We Don't Need No Stinkin' Patches

02 Aug 2010

Kandahar, Afghanistan

We don't need patches, but we seem to like them.  There has been a proliferation of unit patches representing the various departments and sub-departments, thanks to some creative minds and a willing embroidery shop here on the Boardwalk.

Every patch tells a story.  The one above is the trauma bay patch showing the silhouette of the UH-60 helo that brings us our wounded, and the one in which we on the Enroute Care team fly when picking up casualties.  Their motto is curious: "Actually, We Don't Have Any Days Off."  It's true that the trauma teams never seem to have a day to themselves, which distinguishes them from their nurse counterparts in the ICU or ward who work two days on and two days off.  Apparently this assertion has created a rift in the nursing community - I am finding this out via my roommate, who is a nurse.

To be frank, I preferred their other motto they were considering: "Will Work For Hot Meals."  The story behind this is as follows:  because we tend to spend large tracts of time in the hospital when casualties come in, need to go to the OR, need resuscitation in the ICU, etc, we often would miss dining facility meals and have to eat the meals brought in from these DFACs.  The patients have first dibs on the food, of course, but there was usually plenty of food - hot food - to feed the hospital staff as well.  We would eat these meals when we were in the old ROLE 3 in a place called the "Standeasy."  The Standeasy was a tent that was "tricked out" with a wooden deck, Christmas lights, and an old dimming TV on the inside.  There were several fly strips hanging from the ceiling, filled with decaying black flies.  It was gross and quaint at the same time.  It was comforting because one could sit on a frat-worthy couch and eat some warm food, away from the trauma bay or ICU - you could forget them for 30 minutes or so, which was good for the soul.


One of the trauma team members applying the logo to a helicopter door, which was brought to us as a makeshift litter during one of our mass casualites.

Apparently we ate too much food and some was being wasted.  So instead of titrating the right amount of food through trial and error, the command decided to nix hot food for the staff.  We now eat day or two old sandwiches, cold and very unappetizing.  This has been a nagging sore which hasn't quite healed since the policy was instituted.  In the Navy when deployed, one has few things to look forward to:  mail and hot food comprising most of those things.  When the food gets screwed with, folks get angry, and they have been for awhile.  As one nurse told me recently, "It chaps my hide that I have to serve a hot meal to a Taliban, then go to the break room to get my nasty cold sandwich."  I couldn't disagree with him.  So, "Will Work For Warm Meals" struck the right cord with me, but I think the patch-makers were a bit spooked knowing the command would eventually (quickly probably) find out about the motto.

I designed the ICU patch, "Like a Cobra Bite to the Face."  If you've been following along you may recall that we had a child who was bitten by a viper on the face, a story the ended up on the front page of the NY Times.  The child had initially been billed as a cobra bite, and the legend has endured.  The phrase "like a cobra bite..." has become part of our vernacular here in the ICU.  If you've had a bad day, it's "Like a Cobra Bite to the Face."  OK, we're admittedly a bit stir crazy after 6 months.

My favorite patch is the lime green CCAT Anesthesiologist patch - "Passing Gas in the O.R. or at Altitude."  The CCAT team is the crew that takes our sickest patients from our ICU eventually to Germany.  They are manned primarily by anesthesiologists who typically work in OR's in military hospitals in the states.  They work hard and under challenging conditions, usually with several patients "trying to die," riding in a C-17 which happens to be very crowded and extremely loud.  As far as I know, there has never been a death while on a CCAT mission.  Incredible.  Oh, passing gas refers to the gas of sedation used in the O.R. - we call anesthesiologists "gas passers."  Every subspecialist has his or her own monniker:  ENT docs are "booger pickers."  Orthopedic surgeons are "knuckle draggers."  Internists are "fleas" - the last thing to leave a dying subject.  A stethoscope is a "flea collar."  We're a weird bunch, but keeping things light keeps one's sanity intact.