January 2011

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This past month has brought many unique learning experiences!  Who know the best supply system the US could help build would require 14 signatures just to get a box of gauze?  Or how about my new friend Saied (above), who weighs an astounding 37 Kg…  No really I weighed him twice and then changed scales (it took me 1 hour just to find another scale…).  His physician told me there was nothing left to do, he couldn’t eat, and transferring him would look bad…  I quickly introduced him to LT Young’s school of integrity and excellence.

Saied is a tough young Afghan.  I am proud to call him a friend.  He was injured 1 year ago in Host province (south of me) and was paralyzed.  He waited 16 days for surgery… Four months ago he came to the National Military Hospital complaining of a swollen abdomen.   He was treated for constipation and sent home.  No studies were done.  3 weeks later his father paid to have an ultrasound done because his son was getting worse…  Diagnosis, complex abdominal abscess.  Surgery was performed draining 2 liters of puss from his abdomen…  So here we are, no central line, no IV feedings (we cant get any here) and Young not taking “No” for an answer.  Today we have tubes for abdominal irrigation, central IV for feeding, and TPN!  Best of all, Saied’s father refers to me as his Son.  He cant remember my name, really pronunciation, so I had him pick an Afghan name.

Saied is a bit of a legend here in Kabul for the US forces.  Every person who comes to the hospital stops to see him.  He has met Generals, Admirals, Captains.  I am still waiting for his autograph…

The high destiny of the individual is to serve rather than rule

I would like to tell you these stories are few and far between, but the level of medical knowledge isn’t very high.  There are some physicians/nurses who are comfortable with the status quo, but others want to be better…  Those people I target and will teach them all I know.

I told one physician the other day, “I treat your Son’’s like they are my Son.  I assure you one day you will need help for your son, and you better hope someone will care for him like he is their own.”  The Afghans are a deeply scarred culture.  30 years of violent war has an effect on people.  Some believe we are leaving this summer, and their fear is the Taliban will be back.  There is no future for the citizens under Taliban rule.

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Every person I speak to has a story of a family member or close friend who has been killed by the Taliban.  Many have been subjected to watching public executions as a young child.  So at times it may appear like they don’t care, but I figure they are just playing the system because they fear creating something that will surely be destroyed.  They must conserve emotion for use in survival.  There are still some who just don’t care, and I pursue them with all my person.  Many of these physicians hate to see me coming down the hall…

If they died it was because it was fate. If they lived it was because you helped, cared and loved.

This past week was a very difficult one as I was caring for 3 young children who had been burned by a kerosine fire.  A three year old (45% burned), five year old (60% burned), and nine year old (28% burned).  They arrived as a routine transfer to the Children’s Hospital who had accepted them.  Once we arrived at the Children’s Hospital care was denied because they were too sick…  That was helpful.  We ended up brining them to NMH, and we are not equipped for children.  Pedi ICU was created.

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Despite hours of effort, monitoring and frequent trips to the ICU the two youngest and smallest children lost their battle.  Myself and this team have had a bit of a hard time with this.  The oldest was transferred to the US hospital in Bagram.  Our team worked tirelessly on this challenge, and we can only pray for the best now.

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