5/14

Infidelity is starting to be an issue back home in the States. Unfortunately, some of our friends are beginning to question their loved ones as phone calls and emails go unanswered.

A lot of our friends are experiencing heartache- from the medic who's on his first tour and already having trouble dealing with trauma and death, to a UK nurse who has only seen her new husband a handful of times since their wedding last summer. 

In a world where we can be so connected despite being worlds apart, I feel like social media actually makes things harder. When someone doesn't respond to a message right away, we wonder what they are really up to. When we see pictures posted on Facebook, we obsess about what that picture means. Who is that other person and what are they doing together? It doesn't matter how innocent the situation may be. When you have nothing but time to ponder these things, you can overcome your mind with all sorts of unpleasantries and destructive fantasies.

It's important to take care of each other here. Essentially, we are family, even if we don't always like each other, even if we would not have acknowledged each other back in our home units. 

My friend from home has appointed herself as the "unit's hugger" and hugs everyone who comes by. I'm not quite as affectionate, but I do like to make cards for people. Just give me a blank piece of paper and a Sharpie and I can make anyone's day better!

Part 6 of a 13 part miniseries following the personal memoirs of a deployed soldier

A soldier from the 36th Infantry Division, Texas Army National Guard observes a section of the Rio Grande River at sunset. He is serving at the Texas-Mexico border in support of Operation Strong Safety. (U.S. Army photo by Maj. Randall Stillinger)

 Story By Maj. Randall Stillinger

Story by: Sgt. Suzanna Carter

Posted: September 21, 2014

BROWNSVILLE, Texas – Texas Military Forces, in partnership with state and local authorities, gained valuable training experience from the 16th iteration of Operation Lone Star in the Rio Grande Valley and Laredo, Texas, Aug. 4-8, 2014.

Texas State Guard, a component of the Texas Military Forces, in particular, put into practice the second step of its shelter, recover and return emergency response plan during this annual, medical and emergency preparedness exercise that covered five sites throughout South Texas.

"[Civil authorities] would have us come in, work with them, and we would run the operation of the shelter, managing the clients within it, meeting their needs, keeping them safe in a disaster situation," said Capt. Vicky Nunn, 39th Composite Regiment, 1st Battalion, Texas State Guard. "[Meeting client needs] is what you'll see here. It's recovery training."

The interagency collaboration necessary to activate Operation Lone Star, one of the largest medical and emergency preparedness missions in the country, benefits from the inherent value in utilizing the Texas Military Forces to serve the citizens of Texas.

"It's a good value for the State of Texas because as Citizen Soldiers, we're able to be activated, come down, provide the care, and then go back to our civilian jobs after that," said Army Capt. Adam Wood, a field surgeon with Texas Medical Command, Texas Army National Guard. "So the amount of resources and time and money it takes to use us in that tactical situation is significantly less than it would be to use the active duty side in that same tactical setup."

Brig. Gen. Sean A. Ryan, commander of the 71st Troop Command, Texas Army National Guard, also emphasized the role of the Texas State Guard in the planning and implementation of this collaborative training exercise.

"We have more relied on our Texas State Guard to the point where we're pretty much ready to turn it over to [them] to do all the planning, the preparation, the training" for Operation Lone Star, Ryan said. "I think it has really helped us to exercise … the Texas State Guard to really do their mission. They are a huge part of what we do during a natural disaster."

Texas Army, Air and State Guard involvement in Operation Lone Star also fosters vital relationships with state and local agencies that they would work with in an emergency situation.

"This is just another incident in a different county with different relationships with other authorities," Nunn said. "Because we may be deployed here at some point if they need us, I think it is very important to build those contacts."

Service members often form relationships with patients who return to Operation Lone Star every year for the critical health services that are provided.

"Some of our Soldiers look forward to coming back here year after year to see individuals who might be returning and to see the updates in those families and how their children have grown and how their lives have changed," said Army Maj. Jerri Gates, senior behavior health officer with Texas Medical Command, Texas Army National Guard. 

Spc. Marcus Fernandez, 39th Composite Regiment, 1st Battalion, Texas State Guard, said that interacting with patients was all part of the training experience that prepares him and other service members for future emergency response situations.

"We see, throughout the week, so many different things that if we have to open a shelter, anybody that comes to the door, we should be able to handle it because we have this experience," he said. 

Area residents who visited Operation Lone Star expressed appreciation for the services that were available through the collaborative training exercise.

"Seeing the men and women in uniform is an awesome blessing, because everyone is walking around with a smile, very happy," said Zulema Silva, a Brownsville resident. "It's just a happy feeling to see y'all here, helping us and providing us with services that we otherwise wouldn’t be able to afford. Again I appreciate everything that you all do for us in the community."

Story by: Sgt Suzanna Carter

Posted: September 19, 2014

LAREDO, Texas –Texas Military Forces with international, state, and local officials, celebrated the successful collaboration among multiple agencies to plan and implement Operation Lone Star 2014 during a ceremony at the medical point of distribution (MPOD) in Laredo, Texas, Aug. 6, 2014.

Brig. Gen. Sean A. Ryan, Texas Army National Guard deputy commander, senior members of the Chilean military and a Chilean emergency response organization, and other officials toured the medical and emergency preparedness exercise site following the ceremony to see the cooperation among the various organizations represented.

"We're directly working with the Department of State Health Services … the state judges that you see, the superintendents, the leadership of a lot of the emergency services that we would be interacting with in the communities," in the event of an emergency or disaster, Ryan said. "[These partnerships have] just gotten better every year."

Chilean military and emergency response representatives visited the Laredo MPOD to gain a greater understanding of interagency collaboration for disaster response as part of a standing partnership between the Texas Military Forces and Chile.

"Operation Lone Star is what we consider a remote type of emergency disaster response scenario," said Air Force Lt. Col. Daniel Rodriguez, the bilateral affairs officer who coordinated the Chilean representatives' visit through the U.S. Embassy in Santiago, Chile. "With all the earthquakes and recent wildfires they've had in Chile, a lot of their areas are considered to be remote. So they're just kind of taking some lessons learned and doing some subject-matter exchanges with the personnel at Operation Lone Star who have been doing this for years."

While Operation Lone Star is a valuable training exercise for medical and emergency preparedness, it also provides much needed medical services to underserved residents in Laredo and the Rio Grande Valley. These services include vision, hearing, and diabetes screenings, immunizations and physical health assessments. Five MPODs in Laredo and the Rio Grande Valley offered these and additional.

Sgt. Marlene Duncan, 100th Mobile Public Affairs Detachment, Texas Army National Guard, right, role plays as a civilian media reporter during Operation Saber Junction held at Hohenfels in Nuremberg, Germany, Sept. 10, 2014. The 100th MPAD supported 17 countries, including the U.S., with realistic civilian media coverage; giving leadership a better understanding of how to work with civilian media in an operational environment. (U.S. Army National Guard photo courtesy of the 100th MPAD)

 Story by Sgt. Adrian Shelton

  NUREMBERG, Germany (Sept. 12, 2014) - Public Affairs soldiers from 100th Mobile Public Affairs Detachment, Texas  Army National Guard, in Austin, Texas, traveled to Nuremberg, Germany to capture the activities of thousands of troops in  a joint exercise called Saber Junction, August 23 – Sept. 12, 2014.

4/28

I had my first detainee patient today. 

The "fighting season" has officially begun and the intensive care unit has been slammed with roadside bomb and gunshot wound patients from both sides of the fight. The injuries are crazy; anything from extremity amputations to enucleated pupils to one guy's chest literally being opened up and attached to a wound vac. 

My patient suffered from a gunshot wound to the neck with an exit wound resulting in the loss of his left eye, and severe soft tissue damage from is left thigh down to his calf. He is young, probably in his twenties, although sometimes it is near impossible to tell. When the interpreter asked him his age, he didn't know it. The interpreter said that it was pretty common for people in this part of the world to not know their age. 

When a detainee comes through the hospital, a guard is assigned to watch over the nurse. We use mobile curtain partitions. I kept my partitions completely surrounding my patient's bed and monitors, so that he could not see the exit or other patients who are on the ward. I left a small opening in the partitions to walk in and out of my makeshift room, and positioned it so that the guard could have eyes on me at all times. At one point, some Afghan soldiers came in to visit their fallen comrades, and I completely shut off the partitions so that my patient could not see anyone.

I had heard horror stories of other detainee patients shouting, spitting at their nurses, and being downright hateful to everyone trying to help them. I also knew the rumors that everyone is addicted to heroin (this is the poppy capital of the world, after all, and heroin is probably the number one export for Afghanistan) so many patients who come to the hospital start going through withdrawals.  I heard of one guy yanking his urinary catheter out and then banging out all of his teeth on the metal bed frame.

My detainee patient, however, was neither rude nor going through opiate withdrawals. He mostly slept, waking up occasionally to ask for "ooba" (water) or saying "dard" (pain). After giving him something for his pain, his respirations and oxygen saturation began to dip down a little, a common side effect for this medication. I simply demonstrated taking deep breaths and then pointed at him, and he willingly complied. 

This was not the experience that I had prepared myself for this morning when my shift leader told me that I would have him. My patient is no different than anyone else I have cared for. In fact, I'm having a pretty decent day and can't complain about anything. I spoke to my senior leader, a Lieutenant Colonel who’s been an ICU nurse for years, about it.  This isn't his first rodeo. He basically broke it down for me like this; not every "bad guy" is on that side because they want to be. Some fall into the Taliban when they are children. Some become part of it because they have families to support. It's no secret that members of the Taliban have an easier life than others. These people are already uneducated far beyond my imagination. I mean, who doesn't know when their birthday is?

I'm not saying that the Taliban is ok by any means, but maybe I shouldn't be so quick to judge someone when I don't know their circumstances. What would I do if my situation was different? What would you do? 

But I did not have a patient who was spitting at me. My views might be a little bit different tonight if I did. 

I also got promoted to captain today. We did it right there in the ICU. Everyone broke away from their patients' beds so they could watch the promotion ceremony, which lasted about five minutes. The Lieutenant Colonel pinned my rank on. 

Later this afternoon, one of the British nurses called me over to her bed space. Her young Afghan patient, who had just lost both of his legs, was trying to tell me something in Pashtu. He pointed to my chest where my new rank was and then clasped his hands, gave me a thumbs up and smiled. He had seen the promotion ceremony, and although he didn't speak English, he understood what was going on and wanted to congratulate me. I'm not a super emotional person, but that resonated deep in my heart.

This deployment has already been worth it for me. I don't know how I'll feel after six months, but I'm thankful for the experiences I've had thus far. It's helped to break down some of my barriers and perceptions. It's been incredibly humbling, and this is still just the beginning.

Part 5 of a 13 part miniseries following the personal memoirs of a deployed soldier

Texas Army National Guardsmen honor the memory of Sgt. Tomas Garces, at a ceremony held in Weslaco, Texas, Sept. 6, 2014.  Garces  was killed in action,Sept. 6, 2004 and was the first Texas Army National Guard Soldier to die in combat since World War II. (Photo courtesy of Texas Military Forces)

Commentary by: Capt. Martha Nigrelle

Soldiers and family members of the 436th Chemical Company, Texas Army National Guard, released 1,000 balloons in honor of five of their fallen soldiers during a ceremony held at the National Guard armory in Laredo, Texas, Sept. 9, 2014. (U.S. Army National Guard photo by Staff Sgt. Amanda Torres/ Released)

4/25

It's funny how our perceptions of a situation or a group of people can be changed in a matter of hours.

Yesterday I was assigned to take care of an Afghan patient who I could barely stand to touch when assisting with a turn a few days ago. I looked at him, with his thick scraggly beard and dark skin, and only felt disgust. I knew he wasn't a part of the Taliban but I still had strong reservations. I had a difficult time seeing them as people. Of course, the fact that he was intubated, sedated, and missing both legs with several inches of femur on one side sticking out of his new stump didn't help. It can be hard to see past that and look at the patient as a person sometimes.

I was taking report from the outgoing shift when I learned that he wasn't just a local. He was part of the Afghan National Police, and had set off an IED while on patrol searching for Taliban. So maybe he's not so bad after all. Maybe he's just trying to make this country a better place for his family, just like our ancestors did years ago in this country for us. And unlike us, he hasn't had the same access to a life of privilege, education, and opportunity. 

Today when I came to work he had been extubated and off of his sedation, so it was even easier to interact with him. He didn't speak any English, and I certainly don't speak Pashtu, but we were able to communicate nonetheless. The look of gratitude in his dark eyes was unmistakable in any language. I fed him a banana and some French toast, and when he got transferred to the med-surg floor, I told him it was an honor and a pleasure to care for him. I don't know if he understood the words, but I'd like to think that he understood the meaning.

Working in this hospital is going to be a challenge. It's advanced yet primitive at the same time. For example, flies should never be buzzing around in the ICU, yet we have a staff of some of the most qualified surgeons in the nation here. The British may speak English, yet they have many different words for things and it can get confusing. Today one of the nurses needed to hang some fluids and asked me for a Gemini. I came back with the Gemini infusion pump. All she needed was the tubing. Oh well, at least we weren't in a code. A lot of the medications we use are the same but have slightly different names as well and not all of their equipment functions like ours. 

I know the day will come when I have to take care of a detainee. I'm not sure how I will feel about that, I guess just take it as it comes. I'm thankful, however, that my first experience with an Afghan patient was with this one. It helped break down some of the unfair and ignorant biases that I had and see them as people. 

Part 4 of a 13 part miniseries following the personal memoirs of a deployed soldier