", Rumsfeld said on Nov. 14, 2002, three months before the invasion.

"Now, you're thinking of Europe as Germany and France. I don't. I think that's old Europe, Rumsfeld said on Jan. 22, 2003.

"It is easier to get into something than to get out of it," Rumsfeld wrote in his published list of truisms known as "Rumsfeld's Rules."

And finally, back in December 2004, Defense Secretary Donald Rumsfeld faced renewed criticism Sunday from lawmakers after he said he has not personally signed letters sent to family members of troops killed in action. That he did not take the time to personally sign these letters demonstrated how he felt about and valued these soldiers and their families. I have one of these letters.

It is long past time for Rumsfeld to go. He failed the troops and he failed this country. GOOD RIDDANCE!

VOTE

Guilty, Guilty, Guilty

Early in the morning of December 15, 2003, when my son, Lt Ken Ballard was stationed in Iraq, he sent me an instant message:

they just got saddam!

Ken told me that the way the soldiers heard the news of Saddam's capture was by the sound of celebratory shooting by the Iraqis. The men from 2-37 of the 1st Armored Division did the manly thing and lit up some cigars!

3 years later, the verdict is finally in on Saddam Hussein today and no one should be surprised. Of course he's guilty for the killing of 148 Shias in Tigris river city of Dujail in 1982; crimes against humanity including premeditated murder, torture and forced deportation. Saddam Hussein is one of the bad guys in this world, one of the worst.

There have been questions whether the end to this long and difficult trial will be a defining moment of the war (no) or whether it will just be another on the long list of horrors and milestones that define the war. The trial which started nearly a year ago, was defined by boycotts, delays, murders, hunger strikes, arrogance, more delays, outbursts and drama.

Earlier this year, back in July, Saddam requested that he be executed by gunfire rather than by hanging if he was found guilty and condemned to die. He said "shooting is the appropriate means of execution for a military man like himself".

Saddam's response to the verdict today? ``Long live the people, down with the traitors,'' Hussein, 69, shouted as the verdict was read out. ``God is great. You are the servants of the occupiers. Long live Iraq.''

George Bush's response? He said Hussein's conviction was a ``major achievement'' for the country's elected government and brought a measure of justice for Hussein's victims.``Saddam Hussein's trial is a milestone in the Iraqi people's efforts to replace the rule of a tyrant with the rule of the law,''

Just 2 days before the US midterm elections, some people have wondered whether the timing was curious. Well, yes, it it is and it is political and the Bush administration who backed the trial was full aware of the timing. If they try to deny it, this will be yet another lie that they have told us about the war.

Be very clear though, that this should not affect our elections here by one single vote. With 2831 US military casualties, nearly 45,000 non- mortal casualties, between 50,000 & 650,000 Iraq casualties (we don't know that number because as General Tommy Franks told us "we don't do body counts"), Saddam Hussein's conviction will be nothing more than a comma when the history of this war and occupation is told. This conviction does not mean that the Republicans are strong on terror any more than it means the Democrats want to cut and run.

Today is just another day in this horrible war. I'm pretty sure the Dujail families aren't having a party or celebrating this "major achievement". What's to celebrate? I'm pretty sure they just want their country back.

Incompetence

Richard Perle, The Prince of Darkness, and one of the architects of the war in Iraq is not my favorite person.

He is one of the signatories of the 1998 PNAC (Project for a New American Century) letter to President Clinton regarding policies in Iraq.

Given the magnitude of the threat, the current policy, which depends for its success upon the steadfastness of our coalition partners and upon the cooperation of Saddam Hussein, is dangerously inadequate. The only acceptable strategy is one that eliminates the possibility that Iraq will be able to use or threaten to use weapons of mass destruction. In the near term, this means a willingness to undertake military action as diplomacy is clearly failing. In the long term, it means removing Saddam Hussein and his regime from power. That now needs to become the aim of American foreign policy.

Don't let anyone tell you that the 2003 war/occupation in Iraq wasn't predetermined. Neoconservatives like Richard L. Armitage, William J. Bennett, John Bolton, William Kristol, Donald Rumsfeld and Paul Wolfowitz also signed the letter.

Richard Perle & I had a close encounter in DC back in May 2006, so I speak of his evil and dark aura on good authority. The man has no soul and he certainly has no compassion. But when someone comes around and admits they are wrong, I'll give them their due- but not much more.
In the November online issue of Vanity Fair, in an article titled Neo Culpa, David Rose interviews several of the war's neoconservative cheerleaders who have turned against the Bush administration using one word- incompetence. He spoke with Perle:

As he looks into my eyes, speaking slowly and with obvious deliberation, Perle is unrecognizable as the confident hawk who, as chairman of the Pentagon's Defense Policy Board Advisory Committee, had invited the exiled Iraqi dissident Ahmad Chalabi to its first meeting after 9/11. "The levels of brutality that we've seen are truly horrifying, and I have to say, I underestimated the depravity," Perle says now, adding that total defeat an American withdrawal that leaves Iraq as an anarchic "failed state is not yet inevitable but is becoming more likely. "And then," says Perle, "you'll get all the mayhem that the world is capable of creating."

According to Perle, who left the Defense Policy Board in 2004, this unfolding catastrophe has a central cause: devastating dysfunction within the administration of President George W. Bush. Perle says, "The decisions did not get made that should have been. They didn't get made in a timely fashion, and the differences were argued out endlessly. At the end of the day, you have to hold the president responsible. I don't think he realized the extent of the opposition within his own administration, and the disloyalty."

Perle goes so far as to say that, if he had his time over, he would not have advocated an invasion of Iraq: "I think if I had been delphic, and had seen where we are today, and people had said, 'Should we go into Iraq?,' I think now I probably would have said, 'No, let's consider other strategies for dealing with the thing that concerns us most, which is Saddam supplying weapons of mass destruction to terrorists.' I don't say that because I no longer believe that Saddam had the capability to produce weapons of mass destruction, or that he was not in contact with terrorists. I believe those two premises were both correct. Could we have managed that threat by means other than a direct military intervention? Well, maybe we could have."

I'm not big on "I told you so's", but I am perplexed at how these supposedly intelligent people with decades of experience could have been so wrong? I'm not going to go there, I hope they still have some influence in this administration to make the necessary changes to the failed policies in Iraq. That doesn't look likely either.

In David Rose's article he also quoted Michael Ledeen, American Enterprise Institute freedom scholar: "Ask yourself who the most powerful people in the White House are. They are women who are in love with the president: Laura [Bush], Condi, Harriet Miers, and Karen Hughes."

ewwwww I don't know whether to cry or throw up. But mostly it's too bad this political hindsight doesn't help the 2829 dead American soldiers and their families who really could have used some champions before the war got started.

(Photo Courtesy of Jim Choi- I didn't remember the hand gestures Perle used when he was speaking at me. Also look at the onlookers expressions. He was responding to my question of why my son, Lt Ken Ballard came home in a flag covered box because of his policies. Perle was not kind to this Gold Star Mom that day)

Question of the Day

Barack Obama asks a good question "Why is it the war on terrorism seems to be fought between September and November every even-numbered year?"

The Price has Been too High

Sen. Allen the Price has Been too High

and you know it!

The Man from Hope Came to our Town

A friend sent me an email on Monday letting me know that former President Bill Clinton was going to be in Stockton, CA campaigning for Congressional candidate, Jerry McNerney that evening. Jerry is running against incumbent Richard Pombo, another Dick, who is one of the most corrupt members of congress. He's bad for the environment and his entire platform and legislative history shows us every reason that this good old boy rancher should be sent back to his old job. When George Bush came to town a few weeks back to campaign for him, no one batted an eye wondering about that team; no one questioned their relationship, Pombo & Bush- they deserve each other, but we don't!

I quickly did a bit of research and found that yes, indeedy, Bill Clinton, #42 President of the good old USA, the Man from Hope, AR was coming to town to bring us progressive types an idea, a feeling that there might be some hope for this country afterall.

I immediately called my friend Gold Star friend, Nadia, Patrick's mom, and told her to call the McNerney campaign office and tell them that we wanted to meet Bill; yes, actually talk to him. Nadia lives in McNerney's district and has done some campaigning for them, so everyone on the staff knows her well. In my naivete I believed that would be able to meet with Bill Clinton. While I have worked on several political campaigns and have plenty of media experience, I guess I really didn't know what I was thinking! Even after we had been at the event for an hour or so, I was still hopeful. But as the rain continued falling along with the temperatures, I decided that the best we could hope for was to be standing in the front row, and that was okay, especially since we were standing in the front row, not more than 10 feet from the speakers platform. We had a great vantage point for this event.

The BIG DEMOCRATIC machine rolled into Stockton Monday evening with 24 hours to prepare for this campaign stop. The warm up acts were Democratic candidates for Lt Governor, John Garamendi; Secretary of State, Deborah Bowen (she's my hero in her firm stand on electronic voting among other issues), Insurance commissioner, Cruz "I lost 70 pounds" Bustamante and a few state level Democratic officials. The headliners were Jerry McNerney & Bill himself. Jerry McNerney knew the spotlight was on him as he introduced the former president to this welcoming crowd.

Bill had started his morning in Memphis, TN, campaigning for Harold Ford, headed to Colorado to campaign for Ed Perlmutter, into San Francisco for a fundraiser that netted over $2 million dollars! They left San Francisco and took a quick jet ride to Stockton Jet Center for this event.

Before I get started and get accused of god knows what as I wax eloquent about Bill Clinton, let's just have some of that full disclosure. William Jefferson Clinton was not the perfect president; he made mistakes, and he admitted them. Mostly our lives were different back in those days late in the 20th century. Different and better. Hope not fear.

Bill's speech tonite was crisp and funny and intelligent and smart and hopeful and honest and compassionate and everything that George Bush is not and will never be. George Bush can not hope to be the man that Bill Clinton is and perhaps that is demonstrated in George's feelings of inadequacy.

He opened with "Thank you for waiting," Clinton said to the roaring crowd. "It may be raining tonight, but the sun will be shining on Tuesday." He covered a lot of territory as he spoke about the war; Clinton took special umbrage at how Bush derisively refers to Democrats as "the party of cut and run." "We're not the cut-and-run crowd, we're the stop-and-think crowd," he said. "We're only too happy to fight, but we want to stop and think first." and the environment, but mostly about the differences between the two parties; although he somehow managed to do that in a positive, not divisive way. He told stories and he told jokes. He was convincing that our country can get back on track to be the county; that we can do better. There was no mention of Kerry's unfortunate gaffe, no 3 word slogans tonite. There was hope and promise for change. In my mind there was nostalgia for a different, more positive time in this country.

As these campaign stops and schedules go, I am sure that Clinton was scheduled to speak for 10 or 15 minutes, but he had barely hit his stride by then and he ended up speaking for more than 40 minutes. Clinton did not disappoint this crowd estimated at 1000.

As Clinton entered the speaking area he shook hands with many in the crowd. At the end of his speech he jumped off the stage to come down to be with the people again; it is what feeds him. Because Nadia & I were front and center, I felt that we would at least get to shake his hand. He did shake our hands and when I told him that we were mothers whose sons were killed in Iraq, he just stopped and we became the most important people in his world for the next 5 minutes. He gave us a genuine hug and someone nearby told me afterwards that he noticed Clinton tearing up. He read Patrick's name on Nadia's button that she wears. I showed him Ken's photo. I told him that we were there to meet a president of our country who really cares about our kids. He told us he was sorry for our loss. His security people seemed to be impatient that he spent this much time with us, but Clinton's time with us showed us where his priorities were. This was a private conversation between 2 moms and a concerned, compassionate former president. (photo courtesy of Jim Choi)

After he hugged us again and moved on to greet the rest of the crowd, people asked us if they could ask what we were talking about and did we know him personally. We explained why we came to the rally and they responded with empathy. Some people nearby had overheard the entire conversation and were also impressed that he had spent that much time with us.

I ask again, what did we do to deserve Bush and his gang in the White House? We can do better by voting for a change on Tuesday. We must do better!

Laura Bush is scheduled to campaign for Pombo later this week. My message to Laura- your husband is not welcome in California and neither are you. Just stay home.

Message from the Medical Front

More news from our modern day Florence Nightingale. I was having a lousy day at work today; lousy as in when people just don't do their jobs so I can do mine. My reality and this message from the front reset my definition of lousy. Nothing is "hard" about my days compared to one day in a Baghdad hospital.

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.

Cost of Freedom Buried in the Ground

Back in 1982, Stephen Stills, of Crosby, Stills, Nash and Young, wrote a song called Daylight Again (lyrics below), a song about the cost of freedom and young dead soldiers.

All the brave soldiers that cannot get older ....

.....do we find the cost of freedom buried in the ground?

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!

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DAYLIGHT AGAIN

Find the Cost of Freedom

(Words and music by Stephen Stills)

Daylight again

Following me to bed

I think about a hundred years ago

How my Fathers bled

I think I see a valley

Covered with bones in blue

All the brave soldiers that cannot get older

Been asking after you

Hear the past a' calling

When everyone's talking and no one

Is listening

How can we decide

Do we find the cost of freedom

Buried in the ground

Mother Earth will swallow you

Lay your body down.

How low can they go?

In a previous post on this blog I wrote about Major General Caldwell's comments from Baghdad about the increasing violence which has resulted in 78 US deaths so far this month. He said it was disheartening. Who can disagree?

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?

Somehow

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,
Kevin Tillman

http://www.truthdig.com/report/item/200601019_after_pats_birthday/
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

Disheartening

I'm in the middle of employee evaluations at work, so when I heard Maj General William Caldwell call the recent rise in violence in Iraq "disheartening" and "In Baghdad, Operation Together Forward has made a difference in the focus areas but has not met our overall expectations in sustaining a reduction in the level of violence, well it got me wondering.

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?

No Time Like the Past

Twilight Zone - No Time Like the Past

Truer words have not been spoken.

Message from a Baghdad hospital

I got another email from our modern day Florence Nightingale direct from Baghdad:

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.

Tonight I am working in the SDU (step down unit). It is a little different from the ICU. The patients here are usually not intubated, or on ventilators. Their medical/surgical issue does not require one on one attention from a nurse or require certain medications to keep them alive. Basically they are doing fairly well on their own they just need frequent monitoring of their vital signs and of their issue to prevent further deterioration in their condition. Usually they stay for a short period of time before they are transferred to a ward. Tonight I have 4 patients. Not bad. :)

This last week was a rough week for me. It is hard to say a rough week without laughing at myself, because I have really only been here for 3 weeks thus far. Plus, the people who have been deployed before keep telling me that things really haven't gotten too crazy yet. I'm afraid of this!

The ICU is my new challenge as I think that I have expressed before. We take care of Iraqi nationals, Iraqi Army, Coalition forces, and US soldiers. Mostly we take care of the Iraqi people which includes suspected insurgents and prisoners. It is a real challenge to care for someone who may have killed, attempted to kill, or injured a fellow brother or sister in the military. It is a topic of discussion amongst my fellow nurses and poses many issues for us. It is my biggest ethical dilemma I have faced in the last 9 years of nursing. I do my best to take care of any patient that comes my way and I work just as hard to keep them alive regardless of who the are.

I took care of a Marine last week which became a difficult challenge for me. Not only was he very injured with an amputation being only one of his injuries, he was, what we call unstable. He had a hard time maintaining his blood pressure , which of course can lead to many other issues. I worked so hard that night from the moment he rolled up on my floor to the next night when I put him on the chopper to send him on his way back to the states. I just hope that all my efforts were enough. He has a difficult and long road ahead of him. After working at Walter Reed for the last 2 years I have seen the new challenges this soldier will face. A soldiers resilience to adapt and overcome the obstacles placed before him is one of the most amazing gifts I have been a witness to.

I get attached to my patients. It is so hard for me not to. As an Army nurse you share a common thread with those soldiers that you care for. They are your brothers and sisters in arms. They fight for freedom and i fight for their life. My battle buddy coined that phrase the other day and I almost broke into tears. It sums up how I feel, how I work, and why I am here.

I also learned about Angel flights this week. Angel fights are the flights where the American soldiers who have died are flown home to their families. I have not been a witness to the actual loading of these great American heroes because it hits a little too close to home for me. I'm not sure that I can quite handle that at this point. I was told about what happens though. The Army song or the Star Spangled banner is played while each soldier is removed from our morgue and hand carried and placed on the helicopter. A salute is rendered to the soldiers on that bird by the hospital staff standing at attention on the helipad. It is a solemn moment. The soldiers from what I understand are flown from us another base and a memorial ceremony is conducted there and then they make their final journey home. Maybe I will find the courage to witness this flight, but for now I will honor those fallen.

I have seen alot this week. I have been exposed to amputation, multiple fractured body parts, gun shot wounds, and a variety of other trauma that I couldn't comprehend until I got here. I am giving medications I have never given before and transfusing blood at a pace unsurpassed in my nursing career. I am working with monitors and equipment I haven't used before. I am using supplies that may not get replaced as quickly as I wish they would. I am making the best of what I have.

On a lighter note, I just want to say thank you for all of you that have been sending me packages. I appreciate them so much. My roomies do to. I love getting mail and you have made going to the mail room exciting for me. Thank you so very much.

Oh and I decided that I would save my little updates and use them in my scrapbook when I get home, so... if any one happened to save my very first email I would appreciate if you could forward me it so that i can print it off and save it.

I guess I will end this here. Let me know if you have any questions or want to know about certain things that I am doing or whatever so I can include them in my next email. I hope all is well with you! Missing everyone.