332nd EMDG Specialty Clinic/Urology

Welcome to the Specialty Clinic in Balad. It supports Urology, Ophthalmology, EENT and Oral Maxillofacial Surgery. We all share an office and telephone and we each have an examination/procedure room. We really don't do much in the way of office procedures except as an emergency. For the most part, since we are a trauma hospital, the clinics are not that busy. Just to bring a little of Montana to my desk, I brought along my bull scrotal sac that I use as a candy jar. There were a few that had their reservations about sticking their hand inside a scrotal sac so there was a cup for them. This in my corner of the office, plenty of room for the two computors that we use for all of the clinic notes. There are two separate EMR systems of which one is DOS based. Now what does that tell you about being user friendly. I type in everything, all my own H&Ps, progress notes and operative reports. Jackie, you would be out of a job because there is no scanning and no one answers the phone except one of the doctors. Makes our eClinical system seem like the cadillac of EMRs unless you really want to compare it to the cadillacs of Al Udeid.

This is the urology clinic, one room for everything: cystoscopy, stent removal, bladder scan, wound care, physical exams , storage room, and office for my urology staff...one technician. See Dan, we ARE over-staffed.

Ready for work

And for any emergency prostate exams.

Balad the Beautiful

Concrete and more concrete; you walk on it, you walk between it, you ride by it and you work under it. Balad scenery; but for a purpose.
Joint Base Balad (JBB) or Balad Air Base or Logistic Support Area or LSA Anaconda is one of the largest American military bases on foreign soil. Also referred to "Big Snake" or "Mortaritaville", hense the importance of all the concrete barriers. Not all that attractive but it may help save a life.

Except for food, the base is totally self sufficient. The water is piped in from local canals and filtered and bottled right here. The base goes through 50,000 bottles of water a day. The plastic bottles are made here as well. Additional water is shipped to all the other bases. If you have all of these concrete barriers, then you will have your own cement plant. All contruction is also done by on base contactors. There are acres of truck, and storage areas as well as huge convoys that bring in supplies for all of the bases; a huge local distribution center for everything.

Everything is tan or grey. There are hardened shelters that were built in the 80's as at one time this was the most important airfield in Iraq of the iraqi air force. It has four hardened areas with about 30 individual airctaft shelters

The base is about 68 miles north of Bagdad in the Sunni triangle. There are about 5,000 USAF personnel and 10-15,000 Army personnel. Another 10,000 are contractors and support workers that run everything from the laundries to the dining facilities. The base can be expanded to accommodate up to 35,000. Scattered trough out the base are structures that were once part of the Iraqi base as well as the Iraqi air academy.

Most of the new contruction has a double layer which provides a shell or covering that protects the roof from incoming mortars. The perimeters of the buldings are all surrounded by the concrete T-barrier that would protect the building if something should land outside. Again, function over form.

Scattered through out the base are the hardened structure that have been converted either for storage or as aircraft hangars.

Not too far from the hospital is a mosque. Note the nice layer of dust that settles everywhere.

As far as a sunset, this is about as clear as it gets with the ubiquitous barb wire everywhere.

Iraq, The First Day

The "bus" to Balad in our IBA (Individual Body Armour) or "Battle Rattle". Like a concrete corsette so you can easy sleep sitting up. Got in a cat nap. Stopped at Al Asad which is in the Marine sector. Look it up on Goolgle. At that time I had no clue at to where we were. Landed, dropped of a pallet of supplies and shortly were on our way again.

Everything is brown. A quick glimpse of the Marine Air Base at Al Asad.

Landed in Balad about 9:30 and went through in processing again. No Customs. Picked up by the Commanding Officer of our base squadron. He just learned about 15 minutes before we landed that I was arriving that AM. Checked into the hospital and was getting oriented to the clinic set-up when "ALARM RED" was sounded. As part of our training, I had learned it meant hit the deck and cover your head and ears. I just didn't think it would be so soon. While lying on the floor, I heard a voice from across the room say in a very calm and matter of fact tone: "Welcome to Balad." It doesn't actually happen very often but they take it very serious no matter what. They can detect direction of an incoming and within seconds determine potential impact point. They then send out the alarm to just the part of base at risk. There are hidden and secret assets that can also shoot the missle, rocket or motar out of the air. Still probably safer here that driving on 10th Avenue South.

The next step was to get situated in tempoary quarters next to the hospital until LtCol Jackson and I can swap rooms. I got cleaned up, took a shower, ate dinner and by then, it was almost 6 PM and I was soon fast asleep

4 AM and wide awake. Took a walk around the compound behind the hospital and there it is, "The Wire" and the rest of Iraq. My first sunrise in Balad.

Still in Al Udeid

It is early Friday and staying up to try and get back on a normal day night cycle since I am wide awake right now in spite of only getting about a total of 8 hours of sleep since last Saturday night. Since this will be my last night in Al Udeid I worked more on my blog; this is when I put in most of the pictures of Montana and family. It actually feels sort of pleasant compared to the 115 during the day. Our PT gear has built in reflective material so it made a nice nice shot.

Here as well as multiple places there are memorials to individual. This is for the individual that this camp is named after; right next to it is one for the MIA's.

By early dawn it was still cool enough so that I took a run/walk around the camp perimeter.

Although not active, the multiple guard towers are a reminder of activities during the past active part of the current Iraqi War (excuse me...Overseas Contigentcy Operation)

Certainly makes it hard to run off in the wrong direction.

About 4:30 and sunrise.

Already getting warm and another hot, damn hot day.

Why our sanitation facilities are called Cadillacs, no one could tell me, but they are nice!

Big and clean and lots of them but not too busy at 5AM.

SEE!

Now after jogging, having breakfast, working out, lifting weights it is only 9 AM and getting board so started taking pictures of the ground. Basically the ground it the very top of a limestone slab several thousand feet thick so everything is limestone dust and ruble.

If not big pieces, then it is crushed limestone, everywhere.

The only place that is not either concrete or crushed limestone was on the volley ball court which was no doubt imported sand. What a stark contrast and very abstract in a photo. In the desert and no actual sand.

OK, time to adjust, adapt and improvise. Not enough room on the flight for all our "chalk" A "chalk" is a group of individual that are to go to the same place at the same time. I think that the term "chalk" may have referred to a list on a chalk board. Although we all came on the really big bus (DC-10) only 30 of us are destined to go to Balad and the "4:10 to Yuma" only had room for 15. So my half of the "chalk" gets to fly out on the 4:10 AM to Yuma. As it turned out we had to check out of our "hotels" at 0030, and muster at the PAX terminal at 0200 and go through custums to get out. The "bus" (a C-130) did not actually leave until 0600 with a stop en route at Al Asad. So much for sleep but at least finally on the way to Balad.

Al Udeid

Al Udeid is a large transitient center; like a huge Greyhound bus terminal except with planes. Every oand everything that flies in and out of the AOR (Area of Responsiblity) for the Air Force comes through here. Once you are here, you stay until they find a resource to put you on and get you to your final destination. Since there is nothing to do but wait, they provide a lot of diversions. Most of the transients as we are labeled stay on these 40 man tents. Dark and cool.

The compound that we are kept has accomodations for several thaousand plus the semi-permanent quarters for all of the air crews that are based here. There is also a British and Australian cintingent here. This bulding is the head quarters for the air field operations.

The "Bra" in the center of the camp and where people congragate when it is cooler. This is where to get WiFi access.

There are a number of "neighborhoods" that house the varies semi=permanent dtachments that are here. The USAF hood, Navy hood, etc. The covered areas are for smoking.

There are a number of depots through out the compound where water bottle are distributed at night by a large semi trailer labeled the "Water fairy".

The streets are endless with each one the same.

Just as a reminder that you are not "home", there are motar and rocket shelters everywhere.

For your veiwing pleasure, there are movies at the theater 24 hours a day. I did not discover it until the day I left.

There is a pool which is crowded all day. I took this just after it closed at 10 PM.

The Green Bean coffee shop just like Star Bucks is open 24 hours a day

There is a gym, weight room and exercise facility also open 24 hours aday.

And if you don't want to walk a half a mile for the dining facility (which is also epen 24 hours a day) you still have for eateries on the little main street.

Faded at 3 PM and awake at 7 PM. Not having much luck stayng up all day. Maybe better luck tomorrow as we are slated to get a flight out in the afternoon which will get us into Balad Thursday PM. So will stay up all night.

Al Udeid Night Life

After having fallen to sleep at about 1 PM I awoke some hours later to a uncomfortable sensation from deep within my loins. I had to pee and I had to do it NOW. We take for grated that anyone of us can get up out of bed, flip on the light and walk to the bathroom in your sleeping gear and go to the bathroom. Not any more. The mass sleeping accommodations are 40 man tents that are kept in the dark. If you plan ahead (which I learned to do for next time) you keep a little fob light on your "man purse-- more about that later-- so you can see. Per the rules, if outside you have to be in an authorized uniform which can be USAF PT gear; shirt tucked in, shorts, shoes with appropriate sock or approved sandles (and only if going to the "Cadillac") and if after dark a reflective belt. Using a container to pee into is strictly forbidden (and for very good reasons) but was the first thing that came to my mind. Under duress I dressed in the dark funbling for anything and finally found the door only to be surprised that at 6 PM it was already dark. So back into the dark and to find my reflective belt. Finally mission accomplished but only thanks to
Kegel's exercises and pelvic floor urge inhibition techniqies and a strategically placed thumb and forefinger.

Now there were people all over, like ants that finally had crawled out. Maybe the 115 in the day and only 90 at night made the difference

There was a band playing country but nothing like the Sky Light back home.

I found a group of pilots from Minnesota playing hokey with a tennis ball.

A bunch of water bottles made a nice goal...SCoooooorrrrrrrreeeeeee!

Midnight and wide awake so I will shoot for another day night cycle and await word about flight outog here. Tonight I did start my blog which kept me occupied unto sun up.