Civil Military Operations Conference

Good Evening All,

We had a very busy week. Yesterday we had our Civil Military Operation Conference. We had a number of dignitaries who attended and we spent the day getting to know a variety of physicians from Iraq and several political and tribal leaders. The purpose of the conference was to help facilitate the transfer of medical care and assets to the Iraqi's. We absolutely need to develop a self-sustaining Iraqi health care system. This conference was the step in that direction. I was pleased to be able to present the State Departments Brief on the military medical capabilities and assets as well as presenting the local physicians with our medical matrix. The idea behind this is to share information on how to begin to develop the foundation of a medical health care system. Below are some pictures of the conference. I would like to thank Dr. Andy Altman for helping me with my portion of the conference and I would also like to thank Sgt. Easom who took these photos for us. She is perhaps the most talented and hard working medic in our clinic.

Those in attendence at the conference included the Mayor of Balad, the Deputy Minister of Health for Iraq who by the way used to serve as the Iraqi Surgeon General under the Saddam Hussein Regime. Additionally, we had the regional Sheik who is the tribal leader of the area, we had the Chief of Police and the Balad City Council President. In addition to the above dignitaries we had three newspapers who were covering the event and a number of physicians who will be responsible for structuring the future Iraqi Health Care system.
















Picture 1: Dr. Altman and the Balad's hospital administrator. He serves as the administrator but is also an orthopaedic surgeon.

Picture 2: The lady on the left in uniform is one of our OB/Gyn docs. The lady in the middle is an OB/Gyn as well and the lady on the right is their interpreter.

Picture 3: Andy and Dr. Bakkan who is one of our two neurosurgeons.

Picture 1: Myself, Andy, and our boss, Dr. Schoup. He is our division surgeon.

Picture 2: Dr. Bakkan talking to some of the Iraqi physician. The older gentleman in the middle is Dr. Sami. He served as my interpreter for my presentation. He is a very capable man.

Picture 1: The men in uniform are our Battalion Commander and our Battalion Sgt. Major. They are talking to a couple of Iraqi physicians.

Picture 2: The man on the right is the Director of Medical Services for the Department of State. The lady in the middle is an interpreter and the man on the left is Dr. Sami.

Picture 3: Dr. Bakkan and myself having a discussion prior to the start of my presentation.

Picture 1: Dr. Altman and Dr. Bakkan. Dr. Altman was upset because he didn't have a walkie talkie like Dr. Bakkan has. Surgeons get all the good equipment.

Picture 2: The State Dept. Medical Director and the Mayor of Balad on the left.

Picture 1-5: Just me starting my presentation. Dr. Sami is interpreting for me. The last picture I started singing, "I should have been a cowboy" Based on the blank stares, I'm not sure they got it.

Picture 1: This gentleman is the current Deputy Health Minister of Iraq. He was Saddam Hussein's Surgeon General. He is a very nice man and is extremely motivated to get the Iraqi health care system up and running.

Picture 2: Just me, blah, blah, blah. The last picture I am laughing because the Iraqi's have a good sense of humor.

Picture 3: The political leaders of Iraq.

Picture 1: The young lady in the middle is a registered dietician and our public health officer. She shared the importance of preventative medicine measures when establishing a health care clinic.

Picture 2: Going over some information.

Picture 1: The gentleman dressed in the traditional robes is the area's tribal leader. He actually has more authority and power than the politicians do. I am in the back talking to Dr. Sami. He shared so much information with me concerning the medical history of the Iraqi health care system and was of great help to me as I put together my information.

Picture 2: Andy has an unusual ability to sleep with his eyes open. The only way you can tell that he is sleeping is by the small streak of slobber that is coming from the side of his mouth. He also snores.

We will be conducting another conference in two months. We gave the local government and physicians a goal of developing a health care matrix and a comprehensive list of medical assets that they will need to establish a sound health care system.

Lt. Nott's Knot and Upcoming Transition

Good Evening Everyone,

We have been very busy lately and so updating the blog has been a little difficult. The flu went around and most of us were ill over the last two weeks but that has passed. Let me update you all on a few things that we have been dealing with here. First of all, we had several of our troops get into trouble. We had one of our guys actually made his own alcohol out of fruit, sugar, and yeast that he ordered from Germany. Well, he and several others were caught drinking. Alcohol consumption is illegal here, in addition some of the troops were under 21, so it was a double whammy. So, that has taken a few of our medics out of our clinic while they deal with that issue. Then we had a soldier who decided to go out on patrol without informing the command element. He was unaccounted for at least 10 hours. That is a big deal here as accountablility is of the utmost priority. So, that has been taking time for our command to manage.

Friday, Dr. Altman and myself will be putting on a small conference for Iraqi physicians. The purpose of this conference is to begin the process of transitioning the responsibilities of providing medical care from the U.S. military to the Iraqi's. It is a process that will take a few years but we are honored to be able to start that process Friday. I will post pictures of the conference next week.

We welcomed our new optometrist and his technician this week. Dr. Jin Ha will be taking over for Dr. Geiman. I am glad to have him as a part of our staff. Optometry is a big part of our mission. Next week I will be going through the clinic and take pictures of our staff so that you can all have a face to put to the names when I talk about them.

We have been truly blessed with care packages and letters from home. We have at least 100 care packages in our MWR room right now. We combine them and give them to our troops and to our patients. But of all of the items that we receive, the most treasured are the letters for elementary students. Many schools back home have sent their childrens letters and cards of encouragement to us. In an instant, these letters brighten our day and put a smile on our faces. It is amazing to see the biggest and most rugged of soldiers become almost giddy when reading these letters. We have all taken time to write back to these kids and have found it to be very therapeutic. These children remind us of those we have left behind and they somehow fill an empty place in our hearts.

Well, Lt. Nott our Registered Nurse came to me and asked if I could remove an abdominal cyst. He says that it is in an area that causes him some discomfort when he bends over. So, when we had some down time, I took him into the trauma room and removed it for him. Here are the photos. Lt. Nott gave permission to post these on this blog. As a note, I do not publish photo's of any combat trauma or battle injuries. So you are stuck looking at our own boring photos.

Lt. Nott is psych'ing himself up for the procedure.

I have given him a local and have prep'd the area with betadine.

Making the initial incision.

We had a little audience gather to comfort Lt. Nott. Actually, they taunted him the entire time.

Things are going well.


I have dissected down to the top of the cyst.

Putting on traction

Spc. Gravitt assisted me with this procedure. She is a good medic and also our resident swimming instructor.

Behind me is Dr. Rod McPhee. He is an allergist and he wanted to come in and see what we were doing. So, I put him to work as our circulator. He is a great guy to work with.

Just another lipoma.

Here I am exploring the wound to make sure I didn't leave anything behind.

Ready to close

Just approximating the wound edges

Finishing up the closure. It is a little tight but will do well. I used a locking suture for this which will provide appropriate tension when the skin is pulled tight and will relax when pressure is removed.

I think Lt. Nott needs some sun on that skin

Peace

Lt. Nott is relieved. I don't think it was as bad as he thought it would be. He did a great job and only cried twice.

Another happy customer.

Travel Pictures

Well the flu is going around our company and everyone has the sniffles. We actually had a patient who really had influenza A. It was taken from a nostril swab. Often times we pick up some sort of virus and assume it is Influenza but often times it isn't. So, we are all a little under the weather.

The other day we finally received our foot lockers that we had sent forward from Washington State. In my foot locker, I had my external hard drive where I had most of my photos stored. So tonight I thought I would share a few photos with you.

As many of you know, Karen and I have a passion for travelling. Even after Karis was born, we continued to travel. I am hoping that she will develop the same passion for exploring other countries and cultures as we have. I used an Olympus Camera to take each of these photo's and I have been pleased with the outcomes.

So with little introduction, I will start.

The Red Desert of Arizona

Caesar's Palace in Las Vegas. This is where Celine Dion held her shows.
I am not a fan of Vegas as the city is nothing but gambling, drinking, stage shows and empty souls looking for fulfillment in the wrong places.



The Hoover Dam

Zion National Park, Utah

The Grand Canyon

These are little monkey's that I encountered in Costa Rica. They were crafty theives. While one would distract you, another one would steal the hat off of your head. Here a German woman had her bike knocked over by a couple of aggressive monkeys and had the contents in the basket of her bike stolen.

A black sandy beach in Costa Rica

This is Karis in front of Cinderella's Castle at Disney World in Florida.

Mount Ranier Washington State

Gatlinburgh, Tennessee

These flowers were taken on Vancouver Island, Canada.

Jefferson's Monument, Washington, D.C.

This is a church in Koln, or Cologne, Germany. During WWII ferocious battle were fought in this beautiful city. Both sides made very careful efforts to not harm this church during bombing runs and mortar fire. It remained intact and is still in use today.

This is the Atomium Structure near Brussels, Belgium. The design is in the form of a unit cell of an iron crystal and was built for the 1958 world's fair.

This is Old Luxembourg City in the country of Luxembourg. This city was built along the river so that the locals could have quick access to the water way. Unfortunately, due to it's location in the valley, the town was an easy target for enemy aggression. As a result, this city was conquered numerous times by different countries. Eventually, the locals built a large brick wall around the entire city and posted guards. Most of the wall has since fallen but there are still some standing wall structure left to see. Look at the upper right portion of the picture and you can see the wall.

Windmills of the Netherlands. These mills are used to remove water from the marsh areas of Holland. Families used to live in these mills and you can go inside and see the home decor. that was used many years ago.

The British Parliament, London England

This is a portion of a beach on the small pacific island of Moorea. It is the island that I referred to in my book, 'Hannah KaReese and the Island of Moorea. The Island is part of the French Polynesian Chain and is just a short flight from Tahiti.

Lake Louis, Banff, Canada

13,000 feet in the Rocky Mountains, Colorado

Lighthouse in Maine. I took this one from a boat when we took a dinner cruise of the harbor.

Alaska. The beauty here was breath taking. The sea otters that followed along our boat kept us entertained.