Day 191: Thanks for the Trust

As healthcare providers, we all say things to our patients in an attempt to comfort them as we do something uncomfortable or painful to them. It is often hard to know exactly what to say as you jab them with a sharp object or put something foreign into the body that was never intended to be introduced. Somehow “sorry” doesn’t quite seem to be enough as tears well up in their eyes or a cry of pain escapes their mouth. It is not a fun thing. However often it is a necessary evil.

Well today I was on the receiving end of the pain for once as I visited the dentist. I sat in the dental chair as he repeatedly jabbed me with a needle. With each poke of the needle, he repeated in a nearly inaudible whisper...”thanks for the trust.” Over and over he kept repeating “thanks for the trust.” I know his intentions were good. However, his tone of voice and the way he said it was more creepy than reassuring. I found with each injection I trusted him less and less. It made me ponder what my patients are thinking as I try to comfort them or apologize for the pain I am inflicting.

Anyway, the experience really was not that painful. However, the jury is still out on whether it was worth flying across the country to visit this particular dentist. He was very fast and I am not convinced that it was the highest quality of dental care. Time will tell I guess. It is a good thing my brother in law will have graduated from dental school by the time I make it home. I may need to make an office visit to get things fixed up.

Here is a picture of the hospital where the dental clinic is located. Bagram is the largest American hospital in Afghanistan. It is a large and very modern facility. I somehow felt a little homesick as I walked the halls and remembered the days when I actually practiced medicine. I saw doctors walking around in scrubs and with pagers on. It reminded me of my life before these 452 days began.


Attached are a few other pictures of Bagram...a very large and interesting place. It really is like a small city. The main roadway is packed with cars. There are a lot of soldiers, but interestingly there are an equally large number of civilians. They are all over in civilian clothes--making it seem even more like a little city. Also, there is a Dairy Queen, Orange Julius, Subway, Burger King and Pizza Hut (I was tempted to visit one of them but I decided to stick with the fattening, fried food that was free). They also have a large shopping area--a mini mall which I quickly exited. I will leave the shopping for Sue back home.


Here is the USO. It is named after Pat Tilman who was an NFL player who was killed by friendly fire during the early years of the war.


This picture doesn't quite do it justice but there is often a traffic jam on this road.


Here is my living space for the past few days--a little crowded, a little noisy, and a little dirty.

Day 190: Going to the Dentist

Today I flew from Herat to Bagram Air Field (near Kabul). The reason for my trip...no it isn’t a top secret mission or a personal visit to President Karzai...rather I came for a dental appointment. That’s right, there is no jumping in the Humvee and running down the street to visit the dentist in Herat. Instead, you have to get on a plane and fly to the Capitol in order to see an American dentist. I could have had an Afghan dentist take care of the problem--I chose to fly across the country. I’ll let you know tomorrow if I made the right choice.

Here are some pictures from the days journey.


This is a huge tank of highly flammable liquid oxygen that sat right in front of me the whole flight. Good thing they have a no smoking policy.










By the way, the answer to my question yesterday was India. The others were probably obvious except maybe China--it has only a small segment that borders Afghanistan.

Day 189: On The Border

Multiple Choice Question:

Which of the following countries does NOT share a border with Afghanistan?

1)Pakistan
2)Iran
3)China
4)India

The answer will be in tomorrow’s post.

Afghanistan is a land-locked country about the size of Texas. The country’s vast borders are in constant threat from potential enemies both foreign and domestic. Also, the border is a highway for arms and drugs trafficking. To held defend the country from these threats, the Afghan government has created the border police. These police work in some of the most remote and desolate parts of the country to keep it safe.

Today, I went out to the border patrol headquarters for the region to visit the medical clinic there. It was an interesting ride as we drove through all of downtown Herat and then up onto the edge of the mountain to the base. As always we saw sheep, camels, 20+ people packed into a car, fruit stands, kids waving, etc. It was a nice trip.

Day 187: Thanksgiving

Today I celebrated my first major holiday away from home. It was good preparation for next month and Christmas. Honestly, the Army did a good job of making it a nice and enjoyable day. We had several activities including a 3 on 3 basketball tournament (my team took 3rd place this time), horseshoes, and a ping pong tournament. What made it even better is that we are still experiencing some unusually warm weather--it is nice to be out in shorts and a t-shirt on Thanksgiving. The food was pretty good and the kitchen staff did a nice job of trying to make it seem as much like home as possible--although, warm homemade rolls and pumpkin pie with whipping cream were noticeably absent.

On this day, I give thanks to my Father in Heaven for the blessings I have. Although I am far from home and am missing all of you, I am grateful for my safety, my family back home, my country, and all the many other things I have been blessed with. I hope you all have a fun and safe Thanksgiving back home...and by the way, someone eat an extra piece of pumpkin pie for me.

Day 186: A Thanksgiving Thought

In the early 1600's the Pilgrims held a feast of Thanksgiving to thank the Almighty for their harvest and the blessings they had received. From that point in time, days of thanksgiving were held intermittently in the Colonies and during the early history of the United States. In 1863, during the midst of the Civil War, Abraham Lincoln called for a national day of thanks to be celebrated in the country. Since that year, Thanksgiving has been a tradition and a holiday that has been honored every year in America.

I think it is interesting that Lincoln called for a celebration of thanks during such a dark time in our history. However, he recognized the hand of God in the preservation of his country and the blessings that the people and the country as a whole had received. This year I will spend Thanksgiving in the middle of a war torn country. There are many struggles and trials here. There is still much anger and hatred. However, like the times of Lincoln, there is also much good. There are many blessings that a loving Father hath bestowed upon me, my family, my country and the good people of Afghanistan. Here are the words of Lincoln as he called upon the people to remember God and thank Him despite the difficulties that they faced. I found it a good reminder of why we celebrate Thanksgiving and wanted to share it with you.

"The year that is drawing towards its close, has been filled with the blessings of fruitful fields and healthful skies. To these bounties, which are so constantly enjoyed that we are prone to forget the source from which they come, others have been added, which are of so extraordinary a nature, that they cannot fail to penetrate and soften even the heart which is habitually insensible to the ever watchful providence of Almighty God. In the midst of a civil war of unequalled magnitude and severity, which has sometimes seemed to foreign States to invite and to provoke their aggression, peace has been preserved with all nations, order has been maintained, the laws have been respected and obeyed, and harmony has prevailed everywhere except in the theatre of military conflict; while that theatre has been greatly contracted by the advancing armies and navies of the Union. Needful diversions of wealth and of strength from the fields of peaceful industry to the national defence, have not arrested the plough, the shuttle, or the ship; the axe had enlarged the borders of our settlements, and the mines, as well of iron and coal as of the precious metals, have yielded even more abundantly than heretofore. Population has steadily increased, notwithstanding the waste that has been made in the camp, the siege and the battle-field; and the country, rejoicing in the consciousness of augmented strength and vigor, is permitted to expect continuance of years, with large increase of freedom.

No human counsel hath devised nor hath any mortal hand worked out these great things. They are the gracious gifts of the Most High God, who, while dealing with us in anger for our sins, hath nevertheless remembered mercy.

It has seemed to me fit and proper that they should be solemnly, reverently and gratefully acknowledged as with one heart and voice by the whole American people. I do therefore invite my fellow citizens in every part of the United States, and also those who are at sea and those who are sojourning in foreign lands, to set apart and observe the last Thursday of November next, as a day of Thanksgiving and Praise to our beneficent Father who dwelleth in the Heavens. And I recommend to them that while offering up the ascriptions justly due to Him for such singular deliverances and blessings, they do also, with humble penitence for our national perverseness and disobedience, commend to his tender care all those who have become widows, orphans, mourners or sufferers in the lamentable civil strife in which we are unavoidably engaged, and fervently implore the interposition of the Almighty Hand to heal the wounds of the nation and to restore it as soon as may be consistent with the Divine purposes to the full enjoyment of peace, harmony, tranquility and Union."

Day 184: Happiness

Yesterday Sue had an insightful post into finding joy and happiness in our lives. Her point was well taken...sometimes feeling joy isn’t an automatic thing. It often has to be desired and worked for.

Well, today I decided to try and find all the things in my life that brought me joy. Here is my list:

1) A 5AM wake-up call to talk with my favorite people--Sue, Abbie, Ellie, Eden and Ammon.
2) Complaining about it being too HOT...last week it was freezing. Pretty nice weather for the end of November.
3) Eating 1000 calories worth of chocolate chip cookies at lunch (yes, I added them up) and being able to run the 6 miles tonight needed to work them off. I think the cookies made me happier than the running!
4) Having the Afghans laugh at my attempts to speak their language...and being able to laugh at myself at the same time.
5) Leaving Camp Stone and going back to my private room, wireless internet, and cable TV for a few days.
6) Getting to talk with Sue and the kids one more time before going to bed.

Life is full of ups and downs. I have learned from this deployment that you have to try and look for the positives or else the negatives will just drag you down. Sometimes it isn’t enough to just wait for happiness to run up and find you, but rather, you often have to chase after it. Happiness has to be desired and then sought after.

Interestingly, as I was reading my scriptures this morning I ran into a few verses that talk about this topic. Alma 41:4-5 explains that after this life we will be restored to a state based on the works done in this life. We can either be raised to a state of “endless happiness” or “endless misery”. Alma goes on to explain that those who are “raised to happiness” are done so according to their “desires of happiness.” It isn’t necessarily that we are raised to a level of happiness equal to that which we achieved in this life, but rather, equal to that which we DESIRED in this life. Bad things will happen. Hardships will come to each of us. Sometimes life isn’t always fair. However, if we are constantly seeking for that which is good and that which will bring happiness, we will find it in this life and the one to come.

Thanks for the reminder Sue. I love you. Here you can see my greatest source of happiness--I miss you guys.

Day 182: Pizza Party

This evening I was invited to a pizza party. All of the medical personnel on base got together and had pizza and played games. It was a nice diversion and good to socialize a little bit. I was a little late to the party, so by the time I got there I had to choose from the left over pizza. There was some ham, some cheese, and then I came across something I had never seen before...plain crust. Now I know a lot of pizza places throw some butter and garlic on their crust and call it breadsticks. However, this was completely plain. Just pizza crust cooked and served. I tried it...it wasn’t bad...it just tasted like pizza crust. Interesting.

By the way, I will be sleeping during the BYU/Utah Football game so somebody cheer for me...Go Cougars!

Day 180: Welcome Home

I wish the title of this post meant I had just walked off a plane and that I had a beautiful wife and four little kids running towards me to give me a big hug. Unfortunately, “home” in this case refers to my beloved Camp Stone. After nearly two weeks away, I finally returned back to my home away from home.

It is always nice to be home--even if it is only here. It was especially nice to come home and find that I had not one, not two, but three packages waiting for me.


First, there was a package from my mommy. She sent some treats (notice the return to zero for my no treat tracker), some books, and some other fun stuff. I always like getting stuff from my mom. Somehow it always makes me feel like a kid in elementary school again--you know how you felt when you would open up your lunch and find a note inside. Thanks mom.

Second, there was a package from Sue and the kids. As always the kids sent me some pictures and notes--always a highlight in a package. Sue sent me a mushy love letter which can’t be quoted as this is a family friendly blog (I love you sweetie pie). Also, I was very excited to see that she had sent to me a webcam and headphones so that I could see them every single day--hopefully they won’t get tired of me. Abbie sent me a nice poem. It reads:

A hug for Mom.
A hug for Dad
And one for Sis & Brother.
There’s nothing like a family hug,
To show we love each other.

Pretty good huh? Abbie did you copy that from somewhere? Anyway, it was very sweet and I loved reading it.

Lastly, came a package from Phoenix. I tried to think who I knew from Phoenix and no one came to mind. I was even more intrigued when I noticed it came from an elementary school. As it turns out, our friends, Brynn and Kalvin, have a friend who is a teacher in Phoenix. She had her students write some cards and they sent them to me. It was very thoughtful and I really appreciated it.

So although my welcome home was only a welcome home back to my dust-filled, power constantly going out, it’s freezing and I can’t believe I have to walk outside to go to the bathroom home, the love and thoughtfulness of those back home made me feel a little bit closer to the real thing. Thanks everyone.

Day 179: 23 Students

Over the past 2 weeks, I have taught a group of 23 police officers basic combat lifesaving skills. It has been a rewarding experience. More than anything else, I have enjoyed interacting with and getting to know these neat people. I feel like I know the Afghan people a little better after spending a portion of each day with them. I have laughed with them. I have let them stick me with a needle. They have shared with me personal stories of fear and tragedy. I have seen their goodness and their desire to better their country for themselves, their families, and their fellow Afghans. There is so much that is different between them and me--their language, their religion, their culture, and their up-bringing. However, deep down they are more similar to me than different. Their hopes, fears, and dreams are really not that different from mine.


Today they graduated from my class. They will be traveling home within the next few weeks. My students come from two main areas--one in the south and one in the north. Both areas are some of the most dangerous that we have here in the region. Life as a police officer in Afghanistan is a dangerous job. We have areas where large numbers have been killed in the line of duty. As my students graduated today, I wondered what would happen to them. I wondered what kind of experiences lie ahead for them. I hope they will go forward and make a difference for their country. I hope none of them will be hurt or killed. Hopefully, they will use some of the skills they learned to help save the lives of others.


Here they are posed in front of our classroom with their certificates. Afghans love certificates. Anytime they do anything, they always want a certificate. I was happy to give them theirs--they are a good group of guys.

P.S. Happy Birthday Mom.

Day 177: Fried Onions

Today the Afghan doctors I am mentoring taught me a new way to deal with skin infections and abscesses. Their solution--fry onions and then place them, while they are still hot, on the infected area of the skin. This hypothetically will help draw up all the infection and bring it to the skin’s surface. I know this a good approach to making a hamburger taste better but using onions on skin infections...that was a new one for me. Their approach isn’t necessarily wrong (who knows it may work), it is just different from how we would approach the problem in Western medicine.

This experience reinforced the fact that just because we don’t do something in the United States, doesn’t necessarily mean it is a bad idea or that it won’t work. I try to keep an open mind and try not to judge their approaches to practicing medicine. However, I do try to make suggestions. For example, I have noticed that Afghan doctors don’t keep any kind of medical record. A typical patient encounter goes something like this...patient comes in, the doctor asks one or maybe (on a good day) two questions, the physical exam is usually skipped, and then they write a prescription for some kind of medication. They don’t document anything about the encounter and no kind of permanent record is kept. So today, I suggested that I help them start making very simple patient records...basically a folder with some blank paper in that they can put some notes in. I explained in detail all the advantages for both them and their patients of keeping a medical record. They seemed to agree and we decided to start working on the project.

However, as we continued to talk more about it, some of their concerns about keeping medical records surfaced. “How could a hospital keep a record on every patient that comes in”, they asked. “It would be impossible”. I tried to convince them that it isn’t only possible but necessary. “This is Afghanistan, not America”, they continued, “we can’t do everything you do there.” I continued to try and convince them to my way of thinking.

Finally my interpreter ended the discussion by helping put it all in perspective. He said, “Hey, we don’t even know when our birthday is here in Afghanistan. If we don’t even write that down, how do you expect us to keep a medical record on every patient.” He had a good point. I chuckled and agreed with him. In a country where most people don’t even know the day they were born, maybe asking them to keep a comprehensive medical record is asking a little too much. Let’s work on birth certificates first.

I still will probably keep working on the project and try to teach them how to write and keep notes on their patients. However, I think my first priority will be teaching them how to use their onions to make a double cheeseburger. I think that might be more rewarding!