The FST

This is the entrance to our FST, the 909th. All injured patients are brought through these doors. There is a tent just to the left where all patients are stripped to a blanket only, to make sure no weapons or suicide bombs are smuggled in.


Things are going ok. I am getting into a routine of seeing patients, getting a work out in the morning and being available for consults and traumas. Most of the traumas injuries we see are in the local nationals, as we refer to them, mainly the Afghanistan military and some police. I am always suspicious if they are good guys or some bad guys who made it into their military and are spies for the Tailbon. Either way, if they are brought in injured we do our best with what we have to take care of them.


This is our OR with 2 beds. Only one time did we have to use both beds at the same time. The blue structures are the arm boards. We move them to the side, then carry the injured on the stretcher and place then on the table. We operate with them on the stretcher (litter).



This is our ICU (Recovery Room) with a stretcher holder in place. We keep patients here until arrangements are made to helicopter them to Bagram.



One of our vascular surgeons did a great job saving a local national’s leg the other day. Their vehicle, a pickup truck, was hit by an IED. The Afghan military have very little to protect themselves, just the body armor and their AK -47. They don’t have MRAPs like we do. Anyhow, he had shrapnel tear through an artery in his leg. Our medic who first responded put a tourniquet on him; otherwise, for sure he would have bled to death before we have been able to treat him. We stabilized him, resuscitated him, and took him to the OR. In the OR, we explored his leg, found the artery with a big gaping hole in it. The vascular surgeon put in a bypass, a gortex graft that basically looks like a flexible straw. He tied this in above and below the hole. This restored the circulation to the rest of the leg and saved his leg. If he would have been treated by the local hospital, he would have ended up with an amputation. Once he was stable, he was transferred to Bagram for definitive surgery.
I am including pictures of my work facility. It is not quite like the hospitals back home. We don’t have a doctor’s lounge or locker room or even a scrub sink. We have an ACLS (essentially our ER or evaluation room), an operating room and what they call ICU, which is actually our recovery room. From the ICU, if they are critical, the Medivac helicopter will pick them up and fly directly to Bagram for further treatment. If the injuries are not too bad, once they are stable, they are transferred to another tent which is essentially a holding area.


Woke up one morning this week to this stuff. The good thing is that it is gone by the next day.




I am working with a Czechoslovakian doctor on a local national military leg. I am doing a fasciotomy for an open fractured tibia. Because of anticipated swelling, I release the thick band of fibrous tissue (fascia) that holds the muscle in place. The swelling can get so intense that it can block the circulation to the muscle and nerves, causing them to die.








Closer view of the surgery. I eventually perform the same thing on the other side of the leg. I also applied metal fixation (external fixator) to stabilize the fracture.


Tom