FaST Surgeon (in Afghanistan)

Blogging Woes and Facebook Pages

noreply@blogger.com (Joseph Sucher, MD FACS) — Thu, 25 Apr 2013 08:05:00 +0000

MedEvac (DustOff)

I had to abandon the blogging format in favor of Facebook. It wasn't an easy decision, but it was necessary. This post took over 45 minutes just to download and format versus 5 minutes it would have taken on Facebook. Needless to say, it just wasn't a competition where time was involved. I had to make the move.

Litter team prepares to off load MedEvac

Moving on forced a change in the style of my writing, making me focus on a single photo with a very concise narrative. Some may thank the good Lord for this switch, as I've been known to be long-winded. :)

FST and BAS team prepares and evaluates patient prior to entry into FST

Additionally, moving to Facebook has made it easier for people to find this story of Forward Surgical Teams that I've been fortunate to serve with over the past 3 deployments. Each being unique in their personnel and locations. Each deployment has had their ups and downs and every single day I find myself searching for becoming better as a surgeon and as a person.

FST members evaluates trauma patient

I've worked with so many people, and no matter who they are, or what position they held, or how they felt about me or how I felt about them, they all have made a positive impact on me. Yes, for sure there are people who didn't like me or I didn't like them. No matter - as some had good reason not to like me. I learned that I needed to try harder to be better.

FST surgical team performs emergency trauma operation.

I have moved forward (mostly) and the previous deployments have made this deployment successful in most every way. My grandfather told me that you never stop learning. When you're just a 10 year old, that's hard to understand. Heck, it's even hard to understand as a 20 year old. But when your more than double that age, you really start to understand how true that really is. Another great mentor of mine, Dr. James "Red" Duke used to say almost every day - "I've never seen that before". He was over 70 when I heard him say that. I bet he still says it today. But, gosh darn it, he was right also! You never stop seeing something new, as long as you keep your eyes open.

Lieutenant "C" and his famous smile

So, with that all being said. If you haven't come over to see the FaST Surgeon Facebook page, just click the link and check it out. You don't have to sign up to be a Facebook member. You can still check it out and see the photos and commentary. Thank you all. I hope that you see someone you know or get a better understanding of what we do as part of a Forward Army Surgical Team - FaST.

Back in the 'Stan

noreply@blogger.com (Joseph Sucher, MD FACS) — Thu, 21 Feb 2013 03:59:00 +0000

I have arrived. Or so the saying goes. It's cold in Afghanistan and I made it to my final destination just in time before the snow closed the passes. Movement in Afghanistan is limited by weather and terrain. Helicopters need to have clear weather to fly through the mountain passes. So, it's not uncommon to get stuck in a particular location for many days if not weeks during the winter months.

I am still trying to make a final decision on what to write about this go-round and where to post. I may abandon the old blog format and move over to only posting on Facebook. If you haven't yet clicked on the Facebook "Like" button, please do so now. :)

23 SEP 2012 - Video Memories - OEF XII - 94th CSH (FWD)

noreply@blogger.com (FaST Surgeon) — Sun, 23 Sep 2012 20:28:00 +0000

A FaST Surgeon’s Goodbye

noreply@blogger.com (FaST Surgeon) — Sat, 23 Jun 2012 08:30:00 +0000

As the song goes by REO Speedwagon… It’s Time For Me To Fly… It certainly goes by fast. At least it does for me. But in real time, it’s a chunk of life. Just think about 3 months. What do you plan on doing for the next 3 months. How much does your family need you over that time? What about your work? It’s hard on those back home. Now think about a year, because that’s how long the rest of this team spends here. It’s a daunting commitment.

The surgeons are the lucky ones. We do the work that we really love to do and we do it for people who are incredibly deserving of the best care possible. So don’t ever worry about us. We get more back than we could ever put in.

Plus, it’s not all war all the time. We get time to enjoy the finer things in life. Like shooting a SCAR heavy! … that’s what put’s a big smile on my face.

I get to meet really good people. But frankly, we come and go. We’re visitors to the team that stays here for an entire year. The photo above was taken with two providers that were leaving (the middle guys with helmets). Other people will replace me, and the cycle will continue. I’m not the only FaST Surgeon in town.

The medical provider teams out in forward locations can be quite small. We cover 24/7. But there’s enough down time to recover. It’s not much unlike being a fire fighter. There’s tons of time to sit at the fire station. Most fires are readily manageable with the assets that you have. But when the fire rages, it can challenging.

But it’s the team that counts. The surgeons and anesthesia providers are supported by nurses, medics, technicians and administrative staff that make it all possible. I thank the 94th CSH(FWD) for their great leadership and ongoing commitment to providing the best care possible. I thank my former team (the 909th) for giving me a terrific baseline of experience and knowledge, helping me come well prepared for this deployment.

So, with that… I’ll leave you with sunset pictures of FOB Salerno. Let it serve as my metaphorical cowboy ride into the sunset. Let’s all hope that this war comes to a close as soon as possible.

Sewing For Troops–They Need Your Help Now

noreply@blogger.com (FaST Surgeon) — Sat, 23 Jun 2012 06:59:00 +0000

During my 2010 deployment, I came upon quilts (fantastically well made quilts) that were given by our nurses to our wounded soldiers prior to them being evacuated from our FST. As I checked into their origins, I found Linda Swinford. Through the years, Linda and a team of generous and caring people have put in their hard work and time (and money) to make neck coolers, helmet liners, blankets and quilts for our troops. They have had a few names previously associated with them – First, “Operation Helmet Liner”, then “Citizen S.A.M.” … but eventually, Linda and her volunteers had moved on to become “Sewing For Troops” and “Homemakers Extension Association in Benton, IL”. I want us all to at least remember … “SEWING FOR TROOPS” (because it’s easier to remember than HEA in Benton).

Linda was kind enough to get in contact with me again, so as to send quilts, blankets and sheets to us at FOB Salerno. This gave me the opportunity to ask her more about her crew, how they do what they do, and more about the organization. Below is an edited excerpt from an email that she sent to me:

Currently, our "crew" consists of:

1. A group of volunteers who meet at Sandy's Sewing Center in Springfield, IL regularly to make neck coolers and serge around fleece blankets, the latter for our wounded heroes over there. They also make 100% wool neck gators from wool fabric for Special Forces when we have funds to buy the wool. Sandy designed this pattern, and SF loves the gators, as they are versatile for how they wear with helmets.

2. Jules, a Marine in Korea, and his wife LaMoyne who make neck coolers and troop quilts. LaMoyne is my quilting mentor.

3. Joann, in Salem, IL, who knits the wool ski masks (helmetliners) when we have funds to buy the yarn. She does beautiful work and has cranked out hundreds of these to warm our troops outside the wire.

4. After moving down here to Southern Illinois, we started a group of volunteers (Homemakers Extension Association in Benton, IL), who meet monthly to make neck coolers.

5. I work here in our upstairs with about half of the area committed to troops with the big longarm quilting machine, sewing machines, sergers, etc. My role has been to pick up from the various volunteers named above, maintain contact with our deployed troops, and ship to them.

-Linda

Quite frankly, Linda and her group of volunteers could use your help. They have had very little support recently. I surmise that folks around the country simply have grown tired of the war, or just don’t realize that our troops are still out here in the fight every day. This year (reported as of June 22 ,2012), over 1,326 US Service Members have been wounded in action and 108 have been killed in action or have died of their wounds, while serving as part of Operation Enduring Freedom (OEF). In total, 1,583 troops have lost their lives and 16,553 have been wounded in action in OEF.

We are still here, and our country will continue to have troops in harm’s way for the foreseeable future. Take the time, right now, to help Linda and her all volunteer team by making a cash donation. 100% of every donation has gone, and will continue to go, to buy materials or to pay the postage for shipping overseas. In the last 7 or 8 years, they have shipped somewhere between 90,000-100,000 neck coolers, helmet liners, blankets and quilts to our troops. Today they are in need of funding and most certainly appreciate your donation.

You can donate two ways:

1. Send Checks To:

Sewing for Troops

1750 W. Wabash Ave. Suite B

Springfield, IL 62704

2. Those with PayPal accounts can donate via PayPal to sewingfortroops@gmail.com (*PayPal deducts a service fee for donations paid by credit card*).

Please visit their website for more information.

Note: This is a personal request, by me only, and should not be considered endorsed by the US Army, or any agency of the US Government. Sewing For Troops is a small, private, charitable organization. Currently, they have not had the funding to file for a 501(c)3 and therefore your donation may not be tax exempt.

Picture Of The Day–23 Jun 2012 “Whiskey Redux”

noreply@blogger.com (FaST Surgeon) — Sat, 23 Jun 2012 06:12:00 +0000

I’ve previously posted about the 68Whiskey Combat Medic (AKA Health Care Specialist) during my last deployment. That post was focused on the “line” medic, who’s job is dedicated to providing point-of-injury care during the battle. Our medics take on a broader variety of responsibilities. They are integral to the assessment, care and management of our patients from the time they enter the emergency room, to the time that they are evacuated. They obtain IV access and vital signs, assist in evaluation of the patient, and help the surgeons with emergency procedures. The photo above is illustrative of the broader experience that medics can get while attached to an FST or CSH. They can assist in operative procedures and gain further understanding of wounds and their operative management. Finally, they continue to care for the patients in the ICU until their eventual evacuation. Today’s salute is for all the 68W combat medics.

Picture Of The Day–22 JUN 2012 “Boom–Boom”

noreply@blogger.com (FaST Surgeon) — Fri, 22 Jun 2012 05:29:00 +0000

From Wikipedia: The AT4 (also variously AT-4, AT4 CS, AT4-CS, or AT-4CS)^[6] is an 84-mm unguided, portable, single-shot recoilless smoothbore weapon built in Sweden by Saab Bofors Dynamics (previously Bofors Anti-Armour Systems). Saab has had considerable sales success with the AT4, making it one of the most common light anti-tank weapons in the world.

All I really know is that this puppy makes a giant “Boom” followed closely by another farther away “Boom”. It’s impressive.. that’s to say, I walked about 800 meters, still being another 200 meters from the range, and this thing woke me up from a dead sleep. It’s darn loud.

Picture Of The Day–21 JUN 2012 “FEVER”

noreply@blogger.com (FaST Surgeon) — Fri, 22 Jun 2012 05:07:00 +0000

1LT Laura M Walker Army Airfield is located on FOB Salerno. It’s runway is suitable for C-130 missions, giving us the added capability to evacuate critical patients in situations when rotary aircraft aren’t suitable. This may be due to large numbers of patients needing emergent evacuation, or when the weather prevents rotary wing aircraft from flying safely.

When we request fixed wing air evacuation, this comes to us as an Air Force C-130, under the callsign “FEVER”. The airframe provides significantly more space than a UH-60 Blackhawk, thus allowing for more medical crew to tend to patients. This medical team can consist of physicians, nurses and medics, giving them the ability to provide the a high level of attention during the flight. Finally, the C-130 has a speed advantage over rotary evacuation, cutting the time from Salerno to Bagram in half.

Picture Of The Day–20 JUN 2012 “Evac”

noreply@blogger.com (FaST Surgeon) — Fri, 22 Jun 2012 04:42:00 +0000

Evacuation of critical patients is a complex task that requires significant resources and logistics. It’s a huge team effort that reaches across a multitude of lines. Coordination occurs across the country, because patients are moving to and from multiple locations simultaneously. It’s easy to think that you’re the only fish in the pond…. but the pond is an ocean and there’s a lot of other fish out there doing the same thing we’re doing at the same time.

Picture Of The Day–19 JUN 2012 “We Stand Ready”

noreply@blogger.com (FaST Surgeon) — Fri, 22 Jun 2012 04:34:00 +0000

Our mission is straightforward. We’re here for the troops. There’s no better mission.

Picture Of The Day–18 JUN 2012 “Seconds Count”

noreply@blogger.com (FaST Surgeon) — Mon, 18 Jun 2012 18:54:00 +0000

When someone is seriously injured or wounded, the troops call for a DustOff. This ignites a series of events that is time critical. Overhead, the loud-speakers on the FOB (AKA “The Giant Voice”), announce an emergency code for the crew. In a split second they literally stop whatever they are doing and run at a flat out sprint to the birds. The engines are started, and the rotors begin to turn. Grid coordinates and mission essential information is transmitted. Within 10 minutes (and more often less), the team is ready to launch. This is the standard that they hold, and the team here takes serious pride in beating the standard every time.

Picture(s) Of The Day–17 JUN 2012 “Nose Art”

noreply@blogger.com (FaST Surgeon) — Sun, 17 Jun 2012 19:40:00 +0000

You really can’t get enough nose art these days. In fact, this is the only place where I’ve been lucky enough to come upon any airframe with some good, WWII type, nose art. Frankly, I hope to see more. To me, it’s nostalgic and morale boosting all at the same time. So, I present to you a few shots from Chinooks here at FOB Salerno.

Picture Of The Day–16 JUN 2012 “Tinker Bell”

noreply@blogger.com (FaST Surgeon) — Sat, 16 Jun 2012 17:54:00 +0000

We do all that we can to give our troops the best care possible, even down to the sheets on our hospital beds. The Tinker Bell bed is my personal favorite. Others include Spider Man, Star Wars, GI Joe, and others. But come on…. who wouldn’t want to be tucked in with Tink?

Picture Of The Day–15 JUN 2012 “Damn Hot”

noreply@blogger.com (FaST Surgeon) — Fri, 15 Jun 2012 17:35:00 +0000

The days in Khowst, Afghanistan start early with the sunrise around 04:40 and end with the sunset just around 19:00. The weather patterns are seemingly unpredictable, with days that are sweltering and others that are mild, while still others are dusty, windy and cloudy. It’s all over the weather map – so to speak. But mostly it’s just damn hot :).

Picture Of The Day–14 JUN 2012 “Fire”

noreply@blogger.com (FaST Surgeon) — Thu, 14 Jun 2012 17:21:00 +0000

Well, you just never know what you’re going to see when you go to war. But there’s definitely one thing that you wouldn’t expect… and that’s a big red fire truck, complete with firemen. Yuppers, this FOB has been around for more than a decade and like others it’s size, it has buildings. Where there’s buildings, there’s the potential for fires. So, where there’s fire, there must be firemen.

Even more surprising was to have firemen deliver patients from an accident on the FOB. These guys were all kitted out with full-on fire gear… and it was hotter than heck outside. I don’t know how these guys didn’t drop in front of us from heat exhaustion. Well… you just never know what you’re going to see from day-to-day on the FOB. :)

Picture Of The Day–13 JUN 2012 “Faster Than Death”

noreply@blogger.com (FaST Surgeon) — Wed, 13 Jun 2012 07:24:00 +0000

So goes the motto on a flight medic’s t-shirt. It’s quite fitting. Emergent evacuation from point of injury focuses more on speed and less on treatment. While our flight medics possess advanced medical talents, they also know that there is only so much that can be accomplished on the dirt and under fire, and the best way to save lives is to get them off the battlefield as quick as possible, and to a safe place where we have the tools needed for more definitive stabilization and care. This has given our troops more than a 96% survival rate after they arrive to a Forward Surgical Team. So, quite frankly, MedEvacs are….. “Faster Than Death”.

Picture Of The Day–12 JUN 2012 “Bam Bam”

noreply@blogger.com (FaST Surgeon) — Tue, 12 Jun 2012 02:17:00 +0000

1-17 Cav (Air) – 82d Airborne flies the venerable OH-58 Kiowa Warrior in Khost, Afghanistan. This scout helicopter, also known as “Bam Bam”, can deliver deadly accurate fire in support of ground operations. The ground pounders love ‘em because they fly nap-of-the-earth (so close to the ground you can darn near give them a high-five). I love ‘em because they take care of our guys on the ground (and because I used to be a dirt eatin’ cav scout in my much younger years). Scouts Out!

Picture Of The Day–11 JUN 2012 “Night Life”

noreply@blogger.com (FaST Surgeon) — Tue, 12 Jun 2012 01:13:00 +0000

I’m still working on the night photography. I think I’ve got a ways to go and a bunch to read. But no time.. it’s busy and I am falling behind in my posts. This one is a bit late, so I will take this early morning wake up time and get to the next one now.

Picture Of The Day–10 JUN 2012 “Laser”

noreply@blogger.com (FaST Surgeon) — Sun, 10 Jun 2012 12:36:00 +0000

I’m still trying to experiment with night time photography. It’s been a bit of a challenge. On this full moon night, we went up to the roof and took a cigar break with “the guys” (gals are invited, but don’t seem to show up). Anyhow, this shot was a 10 second shutter, with a full moon in the sky, and I took a stroll with my green night light across the frame. This exposure gave my light a laser-like appearance. It was just pure luck that I bobbed upward across each persons’ heads.

Picture Of The Day–09 JUN 2012 “Papa”

noreply@blogger.com (FaST Surgeon) — Sun, 10 Jun 2012 12:30:00 +0000

The Army’s 68 Papa (Xray technician) is a vital part of our medical team. They bring a breadth of experience from plain film xray techniques to real-time fluoroscopy in the operating room (picture above). Job training for a radiology specialist requires 10 weeks of Basic Combat Training and 24 weeks of Advanced Individual Training, including practice with radiological equipment. Our techs are fantastic. They continually strive to provide us optimal imaging so that we surgeons have the best information attainable to better take care of our patients. It’s a demanding job out here, and they have to be ready 24/7. We salute the 68P’s today!

Picture Of The Day–08 JUN 2012 “Best Seat On The House”

noreply@blogger.com (FaST Surgeon) — Fri, 08 Jun 2012 13:46:00 +0000

They say it’s the little things that make a difference. Like having an opportunity to just find a place to relax by yourself and have a good view to boot. There’s a set of stairs that gets you to the roof of the hospital. If the helicopters aren’t landing or spinning their rotors, then it can be a really quiet place to get some peace and quiet. I use it fairly often. Sometimes we go up there for a morning cup of coffee, or every once in a while at night for a cigar before bed (you have to have a vice while out on deployment).

Picture Of The Day–07 JUN 2012 “Myna”

noreply@blogger.com (FaST Surgeon) — Fri, 08 Jun 2012 01:56:00 +0000

You can’t go anywhere on Salerno without seeing (and certainly without hearing) a Myna bird. I took the time to research this bird in the great Oracle – Wikipedia. - The mynah or myna is a bird of the starling family (Sturnidae). This is a group of passerine birds which occur naturally only in southern and eastern Asia. Especially North India. Several species have been introduced to areas like North America, Australia, South Africa and New Zealand, especially the Common Myna which is often regarded as an invasive species. “Myna" is derived from the Hindi language mainā which itself is derived from Sanskrit madanā.

Reference: Wikipedia - Myna

The Hardest Working Lizards In Afghanistan

noreply@blogger.com (FaST Surgeon) — Thu, 07 Jun 2012 07:14:00 +0000

FOB Salerno has a little more wildlife than my last deployment location (FOB Shank). This place teems with birds, bats and monitor lizards (and apparently camel spiders and Sind Krait snakes… but I have yet to see any). The funny thing is that the birds don’t like the lizards at all. It’s not uncommon to see birds swooping in and attacking a monitor lizard (they never seem to do any harm, but the lizards run like heck from the aerial attacks).

The monitor lizards around here are Bengal monitors (common Indian monitor) and seem to be somewhere on the average of 3 feet long. They can grow to be around 5 foot 9 inches long and can give you a good scare if you happen upon them at night. However, they’re rather harmless reptiles. They aren’t venomous, and they want nothing to do with humans.

This poor fella (I guess it’s a fella) was being harassed by the birds and couldn’t seem to find his way to the other side of the fence. He likely lives underneath the connex’s by the helicopters. This guy proved he wasn’t the brightest of beasts, as he spent about 30 minutes trying to poke his way through the openings of the chain link fence. Unfortunately, his girth was simply to great to allow him passage through the fence line.

So after capturing some glamour shots, we decided to help the poor beast out and give him a little direction. After LTC M gave him her patented “do what I tell you, or I will rip out your heart” stare; giving him just the guidance he needed to make the right choice and turn towards the gate opening. MAJ W used a more gentle approach and gently talked him through the final 15 feet of fence line. He made his escape just before a bird swooped in to give him a “don’t let the door hit you in the ass” dive (see video below).

FOB Salerno Bengal Lizard Finds Freedom (but not before a bird gets in his last harassing dive).

Picture Of The Day–06 JUN 2012 “Got Blood?”

noreply@blogger.com (FaST Surgeon) — Wed, 06 Jun 2012 11:49:00 +0000

The Army’s Medical Laboratory Specialists (68 Kilo) perform a variety of duties, including blood component and chemistry analysis, in addition to blood collection, bank and distribution responsibilities. Their work is never done on a busy FOB. 24/7, SSGT C and SGT V are available to ensure expedient analysis of blood specimens for all emergencies. They also maintain, check and recheck the blood bank that we have at FOB Salerno. As you might imagine, this is a critical component to the rapid care we provide for our wounded. Thanks to her, and all the blood donors back home. Her work and your volunteer donations are life savers – literally.

Picture Of The Day–05 JUN 2012 “Deltas”

noreply@blogger.com (FaST Surgeon) — Tue, 05 Jun 2012 18:18:00 +0000

The Army Physician Assistants (65Deltas) are more than just an “assist”. They provide patient care alongside physicians, AND they are responsible for a significant amount of direct medical care for our soldiers, not only within medical facilities, but also far forward in the battlespace (eg battalion aid stations). In other words, they take on a great burden of medical care throughout the war theater.

These providers are organically imbedded within the brigade combat teams – that’s different than Army Reserve surgeons like me, who are “spare parts”… They just plug me into wherever they need me - Such as an FST (Forward Surgical Team) or a CSH (Combat Support Hospital), or something larger, like Walter Reed. The PA’s that I work with in theater, are part of the brigade and take ownership of their teammates, almost like they’re their children. They’re great professionals with a tough job. FaST Surgeon salutes all our 65 Deltas!