Tag Archives: icu

Too Young: In Memory Commander Marsha Hanly, Nurse Corps US Navy

LCDR Marsha Hanly caring for a patient in the ICU of the USNS Comfort 

“Nursing is an art:  and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit?  It is one of the Fine Arts:  I had almost said, the finest of Fine Arts.”  Florence Nightingale

This afternoon I was stunned to learn that a very dear co-worker and friend from Naval Medical Center Portsmouth had unexpectedly passed away. Marsha Hanly was a ICU Nurse who arrived at Portsmouth about the same time I did in 2008. She had just completed a Master of Science in Nursing at Duke with a specialization in Adult Critical Care nursing.  Marsha exemplified all that is good in nursing and was as devoted to her calling as Florence Nightingale described.

I remember what seem like countless times where I stood beside Marsha as she cared for critically ill or dying patients, comforted their families and helped the other nurses and physicians in the ICU. I also cannot count the number of times that she stood by me as I prayed for patients as they lay in critical condition. She was an outstanding nurse and Naval Officer as well as one of the most kind and compassionate people that I have ever met. She was devoted to her husband and children and to the welfare of those committed to her care. She was funny and joyful person who was real. She was a committed Christian, wife, mother and fantastic nurse. She could laugh and she could cry, she really loved and cared for those that she served.

Last year Marsha deployed on the Hospital Ship USNS Comfort as part of Operation Continuing Promise, a medical mission to the Caribbean Sea, South and Central America. While deployed she was selected for Commander in the Nurse Corps. She returned late in the Summer and in November was diagnosed with Cancer. She underwent successful surgery which left her cancer free but in need of Chemotherapy to ensure that she remained so. She returned to work in late April and began her Chemo this week. Her last post on her Caring Bridge blog ( http://www.caringbridge.org/visit/mahanly )talked about how she described what she believed would be the course of her Chemotherapy, side effects and how long it would take. She was looking to the future and even to this weekend with her children. I don’t know the circumstances of her death but imagine that it was a sudden and catastrophic event related to the Chemo in some way.

When I read the news on Facebook, where I keep up with my friends from that ICU as well as so many others in my life I was stunned. As I read the comments of her fellow nurses and my former co-workers, nurses and physicians alike I felt like I had been kicked in the gut. I couldn’t believe it because I simply expected this otherwise healthy, young and vibrant woman to sail through Chemo and completely recover. I am so stunned that I cannot believe that his has happened.

This is one of those times where I ask God “why?” I have to admit that I cannot understand this and I have a hard time with the whole “God’s will” thing when things like this happen to people like Marsha. People that devote their lives to caring for others and raising their young children.  I grieve for her husband and kids, I remember her bringing them in to work sometimes.  I pray for her husband Scott and their two young

Likewise I grieve for those who knew and loved her in the Portsmouth ICU. For those that have not been closely connected with those that labor in critical care specialties like a busy ICU there are few places where people bond so closely. Critical Care Nurses and Physicians work in a surreal world where life is constantly hanging in the balance and as a result have a camaraderie that is much like combat soldiers, police and firefighters. This is not just a job, it is a calling, in a sense a sacred vocation. Marsha exemplified the best of her profession and what it is to be a friend.

Even though I left Portsmouth in October 2010 to come to Camp LeJeune I still count the staff there as my friends. We went through a lot together. Many of them were there for me when I was going through difficult times as their Chaplain. Marsha was one of those people. I cannot imagine her not being there when I go back at some point or not seeing her serving and caring for Sailors, Marines and their families somewhere else.

Last week we honored Nurses during National Nursing Week and the anniversary of the founding of the Navy Nurse Corps. Marsha was the best of both. The Nurse Corps has suffered a terrible loss.

Marsha touched so many lives. I know that my former co-workers and friends at Portsmouth are taking this hard. It doesn’t seem right and it doesn’t seem fair. I have a hard time theologizing deaths of people like Marsha. While I am sure that the Lord has her with him I don’t understand her loss here.  While I fail to understand I do still pray that God must have a purpose and I do give thanks for the honor and privilege of knowing Marsha and working with her. In times like this I find some comfort in the prayers of the liturgy and find this one from the Book of Common Prayer to be one that I can pray in good conscience even when I struggle.

“O God of grace and glory, we remember before you this day our sister Marsha. We thank you for giving her to us, her family and friends, to know and to love as a companion on our earthly pilgrimage. In your boundless compassion, console us who mourn. Give us faith to see in death the gate of eternal life, so that in quiet confidence we may continue our course on earth, until, by your call, we are reunited with those who have gone before; through Jesus Christ our Lord. Amen.”

Rest in Peace Marsha. Rest in peace.

Padre Steve+

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Filed under faith, remembering friends, shipmates and veterans

The Brotherhood: Veterans Day 2013

I am always a bit on the melancholy side on Veterans Day.  This year is no different but is a bit different because for the United States the war in Iraq is over, at least for now while the war in Afghanistan grinds on as we prepare to transition.

For me our wars are more about the incredibly small number of Americans who for the past 12 years have borne the burden of these wars.  They are my brothers and sisters, the 0.45% of Americans that serve in the military.  While this is a terribly low number it is only marginally lower than most of our previous wars.

In fact for most of our history it has always been a small minority of Americans that have fought our wars.  Kind of funny when you think about how much our culture worships militarism. World War II was an anomaly as just over 16.1 million people or 9% of the population served in the military then.  That number while large pales in comparison with percentages of those that served in other nations involved in the Second World War. The reason that I point this out is just to say that as a nation it has always been the few that have borne the cost of war. We are “the few.”

This story shall the good man teach his son;
And Crispin Crispian shall ne’er go by,
From this day to the ending of the world,
But we in it shall be remembered-
We few, we happy few, we band of brothers;
For he to-day that sheds his blood with me
Shall be my brother; be he ne’er so vile,
This day shall gentle his condition;
And gentlemen in England now-a-bed
Shall think themselves accurs’d they were not here,
And hold their manhoods cheap whiles any speaks
That fought with us upon Saint Crispin’s day.

From the Speech of King Henry V at Agincourt in Shakespeare’s “Henry V” 1599

In the midst of the petty politics surrounding the Afghan War so so ponderously and pompously purveyed by politicians and pundits of all strains I feel the need to speak up for that small band of brothers that has served in these wars. They are to steal a phrase applied to a previous generation the “New Greatest Generation” something that I am loathe to apply to much of the population at large.  You see the cost of these wars is finally beginning to sink in, at least the financial cost. The real fact of the matter is that these ill advised wars have harmed us as a military and as a nation, our superpower status which was uncontested before 9-11-2001 is challenged because our military is hollowed out, economy weakened and our moral authority questioned by those wars, war crimes and spy scandals.

I’m not so sure that the human cost factors in for most Americans because the tiny percentage of the population that serve in the wars. The fact is that the volunteer military is an insular community which for the most part is based on bases away from most of the population. We have become a society apart from the society.

We used to have big bases in or near major cities, the New York Naval Yard, the Presidio of San Francisco, Long Beach Naval Shipyard, Fort Devens Massachusetts near Boston, Fort Benjamin Harrison Indiana at Indianapolis.  But after the Cold War they and hundreds of other bases were eliminated and with them a connection to the active duty military.  That is not the fault of the people in the big cities it just happened that way, no the military with a few exceptions is based away from most of the population. As a result people may support the troops but most have no idea what they do, how they live and what they suffer.

In spite of that this many of the new Greatest Generation’s accomplishments will largely go unheralded by history. Unlike the “Greatest Generation” of World War Two they will probably not receive the full honors and accolades due them.  This brotherhood of war who have served in the current War on Terror, Iraq and Afghanistan campaigns have now been serving in a war that is now twice as long as the American involvement in World War Two.  Many, like me have been in this since the beginning and many have made multiple deployments to the combat zones.  And many of us, if not most of us would go again. I know that I would because part of me is still in Iraq; for me this war is still un-won and un-finished.

The battles, Fallujah, Ramadi, Haditha, Mosul, Baghdad, Tal Afar, Marjah, Kandahar, Anaconda, Wanat and thousands of other places significant and insignificant are vivid in the minds of those that were there. Unfortunately for most of their countrymen they might as well be on a different planet.

With no disrespect to the Greatest Generation of World War Two, most who were drafted, all of the current Soldiers, Sailors, Marines, Airmen and Coast Guardsmen volunteered to serve in time of war.

At any given time only about one half of one percent is in uniform.  In the three years and ten months of the Second World War about 16.1 Million Americans served in the military, the vast majority being draftees.  Likewise the current generation has fought the war alone.  The vast bulk of the country has lived in peace untouched by any inconvenience to daily life such as gas and food rationing, requirements to work in war industries and the draft as were citizens in World War Two.

In the Second World War Americans shared the burden which in large part has not occurred in this war.  While many have pitched in to help and volunteered to help veterans and their families the vast majority of people in this country are untouched by the war, not that there is anything wrong with that.  This is simply a comparison of the situation that those who served in World War Two and the present conflicts faced.  So I have to say that our current “Greatest Generation” is only a small part of the generation, as the line in Henry V “we few, we happy few who fought together….”

These Soldiers, Sailors, Marines and Airmen from the United States as well as our Allies who serve alongside of us are my brothers and sisters.  They too are volunteers and represent a miniscule portion of their countries population. I am friends with military personnel from the UK, Canada and Germany who have served in the various combat zones or at sea and met quite a few others from France, the Netherlands and Australia. Of course my Iraqi friends who I served with while with our advisers in Al Anbar province who are not only trying to bring peace and stability back to their country but have to worry about the possibility that their families become the target of terrorists.

There are a number of things that unite us in this relatively small brotherhood.  However, I think that this brotherhood could also be extended to our brothers who fought in Vietnam, French, Vietnamese, Australian, South Korean and American, the French who served in Algeria and the Americans and others that served in Korea.  All of these wars were unpopular. All had little support on the home front and often returning veterans found themselves isolated and their sacrifices ignored or disrespected.  For those Americans who serve in the current wars I can say that at least to this point the public has been much more supportive than they were to our Vietnam brothers, many of who were even disrespected by World War Two vets who had fought in “a real war.”  I cannot count the Gulf War in this list as it was hugely successful and the returning vets were hailed as conquering heroes with ticker tape parades.

Our shared brotherhood includes our scars, physical, psychological, neurological and spiritual.  Those who served on the ground in Iraq and Afghanistan as well as those who served in Vietnam, French Indo-China and Algeria have a common shared experience.  All fought people who didn’t or don’t like foreigners no matter how noble our intentions and who by the way have a long history of outlasting people that they believe to be invaders or occupiers.  We have had to fight wars with no front lines, no major units arrayed against us, but rather asymmetrical threats propagated by creatively devious foes who use low tech easily available technology and a willingness to sacrifice themselves and others to force attempt to kill us.  Thus we have cleverly designed and often quite powerful IEDs or Improvised Explosive Devices which can obliterate a HUMMV.

These threats create a situation where there is no front line and thus where every excursion outside of a FOB (Forward Operating Base) or COP (Coalition Outpost) is automatically a trip into a potential danger zone.  Enemies can infiltrate bases posing as local nationals in either military uniform or as workers, rockets and mortars can be lobbed onto even the largest and most secure bases at any time and any vehicle driving by you on the road could be loaded with explosives and just waiting to blow you up while insurgents with automatic weapons and Anti-Tank Rocket Propelled Grenades (RPGs) have taken down helicopters.  When you have taken fire on the road, in the air and had rockets whiz over your head you this becomes a reality that you never forget.

As a result we many men and women with physical wounds as well as wounds that have damaged the psyche or the soul.  PTSD is very common either from a direct encounter or the continual wear and tear of being in a danger zone wondering if you were to get hit that day every day of a tour.  I have lost count now of people that I know who have mild to severe symptoms of PTSD.  Traumatic Brain injury is another condition men and women attacked by IEDs, mortars and rockets experience. Likewise there are the injuries that shatter the soul.  These are the images of ruined buildings, burned out vehicles, wounded bodies, injured children, refugees and wars desolation that can leave a person’s faith in God, or ideals that he or she believes in weakened or even destroyed.  There are the smells of smoke, death, diesel, garbage and sewage that when encountered far away from the combat zone send us back.

The wars have been costly in lives and treasure.  The “up front” casualty numbers are below; they do not include those with PTSD or mild to moderate TBI. They also do not count those that have died later after their service in VA or other civilian care, those that did not report their injuries and those that have committed suicide.

Iraq                   KIA    US  4483       UK 179    Other  139           Total  4801

Afghanistan     KIA  US  2290         UK 446     Other 659        Total  3395

US Wounded   Iraq  32224      Afghanistan   17674

The financial cost: over 1.2 trillion dollars and counting.

As many idealistic and patriotic military personnel question God, their National Leadership and even themselves because of their experience in Iraq or Afghanistan.  I cannot get the image of a refugee camp on the Iraqi Syrian border full of Palestinian refugees who have nowhere to go; they had been invited to Iraq under Saddam and have been sitting on the border trying to get home for years now.  The Palestinian authority wants nothing to do with them. I cannot smell smoke or hear a helicopter or pass a freshly fertilized field without being reminded of Iraq.

These men and women are my brothers and sisters.   I have seen quite a few of my colleagues at the Naval Medical Center and Naval Hospital deploy and deploy, the medical personnel don’t get much of a break.  These are my friends and I do get concerned for them and pray earnestly for their safe return.  I wish that I could go with them because I know them and have already walked with them through the dark valley of the shadow of death in the Medical Center ICU or the wards and clinics of the Naval Hospital.  We already have a bond that will not be broken.

It is now six years since I served in Iraq and five years since my PTSD crash.  However, I still would do it again in a heartbeat.  There is something about doing the job that you were both trained to do and called to do that makes it so.  Likewise the bonds of friendship and brotherhood with those who you serve are greater than almost any known in the human experience.  Shared danger, suffering and trauma bind soldiers together, even soldiers of different countries and sometimes with enemies.

I remember the conversation that I had with an Iraqi Merchant Marine Captain on a ship that we had apprehended for smuggling oil violating the United Nations sanctions.  The man was a bit older than me, in his early 60s.  He had been educated in Britain and traveled to the US in the 1960s and 1970s. He had the same concerns as any husband and father for his family and had lost his livelihood after Saddam invaded Kuwait in 1990.   He was a gentleman who provided for his crew and went out of his way to cooperate with us.  In our last meeting he said to me: “Someday I hope that like the Americans, British and the German soldiers at the end of the Second World War can meet after the war is over, share a meal and a drink in a bar and be friends.”  That is my hope as well.

In the final episode of the series Band of Brothers there is a scene where one of the American soldiers, Joseph Liebgott who came from a German Jewish family interprets the words of a German General to his men in the prisoner compound.  The words sum up what the Americans had felt about themselves and likewise the bond that all soldiers who serve together in war have in common, if you have seen the episode you know how powerful it is, I ended up crying when I heard it the first time and cannot help but do so now that I have been to the badlands of Al Anbar Province.

“Men, it’s been a long war, it’s been a tough war. You’ve fought bravely, proudly for your country. You’re a special group. You’ve found in one another a bond that exists only in combat, among brothers. You’ve shared foxholes, held each other in dire moments. You’ve seen death and suffered together. I’m proud to have served with each and every one of you. You all deserve long and happy lives in peace.”

As do we.

Peace

Padre Steve+

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Filed under History, Military, shipmates and veterans

Sometimes between Life and Death a Baseball often Matters as much as a Prayer

I have had a number of patients in my ICUs who have been avid baseball fans.  Likewise there are a number of physicians and nurses who are avid fans of the game, or sometimes certain teams.  Like me they were members of the Church of Baseball.  Some even attend my parish, Harbor Park.  It is funny how in the intersection of life and death that baseball finds a place more than any other sport.  Baseball has a quality and nuance that is different from most other sports, save perhaps golf.  Baseball is not bound by the constraints of time.  It has an eternal quality that somehow transcends life and death and one can see that in the stories that we tell in film in novels, histories and our own narratives.

There is a scene in The Babe Ruth Story where a critically ill child asks the Babe to hit a home run for him.  The Babe then went out and hit two.  Later in the movie when the Babe is dying of cancer he is given a Miraculous Medal.  The film was rushed to completion before Ruth died and the scene at Yankee Stadium was filmed shortly before a game and Ruth came from his death bed to be there.

In Field of Dreams the spirits of the 1919 White Sox who were forced out of baseball in the Blacksox scandal.  The Pride of the Yankees deals with the life of Lou Gehrig, baseballs original Iron Man and his battle with ALS.  His speech at Yankee Stadium when he retired from the game is classic.  It is a reflection on life well lived and thanksgiving for what he experienced.

“Fans, for the past two weeks you have been reading about a bad break I got. Yet today, I consider myself the luckiest man on the face of the earth. I have been in ballparks for seventeen years and I have never received anything but kindness and encouragement from you fans. Look at these grand men. Which of you wouldn’t consider it the highlight of his career just to associate with them for even one day? Sure I’m lucky. Who wouldn’t have considered it an honor to have known Jacob Ruppert? Also, the builder of baseball’s greatest empire, Ed Barrows? To have spent six years with that wonderful little fellow, Miller Huggins? Then to have spent the next nine years with that outstanding leader, that smart student of psychology, the best manager in baseball today, Joe McCarthy? Sure, I’m lucky. When the New York Giants, a team you would give your right arm to beat and vice versa, sends you a gift, that’s something. When everybody down to the groundskeeper and those boys in white coats remember you with trophies, that’s something. When you have a father and mother work all their lives so that you can have an education and build your body, it’s a blessing. When you have a wife who has been a tower of strength and shown more courage than you dreamed existed, that’s the finest I know. I consider myself the luckiest man on the face of the Earth. And I might have been given a bad break, but I’ve got an awful lot to live for.” – July 4, 1939 at Yankee Stadium on Lou Gehrig Appreciation Day

These are intersections of life and death.  In the ICUs I have a surprising amount of dealings with baseball.  In one ICU I had a lady that was very sick with chronic and apparently terminal heart disease.  She was a delightful woman with a wonderful husband.  I had met them and while she had struggled she looked like she was on the uptick. She was delightful to spend time with and in those pastoral conversations when I had the overnight duty we found that we shared a common passion, baseball.

We agreed that the Biblical writer’s description of heaven was inaccurate being that they were unaware of the Deity’s love of baseball. We agreed that heaven had to have not streets of gold, but the most amazing turf and most immaculate infield which one could imagine and foul lines that went into infinity. She and her husband were watching the Nationals and Astros play deep into the night but the following day she took a bad turn for the worse.

I saw her that day we visited again and she was struggling. I prayed and anointed her at her request.  And I asked her if she would like a baseball. Her eyes lit up and she nodded “yes.”  So I promised that I would get one from the stadium last night.  The game at Harbor Park was rained out that night so I went home and got a ball that I had received after throwing out the first pitch at a Kinston Indians game.  I inscribed it to her and took it to her room the next day. She was pretty heavily sedated and her sister was with her.  I spent some time with her sister to let her know that I had the baseball for her.  We then went to the bedside where I let the lady know that I had her baseball. She opened her eyes and I put the ball in her hand.  Her hand gripped it tight and I blessed her.

The lady did get better and about 8 months later following my “Christmas miracle” I was walking past the Medical Center Pharmacy and I heard a familiar voice. It was the lady’s husband and she sat beside him looking very well. It turned out that they had been able to correct the worst part of her condition through a catheterization after she had gotten out of the ICU. New medications were also helping but she was most thankful of my little visits to her and the gift of the baseball.

Her husband talked of how the ball seldom left her hand during her ICU stay.  As we visited they both told me how much what I did in the ICU meant to them, the prayer, anointing of the sick and the baseball.  She told me that the ball, an official Carolina League ball was now on her mantle.  We chatted some more and talked about all the prayer that had been made on her behalf as well as the hard work of the ICU and Cardiology teams to keep her alive and help her recover.  I mentioned that it was likely that the whole companies of baseball “saints” in heaven were praying for her as well and we all had a great laugh.  I had to leave and go to a call but we exchanged hugs and blessings.

Sometimes the miracle is not in the prayer but in the things that touch us and mean much to us. For this lady, her husband and I that was baseball.

Peace

Padre Steve+

2 Comments

Filed under Baseball, christian life, faith, film, movies, Pastoral Care, philosophy, Religion

The Bond

This story shall the good man teach his son;
And Crispin Crispian shall ne’er go by,
From this day to the ending of the world,
But we in it shall be remembered-
We few, we happy few, we band of brothers;
For he to-day that sheds his blood with me
Shall be my brother; be he ne’er so vile,
This day shall gentle his condition;
And gentlemen in England now-a-bed
Shall think themselves accurs’d they were not here,
And hold their manhoods cheap whiles any speaks
That fought with us upon Saint Crispin’s day.

From the Speech of King Henry V at Agincourt in Shakespeare’s “Henry V” 1599

In the midst of the petty politics surrounding the Afghan War so so ponderously and pompously purveyed by politicians and pundits of all strains I feel the need to speak up for that small band of brothers that has served in these wars. They are to steal a phrase applied to a previous generation the “New Greatest Generation” something that I am loathe to apply to much of the population at large.  You see the cost of these wars is finally beginning to sink in, at least the financial cost. I’m not so sure that the human cost factors in for most people because the tiny percentage of the population that serve in the wars. The fact is that the volunteer military is an insular community which for the most part is based on bases away from most of the population. We used to have big bases in or near major cities, the New York Naval Yard, the Presidio of San Francisco, Long Beach Naval Shipyard, Fort Devens Massachusetts near Boston, Fort Benjamin Harrison Indiana at Indianapolis.  But after the Cold War they and hundreds of other bases were eliminated and with them a connection to the active duty military.  That is not the fault of the people in the big cities it just happened that way, no the military with a few exceptions is based away from most of the population. As a result people may support the troops but most have no idea what they do, how they live and what they suffer.

In spite of that this new Greatest Generation’s accomplishments will largely go unheralded by history. Unlike the “Greatest Generation” of World War Two they will probably not receive the full honors and accolades due them.  This brotherhood of war who have served in the current War on Terror, Iraq and Afghanistan campaigns have now been serving in a war that is now twice as long as the American involvement in World War Two.  Many, like me have been in this since the beginning and many have made multiple deployments to the combat zones.  And many of us, if not most of us would go again. I know that I would because part of me is still in Iraq; for me this war is still un-won and un-finished.

The battles, Fallujah, Ramadi, Haditha, Mosul, Baghdad, Tal Afar, Marjah, Kandahar, Anaconda, Wanat and thousands of other places significant and insignificant are vivid in the minds of those that were there. Unfortunately for most of their countrymen they might as well be on a different planet.

With no disrespect to the Greatest Generation of World War Two, all of the current Soldiers, Sailors, Marines, Airmen and Coast Guardsmen volunteered to serve in time of war.  At any given time only about one half of one percent is in uniform.  In the three years and ten months of the Second World War about 16.1 Million Americans served in the military, the vast majority being draftees.  Likewise the current generation has fought the war alone.  The vast bulk of the country has lived in peace untouched by any inconvenience to daily life such as gas and food rationing, requirements to work in war industries and the draft as were citizens in World War Two.  In the Second World War Americans shared the burden which in large part has not occurred in this war.  While many have pitched in to help and volunteered to help veterans and their families the vast majority of people in this country are untouched by the war, not that there is anything wrong with that.  This is simply a comparison of the situation that those who served in World War Two and the present conflicts faced.  So I have to say that our current “Greatest Generation” is only a small part of the generation, as the line in Henry V “we few, we happy few who fought together….”

These Soldiers, Sailors, Marines and Airmen from the United States as well as our Allies who serve alongside of us are my brothers and sisters.  They too are volunteers and represent a miniscule portion of their countries population. I am friends with military personnel from the UK, Canada and Germany who have served in the various combat zones or at sea and met quite a few others from France, the Netherlands and Australia. Of course my Iraqi friends who I served with while with our advisers in Al Anbar province who are not only trying to bring peace and stability back to their country but have to worry about the possibility that their families become the target of terrorists.

There are a number of things that unite us in this relatively small brotherhood.  However, I think that this brotherhood could also be extended to our brothers who fought in Vietnam, French, Vietnamese, Australian, South Korean and American, the French who served in Algeria and the Americans and others that served in Korea.  All of these wars were unpopular. All had little support on the home front and often returning veterans found themselves isolated and their sacrifices ignored or disrespected.  For those Americans who serve in the current wars I can say that at least to this point the public has been much more supportive than they were to our Vietnam brothers, many of who were even disrespected by World War Two vets who had fought in “a real war.”  I cannot count the Gulf War in this list as it was hugely successful and the returning vets were hailed as conquering heroes with ticker tape parades.

Our shared brotherhood includes our scars, physical, psychological, neurological and spiritual.  Those who served on the ground in Iraq and Afghanistan as well as those who served in Vietnam, French Indo-China and Algeria have a common shared experience.  All fought people who didn’t or don’t like foreigners no matter how noble our intentions and who by the way have a long history of outlasting people that they believe to be invaders or occupiers.  We have had to fight wars with no front lines, no major units arrayed against us, but rather asymmetrical threats propagated by creatively devious foes who use low tech easily available technology and a willingness to sacrifice themselves and others to force attempt to kill us.  Thus we have cleverly designed and often quite powerful IEDs or Improvised Explosive Devices which can obliterate a HUMMV.

These threats create a situation where there is no front line and thus where every excursion outside of a FOB (Forward Operating Base) or COP (Coalition Outpost) is automatically a trip into a potential danger zone.  Enemies can infiltrate bases posing as local nationals in either military uniform or as workers, rockets and mortars can be lobbed onto even the largest and most secure bases at any time and any vehicle driving by you on the road could be loaded with explosives and just waiting to blow you up while insurgents with automatic weapons and Anti-Tank Rocket Propelled Grenades (RPGs) have taken down helicopters.  When you have taken fire on the road, in the air and had rockets whiz over your head you this becomes a reality that you never forget.

As a result we many men and women with physical wounds as well as wounds that have damaged the psyche or the soul.  PTSD is very common either from a direct encounter or the continual wear and tear of being in a danger zone wondering if you were to get hit that day every day of a tour.  I have lost count now of people that I know who have mild to severe symptoms of PTSD.  Traumatic Brain injury is another condition men and women attacked by IEDs, mortars and rockets experience. Likewise there are the injuries that shatter the soul.  These are the images of ruined buildings, burned out vehicles, wounded bodies, injured children, refugees and wars desolation that can leave a person’s faith in God, or ideals that he or she believes in weakened or even destroyed.  There are the smells of smoke, death, diesel, garbage and sewage that when encountered far away from the combat zone send us back.

The wars have been costly in lives and treasure.  The “up front” casualty numbers are below; they do not include those with PTSD or mild to moderate TBI. They also do not count those that have died later after their service in VA or other civilian care, those that did not report their injuries and those that have committed suicide.

Iraq                   KIA    US  4463       UK 179    Other  139           Total  4781

Afghanistan     KIA  US  1637         UK 374     Other 537        Total  2548

US Wounded   Iraq  32227      Afghanistan   11191

The financial cost: over 1.2 trillion dollars and counting.

As many idealistic and patriotic military personnel question God, their National Leadership and even themselves because of their experience in Iraq or Afghanistan.  I cannot get the image of a refugee camp on the Iraqi Syrian border full of Palestinian refugees who have nowhere to go; they had been invited to Iraq under Saddam and have been sitting on the border trying to get home for years now.  The Palestinian authority wants nothing to do with them. I cannot smell smoke or hear a helicopter or pass a freshly fertilized field without being reminded of Iraq.

These men and women are my brothers and sisters.   I have seen quite a few of my colleagues at the Naval Medical Center and Naval Hospital deploy and deploy, the medical personnel don’t get much of a break.  These are my friends and I do get concerned for them and pray earnestly for their safe return.  I wish that I could go with them because I know them and have already walked with them through the dark valley of the shadow of death in the Medical Center ICU or the wards and clinics of the Naval Hospital.  We already have a bond that will not be broken.

It is now four years since I was in the process of leaving for Iraq and three years since my PTSD crash.  However, I still would do it again in a heartbeat.  There is something about doing the job that you were both trained to do and called to do that makes it so.  Likewise the bonds of friendship and brotherhood with those who you serve are greater than almost any known in the human experience.  Shared danger, suffering and trauma bind soldiers together, even soldiers of different countries and sometimes with enemies.  I remember the conversation that I had with an Iraqi Merchant Marine Captain on a ship that we had apprehended for smuggling oil violating the United Nations sanctions.  The man was a bit older than me, in his early 60s.  He had been educated in Britain and traveled to the US in the 1960s and 1970s. He had the same concerns as any husband and father for his family and had lost his livelihood after Saddam invaded Kuwait in 1990.   He was a gentleman who provided for his crew and went out of his way to cooperate with us.  In our last meeting he said to me: “Someday I hope that like the Americans, British and the German soldiers at the end of the Second World War can meet after the war is over, share a meal and a drink in a bar and be friends.”  That is my hope as well.

In the final episode of the series Band of Brothers there is a scene where one of the American soldiers, Joseph Liebgott who came from a German Jewish family interprets the words of a German General to his men in the prisoner compound.  The words sum up what the Americans had felt about themselves and likewise the bond that all soldiers who serve together in war have in common, if you have seen the episode you know how powerful it is, I ended up crying when I heard it the first time and cannot help but do so now that I have been to the badlands of Al Anbar Province.

“Men, it’s been a long war, it’s been a tough war. You’ve fought bravely, proudly for your country. You’re a special group. You’ve found in one another a bond that exists only in combat, among brothers. You’ve shared foxholes, held each other in dire moments. You’ve seen death and suffered together. I’m proud to have served with each and every one of you. You all deserve long and happy lives in peace.”

As do we.

Peace

Padre Steve+

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Filed under History, iraq,afghanistan, Military, PTSD, shipmates and veterans, Tour in Iraq

Thoughts on the Occasion of getting ready to Transfer

Two years ago I was preparing to leave EOD Group Two and getting ready to move over to Naval Medical Center Portsmouth.  At that point in my life I was falling apart. The ravages of PTSD, depression and chronic pain from shoulder, knee and ankle injuries sustained in Iraq had taken their toll. Chronic anxiety, flashbacks, night terrors, vivid and disturbing dreams of Iraq, nearly uncontrollable emotions that ranged from intense sadness complete with that girl thing of crying to intense anger and rage, especially in traffic were a daily staple of life. Fear of large crowds, noise and light sensitivity panic in airports and fear of new places brought me more isolation and pain.  I went to the new assignment with trepidation but with a desire to make an impact.

When I got to Portsmouth I did my best to cover up the affects of PTSD and everything else that I mentioned in my life for the sake of work. I threw myself into the job; especially the patient and staff care aspect of it.  I worked painfully long hours usually due to my own need to know that I was still of some use despite all that was wrong with me and I ended up getting worse and not better.  I was in therapy and most of my colleagues and my boss tried to take care of me although I’m sure that they probably wondered if I was salvageable at times. I am thankful for their support as it was needed and vital to getting me through but I still sunk down deeper into the abyss.  Nothing was getting better and I even doubted if God was even around, or if he was around if he even gave a damn about me. I was experiencing what I am now not afraid to call, not just PTSD but let me call it what it is, mental illness.  In addition I was in a full-fledged crisis of faith. During the year I had experienced the loss of a number of friends and colleagues and each one deeply affected me plunging me deeper into depression. Christmas of 2008 was the worst that I had ever experienced from a spiritual point of view. I left the Christmas Eve Mass at my wife’s church before the Mass began into the night for an hour before I got home. I looked up at the sky and cried much of the time wondering if God was there and if he was wondered if he had abandoned me.  As I got worse I stopped doing the things that I needed to do to take care of myself, good nutrition and exercise was out the door and I gained 25 pounds in 6 months and ended up on the fat boy program.  By late August I was in worse shape than I had been the previous September and it was in mind, body and spirit.

For someone like me this was almost more than I could handle and my boss, recognizing that I was not doing well pulled me kicking and screaming out of the ICU and PICU and pushed me to take care of myself and get help.  I began to do this but if you have been as down as I was you understand that recovery doesn’t happen in a day, or even a week.  It is a continuous and often painful process mixed with times where you begin to see occasional fleeting glimpses of hope.  I struggled for the next three months until a couple of weeks before Christmas I was called to the ER and in a moment of grace in the midst of my own despair I was called upon to perform Last Rites for a retired physician that was Episcopalian. As I performed the Sacrament he breathed his last, his wife and son said it was like he was waiting to receive that before he died.  Something happened that night and things began to turn around, unfortunately the young Intern physician that called me to the scene and with whom I took remedial PT tests and nutrition classes died a little over a month later.

However, Christmas of 2009 was different, for the first time since I was in Iraq I felt joy, and slowly things began to turn around.  The first part was spiritual, the next physical and psychological.  Each month I got a bit better and it was if a thick blanket of California Central Valley Thule fog was dissipating with the sun beginning to peek through.  In February I was felled by a kidney stone for a month, my physical recover was slowed but didn’t stop. Spiritually things were getting better, on the psychological side of the house my PTSD symptoms were evening out, panic attacks were going away and for the first time since before Iraq I was beginning to sleep.

In June I had three events that converged to change my life.  I was selected for promotion for Commander on June 22nd, or at least that was when the message was released.  The next day my dad who had been suffering from Alzheimer’s disease for nearly 7 years passed away and two days after his memorial service I found that I was being transferred to be the Command Chaplain of the Naval Hospital at Camp LeJeune North Carolina.

As far as promotion I am grateful to my boss because I showed up damaged and was not fully functional he chose to grade me on my potential for service on my fitness reports and made sure that what went to the promotion board was something that would help my selection.  I would guess based on my knowledge of the system that not many senior chaplains or for that matter senior officers would do the same thing.  I would have been dealt with like I was a broken piece of equipment and allowed to serve out my career but never rising to anything more than that.  This leads me into the transfer which will allow me to get my feet wet as the Command Chaplain of a decent sized hospital on a very busy base which is fully engaged in the war.  It will be challenging and I will supervise three chaplains and three enlisted religious program specialists.  Much of what I have learned recently will help me in that job and I hope to do well in it to serve the patients and staff in that hospital.  I want to be a good boss to the men and women that work in the department and hopefully am able to do some things that will knit pastoral care even more tightly into the interdisciplinary team for better care of patients, their families and hospital staff.

I have mixed feeling about leaving. I will really miss the people that I have worked with the past two years. I will not miss the perpetual staff shortages and having to be the go to guy so often, maybe even get to take some leave that is actually the kind for refreshment versus taking care of family emergencies.

My friends at Portsmouth will be that and I will miss them and keep up with as many as I can through e-mail and Facebook.  Some have been, are being or will be stationed in LeJuene and it will be great to be with them in North Carolina.

Today was a frustrating day that kept me going all day and with the exception of my PT test which I crushed with 100 sit ups, 70 pushups and just under 12 minutes for the 1.5 mile run, which I did on a stationary bike so the calorie count was converted to the run time. Not too bad for a 50 year old. I would have done the run as my ankle and knees are fully healed but I couldn’t do it until noon when the temperature was too hot.  When I get to LeJeune I will do the run. My interval training and PT program coupled with my diet is paying great dividends.  I have lost 4.5 inches around my belly since late November 2009, lost 16 pounds and 10% body fat, going from 32% body fat to 22%. I am not done as I want to lose 3 more inches around the belly and 10-12 more pounds of weight.  I’d like my body fat to be under 20% and keep it there, getting lower of I can.

I’ll have some more reflections over the next couple of weeks. My friends in the ICU are planning something for me and I am really blessed to have such great friends and colleagues. I am told that the pastoral care staff will have a good-bye as well, but that is kind of expected, the real joy for me comes from the people that I have gone through difficult times within the ICU in the high stress environment of live and death situations, ethical consults and pastoral care administering prayers, counsel and sacraments to our patients, their families and our staff, my friends.  That means more than almost anything to me as they have walked with me through the darkness.

Peace,

Padre Steve+

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Filed under faith, healthcare, Military, Pastoral Care, PTSD, Tour in Iraq, US Navy

A Tangled Mass of Emotions: Dad, the Boss, an ICU Death and the All-Star Game

The Big “A” that I knew

I am a mess the past day or so. Not that anything is bad or going wrong it is just that emotionally I am a mess.  As I try to get back into normal life I find emotions brought up by my dad’s death three weeks ago going all over the place.  Today was so strange; it actually began a couple of days ago when I finished the third chapter of my series on “Meeting Jesus and the Team at 7-11” entitled “A Death, a Rain Delay and a Visit from Saint Pete.” Since my dad’s death due to complications from Alzheimer’s disease I have experienced number of things that sent my emotions into overload because they somehow connected with dad and his death.  Over the past couple of days these intense emotional surges, I cannot call them swings because they are not swings, I am not going between depression and elation but rather experiencing strong emotional impulses as things remind me of my dad or of childhood.  I know that I am okay because grief and the emotions that follow the loss of a parent particularly your father if you are the oldest son are guaranteed to mess with you. They are normal, I am a highly trained pastoral caregiver but since I am not a Vulcan but a Romulan with probably a bit of Klingon mixed in the emotional surges that well up from under my normally cold and logical exterior are a real bitch, no wonder the Romulans wage war with such ferocity and the Klingons appear to be in a perpetually foul mood.  But I digress…

The past couple of weeks have been weird because I never know when something is going to trigger emotions that remind me of my dad.  Much of this of course revolves around baseball as it was my dad that taught me to love the game and through the connection between baseball and dad there has been, even when he was no longer himself due to the ravages of Alzheimer’s something that brought a sense of stability and peace to life, even when I was a post-Iraq PTSD mess.

Now I am a mess again as things that I see, hear and experience things that bring me back to dad.  At this moment my excrement is together but I have no idea what or when the next emotional surge will hit and I will be blubbering like I girl, not that there is anything wrong with that.

The past few days are a case in point. I went to Harbor Park on both Saturday and Sunday and had a great time, at the same time I felt like my dad was there. He never came to Norfolk during my time here because of his physical and deteriorating mental state but now since his death it almost feels like he is there with me.  I went to work Monday and had the on-call overnight duty at the Medical Center and was doing pretty well but in the late afternoon I was called for a cardiac arrest of an 81 year old man and off and on throughout the evening was called back as he continued to get worse to take care of his family, a wife of 63 years and a son a couple of years old than me.  I really wanted this man to live but it became apparent as the night wore on that he would not survive the night and his wife asked me to perform the Sacrament of Healing or what some used to refer to as “Last Rights” which I did with she and her son present using the rite form the Book of Common Prayer.  With his condition somewhat stable I went to our call room where I attempted to get a little rest on the bed from hell.   Of course getting to sleep on said bed is difficult at best and since when I am on duty the hyper vigilance factor is real and present it takes a while to get to sleep.  About 0215 my fitful sleep was interrupted by the pager going off and with it the message to come back to the ICU as the patient was dying.  I went back and was with the family when he died and until they left the building about 0315.

The next morning or rather later in the morning, but not much later I was back up and preparing for a meeting across the bay at the VA Medical Center. While I prepared I found out that George Steinbrenner had died.  When I felt the emotions well up in me, especially while I was watching ESPN’s Sports Center and various players, managers and other sports figures were interviewed about the Boss the emotions started coming in waves, funny how that happens.  As I reflect on this I guess it is because in many ways my dad and Steinbrenner were similar, passionate, outspoken, driven but also caring and good fathers who often showed compassion to others but in a private manner. Now my dad was not a fan of Steinbrenner or the Yankees, but the Boss engendered such emotions in people, positive and negative I am not surprised my dad had little regard for the American League after all he was a National League man.  When I heard Derek Jeter, Joe Morgan, Paul O’Neil and so many others talk of their relationship with Steinbrenner I laughed, cried and reflected on dad.  Strange connection but a connection anyway.

Photo Day 1970 with Angels Manager “Lefty” Phillips

Later in the evening I went to Gordon Biersch for a salad, beer and to watch some of the Major League Baseball All-Star game which was being played at the home of the Los Angeles Angels, at one time th California Angels, Anaheim Stadium, the place where more than any my dad taught me a love and respect of the game of Baseball.  As I looked at this cathedral of baseball, now expanded and Disneyfied since I was a child shagging foul balls and collecting autographs I was taken back in time.  I remember the very first game that dad took us to at Anaheim Stadium as it was then known as the “Big A” like it was yesterday, July 4th 1970 the day after Clyde Wright pitched a no-hitter. On this day the Angels did not win, the A’s won 7-4.  I saw the first major league home runs that I can remember seeing in person that night as we sat in the lower level of the right field corner near the foul pole. At that time the bullpen was adjacent to the grandstand and there were no mountains, valleys, palm trees or whatever else is out there, a log ride perhaps, but I digress. Back then there was a warning track and a fence as well as an amazing scoreboard in the shape of a big block “A” with a halo near the top.

That night I saw home runs by Reggie Jackson, Bert Campaneris and Sal Bando for the A’s and Jim Spencer for the Angels.  Jim “Catfish” Hunter got the win and Jim “Mudcat” Grant got the save. Rudy May took the loss for the Angels.  The fact that I saw two future Hall of Fame players in this game was amazing, the winning pitcher, Hunter and Reggie Jackson.  Later in the year I entered a contest and wrote why Jim Spencer was my favorite Angel.  I had met Spencer at an autograph signing event at the local Von’s grocery store and when the contest winners were announced I was a runner up. I got tickets behind home plate and my name announced by legendary sportscaster Dick Enberg on the radio and my name in the Long Beach newspaper that sponsored the contest.  Dad took us probably to 30 or more games that year and I fell in love with the game.

Back in those days teams still had photo days where players would be available on the field for pictures and autographs and on autograph day in 1970 my dad took my brother and I onto a major league ball field for the first time and I was in awe.  The warning track was a red clay and the field was lush green as I looked back in toward home plate I wondered what it would be like to play in such a place.  From that season on the game had a hold on me. Dad and I did not have much in common, my brother I think is actually more like him than me but Dad taught me about the game at the stadium and in our back yard and gave me a gift that connected him to me more than anything else, something that I didn;t realize until much later in life.  I looked at that stadium on television and I saw the field, the main part of the stadium is still so much like it was when dad took us there and as I looked at it and remembered him I was in tears, I had a hard time keeping my emotions in, kind of embarrassing to be in tears at a bar during a baseball game but I was doing my best to hold it in.  Judy told me that I probably needed to talk to Elmer the Shrink about this but he is out of town until next week.  So I’ll wait, everyone deserves time off.

While we were still there and I was working on my second Kölsch style sömmerbrau a friend came up to me. He was a bit lit up having consumed his fair share and maybe more for the night but God used him and in his own way to bring comfort to me in what appeared rather earthy and even ludicrous manner but when he was said and done I felt better.  I think that he will need to serve as a model for some character in the Meeting Jesus and the Team series, I have no idea which figure from the Bible or Church history just yet but I will look around because what he said even though a tad under the influence of decidedly good beer was profound.  God does use people in strange and mysterious ways.

So I will continue I am sure to have emotional surges whenever something reminds me of my dad and I guess in the long run that is a good thing as my friend said it would make me better at what I do, I have now experienced the loss of my dad and am that much closer to the time that I will pass away, a generation has been removed between me and the end of my earthly life. This is something that so many people that I know already deal with.  It allows me to be connected to them in a way that just a few weeks back that I could not be.  It makes me a bit more human and more connected.

Dad, the Boss and the All-Star game at Anaheim Stadium, it is amazing what this concoction of images, memories and feelings can turn me into, a blubbering girl, not that there is anything wrong with that.

Peace,

Padre Steve+

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Filed under Baseball, faith, Loose thoughts and musings, philosophy, Religion, sports and life

Baseball Beyond Life and Death in the ICU

“I consider myself the luckiest man on the face of the Earth. And I might have been given a bad break, but I’ve got an awful lot to live for…” Lou Gehrig

Today I was walking away from our hospital pharmacy where I had to pick up a prescription and I heard a voice of a man call out to me…no not a voice crying out in the wilderness, but a familiar voice.  I looked around and immediately recognized the man as the husband of the woman who back in May of last year was very near death in our ICU.  I wrote about that in a little post called Baseball in Between Life and Death in the ICU. That post came at an interesting time for my PTSD battle was still raging, my dad’s condition was getting worse and I was getting ready to go home for what I thought be my last visit and I was heavily engaged on the ICU and PICU.

The lady sat next to her husband, and it was yet another of the recent blessings in my life that I have begun to count as miracles. She looked great, especially since last year her prognosis for her life once she left the hospital was measured in weeks or a couple of months.  The woman was a big baseball fan and even coached.  Her husband kept baseball games on her ICU television whenever they were on even though she was for the most part very heavily sedated and only occasionally conscious. We had many visits by her bedside and one day I brought in a baseball that I had thrown out as the first pitch at a Kinston Indians game on a wedding anniversary a few years back.  With her husband and sister in the room I put the ball in her hand which tightened around it.  For what I understand the ball seldom left her hand as she remained in the ICU.  As we visited they both told me how much what I did in the ICU meant to them, the prayer, anointing of the sick and the baseball.  She told me that the ball, an official Carolina League ball on her mantle.  What was funny she only vaguely remembered my face because of her terrible condition and sedation, but that her husband would not stop talking about me. We chatted some more and talked about all the prayer that had been made on her behalf as well as the hard work of the ICU and Cardiology teams to keep her alive and help her recover.  I mentioned that probably the whole companies of baseball “saints” in heaven were praying for her as well and we all had a great laugh.  I had to leave and go to a call but we exchanged hugs and blessings.

Today has been a busy day.  I have already dealt with the death of a relatively young woman with cancer in palliative care; withdraw of life support from a man and several other situations where people could be spending their last hours or days on earth.  I had given last rites to the woman who passed away tonight last Thursday when I was on call.

I mentioned last week that despite everything I still felt good emotionally though I was physically worn out. Today I am pretty fresh even now and know that I will need to remain her much of the day tomorrow no matter what happens tonight.  However for the first time in a while I can say that I am ready and feel something like my old self again.  What began as Padre Steve’s Christmas Miracle has continued into the New Year and despite complications and infection associated with my implant surgery I feel good. I am hoping to be cleared Wednesday to PT again and am looking forward to good things even in the midst of life and death both inside and outside of the ICU.

There are some other things going on that I will be writing about in the coming days. Baseball spring training is getting closer and lots of deals and trades are happening. The Orioles and Giants have both picked up some hitting and have great young pitching.  On the other news front I am glad that Mark McGuire finally admitted his use of steroids.  At the same time I am not going to condemn him as so many others were doing the same thing, I just wished he had not taken them and come clean sooner.

Now I’m heading back upstairs to check on all of my really sick folks and savoring the bit of time that I had for dinner and to write this little post.

Peace

Padre Steve+

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Filed under Baseball, healthcare, Pastoral Care, PTSD, Religion