Dr. Gary Brickner Guest Post

December 2, 2011, 12:18 AM UTC

I have now been on active duty and in-country long enough to develop some early impressions.  The first is that I am  once again reminded of the amazing ability of the US to mount major military operations.  The constant movement of personnel and materiel from CONUS (the continental US) to OCONUS (outside the US) is on a magnitude unprecedented in history.  That it can do so over a prolonged period of time with only 1% of its population in uniform speaks to the quality and dedication of the men and women (many of them part-time reservists) of the Armed Forces.  There is a singlemindedness in the military to complete any mission successfully that is not equalled in any civilian endeavor.  It is particularly impressive when you take into account that we have now been at war for 10 years–almost 3 times longer than both the Cvil War and World War II.  Which brings me to my second observation.  There are very few rookies over here.  Almost all of the officers and NCO’s have been deployed at least 2 or 3 times.  It is a veteran force that has become extremely professional and capable.  Junior officers who gained experience in  Iraq are now moving into more senior positions of authority here.  They are bringing their hard-won knowledge of how to fight an insurgency to the mountains and plains of Afghanistan. Finally, this deployment has brought me into much closer contact with the enemy than my previous two.  It is not a pleasant experience being in the presence of men who would as soon as slit my throat as look at me.  And it is difficult not to feel great anger when captured Taliban proudly boast of American soldiers they have killed–and how they would eagerly do it again if given the chance.   If anyone ever doubts there is true evil in the world they have only to spend time here.

As most of you know by now, I am posted to a small base just outside of Bagram, Afghanistan.  It is considered a “joint base” because it is manned by personnel from all the branches of the Armed Forces.  We have regular Navy and Air force people here and even a few Marines although the largest contingent are Army—mainly National Guard and Reserve.  These latter units come from  all across the US but especially northern California, the Midwest and New England (and, of course, me representing the great Garden State).  Between the crunchy granola types from the west coast, the solid mid-Americans and the craggy New Englanders there are some interesting discussions in the DFAC (dinning facility). But it may surprise you that these are never political.  Soldiers, I have found, almost always keep their personal political views to themselves. We are here to carry out a mission and political views are irrelevant to that.  The American military takes very seriously its duty to execute policy not to make it.

One of our main functions here is to process and hold many of the worst Taliban prisoners.  Since the debacle at Abu Gharib in Iraq, the US has taken extraordinary measures to insure that all prisoners and detainees are treated humanely and with respect—and that includes medically which is where I come in.  I am the Battalion Surgeon for a National Guard MP (Military Police) battalion from Nebraska whose members are in integral part of the security here. As such, I split my time between tending to their medical needs (as well as all US military and Coalition Forces on base) and those of the prisoners.

As I write this I am spending the first of two consecutive nights “inside” as the only medical provider for the entire facility.  I am unarmed, in an unlocked medical station and, to paraphrase Jack Nicholson, closely surrounded by several thousand men sworn to kill me—protected by MP’s (male and female) who are mainly in their early to mid-twenties.  Fortunately for me, they are quite good at what they do as are the young medics who man the station with me and do most of the heavy lifting.

So far I have sutured an accidental facial laceration, medically cleared several prisoners both before and after their interrogations, sedated someone on suicide watch and been informed of a possible heart attack—and still have eight  hours of my eleven hour shift to go.  Plus, before the night is over, I will make “rounds” on about fifty men on the  medical unit and either give or supervise the administration of parenteral medications to some of them.  Despite thirty years in medicine, nothing I have done in civilian or military life has quite prepared me for this mission but that is true of most of the people I am serving with.  Among these are three doctors, four Physician Assistants, one of whom is also a Certified Nurse Midwife (from California, of course) and several Nurse Practitioners.

As I alluded to in my previous posts, there is no rah-rah atmosphere here, just a grim determination by a lot of good  men and women to see their mission through, move the ball down the field a few yards and hand it off to the next group before going home to resume their interrupted lives.
(For obvious reasons there can be no photos with this post but I will try to make up for that next time.)

For some odd reason there seems to be a lot of curiosity about my living conditions over here so I thought I would give you a quick photo guided tour of my Army-issued 3-Room Suite.  The first picture shows the entrance to the tent I share with four other officers–2 Medical and 2 JAG. This tent is the culmination of almost eight hundred years of tent technology but I bet if you were able to enter the one used by King Richard the Lionheart on his Crusade it would look almost identical.  The next is of my bedroom and dressing room.  Note how my rank entiltles me to a canopied bed complete with curtain.  The final picture is of my sitting room.  There is no TV reception here nor is there a DVD drive in this model.  I have no idea why it was brought or left here by the previous occupant but I keep it around to give the place a more homey feel–maybe he did , too. There is a bomb shelter almost at our front steps, the bathroom facilities are only a short walk away and we only have to share the latter with three hundred other men. In truth, the only times things get dicey are when the AC quits (rare) and then this tent becomes the world’s largest oven and you could roast a chicken in here and when the winds kick up (often).  Then, it feels and sounds as if you were living inside a whipping flag during a torrential downpour. The reactions of the various Services to these quarters are interesting.  The Army guys feel this is pretty much par for the course and better than some, the Navy people think they have died and gone to heaven because it is so much more than they get on board a ship and the Air Force think they are living in the black hole of Calcutta.

Having one of our few days off since hitting Theater, my MP Colonel friend Dave and I decided to travel to the main US base at Bagram for a little in-country R and R.   Dave plays  an important and sensitive role in the war effort—so much so that he occassionally briefs General Petraeus.  However, more impressive, and of immediate importance to me, is the armored Ford 4×4 kept at his disposal that allowed us to make the trip in relative comfort and safety.
I was last in Bagram in early 2005 when we regularly convoyed there from our base outside of Kabul about 45 miles away. There were only about 23,000 American troops in the entire country back then and it was a “quiet” base with neatly laid out tent and B-Hut (a wooden one-story building) areas for living and working interspersed with drab two and three-story buildings left over by the Russians.  The Combat Surgical Hospital (“CASH”) was nothing more than several B-Huts thrown together.  All in all there was a small-town feel to the place and it had the best PX (Post Exchange) in Theater with a Burger King right next door! (You had to be there.)
Times have certainly changed and not all for the better.  With the rapid buildup of troops over the past couple of years, the base has been expanded rapidly and not in ways especially aesthetic. It now more resembles a third-world capital during a coup d’etat.   Dust and dirt are everywhere with uneven and broken pavement the norm where infra-structure is being put in. Most of the tents are gone replaced with multistory pre-fab buildings built chock-a-block with deteriorating B-Huts most of these surrounded by concrete walls topped by concertina barbed wire. The CASH is now a fixed building resembling a well-equipped community hospital.   And at its height the traffic, between the ubiquitous armored military vehicles and the “civilian” ones like ours, can make Manhattan rush-hour seem hurried.

One thing that hasn’t changed, however, are the numerous mine fields that surround and weave through many sections of the base.  The Russians in their zeal to “protect” Bagram when it was their main base in the 1980’s heavily mined all approaches (but somehow failed to keep precise records as to exactly where they put them).  To this day there are mines being discovered in occupied sections of the base.  In general though, as long as the mine warning sign you are reading says “mines” you are on the right side of the fence—if it doesn’t, you are probably too late to do anything about it anyway.

Despite all the changes, Bagram still has a great PX, although the Burger King was nowhere to be found (thank you General McChrystal), and several bazaars where Afghani merchants can sell their wares.  It was to these that we were headed.  When last in-country I had become adept at the art of bargaining with the vendors, an old and honored custom here.  The aim is not to get the lowest price but to get one somewhere between yours and theirs in such a manner that leaves both sides pleased.  The art, of course, is to recognize that “sale point”. You know you’ve succeeded if the merchant throws in a little token gift at the end to seal your “friendship” and offers you some chai tea.
The main products found at these bazaars are oriental carpets, native clothing, leather goods and jewelry at prices that are—well let’s just say they start well below wholesale and go down from there.  The jewelry consists of precious and semi-precious stones mined in-country including lapis lazuli a stone almost unique to Afghanistan and apparently much desired—if requests I have received from people back home are any indication. It is a deep blue stone with flecks of gold laced throughout and when polished can be quite beautiful.   It is said that Alexander the Great brought the stone back to Europe when he conquered this part of the world and it is used in jewelry here in much the same way turquoise is used in the American southwest.  The last time I was in Afghanistan I sent home enough oriental rugs to carpet a small palace and silk scarves to clothe a harem so my “mission” on this deployment was to find some of Alexander’s blue stone—because one should never go to war without buying your spouse a nice souvenir while you’re at it!

When last heard from, the Colonel and I were on our way to the main attractions at Bagram, the PX and Bazaar.  I was fully prepared to do battle with the local merchants on my own, but the Colonel, to his everlasting credit, brought along his personal “tajuman” (interpreter) to assist in the effort.  I will call her Razia (not her real name) and her story and background are fascinating, but first, a little about the tajuman in general.
The US forces here make extensive use of the tajuman because, let’s face it, Dari and Pashto, the two main dialects spoken here are on very few high school or college curricula in the States and I have yet to find an American who speaks either fluently.  So, from our earliest involvement here we actively sought out and recruited Afghanis who  spoke English to assist us.  These men and women are among the bravest people I will ever meet.  They go where our troops go, usually unarmed, and run the same dangers from IED’s and small arms fire.  Moreover, they will have to live here long after we return to the safety of the US.
They do this, partly for the money of course, but much more so for their country. This was true of many Afghanis after we helped them throw out the Taliban.  I remember one man, in particular, when I was here in 2004.  His wife and son had been killed by the Taliban.  One day he appeared at the front gate of our base outside of Kabul and took up a post alongside our troops. And there he remained day after day helping the sentries clear local nationals for entry by interpreting for them.  And one of my most vivid memories is the smart salute he would render each time a convoy entered or left the base.  Whenever someone would ask him why he was doing this, he would simply say it was to thank the Americans for freeing his country from the Taliban.
Razia was born in Afghanistan into a relatively a well-to-do family said to be related to the old Royal Family (yes, Afghanistan had a monarchy until 1979 when the King was deposed in a coup sponsored by the Russians).  For Afghanistan, that was the last time of relative peace and prosperity before the onset of almost forty  years of war, and many Afghanis view it with nostalgic longing.  Thus, anyone who can claim a degree royal lineage is accorded great deference.   However, while Afghanis are a fine and noble people they do tend, at times, to slightly exaggerate their accomplishments.  For instance, if every Afghani who claimed to be a doctor (but whose documentation was “lost in the war”) really were so, they would outnumber their patients here by a large margin.  So, I wasn’t sure I was buying all of this royal blood stuff until we went into the first bazaar shop and the merchant practically genuflected in her presence.  I knew then that I had brought a gun to a knife fight and I was going to do very well indeed.
Razia and I even perfected a strategy. She would introduce me to the merchant as a good friend (a very meaningful term in Afghani culture) then walk away and allow me to bargain to a good price.  At that point she would saunter back over, inquire as to the agreed upon price, raise her eyebrow skeptically say a few words in Dari and another 20-30% would instantly come off.  And I still got my “token of friendship” gift, chai tea as well as a plea to return as soon as possible to buy more.  I love this country!!
After completing our business at the bazaar, we repaired to the main PX to stock up on neccesities.  Alas, there is no bargaining here as the price you see is the price you pay. But, these are government run venues so the prices are well subsidized by Uncle Sam.  The PX is also where you will find a veritable United Nations of troops as all Coalition Forces are allowed unlimited access to the PX’s.  Of the approximately forty nations with personnel here, the largest number are from Great Britain, France and Germany with a good amount of Romanians and a smattering of Koreans and Poles among the many others (including Mongolians). The ambience at the PX is internaltional, the mood relaxed and since by definition you are not on duty a holiday spirit prevails on the small plaza out front. An almost Student Union-like atmosphere if you can ignore the fact that  everyone is in uniform and armed to the teeth.  And, while the Burger King no longer exists there is a Starbucks-like coffee shop and a Pizza Hut available.
However, as we had been eating nothing but American-style food in the DFAC, were on a one-day R & R and had the company of an Afghani princess to guide us we decided instead to go “native” and  headed for Aziz’s, the place to go in Bagram for authentic Afghani food.  Now Bismarck once famously stated that the public should never be allowed to see how laws and sausages are made.  If the Iron Chancellor were alive today he might add Afghani food to the list.  I have seen how it is prepared. During my last deployment here we regularly ate at Afghan National Army dining facilities and we were once given a tour of their kitchen.  Once was enough.
However, as I survived that tour of duty, I assumed my stomach was stong enough for this one and I am glad to report it was delicious.  We had lamb in a rice sweetened with raisins and spices as well as flat bread and steak kabobs.  No one left Aziz’s hungry, we all made it back to base that night and back to duty the next day without any untoward reactions at all.

Let me preface what is to follow by stating once again that the detention facility on our base is the anti-Abu Gharib.  Every effort has been made to insure that the rules of the Geneva Convention are followed.  So much so that the International Red Cross is permitted to maintain a permanent presence just outside the front entrance and is pretty much given the run of the place.
Do not misunderstand, the detainees are not being coddled.  They are confined most of the day in either communal cells holding 25-30 men or single cells for those who break the rules.  They are only allowed limited recreation time and almost no contact with the outside world.  But the cells are kept clean, the detainees are given Q’urans and prayer mats and a schedule of prayer times and are free to practice their religion. They get three hot meals a day, excellent medical care and no one is trying to kill them. In addition , there is a review system in place before and after they arrive here to make as certain as possible that the truly innocent are not detained.  Moreover there is a well-financed Vocational Center on-site which seeks to train and rehabilitate the less dangerous detainees in order to reinsert them into Afghan society as productive citizens. Needless to say, all of us here are quite certain that the Taliban would do as well for us were we to become their prisoners.  But that difference is what makes us the good guys.
While interrogations are frequent, often in the middle of the night and sometimes repeatedly so, they do not involve physical methods.  I have observed many such sessions and they are actually deadly dull, at times resembling more a job interview or deposition than what most people probably conjure up. Moreover, every detainee is medically examined  before and after each session and I have yet to see or hear of a single case of abuse.  Indeed, the only people abused at the facility are the young American Guard Force MP’s and medics who are frequently spat upon by the detainees and hit by all manner of their human waste.
The feeling most of us get upon first  encountering the world  “inside” the facility is best described as falling down the rabbit hole and entering bizzaro world.  The ordinary rules of war get turned upside down.  Men who just days before were doing their best to kill and maim us and whom we were trying equally hard to kill, have suddenly become our responsibilty to keep not only alive but in good health.  This can lead to some surreal encounters.  Consider the time a recently captured detainee was complaining bitterly to me about the poor medical care he felt he was getting for the gunshot wound to his leg—a wound sustained, by the way, while he was about to set off an IED against one of our patrols–truly, taking the concept of “chutzpah” to a whole new level. (For the record the care was first rate and he got to keep his leg which is more than can be said for many of our troops hit by those IED’s.)  Or the irony lost on a Taliban proudly boasting to me  about how many American soldiers he had already killed just before asking his very American doctor to treat him for a myriad of bodily ailments that seemed to start the moment he was captured.  (Once in our custody, many Taliban suddenly become as needy, helpless and petulant as children. And the US, in their eyes, instantly morphs from the “Great Satan” into the “United Pharmacy of America”.)
But as bizzare as the detainees can be, the even weirder stuff inside has to do with the Afghan National Army (ANA) MP’s and medics we are training to one day take over this facility.  When I was here in 2004-5 we were also training the ANA.  We would regularly conduct joint missions and patrols and often  there would be an ANA soldier walking behind me with a locked and loaded AK-47.   But never once did  I consider myself at risk or threatened by them.  We also reguarly went to their bases and ate at their facilities also without fear.   Sadly, that has all changed. There have been numerous cases of ANA soldiers and/or ANA infiltrators turning their weapons on their American mentors with fatal results. Although security here is tight, we have been warned to be wary and vigilant at all times–a neat trick when your mission is to work beside and train the very soldiers you fear may be about to turn on you.  Talk about your hostile work environment.  Can it get any stranger than to be more concerned about the people outside the cells than those inside.  Or, to put it another way, what does it say about a place where you are more leery of your allies than your enemy?
But, just when you think the world has finally and irrevocably spun off its axis, something occurs that restores a bit of hope to an otherwise dark place.  Recently we were in-processing a group of detainees that were hard-core Taliban.  One, in particular, could have had his picture in the dictionary under “fierce insurgent”.  He had straggly black hair, a full beard and piercing dark eyes.  Think a combination of Charles Manson and Rasputin. And true to form, when we took a medical history through the tajuman (interpreter) he practically growled his answers.  However, when I started the abdominal exam he began to giggle, yes you read that correctly, giggle. And the more I examined him the more he giggled. Soon, depite the dismal circumstances, we were all smiling and then laughing. I asked the tajuman to tell him that, to paraphrase Tom Hanks, “there is no giggling in war.”  But he just kept on doing it.  I think everyone in that room, at that  moment, understood anew that friend or enemy we are all still part of the same human family.