I Know More About Planes

As an Air Force officer, I feel it is my duty to actually know something about planes.  Unfortunately, before this summer, all I knew about planes was that I flew in large ones frequently to get to various destinations.  Basically, I knew nothing.  Now, I'm not saying I actually know all about planes now, but I'm gradually increasing my knowledge.  We had lectures specifically on the B-2 and U-2 operations last Friday, and we've been learning at least the names and relative sizes and operations of different systems along the way as well.  Great.  Well, today I was able to put some of my newfound knowledge to work out at Randolph AFB as we spent much of the day near a runway.

Nice, long runway.  Lots of fuel trucks.

Our main activity of the day was to learn about the firefighting operations at the base.  As flight surgeons, we will work closely with the fire department to help in medical or other emergencies, so it makes sense to learn how a base fire department works, what kinds of operations they have, what their typical day is like, etc.  We all felt like little kids looking at the shiny fire trucks and various types of equipment out in the hot Texas sun.  To make things even more interesting (and warm), some of us got to try on the firefighting gear.

Like me!

I give those guys credit.  They have a TOUGH job.  Not only are they constantly on call for whatever type of emergencies crop up at an Air Force base, but they also have to keep in good shape just to be able to work in all of that gear!  I was drenched in sweat by the time I took the equipment off.

It's not easy dragging a 165-pound dummy while wearing a 60-pound suit.

While we were there, we were treated to the magnificent sight of three F-15E's that landed (briefly) on our runway in the midst of some sort of training or mission out of their base in Missouri.  We were all giddily scrambling to take pictures of the jets.  The pilots must have thought we looked ridiculous, but they waved at us from their perch in those beautiful aircraft.  Then, a few minutes later, they took off again.  I have never heard a louder sound in my life; the entire earth was shaking.

Sleek

Finally, we ended our day with a visit to the air traffic control tower.  It was a treat to see an overhead view of the entire base as well as the runway.  We were even able to watch two T-38's take off simultaneously, as well as a T-1 landing and a solo T-38 a bit later.  Amazing day.  Can't wait for tomorrow...

We'll see you again soon.

25,000 Feet

Well, today was the first of several things I've been looking forward to: we "flew" in the altitude chambers in the Aerospace Physiology facility.  That may not sound all that exciting to someone who's never done it or even thought about it, but let me assure you that it is a big deal.  After a short briefing, we were fitted for helmets and oxygen masks.  I have to say that the mask-fitting and some of the later pressure-breathing were probably the closest I've ever felt to being claustrophobic; I definitely take the ease of breathing at ground level, unimpeded by any sort of hardware, for granted.  (Understandably.)  As soon as we were fitted, we entered the chamber, plugged all the hoses and cables in, and awaited further instruction.

The first task was to "ascend" to 5,600 feet for an ear-and-sinus check.  Basically, the chamber's conditions mimic the conditions at these different altitudes.  As the air thins out, there's a lot less total pressure as well as partial pressure of oxygen.  The ascension from ground level to 5,600 feet took care of a bulk of the reduction in pressure, so if we had no problem clearing our ear canals to equalize to the new pressure at that altitude, then we were fine to ascend higher.  We didn't ascend any higher yet, though.  We actually descended back to ground level for 30 minutes of de-nitrogenation; we cinched our masks so they were completely sealed (actually a little painful, to be honest) and breathed 100% oxygen to prevent later decompression sickness as much as possible.  Then it was time to go up.

I had no problem getting my ears and sinuses to equalize as we rose to 25,000 feet -- and then it was time for some fun.  On cue, we removed our masks and began breathing the extremely thin air at an altitude whose Time of Useful Consciousness is rated at 3-5 minutes for the average person.  The goal of the exercise was so that we could all experience the first few symptoms of hypoxia and then put our masks back on unaided.  The point is that, if we were in an airplane undergoing gradual decompression, we would hopefully be able to recognize that we were becoming hypoxic and be able to take emergency, corrective measures before we got to the point of passing out.  (This would certainly be useful if you were, for example, a doctor in the back of a transport plane taking care of patients.  If the doctor becomes hypoxic and passes out, then the patients wouldn't even have a chance.)  My best way of describing the symptoms of hypoxia would be to compare it to the effects of drinking alcohol, but slightly different.  I was sad that I didn't feel any tingling or numbness (two of the common effects), but I did feel lightheaded, a bit slow-thinking, and cotton-mouthed.  When I was asked to count backward from 100 by 3's, I failed somewhere in the 70's and decided that those 6 minutes or so were enough; I had successfully experienced my first symptoms of hypoxia.

Once we had all "cleared the cobwebs" by breathing the 100% oxygen again, we descended to 18,000 feet, where we did our next exercise, which had to do with night vision.  The Time of Useful Consciousness at this level is 20-30 minutes, but this was a good level to demonstrate just how important oxygen is for night vision. As our eyes adjusted to the dark, we could gradually make out different colors on our individual color wheels.  At the same time, the gradual oxygen deprivation caused our brains to suck away oxygen from the nearest source: the rod cells in the eyes, which are the ones responsible for low-light vision.  A few minutes later we were instructed to hold our masks back up while still paying attention to the color charts in front of us.  Three deep breaths later, the reds and oranges suddenly popped out, and everything acquired a fleeting reddish glow.  I had experienced the "red flash" that often accompanies a rapid return of oxygen perfusion.

After a few different exercises in which we felt what it was like to breathe under high pressure (not so pleasant), we came back to ground level.  Our final exercise was one of rapid decompression.  We learned how to use the quick-don masks, and then, without warning, we decompressed from 1,000 feet to 11,000 feet in a split-second.  The water vapor in the air turned to mist, the temperature immediately plummeted, and we rushed to grab our oxygen.  It was great!

Now all of us are on the lookout for signs of decompression sickness.  I haven't felt any joint pain or noticed any rashes yet, so hopefully I'm in the clear.  Throughout the day I've been popping my ears a bit more than usual; apparently the 100% oxygen that we used to perfuse all of our tissues has to somehow leak back out again, and it commonly comes through the ears.  We have all been warned not to panic if we wake up at 2 a.m. with a huge pain in our ears requiring a loud, painful POP!  It's just the oxygen.

Chute!

Today, we headed over to the Aerospace Physiology building for some more classes and excitement.

This place.

It certainly was an exciting day.  In our night vision lecture, we all felt what it was like to be functionally blinded in one eye.

At that point, the preparation the goggles that they gave us didn't even matter.

We went to Subway and felt really cool.

Not everyone can look this awesome while eating sandwiches.

But the best part of the day was the parachute simulation lab.  We all had the chance to strap on the parachute gear, hang by the harness, put on the helmet with the specialized computer-simulation visor, and attempt to hit our landing spot.

Some didn't do so well...

...but that doesn't mean it wasn't fun!

Finally, at the end of the day, Col Brandt instituted a lottery for a very exciting upcoming event.

I may be horrible at keeping secrets, but you'll just have to wait until next week to find out about this one.  Mom, no telling!

Doggone It, No Kiddin'!

Fun fact of the day: Rapid decompression can cause your teeth to explode.  No kiddin'.

Fast plane

Today we spent the entire day with Lt White, an aerospace physiologist who is the self-proclaimed "oldest first lieutenant in the Air Force."  (He really wasn't that old, but certainly older than the typical first lieutenant.)  He taught us all about the changes the body goes through and the adaptations it must make to the unique stresses of altitude, especially rapid changes in altitude.  We learned about the 4 different kinds of hypoxia (hypoxic, hypemic, stagnant, and histotoxic), decompression sickness and its manifestations, and, among many other things, the unique difficulties associated with trapped gas inside the body (e.g. in the Eustacian tubes, the bowels, and, yes, teeth).  In medical school, I typically feel as though I'm just going to class because I have to, out of obligation.  Today, I was sad when class ended after 8 hours.  I want to be here; I want to learn as much as I possibly can about flight medicine.  This is the first time since being accepted to medical school that I have felt this amped-up about anything career-related. There's no doubt in my mind: I want to be a flight surgeon.  I'm not going to give away any surprises, but I am so incredibly excited for the next 2 days -- well, really, the rest of the 2 weeks.  Ahh!

Camo plane

After classes were over, a few of us drove over to Lackland AFB to get some uniform shopping done but also just to check out the base.  It's like a city in there; it's huge!  We stumbled upon a parade field surrounded by models of historic planes, so for your viewing pleasure, I have included a few.

Big plane

Fat plane

Stealthy plane

Michelle-sized plane

Crush the Earth

The colonel ambled slowly to his seat at the front of the room and sat down heavily.  "Whooooo," he sighed in a mysterious, slow exhalation.  He peered out at the 25 of us.  "What a terrifying conglomeration of lieutenants...the force of which would surely crush the earth."  Well, he was partially right.  We were, after all, mostly lieutenants.  Most of us have only one year of medical school under our belt.  As far as the Air Force goes, we may be officers, but we're still pretty low on the totem pole, especially once you consider that most of us have only had our 5 weeks at COT as military experience.  Still, we could already tell that this would be much different from COT. Four colonels later (all within one morning of classes), we knew that this was much different from COT, my first definitive proof that Capt Raley really wasn't lying when she promised that the operational Air Force would be nothing like that first month of training.  Also within one morning of class, I had made up my mind: I want to be a flight surgeon.  If all that they told us this morning is true (which, I suppose, I will be able to find out in the next 2 weeks), then I can't see anything about aerospace medicine that isn't completely exciting, entirely satisfying, and totally what I want to do.  I won't give away any of the upcoming training, but suffice it to say that the 2 weeks will not be enough for me.  It is just a taste, and it will taunt me until I can complete the final 4 weeks in my fourth year of medical school.

In the meantime, my observations of Brooks: This is a strange, strange base.  It used to be called Brooks Air Force Base, but it is now being slowly taken over by the city of San Antonio (as the Air Force slowly moves out); it is now called Brooks City-Base.  Soon it will no longer exist.  Apparently it used to be a thriving base, the headquarters of USAFSAM (pronounced, as I've found out, as you-saff-sam -- the United States Air Force School of Aerospace Medicine).  The golf course, according to one of the colonels, used to have the highest concentration of generals in the entire United States.  Now the golf course is overgrown.  The base is nearly empty.  All of the bases in San Antonio are gradually combining into one super-base.  USAFSAM will soon relocate to Wright-Patterson AFB in Ohio, so we are one of the last classes to experience it here at Brooks.  Personally, I'm happy.  I'd rather be in Texas than Ohio.  However, when I go back to complete AMP 201 and 202 in my fourth year, I concede that it will be better to be on a larger base, especially given that those combined will be a month long.

Living on an empty base has its challenges.  Unlike COT, we do not eat at a dining hall.  We are expected to provide our own meals.  Luckily, the base is small, and there are several restaurants and stores just outside of the gates.  A few of us went to H-E-B this evening to buy breakfast and lunch-making materials after having to (quickly) scrounge for lunch during our 20-minute break today.  (This is not normal; today was just a tightly scheduled day because of all the administrative things we had to do -- picking up books, filling out forms, getting blood drawn, the usual).  This evening, I went for a run with one of my classmates.  We quickly came to the edge of the base and simply turned around again.  It's not a big base.  Tomorrow, some of us are planning to make a trip to Lackland AFB (our neighbor base, the one where all the new AF recruits go for boot camp) primarily to go to AAFES.  Don't ask me what the acronym means.  It's where we buy uniforms. I'm hoping to pick up some princess-cut blues shirts because a.) I would be happier not to have to tuck my shirts in, and b.) I want my blues -- you know, the uniform that's supposed to look really sharp -- to actually fit rather than be several sizes too big.  Let's just say that Maxwell had some supply issues last year.  Anyway, we're planning on leaving right after class without changing out of our uniforms.  Call us sadistic, but we're looking forward to seeing if any of the new recruits who may be wandering around are going to freak out seeing this "terrifying conglomeration of lieutenants" walking by.

And now, for my final thought, here is my rental car:

Bright red Chevy HHK, the ugliest car in the world

Who Goes to a Wedding...

...without taking any pictures?  Apparently I do.  I had the pleasure of participating in my cousin, Jessica's, wedding this past weekend in Alexandria, VA.  It was so beautiful!  Jess looked stunning, and clearly Will thought so too by the look on his face the entire service.  The two of them had a beautiful wedding and seemed incredibly happy.

As for me, I had a great time seeing family, many of whom I haven't seen in several years.  Also, I was able to meet many of Jess and Will's friends from the Academy, high school, etc.  Of course, there was much good food and drink throughout the weekend.

Travel?  Well, it was a bit tiring.  On Friday morning I needed to catch the 6:30 bus so that I could make my morning train to D.C.  Then on Saturday night, taking the train and then a cab, I didn't arrive back at my apartment until nearly 1:30 a.m.  Finishing up last-minute packing, I didn't get to bed until 2:30 a.m., only to get up four hours later for church and to catch a cab to the airport.  And now...Texas!  I have arrived in San Antonio, picked up the ugliest rental car in the world (pictures later), and driven to Brooks City-Base, where we will have 2 weeks of Aerospace Medicine Primary 101.  Even though I have very little idea what we will be learning or even what the schedule will be like, I can already say that I'm loving the perks of being an officer: each of us has our own suite -- living room, bathroom, bedroom.  With 2 TVs.  It's nicer than my apartment in the Bronx...I can live with this.

Home in Minnesota

As usual, I am short on time.  Here are some highlights (and pictures) of my 6 days at home this summer:

To make things easier yet slightly more travel-intensive than usual, I stayed the first few nights in St. Paul with Heidi and Kate.

Heidi, as usual, went out of her way to make me feel at home.

A large group of us went to see the Twins vs. Royals game on Thursday night.  On our way to Target Field, we ran into a Target Corporate employee.

We literally ran into him on the street.  It wasn't planned.

The new field was beautiful.  It seemed like a fitting home for our team.

It wasn't a bad night, either -- just a little bit of rain for 2 innings or so.

After a disappointing first half of the game, the Twins suddenly turned on the heat.  It looked as if they would pull an upset...but alas, the Royals held them off, winning the game 9-8.

It's okay.  We're still fans.

The rest of the week was filled with meeting friends all over the place.  India classmates for brunch in Minneapolis, high school friends in Rochester for coffee, drinks, dinners, you name it, and college friends for ice cream.  Despite it being rainy every day except the last, I thoroughly enjoyed just being at home.  Even running in my neighborhood felt more exciting than it should (although I suppose it's no stretch to understand that I might enjoy running in Rochester more than the Bronx).  Six days after arriving, I left again.  It was too short, but there was really no choice: tomorrow I leave for Jess's wedding, and then on Sunday I will fly to San Antonio for Air Force training.  Today, understandably, has been filled with packing and not much else.  Yes, it's busy, but the excitement is certainly worth it.

Just Because I Can

Of all places, I never thought I'd be able to post from 35,000 feet.  That's right, I'm on the plane right now.  We just passed over Sault Ste. Marie en route to New York, so there was a nice view of Lake Superior/Michigan which unexpectedly popped up through the rather unrelenting cloud cover.  Anyway, I'm sure this is boring, but it was a novelty so I had to do it.  Hopefully I'll post tomorrow about my all-too-short trip home to Minnesota once I get my pictures loaded.  Until then...smooth flying!

One More Day

That's all that is left of my first year of medical school, and my goodness, has it gone quickly!  Sure, Histology seems like it was forever ago, but the crazy thing is that we use our histological knowledge ever more frequently as we discuss pathologies of organs and systems.  All those "useless" slides and cells are not only relevant but are now also becoming useful and necessary as we learn to distinguish between diseases with once-foreign-sounding but now ever-too-familiar names like membrano-proliferative glomerulonephritis and focal segmental glomerulosclerosis.  Sure, Anatomy was, in many ways, a dark time in our lives that I'd be happy to never have to repeat, ever, but at the same time, the hours upon hours of lab time and studying and smelling like preservatives helped form some of the most unexpected but fruitful friendships with fellow classmates.  Yes, the year has flown by, but it's been incredibly rewarding.  Now, at the end, when I finally feel comfortable and at home, surrounded by all the friends that I've made throughout the year, I actually feel sad to be leaving for the summer.  It's comforting knowing that there's a reason to look forward to coming back for second year in the fall.

But what am I saying?  I'm getting ahead of myself.  We still have one more test: renal pathology, tomorrow morning.  As soon as that's over...FREEDOM!  But until then...DOOM!

Appreciation

Apparently, it's Fleet Week.  I don't actually know what that means, and since I'm too lazy to look it up on Wikipedia, all that I've noticed was that there were lots of little groups of men and women in uniform in Manhattan.  Obviously, a sight like this makes me proud and happy knowing that I am a part of the big family of the U.S. military, but I also wondered what the New Yorkers thought of it.  It's easy to brush off New Yorkers as being too busy and self-absorbed to care, because really, when do they ever stop and give you the time of day while speedily dodging past on the sidewalk?  I was surprised, then, when I was walking slightly behind a group of three young women in Navy uniforms, and a man walking past cheerily said, "Thank you, ladies!"  The women looked at each other and giggled, and I couldn't help smiling as well.

Out of the City

Something that I've always loved but have always taken for granted until this year is, simply, driving. We drive everywhere in the Midwest -- because we can, because we have to, because we enjoy it (well, some of us). In the big city, it is neither easy nor convenient to drive; public transportation is great, but sometimes I just want to hop in the car, blast some tunes, and sing to myself. I had the opportunity to do that recently when I drove to Burlington, Vermont, to visit Kristen. Once I crossed the Hudson, the remaining 5 hours of the drive were stunning: green mountains, fields, trees, country roads, Flogging Molly, and lots of caffeine are all it takes to make me happy, apparently.

The rest of the weekend was delightful. What exactly does one do in Burlington? All the things that I've been missing (and even some that I didn't know I was missing) this year in the city:

Hiking in the woods with friends...

Chatting by the lake in the warm sunshine...

Planting a garden...

And having an unexpected photo shoot at the hippie party on the beach...

...of beautiful Lake Champlain.