Tag Archives: dustoff

Going to War: Life at TQ, Chuck Norris Visits and Mass Casualties

While we prepared for our first mission we adjusted to what life was like on a large airbase and logistics hub. Ta Qaddum is one of the larger Iraq Air Force bases from Saddam’s time but has a history going back to the old Royal Air Force base at Habbinyah which is just down the hill.  In 1941 the Iraqi Army laid siege to the British forces in Habbinyah from the escarpment that overlooks the town from what is now the northern edge of TQ.  One only has to imagine the feelings of the Iraqi soldiers short on supply and exposed to air attack on the escarpment while waiting for German intervention only to be driven off by the British when their relief force arrived from Jordan.

iraqi bomber at tqWrecked Iraqi Bomber at TQ

The Iraqi legacy on the base looms in some of the infrastructure as well as the hulks of Soviet made Iraqi Air Force bomber and fighter aircraft near the edge of the airfield.  When I was there in 2007-2008 the base was under the command of the 2nd Marine Logistics Group or 2nd MLG.  The MLG is a command and control headquarters for logistics support units of the 2nd Marine Expeditionary Force.  It is tailored to support the Ground Combat Element, the 2nd Marine Division and the Air Combat Element, the 2nd Marine Air Wing and attached units.  Its function is similar to an Army Corps Support Command or whatever the Army calls them now.  TQ was also the home of several helicopter squadrons Marine and Army as well as a local defense force at the time made up of the 1st Battalion 11th Marines from Camp Pendleton. 1/11 was an artillery battalion but was being primarily used as a security and convoy protection force.  Other units including Navy Seabees and Army logistics units operated from TQ.  A Marine Infantry Battalion was stationed in Habbinyah while elements of a Marine Expeditionary Unit (MEU) were operating in the area as part of the surge.

The base is about mid-range on the amenity scale for troop comfort. At the time we were there the only non-DFAC/ Chow Hall was the Green Beans Coffee trailer as opposed to places like Al Asad and Camp Victory which had a multiplicity of fast food places for the troops.  The Marines are tougher on communication security than the Army and many websites which troops could use on other bases were unavailable unless one went to the Iraqi internet café or the MWR computer and phone center.  The Iraqi run shop had the fastest internet on the base but you had to contend with huge amounts of second hand smoke and pay a nominal charge to use it.  The MWR facility often had broken machines, had a waiting list to use them and the connections were very poor with pages slower to load that the old dial up days.  On the plus side TQ did have a relatively decent Marine Corps exchange, not as big as Al Asad or Camp Victory, but one of the larger exchanges in Iraq and second only to Al Asad in the West.  Most places including Ramadi had pretty small and not well stocked exchanges.  TQ had nice fitness center facilities which I used a lot being coached by Nelson.

060Chaplains and RPs with Chuck Norris

The base MWR worked with the USO and other agencies to bring sports stars or celebrities to the base.  Just before we left on our first mission Chuck Norris came through.  Chuck was made an “Honorary Marine” a few years back and has made it his task to try to meet every Marine deployed in Iraq and Afghanistan, shaking the hand of each one he met.  The chapel was the host facility for the visit which last about 2 hours in which Chuck pressed the flesh and had his picture taken with probably close to 5000 Marines and other personnel, maybe more.  The Chaplains were drafted to be the photographers and I lost count of how many different types of digital cameras that I took pictures with.  Chuck enjoyed the heck out of Nelson and was impressed with his fighting resume.  I think that Nelson got more face time with Chuck than anyone on the base and he deserved it.  Chuck was accompanied by Chaplain Langston and RP1 Roland our friend from Fallujah.  After they were done he had to get on the waiting helo and fly out to his next stop.

058Chuck and Nelson

The chow halls, of which there were two, were large and usually had a pretty good menu.  I especially came to like the Indian nights where Indian specialties were served.  Since many of the cooks employed by Gulf Catering who had the contract were Indian, Pakistani, Bangladeshi or from Ceylon so it generally was pretty good unless they had to scrounge for suitable ingredients.  I like the curry chicken, but occasionally it was made with chicken nuggets when the real chicken was in short supply.  It almost reminded me of the Spam Lamb in the TV series M*A*S*H or the great quote out of the movie Meatballs: “Attention. Here’s an update on tonight’s dinner. It was veal. I repeat, veal. The winner of tonight’s mystery meat contest is Jeffrey Corbin who guessed “some kind of beef.”   I think that there were a number of times when I really wondered what the meat was.  They usually had a pretty good salad bar unless resupply convoys were interrupted and fresh vegetables had run out.  There were a number of times where the pickins were slim and Nelson and I had to get creative.  Breakfast was usually good with a good choice of food choices, some even healthy.  The workers were great, always friendly despite working 12 hour days 6 days a week for $300 a month.  Many had signed up through agencies which cost them $4000 so the first year that many worked was for nothing.  It was in my opinion a case of a KBR/ Halliburton subcontractor using them in effect as indentured servants and pretty well damned close to slaves, all legal by the US Government.  I thought that it was pretty immoral and certainly a case of a company contracted by the government reducing labor costs on the back of some of the poorest people in the world. Back at the end of the Cold War the military downsized and eliminated most of the Army and Marine mess specialists which paved the way for the contracting industry, led by the former Secretary of Defense and his Halliburton team to begin their massive contracting operations with the Bosnia deployments back in 1995.  They were limited to their own compound far away from anything and were always the last to eat.  They were polite and really tried to accommodate sometimes rude and condescending Americans, the local management did the best they could to give them good accommodations but were limited by their parent company.  Many of the workers were Roman Catholic or Anglican Christians  and Fr Jose had a great ministry that he took on to support them by going to their camp a couple of times a week to celebrate Mass.  His masses were packed and what a source of life and the love of God he was to so many people at TQ, Americans and non-Americans alike.

988Fr Jose on the bank of the Euphrates at Habbinyah

About a week after we got to TQ Marines from the battalion in Habbinyah were hit in an IED complex ambush while on patrol.  A couple of vehicles were hit, Jose was across the base celebrating Mass and Pat was in Fallujah.  A chaplain was needed in the Shock Surgical Trauma Unit or SSTP.  Wounded were being brought in, the platoon had been hit hard, 14 wounded and a couple killed.  I figured that since I was a pretty experienced trauma and critical care chaplain who had dealt with over 500 deaths, many traumatic with bullet wounds, burns and the host of other types of trauma, and tended to probably twice that many who did not die that I could handle this.  When I got to the SSTP I was greeted by a couple of nurses and docs and briefed as to what was going on.  Within a few minutes the casualties were beginning to roll in as the UH-60 Dust-off MEDIVAC helicopters landed and teams went out to meet them.  Some were ambulatory, or walking wounded bandaged with lacerations and burns on their faces and upper bodies, other were brought in on stretchers and ushered into the treatment beds in the area outside the OR.  It was like a scene out of M*A*S*H as the well honed surgical teams, surgeons, anesthetists, nurses and corpsmen went to work.  I now work with a number of these fine people. I was able to make my way about to the wounded Marines, praying with some, holding hands as and with a couple performing the sacrament of healing, or the anointing of the sick.  As I listen to Marines, prayed with them or anointed them there was a tremendous sense that this was different than what I did at Parkland or Cabell-Huntington.  These young men wore the same uniform that I wore, served the same country that I served and travelled the same roads that I would soon be on.  As each was assessed and moved off to surgery, prepared for further evacuation or treated and sent to a ward I noticed the little things about each of them.  The wounds, the torn uniforms, the burns and even the tattoos, these were our guys, they weren’t gang bangers or criminals but young Americans fighting a brutal war against a enemy that had terrorized Iraqis and found devastating ways to kill Americans.  Some of the Marines asked if they would be okay, others asked about friends and in those moments I learned what it was to care and be with men traumatized by the violence and brutality of war against an enemy that would not fight by our rules, much as the North Vietnamese and Viet Cong refused to fight our war.  The enemy was clever and determined and his weapons were deadly.

Stars and Stripes sstpTQ Surgical During Mass Casualty Event (Stars and Stripes Photo)

The teams did their work quickly and soon the event in the ER was done as the Marines were moved off to OR, the ward or further evacuation. I spent some time talking with unit Corpsmen and less wounded Marines and learned about the attack. They were in a convoy heading back to Habbinyah when the there was an enemy contact ahead of them.  As they moved forward to engage a primary and secondary IED hit the convoy heavily damaging two trucks with an ensuing firefight.  The Marines fought off their attackers, the wounded were treated and security set up as Dust-off came in to evacuate the wounded.  I thought back to my days as a Medical Service Corps Officer in the Army and remembered my friends who had elected to apply for flight school to become Dust-off pilots.  I remembered learning to call in MEDIVAC missions and some of the Army MSC aviators that I knew; some had flown in Vietnam, being a Dustoff pilot can be a sporty occupation.  They fly an unarmed bird into hot landing zones and get badly wounded troops to medical facilities in 100 degree plus weather without killing them enroute, those guys are good. As the crowd dissipated I spend so time with some of the staff.  Eventually with night having fallen I began the walk back to my office in the Chapel.  I looked up at the night sky, in the darkness a another UH-60 sat down to pick up others being evacuated on to Baghdad or Balad.  I looked up at the sky and saw more stars than I had seen at any time since I was at sea on the USS HUE CITY.  It was amazing; it looked like you could almost walk across them from horizon to horizon. When I got to my office I checked on my our mission status, I had submitted our first Air Support Request earlier in the day, of course it had not moved yet, but at least it gave me something to do.  I checked my unclassified e-mail and knew that there was nothing that I could share with anyone so I looked at baseball scores, checked a couple of news sites and headed off to my “can.”

medivacPackaging a Casualty for Further Evacuation on the TQ Surgical Pad

That night I did not sleep well, the images of the wounded Marines were burned into my mind; I could see their faces, their wounds and their tattoos.  I prayed the office of Compline from the Book of Common Prayer using Psalm 91 and the prayer “Be our light in the darkness, O Lord, and in your great mercy defend us from all perils and dangers of this night; for the love of your only Son, our Savior Jesus Christ.  Amen.” I took some comfort in this, walked out again into the night to see illumination rounds in the vicinity of Habbinyah and the distant sound of automatic weapons fire.   For once my insomnia was not related to jet lag or exhausting night flights, it was instead a realization that what happened to these Marines could well happen to me as I we launched later in the week.

The next morning another eight or ten Marines from the same company came in, this time I went to the SSTP with Jose and we did a tag team match, we tried to determine religious affiliation of the wounded Marines with him taking the Roman Catholics to provide sacramental needs and me taking the rest.  Once again the images were vivid; these Marines were on a mission to recover the damaged vehicles and were hit by IEDs on their way back to base.  This time one Marine was killed.  I walked to the graves registration and mortuary affairs team with the battalion surgeon and a corpsman who were to identify the body.  I listened to their frustration and heartache as they described what they had been through the past two days.  The company had taken over 20 casualties including 3 dead.  A high percentage of casualties for a unit that probably numbered about 120 men.  Once again I walked back, this time in the hot mid-morning sun with Jose to the Chapel.  We talked for a while about the past two days, he knew the battalion that had been hit well as he supported them as well.  The surgeon was one of his parishioners.  After we went our separate ways I did my morning prayer and settled in to study more about where we were going.  Nelson and I got PT later in the evening and I spent a restless night in my “can” playing computer Maj-Jong and Chess on my laptop deep into the morning.  Once again I spent time walking in the dark looking at the vast sea of stars above me.

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Going to War: Building Blocks for Success at TQ

Note: This is the latest chapter of my “Going to War” series which documents my deployment with RP2 Nelson Lebron to serve as the Religious Support Team for all advisors in Al Anbar Province.  Previous posts of this series are located in the “Tour in Iraq” link in the topics section on the left hand column of the website.  If you have friends or family who are serving in Iraq or Afghanistan and a little bit of an idea of what they might be experiencing or might have experienced feel free to read and share.  Peace and Blessings, Steve+

tq vew from airTQ: The Chow Hall is on the Right

It was about 0400 when I got to sleep after our flight to TQ.  About 0900 I woke up with the sun shining through the small holes in the metal shade over the window of my can.  I was still pretty groggy when I got up, went and got another shower just to try to wake up.  Even at 0900 it was close to 100 degrees and the sun beat down on me as I walked the 100-150 yards to the shower trailers in my PT gear.  After waking up and getting myself together I knocked on Nelson’s door and woke him up.  Nelson looked pretty beat as well and after this I walked over to the only non-military food outlet the “Green Beans Coffee” trailer and got me some coffee before I walked over to the Chapel.  The Green Bean is interesting; a couple of guys from California started with one store in Saudi Arabia and now is located around the world with U.S. Forces.  They have a program to buy a cup of Joe for a Joe.”  The company website is here: http://www.greenbeanscoffee.com/ now I have to admit I never got a free cup but it was good coffee.

I kind of surveyed the area.  My “can” was located not far from the chapel, the gym and MWR facilities.  A bit down the way a hundred and fifty yards or so was the Marine Corps exchange which though not bad was often like shopping in East Germany, long lines and limited quantities of merchandise.  If you needed something and waited to buy it there was a strong likelihood that the exchange would not have it on your next trip.  About 400 years past the exchange was the main chow hall which was pretty large and covered with a canopy designed to cause high explosive shells from rockets or mortars to burst before they could penetrate the roof of the actual facility.  The chow hall was staffed by contractors, mostly workers from the Indian subcontinent of Sri Lanka and like other areas inside the perimeter guarded by a contracted Ugandan security force.

I walked over to the Chapel and was met by RP1 who introduced me to Fr Jose Bautista Rojas, the Group Catholic Chaplain and the Apostle of TQ.  Jose and I instantly hit it off.  He is out of Los Angeles and really has a good way with people.  On his first tour and first deployment he was having a huge impact around the base.  His support and prayers would be greatly appreciated by me and by Judy in the coming months.  Not long afterward, Chaplain Pat McLaughlin came in after a meeting.  Pat was a fairly newly promoted Commander who was the 2nd Marine Logistics Group Chaplain and was on his second one year tour in Iraq.  He had previously served as the Chaplain at Camp David.  He immediately gave us his full support and put his staff to work helping us get settled and to link us up with all the support staff that we would need to conduct operations. Without this our tour would have never have had the success that we had.

05_Flatbed_1 - NOVEMBERSouthwest Asia Huts or SWA Huts at TQ I stayed in one of these at the end of my tour

TQ was a major air and logistics hub perfectly suited to operate from to support advisers around the entirety of the province.  We had access to rotor and fixed wing aviation assets, excellent telephone and internet, secure and non-secure access, a place to call home and excellent support.  This is critical when you are operating independently and supporting multiple organizations.   Other Army Chaplain teams had gone into areas where they were given little or no support by the Army teams that they supported.  Unfortunately from a chaplain perspective the talk that I heard had more to do with the Army Chaplains than the units that they supported.  Part of the problem was that most of the Army teams were reservists with minimal training or preparation for a mission type that they were never taught about in chaplain School.   I know of a Navy Chaplain with Marine experience who had no significant problems when he was placed with an Army division level team in Mosel. There were probably a number of reasons for this, and to be charitable I will chalk it up to lack of experience, but lack of support was something that we never had to face.

Lebron, Bautista, McLaughlin, Dundas 2A Great Team: Nelson, Jose, Pat and Me…Pat and Jose helped us tremendously

Within days we had our “operations center” set up in an office in the back of the Plywood Parish chapel. The office had a somewhat auspicious history having taken a hit by a rocket or mortar earlier in the year, a shot that had also made a mess of the drums and other musical instruments of the chapel praise team.  The chapel was kind of a ramshackle affair but had some interesting touches mostly donated by the military personnel to include doors which had been made with care and donated.  Part of getting it together was having phone and internet cables run to the office.  The communications people made this happen quickly and they also got our elderly computers set up and loaded with all that we would need to operate on the secure and non-secure side the house.  I think that we were one of the few ministry teams lower than Regiment or BCT level to have the communications suite that we had been provided.  Likewise the G-3 Air section at the MLG headquarters gave us tremendous support and quickly got us the ability to plan and submit our own air mission requests.

The information that Luke Fabiunke had provided me back at Fallujah now became a gold mine to begin operations.  It was an amazing amount of information, not all current but the situation with adviser teams was always fluid and subject to change based on operational considerations.  There were phone numbers, secure and no secure e-mail contacts for key leaders.  Once we had our communications up the communication began with teams across the province and our calendar was rapidly filled.  The only “glunk” that we had in this was with the senior adviser for one of the Military Training Teams in our local area.  Though his staff and subordinate unit team chiefs were happy for our arrival he for all intents and purposes froze us out of his area.  That did not keep me from continuing to build relationships with some of his people which paid dividends later.  I think that sometimes some chaplains are intimidated by people who rebuff their honest and well meaning efforts to provide support.  I don’t work that way and will constantly work whatever angle I need to in order to get the mission done.  In order not to burn bridges I usually use a slow and patient approach to continually work to build relationships with those in charge of the units that I serve.  It really is an indirect approach.  If I can’t get in one place I put it on the back burner without burning the bridge.  I then work with all the other teams that I can and get out among people.  As we did this “back doors” to ministry opened with teams where we had been locked out of before as they contacted us to get support.  So I did not give up on these local teams but reached out to the furthest reaches of the province with the teams of the 7th Iraqi Division and the 2nd Border Brigade with its Border units and Port of Entry teams.  The senior advisers of these units, Colonel Cottrell and Lieutenant Colonel Bien gave me absolute freedom to coordinate with their teams and opened doors that were never shut.

As we prepared for our mission the first few days were days of acclimatization to the base and to finally recover from the long road in.  One of the first things that we noticed was the pall cast over the mood of the camp by the crash of the Army CH-47 the day of our arrival.  The chapel was being rigged by the staff for the memorial service for the five Army aviators, all of who were significantly younger than me.  The Army was in charge of the service so except for the set up of the chapel and other miscellaneous administrative support.  It is a sobering thing to come into your base of operations and see the set up for five men who died in service of their country.  To look at their pictures and to read their biographies was humbling; one was on his last enlistment before retirement others at different points of their careers, all left behind families, friends and their fellow soldiers who did not know if the bird went  down to mechanical failure or hostile action.   This was in no small way lost on me as we would fly many missions with the men and women of this Army squadron.

Nelson and I worked hard that first day and thereafter to get set up for our first missions.  While I worked the big picture parts of the mission he took care of the little thinks that ensured our success.  Working with Pat, Jose and RP1 he became a key part of the team whenever we were not traveling.

That evening we went to dinner at the chow hall and took in some PT.  Following that I went back to my can where I continued to unpack and make the place somewhere that I could relax.  Though still exceptionally tired from the trip I had a difficult time getting to sleep between my own anxiety the din of UH-60 Army Medivac choppers coming in and out of the LZ for the Shock, Surgery and Trauma Platoon.  Not able to sleep I walked out of my can where I saw the sky light up to our north near Habbinyah with illumination rounds while outgoing artillery sent rounds somewhere into the night and small arms fire could be heard nearby.  A number of Marine and Navy officers gathered near me as we watched the display and talked among ourselves as we wondered what was going on.  Eventually I would get to sleep, but it was very late, that night I found the Office of Compline to be of great comfort, especially this collect.

“Be our light in the darkness, O Lord, and in your great mercy defend us from all perils and dangers of this night; for the love of your only Son, our Savior Jesus Christ.  Amen.”

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The Art and Science of Staying Awake and Going to Sleep When You Have PTSD

“The blood level in my caffeine is getting too high” Woody Paige on ESPN’s Around the Horn

opus coffeeToday: 3 24 Ounce Cups of Southern Pecan Coffee with French Vanilla Creamer and Splenda

Which came first the chicken or the Egg McMuffin?  That is the type of life I have when it comes to a little thing that you never notice until you can’t do it…something called sleep.  Today is one of those days where the inner Chinese kids, Yin and Yang are trying to get themselves into some kind of equilibrium, or maybe even equilibriumnumnum after a pretty rough week and a night on call at the medical center.  As usual my insomnia and anxiety have joined their ever loving hands together to ensure that I have had less than optimal sleep.  Yesterday’s on call duty and that of last night was fairly relaxed.  I had my new residents with me getting oriented to pulling duty and I have to say they are a fun bunch. We have two Americans and two Canadians all with great senses of humor and all who have had some kind of combat tour.   I actually like being around them which I cannot say of everyone that I have worked with in 28 plus years in the military.  They are a joy.  Likewise I love being around the hospital staff doing my rounds at night and to top things off there were no tragedies.

This being said I still could not get to sleep last night which kind of tops off a week of crappy or too little sleep.  Love them or leave them crappy or insufficient sleep over a long period of time beat the hell out of you.  I know, it has me and to make an astute observation it makes me tired.

My battles with insomnia began about a third of the way into my Iraq tour. When we came back from a mission I would go to my “Can” and just sit awake either reading, playing chess on my computer or going out and watching the Dustoff helicopters coming in and out of the Surgical Shock Trauma Platoon helipad or looking off to the perimeter to see illumination rounds lighting up the night sky and hearing occasional gunfire and explosions.  It was incredibly hard to get to sleep no matter how tired I was.  That continued the whole tour and got worse.  Part was the late night flights that we so often took, part the danger that we faced and part the conditions that we slept in. At one FOB in Ramadi we stayed in an old trailer that we could hear the rats chewing on the ceiling. When we had to stay in Al Asad to catch a morning flight after having flown in our tents were near the flight line and F-18s flying in and out all night do not make for a quiet and restful night’s rest.  In some of the more remote FOBs the isolation and vulnerability made it hard to rest.  I think that it was about two-thirds of the way through that the dreams and nightmares started.

Doonesbury-082108Too True I can Relate

Having talked to others with PTSD or other combat related injuries of the brain and nervous system I find that I am not alone and most of us are mid-grade to senior career officers.  It’s kind of weird because when you are young in the military you are taught just to “suck it up” and as you go through your career you tell others the same thing until it happens to you. Thus for us old guys I think PTSD is actually harder than for young people because it destroys our world view and our tough personas which most up us have cultivated over a long period of time.  My friends and I share the same or similar experience and we all are trying some way of managing it.  All of us have some drugs, the legal kind of course to help us with anxiety, panic, depression and insomnia.  However there are times when the drugs don’t work as well as they should, or they need to be adjusted or changed.  In those times you still have to find ways of getting to sleep and for the times where you can’t sleep ways of keeping sharp so you can stay in the game and not screw anything up.

bean church 1Staying Awake

Some guys I know have added to the mix other kinds of over the counter drugs and supplements.  I don’t do that, not that there’s anything wrong with it, but I guess I never grew up.  I like my medicine whenever possible to taste good.  Thus my self-medication is limited to caffeine and really good beer.   My choice in caffeine is coffee which I have been drinking since I was 12 and I believe that by my junior year of high school Navy Junior ROTC my index finger was beginning to mould itself into the shape of a coffee cup handle.  With caffeine there is little moderation because since I don’t sleep I need to stay awake.  My alcohol consumption is moderate and I don’t drink hard liquor.  I always try to maintain the Yin and Yang of the blood to medicine to caffeine and alcohol at some kind of balance so I can get to sleep and then not be exhausted the next day.  I make sure that I don’t mix alcohol with my meds since I don’t want to do the Karen Anne Quinlan thing and end up in a coma, and end up in a broccolitative or asperagative state (I don’t do just any vegetables thank you).  However I know guys who have a lot heavier load of meds than I do who have no problem ingesting them and alcohol close together and most of these guys don’t just drink limited amounts of beer.  I’m quite happy not to be there and mixing meds and alcohol.  So for me the equation looks like this.  Please note I am a historian and not a mathematician and that since this is a new field of study for me that it does not yet factor in sleep quality:

Drugs- caffeine² ± beer÷ “defensive factor” (anxiety+ hyper-vigilance) + normal work and life stress ÷ spirituality factor² = sleep

Now also since I am a Priest and Chaplain there is the spirituality factor which is hard to quantify but can be stated very simply “Please God let me sleep + have I been to a baseball game.”  This is hard to quantify but I have given it a numeric value for the sake of argument. Now I’m not a mathematician by any means but this seems to work somehow.

axieties and dreamsYep…Them Iraqi Snorklewackers Show up Often

Now back to me and the guys I know who struggle with this.  Pretty much to a man we all still manage to do our jobs.  In fact we all love what we are called to do which probably helps us as far as the management of our situation.  Many of the folks I know are like me and if we had the chance would go back to the fight.  You put us together with men and women who have similar experiences in combat and we are in our element, there is a shared brotherhood because of the real dangers that we faced.  However that is not necessarily true of others that we serve alongside who have not been, as is oft said “in the shit.” Within that category there are those who are people that help us and care for us, they are appreciated even if they have not been in our shoes.  The often exude a kindness and love that helps us make it when we have bad days.  But there are also those that don’t always seem to have our interests at heart or who would appear by their words and sometimes their actions to use our injury against us.

garfield show me the coffeeAmen!

So this whole deal gets weird when you can’t sleep due to anxiety or insomnia and have to maintain your ability to do your job.  Now this is where the art and science of self medication come together. You have to be able to figure out how things balance out. Medications are set by prescription unless you throw in a wild card of over the counter meds and supplements.  Thus for me they are a relatively stable factor.  Then you factor in the caffeine factor.  This may vary but in my case I drink 24-72 ounces a day of coffee which is usually spread over a 4-8 hour period, and maybe 12-24 ounces of Diet Coke, Coke Zero or Diet Dr Pepper later in the day.  My caffeine level is variable based on how tired I am. If I am well rested the amount consumed goes down.  Today I was maxing out the caffeine factor because my ass was whipped and it was all I could do to get through the day.  Today I was so wiped that I added in the Skittles factor to get the quickie sugar rush.  I hate skittles, when we were poor in seminary it was the only candy we got because the church food bank gave them out.  Skittles, Boston Baked Beans, Swee Tarts and Smarties are all great instant energy, the problem with them is that they are like lighting the afterburner; they are only good for short spurts.  Beer varies but if I am home I might have two beers at dinner.  I have stopped any late night drinks.  Then there is the “defensive factor” which for me includes my anxiety and hyper-arousal levels.  This is combined with normal life and stress and divided by the spirituality factor to get a night’s sleep.  That is the science.  The art is how to make the adjustments to the factors that are variable fit the current life situation and find those illusive Chinese kids, Yin and Yang.

pub1

So the week is coming to a close, I have now been up 36 of the last 40 hours and have worked every day since last Monday, though Saturday and Sunday were just a few hours each despite having the duty pagers. I am tired I had a decent meal complete with vegetables, several portions of fruit and other healthy things.   As soon as the Orioles game is over I plan on heading to bed and hoping my meds and my general sense of exhaustion will overcome any anxiety or insomnia that might join hands to interfere with me.  I think I have managed to bring old Yin and Yang into balance for the evening and if I didn’t I I do hope that the Deity Herself will assist this effort tonight.

Peace, Padre Steve+

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The Gifts of PTSD: Insomnia is a Terrible Thing to Waste and the Hidden Value of Hyper-vigilance

068On Board a 53 out near Syria

I’ve been asked by a number of people at work just how I manage to find the time to write the way that I do.  The answer, which I have said to all of them is simple…insomnia, which it turns out is not necessarily a curse, but for me in some ways is a gift.  I find that insomnia really is a terrible thing to waste.  Until I went to Iraq I went to bed at a decent hour every night and seldom did I have problems sleeping.  At the same time my life while busy pursuing work, military and professional education as well as academic degrees was full but not completely fulfilling.  I had always wanted to write on a variety of subjects to include military history, theology, ethics and baseball.  In fact someday I hope to get published.  However back then I was always too distracted to write what I wanted to write.  I could t stay on task for anything other than things that would seemingly directly affect my military career, even my marriage.

081Convoy On Route Michigan

Iraq changed that more than I thought it could.  I got back, fell apart about 90 days after returning home and despite pushing myself harder at work, ministry and academically I was not making it.  Nightmares, dreams, chronic pain and anxiety, stress reactions even in church about crippled me.  About the only place I felt some peace was at the ball park.  Somehow the sight of that great field and the infield diamond settles me. Sleep deprivation became a very real and persistent part of my life.  I guess it was the fact in Iraq that we did most of our travel at night by helicopter, usually CH-46, CH-47 or CH-53’s and had very irregular schedules.  Likewise when we came back to base there was another little issue.  The pad for the Army Medivac Choppers, or “Dustoff” was about 200 yards from my quarters so all night long I was subjected to the constant noise from these aircraft.  If I hear a UH-60 Blackhawk or SH-60 Seahawk at night I still get a startle reaction.  Outgoing artillery fire and occasional fire, explosions and sirens in the adjacent town of Habbinyah were staples of life.  When bored I would stand outside and watch illumination rounds going off the highway just outside our entry control point or wander over near the Shock Surgery Trauma Platoon facility where “Dustoff” was waiting on the pad.  I’m sure that working a number of mass casualty events and seeing our wounded Marines and Soldiers being treated as well as Iraqi civilians including kids had to affect me.  These Americans and Iraqis were out driving the same roads that we would drive on a regular basis and the sight of their shattered bodies went through my mind every time we went on a mission.

As I got deeper into my tour I found that no matter how tired that I was I had great difficulty getting to sleep.   I’m sure this was due to our operational tempo, odd hours, demanding travel, sleeping conditions which varied at every location and occasionally getting shot at.  The most cool of those were when our Army CH-47D talking off from Ramadi , took fire from the ground and proceeded to pop flares, take evasive action while the tail gunner opened fire with his M240 series machine gun.  Since I was sitting two seats from the tail gunner and saw, heard and smelled the gun as it fired I’m pretty sure that it happened.  However, when I called the Army squadron to see what happened they denied that the event happened.  I hear that was not an uncommon occurrence.    So anyway by the mid-point of my tour I was no longer sleeping so I would sit up and play games on my computer, such as chess and Ma-jong.  It is amazing how good you can get at stuff like that through sheer repetition.  It was playing these games that I would wear myself our enough to sleep since I usually did an hour or two of PT during the day or late evening when not on the road.  It is comforting when you are running near the perimeter on a cool Saturday morning and hear explosions and exchanges of automatic weapons fire going off about 2 km to your right.

So now despite my cool concoction of meds I still have difficulty getting to sleep.  In order to sleep I have to wear myself out and when I am done I take my meds and crash.  If I take them before I am exhausted I see little effect and I am not about to start mixing them with the good beer that I enjoy so much.  I do not drink crappy beer thank you.  Maybe it will be time to go back to the doctor when my provider’s relief arrives in August or September.  I probably need to talk to my buddy Elmer the shrink again soon.  Elmer is great but my schedule has not lined up well to see him the past couple of weeks between leave, call schedule and the emergency root canal.  I probably have to go back in on that sooner than my appointment as I still am having some pain and wonder if there is an infection there.

Since I don’t believe in wasting time I have decided to be productive when I can’t sleep.  I started writing as I finished my class requirements for my latest Masters Degree.  I still need to do the comprehensive exams but will wait until September so as not to mess with any home games the Tides have left.  I began writing as a means of both helping me and disciplining myself to write regularly.  I have several book ideas but have never been able to get any off the ground because I could not stay focused.  This website helps me do that and has got me thinking creatively again.  So my answer to how I can find the time to write is simple, if I have 20 or so extra hours in the week late at night that are going to be there no matter what I do, then I shouldn’t waste them.  So my point is that insomnia is a terrible thing to waste.   It could be worse. I know of other vets who can’t sleep either due to war experiences and some have fallen off the deep end with self destructive behaviors at least I am not doing online gambling, porn or other distractions that have helped continue to ravage some of my brothers and sisters who have served in Iraq, Afghanistan and Vietnam.  I have found in a strange way that the chronic insomnia has been a gift which has enabled me to gain insights on life and experience that I had never been able to put down before.  It has forced me to take advantage of time that I would otherwise waste web or channel surfing until I fell asleep.  It is interesting to see what comes out of your computer when you are trying to write while falling asleep.

Here is an example that I found and saved a few weeks ago:  “Manages not only check their the firduk about what they fell than…”

I have no earthly idea what it means or what a “firduk” is or what “manages would “not only check their the firduk” means and I don’t want to find out.  God only knows what it means but it reminds me where a half-asleep Jerry Seinfeld wrote down something that he saw on TV that he thought was funny.  He spent the show trying to see what he wrote and then finally saw what he actually heard.  He discovered that it was not nearly as funny as he thought.

Another gift I have been given with my PTSD is that of hyper-vigilance.  I am much more alert and observant than I ever was.  This is on the road, in crowds or even as I do my job in the hospital.  I have begun to notice the little odd things that are clues to other possibly more significant issues.  This probably has saved my life on the road on several occasions since I returned as I have a much great “feel” for what is going on around me than I have ever had while driving.  There have been at least three times where I “felt” the danger of another vehicle and took evasive action to avoid a collision before I heard or saw it.  Of course the colorful euphemisms which poured out of me on these occasions were quite memorable, I think the best being “You Oedipal Mother F—-r!” when some asshole almost plowed over me in a grocery store parking lot not far from home.

So, despite the inherent problems that PTSD, insomnia and the other maladies I have incurred have caused me, the Deity Herself has also given them to me as a gift.  For which I am strangely grateful. Even a few months back I saw them as a curse, but now they have become a source of blessing.  Like Commander Spock might say to Captain Kirk after observing a human idiosyncrasy “fascinating Captain, fascinating.”

pub1It’s a Gift…Enjoy

I’m back on duty tomorrow for another overnight.  This will be a long week, 3 duty nights out of 5 work days.  Thankfully I will not have duty again for two weeks after Friday.

Peace, Steve+

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