Saturday, December 27, 2008

Letter 8

Letter 8 December 26, 2008
Balad, Iraq

Everyone:

Well, I hope everybody had a great Christmas. I have been pretty busy since I last wrote. The first item is that I am finally a full PhD Candidate. This means that I get to start writing the final draft of my dissertation and hopefully be granted my degree soon. This is a long road that I have been working on for about 5 years…to say that I am ready for it would be a severe understatement. The topic of my dissertation revolves around cutaneous leishmaniasis which is a parasitic disease that is endemic in this part of the World. My research is specifically within Afghanistan. However, about a month ago I saw a patient in our clinic that I diagnosed with leishmaniasis. I finally just received the pathology report from Walter Reed and my diagnosis was confirmed! It is one of the few cases in American Soldiers seen in our area of operation (AO) within Iraq. It is amazing that I saw a case of leishmaniasis here and it is my dissertation topic.

We also received our combat patches since my last letter. The combat patch is a symbol that Army soldiers wear on their right sleeve below the American flag that indicates a soldier is a veteran that served in a combat zone. We are serving under the 421st Med BN which is part of the 30th Med Brigade. They are an active duty unit that is currently located in Germany. The combat patch is seen below:


The Army has symbols in everything. The patches are no different. Everything on an Army patch has meaning. The maroon background on the patch is the Army color for medical. The snake is a universal symbol for medicine. The sword indicates combat (I am not sure of all the additional meanings with the sword). The star in the snake’s mouth is for the State of Texas (star on their flag) which is where the 30th Med Brigade originated in 1933.

The Holiday season has been…interesting. It has not felt at all like Christmas to me. I have found it hard on me emotionally this time around as I really miss my wife and kids and of course everybody back at home. The Army and our unit as tried to help ease the difficulty of being away from home. Santa came to visit us at our unit…below is his surprise visit.


This picture is taken in our MWR (moral, welfare, and recreation) room at our clinic. We even have a Christmas tree. If you look along the wall of books you will see that nothing says Christmas like an M16 rifle…it kind of makes Ralphie’s request in “A Christmas Story” for a Red Rider carbon action BB gun a little less dramatic. Santa is actually Major Romig, who does a pretty good Santa. We actually had a Christmas parade on post and he was the Santa in the Parade. I also ran in a 5K jingle run road race…this means that we had small jingle bells on our shoes while we ran….yeah, that lasted about ¼ mile and they stared flying off shoes creating a potentially dangerous obstacle course for those in the back of the pack….No…I was not in the back…ouch that hurts to all of you who immediately thought of me falling down.

The chow on Christmas was pretty good. They served us prime rib, glazed ham, and turkey…wow…here are some pictures from our chow hall.


This is our food lines. That is “fresh” meet that is being sliced for us by some locals. Again, all the decorations are a bit over the top. It was a bit surreal to have Iraqi’s or locals serving us dinner with “Merry Christmas” aprons on and “Santa hats” on especially here in Iraq. Here is a manger scene that is actually made out of bread and icing.


The sign above the manager states that the items are all made out of bread dough. It was a pretty amazing piece of food art. I look at this picture and several questions come to mind…where is Joseph? The most pressing question to me is why is there a Holstein cow at the manger…Is it for baby Jesus? Got Milk Jesus? Here is another piece of Holiday art work from our chow hall.


Reindeer and penguins…together…with palm tree leaves? Is that surreal? Wow…the stage behind Noah’s ark is where some Iraqi men performed some local festive folk dances for us. I did not get any pictures of them dancing…sorry, yes it was…interesting.

Finally, below is a picture of our “Christmas tree” here at Balad:


Balad used to be a major Iraqi air-base. This is one of the major roads on our base and the “tree” is on a round-a-bout. This is near the hospital. The road leads to one of the major gates entering our base.

The base has been pretty quiet over the past couple of weeks…well, I say that and I just heard an “all clear” over our alarm system indicating that we just had another indirect fire attack and it was ok to leave the bunkers…yet another attack that I did even know we had. We did not have any attacks over Christmas; I guess the insurgents respect the Christmas holiday. We also did have another larger attack today…not sure where the mortars landed, but it was not near our area.

We are close to one of the runways, below is a picture of an F18 taking off near our clinic.


The fighters use their afterburners once they are airborne to get altitude before they leave the security of our perimeter. The use of the afterburners is very loud. It is a pretty awesome site.

I wanted to have a picture of all of our medical staff for our clinic.


This was taken in our provider room in our clinic. From left to right: LTC O’Bannion who is our dentist is from Kentucky. Next is 1LT Welch (Butler Grad), then me, MAJ Baez who is from Massachusetts. 1LT (now CPT) McFarland in front is another Butler Grad. Behind him (blocked by CPT McFarland) is Major McPhee from Michigan. Major Romig a PA from Illinois, and finally Major Altman from Tennessee. What do you think of our new camouflage scrub tops?

Finally, I wanted to thank everybody who has sent me pictures, cards, care packages. I am overwhelmed at all the generosity. Here I am opening one of the packages that was sent:


I am in the clinic (can tell by the coffee pot)…for those that have been overseas, there is nothing like getting mail. I am sorry that I have not written to everybody, but I really want to thank everybody for all the support for my family and all your thoughts and prayers. There are simply too many people to thank. I also wanted to tell all my students that I am proud of all your hard work this semester…one more down.

I look forward to the New Year. Please keep all the soldiers in your thoughts and prayers. Please especially remember the families and NEVER FORGET why we are here and what we are doing. NEVER FORGET that we live in the greatest nation on Earth. I did almost forget; Major Romig is helping some Iraqi doctors try to set up some healthcare clinics in this area for the local population. They really have nothing. If you are thinking of sending something to us over here and not sure what to send, maybe you might consider anything medical. We are not talking about anything major, maybe a cheap stethoscope, blood pressure cuff etc. The clinics have nothing and there is not a lot of money that our State Department is willing to spend for an Iraqi clinic. You can mail it to me or directly to Major Jeff Romig. Our address is 215th ASMC/Phipps Clinic, APO AE 09391.

God bless all of you, and know that you are all in my prayers as well! Have a great New Year, and I look forward to seeing each of you in person in 2009.

CPT Mike Roscoe
(Almost Major)

Sunday, December 7, 2008

Letter 7

December 06, 2008
Balad, Iraq

Everyone:

I hope this letter finds everybody well. Things have been pretty busy here since my last letter. The clinic is busy as usual, and I have been pretty swamped with teaching and working on my PhD. The weather has started to turn cold…it actually gets into the 50s now at night…sorry, I know it has been pretty cold back home. Thanksgiving was interesting here. It just was…off…here are some pictures from our chow hall to show you what I mean.


Nothing says Thanksgiving like a bunch of carved watermelons…especially with carvings of frogs. It was pretty amazing “fruit art” but having a local serve me fruit just didn’t feel right. Here is another picture.


This is a view back toward our serving lines. Look past Tonto and Pocahontas and you can see some more of the over-the-top decorations…”Thank S”…The food was pretty good. We had all the traditional staples of a good Thanksgiving dinner, and there really was an effort to try to give us a sense of home. However, the two mortar attacks during the day were an effective reminder that we “are not in Kansas anymore”. I think that is what makes this place so surreal. We have things like a movie theater, Burger King, a pool and….bunkers.

The world is a small place! I met up with the head of the ER at the Air Force Hospital, which is the hospital for this part of the country. Anyway, his name is COL John McGoff…six degrees of separation means that he is an ER doc with Community Hospital North and East in Indianapolis. I worked for him as a PA for several years! Even more…he was a class mate in med school with my boss at Butler, Dr. John Lucich! Can you believe that? Below is a picture of Dr/COL McGoff, me and 1LT Travis Welch (a Butler PA grad).


We of course are standing on Indiana Avenue. The large building behind us is our PX (mini Walmart type store). The large roof on it is for mortar protection. What is most amazing about this picture is that Dr. McGoff is Air Force and has his weapon on!

Anyway, I will send pictures in the next letter or two from the hospital and our clinic. Col McGoff wants me to work some shifts in the ER with him. More to do, but it would be great experience. I am not sure if you saw on the news this week about another suicide bombing in Falluja…I was in the ER when several of the patients (all Iraqi) came in…it is amazingly terrible what these blast do to the human body. The blast was of course meant to kill innocent civilians. This place is insane…it just seems that the Sunni and Shi’ites just can’t wait for us to leave so that they can get back to killing each other.

We do not get trauma in my normal clinic. We generally see “med-check” or “doc-in-the-box” type of things, but I did see four US soldiers that were in a vehicle that was a direct strike on an IED. The vehicle they were in was similar to the one in the picture below:


These are very, very, very armored vehicles. The soldiers all walked away from the blast without any injuries! This is the same type of blast that was killing our soldiers less than three years ago. It is really amazing all the things that we now have to keep our soldiers safe. Speaking of that, below is a night picture of what is known as a C-RAM. It is an anti-mortar system. It shoots down incoming mortars before they hit the ground. In this picture it is a test fire (I would not be out if it was a real attack).


It looks like a laser, but it is a bunch of large tracer rounds that are moving so quick the camera can’t distinguish the difference. It is a pretty awesome site; it is close to our clinic, so I feel a whole lot safer. It is one of the primary reason that no mortars have landed close to where I live and work.

I want to show you “Hero’s Highway”. This is the tunnel where injured soldiers are moved from the MEDEVAC helicopters into the ER.


The top picture is from the Air Ambulance entrance into the ER looking out to the landing pad. The bottom picture is from the landing pad looking toward the ER. It is very solemn, but I also felt proud of our soldiers and their sacrifices in this place.

Ok, Ok…time to lighten the letter a bit. Last week we had a USO show here on base. Aaron Tippin, a country music singer, gave us a concert. Below is a picture of the show.


We are sitting in the stands of a stadium on base. This base was an Iraqi air base before we took it over, it was also the site where the Iraqi Olympic team trained. The stage is actually on a soccer field surrounded by a track. The lights just over the American flag, in a line is actually the perimeter of the base. I guess it gives motivation for the singer to put on a good show, in that everybody (except the Air Force) is armed…gives a new meaning to “knock ‘em dead”. It was a good show; I have a lot of respect for the entertainers that are willing to come here for our soldiers.

The final part of this letter is a tribute to how God always seems to present something to me at just the right time. I was feeling a bit overwhelmed with everything going on, I was missing my family, busy with teaching and working on my PhD, I had just gotten off a very busy shift in the clinic when I walked into our break room to find some hand knitted caps that a Church sent to us. I took a picture of the message that was sent with the hats. Anyway, I wanted to share it in my letter because I think that there are several people that need this simple message besides just me. I know that there are a lot of PA students that are feeling a bit overwhelmed right now with finals being next week. I know how hard it is for my family with me being gone…We all have a purpose that God has given to us and nobody said that our cross would be easy or light, but we have to keep moving forward and be willing and open to His plan.


Thank you everyone who has written me, sent me packages, and has prayed for me and my family. I appreciate it more than words. However, I think I have had enough Halloween candy to last a lifetime! Thank you to everyone who continues to help my family out. I appreciate it more than words can say. Please continue your thoughts and prayers for all the soldiers and their families, especially during this holiday season. Never doubt that you live in the greatest country in the World with freedoms only dreamed by others. I will hopefully have the next letter out within two weeks.

CPT Mike Roscoe

PS: If you are just receiving this letter for the first time and you want to see previous letters, please go to http://buprofessor.blogspot.com/. Additionally, my address is:

Mike Roscoe
215th ASMC/Phipps Clinic
APO AE 09391