Photo Journal

Today I thought I would post a few pictures to help document the last

week as Matt and I have been getting to know each other once again.

Now, we have only a line .... that is, two of the corners of our isosceles

triangle have joined, and now we only have to wait a few more days for

our triangle-now-line to morph into something we haven't known in a

long time: a single point in space and time containing two big hearts and

one little one.

Here are some pictures of Matthew and I just after he arrived in El Paso last week:

And here are some of the pictures from "Breakfast with the Elephants" at the El Paso Zoo this morning:

On Sheep, Wolves and Sheepdogs

The following is a reproduction of a short essay by LTC Dave Grossman which was published in his 2004 book, On Combat.  LTC Grossman is a former Airborne Ranger who spearheaded a new scientific research endeavor appropriately termed "killology", which aims to further our knowledge regarding "our understanding of killing in war, the psychological costs of war, the root causes of the current 'virus' of violent crime that is raging around the world, and the process of healing the victims of violence, in war and peace" (from his website, which incidentally contains fascinating information about his field of research and his conclusions). 

I first read this essay a week or two ago when it was forwarded to me via email; it has since spurred a very interesting internal dialogue about whether I am currently a sheep or a sheepdog, and whether I should be a sheep or a sheepdog.  Some other questions which may be interesting to ponder as you read:

- Can one "choose" to be a sheep, a sheepdog, or a wolf as LTC Grossman asserts?  Precisely what defines each of these categories of people?  Does the perspective of the observer (the person assigning the categories) matter, or is an individual always a sheep, a sheepdog, or a wolf?

- A fundamental characteristic of sheep is their ability to deny, deny, deny even in the face of hard evidence.  But how much denial makes one a sheep?  By what metric should we "measure" denial?

- Does the Darwinian theory of natural selection apply to the relationship between wolves and sheep?  If so, what does that say about the relationship between sheep, sheepdogs, and wolves a million or so years in the future?

- In LTC Grossman's analogy, is there such a thing as a wolf in sheep's clothing?  How does a sheepdog differentiate between true sheep, and a wolf parading around as sheep?  And what is his obligation to the sheep of the world when he discovers a wolf in sheep's clothing?

- Are there other categories of citizens besides sheep, sheepdogs, and wolves?  Or does every person fit into one of these categories at any given time?

- LTC Grossman asserts that sheep can become sheepdogs.  What differences exist between sheepdogs who have always been sheepdogs, and sheepdogs who have morphed from sheep?  (Think about philosophy, appearance, reactivity level, thirst for adrenaline, and personal relationships.)  Which would you rather be? 

And now, without further, here is the essay ..... please enjoy and comment as you see fit. :-)

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On Sheep, Wolves, and Sheepdogs

By Dave Grossman

"Honor never grows old, and honor rejoices the heart of age. It does so because honor is, finally, about defending those noble and worthy things that deserve defending, even if it comes at a high cost. In our time, that may mean social disapproval, public scorn, hardship, persecution, or as always, even death itself. The question remains: What is worth defending? What is worth dying for? What is worth living for?" - William J. Bennett   In a lecture to the United States Naval Academy   November 24, 1997

One Vietnam veteran, an old retired colonel, once said this to me: “Most of the people in our society are sheep. They are kind, gentle, productive creatures who can only hurt one another by accident.” This is true. Remember, the murder rate is six per 100,000 per year, and the aggravated assault rate is four per 1,000 per year. What this means is that the vast majority of Americans are not inclined to hurt one another.

Some estimates say that two million Americans are victims of violent crimes every year, a tragic, staggering number, perhaps an all-time record rate of violent crime. But there are almost 300 million Americans, which means that the odds of being a victim of violent crime is considerably less than one in a hundred on any given year. Furthermore, since many violent crimes are committed by repeat offenders, the actual number of violent citizens is considerably less than two million.

Thus there is a paradox, and we must grasp both ends of the situation: We may well be in the most violent times in history, but violence is still remarkably rare. This is because most citizens are kind, decent people who are not capable of hurting each other, except by accident or under extreme provocation. They are sheep.

I mean nothing negative by calling them sheep. To me it is like the pretty, blue robin’s egg. Inside it is soft and gooey but someday it will grow into something wonderful. But the egg cannot survive without its hard blue shell. Police officers, soldiers and other warriors are like that shell, and someday the civilization they protect will grow into something wonderful. For now, though, they need warriors to protect them from the predators.
“Then there are the wolves,” the old war veteran said, “and the wolves feed on the sheep without mercy.” Do you believe there are wolves out there who will feed on the flock without mercy? You better believe it. There are evil men in this world and they are capable of evil deeds. The moment you forget that or pretend it is not so, you become a sheep. There is no safety in denial.

“Then there are sheepdogs,” he went on, “and I’m a sheepdog. I live to protect the flock and confront the wolf.” Or, as a sign in one California law enforcement agency put it, “We intimidate those who intimidate others.”

If you have no capacity for violence then you are a healthy productive citizen: a sheep. If you have a capacity for violence and no empathy for your fellow citizens, then you have defined an aggressive sociopath--a wolf. But what if you have a capacity for violence, and a deep love for your fellow citizens? Then you are a sheepdog, a warrior, someone who is walking the hero’s path. Someone who can walk into the heart of darkness, into the universal human phobia, and walk out unscathed.

The gift of aggression

"What goes on around you... compares little with what goes on inside you." - Ralph Waldo Emerson

Everyone has been given a gift in life. Some people have a gift for science and some have a flair for art. And warriors have been given the gift of aggression. They would no more misuse this gift than a doctor would misuse his healing arts, but they yearn for the opportunity to use their gift to help others. These people, the ones who have been blessed with the gift of aggression and a love for others, are our sheepdogs. These are our warriors.

One career police officer wrote to me about this after attending one of my Bulletproof Mind training sessions:

"I want to say thank you for finally shedding some light on why it is that I can do what I do. I always knew why I did it. I love my [citizens], even the bad ones, and had a talent that I could return to my community. I just couldn’t put my finger on why I could wade through the chaos, the gore, the sadness, if given a chance try to make it all better, and walk right out the other side."

Let me expand on this old soldier’s excellent model of the sheep, wolves, and sheepdogs. We know that the sheep live in denial; that is what makes them sheep. They do not want to believe that there is evil in the world. They can accept the fact that fires can happen, which is why they want fire extinguishers, fire sprinklers, fire alarms and fire exits throughout their kids’ schools. But many of them are outraged at the idea of putting an armed police officer in their kid’s school. Our children are dozens of times more likely to be killed, and thousands of times more likely to be seriously injured, by school violence than by school fires, but the sheep’s only response to the possibility of violence is denial. The idea of someone coming to kill or harm their children is just too hard, so they choose the path of denial.

The sheep generally do not like the sheepdog. He looks a lot like the wolf. He has fangs and the capacity for violence. The difference, though, is that the sheepdog must not, cannot and will not ever harm the sheep. Any sheepdog who intentionally harms the lowliest little lamb will be punished and removed. The world cannot work any other way, at least not in a representative democracy or a republic such as ours.

Still, the sheepdog disturbs the sheep. He is a constant reminder that there are wolves in the land. They would prefer that he didn’t tell them where to go, or give them traffic tickets, or stand at the ready in our airports in camouflage fatigues holding an M-16. The sheep would much rather have the sheepdog cash in his fangs, spray paint himself white, and go, “Baa.”

Until the wolf shows up. Then the entire flock tries desperately to hide behind one lonely sheepdog. As Kipling said in his poem about “Tommy” the British soldier:

While it's Tommy this, an' Tommy that, an' "Tommy, fall be'ind," But it's "Please to walk in front, sir," when there's trouble in the wind, There's trouble in the wind, my boys, there's trouble in the wind, O it's "Please to walk in front, sir," when there's trouble in the wind.

The students, the victims, at Columbine High School were big, tough high school students, and under ordinary circumstances they would not have had the time of day for a police officer. They were not bad kids; they just had nothing to say to a cop. When the school was under attack, however, and SWAT teams were clearing the rooms and hallways, the officers had to physically peel those clinging, sobbing kids off of them. This is how the little lambs feel about their sheepdog when the wolf is at the door. Look at what happened after September 11, 2001, when the wolf pounded hard on the door. Remember how America, more than ever before, felt differently about their law enforcement officers and military personnel? Remember how many times you heard the word hero?

Understand that there is nothing morally superior about being a sheepdog; it is just what you choose to be. Also understand that a sheepdog is a funny critter: He is always sniffing around out on the perimeter, checking the breeze, barking at things that go bump in the night, and yearning for a righteous battle. That is, the young sheepdogs yearn for a righteous battle. The old sheepdogs are a little older and wiser, but they move to the sound of the guns when needed right along with the young ones.

Here is how the sheep and the sheepdog think differently. The sheep pretend the wolf will never come, but the sheepdog lives for that day. After the attacks on September 11, 2001, most of the sheep, that is, most citizens in America said, “Thank God I wasn’t on one of those planes.” The sheepdogs, the warriors, said, “Dear God, I wish I could have been on one of those planes. Maybe I could have made a difference.” When you are truly transformed into a warrior and have truly invested yourself into warriorhood, you want to be there. You want to be able to make a difference.

While there is nothing morally superior about the sheepdog, the warrior, he does have one real advantage. Only one. He is able to survive and thrive in an environment that destroys 98 percent of the population.

There was research conducted a few years ago with individuals convicted of violent crimes. These cons were in prison for serious, predatory acts of violence: assaults, murders and killing law enforcement officers. The vast majority said that they specifically targeted victims by body language: slumped walk, passive behavior and lack of awareness. They chose their victims like big cats do in Africa, when they select one out of the herd that is least able to protect itself.

However, when there were cues given by potential victims that indicated they would not go easily, the cons said that they would walk away. If the cons sensed that the target was a "counter-predator," that is, a sheepdog, they would leave him alone unless there was no other choice but to engage.

One police officer told me that he rode a commuter train to work each day. One day, as was his usual, he was standing in the crowded car, dressed in blue jeans, T-shirt and jacket, holding onto a pole and reading a paperback. At one of the stops, two street toughs boarded, shouting and cursing and doing every obnoxious thing possible to intimidate the other riders. The officer continued to read his book, though he kept a watchful eye on the two punks as they strolled along the aisle making comments to female passengers, and banging shoulders with men as they passed.

As they approached the officer, he lowered his novel and made eye contact with them. “You got a problem, man?” one of the IQ-challenged punks asked. “You think you’re tough, or somethin’?” the other asked, obviously offended that this one was not shirking away from them.

“As a matter of fact, I am tough,” the officer said, calmly and with a steady gaze.

The two looked at him for a long moment, and then without saying a word, turned and moved back down the aisle to continue their taunting of the other passengers, the sheep.

Some people may be destined to be sheep and others might be genetically primed to be wolves or sheepdogs. But I believe that most people can choose which one they want to be, and I’m proud to say that more and more Americans are choosing to become sheepdogs.

Seven months after the attack on September 11, 2001, Todd Beamer was honored in his hometown of Cranbury, New Jersey. Todd, as you recall, was the man on Flight 93 over Pennsylvania who called on his cell phone to alert an operator from United Airlines about the hijacking. When he learned of the other three passenger planes that had been used as weapons, Todd dropped his phone and uttered the words, “Let’s roll,” which authorities believe was a signal to the other passengers to confront the terrorist hijackers. In one hour, a transformation occurred among the passengers--athletes, business people and parents--from sheep to sheepdogs and together they fought the wolves, ultimately saving an unknown number of lives on the ground. 

“Do you have any idea how hard it would be to live with yourself after that?” 

"Here is no safety for honest men except by believing all possible evil of evil men." - Edmund Burke   Reflections on the Revolution in France

Here is the point I like to emphasize, especially to the thousands of police officers and soldiers I speak to each year. In nature the sheep, real sheep, are born as sheep. Sheepdogs are born that way, and so are wolves. They didn’t have a choice. But you are not a critter. As a human being, you can be whatever you want to be. It is a conscious, moral decision.
If you want to be a sheep, then you can be a sheep and that is okay, but you must understand the price you pay. When the wolf comes, you and your loved ones are going to die if there is not a sheepdog there to protect you. If you want to be a wolf, you can be one, but the sheepdogs are going to hunt you down and you will never have rest, safety, trust or love. But if you want to be a sheepdog and walk the warrior’s path, then you must make a conscious and moral decision every day to dedicate, equip and prepare yourself to thrive in that toxic, corrosive moment when the wolf comes knocking at the door.

For example, many officers carry their weapons in church. They are well concealed in ankle holsters, shoulder holsters or inside-the-belt holsters tucked into the small of their backs. Anytime you go to some form of religious service, there is a very good chance that a police officer in your congregation is carrying. You will never know if there is such an individual in your place of worship, until the wolf appears to slaughter you and your loved ones.

I was training a group of police officers in Texas, and during the break, one officer asked his friend if he carried his weapon in church. The other cop replied, “I will never be caught without my gun in church.” I asked why he felt so strongly about this, and he told me about a police officer he knew who was at a church massacre in Ft. Worth, Texas, in 1999. In that incident, a mentally deranged individual came into the church and opened fire, gunning down 14 people. He said that officer believed he could have saved every life that day if he had been carrying his gun. His own son was shot, and all he could do was throw himself on the boy’s body and wait to die. That cop looked me in the eye and said, “Do you have any idea how hard it would be to live with yourself after that?”

Some individuals would be horrified if they knew this police officer was carrying a weapon in church. They might call him paranoid and would probably scorn him. Yet these same individuals would be enraged and would call for “heads to roll” if they found out that the airbags in their cars were defective, or that the fire extinguisher and fire sprinklers in their kids’ school did not work. They can accept the fact that fires and traffic accidents can happen and that there must be safeguards against them. Their only response to the wolf, though, is denial, and all too often their response to the sheepdog is scorn and disdain. But the sheepdog quietly asks himself, “Do you have any idea how hard it would be to live with yourself if your loved ones were attacked and killed, and you had to stand there helplessly because you were unprepared for that day?”

The warrior must cleanse denial from his thinking. Coach Bob Lindsey, a renowned law enforcement trainer, says that warriors must practice “when/then” thinking, not “if/when.” Instead of saying,“If it happens then I will take action,” the warrior says, “When it happens then I will be ready.”

It is denial that turns people into sheep. Sheep are psychologically destroyed by combat because their only defense is denial, which is counterproductive and destructive, resulting in fear, helplessness and horror when the wolf shows up.

Denial kills you twice. It kills you once, at your moment of truth when you are not physically prepared: You didn’t bring your gun; you didn’t train. Your only defense was wishful thinking. Hope is not a strategy. Denial kills you a second time because even if you do physically survive, you are psychologically shattered by fear, helplessness, horror and shame at your moment of truth.

Chuck Yeager, the famous test pilot and first man to fly faster than the speed of sound, says that he knew he could die. There was no denial for him. He did not allow himself the luxury of denial. This acceptance of reality can cause fear, but it is a healthy, controlled fear that will keep you alive:

"I was always afraid of dying. Always. It was my fear that made me learn everything I could about my airplane and my emergency equipment, and kept me flying respectful of my machine and always alert in the cockpit." - Brigadier General Chuck Yeager   Yeager, An Autobiography

Gavin de Becker puts it like this in Fear Less, his superb post-9/11 book, which should be required reading for anyone trying to come to terms with our current world situation:

"..denial can be seductive, but it has an insidious side effect. For all the peace of mind deniers think they get by saying it isn’t so, the fall they take when faced with new violence is all the more unsettling. Denial is a save-now-pay-later scheme, a contract written entirely in small print, for in the long run, the denying person knows the truth on some level."

And so the warrior must strive to confront denial in all aspects of his life, and prepare himself for the day when evil comes.

If you are a warrior who is legally authorized to carry a weapon and you step outside without that weapon, then you become a sheep, pretending that the bad man will not come today. No one can be “on” 24/7 for a lifetime. Everyone needs down time. But if you are authorized to carry a weapon, and you walk outside without it, just take a deep breath, and say this to yourself... “Baa.”

This business of being a sheep or a sheepdog is not a yes-no dichotomy. It is not an all-or-nothing, either-or choice. It is a matter of degrees, a continuum. On one end is an abject, head-in-the-grass sheep and on the other end is the ultimate warrior. Few people exist completely on one end or the other. Most of us live somewhere in between. Since 9-11 almost everyone in America took a step up that continuum, away from denial. The sheep took a few steps toward accepting and appreciating their warriors, and the warriors started taking their job more seriously. The degree to which you move up that continuum, away from sheephood and denial, is the degree to which you and your loved ones will survive, physically and psychologically at your moment of truth. 

Passing the Torch

About a week ago, I took this picture of the miniature T-wall outside the building where we've worked for 10 months (T-walls are normally 12-foot tall blast walls). This thing has been standing here since we got to Iraq, but I took the picture to commemorate a recent change: there is an end date painted on it!


Yes, our replacements are here, and they are here in force. We have been showing them our jobs, giving up our desks, introducing them to the revolving door of temporary colleagues they will be working with while in theater, as our predecessors did before us, and as they will do for someone else.

I normally don't post about the goings-on of my unit itself, and while I realize those are the juicy details that sell papers, they're also the kind that the Army doesn't like posted in blogs and, incidentally, the papers. Well, the secret of our redeployment is already out, and it wasn't posted here on OIT first (it was posted here ...), so I think I'm ok. If I end up with the guys in black coats and generic government cars, you all know what happened ... (they didn't get their free T-shirt from the last run we sponsored).

As the article says, we're waiting for movement back to the US to do a mountain of paperwork, and to get released. As such, we have a lot of time to think about the last year, even if all anyone talks about is what they're going to do when we get home. I know of a couple of motorcycles, a bunch of new computers, drinking too much beer, and a whole lot of romantic dinners (mine and Autumn's included!!) that are frequently mentioned plans. I'm also afraid that things won't be ok, and I have no idea what to do to prepare for it except to meet it head on as the last trial of the deployment.

The ironic part about that is that even the unknown over here had an air of finality to it - I took the baton from someone working on a problem, carried it all I could (due to time or the limits of my knowledge/ability/authority/etc), then passed it to the next appropriate person. The next step was always clear here, where the environment is so volatile and complicated, and I know it won't be so simple at home where the environment is presumably peaceful and uncomplicated.

Oh well, once more into the breach ...

Transitions

Much has been written about the transition a soldier must endure following deployment. When I left Bagram, I assumed that I would "power through" the redeployment and reintegration phases, hurry up and get it done, and move on with my family and my job. I have "powered through" many things in my life with pure determination and perseverance; it generally suits me well. But the past 2 days have taught me that I was wrong. Very, very wrong.

It has been a tough few days. I returned home from Atlanta to find that there were several challenges awaiting me: first and foremost, my car was dead and the brakes were nonfunctional. Secondly, the AC in the house wasn't working, and of course the gas was off. Luckily, there was some very good news as well, namely that the house wasn't underwater and that it actually looked quite clean. My first shower was tap-water cold, but other than that, things were actually looking tolerable.

Day 1 was great until late in the day. I spoke with some friends in Afghanistan on skype, made some calls to my command to let them know about my car troubles, and did some cleaning up around the house. Around 4 pm, I received a call from my command telling me to report in the morning and threatening AWOL paperwork for my absence during the day. I nearly reached through the phone and strangled my company commander for this little "welcome" home. I had been in contact with the command by email or phone more than 5 times in the 18 hours I had been back in town, and they were threatening AWOL paperwork??!! They deploy me and my husband at the same time so we have to abandon our house for six months, and when my car isn't working (not to mention the fact that I had no gas or air conditioning in the house) they want to start AWOL paperwork??!! I was incensed to the point of tears. Strike 1. The day went downhill from there.


I called AAA to have my car towed, just to be informed that my membership had lapsed while I was gone and there would be a 7-day waiting period for my full membership to begin again. Strike 2. I had my dad look into rental cars, and we basically found none in El Paso for any reasonable price. Strike 3.



Day 2 was a better day, although it too had its challenges. (It didn't help that I couldn't sleep, even after doing some yoga.) The biggest challenge was reporting to the hospital in the morning. For the first time, I felt the need to be anonymous at my own hospital. I didn't really want to see anyone that I knew (of which there are few), and really didn't want to meet anyone new either. I just wanted to get a few signatures on my paperwork and get out of there. It was highly overwhelming to be back in a "normal" and "calm" hospital, one without the ominous overhead pages ("Level I Trauma in the Emergency Room, 5 minutes") and the constant pall of a combat surgical ward. I wanted to be anonymous for many reasons, but mostly because I feel that no one understands what I've been through. I haven't kept in touch with anyone who is still assigned to the hospital, and how does one encapsulate 6 months of combat service into a few sentences when an acquaintance asks? An additional complicating layer involves the status of the acquaintance: if the person is a civilian without combat experience, there is absolutely no way for him/her to comprehend the challenges of a deployment. The person may be appreciative, may get misty-eyed to see me, may say how good it is that I'm home in one piece - but fact of the matter is that no one without deployment experience could possibly understand its challenges.

The war zone evolves depending on the fortitude and proclivity of the political winds of change. Therefore, even the military members can't understand (or they don't care ... I'm not sure which sometimes). Generally, servicemembers with a combat patch will at least remember the emotional toll caused by absence from family and friends, as well as the difficulties of reintegrating into normal American society. I'll give them that. But unless you have worked in the Bagram hospital and/or at Fire Base Lilley in 2009, there's no way to understand what I have gone through. A soldiers' experience while deployed depends not only on his/her internal support mechanism with family & friends, but also the location, time, length of deployment, strength of leadership, level of security, and operational specialty (position). No two deployments are ever the same; the differences between, say, OIF and OEF are staggering. Even a deployment to Helmand province in Afghanistan bears little similarity to my experience in Bagram. The differences between the PICU in Bagram in 2005 (when the hospital was a tent) and 2009 are also impressive. Needless to say, no soldier at my hospital has experienced Bagram and at FB Lilley in Afghanistan in 2009, so the building is full of people and faces but still feels quite empty.

Later in the day, I drive my now-functioning car to the grocery store to fill the pantry with basic food in preparation for Matthew's arrival the following day. I walked into Wal-Mart and had to engage in deep breathing and self-talk: the place is big, and loud, and full of people. The biggest problem, though, wasn't the crowds or the fact that I was starving as I shopped; it was the preposterous number of options I encountered for every item on my shopping list. The cereal aisle was the worst - I have eaten Special K and Cheerios for six months, so having the option of Crispix or Shredded Wheat (in 5 varieties) or Captain Crunch or Rice Krispies (also in at least 5 varieties made by several different manufacturers) was mind-boggling. The same mind freeze occurred in the ice cream aisle, since I have had the choice of exactly 6 flavors during the deployment - sometimes less, depending on supply. How was I supposed to decide intelligently between Starbucks flavors and Ben and Jerry's and Dreyer's with all of their attendant gustatory variances??! Ultimately, I had to tell myself to make a relatively quick decision and get comfortable with the fact that I might change my mind later .... and remember that I now have the freedom to drive back to Wal-Mart and get other flavors if I feel the urge. (By the way, I ended up with Honey Bunches of Oats and Reese's Puffs for cereal, and vanilla, peanut butter cup, pumpkin, and a bunch of single-serving Ben & Jerry's cups to satisfy my ice cream fetish.)

In writing this post, I thought back to an email sent to me by my wonderful Grandmother during my last days in Bagram:

"You are packing up and getting ready to leave Afghanistan. I know how you feel. You wish that you could take everything there home with you and that you could have ALL of both worlds. You can do that, but with the memories you will always take and have with you. But it's hard to leave those places and those people who have meant so much to you for even a short amount of time.

You will never untie those knots,
even though you might never see some of those people again.

I, and I know the rest of our family, will be here waiting for you
with our arms open to clasp you to our hearts again."

Right now, less than a week after my return to the US and before I have seen any friends or family in the states, I am still depending heavily on my friends in Afghanistan for reassurance that everything I'm feeling is normal and that I will feel less overwhelmed over time. My friends that have deployed before can provide insight into the process that no one else can, and thus I need them right now.

I know in my brain that the reintegration process isn't quick. I know that there will be bumps in the road - maybe even gigantic potholes. I know that I will miss Bagram - I already do miss the simplicity of life in Afghanistan - and especially the friends I made there. I also have to be confident that my loved ones both in the US and in Afghanistan will be patient with this transition, and that there will be no pressure to "power through" as I had initially strived to do. My friends and family realize (or will realize) that I can't just cut off my friends in Afghanistan, since these soldiers 7,500 miles away have not only been my lifeline over the past 6 months, but also because we have shared some significant emotional experiences. My friends in Afghanistan, on the other hand, should understand that my family and friends here are .... well, here. And I have missed them terribly during my deployment, and need to get to know them again during this transition period.

I don't know how long I will need to feel "normal" again here in America. My transition has been and will be stepwise (which, by the way, is a really good thing); I started by staying in a hotel at Benning for 2 days, then came home for a few days to an empty house and no friends or family; this weekend, my mom and Matt will come into town and I'll have the opportunity to get used to being around them, and soon James will be home and we will reintegrate as a family. Over the course of several weeks, we three will be together visiting with our family in California, and finally return to El Paso to begin a more "normal" post-deployment life together. We have a whole lot to figure out between now and then!

(More on "normalcy" - also known as BORING! and PREDICTABLE! - in a future post. I promise!)

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Read more about redeployment and reintegration:
US Army Europe
Military OneSource

Goodbye, Middle East!

I’ve just arrived in Georgia after many, many arduous hours of waiting, preparing, flying, and loading. It’s been a long 96 hours since I began the process, but the whole process has been surprisingly smooth so far.

Check-in at Bagram for the flight to Kuwait was at 1500, and we ultimately took off around 1845. Our bird was a C17 full to the brim with passengers and equipment. C17s are equipped with “middle” seats that look like commercial airplane seats, as well as middle-facing “jump” seats on the sides (see picture, above). There are no walls, no carpet, no yucky airplane food, no stewardesses. However, a few minutes into the flight, the passengers are able to lay on the floor wherever they see fit – and there is a lot of floor space to enjoy. So my friends and I went to the back of the plane (near the cargo ramp) with our pillows and took a little nap, and following our siesta started the movie “Fight Club”. The ride was smooth but loud (which is normal for a C17), and we arrived in Kuwait at around midnight Bagram time. We made quick work of checking in, getting our billets, checking on our outbound flight, having our first McDonald’s meal in six months, and using a gator to get our multiple, multiple duffel bags. I checked email at the MWR before going to sleep around sunrise.

I was assigned to a tent with 15 other women, so sleep was difficult overnight. I had all night and all day to sleep, but ultimately ended up exhausted from all of the interruptions. I got up around 1100, had lunch, checked email again, talked with my friends, went to the gym, did some laundry, ate dinner, packed up my bags, staged my bags, and ate midnight chow. It wasn’t supposed to be a busy day, but it was.

We began to get into formation around 0100. Now, if you think that customs when returning to the US for vacation is bad …. Try customs after a 6-month deployment. I had to dump out all 4 of my duffel bags as well as my single carry on, have it all inspected, then repack (see picture). I finished with customs around 0730, passed my two metal detector checks on the way to the terminal, and settled in for a long day of hurrying up to wait.

The lockdown waiting area had about 10 tents as well as sundry amenities like Pizza Hut, a coffee shop, bathrooms, etc. We were moved from tent to tent all day with roll calls in between. I managed to take a little nap, watch an episode of Army Wives, and start the first “Lord of the Rings” movie. The pizza was terrible, but the espresso chai latte was fabulous. We got into formation again around 1600 to prepare for our flight to Europe.

I was traveling with two friends – well, one good friend, a SFC who had worked in the admin section of the hospital, and one of his soldiers. The SFC volunteered to help with the baggage loading, and the other two of us basically stuck with him. There was an ulterior motive to this madness: those that help with the loading tend to get the choice seats on the plane. And when the flight is 6-7 hours long … seating makes a big difference.

Quick tangent: while waiting for umpteen dozen hours in the terminal, I encountered two soldiers who were wearing James’ unit patch. (For those of you that are unfamiliar with the Army uniform, here’s the down and dirty: on the left shoulder sleeve soldiers wear the patch of the unit to which they are assigned, and on the right shoulder sleeve they wear the patch of the unit to which they were assigned during deployment. These two patches may be the same, or they may be different, depending on the number of times the soldier has deployed and the unit(s) to which he was assigned during the deployment. Left and right shoulder sleeves identify the soldier’s unit and combat status.) These two soldiers were members of James’ unit who were redeploying a week or so earlier than the rest of the unit! In fact, the chief warrant officer I spoke with was the person who processed James’ request for assignment to the active component of the Army. We had a great talk about their deployment, their reintegration plans, their homecoming ceremony (which, by the way, is scheduled for the 30th but is subject to change), and about the military ball in November. It was a small slice of normalcy and reminded me that the Army is a small, small place.

I was yet again reminded of the small world of the Army when we stopped briefly prior to arriving on the flight line. I stepped off the bus and was greeted by an exuberant, “Autumn! Autumn!” It was a friend of mine from residency (she was a neonatology fellow during my residency) who is deploying to Iraq for a tour as a general medical officer. She was traveling with a few other doctors (mostly pediatricians) and although I only had a brief period to talk with them, I was astonished at their innocent and oblivious questions. They asked, for example, “Did you ever get attacked?” and “Did you feel prepared to deploy?” (First of all, I just spent 6 months in a war zone – of course we were attacked! – and second of all, is anyone ever really prepared to see the types of things I have seen?!) I am so different – in good and bad ways - than my peers who have not deployed. I’m going to have to come to terms with that as I reintegrate.

We ended up loading the plane at 1830, and taking off from Kuwait at 2100. Let’s do the math here: it took 20 hours to prepare and load ~250 military passengers and their ~ 750 bags onto the commercial DC-10 which would fly us out of the theater of operations. Painful, but tolerable. Almost anything would be tolerable when the ultimate outcome is arrival in the states!

We landed in Shannon, Ireland, for an hour or two layover. The amenities were impressive – a duty-free shop, a real European bar (of which we are forbidden from partaking, although the Air Force servicemembers with layovers in Shannon are allotted 2 beers….?), and showers. It was a 10-hour flight across the Atlantic - most of which I spent sleeping - and a crazy rush to turn in our gear once we arrived at Fort Benning. We were released around lunchtime, and I went to the Benning Army lodging facility to get a room that I wouldn't have to share with 5 other women. :) I then went for filet mignon at a real restaurant and saw a movie, like a regular person might on a Sunday afternoon. It was perfect.

I have this unreal - perhaps surreal - feeling that I just can’t shake. It’s as if I went through the Stargate on February 28th and it fast-forwarded me to September 13th. So much has happened in the interim, but like a dream, time seemed to alternately stop and fly during my deployment. At this moment, it feels like I blinked on February 28th, and when I opened my eyes again, I found myself in the same terminal in Shannon 6 months later. It feels bizarre to be headed home, to know that in a few short days I will see my mother and my son again. I have described my anxiety regarding homecoming in prior blog posts, but luckily my anxiety has been replaced with untainted euphoria and jubilation.

After Action Report: Lilley, Take 2

I know my silence on the web has been deafening. I haven't posted to the blog or kept in touch via email much lately, mostly because I spent the last 2 weeks downrange at my favorite little fire base on the Pakistan border. :) Yes, I had the distinct opportunity to once again visit Fire Base Lilley as a pediatrician, and this trip was even more eventful than the first!

The mission was conceptualized in July as I met the two Lilley SF medics when they arrived in Afghanistan and spent a few days in Bagram on their way downrange. Honestly, here's how it all started:

Jason (SF medic): "Hey, Autumn, what do you think about coming down to Lilley to do some teaching?"

Autumn: "That sounds good. How are we gonna make that happen?"

Jason: "I don't know. Let's looks into it."

The process of mission authorization was arduous and bureaucratic, requiring coordination at multiple levels of leadership within both my command and the SF command at Bagram. There were many times I thought, "This is never going to be approved." Incredulously, a few days before the mission was supposed to commence, we got the word that the mission had been approved at the highest levels. I was elated.

The medics and I began facilitating the logistics of the mission and planning for the training modules for the medics and local national providers. We discussed equipment and materials necessary to complete the mission, and within days transportation had been acquired. The flight out of Bagram was one day sooner than expected; although this caused me additional stress in the preparation phase (I got under 2 hours of sleep that night!), I was super excited to get down to Lilley and begin the mission.

Radio delays at Bagram caused me to miss my connecting flight from Salerno to Lilley; however, this deviation from the expected travel plan allowed me to spend a day experiencing Salerno. I used the day to further my knowledge of the resources available at the forward operating base (FOB) by meeting providers at the hospital as well as learning about the medevac capabilities staged at Salerno. It was a great opportunity to meet other medical professionals and become familiar with the medicine practiced there. Meanwhile, transportation was worked and re-worked and re-worked again; the medic at Lilley and the air coordinator at Salerno worked their tails off to ensure my safe passage downrange.

I caught a rotary-wing flight the following day to FOB Boris, a small base north of FB Lilley. I had met the doctor at Boris during my prior visit to FB Lilley, and he graciously provided quarters and other assistance during my stay there. Once again, I took the opportunity to experience as much as possible of the FOB by speaking with the medics, clinic NCOIC, and operations center. This FOB of around eighty soldiers was much smaller and more austere than Salerno, and the differences in personnel and environment were palpable. Meanwhile, I was kept informed of the tactical situation and plans by the medic at Lilley, and was picked up via convoy by the SF team in the middle of the night, arriving at Lilley around 0400. They had convoyed for 5 hours before they picked me up, so the team wasn't in the greatest of all moods, but we listened to Ace of Base in the MRAP and that seemed to make everything better. I stayed awake through sunrise in order to document the beautiful glimmers of light over the mountains of Western Pakistan.

We then settled into a solid daily routine. While not set in stone, our schedule loosely followed this paradigm:

Mornings - I saw women and pediatric patients at the Lilley local national clinic with the two Afghan providers. The SF medics joined me when possible. I encountered a wide range of complaints and diagnoses, including pneumonia, gastroenteritis, routine pregnancy, skin conditions, malnutrition, animal and insect bites, and gastritis.

Afternoons - I prepared and executed several hours of pediatric-specific training for the SF medics and local providers. The remaining time was used in organizing the clinics, conducting preventative medicine operations, and developing medical protocols.

Evenings - After dinner, the medics and I would see patients in clinic as needed. In between patients, the medics would provide blocks of instruction to train me on topics in tactical medicine. I learned about tourniquet use, building medic bags and individual first aid kits, regional and general anesthesia, acupunture, the different types of weapons used by the SF team, and so much more!!

As needed - I assisted the SF meds in other activities around the FB, including resupply missions and preventive medicine.

FB Lilley came under a rocket attack within a week of my arrival. I was headed to clinic when the first rocket hit within 30 feet of my destination; I didn't hear it nor see it, but I was told to take cover. I don't remember any of the other four rocket strikes, but I do remember the gigantic bang when the ammunition cache exploded (the explosion was estimated to equal around 1000 pounds of TNT).

With the SF medics, I treated two patients - one with a severe concussion and one with a knee sprain. The decision to medevac the patients was made, and I was given around 12 minutes to college my belongings and body armor, and be ready to board the bird. I did my best to pack for this unknown trip, but ultimately didn't do a very good job. :( Via blackhawk medevac, we went to Orgun-E for initial stabiliation, and then flew to Salerno for a CT scan. I spent one night in Salerno after the most seriously-injured patient was released from the hospital, and fortunately returned to FB Lilley the following morning within 24 hours of the rocket attack.

The operational tempo at the FB following the rocket attacks was quite high. (As well it should have been ..... the enemy has been unable to hit the base for over a year.) Once I returned from Salerno with the patient, the SF team prepared to go on a mission, and because some of their team members were non-mission-capable due to the attacks, they elected to assign me as the medical support for the FB in their absence. For 24-48 hours, I served as the only coalition medical professional at FB Lilley, which required me not only to see patients at the local national and coalition clinics, but also to keep abreast of the operational and tactical developments throughout the region. During this time, an additional three rockets hit FB Lilley, but fortunately no soldiers were wounded.

This second mission to FB Lilley was the capstone experience of my deployment. It was fun, it was challenging, it was new and different (even though I had been at Lilley before), and it convinced me that operational medicine - in some way, shape, or form - is my calling. 100% of me now believes that I'm probably in the wrong field of medicine, and that I need to change my plans and my career course. I haven't completely decided where to go with my career, but the options include intensive care pediatrics, flight surgery, public health (which will allow me to travel), pre-hospital care, operational/tactical medicine (e.g. with Special Forces), and emergency care. There are lots of options, and now I need to decide which suits me and my family best.

Bon Voyage 4-miler

A week ago, I got up at 4:30 AM, worked for half an hour, then ran 4 miles. What could possibly have compelled me to get up that early on a Sunday, when we don't have a hard shift change and I can be a few minutes later than normal? Yes, you guessed it: a free T-shirt!

1LT Michael Olsen organized the "Bon Voyage 4-miler" footrace as a last hurrah for our unit in the Camp Victory footrace sub-culture. It was a surprisingly well planned and well run race - not surprising because I expected any less of Michael, but because everything seemed to work behind the scenes and it all seemed effortless for him to execute and organize it. He and his crew of 30 volunteers (me among them) pulled it off and kept our flag from being dragged from the flagpole in front of our building by a disgruntled mob of hungry/thirsty/T-shirtless/etc runners. The T-shirts were also quite well done, sporting a simple design and a good background color. I won't mind wearing this one around!

My time was a few seconds over 27 minutes, which puts me in the 6:45/mile range - not too bad, but considering all the time I had to improve my run times, I should be running like 5 minute miles by now. I guess I should just accept it and embrace my inner Cinnabon.

Without further ado, the pictures:

Yep, that's me in the picture, running the last footrace we will get to run in Iraq!


... and this is me with my roommate Bob, the proud owners of free T-shirts. Bob didn't have to run to get his, he just volunteered to register people before the race and hand out XL T-shirts at the end. I realized too late that all this time I could have been volunteering to help for the races and still getting the T-shirts!! Oh well, at least I burned off some Cinnabon.


Here's the newest addition to the collection, front and back: