Wednesday, September 30, 2009

O'fest/Munich pics

Somehow the photos are in the reverse order that I selected. From the top:
1. View of eastern Greenland on return flight
2. Isar River, Englischer Garten, and my trusty steed
3. Bottom's up!
4. Inside the Lowenbrau haus
5. Inside the Haufbrau haus
6. Showin' my leder hosen in Marienplatz
7. O'fest crowd
8. First of many


I'm honored to have had the chance to help our wounded troops at Landstuhl. Unfortunately, it looks like more such help will be required for years to come. As our military enters its 8th year in Afghanistan and 6th year in Iraq (US involvement in WW2 was only 4 years) I think it is past time for all of us to consider what we as individuals can do for the men and women serving in the military, as well as for their families. The bigger picture, of course, is to consider what we all can do to bring these soldiers home while maintaining our national security.

An easy and worthwhile thing to do is to financially support charities such as the Fisher House Foundation ( which provides housing and support for families of wounded soldiers near military hospitals around the world (there are 2 Fisher Houses at Landstuhl). Another worthy charity is the National Military Family Association ( Both put >85% of donations into their service programs rather than administration, advertising, etc.

An important, but somewhat indirect way to support our troops and country is to become better informed about foreign affairs by listening and reading about all sides of the issue - not just listening to those you already agree with. Not only will this broaden our view of these complex issues, but it just might help restore the "civil" in our civilization. Use this knowledge to vote for those who might also examine all sides of an issue before making a decision.

Lastly, we have to think of how we can best defeat those who would harm us. Both Al Qaeda and Iran are heavily dependent on money from oil revenues. Likewise, Russia can't be a threat without oil money. If the US dramatically and quickly decreased our use of petroleum, then the funding for nefarious activities carried out by these groups would be cut off. There are obvious environmental benefits for using less oil, and potential economic benefits for quickly developing alternative energy sources. I'll test the civility of our relationship by proposing a $1 per gallon tax on gasoline as a way to accomplish this. In past wars, the entire country sacrificed for the common good - we really haven't done this since the 1940s. However, I believe this is ultimately the best way to support our military, make us safer, and keep the rising seas from covering Scuttlebutt.

On a lighter note, I'll post Oktoberfest/Munich photos later today.

Monday, September 28, 2009

The Rest of Munich

I felt a little burned out on the whole O'fest thing so I rented a bike and set out to see the city this morning. Munich is perfect for biking. The city is absolutely flat - not a single hill. There are dedicated bike lanes on the sidewalk (sometimes on the street). Lots of people are doing it, usually carrying stuff in a large basket. I first went out to the Nymphenburg Palace, maybe 8 -10 km west of downtown. Looks a lot like Versailles. Then I went 5-6 km to the former Olympic Village (Summer Games 1976), then over to BMW Welt (they seem to be promoting the SUV/sedan crossovers and hybrid engines). I continued on to the Englisher Garten, which is really just a very large, beautiful and minimally developed woodland along the Isar River. Then I rode back into the Old Town, parked the bike, and strolled around.

All of the exercise made me pretty hungry. Unfortunately, my worst (wurst?) fears about eating unknown German food were reaIized in the Victualen Markt (which is kind of like Pike Place Market). I saw a guy eating what looked like a particularly good ham sandwich, and I asked him what it was. He pointed to the menu and said "leberkase", so I went with it. It tasted sorta like ham, but the consistency was a little softer. Only after I downed the thing in just a few bites did I think to use the dictionary that I was carrying. Leberkase is "pork liver meatloaf". Although I don't think that I'll order it again, it was really pretty good, and so far I've managed to keep it down.

I have to catch a train at 0550 to get to the Frankfurt airport in time for my 1100 flight tomorrow morning. I think I'm done with Oktoberfest, but maybe I'll just wear my leder hosen around town for awhile (in Munich this time of the year it's not as crazy as it sounds...)

Sunday, September 27, 2009

Beer, Brats and Breasts

I left Landstuhl after work Friday with 4 of my new Army buddies. We drove the autobahn for about 4 hours to get to Munich. There was some construction and traffic in parts, but we still managed to get up to 200 km/hr. We had thought ahead to use Google map to get us to our hotel, but it was pretty useless, since we can't read the traffic signs. We miraculously found the hotel without too much trouble. Our good karma continued by having one of the best bars/beerhalls I've ever been to be located just a block away. The Lowenbräuhaus was rocking when we got there about 11:30. It was so much fun that we went there again after we left Oktoberfest the next night. It's a different (younger) crowd than O'fest, and the band plays much better music.

On the way to O-fest Sat morning, we bought our obligitory leder hosen (goat leather, very nice). Not cheap, but probably 75% of people (guys) had them on. The locals (all ages) wear their LH and dirndls (the low cut dresses that add at least 1-2 points to any 1 - 10 score) without any sense of irony - they are totally in to it.

We got to O'fest before noon on Sat, but the place was already packed. I briefly saw Tanner, but there wasn't room for all of us at his table - we had to move on. You must be seated at a table to be served in the beer halls. We had to go to a couple more places before we found seating for 5. After all that effort, we felt compelled to stay for awhile. Beer is served by the liter. After the first one goes down, the next doesn't look as intimidating. The food is also served in large portions and is really good.

The Germans have interesting customs. They LOVE to sing - either unintelligible Bavarian folksongs, or American rock songs from the 70s and 80s. Traditional um-pah bands are in all the halls, and the crowd seriously digs it. The other thing Germans love to do is drink beer, and the bands play songs specifically made for toasting and drinking. During band breaks, the crowd spontaneously starts singing things like "hey........ay baby, I want to know.....ow if you'll be my girl". I've probably heard that 100 times in the past 48 hours. As funny as the singing is, it is kind of cool to see people of all ages singing these traditional German songs and drinking together.

My newest best friends left this afternoon to return to Landstuhl. I'm solo till I fly Tues am. I'll try to post again tomorrow. Since I don't have an electrical converter plug for the laptop, I won't post pictures till I'm back in the States.

Friday, September 25, 2009

Goodbye Landstuhl

My last day was quiet. Many patients transferred back to hospitals in the US, and only a couple of new patients arrived.

After 2 weeks of this I believe that I can draw a few conclusions:
1. The soldiers, doctors and staff are extremely loyal, brave and hardworking. They seem to have incredibly high level of morale despite the sometimes dysfunctional military medical system and the endless procession of badly injured young men and women.
2. These military professionals will do whatever their commanders tell them to do. They might not agree or like it, but they will do it wholeheartedly.
3. The Commander in Chief, President Obama, has the ultimate responsibility for the decisions which place these soldiers in harm's way. The officers whom I have spoken with (admittedly a small sample) generally like his approach to our current international problems, and understand the complexities of the situations. They are capable of having an informed, rational, and unemotional conversation about controversial issues without resorting to name calling or hysterics.
4. We have an all-volunteer military. For many of us, it is easy to tell somebody else to take risks when we are shielded from the immediate consequences of our decisions.
5. If military personnel are disciplined enough to rationally discuss issues that directly bear on their risk of death or serious permanent injury, why can't the rest of America do the same?
6. By all accounts (including Chris's and my direct observation during our work in Pakistan in 1988), Afghanistan is a hellhole. I believe that sending more troops will only increase the work in medical facilities downrange and at Landstuhl, without fundamentally changing the situation in the region.

Since I got that off my chest, the autobahn becons and I'll lighten up by driving to Munich this evening with a group of medical residents from here. The weather is supposed to be perfect, but it probably doesn't matter. Pics to follow...

Thursday, September 24, 2009

Winding Down

It has been a little quieter for me the past couple of days. Patients continue to come in, but there hasn't been much vascular-related work. Did have an impressive bleed from an iatrogenic innominate vein injury from an ill-advised attempt a tracheostomy in a coalition hospital in Afghanistan (apparently not run by the Americans, but another unnamed European ally). The commander of Landstuhl Med Center happens to be a cardiothoracic surgeon, so he did the sternotomy to repair it (the big dog's gotta eat!).

Had a fairly interesting video conference today with the trauma teams downrange in Afghanistan and Iraq, as well as uprange at Walter Reed, Bethesda Naval Hospital, and Brook Army Med Center. They track all of the trauma pts from beginning to end. The process and logistics are impressive, but it's sometimes hard to understand the military jargon.

I'm going to get my liver enzymes warmed up tonight at "Belgian beer night" at Ramstein Air Base which is about 10-15 km away, then on to Munich and Oktoberfest this weekend.

Tuesday, September 22, 2009

Castle pics

1. outside of castle
2. Ramstein Air Base in distance - this is where the planes from downrange land
3. Landstuhl Army Hospital is on the top of the hill - you can't see it, but trust me on this. The town of Landstuhl is in the little valley
4. more castle
5. in case you missed it, I have another post from today below this one