Off to Japan (take 2)

Wed 17 Oct:

As you may know, it has been pretty busy around here since the summer. In addition to 9-day electives in July and August, I was in AK in Sept followed by courses in VA, NY and now, Japan. In the middle of this, I have had my usual hospital shifts. Dharmasuri and I have also found the time to buy a 3 story building in Portland, in part to help house Nagaloka. If you follow her on facebook you will read more about that venture. I will focus on my stuff.

Last week, we completed our second Battlefield Medical Responder course (BMR) for 24 conflict-zone correspondents. We apparently learned something from the first one because this latest iteration represented a notable upgrade. The course was as equally satisfying as the first. I am not sure that students from other courses appreciate the immediacy and potential relevance of our training like those in the BMR. After the course wrapped up, I hung around our classroom at the Bronx Documentary Center for a few hours to watch films produced by some of our students. They included one on refugees in Sudan, children commandeered into military service in W Africa, and police operations to clean up the favelas in Rio de Janeiro in preparation for the FIFA World Cup in 2014 and summer Olympics in 2016. All of them were really powerful; all done without any seed money.

I returned home early Sat AM and was on a plane for Japan about 24 hours later. This is my second visit in 9 months. This course is again focused for doctors (8), paramedics (6) and nurses (6). In addition 4 of the students from the earlier course are returning for a refresher. We gained a good reputation with these professionals in January so there is a lot of enthusiasm for the course. 4 have traveled from the N of Japan where the earthquake and resulting tsunami (up to 40 meter/130+ ft) devastated the landscape. Here is a link to one of many videos posted online.

I arrived in Tokyo Monday evening, greeted by warm weather and Tues, by crystalline blue skies. Tuesday afternoon, we drove to Gotenbashi in Shizuokaken prefecture. This city is near the base of Mt Fuji. Shrouded in clouds on our arrival, it appeared out of the mist just before sunset. Like Mt Ranier near Seattle, Fuji dominates the view toward the NW. This morning, in an otherwise cloudless sky, it was haloed by a small, donut-shaped tuft of clouds. As tranquil as it appears, it last erupted 303 years ago and is overdue for another.

Battlefield Medicine in the Bronx

Last week I was in the Bronx helping to teach a new course, the Battlefield Medical Responder.  You must be wondering how I got myself into this.

About a year ago, Tim Hetherington was killed in Libya.  Tim was a prize-winning photojournalist and filmmaker/videographer.  His death was deeply felt by combat-zone reporters everywhere, especially by Sebastian Junger.  Although Sebastian is most famous for the book the Perfect Storm, for over 2 decades, he has reported with clarity, insight and compassion from many hotspots around the world.  Tim and Sebastian were close friends and collaborators as the directors of the movie Restrepo.  This documentary chronicles a year-long push by an infantry platoon to establish control over a strategically important location in a heavily contested area of Afghanistan.  It is 93 minutes of riveting cinema that is masterfully done.  Forget the questions of why we are there and all the good or bad that we may or may not be doing.  Restrepo is about young men trying to do their job, a thankless and very difficult one.  It left me numb and heartbroken.    These men represent the too-often overlooked elephant in the room for America.  They are the emotionally damaged goods of the last decade’s conflicts in the SW Asian theater.   The costs of the repatriation, rehabilitation, and support that these people and their families will require will easily dwarf the costs of the materiel used to wage war.  But this past week was about Tim and the others who risk their lives to tell the stories we don’t want to see and hear but need to.  These are the images and descriptions of the soldiers and the collaterals, the women, children and the elderly, innocent victims of the purposeful and accidental acts of the combatants on both sides. 

Although the big networks and print media provide training for their combat-zone correspondents, most freelancers working in these dangerous places live on meager budgets and therefore have none.  After Tim’s death, Sebastian was haunted by grief and guilt, especially after learning that Tim might have been saved with some decent first aid.  As a result, Sebastian organized a not-for-profit (RISC) to help underwrite the training for the freelancers.  That’s where we came in.  Sebastian approached us last autumn and asked if we would be interested in doing the training.  He had only a vague notion of what he wanted, including some things that did not make sense to me.  After my initial proposal was accepted, we went to work.   The 24-hour course is based on our 16-hour first aid course, expanded to meet some special needs.  The main foci included care under fire, travel concerns, and general medical/injury management.  The leader for this project is Sawyer Alberi.  After 6 years with the Coast Guard, she enlisted in the army reserves and has served tours in Iraq and Afghanistan as a frontline, combat medic.  Sawyer is a wonderful instructor who had a clear vision of where we needed to go.  We used our usual teaching materials and then produced a supplement for the students.    

The course was run at the Bronx Documentary Center (BDC) housed in a beautiful restored building on 151^st Street in the Bronx.  We stayed in Chelsey in lower Manhatten, near 23th and 3^rd.  Our backdrop was a classroom wall covered with photographs from the recent conflicts.  It was a graphic reminder of why we were there.  Each day was packed with didactic sessions, skill labs and simulated rescuer/patient interactions.  We supplemented our usual class materials with body armor, sound effects, smoke flares and lots of fake blood powder.  It was a lot of work for everyone involved.  The neighborhood was engaged as well, especially when we conducted drills outside.  On the final day the students had to pack a large, bleeding wound (innards of a chicken from which fake blood was hand pumped out) and rescue an unconscious, bleeding patient (180 lb dummy) in a simulated street scene.   

We had 24 students in class, including photographers, writers, a cameraman, and several documentarians.  We didn’t know much about any of them during the class.  Later, in a bar sharing drinks after the class was over, we found out that many are award-winning journalists producing work that has appeared in important venues around the world.

It is hard to write about how all of this felt and the impact I believe we had.  Given their zeal to get to the truth, I have little doubt that someone will use this training in an important way.  We are scheduled for a course in London in Oct and Beirut sometime in late 2012 or early 2013.  Below are a couple of links that have blog posts.  The bronxdoc and facebook links have some pictures, too.  I will forward a video link once it has been posted.

Sebastian Junger, Michael Kamber, Lily Hindy, the BDC and other members of RISC are to be commended for their collective vision and efforts.

https://www.facebook.com/media/set/?set=a.207130886069509.45675.147711532011445&type=1

http://bronxdoc.org/page/2

http://www.capitalnewyork.com/article/media/2012/04/5734184/sebastian-junger-done-war-reporting-convenes-journalists-bronx-learn-s

http://lens.blogs.nytimes.com/2012/04/18/life-saving-training-for-reporters

http://www.outsideonline.com/blog/outdoor-adventure/sebastian-junger-talks-about-risc-and-tim-hetherington.html

http://www.economist.com/blogs/prospero/2012/04/journalists-under-fire