Alright, now for the latest update. I guess these have spaced out a bit more than I planned, so I will try to be better at keeping up on these things. Not that all that much exciting has been transpiring here. Things have become routine - with a few little changes that I will get to at the bottom of this posting.

Thankfully, aside from a spike in activity two weeks ago, things have been returning to a level of boredom. Less combat by both the Iraqis and the US troops have meant that we are staying relatively quiet in the hospital. Of course, that means more time to try to find things to do and to try to stay out of trouble the best that we can. The Nintendo Wii is a big hit with daily Tennis and Guitar Hero matches. Entertaining to watch a bunch of adults become fixated on a TV screen, shouting obscenities when they lose at little video cartoon characters.

Got another chance to go combat biking and explore the rest of the International Zone. realizing that peering into these bombed out places is very voyeuristic - but really, there is not all that much else to do. Stopped by one of the local mosques. We, of course, did not go inside, but instead snuck a peek over its surrounding walls. There are still a little less than 10,000 Iraqis who live within the limits of the International Zone - so the mosques stay pretty active from what we understand. Multiple times a day, you can hear the call to prayer. It is an eery sound given that we have been conditioned by Hollywood to believe that they are essentially a call to kill the infidels, too. When you are able to get over that misbelief, there is actually almost a mystical/beautiful sound to it.

The next stop on our outing was to a FOB called Union III. It was a palace being built for the Ministry of Justice before it was gutted by a few thousand pounds of American bombs. It is now home to a few American units, some Australian troops, and a few contracting groups.

It is across the street from the FOB occupied by the Georgian Army. We had never come across anyone who had actually been inside their compound as there is very little interaction between the Georgians (who speak no English) and the Americans (who speak even less Georgian). With nothing else to do we stopped by and asked to have a peak around. Their response was perfect... "Why would anyone want to come in here?" We told them we were just out exploring, and just shocked that we had come by they hesitantly said... "OK" and opened up their gate for us. Essentially another bombed palace with very few people around. Although you could tell there used to be a beautiful garden in the back of the building where they actually had a flowering vine growing (the first flowers I have seen in Iraq). The only actual military object we found the entire time was an old Soviet era tank. As we were leaving, the Georgian soldiers gathered around and insisted that we all take pictures together. OK.

The final stop was to an area of houses that used to belong to Saddam and his friends as yet another place to throw parties - particularly his son Qusay. Also the recipient of American "largesse" in the form of high explosives. It was obviously at one point a beautiful building with a landscaped courtyard, several indoor/outdoor pools, and some classic artwork.

The rest of the month was pretty uneventful until the end when we met up with some friends who are contractors and have access to some more weapons and essentially unlimited ammunition and range time. (Paid for by you the tax-payer, of course... thank you). Spent some time firing machine guns - an awesome experience. A little bit on the warm side on the concrete, but definitely worth it. If you have the opportunity, I would definitely recommend putting some holes in paper targets this way.

And then for the big change. the 86th CSH is actually divided into two sections - the larger section (about 3/4 of the hospital) is in Baghdad, where I had been. The other 1/4 is in Mosul, which is in the northern part of the country - about 300km away. A much smaller support mission. Since we are all part of the same hospital, though, we have to cover when we go on leave. The part in Mosul only has one ER doctor (as opposed to the 3 we have in Baghdad) - so the doc in Mosul is going on leave, and I had to travel up here to backfill him. After about 18 hours (to go 300 km), we made it up here. Quite an experience. Took an armored bus (The Rhino) from the International Zone to the Baghdad Airport. Since the route goes through the 'Red Zone' it is a convoy driving at speeds you don't think are safe in a giant, overweight bus. Anyway, once there, we had the nicest of Army accommodations for the overnight until our flight left on a C-130. We were packed like sardines into the uncomfortable webbing seats, in about 130 degree heat with all our body armor on - waiting on the runway for about 2.5 hours - you thought your flight on United was rough. Most people passed out eventually. Only to be woken up as we were getting ready to land in Mosul using a 'combat landing'. This involved dropping the 17,000 feet in a few seconds coupled with tight spirals and jerking back and forth - mind you still in the hundreds temperature wise in the aircraft. No windows to get your bearing either. By the time we hit the ground - hard - there was not a face that was not a deep green shade. My biggest concern on the aircraft was not getting shot or crashing - but what the proper etiquette is when you lose your lunch -do you do it into your helmet, your rucksack, your neighbor...

Anyway, now I am here for some time. I will be returning back to Baghdad in a month or two. In the meantime, this is a very different place - living in a trailer (CHU - Containerized Housing Unit) - no place to go off and have adventures as the FOB sits right on the wall between us and the City of Mosul. The hospital abuts the airfield here, so the constant drone of helicopters and airplanes is a constant accompaniment. For those interested, you can actually see the hospital by going to Google Earth and mapping to Mosul, and then zooming down on the runway. The view outside my CHU is not quite scenic - actually just a bunker and hundreds of 'T-walls' as rocket and mortar attacks are about as common as they are in Baghdad.

Meanwhile, my girls are getting cuter - you just have to admit it - they might be the cutest ones out there.

I hope you are all having a great Fourth. Please have some beer and hotdogs for me. Actually, just have the beer and hold it for when I get home.

It is amazing to me that it has been a month since the last time I put something in this blog. Both because it is evidence to me that time actually does continue on and amazing for me that so little new has happened here. The repetition of each day blows me away. There have been a few things of interest going on - so of course some pictures will follow. In the meantime - we have passed our halfway mark. Very exciting.

We started the month by getting a visit from the Iraqi Air Force as they were practicing to develop a Medevac (air medical evacuation) system of their own. They landed on our Landing Zone to help us all get familiar with their equipment - as it hasn't been sen in the states for a very long time. The smaller helicopter (Huey) was built 10 years before I was born and had flown in the Vietnam War. The larger MI-17 from the Ukraine apparently spent some time fighting with the Iranians in the 1980's. Who knows, maybe it will see some time against the Iranian's again.

As has been in the news, things have calmed down substantially in the war. The number of war wounded is a fraction of what it was just a few weeks ago - the lowest since we have been here. That combined with the decreased rocket and mortar attacks is truly a godsend. It is almost like practicing emergency medicine back in the states - except for the part of having to take a weapon into the dining hall. (more like practicing medicine in Texas, then). So of course, we have been working hard to find things that occupy our time. Scrabble is one... and it gives us a chance to pretend we are smart. Then of course, there is the invasion of the blue stuff...

The hospital had a 'Design your litter' contest as part of Nurse's week (no, they didn't have a doctors's week). The ER won by a landslide with this creation by some of our medics made out of cardboard. Maybe we do have too much free time on our hands.

One of the local NGO's had a party recently at one of the local FOBs. I am still not one hundred percent sure why I was invited, but I was glad that I did. Basically they had rented out a coffee shop and had brought in a bunch of local Iraqi musicians, had tons of local food. Most of the employees of the NGO are Iraqi and it was one of the few opportunities they have had to relax, celebrate, and enjoy life other than the daily grind that is here. There was a fair amount of dancing (not by me) and people just having a good time. It was very refreshing to see. We get very jaded in the hospital, being that pretty much every local national that we see or meet is due to some catastrophe while they were trying to kill someone or someone was trying to kill them. It is easy to forget that most of the Iraqi's want normal lives, free of violence, really not all that different than ourselves. It is easy to get the impression that there is no happiness or joy in this country. It was great to see.

In the meantime, I have apparently become (in)famous... (http://www.sundayherald.com/life/people/display.var.2310466.0.0.php), as a Scottish reporter was hanging out in the hospital and with our Medevac colleagues for a few days and quoted me completely out of context. Oh well, I guess it could have been worse. It is my one moment in the spotlight, I guess - even if it is over in the UK. (maybe you know him Stacie/Luke?)

And of course, back home I got the honor of being an uncle again and a godfather as my brother Brett and his wife Karin brought Caleb Anders Cohen into the world. No pictures yet as Brett is notoriously bad at sending out pictures. Maybe next month?

Until then... the girls back home are growing like weeds. Amy is doing her best to keep sane and to keep the girls from killing each other or the dog. Sara continues to be quite the chatterbox - telling some pretty impresive stories for a three year old. Naomi is not too far behind, practicing telling Amy what to do.

Hope you are all well...

Happy May Day

Well, I guess it has been some time since the last posting - almost three weeks by my watch. It is strange the way that time seems to slip by, and yet it doesn't seem to move at all. It is hard to believe that we have been here for over 6 1/2 months already - even harder to believe that we have 9 months to go. It is truly hard to express the full groundhog's day effect here. Even when we find things to try to keep ourselves entertained, the next day we are right back to the same routine, same people, same food, same patients... Even the rockets and mortars become routine - almost like they are more noticeable in their absence in the rare days that the early warnings alarms don't go off.

Anyway, got to do a few things in the past few days to try to stave off boredom a little longer. On a recent flight to the Air Force Hospital - our return flight got cancelled, so we got to hang out in luxury on the Air Force Base. It is just like being on a base back home - big dining facilities, PXs, indoor and outdoor pools, and a big Morale and Welfare building with many flavors of slushies not to mention pool tables, dart boards and karaoke. Luckily on the flight with me was one of our ER nurses - Kristi Bischoff so I had someone to play darts with and smoke cigars in their cigar shack. The Air Force does it right - nice digs and only 4 month tours...

Got to fly back during the daytime, though, so had quite a view of the greater Baghdad area and got some good pictures along the way. Even saw a train - or what used to be a train hanging out in a Baghdad neighborhood.

A little bit later, some of the other docs and I had to take a trip over to the Baghdad Airport and its surrounding FOBs for some meetings. Luckily, the work part only took about an hour and then we had the rest of the day to explore the area. There are quite a few of Saddam's palaces in the area -including one that he started building after the first Gulf War which he of course named "Victory of America Palace" to celebrate the Iraqi "victory" during the first Gulf War. Gives delusional a new meaning. There were many other palaces in the immediate area, mostly built for the lesiure of Saddam and his family with dozens of surrounding man-made lakes. We actually had the opportunity to pull up on the side of one of the lakes, put down the tailgate, and just relax and enjoy the wildlife (yes there is some local wildlife). We all agreed, just sitting, relaxing outside without fear of rocket attack, without the smell of the city or the local incinerator, listening to the birds - was the highlight of the day, and probably of the recent past.

So in addition to the palaces - and the famous Saddam's Throne - there was an area called Flinstone Village. It was apparently built by Saddam for his grandkids as a giant playground. The Flinstone's was the only US TV show allowed in Iraq before the war (don't know why) - and so, he built the playground to keep them amused, I guess. It was built - along with a LOT of other palaces while the UN sanctions were in place - giving you an idea of how Saddam used his country's resources.

Finally, as March was Moustache March - we needed some event to mark the passing of May - it became Bald or Bangs May. As the Army frowns on bangs in men - bald it was. Figured, we weren't going anywhere anytime soon, so why not. Besides, unlike my brother, my hair still grows back (sorry Brett), and this way I don't need to get a haircut for a while.

To celebrate our new found baldness - we had to celebrate in the ways of our mentors - Hawkeye Pierce and his cohorts from MASH. We have decided to try to emulate them as much as possible. Including the smoking robes - courtesy of Todd (one of the other ER docs) Baker's wife. While we wish the martinin glasses were filled with, well martinis, non-alcoholic beer had to be substituted.

Well, back to work for me, and same for all of you. Hope you are all well - and no, the fact that 120 degrees is a 'dry heat' does not make this

place any more bearable during the day.

So on to the next installment...

Not all that much to really report as going on here. Things overall have continued to calm down here in terms of casualties - haven't had one of those angel flights in quite a few days actually. As you may have seen in the news, we do continue to get the daily reminders from Sadr City that there is still a war going on in the form of reminder rockets and mortars.

Luckily they remain more of a nuisance without any casualties, just the occasion to get our heartrates up and run into the bunkers or into the closest building.

We did have a nice sandstorm for a few days. Really more of a duststorm in all honesty. Cut visibility quite a bit and at times so much you could barely see 20 feet in front of you. Kind of like thick fog back home, except you could feel the sand get sucked in as you breathed and taste it whenever you opened your mouth. Lots of people with breathing complaints as you might imagine.

I did have the opportunity to celbrate Passover relatively close to where the actual event took place 3000 years ago - being in the middle east and all. There was actually a seder held right here in the International Zone that drew a fair number of people from the local area and from some of the other surrounding FOBs. About half the people were US military, the rest a mix of State Department, Australian military, and even a few Iraqi Jews. I hadn't realized there were any left in this country. Got to go with a bunch of people from the hospital - some fellow tribe members, others who were just along for the experience. Overall it was a lot of fun - and definately a change from the usual around here.

We did have an interesting day a few days ago when we were given the opportunity to explore one of Saddam's palace's - actually the Republican Guard's palace and the bunker complex beneath it that was supposed to serve as a nerve center for the government if there was an attack. Apparently the government fled the city, though, prior to the actual invasion of Baghdad by the US troops. The doors were 'unlocked' by the first forces in the city to find an abandoned complex including everything from kitchens to dorms to media and lecture rooms. Supposedly meant to withstand a nuclear blast - a bunch of American doctors were able to 'conquer' it without oo much problem. It was built in the late 1990's and finished in 2000 (so much for the embargo) by a German company - can't recall which one it was. Anyway - it was definately an interesting trip. The palace itself (sitting on top of the bunker to disguise it) was hit pretty hard during the bombing campaing prior to the invasion and offered an up close view of some of the destruction that follows when one of those things hit.

Part of the day was actually a farewell to a good friend who is rotating back home to Walter Reed. Although we affectionately called him 'Melon Head', we will definately miss Pat Hickey as he heads home to his wife and kids. As a pediatric infectious disease doc - he only had a 6 month deployment, but we try not to hold that against him.

That's it for now. Hope you are all well.

--
Jason Cohen, DO
CPT, MC
Emergency Physician
United States Army


86th Combat Support Hospital
Task Force Baghdad
Ibn Sina Hospital
APO AE 09348

March Madness

Well the end of March was an exciting time here in Baghdad. As you may have gathered from my last email and the news - things here in Iraq got pretty busy from the military and medical standpoint. Starting on Easter Sunday morning and really continuing until yesterday - the skies were busy with a whole bunch of mortar and rockets being launched at various places in the Green Zone and some of the surrounding FOBs. Unfortunately two civilians who work with the embassy were killed and quite a few injuries - but for the most part the attacks were thankfully poorly aimed and didn't cause any casualties. From what the rumors are, most of the firing seems to come from areas in Baghdad called Sadr city. It is mostly poor slums that are heavily controlled by Muqhtada al-Sadr and his Mahdi militia. If you have a few minutes, you may want to google them to get a better idea of what they are about. As far as I can tell, they are mostly about being a gang of criminals with really big weapons who use religion as an excuse to further their own ends violently.

Sadr city itself is only a few miles from here, making it a convenient launching point for most of the indirect fire (IDF - rockets, mortars, and artillery). There had been increased combat that was taking place there and some of the surrounding areas and had accounted for the increased patient workload with injured soldiers and local national Iraqis coming to the CSH.

The hospital was almost at capacity during the week - even with the multiple evacuations out of the hospital -both to Iraqi facilities for local nationals, and to the Air Force hospital for our soldiers to be evacuated on to Germany. We did lose a few soldiers despite some really heroic attempts at resuscitation both by my colleagues down here in the ER - and the dedicated surgeons and intensivists up stairs. Even in the midst of the dozens of tragedies that surrounded us, people were doubly affected by the loss of the troops. Due to the threat of the indirect fire, we were unable to give all of them our last respects with their angel flights. It is strange that one ceremony really has quite an impact on those that work here, and people seemed to be almost as upset about not being able to salute the fallen soldier as about the death itself.

We have since gotten back to some sense of normalcy. At least back to the way it was before last week - as I don't think we can ever call this place truly normal. We have started to be able to return to the gym which is a huge part of what we all do on a daily basis. And now we can go outside again without wearing our body armor. Last night, though, I think I gave Amy quite a scare as I was talking on the phone to her on the roof of the hospital when the alarm for 'incoming' went off and I ran inside the building and hung up the phone by mistake after saying something along the lines of "oh-s*&t". I was able to call her back a few minutes later and put her at ease. And apologize for hanging up the phone on her...

More importantly - now that we can go outside without our IBA on again - we have to get back to the important monthly grilling of steak and lobster donated by our 18Delta - Special Forces medics who come and work with us. They have quite the hook-up, almost makes me want to join the Special Operations command... Just kidding.

As for the rest of the news for the month - thankfully, the moustaches are gone. They were horrendous - at least mine was. But other people were upset about looking like someone out of a B-rated movie as well. We did celebrate St. Patrick's day - even here in Iraq we celebrated. How else, by donning stupid hats and drinking green beer. Alright it was non-alcoholic beer, but still with a little green food coloring, made it just like home.

As usual, the dining facility personnel decorated to celebrate Easter in their usual Bangladeshi style... errrrrr..... whatever that means. No one can quite figure out what kind of animal that is and what it is doing. Any suggestions?

And then finally, as a little piece of home was sent to me from my friends over at UMass - a hat from LifeFlight to remind me of better times - probably the first time one of those hats was worn with IBA on and a weapon in hand.

Back at home - Amy is trying to stay as sane as possible with the girls. She really has her hands full and is doing a phenomenal job as always. I miss the three of them (and Riley) very much and can't wait to see them. 1/3 of the way done...

Anyway, back to work for me. Hope you are all doing well. Thank you for your recent emails and thoughts, very much appreciated.