Happily Ever After*

(*Please allow 90 to 120 days for the "Happily" part to kick in before calling to check on the status of your order. No refunds.)

This will probably be my last post, if not one of them. The "Isosceles Triangle" is now only a couple of miles on each side, and only during the day when Autumn and/or I are at work! I think OIT was a great idea and Autumn and I have given serious thought to a few suggestions that we should make a book out of it for posterity. Hopefully we figure out a good way to archive it so it does not fall into the pit of time, and if we do it right, we can probably open it up and read it from time to time.

I have tried to keep what I share happy and positive, not to create some sort of rosy illusion, but because most of my posts would look like this if I didn't:

"I came off another self-imposed 16 hour day today and had a terrible workout. I tried to call Autumn but no one around the phone knew where she was, and I didn't bother leaving a message I knew wouldn't get to her in a reasonable amount of time. I guess it's just another Monday. The network change we have been planning for two weeks seemed to work at first, but ended up failing sometime after I left. The redundant link stayed up, but I do not know what to try next, so I guess it's time to prepare for a few days of frustrating and embarrassing briefings while we beat our heads against the wall thinking. It sure would have been nice to be able to take an engineering-level class on this equipment, but what did I expect when we did not know the mission we trained for was not the mission we would end up doing? Only six more days until my next down day, large pizza, and sleep sweet sleep."

A couple of those posts and we might as well shade the Isosceles Triangle a nice, creamed-pinto-bean beige to represent the feelings of frustration, apathy, and regret. No, I thought it best to take the gems from the year, dust them off, and share them with everyone so the interesting parts of life are immortalized and the daily drudge fades.

So, I'm not going to sift through and find the "things worth remembering" in this post. It is not because I am not so far away or because there is nothing interesting to tell, but here at the end of the journey, I find that the interesting parts contain a measure of frustration, apathy, regret, and even pain. Omitting this would make my contributions a pleasantly incomplete story, and that is something I might regret when I read this on the eve of my next deployment. Epilogues aren't always the neat little bow on the outside of a wrapped present, right?

So what have I been doing and what has happened to me since I last posted?

I made it back from where I came. Redeployment was everything the experienced guys told us it would be, though there is no way to fully articulate just how excruciatingly slow everything moves when you are trying to leave. Someone, somewhere, at some time in the past has done every self-destructive thing imaginable during redeployment, so there is a briefing, pamphlet, form, or counseling session to cover the Army's butt on it. We sat through briefings where we were told to be careful what ATM we use to withdraw money, don't drink excessively, be patient when you reintegrate with your friends and family - all reasonable so far. However, we were also shotgunned through anti-suicide briefings, at least 4 that included the speaker saying he/she was pleased to be the one to inform us we have benefits under the VA as combat veterans now, and a briefing to synchronize us filling out our travel vouchers (Government version of a commercial expense report for business travel) which ended up being reconvened two more times. I can say it was at least not as bad as mobilizing on the front end of the deployment, where we were "trained" in automatic weapons fired from moving vehicles and how to speak Arabic. I am sure if you are reading this you also read Autumn's account of how she orchestrated a trip for her, Matt, and a bunch of my friends to come to my welcome home ceremony - that was something I did not expect and that no one told me would happen ... !









I got a tattoo. My brother, Charles, and I had been talking about it for a long time, and we decided to get the same tattoo in the same place - a cool design from a Japanese cartoon on the top left of the chest. I don't know if I would have had any more or less inhibition had I not just come back from deployment, but certainly not being able to fulfill our plans while I was away made it all the more satisfying when we finally got it done. Two months after getting it, I can still say I like it, so at least I'm not looking up laser removal clinics. The design we chose has meaning to us on many levels, though I won't detail it all here.





I joined the Regular Army. I am now stationed at Fort Bliss, just like Autumn, and it's almost like we have regular jobs with the same company (commercial company, that is). She has been on travel for a few days, but before she left, we had lunch 3 of the previous 7 days, and we bring Matt to see each other briefly at work on days when one works and the other does not. I make less money, and I am certainly working a lot less without having to manage both my Army career and my full-time civilian career. I am sad I am not working with John Lagozzino and Bob Randolph at GDIT right now, but living in El Paso would prohibit that anyway. We have a few years left here and I want to make the most of it - what I was really going for was what Autumn and I had in high school, which was separate academic careers on the same campus with some of the same activities. I used to play practical jokes on her, surprise her, and generally do things you do to a girl when you like her. When I was working my civilian job in Virginia, I was a one hour drive (each way) from where Autumn was, if she was at the closest hospital! Forget lunch, let alone kindling our respective inner teenagers!





I said goodbye ... again. I left good friends in Delaware, Virginia, and Maryland when I left for Iraq, but it was not reconnecting when I got back that was really goodbye. It's hard for me to say goodbye (silently or otherwise), but harder for me to correspond, as I am sure everyone will agree I am probably one of the worst correspondents this side of three degrees of separation. I will miss my friends, but I would rather say goodbye and remember the relationships as happy than watch them suffocate as I try haplessly to keep frequent communication alive. I did this when I left Hong Kong in 1989, Glendora in 1993, Claremont in 1997, Ithaca in 2001, Georgia in 2007, and probably El Paso in 2012. My memories are strewn with the remnants of old friends the way they were when I last saw them, if not with faces, at least the essence. Lots of things remind me of people I used to know, and who I suppose used to know me. It makes me feel lonely and apprehensive about making new friends.

I have been replaced. Before I left Iraq, I discovered that while Autumn and I had not kept in touch as often as we both would have liked, she found friends with whom she continues to keep in touch in both the medical and the Special Forces communities. That is not a bad thing (I found good friends serving in Iraq), but Autumn has made it clear to me that given a choice of communicating with them or communicating with me on virtually every topic, she is, for the time being, more comfortable communicating with them. I know this because I asked her "not to choose them over me again" now that we're both back, and she not only didn't say "Ok, yes, I won't", she said "it's going to take some time, and you will just have to live with it". So I am living with it, we have a big pink elephant in the corner, and maybe someday I will find I am #1 in her life again. We have talked about it once since she told me to suck it up, and it was a good conversation, but I am still mourning the loss of our intimacy and intensely resentful and jealous of the people who have seemingly replaced me.

I reconnected with my son. I just finished building him a playset that he really likes - the kind with a slide and swings, a climbing wall, a net, and even a little ship steering wheel, and also the kind he used all summer at his cousins' houses. I can be the only one in the room and he is good with it, he smiles when I come in from work, and I can take him on errands without it being a huge cryfest. Those things were not true the few weeks after I got home, and I thought the alienation would never subside, but it has. We are currently working on him letting me put him to bed, which requires a vanishing act by Loretta and/or Autumn at bedtime so I am seemingly the only one around. I guess if dad is a distant 3rd, and he's the only one there, it's ok for him to read books, sing nursery rhymes, and sleep on the floor next to the bed until sleep comes. All in good time, I suppose - something I have a little more faith in now.











I think that about covers it. Hopefully the asterisk on "Happily Ever After" comes down sooner rather than later, but for now, it's a good start with a way to go.

Lessons of a Scorpio

The following is copied from a website which discusses astrological signs. I had a discussion at the end of my deployment about "what it means to be a scorpio", and subsequently did some self-analysis and self-reflection which resulted in the musings of this post.

* The red text was generated by me; the black text originates from http://zodiac-signs-astrology.com/zodiac-signs/scorpio.htm.

Scorpio and Independence:

Scorpios are fiercely independent. They are able to accomplish anything they put their mind to and they won't give up. They are perfectly suited to being on their own. They are not social butterflies like some other zodiac signs and some actually prefer to live on their own that way there is never any issue about who controls what at home, as they like to be in control.

I have, in the past, been a control freak. Deployments in the Army don’t particularly agree with control freaks, since so many details of a deployment are outside of the individual soldier’s control. For example, it took me 10 days to get across the Atlantic to Afghanistan, and 2 days to travel a few hundred miles to FB Lilley. When I was at ROTC Advanced Camp in 2000, I hated the fact that I didn’t have any control over my own schedule, my own personal space, my own food, or anything else for that matter. But I think I relaxed considerably during my deployment to Afghanistan. I’m not sure why, but I’m not so severe of a control freak anymore (at least so far during my transition; this may change!). Perhaps the Army has beaten it out of me. More likely, though, is that I have learned to put time, effort, and passion into the things which will make a difference in my life or the lives of others … and not allow less important things to get to me. My mother has always told me not to allow things outside of my control to “rent space in my head”; I think I am now finally taking that excellent advice to heart.

Scorpio and Friendship:

Relationships with Scorpio are always complicated; just like the person, their relationships are a series of extremes, and they can even be downright moody for no apparent reason. Scorpios are known for their possessiveness and jealousy but on the other hand, they are extremely loyal. They will always remember a kind gesture forever and repay it. Any kind selfless gesture done to a Scorpio will gain trust and respect which is extremely important to them in any relationship, either romantic or not.

Yes, I can be moody for no apparent reason (or, there might be an apparent reason, as those of you who have had the pleasure of dealing with me when I’m hungry have seen). Although I’m not as possessive or jealous as this description might suggest, the narrative is absolutely accurate in reference to my fierce loyal streak. For example, the SF guys at Lilley took good care of me when I joined them in June, and as a result, I vowed to repay them in some way. I settled on becoming something of a liaison in Bagram, helping them to obtain supplies and equipment that they otherwise might not be able to obtain. After my second (very eventful) trip to Lilley, my loyalty and respect for them knows no bounds.

Scorpio and Careers:

Scorpios make excellent doctors, surgeons, scientists and leaders; they are perfectly suited to any form of business that makes a difference in the world, that greatly impacts people and society. Most importantly, Scorpio has to be in a power position: this is why these careers are suited to the Scorpio. They all demand one person in supreme control giving orders and leading a unit of people or practices.

“Impacting people and society” wasn’t necessarily a priority of mine prior to my little vacation in Afghanistan; however, I now realize that “impacting people and society” is, quite simply and accurately, what I enjoyed so much about the deployment. One of my goals has been to make a difference, and in Afghanistan the opportunities to improve the lives of Afghans abound. (I suppose this makes logical sense, for Afghanistan is a third-world country with many societal, governmental, health, and cultural challenges, all of which provide opportunities for intervention and improvement.)

Whether my mission is caring for the children of soldiers who put themselves in harm’s way (i.e. my mission in the states) or caring for the soldiers themselves (i.e. my mission this summer in Afghanistan), all I really want to do is make a difference in somebody’s life every day. My own personal satisfaction is derived from making these small differences in people’s lives, and I am repaid with smiles of appreciation from parents, honest words of thanks from downrange soldiers, and the personal knowledge that I have made the world just a little bit better. I don’t need “stuff” or “things” in return for caring for those who serve this great country – generally their appreciation is payment enough.

Scorpio and Temperament:

Scorpios are extremely ambitious, persistent and determined … and a Scorpio never gives up - they are absolutely determined to reach their goal. The key to their success is flexibility. They are able to re-survey a situation and take a different approach if necessary. This makes them very adaptable and versatile.

The unknown has always been frightening to me; as a self-proclaimed sufferer of OCD (or OCPD), I like not only knowledge of the future, but also some element of control over it. Afghanistan certainly changed my comfort level with regard to the unknown; many aspects of my life were unknown while working at the Bagram hospital. For example, while I would usually know the overnight call schedule in advance, I would never know whether I would admit 2 patients overnight, or admit 22 patients overnight, whether I would get a full nights’ sleep or never see the call room at all. Furthermore, while Bagram was probably the safest base in Afghanistan, the base was attacked with indirect fire several times while I was stationed there; certainly the rocket attacks could never be predicted and we could never be fully prepared. Some soldiers constantly worry about being attacked while in the theater of operations; I was not one of these soldiers. I had to let go of my fear of the unknown – otherwise it would eat me alive, constantly occupy my thoughts, and ultimately compromise patient care.

Scorpios are excellent at restoring order to a chaotic situation and they are just as capable of manipulating for their own greed and benefit. The un-evolved Scorpio is a very dangerous person because they use their powers to benefit only them and step on other people in order to satisfy their own greed.

If there’s anything I have learned during this deployment, it’s that “restoring order to a chaotic situation” is not only an ability of mine, but it is also something I whole-heartedly enjoy. While I have always enjoyed the career fields that involve creating order from disorder (e.g. ICU, emergency medicine), I chose pediatrics because I absolutely love and enjoy caring for children. (Now that I have had some experience taking care of adults again, I am even more committed to pediatric medicine and even more convinced that my choice of patient demographic was correct so many years ago.) I enjoy kids, but I also enjoy the adrenaline rush of an ED code or the chaos of the delivery room when a newborn refuses to take her first breath. Thus I feel that I am at a crossroads: I would like to continue to take care of kids (at least some of the time), but I would also like to participate regularly in the forcible regulation of pandemonium.

There are many options, some of which are plausible and some of which are not. These options include emergency medicine (which would require a 4-year residency in emergency medicine), pediatric emergency medicine (which would require a 3-year peds ER fellowship, which might or might not be supported by the Army), civil affairs doc (who mostly do public health types of missions), SF group surgeon (which would require me to go to Airborne school at the minimum, and would require a complete change of focus to tactical and field medicine), and operational billet (like battalion surgeon or flight surgeon; both positions would require me to give up pediatric medicine).

So where does this leave me? Where am I headed in life with these recent career aspirations? What will the Army allow, and what might be best for my family? These are all questions which demand an answer sooner rather than later. Given that I am now working in emergency medicine and loving it, I think I have a respectable starting point to build these career changes …

Scorpio Deep Inside:

Scorpio is the most misunderstood of all astrology signs. They are all about intensity and contradictions. They like to be aware of a situation and always know what's going on, figuring this out with their probing mind … They are very capable of hiding their true feelings and motivations, as they often have ulterior motives or a hidden agenda.

Scorpios are very emotional. Compared with other signs, their emotions are intensified - both good and bad. Negative emotions of jealousy and resentment are hallmarks of this turbulent astrology sign. On the other hand, Scorpios are well known for their forceful and powerful drive to succeed and their amazing dedication. Scorpios are constantly trying to understand their emotions through finding a deeper purpose in life.

I am far more emotional than I was 6 months ago. I have seen ample death, devastation, passion, poise, tyranny, selfishness, and loyalty during this time. All these emotions were so vivid, unadulterated, and raw that they could never be duplicated. Although I did not experience all of these emotions myself, I was given the opportunity to experience them with and through others; these shared experiences have given me food for thought about the deeper callings in my life and career. This self-reflection – which has been evident on our blog in posts like “Transitions” and “Fear is the best motivator” – is strong evidence of my scorpio tendencies.

Scorpios have a fear of failure that they keep hidden extremely well. Should their confrontation not be successful, or their career fail, they will simply use their adaptive skill to quickly change course and leave the bad experience behind. Do not ever expect them to fess up or share their failure, though, because this shows signs of weakness.

I have often said that I have a primal fear of failure. Nobody really sees this fear; I purposefully camouflage it within a fragile shell of confidence and poise. I know that I have defects in my medical and Army knowledge like everyone else; therefore, I am constantly questioning my understanding of military medicine, and ultimately trying to improve my fund of knowledge. Unlike many docs, I am comfortable with my shortcomings, and do not hesitate to ask for help when patient care hangs in the balance. (Patients come first, far before my fear of failure or concern about the appearance of ignorance.) I don’t let everyone know that I’m not a confident person on the inside – after all, would you like to take your kids to a pediatrician who didn’t sound self-assured? I keep a confident front because I’m supposed to, and it engenders trust from my patients; however, deep down inside I have issues with self-confidence that stem from a deep-seated fear of failure.

Scorpios are very weary about trusting anyone; a person needs to gain their trust but once all the 'trust tests' have been passed, Scorpio loves deeply and intensely. Underneath the cool exterior, energies and emotions are constantly flowing but the Scorpio channels it into useful activities, hobbies, relationships or a career. This is never apparent to the outside observer but knowing this fact explains why Scorpios are so passionate … Scorpios have powerful instincts and they trust their own gut feeling.

It has taken me a long time and much experience to trust my gut. In medicine, I can walk into a waiting room and identify a child who might not be very sick at the moment, but who will in short order become quite ill. Most of the time, I cannot identify anything about the child that gives me this gut feeling; his vital signs, appearance, lung sounds, etc might be completely normal when I first examine him. But when my gut tells me something is awry, I have learned to listen and trust these feelings, even if they do not seem to make sense at the time.

During my deployment, I have learned to trust my gut in more diverse scenarios. For example, after my downrange mission the SF team at Fire Base Lilley was preparing for an outside-the-wire mission (as they do almost daily), but when I got word of the mission, I expressed to one of the team members my gut-wrenching conjecture that something was about to go terribly wrong. We discussed his process for casualty notification (read: notification of family and friends in the event of his death), and because he trusted my gut, he offered to stay at Lilley within the wire while the rest of the team completed the outside-the-wire mission. Of course, I told him that he had to go – his team could not afford NOT to have him – but that he should be very, very careful and tell the rest of the team to do the same. I wasn’t sure why, but I was nearly in tears telling him about my intuition/superstition/gut feeling. Ultimately, I was relieved to learn that the mission had been cancelled; only then was I able to sleep soundly.

The ongoing lesson in life for those born under the Scorpio zodiac sign is to channel their powerful energy into positive goals and not succumb to the darker forces in life (e.g. manipulation and greed). They will then have great success in life and have a clean, happy conscience and a circle of friends they can trust and hold dear to them.

Scorpio in a Nutshell:

Scorpio is the astrology sign of extremes and intensity. Scorpios are very deep, intense people; there is always more then meets the eye. They present a cool, detached and unemotional air to the world yet lying underneath is tremendous power, extreme strength, intense passion and a strong will and a persistent drive. Scorpios have a very penetrative mind; do not be surprised if they ask questions, as they are trying to delve deeper and figure things out. They always want to know why, where and any other possible detail they can possibly know. Scorpios are weary of the games that other people try to play and they are very aware when they are being manipulated. Scorpios tend to dominate and control anyone that lets them. The person that a Scorpio respects and holds close to them is treated with amazing kindness, loyalty and generosity. On the outside, a Scorpio has great secretiveness and mystery. This magnetically draws people to them. They are known to be controlling and overly ambitious - they need control in order to feel safe.