After a relatively quiet week or two, things have been picking up here, and it's sobering seeing our young soldiers arriving as casualties. These guys have my utmost respect, living and working out among the Iraqi population, most of whom are glad to have them around, but some of whom would like nothing more than to kill as many as possible. The problem is, it's not apparent which is which. And so when they arrive at our hospital, injured or on death's door, every one of us here will bust it to do everything we can to save their life or limb. That is the tribute that I can pay to their bravery.

Last night battalion commander Colonel M came around the ward with his Sergeant Major, visiting their injured troops and awarding them the Purple Heart right there in their hospital beds. Some of them, with swollen faces, splinted extremities, and morphine pumps, had little reaction except to nod. I'm proud of those guys, of the grit it takes to do what they do.

I've been busy lately, and although that usually means the misery of someone else, it's a good thing to not be idle. A distal pancreatectomy in a child run over by a car, a repair of stomach, liver, diaphragm, and lung in another Iraqi patient who was shot, and a laparoscopic gallbladder surgery in one of our contractors have kept my hands busy. While it's gratifying to reconstruct an artery in a soldier's arm (thanks to our rocking vascular surgeon T's awesome assistance!), we certainly get to spend more time caring for our national patients who don't have the chance to get airlifted out of country. We form bonds with the people we take care of here, many of them children, who are often the unfortunate "collateral damage" of war, to use a sanitized expression.

I remember watching the ABC Nightly News one night as a boy and hearing about a man shot in the gut with an unexploded tank round in a place called "Iraq", which was at war with "Iran". These places seemed impossibly far away to me then, but we heard about them every night. After hearing the story of this unfortunate man, my dad said to our family, "War is a terrible, terrible thing." I don't know why I remember that, but it's true. Even when there is some justification for it, "good reasons" to engage in it, there is still an overwhelming burden of sorrow and misery that flows from war, and I get to see it every day firsthand.

It's strange to think how my interests have changed. Before, I couldn't have told you where Dijail, Baqoubah, and Muqdadiyah were, or which was more tumultous: Anbar or Diyala, or where EFPs (explosively formed penetrators) came from, but now those are part of my world. The New England Patriots' Superbowl loss and John McCain's wins really have much less daily significance to me than the latest news of Muqtada al Sadr. Fortunately, the Stars and Stripes keeps me updated on both.

This just in: Emergency Room Dr. A has hatched a plan to host the first annual Balad Rodeo this spring, complete with steer-roping (albeit a plastic motionless steer), bull-riding (on a barrel), and other knee-slappin' events...more on that when and if it happens!