Monday 15 November 2010

Dr Beths Afghanistan Blog...(A doctors life in the Red and Green life machine..)

D day -1 (getting ready to deploy)

On the eve our mission to get to Bastion, via a number of ‘undisclosed’ stops. Each flight carries the potential of mechanical setback pre and in-flight, and each stop is of undetermined length...I hear there is a daily unpredictable risk that the metal cargo door will expand so much in the heat on the runway that it will not shut, so we sit around until the temperature drops!

As a hospital we have received a glowing green light, at least procedurally; we have a massive conglomeration of personnel from tri-service and multinational (US & UK anyway) backgrounds who have achieved some degree of unity within 72hrs; we just need to ensure this survives contact with the enemy, our enemy being casualties coming through the door. Hard to glean too much about the personalities, strengths and abilities of the staff with whom I will work when we treat fake patients, certainly not my forte. I do hope that they have learnt a little about me though, enough to support my weaknesses and push me where I require it, but enough to know that I will work as hard as is required and remain loyal to them and my patients.

Me, I’m nervous; anxious is probably a better word. Not about my safety (although I do wish people would stop asking that stupid question of my mother, insensitive springs to mind); but anxious about my ability both to do the job as well as I want to, & to cope mentally with the sight of grown men crying or alternatively being more stoic than I am when faced with their own worst nightmare. No point wasting either energy or sleep worrying now though, will deal when it occurs and pack some herbal sleeping tablets since red wine won’t be available to me. It still is though, so here’s to a last Thai meal and a tasty bottle.

3 Weeks into tour...

So how to summarise these first three and a significant 24hrs more - workload massively outstrips my distorted perception of time. It has flown by, some in a semi-wakeful haze, and other images so much more focused; the red amongst so much sandy camouflage; the dark skins of the locals and the cries of a sad series of children surrounded by a bunch of scissor and stethoscope wielding white strangers working in a well practised routine.

Sleep is a luxury, and in my case, jealously guarded from crap, but so often interrupted by necessity or just spending time chatting with both patients and colleagues, even interrupted for exercise; all of which ensure I retain my sanity. Sugar however is no luxury; we are very well looked after for easy snacks foods, much of it care of our embedded US colleagues; the rest by family! My craving is porridge, nuts, protein and anything other than bloody cheese baguettes for lunch; never for such an longtime have I ever been so incarcerated by my vegetarianism! But I have no inclination to give myself any wiggle room; it no longer appeals in any shape or form. Raisin bakes however, I can thoroughly recommend, oh and Clif bars!

An endless row of changing young USMC faces sit facing blue screens behind which sit the unchanging detainees ostensibly awaiting further medical attention until they fit the very high standards set by the US detention facility, being mobile without the aid of crutches seems a high bar to set to a detainee who has a high hindquarter amputation......we await judicial process. Where I was going with this train of thought is that it is those young guards who provide the Clif bars generously, and gorge themselves on the only fast food at Bastion (beside the hospital) pizza. Usually these USMC guards have recently been through the hospital with a minor injury or illness and are given this role as ‘Light Duties’/recovery time; or as one marine told me ‘everyday is one more day i get to keep my legs’. There is no suitable answer to that. The few British guards don’t bring food but they do make cups of tea, generous with their time and smiles instead, the ward staff, in turn, are liberal with their kit-kats.

I had made a few notes for the first few days of this deployment that I thought might spur me into memory of each day and act as sources of inspiration for typing; how wrong, they sound bland as black and white facts. However 1 tale still appeals – the oft quoted communication barrier between the Americans and ourselves; a US surgeon requested in post op notes that the patient who had just been through major bowel surgery should be on a ‘sips and chips regime’, so the nurses obediently fed said patient with the cookhouse chips washed down with sips of water, against their better judgement i hasten to add. Only on ward round, when the patient had wolfed the offered chips down, was it realised that the intent had been chips of ice. The lady in question did however recover very well but lost no weight.

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