Halfway.

148 days down. 148 days to go.

Lessons learned:

1) Interventional radiology, a subspecialty that relies heavily on the latest and greatest technology, can work and excel in a tent operating room with a regular OR table and a C-arm. The ability to do cases while the patient is on the table undergoing a massive resuscitation attempt is vital, and incredibly exciting and rewarding.

2) Skype may be the world's best invention for people away from home. Even if the quality is lousy sometimes, the ability to see the kids and home is priceless.

3) Watching a non-beating heart in a severely injured soldier suddenly start beating, is both frightening (because I know what challenges lie ahead for him) and awe-inspiring.

4) Making the kids laugh on Skype by simply putting Curious George on my head and spinning around in my chair makes me happy.

5) What may be perceived as inappropriate laughter or comments in the setting of severe trauma helps keep us sane.

6) I like looking at the moon and stars, with the knowledge that the same moon and stars can be seen by my family.

7) I love working dogs.

8) I love pictures of our goofy Boxer, Lilly, sleeping the days away. That's one way to get through a deployment.

9) I love the picture of Ruth and the kids in the snow. Smiles of joy.

10) I'm not going to put down 148 lessons learned.

11) Injured kids make my heart hurt.

12) When the rocket attack alarm goes off, it's worth hitting the deck.

13) Nargis: An Urdu word that means daffodil. A name of a cyclone. A name of a Bollywood star. The brand of tissues that they put in our dining facilities to use as napkins. One wipe of anything slightly moist and they shred and do nothing remotely useful, therefore, we have taken to using the word "Nargis" as an epithet.

14) Curry with mango chutney is one of God's great creations!

15) Desserts named "Spotted Dick" should probably be avoided.

16) Courage: pre-positioning tourniquets on your legs before you go out on a mission with the expectation that you will hit an IED.

17) Watching a priest give last rites to a patient while we are trying to save his life is both disturbing and an acknowledgement of our limitations.

18) Plane watching on the flight line is a great way to pass the time.

19) Having a good roommate can make or break a deployment. I am lucky.

20) Having a strong support system can make or break a deployment. I am lucky.

21) I miss my family.

Headlines

Errant U.S. Rocket Strike Kills Civilians in Afghanistan

Coalition forces fired two rockets with the High Mobility Artillery Rocket System at insurgents firing upon Afghan and ISAF forces, but they struck about 300 meters off their intended target, ISAF said.

Coalition forces have also suspended use of the HIMARS pending a review of Sunday's incident. The intended target was an insurgent compound from where coalition forces were taking direct fire, ISAF said.

The headline comes from the New York Times. The sentences below it come from CNN. Stories about this incident can be found on any major news network. This incident happened during the recent operations in the town of Marja, a known Taliban stronghold. This operation, a combined coalition and Afghan operation with approximately 15,000 troops of which almost half are Afghan military, was specifically advertised in advance to encourage people to leave (both civilians and Taliban) to limit the number of casualties. I will never make light of civilian casualties, having seen enough of them already in my time here, but I question the immediate suspension of a very useful weapons system because the rounds went off target by 300 meters. I guess that this is what the expression "sheer folly of war" means. To quote George Costanza, "I am without speech."

So, with that as introduction, I thought I would present a few more headlines/stories that you might not have seen.

Taliban apologizes for accidentally killing civilians in suicide bombing

A suicide bomber struck a U.S. patrol near Kandahar on Saturday, killing 3 and injuring more. Multiple civilians, including children, were also injured and killed (including 2 of 3 brothers) in the attack. The Taliban apologized for the accidental killing of civilians and has suspended all suicide bombings pending a review of Saturday's incident.

Taliban surprised that IEDs kill civilians too, pledges to remove them all

It has recently come to the attention of the Taliban leadership that IEDs kill and maim a surprising number of civilians. "Weirdest thing, we've planted more of these IEDs than poppy seeds recently, and they seem to also kill and injure civilians when they explode. Who knew?" said a source close to the Taliban leadership.

Small child severely injured trying to retrieve unexploded ordnance

While the truth may never come out, officials expressed surprise that a child would crawl through the barbed wire onto a guarded coalition range to try to retrieve unexploded ordnance. "It seems unlikely that this act was done of his own volition" a source close to the officials was quoted as saying. The child was unfortunately severely injured when the ordnance exploded.

So there you have it. Some headlines that you might have missed. I guess maybe I'm reading a different newspaper.

It is well that war is so terrible - otherwise we would grow too fond of it.

Robert E. Lee, Statement at the Battle of Fredericksburg (13 December 1862)

Chucky

You walk into a conflict as a human, you know there is a chance you may get killed. Even when your version of that conflict involves never leaving an armed base that is so "safe" that we even have a TGI Fridays, for crying out loud. This is a different war. There is no well-defined "front." The enemy choses to practice what we now call asymmetrical warfare...a fancy term for killing by any means necessary: IED, suicide bombers, etc. The enemy also randomly launches rockets onto our base. I kind of view my chances of being hit by a rocket as being similar to winning the lottery, except the downside is a bit worse. That being said, wasting your time worrying about getting hit by a rocket attack is mental energy that I don't feel like wasting. This goes under one my favorite expressions, "Sometimes you get the bear, sometimes the bear gets you." Which gets me back to my opening sentence: as humans we always know there is the chance that something could go drastically wrong, but we take that risk because we feel that the good we have to offer outweighs that risk.

On to writing about the dogs. Do they understand what is going on around them? When they are on patrol with their handler looking for bombs or bad guys what is going through their minds? Do they know fear? Do they know that they may be killed? Or is their sole focus on doing the things that make their handler happy? And when they make their handler happy, that makes them happy. If you've read a couple of my postings, you know I love dogs. I love their fuzzy faces, I love playing with them, I love their unconditional love (I know, an overused expression with respect to dogs), I love how happy they are with the simple things in life and I really identify with that aspect of their personality.

Chucky, a beautiful Belgian Shepherd, a working dog in Afghanistan for private security contractor is out on patrol with his handler. The handler steps on a landmine. The handler took most of the blast breaking one leg, losing part of another leg and has a variety of other injuries. Chucky is brought in on the same helo and put into one of our trauma bays and treated just like any other patient. You can see the blood on his back legs and he lays there quietly under a blanket. He lets you scratch his head. He responds to little whistles and talking. The veterinarian comes over and sedates him and starts working on him. I don't routinely read dog x-rays, but I do here. He has multiple pieces of shrapnel in his back legs with two fractures in his right leg. I talk to the vet and she tells me that these are treatable injuries, but it all depends on the contractor and if they will pay for it. War, like many things, comes down to money. It is, after all, a business. The contractor won't pay. It's cheaper to get a new dog then fix the one that they already spent thousands of dollars on. A rumor goes around that you can sometimes adopt these injured working dogs. One of the people at our hospital goes over to the vet to find out about this...too late, the dog has already been put to sleep.

It hurts to see young soldiers injured and killed. But soldiers know what they are getting into as they go to war. Dogs, like children, rely on their owners (or parents) to take care of them. Maybe part of the reason that dogs and children are so carefree is that they usually don't have to worry about their health and well-being. I think that's why we love them so much because of their carefree approach to life. For those of us who own and love dogs, it hurts to see one of them treated purely as an asset and when that asset becomes a liability it is cut loose and terminated.

I hope Chucky's soul is free to travel the land, running and playing for as long as he would like. Perhaps he'll run into Dorsett. Perhaps they'll go to Belgium and have some pomme-frites. Run free, Chucky, I'm sorry the system failed you. You deserved better.