Civilians is Silly

The other day I got to help my younger brother move furniture. He and his fiancee' are preparing to merge apartments as their wedding approaches, and moving several pickup truck loads of furniture was the next step. It was great to help out with that, because, both of us being busy adults, we had not gotten time to hang out in a few weeks. I was in Georgia, studying for my National Registry Paramedic exam (which I passed, thanks be to God) and he was, is, and still will be for some time, preparing for a wedding.

It is great to have a brother. Friends are great, a wife is awesome, but no one is ever going to understand you like a brother. We can talk about things with that, "You know what I'm saying?" "Yeah, I'm right there with you," "People just don't get it," "No, they don't," kind of agreement. We have different opinions and interests, but we get similar things because we start from the same principles.

Civilians, for instance. Both of us share a similar attitude toward civilians and city folks. We grew up on a farm and were, if not exactly dirt poor, at least soil rich. We liked to build things, break things, learn things, discuss things, argue about things, think about things, and question things. Every thing had a million functions, only a handful of which were included in the instructions. "Ready made" was not in our vocabulary.

Then both of us joined the military and spent years being shuffled like a bad card trick from one side of the globe to the other on various missions. We had no control, we had to be ready to pick up and go at a moments notice and so we learned to discern what was needed and what could be deleted or returned or simply done without. If it doesn't fit in a C-bag or rucksack, it obviously is not required or can be acquired, jury-rigged or hot-wired on-sight, overnight, in flight, on the go.

We have a casual disdain of plans, because they never work. When you make a plan, you have only succeeded in describing one of the million possible ways in which it definitely will not go down. More often than not you have blinded yourself to the one or two ways in which it probably will go down. Best to keep it loose, and just make it up as you go. Screw it, we'll do it live.

One of the biggest discoveries we have both made, which we sometimes commiserate about, is that civilians freak out over the silliest things. Whether it is running late for work, or the color or layout of party decorations, or whether or not they might get a black eye from sparring with friends, or how hard it is to walk up a mountain at 2 mph for a couple of hours, they freak out about it. I once saw a patient in the hospital who was a veteran. He was working in retail as a manager, and when one of his subordinates started freaking out about some boxes that got knocked off the shelf, he told him, "Shut the f--- up and quit crying. No one's got their arms or legs blown off by a suicide bomber have they? No one is dead. No one is getting shot at. So what's the big deal?" This resulted in a complaint, a trip to his superior's office and subsequent trips to a psychiatrist's office. He was unable to wrap his head around the concept that you can't talk to people like that in the civilian work force.

I get where he is coming from. Sometimes I get frustrated and just want to shake people and say, "Wake up! Are you seriously complaining because the server made you wait five minutes before he took your order? Are you starving to death? Are you that important? Do you realize that right now, in a hundred countries around the world (including this one) there are millions of people who are not eating at all? Broaden your horizons and stop being so small and pathetic." People who complain about office politics especially unnerve me, because A: I just want to tell them they haven't gotten shot, lost a patient, or blown themselves up so quit crying; and B: I am going to have to make it in that civilian workplace eventually.

I can talk about this with my brother. He gets it. I can talk about this with my wife. She gets me. Most people start to nod and nervously back away, so I learn to let it go. You see, while our background gives us advantages, it also comes with some drawbacks. Neither of us is good at relaxing. Or rather, what is relaxing to us is incredibly strenuous to others. We want to be engaged, mind, body, heart and soul. The glory of God is man fully alive, and we don't want to be even the least bit dead until we are all the way dead. So a relaxing Sunday afternoon might involve hiking up a mountain, or discussing astrophysics, human genomics, and the moral ramifications of both. As a matter of fact, if we are hiking up a mountain, we are probably discussing some heavy topic at the same time. So we are great at relaxing in our own way, but we have been living at such a high level of intensity for such a long time, that our idea of relaxing is skewed, and neither of us does well with boredom. He goes to school full time and works nights full time. I feel like a day that doesn't start at 4:30 AM and run non-stop until 10:30 PM is wasted. 

We sometimes have a hard time being patient with people who aren't patient with the vicissitudes of life. As my brother says, "We had no control over our lives for so long, we learned to just go with the flow and not stress out about it." (He split that infinitive, not I. I merely left it in, in the interests of historical accuracy.) It isn't life's ups and downs that frustrate us. It is the people who get frustrated at life's ups and downs.

All in all, we are well on our way to being either incredibly active and useful citizens or grumpy old men.

Whichever we end up becoming, we will probably be whole hearted about it. As my brother likes to say, "I never half-ass anything. I always whole-ass it." (Which I believe is a Ron Swanson quote.)

Or, as I would put it, "The generation that carried on the war has been set apart by its experience. Through our great good fortune, in our youth our hearts were touched with fire. It was given to us to learn at the outset that life is a profound and passionate thing. While we are permitted to scorn nothing but indifference, and do not pretend to undervalue the worldly rewards of ambition, we have seen with our own eyes, beyond and above the gold fields, the snowy heights of honor, and it is for us to bear the report to those who come after us. But, above all, we have learned that whether a man accepts from Fortune her spade, and will look downward and dig, or from Aspiration her axe and cord, and will scale the ice, the one and only success which it is his to command is to bring to his work a mighty heart." Oliver Wendel Holmes, 1884 Memorial Day Speech.

Patient Interactions

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My favorite part of medicine is interacting with patients. My second favorite part is fitting the puzzle together, piecing all of the various bits of data from history, exam, labs and the literature to form a coherent image. For some providers, I suppose, that is the most exciting part. Dr. House comes to mind as an example of that disease oriented provider. Others are all about the procedures. They just enjoy getting hands on the patients, physically manipulating the diseased part, and providing healing that way. I suppose that category would include most surgeons. I find, however, that most patient encounters do not require much puzzling. Most are actually quite straightforward. Hardly of my patient encounters require procedures, although they are fun when they happen. However, every patient encounter includes an encounter with another human being. Sometimes these encounters are memorable, sometimes not. Sometimes they are fun, and sometimes they are not. Sometimes there is good rapport, and sometimes it seems that you are speaking totally different languages. Regardless, the encounter is always an encounter with the ineffable other of a human being who is not myself.

Tacoma is known for having a very high percentage of Asian populations. In fact, South Tacoma Way, one of my favorite strips for Asian cuisine, is informally called “South Korea Way.” Street signs are even labeled in Korean. Being a Special Forces soldier, my training includes a foreign language, which, in my case, is Korean. I would not say that I am fluent. I can order food, exchange pleasantries, and maybe chat a little bit about C. S. Lewis’ book “The Four Loves,” (I memorized a good deal of vocabulary for that book when I was preparing for my Korean speaking and listening test). It is not, however, to allow me to hold a conversation with ease with a native Korean speaker.

Several of my patients over the last two weeks were older Korean ladies, wives of Korean war veterans. I usually enjoy chatting with them a little, enough to say “Hello, how are you doing, where does it hurt?” One patient, in particular, was a very sad looking Korean lady who complained of fatigue, tiredness, pain, and heartburn. We talked with her for quite some time trying to come up with a list of her complaints and prioritize them, but she was a very listless and haphazard historian and she complained of confusion. Finally I asked, in Korean, “Sunsengnim (term of respect), do you get confused talking in Korean?” Her eyes widened and she repeated my question back to me in more correct vocabulary. I asked about her Korean friends, and she shook her head sadly.

“I not trusting Hanguk (Korean) peoples, they not sharing feeling. They nod yes, yes, when talk but later they like this behind you back,” she made a blabbing gesture with her hand. I asked if she had any American friends and she said, “I no likey Miguk (Americans) either. They just talking talking saying whatever come in they head. I not like that.”

While the doctor typed his note we chatted about this and that, and she slowly became more and more at ease. It was more “konglish” than either Korean or English. I learned that she was very lonely, and almost always sad. Her house had been broken into (she lived alone) and she just felt nervous and unsafe. She gave me an impromptu lesson in Korean language, history and folklore, and explained why the Korean number 4 “sa” is considered unlucky. I very much doubt we were able to provide any lasting relief for her symptoms, as I strongly suspect most of them had a behavioral or social health basis. She was a sad, lonely old lady, and she needed a friend and a hug more than she needed pain medications, but her fears and isolation kept her from those, so pain medication was all she could understand. However, she seemed to be put at ease by my broken attempts to speak and listen to her in her own language, and there was even something like a half ghost of a smile on her face when we shook hands goodbye.

Was that a good interaction? A positive one? I would not classify it as such, objectively. We learned very little to point our way to a treatment plan, and I do not have much hope that her symptoms will ever be resolved strictly by medicine. However, the attempt to reach out to her was just a little less negative than it otherwise would have been, and I think therefore it was more than worth it.

Another Korean lady the same day came in for coughing and post nasal drip, but she refused to believe that she had allergies. She was very upset at not being able to see her regular doctor (who was on maternity leave) and she denied ever having taken allergy medicine that her doctor had prescribed her. “I throw that medicine away, because I not like takey the pills!” It was hard not to laugh. She was about four feet tall and about two inches in diameter and bound and determined that something was wrong with her, because she could not stop coughing or sneezing, but it was NOT allergies! Bless her heart!

No amount of cajoling in English or Korean could convince her that, yes, in fact she very likely did have allergies, and it was perfectly normal and treatable. We tried to get her to promise at least to try the allergy medicine. When she would not we tried to sneak it into her medicine list without telling her what it was for! We said, “Oh, that’s to make you sniffles stop,” which was true, but she would have none of it. “I not takey the pills.”

Finally when the visit was over she stood up and said, “Thisa better working. You not makey me better I go to Korean doctor!” I felt like saying, “Fine! Go to a Korean doctor! What sense does it make to come to a western doctor and then refuse to take western medicines?” She never got angry, she just laughed at us like we were too ridiculous for believing that she was so weak that things like allergies and pills could apply to her. She did, however, tell us most emphatically that kimchi was going to keep us young and healthy and that I was going to live longer than the doctor because I loved kimchi and he “only likey the pizza!” He had never said that he didn’t like kimchi, he simply had never tried it, but in her mind that lumped him in with all the other pizza eating Miguks!

I cannot get angry at patients like that. I love their eccentricity, and I respect their autonomy. God bless them, if they want to grow old and cantankerous and get their kicks out of making fun of western medicine, more power to them. I hope I have enough spark left in me when I am old to be grumpy and funny like that.

The patients I feel sorry for are like the 60 year old man who came in for a regular checkup. In the course of the interview he mentioned having a new feeling of shortness of breath whenever he walked up hill. This prompted a deeper interview, a physical exam, an EKG, and the end result was that he was going home with a bottle of nitro, a bottle of baby aspirin, and a follow up appointment for an exercise stress test. As the appointment progressed and the diagnosis took shape, I could see the growing possibility reflected in his face and posture. His shoulders sank, more and more, his face became more and more bewildered, distant, afraid. It was a relief when the doctor finally said the word: “Heart disease.”

“We need to make sure you don’t have heart disease.” Amazing how we all knew that was what we were talking about, but we were reluctant to say it.

“Are you doing okay?” I asked.

He looked up at me. “I guess. It’s just I have a lot going on at home. I have family troubles, and my dad is not doing too well, and now this.”

“A hell of a thing,” I said.

“A hell of a thing” He agreed. His dad’s brothers had died in their early sixties of heart attacks. His face fell even further when he found that he could not work out until after the stress test, because of the risk of having another incident. “I can’t go to the gym?” His build spoke for itself. Despite his slight beer gut, his shoulders and arms were thick and powerful. He had been lifting his entire life. Now he would have to give it up, perhaps for a very long time, perhaps forever. Not only that, but because Viagra reacts synergistically with nitroglycerin, and can cause a catastrophic drop in blood pressure, he could not take Viagra until after the stress test, when we would have a better plan.

He looked at the doctor. He looked at me. “No weight lifting? And now you tell me no sex? Doc, what’s the point?”

At times like this you feel guilty about the clock, ticking away, reminding us that his appointment was only supposed to last twenty minutes, and that is long since up. How do you kick him out the door so the next patient can come in and tell us all about his acne and how it is affecting his social life?

I might be getting old, or maybe my parents were just poor and backwards (poor they certainly were) but it never would have occurred to them to take us to the doctor for acne, especially not acne so mild as to be invisible under long, thick black hair. There were a dozen or so cystic comadones around the hairline on his forehead, and another dozen along his hairline in the back. This rates a trip to the doctor?

And yet, it is a big deal to him. It never was to me, (I could have cared less for popularity at that age) and that may make it difficult to relate. One hopes that he grows to be a little less concerned about such things as he gets older and gains perspective, but he is not older. He is a teenager. This is where he is, this is important, and in its own way it is as devastating to him as a tumor would be to me. Why should I allow my age and experience to deprive me of empathy for his lack of age and experience? Would not that be shallow mindedness without even the excuse of youth and ignorance? And how difficult is it to prescribe some erythromycin face wash and an exfoliant? We sympathize with many, many older patients who are just as silly, and with less excuse. Certainly in my life many, many older and wiser people have put up with my ignorance and silliness. Shall I refuse to do the same for him?

So I resisted the urge to write him a script for “soap and water” or “a nice cup of man the heck up!” and provided one for face wash instead. I wish him well at his next high school social function. He was a nice kid, after all.

In reviewing these patient encounters I find it very difficult to classify them as “positive” or “negative.” That is more or less to be expected. Any encounter with another human being is essentially an encounter with the unknown. We do not hear the other perfectly, we do not communicate perfectly. The best I think we may expect of ourselves is the continual effort to be present; beyond all filters, preconceptions, contexts and languages, present for the other to be the other. Is it possible? Probably not. It is a worthy effort, I think, for only thus is any real meeting possible between humans. So, in any encounter, there is always more that could have been achieved, or less that could have been said badly, or some aspect that could have been improved. It is never perfect. The mistake, I think, is to try to reduce it to a technique. Technique is a tool, body language, active listening, participatory conversation techniques, or what have you. The essence, however, is goodwill towards the other. It is goodwill that will overcome all barriers, and hopefully shine through our clumsy, inept attempts at using our various languages, to communicate with something essential in the other person. On that level, perhaps we may even hope that some kind of real healing might occur.

Real Men!!! Rawr!!!

The fact that you can pose with a chainsaw does not mitigate the fact that you are shaving.

 Yesterday my wife and I were video chatting with my parents to congratulate them on their 31st wedding anniversary. The conversation wandered, as conversations will, to gluten, autism spectrum disorders, the emerging links between ASD and autoimmune disorders, and the prevalence of hand sanitizer parents. We agreed that children probably need more dirt and less hand sanitizer in their lives to give their little immune systems more practice. Big, strong, barrel chested immune systems, that's what we need. This led my wife to tell a true story about her great-grandpa. 

One day, while he was working at the saw mill, a fan blade fell off of a scaffold and hit him in the head. It knocked him over and cut his scalp open. So he climbed down to the ground, picked up some dirt and stuck it in the wound to stop the bleeding, and then climbed back up to finish work. After the job was done they drove him four hours to Seattle, where the doctors opened and cleaned the wound and put in a steel plate to replace the missing piece of skull.

Of course both my wife told the story with gusto, pride and appreciation, and my Mom listened to it with the same feelings. How could you not? That is a Real Man! 

I looked at my Dad and said, "You see how they are both in awe of that? Just watch! What would happen if either you or I ever did anything like that?" 

My Dad laughed at the memories (he actually has things like that a time or two and so speaks from experience). "Oh, we would be dead! The fan wouldn't kill you. The wife would when you got home!"

As a case in point, when my dad got his leg caught in a grain auger, which miraculously broke and did not drag him in and chew him into sausage, he did not bother telling Mom because it was just a scratch. He only lost a few square inches of skin and muscle, and a pint or so of blood. Nothing to worry her about. He let my brother and sister know when he got home, expecting them to let Mom know when she got home. It wasn't his fault that they did not pass on the message, and her first clue was the blood soaked socks on the bathroom floor. Oddly enough, that did not go over so well.

It is part of the paradox of manhood, I suppose. I have written about it before, how women always want a "real man." They are attracted to men with strength, courage, determination, and a certain hardiness or indifference to physical hardship and danger. These virtues can take a lot of different forms, from soldiers, firefighters and rescue workers, to youth ministers, farmers, fishermen, mechanics, outdoorsmen, what have you. These virtues can also be found in men who work white collar jobs, although they may not be quite so obvious.
The point is that while these virtues may be attractive, they can also be inconvenient. Nearly every virtue is at some point. My wife doesn't like me to tell her about my Afghanistan days when I was digging up IED's with my field knife. She is all for having fewer IEDs in the world, but she doesn't want me to be the one doing it (I don't either. It was a pointless mission). A firefighter's wife might agree that someone should be putting out fires and rescuing the people trapped in them. She just doesn't want it to be her husband who has to do it.
That's why I love this picture. That is strength. The strength to be crucified. I have to remember that, but not only when endurance of pain, hardship or risk is required. I also have to remember it when the desire for these things comes. You see, if we are honest, I think we men admire stories like that, and sometimes we take the tough guy thing to an extreme because we want to be tough guys, and we want to be known as tough guys. I am not suggesting that Great Grandpa or my Dad was doing that, but I know that a lot of my crazier adventures, if I am honest about them, have not really been strictly speaking necessary. I did them to prove to myself that I could. A more enlightened manhood, I think, simply does what is necessary. If it is easy, he can live with that. If it is hard he can handle that too.

Occasionally he wrestles bears too. Just because it is fun.

A Face That People Can Trust

Once, back in the Q course, I was standing in line at the drop zone. I had harnessed into my chute and was waiting for a jumpmaster to perform his prejump inspection. This is basically a head-to-toe examination of the harness and chute prior to getting on the aircraft, to ensure there are no deficiencies and everything is attached and kosher looking. When the jumpmaster noticed I was ready he came over and began his inspection.

If you take out the middle letters it doesn't count as a bad word.

Now, the JMPI (Jumpmaster Prejump Inspection) is a very quick and fluid process. The Jumpmaster's hands fly swiftly by rote over the same path every single time, and the only time they seem to be paying attention is when they find a deficiency. Especially on this particular jump, the jumpmaster was so unconcerned he was holding a conversation with me.

"Are you jumpmaster qualified?"

"No, Sergeant."

"Well you should be. You have one of those faces, you know? You just look like you know what you're doing. Turn around. That's the important thing. Bend, squat and hold. You don't actually have to know what you're doing, you just have to look like it. Have a good jump."

And he wandered off to the next jumper.

It is true though. By some trick of bone structure and muscle tension, my face when relaxed has always looked like I know what I am doing, which is totally ironic since in reality, at any given moment I am probably winging it. The odds of my actually knowing what I am doing are quite small.

Ryan Kraeger pre-mission photo, circa 2007

A case in point of that occurred in Afghanistan, toward the end of my rotation. I had been working at route clearance for the last six months of a fifteen month trip. (Route Clearance means we went searching for IED's and disarmed them when we found them. I was the guy with the mine detector.)

After six months I had found every one and not been blown up once, which is a good record to have, but I was getting burnt out. I was losing confidence in myself. You know the way you feel when you win five poker hands in a row, and you just don't want to bet anymore because you know the next one is going to be a flop? That's how I felt. Only by "poker hand" I meant "IED" and by "flop" I meant "red mist on the breeze."

I was also developing a deeper, stronger confidence in God. I was coming face to face with my own mortality and fallibility, and yet was still required to do my job, and so I was left with no recourse but to trust God. I did not particularly trust Him not to get me killed. His people have a way of meeting singularly inconvenient ends which sometimes involve explosions, and sometimes do not. How many practicing Catholics have been shot, bayoneted, burned, nuked or gassed in the last hundred years or so? Do you think their mothers weren't praying for them? Seriously, the founder of our Church was nailed to a stake and left to die. How should I expect special favors?

So I had no illusions that trusting God was some magic, IED-proof force field. Which didn't matter to me, because I was not afraid of dying. I knew that if I died, it would be because God thought I was done with whatever it was I was sent to do, and who am I to argue?

God must feel like this psychologist sometimes.

No, I did not fear death, I feared failure. I was afraid of making a bad call and letting the vehicles roll over a bomb and killing someone else. It was a call I made every day, and I was well aware how fallible I was. You never really know. It is one thing to trust God with your own life. It is another thing to trust him with someone else' life. It is another thing to trust Him with the things that really matter to us personally: projects we have invested in, plans we have made for the people we love, surefire ideas to save the world, etc. In a word, control.

It was this that I was called to surrender, the reputation for being right, the illusion of authority. I was learning to give up the illusion of control. There was a measure of irony in the fact that, while I barely trusted myself at all, but trusted God with everything, the other guys in the platoon barely trusted God at all, but trusted me with everything. I am sure God thought that was quite funny.

But in reality, isn't that part of the call of being Christian, to trust God on behalf of other people? It has become an increasingly important component of my prayer at any rate. I know that God is to be trusted. Other people do not, but for whatever reason they trust me. As long as there is a me in the equation this is an alarming concept, but if I can let go of the me and let God take over, then they are really trusting God. Praying for people has become something like an exercise in letting go of them. Simply trusting that God knows best, that He is in control, that even if He lets them die (which He certainly will eventually) He will not let them out of His sight. This is also how I pray for my atheist and agnostic friends. Even if they do not know or trust Him, I feel like it is helpful, perhaps even critical, for me to trust Him with them. Somehow I feel like it does them some good.

I don't know how, but if I am right thus far I don't really need to know how. It is enough to be going on with.

Tacloban, Part VIII

Sometimes, even in the midst of a disaster area you have to stop and notice the beauty. 

Some people might think it a mockery. How could there be beauty in the midst of so much suffering? How dare we enjoy beauty, how dare we rest? Why are we not working still, pushing ourselves, doing something to relieve the suffering? There is no time for anything as frivolous as beauty. It merely mocks the loss of the people who have lost everything.

But then I have to ask, is it really a mockery after all? 

Or is it perhaps a sort of message? Perhaps even an answer?

For behold, all will be well, and All will be well, and all manner of things will be most well. 

Tacloban, Part VII

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A concrete and rebar ammo bunker that got ripped apart by the storm surge. Really.

We landed at Tacloban Airport with not a clue what we were supposed to be doing. There were six of us and only two of us had an explicit job. The Air Force CCT guys were suppose to assess the airfield and get it up and running. The rest of us were supposed to support them.

We had food and water to get us until the next day’s resupply, but the weight restrictions had been so tight and the Air Force CCT kit was so heavy, we had not been able to pack much of anything else. No tent.

We did have six mattresses, little foam pads, twin sized, wrapped in plastic. One of the guys had a hammock, which he strung up in a baggage trolley, so I took his mattress and mine. I laid mine out on the ground and set a heavy tuffbox on each end. Given that I am 5’9” tall and the mattress was barely 6’ long, this shortened my bed considerably, but the rain was coming on and I needed an overhead shelter. I laid the second mattress across the top of the two boxes and weighted down the ends with another box and some large rocks. As homeless shelters go, I’ve seen worse.

The rain started around 10:30 PM. At first it was no more than a steady, cheerful shower, not too cold, just exceedingly wet. I was stripped down to a pair of shorts and my Merrel Trail Glove running shoes, which can get as wet as you like without being ruined, or even especially uncomfortable, so I didn’t mind a little damp. That is fortunate, since I was destined to be quite damp indeed before morning.

At first all I had to worry about was the splashing of gargantuan raindrops in the puddles that rapidly formed around my cozy little dwelling place. Then water puddled on the top mattress and it sagged and when I moved it poured its burden off one edge, onto the bottom mattress. In no time at all I was lying on my side in a puddle. My shelter lasted about an hour before so much water soaked through the holes in the plastic that the mattress was completely sodden, and began to drip continuously. Then, just to put the cherry on top, it began to downpour torrentially. Yes. That is a word.

Home Sweet Home!! (There used to be another tuffbox holding up the left side.)

I have spent more comfortable nights, but all in all, it could have been worse. At least it was a warm rain, and I had some overhead cover. You might not think that makes much of a difference, but the truth is that it does. It is one thing to sleep in a puddle, but when you are wearing next to nothing and it is warm enough, it actually is not that bad. However, continually having torrential tropical depression type rain pounding into you, splashing on your face, chest, back, legs, etc. that is something else entirely. Each rain drop, in hitting you, emphasizes the overall discomfort, wakes you up again, and generally just brings your focus back to the here and now. I assure you it is hardly conducive to a restful night’s sleep.

The worst thing was actually my right hip. It turned into a pressure point because I was sleeping on my side and didn’t have room to stretch out, and the mattress was only an inch and a half of foam on cement. Apparently foam loses its cushioning ability when it is saturated. Who knew? 

At any rate, there I was, and there I stayed until morning. It took the whole rest of the day for the shriveled, macerated look to go out of my hands, probably because it continued to rain more or less constantly until about lunch, and the last rainstorm wasn’t until after 5:00. By then, however, we had received a tent and were figuring out how to set it up. Better late than never, right?

Was it worth it? 
Totally.

Tacloban, Part VI

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You know, people are beautiful, crazy things. When I went back to camp to catch some sleep the night that we finally got the airfield moving at night, a Filipino man called out to me as I walked by. “Hey, Sir!”

He was squatting on the concrete, with his wife and their littlest baby squatting next to him, and six or eight little dark eyed chitlins squatting all in a row behind him, along with some aunties or big sisters or some such relative.

“Hey Sir,” he said again and gestured to the line behind him. He was hopelessly at the back of the crowd, and there was no way he was getting on an airplane tonight. But he had seen lines of people being moved to the airplanes, and he had figured out what we were doing and had separated his family and lined them all up in a row, ready to go.

“Wow,” I said, “All lined up?”

He nodded and smiled hopefully and his wife and babies all looked up at me with big, dark, hopeful eyes that just made me feel like the biggest ogre on the planet for not getting them out right away. (Okay, so I am a sucker for little brown babies with big brown eyes. So sue me.)

What a leader! What a man! I could see that he truly cared about his family, and keeping them together and making sure they were safe was the most important thing to him. They trusted him. They squatted in line behind him, one behind the other, keeping quiet and still and cheerful among the chaos all around them.

What I would not have given to move them right to the front of the line, right then! But I could not. That would have caused a riot, in all likelihood, and that would have shut down loading operations. I had to smile and say, “Good for you. Hang in there,” and walk away.

When I went back again the next day, they were still squatting there, all lined up, and he smiled at me hopefully again. He was still cheerful, but he looked worn out. Other people were still in line ahead of him. I had to get Marilee’s people out, because I had promised, and I owed her. He watched that plane leave sadly, and moved his family into the next spot.

After that I was no longer running the airfield. The Marines had taken over now and I had to go do other things. As I left for the last time, he smiled at me, still hopefully, but with a bit more fear in his eyes. All I could do was point to the only seven rows of people still in front of him, count them out and smile encouragingly, and then walk away.

He was able to get his family out later that afternoon, I think, because there were several planes in later that day, and I didn’t see him again.

Blessings upon him and his family.

Tacloban, Part V

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I walked through the yard where they were collecting the bodies of those killed by the typhoon. They bring them in on trucks, collecting them from out of treetops along the beach, rubble piles in the city, drowned vehicles along the street. A body bag hides a lot about the person it contains, but it cannot hide the size. One old lady was swelled up so huge they couldn’t zip the bag, so they left her with the bag closed to her waist, one arm stiffened over her face, like she was trying to block out the sun.

One body bag had a pair of business shoes sticking out of a rip in the corner.

One body bag had only a single lump in it. A two foot lump in a six foot bag.

The juices oozed out of them and ran across the cobblestones. You cannot get sick from the smell. Death is not contagious.

Only two feet long.

They only had a few trucks left running. They needed them to haul bodies. They needed them to deliver food. So they used the same trucks to do both. Fortunately a weird, twitchy, ex-Pat guy who owns a pest control business donated his time, equipment and 300 gallons of boric acid to spraying out the trucks between uses.

They wanted him to spray down the cadavers at first. He told them it was a waste of time. Save the chemicals to protect the living.

Another lump was just about four feet long.

They do not have time to identify them. At first a few were found and identified by relatives, but by now the decomposition is too advanced. The National Bureau of Investigation is burying them deep in a mass grave, in single file lines, with layers of lime and dirt between each layer of bodies. Later, if they get the orders they may exhume them and forensically identify them.

I think the mother of that tiny lump would want to know.

Do you know how hard it is to get cadaver smell out of your clothes?

I asked God, why?

I think He means us to ask. I think He wants us to challenge Him for an answer. If we do not seek to know His mind can we really have any part in Him.

His answer came back like a fragment of a line of verse: “They died as they had lived, in the palm of my hand. Their mass grave was dug with the point of a nail.”

Tacloban, Part IV

I got an incredible opportunity recently to go to the typhoon disaster zone in the Philippines to help with relief efforts. The next few posts are going to be a series, things I wrote to kind of decompress after returning to my regular mission.

When we finally did manage to load people at night it was almost accidental. We still had several hundred people on the tarmac. Marilee’s group had long since been overrun and surrounded and even though they had originally been first in line they were now completely enveloped by this new crowd, and this new crowd was big, and not willing to go back to their old places by the main gate. Airplanes were going to land all night starting at 10:00 PM so I rushed down to the airfield after supper and started trying to organize a night rescue. First I pleaded with the crowd through the police guards, telling them that airplanes were going to be coming and going all night, but that we were being told we could not load them if people were going to be bum rushing them. I explained that if they could all be patient and wait their turn, then we would be able to load many airplanes and get hundreds of them out. If any of them pushed or tried to run around the line, we would have to cut it off and then no one would get out until the next day.

The crazy thing is that it worked. They were still panicky, and they still begged and pleaded to be put on the airplane first, but there was very little pushing and shoving, very little trying to sneak around the group to get in. Most of those who snuck around the group to cut in line were officers and their families, who seemed to think that the rules did not apply to them.

I had a Philippines Air Force lieutenant who spoke excellent English and got the problem. He understood. There was also an Air Force corporal, a lowly corporal with crazy poofy hair, who likewise got the concept. Between them they were worth more than all the senior officers on the scene put together. They were the ones doing the actual work of setting up the police cordon around the crowd, directing police to the areas they needed to be, deciding who was going to be pulled out of the crowd first, setting them in lines of ten and keeping order among the lines. They did the work of making sure the lines were single-file, and no one cut from one line to the next. They were not afraid physically to grab people and set them down where they needed them to be.

It is remarkable how little actual work I did. A lot of running back and forth, seeing potential problems and yelling them over the engine noise, directly into the ear of the lieutenant, but they did all the actual work. Why did I get so tired then? Possibly because, once again, I had been going for about 20 hours by the time I turned in. It was worth it though. I had finally gotten a system built that allowed us to load at night. It wasn’t really me building it, I just happened to be around when a whole bunch of factors over which I had no control all came together, and I saw that the time was right and we got to it and it worked. I was able to teach it to two US Marine E-5’s (Sergeants) who took it and ran with it. I sometimes make fun of jarheads, but these two were good dudes, smart, compassionate, and squared the heck away. One of them looked like the Terminator. Even I felt small next to him.

Between them and the Filipino Air Force folks, they loaded 250 more people between the time I went to bed at about 12:30 AM and 4 AM. When I checked back in with them the following midnight, they were still going. 

That was a good night’s work.

Tacloban, Part III

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I got an incredible opportunity recently to go to the typhoon disaster zone in the Philippines to help with relief efforts. The next few posts are going to be a series, things I wrote to kind of decompress after returning to my regular mission.  This is a long post, but I felt it was worthwhile to tell the whole story.

It is rare to meet someone who is truly unselfish. It is the most humbling thing in the world, and, hopefully, once you have seen it you will never be the same.

At the end of our second day on the airfield, as we were trying to load up one of the last C-130’s that would be landing during daylight hours, we almost lost control of the crowd. In fact, we did lose control. 500 people pushed through the main gate, onto the tarmac and began moving in a vast, desperate wave, straight for the front of the airplane. The police managed to run and form a cordon around them and box them in before they came anywhere near the running engines, but it was clearly too dangerous to continue loading planes, especially once night fell and we could no longer see the people. No pilot would even land with that many people on the tarmac.

We had to do something. The police tried to push the people back, outside the main gate, but they wouldn’t go. They had been standing in line all day, most of them, with no food or water, and now, having finally reached the front, the tarmac, with freedom and safety in sight, they could not bear the thought of spending the night there. Even worse, they refused to be pushed back outside the main gate where they would lose their places in line.

A Filipino lady named Gigi stepped out of the crowd at this point, and said to me in excellent English, “Sir, I know I am just a passenger, but these people do not want to go back out into line because they are afraid of losing their places. Can you at least tell us when the next plane is going to be here? We need to manage their expectations.”

“I do not know when the next plane is going to arrive, and I do not know if we are going to be allowed to load people. It will be too dangerous in the dark.” It was not a very convincing answer, but she passed it back, and began working to try to convince the people to cooperate. Another woman, named Didit, came out of the crowd to help, along with a man whose name I did not get. Between the three of them, they did more than the police to get everyone backed up. I found a room that used to be part of the terminal complex, perhaps 40’ by 40’ and we convinced the crowd to back into it. They didn’t all fit, and it must have been stiflingly hot and claustrophobic inside, but at least they were off the tarmac.

I went to take care of a bunch of other things, and when I came back, Gigi and Didit were busy organizing the people, trying to get them to collect together by family and sit quietly. They updated me on how the people were doing, (“Hungry, tired and thirsty,”) and then introduced me to another civilian who had volunteered to help. They yelled her name over the engine noise, so I didn’t quite catch it, but it had an “M” and an “R” in it so I thought it was “Marina.”

She was a tiny Filipino lady in a red cross shirt. She had been working her way through the crowd, organizing the crowd into families and getting feedback from them on what they needed, who had family or other contacts in Manila, and so forth. She was short. When I say short, I mean she was short even for a Filipino lady. The top of her head was about on a level with my chest, and she was completely invisible until she stepped out of the crowd. She came right over to me, grabbed my sleeve and pulled me down to her level so she could yell in my ear, “Sir! These people need water right away. They are very thirsty.”

I had to laugh. I am not used to being bossed around by people half my size, but she was taking their cause so completely to heart she did not hesitate. I thought to myself, “Good Lord, Woman, you are awesome.” Little did I know just how awesome she was, but I was going to find out.

I promised to get them water, and then had to break off to help unload the Malaysian planes that had just arrived. I talked to the Malaysians about getting the people some water, and they agreed to help, but they were taking their own sweet time about it. They came up with a plan to provide biscuits for the people, but it took them fully an hour to figure out that they had not brought any water in any of the pallets they had brought. At that point I decided to take matters into my own hands. I talked to the young US Marine Sergeant who was in charge of the forklift operators, since he knew where all the supply pallets that came through the camp went and had a solid idea what was on each one. I tell you what, that was a good kid. He knew right where to find a mostly used pallet of water, and he sent his forklift operator to go get it.

I talked to Gigi and explained that water was coming, but that we could not have people charging out onto the tarmac when it arrived. I needed her to come up with a system for distributing it in an organized manner, so that everyone can get some water, all the way to the back of the room. She said she would handle it, and she did. It was a thing of beauty. After standing in the sun all day, most with no water of their own, they passed the jugs all the way to the back first, disbursing them through the crowd before anyone took any water. Then each person took one of the gallon jugs, took what he needed for himself or his family, and passed it to his neighbors.

The Malaysian planes did not take anyone. When the two American planes arrived we tried to get permission to try to load some people, but it was denied. The camp commander still felt it was too dangerous. I passed the word to the civilian volunteers and they passed it to their people, that everyone should just get some sleep. I cut a deal with the Malaysians to get them some food, and they assured me they would get it very soon. I went to sleep.

When I got back at about 6:00 in the morning, Gigi and the other volunteers were gone. I don’t know where they went, and I never saw them again, but I am grateful for their help. We could not have gotten that crowd under control without them. Only one remained. The first person to greet me was the tiny volunteer in the red cross shirt, with the words, “Sir, these people still have not gotten any food.” I told her that the planes were going to start coming in a few hours and then I bullied, coaxed and coerced the Malaysians until they got food.

All the rest of the day I was running back and forth, back and forth across the flight line, trying to find Americans and other ex-pats, triaging the sick, wounded and elderly who wanted to get priority on flights, arranging people in order to get on airplanes. Every time I ran past her and her group I just saw more and more evidence of her awesomeness. She pulled some of the older people and some ladies with breastfeeding infants out of the crowd and constructed a little awning for them to sit under. She asked me to take her family out on the next plane because her sister’s baby was vomiting, but she assured me that she would stay behind to help organize people. Sure enough, that is exactly what she did. I put her family in the priority lane, and they were on the first plane out. She put together the groups who would board the plane and sent them up by line of ten when I asked her to.

The craziest rain I have ever seen hit without warning, sometime around mid-morning. It was so thick you could not see the planes on the tarmac. She simply stuck her purse (which was her only luggage) under her shirt and kept working.

After the rain she made a deal with the parents in the crowd. If they agreed to stay behind the gate and wait patiently she would let the kids get out on the open cement where they could have some fresh air and room to stretch their legs. Have you ever seen a group of forty or fifty children sitting cross-legged in rows of ten, smiling and happy, just because they can breathe freely? Sitting in one spot and not moving, kept in check by just one tiny woman they have never met before in their lives?

As the day wore on it became obvious that she had taken those people to heart, literally. They were her family and she took responsibility for them with all her might. Every group she sent out to get on the airplane was a victory for her and somehow she made it a victory for all of them. They were no longer fighting for their own survival. They had become a family. I don’t know how she did it. She just did.

About 5:30 PM, just as the sun was going down, she had another group of 40 people all set out in front of her gates, squatting in rows of ten, waiting for their turn to board the C-130 that was idling on the tarmac. Suddenly it happened again. The people at the main gate panicked, broke through, pushed past the police and flooded the tarmac. They completely swept past her and her group, blocking them off from the airplane. I was moving in trying to find some police to help me restore order, and she came rushing out to me with tears in her eyes. “Sir!” she cried. “Sir! These people!”

It was as if that was all she could say. She eyed the huge crowd spread out between her people and the airplane they had been waiting for for days and she looked on the verge of breaking down. Looking behind her I could see her people still waiting, squatting in rows of ten, frightened looks on their faces, but still waiting patiently, trusting her to get them out.

I yelled in her ear. “I know. I am sorry but there is nothing I can do about that. There are too many of them now.”

She shook her head in desperation. “Sir, my families?”

“Marina, there is nothing more you can do tonight. I need you to find a safe place to rest for the night. We probably won’t be loading any more planes, but you have been going all day and you need some rest. I will try to find you later, and make sure these people get food and water.”

She looked at me with a wry, half amused look on her face. “My name is Marilee,” she informed me.

Well don’t I feel like a doofus!

She fell back to her people and the crowd surged around her, and I lost track of her. For the next four hours we were all busy trying to regain control and impose some sort of order on the loading process. By the time I was able to look for her and her people again the whole area was hopelessly crowded and finding one short lady in that whole crowd was impossible. I simply had to pray that she was all right and leave her to her own devices.

That was the night we finally cracked the code and figured out how to load people at night without losing control of them. There were some scary moments, but it went really well. It was almost 1:00 AM before I got to bed, and then I was up again by 5:00. I had some food and did some work around our camp, cleaning up trash, reorganizing the makeshift latrine (Oh, the glamorous life of an SF Medic!). About 6:00 AM someone came to get me to tell me there was a local woman looking for me.

Sure enough it was Marilee. She was wearing a different outfit because she had gotten the police to give her a place to stay for the night and they had lent her some sweats to replace her old clothes. She thanked me for getting so many people out last night, and asked if more planes were coming in today. I said there were and told her that she was going to be on the first one. “Go back to the flight line, and walk about a hundred yards past where you were yesterday and you will see a gate marked arrivals. That is the American passport line. You are going to be in that line.”

“What if they don’t let me?” she asked.

“Tell them Sergeant Kraeger sent you,” I told her. “I will be along in an hour or so to make sure you get in that line.”

She thanked me and headed back to the airfield.

I headed back there about an hour later, but to my surprise, before I got to the American line I saw her standing at the same spot she had been standing yesterday, with a familiar looking group of 40 people seated in rows of ten around her.

“Marilee,” I said, “I told you I could get you out in the American line? What are you doing here?”

“Sir,” she said, “I found these families.” She gestured to the people waiting expectantly behind her. “They are the ones from yesterday. Can I stay and make sure they get out?”

I tell you, my jaw nearly hit the concrete. I don’t know if I have ever felt more humbled in my entire life. Here she was after a full day and a half of taking responsibility for the well-being of strangers she had never met before, coaxing them, encouraging them, bossing them, caring about them. Now she had an opportunity to get out, free and clear. She had earned it, as far as I was concerned, but she was willing to give it up, just to stay with the people that she had adopted.

There and then I vowed to myself that she and her whole group would be on the next flight if there was anything I could do about it. I grabbed up the Marine Sergeant who was now running the operation and introduced him to her and told him, “I don’t care what it takes, this woman and this whole group with her get on the next flight. I don’t care who is in the American line. She takes priority.”

That’s what happened. I was transitioning to other missions, but I took a break to come back to the flight line when the next American C-130 landed, to make sure she got on. That was the only time she almost broke. When we loaded the first group of twenty, she was left behind with the second group and a look of panic crossed her face. She started to argue with the police, telling him that she had been promised, she was with that group. When I came over to reassure her she was staring desperately at the plane and she said, “Sir, I cannot do this another day.”

“You won’t have to,” I promised. “You will be on that plane.”

The crew chief signaled, they sent the next group, and she boarded with the last of her people.

It was strange. At one point the day prior she had said to me in bewilderment, “I am not this kind of person. I don’t like to speak up to people. I do not know how I have the nerve to do this. I don’t know why they do what I tell them to. I am a nobody.”

I wish I had had time to explain that I feel the same way. Most effective leaders do. Deep down inside we are all faking it, pretending we know what we are doing, bewildered and intimidated by the weight of expectation and trust placed on us, wondering how the hell we ended up here. Why me? Why here? Why this job? Why not someone more dynamic, someone better trained, someone more confident?

I did not have time for that. All I had time to say was, “You care about them. People follow people who care.”

Tacloban Part II

I got an incredible opportunity recently to go to the typhoon disaster zone in the Philippines to help with relief efforts. The next few posts are going to be a series, things I wrote to kind of decompress after returning to my regular mission.

For much of the time I spent there we were working to get the airfield organized, and to get people loaded onto military airplanes for evacuation.

At one point we had a crowd of 500 people attempt to rush the airplane. They had been standing in line all day without food or water, some for two days, and night was falling. The prospect of staying there through the night was just too much and they pushed through the gates, pushed past the policemen and surged forward in a human wave across the tarmac, straight towards the front of a C-130 with engines running. We stopped them, and managed to convince them all to move back and crowd into a little room that had once been a hangar (we could not have done that without volunteers from the crowd helping us, lead by a short bossy Filipina banker named Gigi, but that is a different story) and we closed a gate in front of them.

The next two planes to land were Malaysian. One landed right in front of this crowd of desperate people, the other in the second parking spot, about two hundred meters to the right. The officers and crew got out, not even bothering to unload their relief supplies, or even open the ramp. Instead they all rushed to the front of the airplane to take pictures of the refugees. Then they took pictures of themselves posing in front of the refugees, throwing up the thumbs up, the “rock-on” sign, peace signs. They brought news reporters with them who soliloquized with a background of starving desperate people, while the officers, crew and humanitarian workers chatted among themselves.

I was pretty close to running over like a crazy man, tearing the cameras out of their hands, and punching all those fat, self-satisfied grins off all of those uncaring faces. I didn’t. I smiled from ear to ear with the biggest fake grin I could manage and I went up to the captain of one of the planes. “Hey,” I said, after I introduced myself, “I don’t suppose you would be willing to fly some of these refugees to Manila on your way out, would you?” Casually, you know? Like, “Hey, mind if I hitch a ride down to the drug store, if you happen to be going in that general direction?”

“No, we cannot do that. We are flying back to Kuala Lampur.”

“Okay, well, maybe you can help me a little bit here? Like, how much of a detour would it be just to stop by Manila on the way?”

“Oh no, we cannot do that. We are due back very soon.”

“Okay, fair enough. But do you happen to have food on that airplane? I could really use some food for these people.”

“You would have to talk to one of the volunteers. They are in charge of that.”

So I did. I talked to one volunteer, and then another, and then another. The guy who was technically in charge of the goods was worthless, assuring me over and over that he would certainly get some food for the refugees, but too busy getting his photo taken with them in the background to follow through. The second guy said he would do it, no problem. They had boxes of family meals with biscuits in them, but they would have to take all the biscuits out. Okay, that makes sense, they don’t have cooking supplies right now, so biscuits are probably best.

But before they could hand out anything, or even open a single box, they brought out a bag of poster sized stickers and proceeded to stick one on every available side of every available box that came off that plane. The stickers has the Malaysian flag, the Malaysian president, some kind of sunset in the background and some words about the Malaysian people’s relief operation for the victims of the typhoon. Seriously? You cannot give out food until you have plastered stickers on the side of the box, which it is too dark to see, and which we are going to throw away anyway?

1:00 AM rolled around and another American C-130 rolled in, but the camp commander told use we could not load any people on it because he was afraid of them rushing the plane in the dark and getting cut up in the propellers. I had to explain this to the crowd through my civilian interpreters, and explain why there was still no food. I scrounged up an unclaimed pallet of water and distributed that. About twenty gallon sized jugs were passed around that crowd because I couldn’t find individual bottles, and the people sat or stood calmly in rows, filling their own bottles, offering the jugs to the people around them, passing them around that cramped, dark, smelly, crowded structure until every single person had quenched their thirst. There was not even one single argument or voice raised in anger. God bless them.

And still the Malaysians dithered. They had begun opening their boxes and removing individual packets of biscuits and placing them on a smaller pallet, but they were taking their sweet time about it. At 2:00 or 3:00 AM they assured me that they were almost ready and then they would take them over and distribute them. I had been going for 20 hours already so I showed them where the crowd was and introduced them to the civilians who had stepped up to take charge, and they assured us that it would be very soon. I went back to the tent and went to bed. I was up at 5:30 and back to the flight line by 6:00. The first thing the volunteer said to me when I arrived was, “We still have not gotten any food.”

I wanted to take that smiling, simpering, smirking “relief worker” by the throat and squeeze until his eyes popped out of his head. I wanted to hold him in front of that crowd of people and wave his bulging eyes in front of them and yell, “Look at them! They are hungry. They are starving! You have had that pallet of food sitting over there for hours and you haven’t distributed it why? Because it was still dark and you cannot distribute food until the sun is up and it is light enough for your cameras to see you doing it. If you don’t get pictures to make you look good back home, then what was the point?”

I didn’t. I am trained to smile, and be diplomatic, not burn my bridges. I needed him, he didn’t need me, and who knows what favors I might need from him later. What kind of international stir would that have made? Besides, it would not have fed my people. It would have done nothing more than make me feel better for a few seconds.

I went over and found him, congratulated him on having pulled together so many biscuits so quickly (that stuck in my throat like swallowing puke) and suggested that maybe if he was ready to get his media people going, we could deliver them now? Because these people really are very hungry. They have been without food for at least 24 hours by now. Then I physically bent down and grabbed one corner of the pallet and lifted it slightly. “This is light enough we should be able to carry it with four people.” He and two of his people had no choice but to grab the other three corners and I physically led them to the front of the crowd and set it down in front of them. The Malaysians jetted off to look for their cameras.

I explained the situation to the Filipina civilian who was the crowd’s spokesperson and she rolled her eyes, but she was a good sport about it. The whole crowd was. They were far more patient than I was, and I wasn’t the one starving.

Eventually they did get fed, just in time to stand in the sun, heat, rain and wind all over again for another full day, in the hopes of getting out of that place.

He just could not see what was right in front of his face. Punching him would not have helped that.