The Dog Days of Summer

Kandahar, Afghanistan

I may have been the only one who noticed, but I knew she was crying.  She hid it well.  One of the trauma teams had been called in yet again, and her team was assembling outside the NATO barracks to catch the duty van.   We have five trauma teams now and each team is supposed to have at least a day off between trauma call.  But it rarely works out that way.  Whenever more than one Alpha (the sickest of our trauma victims - life is in the balance, usually) shows up in a nine-line message, a second trauma team gets called in, then a third, and so on.  A day without being called in these days is a rarity.

Her team had just gotten off their call a few hours before.  Clearly she was being stretched to the limit.  Many of us are.  This week has been particularly bloody.  In the past two days alone we have had several casualties of coalition forces, folks either dead upon arrival or with a grim prognosis for survival. I just read in the news headlines that the coalition has had 12 dead in 48 hours.

We go through blood products like water here.  One of our key pieces of equipment is the "Level One," which pumps units of blood into a trauma victim in minutes.  We had a trauma victim here this week who had survived the traumatic amputation of both lower extremities and part of one upper extremity, and had a trauma bay thoracotomy and resultant cross-clamped aorta.  It was a huge save.  He had over 80 units of blood transfused before he got medevacc'd up-range.

The Level One

Last night during my call we received a full trauma bay of victims who had been ambushed.  The Taliban had somehow gotten a handful of grenades and other explosives into their living spaces.  The victims arrived in their gym shorts and shirts, when we typically see them in their cammies and flak.

As usual, the trauma teams, surgeons, doctors and nurses all performed admirably and throughout the night, stretching the limit of our operating rooms, ICU and ward staff.




As the summer reaches its apogee, the heat climbs along with it.  Last week it was 51 degrees Celsius, which translates to 'f*ing hot' in Fahrenheit.  123 to be exact.  You know it's hot if you can be shirtless in Celsius degrees if you transposed it into Fahrenheit (51 F, as in).  We have had numerous heat stress and heat stroke casualties here over the past two weeks.  One team was trapped in a fire fight without water.   Scary - fighting the enemy and 120 degree heat, without water.  Could hell be worse?

One-man Afghan tank, near Camp Hero

As we approach summer's apogee, the news is not all bad.  We are on our last lap here.  Our reliefs have just arrived at their training sites this week.  I am told we have just over 20% of our tour left (some folks have elaborate pie charts and countdown websites that calculate these things down to the second or tenth of a percentage).  Phineas Gage, whom I wrote about recently, walked out of here.  We save many.  It's not all bad, but through the thermocline layer comprised of the dust,  the heat, the blood, and the dead it is occasionally difficult to focus on the good.