Monday, March 15, 2010

Homecoming!


In the Navy, we frequently refer to some event in the future as being "X number of days and a wake-up." If something was going to happen a week from now, we would refer to that as "seven days and a wake-up!"

We left Haiti on the evening of March 9th headed for Norfolk. At that time we were "Four days and a wake-up!" Then we had a propulsion plant casualty that left us dead in the water for four hours. For three hours and 59 minutes, my only thought was, "How many days now?" Then, the problem was fixed, and we were off again!

On Wedensday, March 10th, President Obama had a news conference in the Rose garden, attended by two of our crew from COMFORT, where he talked about Haiti, and we watched him, thinking, "Three days and a wake-up!"

On Thursday, we had an MWR day on the flight deck (MWR stands for Morale, Welfare and Recreation). This was basically a chance for people to recreate a little, play some basketball and football and never forget that we were "Two days and a wake-up."

On Friday, we finalized all the plans for our arrival in Norfolk, including all of the VIPs who would be visiting us and as all these details were falling into place, we couldn't help but think that it was only "One more day and a wake-up!"

So I went to bed Friday night, tingling from anticipation of the coming day! I couldn't wait to get to sleep, because then it would be Saturday! I laid down at 10:00pm and started to quickly drift off to sleep. Then at 10:05: 'Hooonnnnkkkkk' (A mind-numbing, bed shaking fog horn located about 30 feet behind and above my rack). Then at 10:07: 'Hooonnnnkkkk,' at 10:09: 'Hooonnnkkkk,' at 10:11: 'Hooonnnkkkk,' at 10:13: 'Hooonnnkkkk,' . . . at 05:59: 'Hooonnnkkkk!'

And then Saturday arrived. All that was left was the "Wake-up!" Reveille sounded at 0600 and the crew sprang to life. It was about 64 degrees in my stateroom that morning (A ship like the COMFORT doesn't shift quickly from the 90 degrees of Haiti to the 49 degrees of Norfolk!) I decided that it was time for the XO to do what he had admonished everyone to NOT do during the whole deployment! It was Hollywood shower time! Throughout this deployment, and the one before, I had repeatedly scolded the crew to conserve water!! For seven months of the last year, I have kept my showering to less than two minutes of water flowing per day: 30 seconds of getting wet! (Turn the water off) Lather up. One minute of rinsing off and you're done! But Saturday morning was a whole different world! No need to conserve water now! Time to truly indulge! So as I got in the shower Saturday, I couldn't help myself! This time, I waited for the water to warm up before I got in the shower! I spent nearly 30 seconds getting wet! Kept the water running for the 30 seconds that I lathered up, and then rinsed off for another minute! Now that was living!!

We were supposed to be pierside at 10:30am, but being the overachievers that we are, we were on track to arrive at 10:00am. But as the fog-horn continued to sound throughout the morning, it became apparent that we might have a problem. Whenever a ship like the COMFORT comes into port, she is met by a harbor pilot who guides the ship into the harbor. In Noroflk, there is also a pier pilot who takes us the last little distance and ensures the ship safely arrives at the pier. The problem is, you really need to be able to see the pier at some point before you hit it. The COMFORT weighs 69,000 Long Tons. That's about 151 Million pounds. When you get that much mass moving even very slowly, it can be hard to stop or redirect its movement.

As I was looking off the bridge toward the water, there were times when I couldn't see anything even 100 feet away from the ship. The fog was so thick that as we passed over the Hampton Roads Bridge Tunnel we couldn't see any sign of the roadway at all.

So we inched along at only about one mile per hour hoping that the clowds would part, the fog would lift and we would be able to see the pier. Finally, with the pier only a couple of hundred feet off the bow of the ship, it finally came into view and the skilled Mariners who drive this beast brought her in flawlessly to the pier.


My wife took these pictures from the shore as we arrived. The Red Cross on the front of the ship slowly appeared through the fog and as the ship slid slowly up to the pier, the clouds broke, the sun broke through and Saturday turned into a beautiful day!


Their were over 400 people waiting for our arrival and as soon as the ship was cleared by customs, they were all brought aboard to meet their family onboard the ship. It was quite a hoot!




Leading the families onto the ship were six Flag officers: Five Admirals and One General who all came to thank the crew of the Mighty COMFORT for their truly heroic efforts in support of OPERATION UNIFIED RESPONSE - HAITI. They said a few words, shook a few hands and soon were on their way. We set the watch, called away Liberty Call, and we all went ashore for the first time in 60 days.

So then we were in Norfolk, and about five days later, we sailed up the Chesapeake Bay and arrived at our home port in Baltimore. We were met by families, hundreds of school children, lots of media, and my dog, Ruffy. It was pretty special.

Now, suddenly, two months have passed and I found that I never actually published this blog entry. Well, better late than never.

Shortly after our return, the COMFORT family suffered a tragic loss: About two weeks after safely steering us through the fog to arrive in Norfolk, and then safely bringing us home to Baltimore, the ship's Master, Captain Bob Holley suffered a heart attack and died in his home in Virginia Beach, VA. A veteran Master of both hospital ships as well as a long career in the Military Sealift Command, Captain Holley will truly be missed by those who knew him.

So, now we are back in our Reduced Operating Status and the ship is a ghost ship again. We spend lots of time showing her off to all kinds of tour groups who come for visits, but the hustle and bustle that is so much a part of every day underway is gone.

I am getting short. (That's a Navy term for getting ready to transfer). My relief has been identified: Captain Kathy Becker, NC, USN. She will be arriving onboard at the beginning of July and I will turn over the reigns to her on or about July 12th. Then I will be off to my next assignment: Navy Medicine Training Center, Ft. Sam Houston, San Antonio, Texas! Where I will get to take young skulls full of mush and turn them into the next generation of highly trained, highly skilled, dedicated professionals who will pick up the gauntlet and carry Navy Medicine into the future!

Of course, anything can happen between now and then and the crew of the COMFORT is ready to respond! It has been an honor to have been able to serve along side some of the most heroic, hard-working, never-say-quit people I have ever had the pleasure to know. I will miss them all!

And for you, dear readers, should this be my last blog entry as the XO of the Mighty COMFORT, I hope that you have enjoyed these posts and that they have given you a little insight into life onboard America's Most Prestigious Ship!

For now at least: XO Signing Off!

Wednesday, March 10, 2010

Wow! It's been almost a month?

I can't believe that it's been almost a month since my last post. It's not that there hasn't been anything to talk about, nor is it that I haven't had the time. Actually, shortly after my last post, the bottom dropped out as far as any new patients coming to the ship. And although my work days are still generally about 14 hours or so, the pace certainly changed.

I think the reason is that early on, writing on this blog was almost cathartic as a means of emotional release. As things slowed down, the day ended not with me needing to unload emotionally, but just needing to go to bed!

So, anyway, here's whats been going on over the last month: From our peak census of about 500 patients onboard, we steadily started discharging patients, even as more came aboard. We had about 31 of what we termed "Difficult to Place" patients who we were very concerned about whether or not we would be able to find a place for them to go here in Haiti. These were paraplegics, quadraplegics, and patients with traumatic brain injuries. It wasn't easy, and took lots of partnership building with a number of non-governmental organizations (NGOs) here in Haiti, but eventually, we were able to place all 31 into local facilities.


On February 27th, we discharged our last patient, pictured here! Then came the hard part: Waiting for the word to head home. We were told from the beginning that we would be here as long as the President needed us to be, so the process of convincing people up the Chain of Command that the need for the Hospital Ship had passed was not a quick task. I don't know if President Obama actually made the decision or not, but finally yesterday at 1:00pm we got the word that we would be leaving! And last night at 7:00pm the anchor came up and we put to sea headed non-stop for Norfolk, Va! Look out Norfolk! Here we come!

But if you listened to the President today from the Rose Garden, he made the point that the work in Haiti is not done. So why bring the COMFORT home now? Good question! Here's the answer: Our mission here was to provide care that was not available in Haiti. At first, that meant any complex surgery came to the ship, as well as many critically ill due to infection. Over the last 50 days that we have been here, a tremendous flood of capability came into the country, and the local hospitals have steadily been coming online to their pre-earthquake capability. So by the middle of February, there were very few cases that couldn't be handled by facilities ashore. We continued to provide some diagnostic services such as CT scans, but eventually, even those facilities were back in business in Haiti. At last count there were five CT scanners and one MRI working in the country. So, it's time for us to go!

Also, there is such a thing as the law of unintended consequences. You might think it's a great thing for the United States to provide all kinds of free health care for the people of Haiti. But the problem with that is that then their medical professionals, clinics and hospitals can't make a living, can't cover their costs, and so can't continue to provide care, and even more people will not have access to care. There have been protests in the streets of Haiti by Haitian physicians who are being driven out of business by all the wonderful help that has come to Haiti. The help is needed, but it needs to be balanced with a strategy that will not end up hurting the country even more in the long run. So, we did what we came to do: Provide services until the country's healthcare system could return to pre-earthquake capabilities. Now it's time for me to kiss my wife! Brace yourself, Debbie!

It has been 53 days since we set sail from Baltimore and in less than three days we will be back in Norfolk! It will be good to get back! My wife will be driving down from Maryland to meet us when we arrive and I can't wait to see her! We will have a couple of days together before she heads home and I go back to the ship. By the end of next week we will hopefully be back in Baltimore and we can put COMFORT back to bed! Then I can say hi to Ruffy! He's just such a boy!

At 6:45pm this evening we were 1018 miles as the crow flies from Pier 12 in Norfolk! Let's see how far we can get in a day!

Saturday, February 13, 2010

One Month Ago. . .


One month ago last night the ground shook in Haiti. At 4:53pm, Dad just got home from work and stretched out for a nap. His wife was busy gathering that night's dinner. It wasn't one of the fancy houses on the hill, but it was his. The streat was cluttered with rubble and garbage that never quite seemed to make it into a pan. Oh well, that's life in Haiti! And then an estimated at 230,000 people died.


Other elements of the Armed Forces of the United States of America were on station three days after the quake and they provided much needed immediate relief. One week after the quake, we took on our first two patients by hellicopter as soon as we were in range. Then day after day after day of gruelling work with people screaming, legs missing, broken thigh bones, crushed heads, and the list goes on.

Last night onboard COMFORT, we took a moment to reflect on that tragedy, said prayers for all the people who were so devistated by what happened. And shared stories of tragedy and triumph onboard COMFORT.

The night started with prayer and scripture reading, both in English and Creole. Then a time of sharing included the story of Isabel Rose, the baby that I talked about shortly after we arrived in Haiti. Isabel Rose was born two and half months premature to a mother who had her pelvis crushed during the earthquake. The injury caused her water to break and it was necessary to deliver the baby, both to save the mother's life, as well as to give the baby any chance at all at survival.

Isabel Rose was born through Cesarean Section and initially was doing pretty well. But as the days went by, she began to fail. She had a tube inserted to help her breathe, another one to help her eat, and an IV for fluids and medications. But she kept getting worse. Her mother was given the bad news. The Chaplain was called to pray and baptized little baby Isabel. Then the decision was made to remove her breathing tube and to keep her warm, until she passed away. So the tube came out, she was wrapped in a blanket and placed back into the incubator. Her mother, the Chaplain, and the team who had so lovingly cared for this, the first baby born on COMFORT, waited for the end.

They're still waiting. God wasn't ready for Isabel to come back to him just yet. As the minutes, then the hours, then the days passes, she kept going. She grew stronger, and bigger, and just the other day, she and her mother left COMFORT for another hospital in Haiti where little Isabel will continue to grow as her mother continues to heal.

Then the singing began. One of our line officers, LCDR Mortimer sang a moving rendition of the Navy Hymn including a special verse written to commemorate this Haitian tragedy. Then the "Joyful Noise" Choir got up and sang "This Little Light of Mine" is a way that would have made every one of their Sunday School teachers proud! Then it was the Haitian's turn. Now I don't know if they have mandatory singing training in Haiti, but I tell you what, you get a group of Haitians together, and every one of them can sing like an angel!


Now you know me. They don't call me the "frozen chosen" for nothing. I still think maybe people are overdoing it a little if they clap their hands in church. But, I tell you what! I was clappin my hands, tapin my foot, and just gettin all warm in side as our many patients joined us on the mess decks to share in this time of remembrence and celebration. It was a hoot!

I truly think things are slowly getting better in Haiti, if only the criminal element and stooges allow it to happen.

Well, I'm about to fall asleep. I haven't been sleeping terribly well for the last few days, waking up a lot during the evening. But that's OK, something tells me I'm gonna sleep like the dead tonight! Ahh the power of the little white pill! It's pretty hard to do this 30 minutes after you took an Ambien. It's all I can do to see the screen. Oh well! Have a great night.

Thursday, February 11, 2010

Change is in the Air!

It rained this morning. Hard. I haven't been ashore to see what the impact has been there, but I have seen some pictures on the news. Doesn't look pretty. This is the first real rain we've had since we got here, and since the earthquake. I can only imagine what the city must look like with rivers of pulverized concrete and muck flowing through the streets.

I thought I would share with you today what COMFORT has accomplished while here in Haiti. To date, we have admitted just under 900 patients. The vast majority of them (just under 800) needed complex orthopedic surgeries to repair their crushed and broken bodies. We delivered two newborns to mothers who were injured in the quake. We have supported and helped facilities ashore and we are now expanding that program to provide even more help in the days ahead. We have returned nearly 550 patients either to home or to other facilities here in Haiti to recouperate. We have medevaced 81 patients to the United States for ongoing care that we couldn't do here on COMFORT.

The pace of new admissions has dropped off over the last week and with the addition of a team of Orthopedic surgeons from the Orthopedic Trauma Association, we have completely caught up on the hundreds of patients onboard COMFORT who were waiting for surgery.

Tomorrow marks one month since the earthquake. Watching the international community come together to help these people has been inspiring. We have had French, Italian, Colombian, Mexican and German ships anchored near us (I'm sure there were others, but that's what I remember off the top of my head!) Ashore there has been an Israeli hospital, as well as teams from many other countries. Today or tomorrow we'll be welcoming a Colombian medical team aboard to work with us for a few days.

When we first got here, there were hardly any lights on in the city of Port-au-Prince. But each night, it seems like there are more.

I miss the snow back home! 90 degrees and February just don't mix in my mind! Oh well, with my luck it'll be 90 degrees in Baltimore when we get home!

Saturday, February 6, 2010

Who is that Handsome Guy?

You know, there are precious few pictures of me on this blog, because I'm usually on the back side of the camera! But, the other day when we were ashore, there was one of the Navy photographers with us and he snapped a few pics that had me in them, so I thought I would throw them up here.

Here, Commodore Laco and I are assessing the area around the city center port where we landed. Lots of damage to the port, but the US Military has made temporary repairs and has botten ships coming in and dropping off much needed material to support the disaster relief.



From there we traveled up to St. Damian's Orphanage and children's hospital and we put together a number of cots that we had been able to provide the hospital to make it possible for them to take some of our post-operative patients for follow-on care.
And after about an hour or so of that work, we got a tour of their facility and got to meet some of the volunteers who were there doing great things for the people of Haiti.

Well, our network is getting ready to go down for awhile, so I need to get this posted quick! Thanks for all your prayers!

Friday, February 5, 2010

XO Goes Ashore: Oh My God!

Yesterday, I went ashore for the first time since we arrived a couple of weeks ago (well, actually, I did go ashore one time earlier, but it was for only a second). I will start this blog post by stating what became an epiphany for me from yesterday's trip: Nothing you or I have seen, nothing you or I have heard, can prepare you for the overwhelming emenseness of this tragedy. Take every picture, every sight, every sound, every word that you have seen, heard or read about this disaster, put them all together and multiply them by a million, and you wouldn't begin to appreciate the scope of the destruction in Port-au-Prince.





As we pulled into the downtown port, the damage was evident. Two large cranes, used to offload container ships were collapsed into the water. I can't tell for sure, but it looks like they were standing on a pier that entirely collapsed into the water, leaving the cranes leaning dangerously over the harbor.



While I could see the collapsed neighborhoods on the hills surrounding the city's plains, I didn't get a chance to go up there. There were a number of buildings that I saw that were completely collapsed, but most of the structures in the lower part of the city, while often damaged, have not completely collapsed. Lots of rubble, lots of broken walls, lots of parts of buildings collapsed, but not the dramatic pancaked buildings that are common in other parts of the city.


But what I did see was mile, after mile, after mile of makeshift tent cities with thousands upon thousands of people milling about with no electricity, no sanitation, no running water, spending every waking hour struggling to scavenge or find enough food and water to keep themselves and their families alive.


But at the same time, there is evidence that the city is reawakening from this nightmare. Traffic, unlike just about anywhere else in the world, is beginning to return to it's normal, hyper-chaotic, "he who gets his front bumper into a space first has the right of way," jumble of vehicles all pushing their way through a turnstile at the same time. Motorcycles and scooters swarm between vehicles in what can only be described as a death wish. But amazingly, with almost two hours of travel in a bus through this environment, not one scratch, not one nick, not one bumped mirror, even with big Mac trucks and tanker trucks squeezing their way along a road built for two lanes of traffic with at least four lanes of vehicles pushing their way along.



Trash is everywhere, along with the rubble, but that's not a lot different from what the place was like last April when we were here. And maybe we were just lucky, but we didn't smell much in the way of decomposition, other than rotting vegetables and the dusty, dirty smell that again was not much different from the pre-quake Port-au-Prince.

But amongst all of that, the people demonstrate the resiliance for which they have become famous. People are generally wearing clean clothes, and are moderately clean. Children are cared for, and people have taken their situations into their own hands and have produced thousands and thousands of shelters from every kind of fabric, tarp, or piece of sheet metal that they could find. Of course, these will be precious little defense against the rains that are only a few weeks away, but they do shelter them from the sun, and if the earth moves again, they won't have to worry about slabs of concrete crushing them to death.

Our mission yesterday was to visit the St. Damien's Orphanage and hospital located only a few hundred yards from the American Embassy. St. Damien's is actually a fine hospital and facility that is well maintained and almost an oasis within the desert of beauty that is Port-au-Prince. St. Damien's has a dedicated medical staff and they are doing everything they can to take care of as many of the injured as possible. We took them some much needed medical supplies to help them care for the 25 recovering patients of ours that they have graciously agreed to help nurse back to health. We also took some cots that we put together and placed in some large tents that they have set up as additional wards in front of the hospital.

Well, I need to run and get back to work, so I'll just say goodbye for now. Keep praying for the people of Haiti. This disaster will soon leave your TV's, but it won't leave Haiti for many years.

Wednesday, February 3, 2010

It’s hard to believe that it’s already been five days since the last time I wrote on this blog. Every night, I try to write something, but for the last four nights, by the time the day is winding down, so is my ability to even think, let alone write.

Tonight, I just quit. As the last two meetings of the evening wound down, I looked around and no one was there with something I needed to do. I could have gone looking, and I probably should have, but I told myself, “If I can make it to my stateroom without the tyranny of the urgent grabbing me on the way, I’m going to go straight there and try to write something for the blog. Well, I made it! So far, the day has been 15 hours. I’ll spend about an hour trying to write this (and get it loaded to the net which is whole nother problem!) and maybe I can get a good night’s sleep.

But even as I’m typing this, we just went to Flight Quarters.

I’ve said this before, but it is so strange to experience the changes to the space-time continuum that has happened over the last two weeks. Two weeks, it can not possibly be only two weeks since we arrived here in Port-au-Prince. So much has happened, so much has been done: We’ve treated over 700 patients, every one of them severely injured. We’ve done over 500 major surgeries including 38 today. We’ve sent over 300 people who came to us broken, bleeding and dying back home to their families. And we’ve stood by 21 souls as they’ve torn this earthly veil and joined the hundreds of thousands of their brothers and sisters who fell victim to the power of nature to shake our world.


Several days ago, I took pictures of some of the other ships here serving in Haiti. I don’t know which ones they were exactly, but we’ve had ships associated with two ARGs ( I think that’s Amphibious Ready Groups, but I’m not sure. We live and die by our acronyms and all I ever call them is ARGs) lead by the USS NASSAU and the USS BATAAN. We also had one CSG (That’s Carrier Strike Group) headed by the USS CARL VINSON. The VINSON and her escorts have left us now.



There are also a number of Partner Nation ships here. This is a picture of the French ship SCIRACCO (sp?). Her Captain and Senior Medical Officer came to the COMFORT for dinner with our ship’s Master, Captain Holley. Tonight we had a visit from the leader of a group of Colombians here rendering assistance to the people of Haiti.


Our Intensive Care Artist has given us two more drawings that I am sharing with you. They really are telling of the scope of this tragedy.



Tonight we’re getting a shot in the arm! We have been overwhelmed with major Orthopedic Surgery cases. Broken femurs, broken legs and feet, broken pelvises, shattered arms, broken backs, broken necks, and broken skulls. We left Baltimore with one Orthopedic surgeon onboard. We received several more when we were plused up after our arrival here, and today, we’re receiving 10 more! Six of which are Orthopedic Trauma surgeons. We plan on running three OR’s 24 hours a day doing nothing but Orthopedic surgery to burn through the hundreds of surgical patients who have been waiting since the earthquake more than three weeks ago for a chance to have their broken bodies repaired.

We also have some new equipment that we’ve received to help them do the voodoo they do: Three C-Arm Fluoroscopy machines. Complete with tech rep to get them up and running and two Radiation Physicists to calibrate and certify them safe for use. These expensive pieces of equipment weren’t ordered until after we arrived here in Haiti. So in less than two weeks, the Naval Medical Logistics Command in Frederick, Maryland turned around a request for these machines, got the quotes, wrote the contracts, got them shipped, then the Supply team got them hop scotched from Jacksonville to Guantanamo Bay, Cuba, out to the BATAAN and then yesterday, finally lifted to the COMFORT. Purely amazing!

OK, that’s enough for tonight. It is getting late and I need to finish this and check to see if that tyranny of the urgent is waiting outside me door!

And Debbie, I love you so much! We’ll be home soon! Well, someday!