DOC TALLY IN IRAQ

A FOND FAREWELL U.S. NAVY!!

2008-10-08T18:31:00.004+03:00

Update #2: It's over! As of 1 October 2008, I am a U.S. Navy Veteran after 5 years of active service. I received my second Navy Commendation Medal on my last day in uniform from CAPT Nelson, Commanding Officer of Naval Health Care New England. It's onward to a private practice orthopaedic surgery group in CT for now. It's been a slow and prolonged process transitioning to civilian life, but we believe it's the right choice for us and we couldn't be happier. I've been blessed to have met a lot of good people in the Navy and I can truly say I'm a better person today because of them. I wanted to thank LCDR Chad Deaton for all of his help during my transition process. I hope to post periodic updates on how things are going later.

Take care,

Doc Tally

UPDATE

2008-02-29T04:25:00.002+03:00

Greetings to everyone. After browsing over my blog from last summer, I thought it might be a good idea to give you a quick update. Things are going well. The little guy you saw on my right shoulder in my last entry (Matteo) is walking, babbling and exploring every corner of the house. My little girl, Mia, is progressing so well in school, we can hardly believe it.

As of today, I'm getting out of the Navy and moving on the either private practice or a 1 yr fellowship and then practice. We'll see. We may stay in East Lyme or relocate, probably to the mid-Atlantic region.

I saw the link to the CNN article about Lex, the dog many of us featured in our blogs after his young Marine handler was killed. It's good to hear that they retired him and he could return home.

Well that's all for now. I hope to hear from some of my old TQ shipmates soon.

Take Care,
Doc Tally

COMING HOME!!!

2007-09-20T12:45:00.000+04:00

DADDY & THE KIDS
I FINALLY KNOW I'M HOME

THE NEIGHBORHOOD DECORATIONS "THANKS"

RITUAL OF HANGING BOOTS AT CAMP LEJEUNE MEANING END OF DEPLOYMENT

OVER 70 IN OPEN BARRACKS IN KUWAIT
CDR PINELLA AND LCDR CARR FIND A JACK DANIEL'S AND COKE DRINK IN GERMANY
ENJOYING MY FIRST BEER IN GERMANY
HEADING HOME

LOADED C-17 HEADING HOME

HAPPY BUS RIDE FROM TQ

MUCH LOVE AND A BIG "BRAVO ZULU" TO TQ ORTHO CLINIC STAFF!

The long 8 month journey is finally over. We arrived home on Monday, September 17th, 2007, after 3 flights and a tremendous amount of waiting. We returned to a hero's welcome at Camp Lejeune at Michelangelo's Pizza place. After spending 3 days in Kuwait 70 deep in open barracks, we started out on what was a very long day getting to Ali Alasem Air Base to go through customs. This process took us roughly about 5 hours. I've never been through a customs check so thorough. They make you unpack all of your bags and empty your pockets, then you have to re-pack everything in front of the customs agent. You're also scanned several times and well as your bags. After customs, we were sent to a holding area on base that actually was quite nice. We stayed there for about 7 hours. Our flights back were great. We stopped in Germany where I had my first real beer in months. I slept most of the way home. We arrived at Cherry Point at about 10am local time and were joyfully reunited with family at Camp Lejeune about 5 hours later. I was met by my tired but happy family. After 3 days of check out we drove back home. Amazingly, we suffered a flat tire on the New Jersey Turnpike!! With the help of a kind driver, we changed the tire before roadside assistance arrived, but managed to run right into the heart of New York's evening rush hour traffic! We just chalked it up as part of my enriched deployment experience. To my wonderful surprise, all of my neighbors (some old, but many new ones) lined our street to greet us as we returned home! It was a wonderful homecoming complete with banners, presents, and even sparklers! We are blessed to have caring people so close to home. I also want to thank the nurses at the Same Day Surgery Center at Backus Hospital in Norwich, CT for sending me a great care package while I was gone. Everyone in our company enjoyed the homemade cookies.

I'm quite overwhelmed with how nice Tanika has decorated the house. She's truly made our house a home. It sure does beat 120 degree heat and dust storms. Well, I'll end my blog now that I'm back home. I'll send out some updates in the coming months to update my shipmates. I hope to get some updates back from them in the future. I want to give a final BIG CONGRATULATIONS TO CHAD AND LAURA DEATON FOR THE BIRTH OF THEIR BABY BOY BORN SEPTEMBER 7TH. TAKE CARE AND STAY SAFE!!

DOC TALLY

FAREWELL TQ/BYE BYE IRAQ

2007-09-13T21:14:00.000+04:00

Well, our time in Iraq is over. Today we left TQ for Kuwait. It's been a long and rewarding 7 months, but it's finally coming to an end. Reality finally sets in once you're boarding the plane heading out of country. We had a short flight returning us to Camp Virginia, Kuwait where we'll stage our return home. Our replacements came on August 31st and we've had several days for turnover including mass casualty drills and inservice presentations. My replacement is CDR Eric Pagenkopf. His presence here confirms that it's truly a 'small Navy' in that we were both partners for two years in Naples, Italy. Therefore, my turnover responsibilities were a breeze. Eric is a Orthopaedic Trauma Subspecialist so most of the injuries he'll see out here will be down his alley. I wish him all the best for a good tour and a safe return home. I also wish his wife, Mia, son, Chris and daughter, Skylar, all love and support during what I know will be a tough time.

Our last few days at TQ were interesting. I got to see the base as a tourist would for the first time in 7 months. After turning my duties over to Eric, I had the opportunity to travel around the outskirts of the large base to see Lake Habbinayah and the Lakeside support facilities. The support facilities include a separate dining facility and exchange. We also got to soak our feet in Lake Habbinayah. I got some great pictures from a gorgeous palm tree near the lake and three wooden crosses perched on a small ridge next to the lake. Every Easter the chapel has a sunrise service at the crosses.

Finally, we are naturally all very excited to be heading home. I can't wait to see my little guy, Matteo. I left him when he was just 2 weeks old and I can't believe how big he looks in his pictures. I also can't wait to see Tanika and Mia too. It's a little strange going back home after all this time, but I'm sure with alittle time, I'll adjust. Tanika is planning Mia's birthday (Sept. 28th) celebration along with my homecoming on September 29th in East Lyme. I'm excitingly looking forward to seeing many family members there. They may be alittle surprised at my appearance as I've lost about 30 lbs., but it's still the same ole' me.

I'll post another blog in the coming days. See ya soon.

Doc Tally

RECOGNITION LONG OVERDUE...

2007-08-13T10:21:00.000+04:00

Uncle Lay
Family after graduation

'NANA' with Matteo,Mia,Jamie,Erin

Mom and her 4 boys (l to r) Ted, Harry, Hardy, and Me

One of my favorite pictures of Tanika and Mia

Embarrassingly so, it has been brought to my attention (by my wife) that I haven't mentioned anything in my blog about some very important people in my life, my in-laws. Unfortunately she is right. I feel bad about this, because they have given me nothing but love and support since Tanika and I met each other six years ago. I regrettably forgot to wish them Happy Mother's and Father's Day via the blog. As you might have guessed I sometimes get self-absorbed into what I'm doing. Overall, I probably haven't mentioned my family enough since I started the blog. Therefore, without further adieu, I would like to send my love and thanks to my mother-in-law, Ruthell (Nana) and Tanika's grandparents, Mr. and Mrs. Raymond and Bernice Hood, my father-in-law, Rev. Reuel B. Williams, and all of my brothers and sisters-in-law (Lamar & Katrina, Derek (MSgt-USAF), Gregory, Cara, and Dale) and my nieces Jamie and Erin. I would like to also like to thank my mother, Patricia, my Uncles (Clyde, Hardy, and Frank) and my Aunts (Martha Raye, Mary, and Mae), my brothers Harry, Hardy, and Ted, all of my many cousins, and all of my nieces and nephews for keeping me in their prayers while I've been deployed. Finally, I would like to thank my loving wife for taking care of home while Daddy's been away. I certainly know it's not easy taking care of a 3-1/2 year old and a 6 month old by yourself, but you've done it seamlessly during this tough time and I appreciate and love you for it. Sorry I don't have pictures of everyone. My family pics are limited out here.

I LOVE YOU ALL AND I'LL SEE YOU WHEN I GET HOME!!

Doc Tally

THE HOME STRETCH!

2007-08-11T18:37:00.000+04:00

Well we are finally in the home stretch! Only 4 more weeks or so in Iraq and we all can't wait to get home. We are all getting pretty tired of walking to the bathroom, the shower, and the chow hall, but we're not complaining.

A lot has happened since my last posting. We finally completed our FMF Officer Qualification. We'll have a pinning ceremony in a couple of weeks. We all had to individually sit for an oral board in front of 3 qualified FMF officers (mostly Marine) and answer 100 questions related to Marine Corps history, structure, mission, and tactical situations. My board took 1 hour and 20 minutes which is about average. Needless to say I'm glad it's over, but it's a great accomplishment for our crew, and one that is well earned and appreciated.

I've started mailing back all of the 'cold weather' clothes I probably should have never taken in the first place, but this place can get very cold at night during the winter and early spring months. It's amazing how much stuff you can accumulate in 6 months. I have a lot of cleaning and disposing of unnecessary items from my hooch. Some of the folks we've met from other units have headed home including the 2/136 Minnesota National Guard who left last month. They did a great job here while having to endure an extension of their deployment from 15 to 18 months. It's good to know they are getting a much deserved homecoming.

Patient flow has come in spurts. We've been reminded by CAPT Jernigan, our Chief of Professional Services, to stay focused and not to become complacent. We continue to see a good number of casualties related to IED blasts. The wounds still never cease to amaze me at the level of soft tissue damage created. Many of the wounded US military are transferred back to either Walter Reed Army Medical Center or the National Naval Medical Center in Bethesda, MD. I'm planning on making a brief stop at one of those facilities on my return home from Camp Lejeune. It's my hope to get chance to see a few of my patients recovering and returning to normal life after sustaining such traumatic injuries.

This will not be my last posting as we still have a little more time left, so I'll save my 'see ya soons' for my last message.

I would like to also wish a HAPPY BIRTHDAY to my oldest brother Harry (July 26) and my Uncle Clyde (August 8). I hope you guys had fun on your special day.

Take care

Doc Tally

It's Hotter Than July!

2007-07-12T14:31:00.000+04:00

LCDRs NEPTUNE AND MEADE SUCCUMB TO THE HEAT

'BUTTER BETSY'

ME AND DR CARR AT STEP AEROBICS
OUR BELOVED AEROBICS INSTRUCTOR BELOW

4TH OF JULY PRAYER BREAKFAST WITH GOSPEL CHOIR

LADIES DAY AT TQ

Sorry for the long delay from my last entry. Patient flow has picked up a bit and we're busier these days. We've finally made it into July! Only about 6-8 weeks to go. We had a festive 4th of July with a large feast at the DFAC (dining facility). Your choice of steak vs. BBQ (or Both!!). We thoroughly enjoyed the decorations throughout the chow hall including Betsy Ross ("Butter Betsy" as I like to call her) and the two incredibly ugly dinosaurs (I have no idea what they have to do with Independence Day). There was plenty of Welch's Sparkling Cider and Near Beer to go around. We also had a TQ Surgical picnic the following Sunday after the fourth, complete with a series of spirited volleyball matches that had heavy officer involvement (including me and I'm still sore!).

Everyone is truly excited about beginning to make re-deployment (return home) plans. The light at the end of the tunnel is looking a bit bigger than the pin prick back in March. Many of us are from commands all over the place. Some will have to fly back overseas (Guam/Naples, etc.) after we return to Camp Lejeune.

One of the things we wanted to do before leaving was have our own American Flag flown over the base. You can buy a flag and have it raised on a special day such as the 4th of July. 2nd MLG will then make a nice certificate signifying the occasion. The certificate has a nice synopsis of the history of the air base at TQ, with interesting facts like the chemical weapons bunkers here and Saddam's plans calling for disassembly, burial, and re-assembling of the MiG fighter aircraft seen parked around the base.

Our FMF (Fleet Marine Force Qualification) course is winding down. We've received lectures on nearly every aspect of the U.S. Marine Corps and had some very interesting site visits and will start our oral boards for qualification this month. I can probably speak for everyone by saying that we're happy it's coming to an end. I think the overwhelming interest in getting back home is alittle too hard to resist.

In true military fashion, everything must change, even our aerobics instructor. He's headed home, so we're continuing with a Marine Corps Staff Sgt, so there's not much let up in her intensity. I've lost about 15 lbs while here, which is great, but the REAL challenge will be the up coming winter back in Connecticut. There's just something about short days and cold weather that makes me want to rest, eat and 'fatten up' like a hibernating bear.

A big thanks goes out to LCDR Neptune for many of the pictures for this post. I can tell I'm starting to wear down as I'm not taking as many pictures as I did in the beginning. Living your life in such a confined space shares a little likeness to prison life (without the fights and open showers Thank Goodness!). I'll try to keep the blog updated regularly as we begin our wind down.

P.S. A big farewell goes out to LT Nicole Stewart, our psychologist, who is back home. She was replaced by LT David Burke from Naples (Welcome Aboard!). Apparently the psychology special leader mandated that all deployed psych docs have their license, therefore LT Stewart was sent home and can complete that requirement. She can also enjoy the comforts of friends, family, and home.

Take care

Special Congratulations!!!

2007-06-26T15:56:00.000+04:00

OBVIOUSLY OVERCOME WITH HAPPINESS!
LCDRs NEPTUNE AND CARR ENJOY THE WEDDING

This is a special entry into the blog. Congratulations are in order for my brother, Ted and his new wife, Dale, who got married on June 22nd. The wedding took place at the Bellagio hotel in Las Vegas. Fortunately, I got to see a web cast of the wedding on the Bellagio's website. Unfortunately, I didn't see it live, but as fate would have it a wounded Marine came in, that needed surgery, about 30 minutes before the wedding. Nonetheless, you could tell by the photo above that some of the crew and I were emotionally overwhelmed by the nuptials. Congrats again Ted and Dale, welcome to the family!!!

Happy Father's Day 2007!

2007-06-14T10:18:00.000+04:00

"THE TQ STARTING FIVE"

THE NBA VETS VS THE MARINES
LCDR NEPTUNE AND LT SMITH TOWERING OVER THE VETS

SHAWN BRADLEY HELPS OUT TO FIX THE NETS (He's really not that tall, but almost!)

PATRICK (MILITARY CAR SALES), LCDRs NEPTUNE & EARLY, AND LT CORWIN EAT POPCICLES ON A HOT DAY

LCDR CARR'S METHOD OF WATCHING MOVIES IN THE OFFICER HOOCH

LCDR NEPTUNE
"ENJOYING" HER ANTHRAX VACCINATION

LAYOUT AT THE NEWLY DESIGNED OFFICER'S HOOCH (THE 'O' HOOCH)

GANG AND CHEERLEADERS AT THE VBALL TOURNEY

MARINES AND CORPSMEN HAPPILY WAITING IN LINE FOR ANTHRAX SHOTS

CDR MOORE, LCDR CROSS, AND LT HITCHCOCK SHARING COMPANY IN THE 'TQ HOT TUB'
LCDR NEPTUNE, LCDR CROSS, AND LT HITCHCOCK GETTING A SPLASH DOWN ON A HOT DAY

Happy Father's Day! It's time to spark up the BBQ grill once again. I want to wish my father, Harry F. Taliaferro, M.D., my uncles, and my brothers and cousins a Happy Father's Day. We are trying to salvage our summer here in this arid desert by making the best of it.

We've had some great visitors to come through to see us here at TQ. This week, 3 former NBA vets took time out to spend time with the troops. Shawn Bradley (Philadelphia 76ers/New Jersey Nets/Dallas Mavericks in the '93-'05), Thurl Bailey (Utah Jazz/Minnesota Timberwolves '83-'99)and Greg Minor (Boston Celtics '94-'99). As you can see from the photos they are all pretty tall. Shawn Bradley is 7'6''. He makes the rest of us in the picture look like the "Evolution of Man" poster. They shot some hoops with the Marines, signed autographs and took pictures. They were all great guys. Kenny Anderson was billed to participate, but we heard that he had passport issues. We hear that the New Orleans Saints Cheerleaders will be coming in the future.

Switching from a good thing to a not so good thing, Anthrax vaccinations have taken place for the last month. Unfortunately, it's been made mandatory again for us. These shots in particular burn when given, unlike the one I had back in Groton, CT. Thankfully, I've received my last one here in Iraq.

Patient flow continues to be slow here for the 2nd month in a row. Thankfully, the newly christened 'O' Hooch, thanks to LT Corwin, is up and running. It's a place where officers can go and relax while watching a movie or play a spirited game of poker (and hopefully not lose your combat pay). All in all, we are all 'knocking on wood' in hopes of keeping the violence to a minimum. The light at the end of the tunnel is getting bigger. We're all missing home quite a bit now.

Take care. I'll keep in touch.

Happy Memorial Day!!

2007-05-28T12:42:00.000+04:00

Greetings from the desert! There's been quite a few events to tell you about. First of all we had a great 5K run/walk benefit for the Wounded Warriors Project. All participants donated $20 for an organization that offers a variety of services to help wounded Iraqi war vets get integrated back into society. The command here wanted to run the race simulataneously with one back at Camp Lejeune (4pm here and 8am there), but due to the extremely hot temperatures, even at 4pm, they decided to move the time to 7am (good choice!) It was up in the 90s by race time (our hottest day so far, 120 degrees; worst to come in June/July). Collectively, TQ Surgical decided to run with CAPT Jernigan, our head doc, to show our appreciation for the wounded warriors. It was a fun morning for a good cause. It just so happened that a civilian won the race in 17 minutes! My finishing time wasn't quite that fast.

Next, our FMF training allowed for us to have two great in-services, one showing us the Marine Medium Helicopter Squadron 262, to see one of their CH-46's, and the other was with the 2/136 Minnesota Army National Guard to see a M2 Bradley Tank. This gives us some insight into what both the Air and Ground Combat Elements do under the operational command of the Marine Corps. I've learned a valuable lesson from both visits. I LOVE WHAT I DO, I CHOSE THE RIGHT CAREER, AND I WOULDN'T CHANGE IT FOR THE WORLD. The spaces within the M2 are very tight and with no air conditioning and flak vests with sapi plates it can feel like 150 degrees in there. They taught us some basic egress maneuvers from the CH-46 (how you would get out of the helicopter in case of a crash landing). I could easy see how you could get disoriented getting out of that thing after rolling over in the dark! I have a whole new respect for the young guys who work in that environment day-in and day-out.

Thank goodness, we are nearing the half-way point on the deployment. Patient flow has slowed down considerably since early May. I see news reports saying that some progress is being made with local community leaders here in Anbar and I believe it correlates to our work load. Being less busy is bitter sweet, because boredom quickly sets in, but you also know that the violence has decreased as well.

Finally, I'd like to wish everyone a Happy Memorial's Day Weekend. Thank a vet, have a beer (a real one), and fire up a grill for me!

Pictures:

Take cover! Doc Tally has the 50 Cal!

Hull of the 46

Me and Squadron Sign

Squadron nickname "The Flying Tigers"

Me and the CH-46

Me staring down the race course with determination (or fear) in my eyes

Side of the CH-46

TQ Surgical before the race

Start of the race

LT Morales (CO) and CAPT Jernigan (CPS) showing blood, sweat, and a lot of tears

Me and the rest of the gang chugging out the 5K

CDR Haugton and LCDR Meade (OR Nurses) with 1st and 2nd place medals from the Wounded Warrior 5K

Ugandan Guard cheering us on

Me and Dr. Carr

Two M2's side by side

Look out! Me in the driver's seat.

M2 Bradley Tank Engine

CDR Haughton, LCDR Carr and LT Moore in the back of the M1

LCDR Carr waiving to LCDR Neptune in the M2 turret

LCDRs Carr and McMindes (one our CRNAs)

Me and LT Meg Moore (Helo squadron flight surgeon)

Bullet hole riddled ambulance.

M2 with bird cage around it.

HAPPY MOTHER'S DAY!

2007-05-14T12:49:00.000+04:00

Well, we made it to Mother’s Day 2007. Happy Mother’s Day to my mother, Patricia, my wife, Tanika, my Aunts, Martha & Mary, my sister, Cara T, and to all the mothers in my family.

Guess what…? IT’S HOT, HOT, HOT. The thermometer tells the story. The interesting part about the heat here is that the wind is very hot, like a hair blow dryer, and it doesn’t let up at night. We lament over having to wear our uniforms now, and the Marines rules about uniform wear don’t allow us to modify their appearance. Everyone must keep there sleeves down while deployed out here. There are also rules as to what amount of physical activity is allowed depending on the temperature outside. Recently, any prolonged physical activity during the day has been prohibited.

Congratulations, are in order for CDR Lew Dyer, who was promoted to CDR on May 1st. He was fortunate to have Brig Gen Kessler of 2nd MLG to preside over his promotion ceremony. Lew is the senior nurse in our company and goes out on flights as an en-route care nurse. I’ve known Lew since my days in Naples and he certainly is well deserving of the promotion. Bravo Zulu!

We also had another celebration on May 12th for two birthdays. LCDR Carr and LT Smith were the honorees. We went up to an open air porch lovingly called the “Bada Bing.” It’s a place where Marines from the Air Wing wind down to relax while smoking cigars and sipping on near beer. I must admit that I’m a cigar novice, but I didn’t want to be the odd man out so I struggled through smoking a couple of Cuban cigars. I didn’t realize how strong Cuban cigars were until I started seeing music and feeling colors. However, it was a great time and a nice break in the monotony.

We’ve started having base movie nights. Every Wednesday and Saturday night a new movie is shown outside. The movie is projected on the side of a truck bed or on a clear wall. Unfortunately, you must be in uniform to see the movie and it’s still about 90 degrees at 8:00 pm. We usually don’t let that stop us. The MWR people pitch in free popcorn and sodas as well.

Another interesting project is MCMAP or Marine Corps Martial Arts Program. The Marines will teach anyone interested in learning Martial Arts leading toward the acquisition of belts. The first belt level is tan, then green, gray, blue, brown, and black. CDR Haughton and LCDR Neptune are both hard charging participants of the program and I got some pictures of them qualifying for their tan belts.
Pictures:

Digital clock showing the temperature of 112 degrees in the lower left corner

The birthday boy and girl, LCDR Carr and LT Smith

Me struggling through my Cuban cigar

The Crew at the Bada Bing, (back row LtoR), LCDR Meade, LT Martin, CAPT Jernigan, Me, CDR Haughton (front row), LCDR Neptune, LCDR Carr, LCDR Cross

More TQ Surgical Caps

TQ Nurses (picture taken for Nurse Corps Birthday)

CDR Haughton and LCDR Neptune during MCMAP testing

CDR Dyer looking stoic at parade rest

Pre-muster before CDR Dyer's promotion ceremony

Me at the popcorn stand prior to the movie

TQ movie night showing the end credits of "Happy Feet"

A stop/warning sign on the back of a Humvee

The Daily, Weekly, Monthly Grind

2007-05-01T17:59:00.000+04:00

We have finished our second month in-country and have about 4 and 1/2 months to look forward to. The idea of spending the better part of 8 months with a group of people can be at best challenging. Fortunately, we have a good group that works well together. As you can see, we've bought embroidered surgical caps with our nicknames. It helps to keep things as light as possible around here. Sometimes, the grind of seeing severely injuried patients can wear you down. This is especially true with children. We had a horrible incident of a mortar hitting a house full of children, killing one and injuring several other kids. The mood after incidents like this is pretty somber, and the ability to cheer yourself up is essential.
Lately, we've been seeing a fair number of patients from two local Marine units and one Army National Guard Unit. The loyalty and support within these units is awe inspiring. Many fellow soldiers will wait for hours until their buddy's surgery is done, and are usually the first to line up for the walking blood bank. The CO of one of the Marine units actually stays with his Marine even into the OR. Sadly, he's been present when some of his Marines have died in the OR, firmly holding their hand as they pass on. We also are blessed to have one of the Chaplains say a prayer at that point. They are just as vigilant as us, and respond to every trauma call for spiritual support.
The pictures posted include the TQ surgical staff caps.
Some pictures from "Outside the Wire" showing a small village near Habbaniyah and local BAS from the 3/6 Marines (Thanks to LT Smith for the pictures).
A picture of the CDR Raheb, LCDRs Carr and Corwin, and myself enjoying our nearly daily AM ritual of Green Bean coffee.
A road on base adopted by the KBR carpenters.
LTs Laquihon and Day and the crew with and their new blue plastic aprons donated from a stateside hospital.

...and then the rains came

2007-04-19T17:04:00.000+04:00

...and then the rains came. We got our first major rain here at TQ and we're seeing up close how this place changes from baron desert to muddy floodlands. The morning after Easter I had to walk to the shower and a 2 foot lake was in front of the shower trailer. The worst part about the rain is the eventual clean up. You can't keep the mud out of your hooch. This past week and a half started out with rain and ended with warm, dry weather. This allowed us to have a BBQ picnic to welcome the new staff from Al Asad. We had a good time with all the near beer and steaks we could enjoy and played volleyball.
Overall, patient flow has been average to below average. Only one mass casualty (over 3 patients) since Easter. Thankfully, no major problems here on base. We had one special patient come through. He was an 18 month old Iraqi boy who was hit by sharpnel from a mortar round in the hand. He instantly melted the hearts of all the staff. Unfortunately he had some tendon and nerve damage which needed to be surgically addressed. Its in situations like this when we find out how frustrating it is to care for Iraqi civilians. They have very little, with respect to health care infrastructure, in our area for traumatic/surgical conditions. It's a topic of heated debate around here, because taking care of Iraqi civilians is not within our mission scope, but we find ourselves from time to time dealing not only with medical issues, but with case management and disposition issues that are extremely challenging. Some of the docs have even had ethical conflicts with standards of care when it comes to treating Iraqis. There's obviously a serious void of Iraqi health care professionals, and we hear occasional stories of corruption amongst some Iraqi officials. It gives you the impression that no matter what happens, some form of humanitarian/medical aid will need to be present here for years to come. A slim majority of patients in our level III facilities are Iraqis and they are generally not permitted to be sent out of country. Unfortunately, we had a Marine pass away after a spirited effort by everyone to try and save his life. Not only did he have severe extremity injuries (above knee amputation and upper extremity arterial injury) , he had undergone emergent chest and abdominal surgery, and more than likely subcame to intracranial bleeding. These are the toughest loses for us. We feel that if a patient can reach us with a pulse, then should be able to save them. I know it's not always possible, but it's more disheartening to lose someone who had signs of life when they reached you.
Day to day, we are trying to keep our minds occupied to help the time pass. Recently, I've turned into an aerobics nut. I must confess that I never tried aerobics before this deployment, but now I'm hooked. It's much more entertaining than running on treadmill, and at the end of the session, I sore in places I never thought could be sore. We are also starting our tradition of the moonlight campfire porch. This is an area just outside of our living spaces where someone sets down a battery powered lantern which we sit around in a circle and swap stories under the bright desert starlight. You have to do things like this or else you'll go crazy from the intermittent boredom.

Pics of the week (thanks to LCDR Neptune for some of the pics):

The lake by the shower trailers

LCDR Neptune enjoying the rain water

CAPT Jernigan fights off the flames from the grill

A picture of one of Saddam's MIG fighters

A make-shift cast shoe (with home made laces) for one of our peds patients

Our friend gets up close and personal with the camera

Our friend posing after his dressing change

CAPT Rodridguez helping me study up on my pediatric hand surgery

Picture of CDR Deordio consoling our friend

A nice shot of LT Morales and his perfect form for his volleyball serve

HAPPY EASTER SUNDAY!

2007-04-09T11:11:00.000+04:00

Happy Easter! Well, it's the day that the Son of God, Jesus, was resurrected! As you can see the staff at our chow hall, chose to erect a life-size replica of Him to celebrate the Holy Day. We were all trying to guess what the statue was made of. Since we weren't allow to touch it, and it looked like butter, we hence forth called it, 'Butter Jesus'. What is more amusing is the idea that the chow hall workers ,most of whom are likely Muslim, probably thought that most of the Christian Americans would love to have a statue of Jesus in the chow hall.

There's been other interesting events this week, including a lecture by one of the docs (LTC Burns) from the Minnesota National Guard who runs the Battalion Aide Station or 'BAS' on the physiological effects of crucifixion. The pictures show a young Marine who was challenged at the end of the lecture to hang for as long as he could on the nails in the cross. He was able to last for 5 long minutes, but he was pretty sore. Interestingly, the most frequent cause of death from crucifixion was asphyxiation. He also told us that prior to crucifixion it was customary to be severely whipped with a whip laced with iron shards and pieces of animal bone much like what was seen in the movie, 'Passion of the Christ'. The only ones not whipped prior to crucifixion were women and children. It's a little bitter sweet that I'm so close to many of the Biblical sites here in the Holy land, but I'm confined to this base for my entire time here.

This week, we also got the chance to visit the BAS I mentioned above, that's run by Minnesota Army National Guard. They are all pretty nice guys. Unfortunately, many of them have been here at TQ for 18 months. They were suppose to go home back in March, but their tour was extended until July 2007. One Master Sergeant told us the last time he was home was July 2005! We all empathize with those guys, because they are here much longer that we are and they don't receive the same benefits as we do on active duty. One of the pictures is me at a little coffee shop they run called the 'Ground Hog Grind'. Their motto is, "If you didn't like today, don't worry tomorrow will be exactly the same!"

The pictures above show 'Butter Jesus'

Me and my new surgical cap.

Me and the Ground Hog Grind Sign

A picture hung at the BAS of the Minn Nat'l Guard Unit and their response to Sen. John Kerry's botched joke about being stuck in Iraq if you don't do well in school.

Another picture at the BAS of Chuck Norris. Amazingly, he is wildly popular with Marines and other Armed Forces personnel. He's been here many times and they just made him a Honorary Marine.

The young 'crucified' Marine and LTC Burns

Light Armored Vehicle

Picture of my 'Wall of Fame'

Some of the gang at Easter Dinner

Sandstorm Sunday

2007-04-01T16:57:00.000+04:00

It's Sandstorm Sunday. This is our first sandstorm since we arrived. It's not too bad, but the fine grain sand gets EVERYWHERE here. Computers, cameras, living spaces, and any other crack or crevice on your body gets sand in it. Overall it's a good thing for us because when sandstorms take place, the fighting pretty much stops, and there are virtually zero flights going in and out of the area. This is also the first Sunday morning we've been able to sleep in or finish going to church services.

This past week has actually been a refreshing break. Incoming casualties have been slow, which has given us time to enjoy other pursuits. I am proud to say that I have completed and passed my Marine Corps physical readiness test (PRT). You're tested on the most pull ups and sit ups you can do in 2 minutes, and a timed 3 mile run. The passing standards for the test are set by age. Given that I wasn't in peak shape, I'm glad it's over. I finished my run in just over 27 minutes (I know, I'm slow as a turtle!) We started at 0900, and by 1000 the sun is bright and hot here. One the good things about the test was we ran on a road that leads over to the town of Habbiniyah and the lake. It's a nice view; I wish I'd taken a picture, but I was concentrating too much on my run.

We've received a scant number of Iraqis this week (civilian, Army (IA) and Police (IP)). We had a young Iraqi boy who was caught in a gunfight and had a bullet lodged in his upper thigh. One of the general surgeons removed the bullet intact. The boy was fine. We worry alot about unexploded ordinances on our patients. It's not uncommon for Marines, IA or IP to have grenades on there person, or even worse, explosive material lodged within their body. There are contingencies for this problem, but we often have to fight that normal impulse in most medically trained people to rush over and start helping a severely injured patient.

Our reinforcements from Al Asad arrived this week. Most of our capabilities have been 'PLUSed UP' with the exception of Orthopedics of course. We now have six general surgeons and 2 more anesthesia providers, along with additions in a host of other medical and nursing positions. Al Asad became a level III facility and was taken over by the Army. That means (among other things) that they have a CAT Scanner and a number of other surgical sub specialists, as well as ICU beds and ancillary services like physical therapy. Therefore, they can be a valuable resource for us. However, with the switch, the Navy personnel there were no longer needed and reassigned to other locations. We can always use the help, and from what I hear, they tell us the food is MUCH better here.

The images this week include:

Hesco Beach Club (where the volleyball is played)

LT Day looking sharp in his food services garrison cover

LT Laquihon hold comforting his patient with the Padre in the background

Me in between sandstorm gusts.

LCDR Carr (again) who wishes to be called Gator given his never ending consumption of Gatorade

LCDR Carr and his Hajji mask attire.

LCDRs Neptune, Carr, and Early braving the elements of the sandstorm.

A week of 'Hit or Miss'

2007-03-25T22:18:00.000+03:00

It's been a week of 'hit or miss' as we say when it comes to incoming casualties to the hospital. We had a 36 hour period of calm, then a steady flow of patients, nearly all requiring some form of orthopedic care. Being the only Ortho surgeon here means I respond to nearly every call when casualties come in. This week, one of our 'patients' was a K-9 (German Shepard), who was unfortunately, caught in the blast zone of an IED. Fortunately some of our corpsmen and a veterinarian tech were quickly able to patch him up. It's always hard to see severely injured patients, but it's especially difficult to see children or animals injured or killed. They are truly defenseless in this war, and the prevailing tone around the hospital quickly turns very somber when a child or animal is hurt. The death of a fellow soldier also brings the same sentiment. When a soldier dies, we at TQ Surgical honor him or her by 'Manning the Rails'; the entire company stands at attention along the hallway out of the facility while the fallen Soldier/Sailor/Marine is carried out on a litter draped with the American Flag. We as a surgical team have experienced this and it's sad no matter how many times it happens. Afterwards, however, our team comes together with renewed focus towards the next patient.

Being busy so far, I haven't had many opportunities to see the rest of the base. The history around this base is interesting. Apparently, Saddam and his sons used a sprawling ranch house on Lake Habbinayah before the war for torturing and killing many Iraqis (shia). He also buried numerous MiG 25 and Su 25 Iraqi Air Force fighter jets, presumably from the time of the Gulf War. Many of these have been dug up. The 82nd Airborne first took over this base, but now it's a Marine base, although we have Army integrated among us.

The days seem long here. There have been many times we'll do a case in the morning and by that evening, it will feel like the case happened the day before. Having said that, we are nearly at the one month mark. I was told today that we'd better appreciate the warm weather we've experienced, because it's going to get very, very hot soon.

As far as the surgical cases here are concerned, it's been challenging. Many times I've had to defer to the general surgeons. A patient may come in with a severe extremity injury and I'm ramped up to go in and fix it. However, if the patient has a head injury or is otherwise unstable, I have to just simply put a splint on the extremity and send the patient out to the next level of care. I certainly want to do more, but it's how the system is supposed to work in order free up space for the next round of patients. In that respect, it's much different than civilian trauma care.

The pictures posted include our fearless patient (one with LCDR Neptune).
One picture of the Arabian night.
A tribute to our en-route care nurses, a picture of their Kevlar helmets.
A picture of HN Labindano putting on a splint (I'm working like crazy to train these guys up!)
An x-ray of what happens to your foot, if you're lucky, after an IED blast.
A picture of the 'body bags' we use to keep patients warm during MedEvac transport on the helicopters.

Happy St Patrick's Day

2007-03-17T11:33:00.000+03:00

Well, it's official. I am finally very tired. We have been operating constantly for the last week. From one to seventeen patients at a time, we are receiving a steady flow of patients both Iraqi's and American service members. I think my daily blog is going to end up being a weekly blog. It feels like we've been here for 3 months, but it's only been 2 weeks. The outgoing surgical team has returned home and the entire responsibility of patient care falls on our shoulders. It's an awesome responsibility, but one that we're proud to provide. I liken this experience so far to being on trauma call during residency, being on call 24/7 and the casualties can and will come in at anytime. However, when I get the call to respond to a urgent surgical medevac I truly haven't felt overburdened or stressed about getting out of bed to go to work. I've quickly learned that my job here is much, much easier than the young (usually 18-24 years old) soldiers, sailors and marines out there on patrols and convoy ops, at check points, and clearing neighborhoods. They are doing the hard work and they rarely complain. Nearly all of them also want to return to there units after being wounded. It's tough to tell a young lieutenant that he'll need to leave his men behind to get more definitive care back in the U.S. They usually have a large amount of guilt associated with leaving their friends behind to fight without them. There's many patients dealing with Post Traumatic Stress Disorder.

I'm also learning about the Iraqi Army and the Iraqi Police. I probably have treated more of them than Americans. So far, we've seen some of them with self inflicted gun shot wounds to the extremities. I've been told that in order to clear there weapons they need take them off of safety and have negligently shot themselves. Some of these patients can't return to duty because of it which is extremely counter-productive to the overall mission here. Also, we have to very careful where we send them after care. They are high profile targets for the insurgents or death squads.

As for life at TQ, I've been too busy to enjoy life outside the hospital. I hope that can change in the next couple of months. I finally have a room to myself and I'm slowly getting settled in. Many of us officers have started classes toward gaining our Fleet Marine Force Warfare Pin. It's something to do out here other than work. It's the Marines' way of saying us Navy guys are part of the Corps. We also have a huge share drive of media files (movies, shows, etc.) we can download from for downtime. We're all waiting for the summer heat, but we have been told to expect some rain in the next couple of months, which is horrible here in the desert. I hear its a sloppy mess all over the camp when it rains.

I have a picture of me and two nurses from the New England region (Groton and Newport), LT Lora Martin and LCDR Chad Deaton. They're both ERC (En-route care) nurses and have one of the most dangerous medical jobs out here. They go out with sick MEDEVAC patients on helicopters. Many of them have experienced being fired on with small arms fire and rocket propelled grenades. They should get special recognition for this, but unfortunately at this time, they don't.

There's a picture of me and CDR Erin Moore one of our surgeons who specializes in vascular surgery. We were busy debriding what was left of the heels of an Iraqi Army soldier who stepped on an IED.

The guy with dusty foot is what happens to splints after just 2 weeks out in the desert.

I also have a picture of the some of TQ Surgical waiting for a MEDEVAC helicopter to land to bring in an urgent surgical patient.

The next picture is me and LCDR Neptune (one of our OR Nurses) at the Hajji shop where you can buy anything from an external hard drive for you computer to bootleg DVDs.

The last picture is me with the outgoing surgical group having hot tea and smoking cigars at the Hajji shop. It's sort of a weekly ritual for the troops to unwind and sit outside on a clear night.

Well I'll try to keep the info coming, but unfortunately this war keeps Ortho docs like me very, very busy.

Take care

Sorry for the Wait

2007-03-10T10:06:00.000+03:00

I apologize for the long wait between postings. Unfortunately, I've been very busy here since last week. I also found out that the computers here don't recognize Microsoft Works documents so I'm typing up this posting from scratch rather than saving a copy on my thumb drive to copy onto the blog when I get to the internet cafe. Internet access here can be spotty. There are times when all internet access is shut down when something happens to someone affiliated with the base in order to limit inadvertent contact to family members. These periods can last from hours to days depending on the circumstance.

As for life here. It's not bad so far. We are learning a lot from the previous group. Patients come through any time of day, but usually the mornings are less busy than the evenings. The nature of the injuries, as I suspected, are grave. Many times the decision I have to make is when do I stop and let the next level take over. I did my first external fixator case a few days ago on a patient with a severely fractured leg and foot. I'm don't think he's going to keep the leg.

I've also found time to check out the Hajji shop and tea house. Iraqis like to sip tea and smoke cigars in the late evening. Many of the Marines and Army guys like to do the same. It's a nice way to relax at the end of the day. We are also working on getting the interpreters to consider starting an Arabic language class. That should be interesting.

I'll try to post some images with this entry. Right now we are in another email blackout period.

Some info on the pictures above. The photo of me and the other guy is Chris Carr one of the general surgeons. One day I accidentally picked up his uniform top and put it on. I didn't realize I had it on until I got to the chow hall and one of the other officers told me. You may notice that we have each other's uniform tops on.

The picture in the OR is me and CAPT Thompson. He's the outgoing Ortho Hand surgeon. He's the program director of ortho for the Navy in San Diego. I'll try not to send any bloody, grotesque operating room pictures.

The Dirty/Clean picture is how the laundry gets done here. Just drop off on laundry day and you get back clean, folded clothes in a plastic bag 2 days later. If only it were like that at home. lol.

The beer picture is actually non-alcoholic beer. I didn't realized so many different beer makers offer a non-alcoholic version. I guess they have to make their money on soldiers somehow.

Take care.

Welcome to Iraq

2007-03-03T21:59:00.000+03:00

Well after a very, very, very long departure process, we finally arrived to TQ, Iraq. The entire ordeal took a week and the timeframe from Kuwait was over 24 hours. Needless to say we were all very exhausted and after eating some breakfast at the chow hall (excellent food), the majority of us went into hibernation. I hibernated for about 7 hours. Angela Early, our trama surgeon scrubbed in on a case immediately. Fortunately, they haven't been too busy here since we arrived.

The base here is huge and many nice amenities for a forward operating Marine base (PX, Internet cafe's, Coffee house, Gym/Aerobics, etc.) They also have other shops run by local nationals. The terrain is baron desert. So far the weather has been bearable with highs in the upper 70s and lows in the 50s. We are learning as much information from our outgoing counterparts as we can before they go. So far, we seen some tough cases. Over 70% of the casualties are orthopedic, so I'll be very busy. Most of the patients are Iraqi's and their disposition after treatment is one of the biggest problems the medical community has to face.

I getting use to life on base and having to walk nearly a half block to go to the bathroom (especially bad in the middle of the night). I'm also beginning to learn the nuances of Arabic culture. I'm still thought in a little shock (and some jet lag) that I'm here. I posted some pictures and will keep them coming when I can.

We'll talk more later.

Almost There

2007-02-28T11:11:00.000+03:00

Well, our short stay in Kuwait will be over soon. The base here is nice, but we don't have much to do other than eat. They have a good assortment of amenities to pass the time including Internet at various spots, PX, gym, call centers, etc, but we're all anxious to get to our final destination to get settled in. We're in the early spring here so it gets warm during the day, but down right cold at night. Especially in these breezy barracks. But I'll manage. Will keep you updated later.

Arrived in Kuwait

2007-02-27T23:24:00.000+03:00

Well, we arrived in Kuwait. We're at a small Army base and adjusting to the jet lag. Unfortunately, you lose an entire day traveling over here, and the news of the stock market is shocking. Sorry, but I'll have to make this brief, as I'm at a busy USO internet cafe and I only have a 30 minute time limit. We'll be heading out soon. I'll keep you update and try to get some pix in too.

Absolute Repeat of Yesterday

2007-02-25T21:38:00.000+03:00

Today, so far, is an absolute repeat of yesterday. We wake up, eat, then slowly repeat the process of preparing ourselves. Fortunately, its given guys in our group a lot of time to talk and get to know each other. I’m currently sharing a room with a general surgeon, ER and FP physicians, and a critical care nurse. Many of us are within the same phase of life, 30s to 40s, married with kids from 2 wks old to the early 20s. Last night we went to go see the movie Reno 911: Miami, which was embarrassingly funny. We are hopeful to leave today, but are unsure due to the weather and other possibilities. The tough part about waiting is not knowing how day-to-day life will be at our final destination.
Many of us have mailed home clothes we don’t need and mailed forward clothes and hygiene products to Iraq, which has left us with little creature comforts here while we wait. I’ve re-washed my clothes everyday for the last 3 days. I’ve also had problems figuring out what, and what not, to bring with me. Although I’ve packed to travel many places before, this is my first deployment, and I want to be prepared for the real contingency of being stuck in Kuwait for 3-4 days, so I’ve had some “separation anxiety” of leaving extra clothes and other comforts. Overall, it’s better to pack very light. Most people fit all personal items in one sea bag, all of their issued gear in another sea bag, and then one carry on bag for your laptop computer, ipod, etc. Some folks have ’bitten the bullet’ and are bringing 3 sea bags, but hoping that 3 light bags will be easier to carry than 2 heavier ones.
It’s amazing how much money most of us have spent for “needed” items prior to our deployment. I estimate that I’ve spent close to $500 on items like an extra uniform, military carry on bag, upgraded boots (2 pairs), PT gear, and an assortment of other things. Not to mention, a few hundred dollars more for airline tickets and car rentals to get around. Even our meals, as officers, are paid out of pocket because we still receive our ‘BAS’ or meal allowance. However, I do hope to save some money while I’m away from the tax free combat zone benefit and other hazardous and family separation pays.
Another part of pre-deployment anxiety for medical personnel is wondering if you can handle the long work load and the severity and acuity of cases coming in. There are no business hours, holidays or days off during deployment. The Navy got out of the trauma business a long time ago, so many Navy surgeons (up until the war), don’t do a lot of trauma. Many of us spent up to 4 weeks in LA for the Navy’s Trauma Training Course, which for some people was helpful. Fortunately, most civilian orthopaedic residencies (especially inner city programs) give good trauma exposure, so I don’t think I’ll be overwhelmed. However, there’s a big difference between a closed tibia fracture and severe multiple limb blast injuries from an IED, so I to have some anxiety about not only what to do, but how much to do, before I MEDEVAC the patient out. As of right now, the Navy has a 5 level echelon of care beginning with level 1 “buddy aid” care in the field, usually administered by corpsmen or another marine. What I’ll be providing is level 2 care, which involves stopping the bleeding, debridement (cleaning) of wounds, and stabilizing fractures with external fixators before getting them on a chopper to a level 3 facility in country for more definitive care. Level 4 care usually involves getting the patient out of country to Germany for even higher more comprehensive care. Then finally, level 5, where the marine will head back to the U.S. for final disposition. The end result of having this system has significantly lowered the death rate of service members who make it to a doctor after being wounded in the field, and its been described as a ‘force multiplier’ and a ‘morale booster’ to the troops in the field.
Well that’s about all I have to say right now. I’m learning to occupy the vast amount of idle time by either reading, using the Internet, and now writing this blog. I’ll keep you all updated on events as they happen.
I’d love to hear from anybody, so feel free to return a comment or send a picture back through the blog when you get a chance.
Take care!

Greetings from NC

2007-02-25T01:46:00.000+03:00

You'll have to excuse me as I've never done a blog before, but initially it seems like fun. I'll try to keep up with it as I go along. So far, it's been one boring ordeal waiting for our journey overseas. It's the classic "hurry up and wait" situation that everyone who has been through this has told me. I'll keep you updated on our departure and arrival.

Fortunately, I'm with a great group of people. The guy on my left is Chad Deaton who is a critical care nurse looking off into the swamp. He's from Kentucky and loves to bet on horses and drink Yueungling beer. Our company has 4 general surgeons (one trauma trained and one vascular trained), 1 orthopaedic surgeon (me), 2 ER docs, 1 FP doc, 2 CRNAs and 1 Anesthesiologists, and a bunch of nurses and corpsmen all committed to saving life and limb of not only US service members, but of Iraqi Nationals.

The plan tonight is have one or two more beers, catch a movie, and then hit the sack and find out what's in store tomorrow.

I'll try to go back and tell you about our training here at Camp Lejeune as time permits in the future.

Love and Kisses to my wife Tanika, my daughter Mia (Sweet Pea), and my brand new baby boy Matteo Francis Taliaferro born February 4th, 2007 (yes Super Bowl Sunday), and to my mother, brothers and rest of the family.