Dr. Eilerman

Here's a picture of me in my office that one of my med techs sent me.

Rain (and Mud) in Afghanistan

So the last two days it has been raining, not hard, but raining pretty much nonstop. I'm sure most of you have heard about the dust around here. You simply can't avoid it. It is everywhere and gets into everything. Well that dust has now turned into mud. Now everything is quite muddy. It makes walking to the DFAC quite an obstacle course. I wouldn't mind so much getting my boots muddy, but most of the time I'm in my gym shoes and PT uniform and I like to avoid wet socks. The back of my PT pants looks like I've been jumping in a mud puddle which, I guess, is not too far from the truth.

Today, however, is quite a beautiful day as beautiful days in Afghanistan go and I have the afternoon off. The best thing about the rain is that it covered the mountains in snow again. We are surrounded, I would guess, three-quarters by mountains. Snow-capped they really are quite beautiful. The is only tainted by the foreground of connexes and MRAP's and tents and wires. I do promise to post pictures soon, now that I've taken some.

As far as the work, not much new. I was involved in the resuscitation of a few new traumas the other day - a bunch of soldiers in an MRAP (mine resistant, ambush protected vehicles) blown up by an IED. The MRAP's do a pretty good job of keeping the guys from getting blown up, but they get rattled around inside the darn things like rag dolls and often come out with some serious spine fractures. I heard someone or some group in Washington is re-evaluating the design. I don't know. These recent traumas came out of it pretty well from what I understand.

That's about it for now. I'm going to sit back and read my Nook at the coffee shop. Not much of a coffee shop really, but I got a free latte today because the guy working the register was a patient I "treated" for the common cold. There are some perks to this job (pun intended).

Irony of being in a war zone

Alright, so I've been a little bad about my postings. I've been meaning to write, especially about the way life is around here.

So supposedly we're in the middle of a war. Thank God I don't see the real action, but I have definitely seen some of the injured from the fighting of which I'd rather (and probably most of you would rather that I) not write about in detail. Nonetheless, I live in a 8 room ply-wood hut that has ducktape insulating the windows and where the walls do not extend to the ceiling between rooms (felted material, rather, keeps our privacy). This is not to complain, because as I've written before, I'm exceedingly grateful for my B-hut room. I wear my holster with a loaded gun around my waist to and from work, walking across large gravel stones that would give anyone tendonitis. You absolutely cannot avoid the dust- everything you own is covered in it, including the everything in the PX. I eat with plastic utensils on disposable cardboard-like trays everyday. Again, I point this out not to complain, but to show the irony that the other day, I walked down to one of the two beauty spa's we have here on base and got my hair highlighted and cut. Apparently at the other beauty salon you can get a massage as well. There are a dozen jewelry and rug shops near the PX and we have two gyms with good equipment and classes. There are poker nights and techno nights, salsa and taekwando classes. You'd have to wonder how we have time to fight a war.

Speaking of life on base, as far as laundry goes, you can take your laundry to a laundry service we have here with about a 3 day turn around time, however, I have heard on good authority that detergent is not used, but rather they use the sanitation cycle (i.e. incredibly hot water). We who work at the hospital are lucky enough to have 3 washers and 8 dryers at our disposal, but it can get very crowded and the wait time can get long. Just about 2 weeks ago, the laundry room was closed because some people weren't following rules. I ended up doing a bunch of my laundry by hand, as I like using soap. The laundry room, thankfully, was re-opened just a few days ago as I was getting to the very end of my clean clothes. If there is one domestic chore I really hate doing, it is laundry, however, I have never been happier to fold my clean dry clothes as I was the other day. Thank the Lord for washers and dryers. I miss my HE W/D that is in storage. So sad.

I usually like to include a patient story or two because often they can be rather humerous, however, I can't say that anything I've seen in the last few days has struck me as something to write about. Okay there was the guy who I saw twice in one day for a cut in his fingers. That morning he'd cut his thumb with his knife- bled pretty good, but it had stopped by the time I saw him and didn't need stitches. Later that afternoon he came back for a laceration on his index finger of the same hand for the same reason. Apparently he'd been using his knife as leverage attempting to pry something open. He was rather embarrassed and I joked about him being one of those cutters (depressive psych disorders) which he obviously wasn't but hadn't learned his lesson the first time. Oh and there was the interesting case of the guy who came in with a "corn" on the bottom of his foot which was wretchedly painful. I started cutting into it and discovered it was more of an epidermal inclusion cyst which our dermatologist finished excising as neither he (the dermatologist) nor I had ever seen one of these things on the foot. I thought the guy was going to cry when he could walk without pain after we were finished. Very satisfying.

Alright, I've babbled enough. If I actually write more frequently I won't forget what I want to write and it won't be as long.

I promise pictures soon. I just need to check OPSEC guidelines.

Random

Can't really think of anything all that interesting to write about from today so a couple random things:

- On a serious, wartime note, I saw a patient the other day who was active duty, but in civilian clothes and beard because he worked with the local nationals, informants to be exact. Said his job wasn't that stressful, but recently one of his informants was captured and tortured by the Taliban by sticking a needle in the pad of his finger then ripping it out perpendicularly. It tore up his fingers pretty bad. Taliban thought he was only working with the Afghan national police. If they had known he'd be talking to us Americans, he would have been killed. Scary stuff. I think I'd be a bit more stressed. Even now, as vague as all that was, no names, places or dates, I wonder if the Taliban would scan blogs to find any information. Obviously OPSEC or operational security is big here.

- On a lighter note, another patient told me today the story of his son getting a tooth stuck in his ear. Instead of putting his first lost baby tooth under the pillow for the tooth fairy, the kid stuck it in his ear. THe parents had no idea, but it wasn't until two and a half years later when he'd been having balance issues and being generally clumsy that the kid was seen by a doctor and the tooth in the ear discovered.

- My last patient of the day today was so one flown in from another FOB with a splinter in her leg. Apparently she'd been sitting on an old wooden picnic table for a picture and just moved the wrong way. The splinter had been there and causing pain for about 5 days, but no one at the FOB wanted to go in to dig it out. You could feel, but not see the darn thing about 1.5 cm in length in her leg. A little lidocaine, a scapel, and about 20 frustrating minutes later I cut a nice little sliver of wood out of her leg. She wanted to save it so we stuck it in a lab tube for travel.

- And one last thing- last Sunday after church the guy sitting in front of me told me I had a beautiful voice. Now those who know me and have heard my singing KNOW the guy must be close to deaf. Dear, dear boy.

That's about all remotely interesting from here. I'll really have to start posting pictures soon.

Just another day a the office

I've been working in the outpatient clinic now for about 4 days. Don't ask me why; it is a bit of a sore subject as I like the work and the interesting patients on the inpatient ward. Nonetheless, there are a few benefits to the clinic- relatively regular hours for one. I also have my own office which is like my second home and another place to keep my belongings (secured). I like the people in the clinic, too. Nothing against surgeons (well only one, but I won't go into that now), but they are usually a bit arrogant and not always personable.

Anyway, today was an interesting smattering of patients. Diagnosis of a ventral hernia, bloody diarrhea, another fake shoulder pain, a wretched case of vertigo (poor guy) and my favorite of the day- thumb pain from accidental morphine injection. ??!! I know. So the story goes that this patient was working in the pharmacy and disposing of outdated medications, one of which was a morphine autoinjector (for the field). This person had never seen one and was curious about how it worked, so holding in her right hand with her thumb on what she thought was the plunger end, she took off what she thought was the needle cap on the other end and POW- a mL of high dose morphine right into the thumb. This was just before Christmas and she thought she was doing okay after her thumb had returned to normal size and the horrible itching all the way up her arm ceased (itching is a side effect of morphine). However, she was still have some significant pain in her thumb and hand. And she comes to me for help. Can't say I've come across this one before. Xrays of thumb were fine. Sent her home on T3's. Think I might have to discuss this one with a few other docs - get a few opinions.

Happy New Year's?

I feel like I've been here for at least 2 weeks and it has barely been one. Half the time I don't know what day or time it is because I've been working the nightshift. I worked New Year's Eve and sadly it was busy. I got a few nontrauma patients- chest pain, appendectomy, two crazies, but we also had a 5 person trauma come in. They were all Canadian Coalition forces who had suffered an IED blast while on convoy. I was actually running one of the resuscitations- basically going through the ABC's of airway, breathing and circulation. My patient was conscience and doing well besides a nice T12 burst fracture - unstable spine fracture- and a L humerus fracture. Not too bad, but it was my first time running my own table. Four of the five ended up coming to the ward (my responsibility) after a thorough evaluation from ortho for their mostly extremity wound/fractures. These guys I just mostly babysit for the 24-48hrs they stay at Bagram- their injuries are mostly surgical and I just make sure they don't crump from any other reason. Sometimes this is easy to do and other times, no so much.

I think at midnight I was in the ER writing admit orders for a guy with purely soft tissue injuries from shrapnel. Someone had gotten some non-alcoholic champagne and we toasted to the new year. Hopefully it will be a good new year. It is predicted to get much busier when the weather starts to warm up. I'm bracing myself for the onslaught, but trying to remind myself of patience and the educational value to this whole experience. I know I will get tired and homesick and frustrated and sad, but I hope to keep focused on my tasks and keep my priorities straight. Only one week in and I know it will be a long 6 months.