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On a positive note, after spending over 11 months here your friends and colleagues here become family.  So, although we could not spend the holidays with our families at home, at least we had the friendship and support of our CSH family.

Fortunately, from a work perspective, the day was relatively quiet.  A few ill patients and some minor injuries, no major casualties.

The NIGHT was a bit different.  I was sitting talking with one of the general surgeons when an American civilian walks in.  He works for one of the contractors out here.  He had a rather big laceration on his forehead that essentially ran the length of his right eyebrow.  The surgeon got up for a closer look.  "What happened?" he asked.

"I fell in the bathroom and hit my head on the sink."

A little too much egg nog, I thought.  Then I stood up to look at the wound and got close enough to smell that he had a LOT too much egg nog.  The significance of this is that most companies ban their employees from drinking.  There are people here who do drink, but they manage to do it quietly.  I am not saying that it is right, but if you are going to do it, just stay out of trouble.  Or, stay on your feet, as in this guy's case. 

The laceration was an easy repair and soon enough he was on his way.  Apparently there will be some actions taken by the company, but I am not getting involved in that stuff.

Shortly after drunk #1 left we received our only casualty of the night.  A gunner in a Stryker vehicle sustained a few non-life-threatening injuries from a vehicle-born IED blast.  His most serious injury was a small piece of shrapnel that entered the side of his nose, crossed through his nasal septum and embedded itself inside the opposite side maxillary sinus.  An unfortunate injury that would require evacuation to Landstuhl for more definitive care.

Just as we were finishing up taking care of the soldier, the Turkish physicians pulls up with a Turkish civilian sub-contractor who was actively seizing.  Most of the time we have a warning that something is coming, but in this case we did not.  We sprung into action.  He was not responsive, but he appeared to be breathing quite well.  A set of vital signs and an IV was started almost instantly.  We sent some blood and urine to the lab.  We put some oxygen on the patient and got ready to give some valium to stop the seizures.  It took two doses of valium to stop the seizures.  I quickly realized that the patient smelled funny.  On closer olfactory inspection, he reeked of alcohol.  I brought this up to the Turkish physician and he said that the people who found him put some cologne on him to help revive him.  Sure they did.  The Turkish physician told me that the patient was found unconscious outside of his trailer.  He said the only thing he knows about the guy was that he had hit his head during the DFAC Bombing.  Uh oh, could he have a bleed?  Now that he was a little more stable and starting to be more responsive we took him down the hall for a CT scan of his head.  Looking through the previous results I found his from the day of the bombing - negative, no evidence of bleeding.  Well, maybe he had a small bleed that has evolved over the last 4 days.  We re-scanned his head and it was negative - STILL no evidence of injury or bleeding.  Strange.  Let's see what the lab has to say...  As we were rolling the patient back to the ER the lab tech had our results.  She reported a positive urine alcohol test.  There you have it, drunk #2.  Christmas celebrations I guess.  The drug screen was negative.  We can only do qualitative tests for alcohol, so we could not get a level, but from my estimation this guy was REALLY shit-faced.  I admitted him for observation so he could sleep off the rest of his drunken stupor.  Every once in a while we get patients in here who are quite intoxicated.  When I admit them I like to keep their iv fluids at a minimum.  I do not want them to miss out on a really good hangover to remind them of the stupidity of their actions.