TALES FROM A PARAMEDIC, PILOT, CAVER, and FIREFIGHTER, WHO MEET IN ANTARCTICA, AND GO ON TO HAVE MANY ADVENTURES IN NEW ZEALAND, TONGA, FIJI, VANUATU, WEST AFRICA, AND UKRAINE. . . . . . . . . . . . . . . Structural Firefighting/ARFF/Joint Antarctic Search and Rescue Team at McMurdo Station Winfly- Summer- Winterover. Sailing a 37' Tayana sailboat in the South Pacific. Ebola Response. Wildland firefighting. War Medic in Ukraine.
Monday, December 16, 2024
Saturday, December 14, 2024
Friday, December 13, 2024
Thursday, December 12, 2024
Wednesday, December 11, 2024
Ukraine: Russian Submarine Missile Launch
This video reportedly shows a submarine missile launch, which targeted Ukraine in December 2024.
Tuesday, December 10, 2024
Sunday, December 8, 2024
Ukraine: The Cost in Dollars of Supporting Ukraine vs Letting Russia Win
Elaine McCusker, Senior Fellow at the American Enterprise Institute, provides a cost comparison:
~112 billion: Cost to the US so far, to support Ukraine with weapons and other equipment (most of this money goes to US arms manufacturers
vs
~808 billion: Projected additional US defense spending that will be needed over the next 5 years, if Russia wins the Ukraine war, including:
- $88 billion for 270,000 more US service members
- $31 billion to harden US facilities
- $109 billion to increase US air combat capabilities
- $28 billion for drone development
- $173 billion in air defenses
- $63 billion to enhance munitions production capability
- $50 in shipbuilding
- $185 in additional training and exercises
- $33 billion in spare parts stockpiling
- $10 expanding special operations forces
- $36 billion expanding space and cyber systems
Saturday, December 7, 2024
Ukraine: IAEA vehicle hit by Russian FPV
IAEA Director General Raphael Grossi reported significant damage to the vehicle, and called the strike "unacceptable". There were no injuries.
Thursday, December 5, 2024
Ukraine: Eliminating Enemy Surveillance drones and Shaheds
Wednesday, December 4, 2024
Tuesday, December 3, 2024
Ukraine: Soldier survives 24 days with a tourniquet in place
Monday, December 2, 2024
Sunday, December 1, 2024
"A Testament" - Poem by Borys Humenyuk, MIA
Today we are digging the earth again
This hateful Donetsk earth
This stale, petrified earth
We press ourselves into it
We hide in it
Still alive
We hide behind it
Sit silently in it
Like little children behind their mother’s back
We hear its heart beating
Its weary breath
We are warm and comfortable
Still alive
Tomorrow we will die
Maybe some of us
Maybe all of us
Don’t take us from the earth
Don’t tear us away from our mother
Don’t gather our remains from the field
Don’t try to put us back together again
And — we beg you — don’t erect crosses
Monuments or memorial slabs
We don’t need them
Because it isn’t for us —
You erect these monuments for yourselves.
Don’t engrave our names,
Simply remember:
On this field
In this earth
Ukrainian soldiers lie
And — that is all.
We don’t need funerals
We know where our place is
Simply cover us with earth
And move on
It would be nice if there was a field
Where rye is swaying
A lark flies overhead
And — the sky
The endless sky —
Can you imagine the grain a field
Where warriors are lying will yield?
To remember us, eat the grain from the field
Where we laid down our lives
It would be good if there were meadows there
And many flowers
And a bee under each flower
And lovers who come in the evening
To weave wreaths
To make love till dawn
And during the day, let new parents
Bring their young children
Don’t keep children from coming to us
But this will be tomorrow
Today we are still digging the earth
This cherished Ukrainian earth
This sweet, gentle earth
And with a soldier’s spade we write as one
On its body
The last Ukrainian poem of the last poets
Left alive
- Boris Humenyuk, currently MIA
Click to text excerpt below to link to Luke Harding's full Dec 2023 story in The Guardian:
Friday, November 29, 2024
Thursday, November 28, 2024
Wednesday, November 27, 2024
Tuesday, November 26, 2024
Ukraine: "The Russian Military Medicine Experience in Ukraine" from CNA
CNA (the Center for Naval Analyses) is an independent, federally-funded think tank based in Arlington, VA. This November 2024 CNA publication details some very basic analysis of the Russian military medical operations in the Ukraine war.
"We Need a Medic! The Russian Military Medical Experience in Ukraine"
On his podcast, Samuel Bendett interviews one of the paper's authors here. Bendett is a CNA analyst, and his podcast usually focuses on drones and technological developments.
Sunday, November 24, 2024
Ukraine: Holodomor Remembrance Day: 23 Nov 2024
Saturday, November 23, 2024
Ukraine: "Hazelnut": the New Russian Missile
On 21 November 2024, Russia hit the city of Dnipro, in E Ukraine, with a new type of missile. The missile traversed the distance from its "Cabbage Canyon" Caspian Sea launch site to Dnipro in 15min. Thirty minutes before launch, Russia used to the ICBM launch protocol to notify the US. Initially, based on flight characteristics and damage assessments, it was mis-identified as an RS-26 Rubezh Intercontinental Ballistic Missile.
Further evidence revealed that it was not a Rubezh, but a new type of missile. The "Oreshnik" ("Hazelnut") is a Russian medium-range missile, capable of carrying a nuclear warhead, but apparently not capable of traveling the 5,000km minimum needed to meet ICBM definition. Various military experts are currently estimating a possible range of 2,000-3,000km. Ukrainian intelligence assessed that the missile traveled at Mach 11, and was equipped with 6 individually-guided conventional warheads, each with 6 submunitions. Putin claims that "there are currently no ways of counteracting this weapon" The same claim was made of the Iskander, which has subsequently been shot down mulitple times by Patriots. So far, Ukraine has intercepted in extraordinary 80% of all missiles fired from Russia. Mach 11, if true, would put the Oreshnik on the upper limit of current hypersonic capabilities- very hard to intercept. On-the-ground reports indicate that explosions persisted in Dnipro for 3 hours after impact.
Friday, November 22, 2024
Ukraine: US authorizes use of ATACMs and Storm Shadows on interior Russian targets
This week has seen the first use of US ATACMs missiles, as well as British Storm Shadows, on non-frontline targets within Russia.
Tuesday, October 29, 2024
Prelude to Medic Work in Ukraine, part 3
Rule #2: "Do Not Harm Enemies Who Surrender: Disarm them and Turn them over to your Superior"
- From the United States Marine Corps Common Skills Handbook, Core Principles of the Law of War
January 2023
It's been a year since Russia's "training exercise" turned into a full-scale invasion of Ukraine.
I've spent that first year of war doing my normal developing world medical work, while filling out applications to every medical NGO that has operations in Ukraine. At long last, it looks like I'll be accepted for a volunteer deployment to Ukraine as a Paramedic, this spring. I'll spend my last two months in Africa hiking up the hill to the "cell spot", in order to do interviews and process onboarding paperwork for Ukraine.
Our rural West African clinic is busy today. Dozens of men, women, and children wait outside the clinic; this is the only free medical care available within 3 days' walk. They chat, share food, and migrate patiently along with the shifting shade of the mango tree as the day progresses. Each evening at the local teahouse, the village men gather around a shortwave radio to listen to BBC. Major news, and a favorite topic of today's conversations, is the war in Ukraine. The general anticipation that Kiev will fall within a few days has turned out to be wrong. Right now, much of the world is rooting for the underdog in this fight. I'm hungry for more details, but information is limited in our remote village.
The history of local disease outbreaks here includes Ebola and measles, so we are careful to arrange as much social distancing as possible for our waiting patients. No inside waiting room. In any case, conditions are far more sweltering inside the clinic than outside. Last night a thunderstorm gave us an early taste of the coming monsoon season, and humidity remains high. We have no fans, but we open the windows and doors to maximize airflow.
In the crash room, we currently have a pediatric patient whose initial presentation would stir panic in the heart of any seasoned US doctor or paramedic. She is 3 years old, limp, listless, dehydrated, semi-conscious, with a racing pulse and raging fever. She might be a critical case in the US, but for us, she's a run-of-the-mill kid with Falciparum malaria. We see several similar cases each week, once the rains start. We'll trial a dose of oral ACT (Artemisinin-based Combination Therapy- malaria has become resistant to many single-drug therapies, so a combination of drugs is now needed). If she doesn't throw it up, she'll almost certainly be stable and sleeping comfortably within an hour or two. If oral drugs don't work, we'll give her intravenous antimalarials, which pretty reliably yield a similar positive outcome. Without antimalarial drugs, she would be in grave danger. Falciparum is the most serious strain of malaria, and it is the country's leading cause of death. Rapid treatment is key. Our door-to-antimalarials time is less than 10 minutes for most serious cases.
While caring for the girl with malaria, we are serenaded by the continuous crying of a 3-day old girl, brought in for a well-baby checkup by her mother. The heat, high patient load, and cries of the newborn are conspiring to create a fairly trying day. As soon as possible, we frontload the newborn. She is mom's first baby, and the pregnancy and birth were uncomplicated. The baby is a bit feverish to the touch. When we undress her, we discover she has a severe cord infection, and is dehydrated and tachycardic. We evaluate options for transport to higher care. The nearest hospital with a neonatal ICU is a 2-hour bike ride away, down very rough roads. Our motorcycle ambulance has already left town with another serious patient. I send a runner out to search for any bikes in town.
We start an IV. Our care options are limited; we have no oxygen, and the infant is too young for us to safely dose with a starting load of antibiotics. As I watch her, her breathing speeds and slows, and her limbs go blue, then return to pink when I stimulate her. With each episode of slowed breathing, the blue cyanosis spreads further, until it rings her mouth. I tap her feet and bounce her gently, and her breathing and color improve. I look up to see that the village Chief has entered the room. Generally we are respectful with the Chief, but this time I order him loudly: "I need a motorbike to the hospital for this baby immediately".
Ten minutes later a driver, baby, mom (still recovering from birth), and I are stacked four deep on a bike, headed down the steep, slippery hill to town. We jolt over ruts and splash through puddles. Mom leans back to make room for baby, and I commence an hour-long situp, tensed abs holding me and her up as I cling to the bar behind the seat to keep us from falling off backwards. I can't imagine how hard this ride must be, physically and emotionally, for mom. She holds the infant and I monitor baby's breathing, vigorously tapping her feet each time the cyanosis creeps back. I'm afraid to try using a bag-valve mask to breathe for her during this bouncy ride. It's easy to over-inflate a newborn's lungs, even under good conditions. My plan is to promote awakeness and breathing through tactile stimulation, and to give her mouth-to-mouth if she goes into complete respiratory failure. That way I can fill my cheeks with air and control the air volume she gets on this bouncing bike.
We settle into the long, familiar ride. The roads are very bad. Riding like this is probably the most dangerous thing we do here, so it's nice to focus on something else. I figure I'll fare better in a crash if my body is relaxed, not tensed. I alternate between watching the infant's breathing, tap-tapping her feet, and looking at the greenery passing by. I wonder what is happening in Ukraine right now. My favorite song, "Whistled By", is playing on repeat in my head. I imagine the patient is a trauma patient, the rig a beat-up, ad-hoc ambulance, and the roads the morass of the 'Rasputitsya' mud season.
The news has been featuring stories of kidnapped Ukrainian children being spirited off to Russia. I find these stories particularly ironic, given that there was no shortage of unwanted street children in Russia during my exchange program time there. Shouldn't Russia see to them, before stealing extra children from Ukraine? I recall living in Vladivostok, and helping serve daily soup and bread to street kids after my Russian classes were over. I worked with several dedicated, kind-hearted Russian volunteers. I got to know a couple dozen of the kids pretty well. Some of the teenagers were my peers. They had their own peculiar street ergot, so I didn't always understand all of the stories they told me about their lives. But I understood enough to know that these kids didn't have the luxury of justice, or of choosing right over wrong. For them, the strong devoured the weak, and that was it.
A few denizens of Vladivostok must have seen me often enough with the street kids to think I was one of them. One day, enroute to class, and being a day-dreaming teenager, I stopped to admire a sailboat at anchor in Golden Horn Bay. I stepped a short distance off the sidewalk to do it, into a used car yard, and for a better view I used a toe placed in the chain link fence to boost myself up a couple feet. As I gazed at the bay, I imagined exploring the world on that boat.
Then I heard a little click. I looked to my left. I took in many things quickly. A hundred meters away was a trailer. On its porch stood a large man in soiled work clothing. His shoulder held open a storm door, and he was rising up, having apparently just clipped something to a bolted chain on the deck.
What he clipped was a lead, attached to an enormous black rottweiler-mix dog.
The dog was silently, teeth bared, making for me, at top speed. His sprint was low, fast, filled with rage and deadly intent, and a chain bounced along the ground behind him. He had already covered half the distance to me. I had a split-second debate: try to climb the fence and hop over, or try to retreat beyond the reach of the dog's chain, before he reached me?
Seeing as time was not on my side, I went for the option that involved the aid of gravity. I pushed hard off the fence, leapt back and sideways several steps, and then the dog was closing on me. His teeth flashed towards my leg, and I jerked it away and rolled backwards over my right shoulder. Arms over my face I rolled several more times, backwards and away from him along the line of his chain. I rose and ran backwards several more steps, but as I looked at him, I saw he had reached the end of his chain. He jerked at it, snarling, spittle flying. As I rolled, he had seized my left pant leg and torn the lower half clean off. Miraculously, the skin of my calf had suffered nothing more than an abrasion.
I looked up at the man. He stood, arms crossed, watching. The dog was very big and I was fairly certain it would have torn my throat out if able. I was also fairly certain the man had seen me, quietly opened the door, and let his dog loose on me. I was worried about the dog's lunging pulling out the bolt that restrained him, but I was far more worried about the man's intentions. He was large, and very possibly armed. I strutted away nonchalantly, showing no fear. But as soon as I was out of view, I ran as fast as I could for friends and safety. 'Well', I reflected, 'there's an accidental taste of life as a Russian street kid for me.'
Over my years of travel, I have developed a habit of rating a culture by how it treats its street kids and stray animals. I've been to places where the stray cats come up and bump your legs, and roll over to show their bellies for caresses. But not in Russia- it has some of the wariest street kids and strays I've encountered anywhere. I've never been to a place with so many mutilated animals wandering the streets- tail-less cats, nose-less dogs. What will this country do to an enemy in a war? The Katyn massacre, mistreatment of civilians and POWs... that behavior from our ally all got white-washed during WWII. Now we have cellphone cameras, satellite imagery, and social media. What will we see from this post-tech-revolution European war?
I relax on the back of the motorbike, comfortably filled with deep thoughts that don't involve the possibility of crashing. The baby girl keeps breathing, and we transfer care to the Neonatal ICU in town. After two weeks of hospitalization for sepsis and acute liver failure, she is discharged with an excellent long-term prognosis. It's been a good day.
Prelude to Medic Work in Ukraine, part 2
Rule #3: "Do Not Kill or Torture Prisoners"
- From the United States Marine Corps Common Skills Handbook, Core Principles of the Law of War
Late January 2022
Things are mostly packed and ready for the yearly journey to Africa. More and more frequently, my daily work occurs with "Comprehensible Russian" podcasts and Ukrainian news playing in the background.
Included in these is Bellingcat's investigative series on Flight MH17. This Malaysian Airlines flight was shot down by a Buk surface-to-air missile in 2014, as it passed over a then-freshly-ignited conflict area in East Ukraine. 298 civilian passengers died in the crash. An international Joint Investigation Team found that the missile originated from the Russian Kursk-based 53rd Anti-Aircraft Brigade, and it was fired from Ukrainian territory held by Russian-backed rebels. Three Russians and one Ukrainian national have since been given life sentences by Dutch courts, and Holland is in the process of taking Russia to the European Court of Human Rights for its role in the downing of MH17.
My old favorite Russian songs of my teens have been resurrected as workout tunes. Later, when the war starts, I'll come to be surprised at how many of my favorite bands make risky anti-war statements. And what about the Russian friends I danced with? Will they protest the war? This will remain a persistant mystery. Even back in 2021, my letters to Russian acquaintances had begun to go unanswered. I'm probably just writing to the FSB now.
A favorite of mine, "Prosvistela" ("Whistled by") comes on. I realize I've never paid enough attention to the lyrics to understand them. I listen now, and pick out a confusion of something falling on the table, a hug, heaven, being prisoners of the motherland. It doesn't really make sense, so I finally google the meaning. It turns out my favorite song was written by Yuri Shevchuk, after a visit to soldiers fighting in Chechnya. Scarred by the horrors he saw, Shevchuk penned an unsubtle composition about a grenade falling into an armored personnel carrier. Everyone inside is killed, but in heaven they reunite with friends, find freedom and happiness, and reflect on the meaninglessness of the war. I'm shocked that this song, which blended seamlessly with the teeny pop discoteca sounds of my youth, had such a deep and dark meaning. You can listen to it here, and a translation of the full lyrics is below: Prosvistela/ "Whistled By", DDT https://www.youtube.com/watch?v=inG69xYWROw
The music draws me back into memories of Russia. I'm 16 again, and it's my first week in southern Russia. My host family doesn't speak a word of English, which is tremendously exciting for me. I've chosen to learn Russian, because I believe one day Russia will cause trouble, and I'll want to know Russian very well. Complete immersion is the best way to learn. I'm constantly thumbing through the heavy Russian-English dictionary I carry everywhere in my backback (no Google Translate or Kindle app in 1998!). Communicating anything- "I'm hungry", "Good morning", "Where is the bathroom?" requires a consult with the book. Unfortunately I had an orange juice explode in my bag on the plane, and the dictionary remains decorated with tiny black mold stains for the year-long duration of my visit. Every morning I select 50 new words and write them down three times, which lets me commit them permanently to memory.During my first few days in-country, southern Russia sees an oppressive August heat wave. My host family retreats to the beach, and I promptly become very ill with food poisoning. My host mother sees me through with a treatment of two shots of heavily salted vodka, followed by bed rest.
By the time my second week in Russia rolls around, it is time to return to school. I'll be accompanying my host sister to the equivalent of a K-12 public school. At 14, she is two years younger, and immensely more worldly than I. "Irina" (name changed for her safety) has it all planned out: on her 15th birthday, she'll try Ecstasy; on the 16th, she'll lose her virginity. At the end of her 16th year, she'll enroll in college, preparatory to Law School. I'm placed in Irina's grade, and she helps me understand the lessons, which are of course all in Russian.
The heat wave, if anything, has grown more intense on our first day back at school. The class swelters, as the teacher conducts what I come to realize is a surprisingly in-depth review of World War II history. My host sister knows far more than the average American college student about 20th century European wars. I half-follow vaguely familiar battle names and dates, thumbing through my trusty, moldy dictionary.
Before math class, I join my host sister and her friends outside, politely declining their proffered cigarettes. Sweating and swatting at flies, we seek refuge under the shade of a tree, but don't stay too long. They must not have taken out the trash since spring; the air stinks of rotting meat.
We return to class, math this time. Suddenly, a woman comes in and draws the teacher from the room. A growing wave of whispering begins: "Samo-ubitso!" I feverishly flip the pages of my moldy dictionary, seeking this new term which has caused such a stir.
It means "suicide".
In the next two hours, I will be introduced to the real Russia, and the reality that, in most of the world, the strong devour the weak. In the next week, at 16 years old, I'll build two key emotional foundations. One is for dealing with Americans who turn a willful blind eye to the evils of the world (as with many future ugly international realities, my American compatriots cope with the alien violence and ugliness of this first day of Russian school, by simply refusing to believe in it). The second foundation is for recognizing and navigating the special mix of 'anything-is-possible and nothing-is-real', which underpins every tug of the marionnette strings, by which the Russian government controls the Russian population.
Our math teacher comes back inside, and acknowledges that there's no chance of us paying attention to the lesson. He releases us, and we join the entire student body outdoors. Kids from age five up through sixteen form a ring around the shade tree, where we had smoked earlier. The body hanging in the tree was discovered shortly after we left. The next group of smoking girls looked up, after it dripped on one of them. It had probably been hanging, twenty feet up in the large oak, for the entirety of the hot weekend.
I saw my first body at age 14, when I discovered my mother had passed away from a mixture of cancer-induced hypercalcemia and pain medications. That was a peaceful and expected relief from pain, and I closed her eyes with more relief for her than grief.
This second body was much messier. The breeze spun him on the rope around his neck. At each of his slow rotations, his face was visible above us. It was plum-purple and bloated, and an impossibly swollen tongue stuck obscenely from his mouth. The military showed up with a pickup, and made a great show of obtaining his passport and reading his name out loud, then showing the passport around to the group of students. One of the soldiers then told the circle of assembled students to back up. He jabbed me in the abdomen with his AK when I was slow to respond. My host sister came to my rescue, saying I was "an Amerikanka, I didn't understand". I really wished she hadn't done more to make me stand out; even at sixteen I instinctively understood that what what happening here was outside the bounds of Rule of Law. Anything could happen. Overtly being an American here wasn't the best idea.
The soldier who had climbed the tree to get the dead man's passport proceeded to tie a rope around the waist of the corpse. The crowd of students parted to allow a pickup truck to drive in. One arm covering his nose, the soldier in the tree reached out and sawed though the rope around the corpse's neck. The circle of students, small and large, stood immobile, barely glancing at the soldiers' AKs. They gazed upward, rapt, wordless. Neck-rope severed, the dead man described a slow-motion arc backwards. His torso came to an abrupt stop at its perigee, impossibly purple face now upside down, and oriented our way. An unexpected amount of what looked like black, clotted blood gushed out of his mouth and into the pickup bed below. I felt fortunate that my parents had enrolled me in many dissection and veterinary classes in grade school. Today's scene was no way to introduce oneself to the ugly side of mammalian biology.
The soldier in the tree undid a hitch, and slowly lowered the body, now essentially hanging upside-down, into the truck. With no further formalities, the soldiers left the scene and classes resumed. Being sixteen, abroad, and not having experienced the aftermath of a grisly suicide at school before, I accepted this as the normal process here. I told my dad about it next time we talked, and otherwise went on with life, and my observations of this very-different-from-American culture. It felt odd to compare the complete lack of response from the Russian school system, to what would have happened at home in America. A scene like that on the grounds of a US school? The school would have been closed for a week, and mandatory counseling given to all students! But, this was Russia. Counseling? Compared to watching the body of one's mother slowly destroyed by cancer, this really wasn't a big deal. As long as you're lucky, healthy formative-years coping mechanisms get built, and life goes on.
Only in retrospect, listening to Bellingcat and Prosvistela, did I begin to appreciate some of the political undercurrents of that day. Even in Russia, where life can be cheap, the man in the tree, so long ago, was probably not just a suicide. The army had taken far too much care- to make sure all the students watched, and to make the name on his passport known. The man in the tree must have been someone... a political dissident, a rebel, an enemy of the mafia. He must have been someone worth making an example of. My dad, of course, believed every word of the story. The convenient denial of the other Americans- the other Exchange Program students and managers- was the first of many, many times that I would cope with this failing of my own culture. Outgoing President Obama would sum it up well in a 2015 speech: "If the American public cannot, or will not, differentiate fact from fiction, than we are in deep trouble".
Well, I'm just one member of that public. But, at sixteen, I surely appreciated my first lesson on what the breakdown of rule of law does to a society. My eyes and mind were wide open. I had expected that Russia would be challenging, romantic, sweet, and world-changing for me. It was all that. It was also ugly, corrupt, and violent.
So, twenty years later, when it came- Russia's wholesale violation of the Law of War in Ukraine, violation of "Do not kill or torture prisoners"? It was absolutely no surprise. Not after what I saw during my year in Russia.
Learning the nature and structure of Russia's ugly parts, and how to recognize their equivalents in other societies (including my own) was the greatest lesson of my time in the Russian exchange program.
Prelude to Medic Work in Ukraine, part 1
Rule #4: "Collect and Care for the Wounded, whether Friend or Foe"
- From the United States Marine Corps Common Skills Handbook, Core Principles of the Law of War
Early January, 2022
Grey clouds threaten to deliver a rare winter snow to my Western US mountain home. I hasten to relieve the springs of my old prius from their burden of medical supply boxes- freshly donated by a local nonprofit partner. The collection of just-expired dressings, sutures, syringes, and IV sets are sure to save a few lives in West Africa over the coming year.
One by one, I lug the boxes in, adding them to the growing stack in the corner of my living room. Mission accomplished, I sprawl onto the couch to endulge my news-junkie compulsions. It's early January 2022. The US legal system continues to weigh in on vaccine mandates, and our societal pandemic response settles ever more firmly into dysfunction, setting the stage for future airborne disasters. But that's no surprise; the same thing happened after the Spanish Flu. As far as mainstream media goes, Trump has been tucked gratifyingly out of sight, as social media platforms and news outlets explore ways to navigate tech-revolution misinformation. Income-inequality fuels populism, while changing population dynamics fuel political extremism. All of these things together are making it feel a little bit like the 1920's and 30's. I turn on some Louis Armstrong and imagine I'm living in Huey Long's Louisiana.
Putin continues to insist that his military buildup along the borders of Ukraine is a mere exercise. Everyone else continues to do the convenient thing, which is to take him at his word. I listen to NY Times interviews, where dismissive Ukrainians refuse to be cowed by these latest Russian antics. Their way of replacing hard 'Gs" with soft "H"s reminds me of the southern Russian accent I acquired, living near Sochi as a teenage exchange student. My time there was punctuated by the "Chechen" apartment bombings. Rumor has it, these were actually an FSB plot, orchestrated by then-Prime Minister Putin, in a bid to rally ordinary Russians to his cause. Russian officials who raised the issue of a possible FSB plot? They developed a habit of dying under suspicious circumstances, and nothing was ever proven. The ensuing Chechen war cemented Putin's popularity, and made the new Chechen leadership into his puppets. Through lies, support of opposing fringe movements, and engineered political theater, Putin progressively undermined Russian society's ability (and will) to tell truth from fiction. Russia is the world's leader in government-by-disinformation. Since the 2016 debut of the Trump campaign, I have been hearing American echoes of Russian propaganda techniques every day.
Outside, the snow has started. Curled around a cup of Earl Grey, thousands of miles from European troubles, I mull over what the future may hold. I compare Putin's antics- his increasingly bold military meanderings, first into Georgia, then Crimea- with the expansionist European strongmen of the 1930s. I don't dismiss the military buildup around Ukraine. Not at all.
That night, in my dreams, I shelter from bombs in the basement of a Ukrainian hospital. A chimeral Russian army sweeps, inevitable as gravity, through my Ukrainian dreamscape. They are certainly nothing like the real Russian army will turn out to be, because they mostly follow the Law of War. They fight only enemy combatants; they don't target civilians. Under a stern-but-fair Russian occupation, my dream-self works as a doctor-POW in the hospital, treating Russian soldiers and Ukrainians injured and taken prisoner in the fighting. Through this work, I gather intel and supplies for the Ukrainian resistance. The isolated case of true villainy is a Russian officer who attempts a rape; the hero is a second Russian officer who covers for me after I confront the villain and shoot him in a struggle over his firearm. Physically, the hero quite resembles Liev Schieber's Defiance character, Zus Belski, and it's all very romantic. In the end, I convince the Russian officer to join the Ukrainian resistance, the Russians are forced out by a NATO contingent, and all ends well for the Ukrainians. It's a very vivid dream, and I wake in the morning with Ukraine stuck indelibly into my subconscious.
Monday, October 7, 2024
Ukrainian "Dragon Drone" destroys tank
Youtube video from the Sun shows Ukrainian "dragon drone" drop thermite on a Russian tank
Friday, September 27, 2024
Friday, September 13, 2024
Fall Mushroom Foray in the Wasatch Mountains!
Here it is again… fall mushroom season in Utah!
This foray was to the Wasatch Front in early September. Even
at 8,000’, it was pretty warm out, and I wondered if we would find
anything. Dry grasses and forbs
crunch-crunched underfoot in an un-promising manner.
Then my footsteps fell silent as I approached a small
stream. This moist micro-habitat, it turned out, was full of mushrooms! Great
find!
Here’s some Cortinarius mushrooms, members of a very large genus which is identifiable by weblike remnants of a cortina on their stems. The cortina is a delicate structure that covers the gills, coming away as the mushroom matures. In the third picture below, a bit of cortina can be seen, still connecting stipe to cap.
Fungi are just about the only organisms that can decompose
lignin, a key component of wood. If not for the vast amount of lignin-digesting
fungi that inhabit the woods, we would be awash in dead and down logs in
perpetuum. Chunky “brown rot”, below, is left behind by organisms that only
consume cellulose. “White rot” fungus consumes both lignin and cellulose,
leaving a pale residue.
Here is Lacterius deliciosa. The lacterius genus oozes white
“milk” from their gills when damaged. In this case, deliciosa is a misnomer-
this mushroom will make you sick.
Below is Sarcodon – the shingled hedgehog. An easy-to-recognize
edible mushroom with a unique musky, minty odor. Some like it and some don’t.
They are better young, becoming bitter when older. The hedgehog has teeth
instead of gills or a polypore structure.
Below is a picture of Cryptospore fungus on a tree trunk. Beetles crawl into the
fungal case to feed, and are covered in spores, which they carry to a new tree.
On the overhanging banks of the stream, hiding amongst
mosses, were charming little bright orange Scutellinia scutelata “eyelash
mushrooms”. Under a magnifying glass, these tiny orange cups are fringed by
eyelash-like hairs.
Porcini bolete- the Utah state mushroom is a large, choice
edible! It can be recognized by its polypore underside, reticulum on stem, and
“penny bun” cap. It is mycorrhizal, often found under younger spruce trees.
The bolete was followed by a couple of rare finds: elven saddles! Top photo is a white one, and the black one in the lower photos may be a new species.
Thursday, September 12, 2024
Thursday, September 5, 2024
Ukrainian Drone Drops Fire into Treeline
Check out this video, posted by Special Kherson Cat, of a Ukrainian drone dropping fire into a treeline:
Friday, August 2, 2024
Fringe Ecosystems: Ghost Grass and the Sonoran Desert
-Ser Jorah Mormont, quoting a Dothraki legend, Game of Thrones.
On a recent hike through the Sonoran desert, the warm air and fantastic shapes of the cactus around me made it easy to imagine I was diving on a tropical reef. At the same time, I had a strange feeling I was in Africa. Numerous acacia trees created classic Africa skyline sillouettes, and beneath them waved a sea of amber grass. The grass was fully cured, the air was 110 degrees, and monsoonal lightning storms were approaching. Minus the cactus, it looked just like West Africa during the harmattan/fire season.
But, unlike many Sahel ecosystems, the Sonoran Desert is not fire adapted. It seemed like this impossibly combustible cocktail should have done in the slow-growing saguaros and other cacti long ago. Some research proved the resemblance to Africa wasn't coincidental; African and Mediterranean fire-adapted grasses have invaded the Sonoran Desert, threatening ecological catastrophe.
The real-world equivalent of Game of Throne's Dothraki Ghost Grass consists of a sinister trio: Cheat Grass, Buffle Grass, and Red Brome. For Western Deserts, the 19th-century introduction of these old-world grasses was, arguably, the most ecologically consequential event since the last Glacial Period.
Adapted to Mediterranean and African conditions, inluding drought and wildfire, these grasses outcompete American species, such as sage and native bunchgrass. Cheatgrass, Red Brome, and Buffel grass create soil characteristics unfavorable for native desert plants. Drying out early into continous fuel bed, they carry wildfire across desert landscapes, where plant spacing used to prevent fire from spreading. Invasive grasses have spread throughout the West, from Texas to California, and the Dakotas to Arizona. Below, a field of invasive red brome fills in the spaces between saguaros.
The NPS publishes the guide, seen below, to identifying and eradicating Red Brome. The eradication options (hand-pulling bunches of grass, or five years of annual herbicide application) may work for individual homeowners. Unfortunately, the idea of implementing these on a large-enough scale to protect the vast stretches of Sonoran Desert which have been invaded by Red Brome is laughable.Ukraine: Jogging in Circles and Red Viburnum Tea
Here is a youtube link to a 2022 version performed by Pink Floyd Chervona Kalina, with Pink Floyd
Chervona Kalina, lyrics:
In the meadow, a red kalyna
In the meadow, there a red kalyna, has bent down low ,
For some reason, our glorious Ukraine, has been worried so.
And we'll take that red kalyna and we will raise it up,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
And we'll take that red kalyna and we will raise it up,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
Do not bend low, Oh red kalyna, You have a white flower.
Do not worry, glorious Ukraine, You have a free people.
And we'll take that red kalyna and will raise it up,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
And we'll take that red kalyna and will raise it up,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
Marching forward, our fellow volunteers, into a bloody fray,
For to free, our brother - Ukrainians, from hostile chains.
And we, our brother - Ukrainians, we will then liberate,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
And we, our brother - Ukrainians, we will then liberate,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
In the field, of early spring wheat, there's a golden furrow,
Then began, the Ukrainian riflemen to, engage the enemy,
And we'll take, that precious, early wheat and will gather it,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
And we'll take, that precious, early wheat and will gather it,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
When the stormy winds blow forth from the wide steppes,
They will glorify, through out Ukraine, the Sich riflemen.
And we'll take the glory of the riflemen preserving it,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
And we'll take the glory of the riflemen preserving it,
And we, our glorious Ukraine, shall, hey - hey, cheer up - and rejoice!
Thursday, August 1, 2024
Ukraine: How Long can a Tourniquet be left in place before the limb must be amputated?
Prospects for limb salvage after tourniquet placement has become a crucial matter for thousands of soldiers and their surgeons in the Ukraine war. Near-peer fighting conditions and lack of air superiority can create extended evacuation times for casualties. Drone threats to moving vehicles have become so pervasive that, in many areas, the last few miles up to the zero line area only traversable on foot. Beyond this zone, mud, bombing damage, UXOs, and the impossibility of road maintenance make vehicle evacuation slow and bumpy. Patients must often wait for nightfall to evacuate, and dawn-dusk day length at the height of summer on the Eastern Front is 17 hours. Today, almost two years into the war, high attrition rates amongst experienced frontline medics means loss of TCCC tourniquet conversion knowledge along the frontline.
For medics and doctors in forward casualty collection and stabilization points, who are receiving tourniqueted patients after prolonged evacuations from a near-peer conflict area, assessing patient candidacy for tourniquet conversion (i.e. removal and replacement with a simple pressure dressing) or movement of tourniquet to a more distal location is a critical outcome-changing skill. Just as important as assessing limb salvageability is 1) readiness to manage acute complications such as acidosis and dysrhythmias, and 2) ensuring that timely transfer to higher-level care is available for potential medium-term complications, such as compartment syndrome and acute renal failure.
Current TCCC guidance assumes that limb salvage becomes highly unlikely 6 hours or more after tourniquet placement. However, this guidance is unavoidably based on the extremely limited data pool available to date. Limb salvage after tourniquet placement is a young and weak science, which stands to benefit greatly from case reporting and retrospective studies originating from the Ukrainian conflict. If we look only at the small pool of my personal experience as a paramedic in Ukraine, several case examples of physician-directed conversions of tourniquets in place for over 6 hours have been performed, or given post-conversion management, by either myself or my immediate colleagues. Clearly, amputating every limb that has been touniqueted for more than 6 hours would result in unnecessary negative life impacts for patients.
Current tourniquet science is based on animal studies done in controlled environments, and a very small number of human case reports. Tourniquets are widely used in routine surgeries, but tourniquet use in traumatic wartime injuries is a completely different animal. The reality of warfare adds in a number of important and unforeseen variables, which defy efforts to cleanly categorize patients as <6 hours vs >6 hours:
1) initial tourniquet placement is likely to occur under extreme conditions. Often, the soldier placing the tourniquet has minimal medical training, may be physically and/or mentally exhausted (many Ukrainian soldiers have been deployed for nearly 2 years with little or no leave). He or she may be receiving fire and/or returning fire, and may be working in conditions of darkness, loud noise, and confusion. The soldier placing the tourniquet may have reduced fine motor control due to cold, exhaustion, or adrenaline, or may be injured themselves. Weather and fighting conditions may have led to heat exhaustion, dehydration, nutritional deficits, soaked clothing, icy gear, numb fingers, or cold injuries of feet and hands, and rapid assessment and tourniquet placement and/or other bleeding control measures may have to be performed over/through multiple layers of clothing and body armor. Tourniquet availability on the frontlines is limited and likely to consist of a mish-mash of tourniquet brands and styles. These factors often conspire to create "partial-tourniqueted" patients. Tourniquets may be tightened enough to slow, but not fully stop, bleeding and limb perfusion. Venous and capillary return may be cut off, without halting arterial inflow.
2) Due to frontline conditions, time of original placement of tourniquets is frequently estimated, or missing altogether.
3) Environmental conditions and threats during evacuation may necessitate rapid movement and rough handling of the patient, which may lead to tourniquet loosening or temporary dislodgement. Poorly made or re-used tourniquets may stretch over time or fail, lead to placement of multiple tourniquets, and intermittent periods of reperfusion or partial reperfusion.
4) Intentional attempts at tourniquet conversion may be made in the field. Due to fighting conditions, these field attempts may or may not be accurately recorded in the documentation that reaches field hospitals. Patient evacuation routes shift frequently, and patients may pass through multiple patient care teams, comprised of a cast of medical providers that shifts daily.
5) The tourniqueted limb may be subjected to a variety of physiological and environmental conditions, including varying levels of external cooling, varying states of patient blood loss and shock, and varying levels of resuscitative care received.
Due to these variables, Ukrainian doctors cannot rely on hard-and-fast rules such as the 6-hour tourniquet rule. Many tourniquets were placed with good intent, but were never necessary in the first place. Doctors are often forced to decide, based on clinical observations and professional experience, whether tourniquet removal is in the patient's best interest. Does the probability of limb salvage outweigh potential systemic risks to patients? Objective numerical values from blood testing can inform these decisions, if lab services are available. But more often, the critical time for this decision occurs at minimally-equipped forward field treatment points, and thus it must be made based on time of injury, exposure to weather, limb skin color and temperature, injury patterns, and overall patient presentation.
Here is an interesting case report from Kragh et al, published in Orthopedic Trauma in 2007, which represents the realities of tourniquet placement in conflicts, as well as variability in limb salvage times. The patient, an American helicopter pilot in Afghanistan, was shot in the hand and received RPG shrapnel to one leg. Hemorrhage from the hand was stopped 1 hour after injury by a combination of one purpose-built and one improvised tourniquet. Bleeding recurred 6 hours after injury, and was stopped by tightening the tourniquet. The pilot lay in a snowdrift, with temperatures at -15C, for a half-day after injury. After that, he was insulated by blankets made from cut-out aircraft insulation. Evacuation was delayed due to an ongoing firefight, mountainous terrain, and inclement weather. The patient arrived at a forward surgical facility after 16 hours of continuous tourniquet placement. He had severe soft tissue loss, irreparable radial artery damage, and compartment syndrome. He underwent surgical debridement and irrigation, radial artery ligation, and 3 dorsal + 2 ventral hand fasciotomies, and the operating surgeon deemed hand preservation was questionable. Repeated surgical debridement and irrigation took place over the next month, first at Landstuhl, Germany, then at Walter Reed, before primary wound closure was accomplished. Several more surgeries and physical therapy followed, to correct pain and stiffness. By three years after injury, the patient had recovered sufficiently to use the hand for activities of daily living, and to return to piloting Chinook helicopters.