Thursday, January 22, 2009

A day in the life...

(The original clinic above, and the new hospital below)

It has been a busy last several days. My typical day begins around 0530. I wake up, shower, and usually try to call my family. I will then go and round on my patients. The hospital is a fixed building that has been there about a year. Originally it was a tent (picture #1), then a tent hospital. It is now a “state of the art” facility (pictures #2). It has a trauma bay that contains four beds for evaluation and resuscitation. We have a new CT scanner that is smoking fast and provides great images when needed. It also has an OR with 2 beds (picture #3) that is attached to the ED. We are capable of running both OR’s simultaneously, and already have done so since I have been here. There is also a ward/ICU. There are four total beds, with the capabilities of caring for critically ill or routine patients (pictures #6). Since most of the patients we are dealing with are local nationals, we take care of them until they can leave the hospital. Anytime a specialist is needed, such as ophthalmology, neurosurgery, or ENT, we can transfer them to Bagram, a much larger facility. Otherwise we care for them. This makes it necessary for everyone to be on the same page and keep people moving through the system, so we can accept new patients.

(The OR Suite)

Once I have seen my patients, the whole team meets around 0715 for rounds. This includes; hospital commander, all surgeons (me as well as a thoracic surgeon and orthopedic surgeon), medicine doctors (there is an internist that works in the ED, as well as primary care providers), nursing staff, and anesthesia (we have an anesthesiologist and two CRNAs). We talk about the patients and make sure everything is happening to make them well and free up beds. After rounds we will begin the cases for the day. There is a local national’s clinic. People come from miles around to be seen. Once they are appropriately evaluated and prepared they will go to the operating room. Clinic will also be seen at this time.

(Our 8 bed ward; ICU capable)

Since the Taliban and other radical Muslims want to inflict the most possible damage, most of the trauma occurs during the day. This is exactly opposite what happens in the states, where trauma usually occurs at night. Around 1030 or so, we usually start receiving trauma patients. Most suffer from blast injuries from IEDs, or have been shot. Injuries range from mangled extremities to burns, to penetrating injuries of the extremities or torso. One never knows what we are going to see during the day. So we usually evaluate the trauma patients and treat them as needed. This usually means making the clinic patients and or the locals that will be operated on wait. Luckily, we have nothing better to do, so everyone puts in there best effort and we are usually able to finish around 1700 (picture #7). I will usually walk around and see my patients again and make sure they are doing well. After wards, it’s to the hooch or gym, followed by a scrumptious meal at the DFAC. So far, we’ve been watching movies at night in the surgeon lounge of the hospital. By then, I’m usually tired and ready for bed, so it’s lights out, only to repeat it again in the morning. Take care.

(Sunset on the flightline)


  1. wow - awesome! keep posting! i changed the layout because i couldn't post a comment - hope it's ok! :*

  2. Your descriptions are fabulous. We can't believe how nice it is inside the hospital. You are really having the experience of a life time, but how do you ever keep up the pace! You are a doctor's doctor. We love you and we are so proud. Be safe!

  3. i'm on jenny's computer, but it's really megan! this is so nice for us to see and hear what you are actually doing! we love you and miss you so much! winston mentions you in his prayers at night..."bless stevie" his version..."b evie". love you!! be safe.

  4. Hey man. You are in Erica's and my thoughts. You are the best in every way I can measure Steve. I know you will have an impact on the lives of many there.

  5. Hey Steve- It's Ryan & Thierry Robinson from the old ward... what an incredible experience you are beginning! You and Kristen are such incredible people, and I am amazed by you both. I look forward to reading about your experiences. You and your family will be in our thoughts & prayers.
    Love you all!

  6. You are SUCH an awesome surgeon. They are lucky to have you!!