Reflections of Service in Afghanistan: Dr. Stephen Sample, MD

Dr. Steve Sample and Dr. Torree McGowan reflect on the differences in their deployments to Iraq and Afghanistan, drawing on their shared experience as emergency medicine residents at SAUSHEC and their overlap in Balad. 

Dr. Stephen Sample, MD graduated from University of Louisville Medical School 2005, and completed his emergency medicine residency at the San Antonio Uniformed Services Health Education Consortium (SAUSHEC) in San Antonio, Texas, in 2008.  He deployed to Balad in 2009 and Bagram, Afghanistan in 2011.  He is currently an emergency medicine physician and Dubois County  EMS medical director in Jasper Indiana. 
He has been married to his wife Tobi for 24 years next month.  His daughter Haley is 23, working at Stitch Fix in SF, and his other daughter Riley is almost 21.  She is a junior at Indiana University, pre-med. He is a frequent guest on MSNBC with Brian Williams and has a large Twitter following at @supermansings.  His dogs Lucy the Newfoundland and Charley an asshole of a Lab/golden mix are the stars of his Twitter. 

Transcript

Torree McGowan: 1:01

The podcast you were about to listen to is a conversation between two old friends over a drink. Please be aware that there is some mild profanity. So Steve, you and I have been together since we were interns together down in San Antonio. And one very interesting overlap when we got to spend a few days together in bilad, when I was replacing you in Iraq.

Steve Sample: 1:23

Now, I've never been so happy to see a human being in my life. So ready to go.

Torree McGowan: 1:29

That's one of the beautiful things about emergency medicine. I really love. Even if you're a complete jerk, somebody is really excited to see you really, at least once a day.

Steve Sample: 1:38

That is right. Oh my god, you're here. And after over six months, and I think I think I was delayed coming out of country a little bit. And when you showed up, I was just like, Yeah, yes. And I was so happy to see you. But I was so happy to get you in my rearview mirror as well. Yeah, my first my first deployment coming out of coming out of residency, I was, I was told that I was going in some cycle in the like, a year or so. And then I got a last minute tasking. I think somebody got pregnant. And I had spun up to train for CCATT and went through all the schooling and I was ready to go and I was a little pissed off at first because I was like, man, I don't want to be an ICU doc in this guy. I want to be on the ground and the shit, you know, and I was super pissy about it. And then all of a sudden, I got an email going, you're deploying in 30 days and you're going he meds to bulat and I was like, and so in that 30 days, you know, the 30 days lead up I mean, you know how much shit you have to do to get ready to go downrange. And 30 days to do it and say goodbye and get my anthrax shot and lie about my smallpox status and, and do all that stuff. So I didn't have to get that and then spin right out of the country, you know, and it's sucked. Of course I got over there into the shit and sandstorms and all that stuff. And I watched all my seacat friends flying to Germany and sometimes having layovers and even drinking beer and playing golf. And I was salty. Salty about that. I was like, I want to read. Yes. See, CCATT was the jam and I missed it on both deployments. I was super pissed off.

Torree McGowan: 3:13

Yeah, agreed. I was pretty upset too. Cuz, man. Getting to drink milk that actually came out of a cow and getting to shower without flip flops on.

Steve Sample: 3:23

Right? Yeah, right. Yeah, I picked nights because I have an instinctive like aversion to people who carry clipboards, around and administrators and stuff. I spent my whole time at Wilford Hall every time I saw a senior nurse who had advanced beyond patient care, and they started coming to the ER with their clipboards and the dress blues. Every time I saw them, I go put some fucking scrubs on and see some patients, let's do the job, you know. And, and we, we did that. And so I knew that I had, I had done my job well, when I was there, because we had to give those you know, you had to do one or two morning reports or something like that, right? As a nod to continuing education, even in the Warzone. And I did my morning report at like, my fourth month in country and I'm, the commander shook my hand afterwards and he was like, You must be one of our new guys. And I was like, No, sir. I am not. But the fact that you have no idea who I am means I have done exactly what I set out to do.

Torree McGowan: 4:24

Beautifully done. Yeah.

Steve Sample: 4:27

When I went home from Iraq, you went to Afghanistan shortly after that right when were you there? Yeah, so I deployed to Iraq. We graduated what may have were

Torree McGowan: 4:41

We oh eight

Steve Sample: 4:43

Yeah, so I went the next June, I think june of oh nine like I stayed from like june of Oh, nine to January of 10, I think. And then we came home and then immediately PCs to RDF Lakenheath over in England. And then I did Afghanistan, basically the same timeframe like June to January or June to December. I know I think I landed it might have been the Fourth of July hit the ground in Afghanistan, but through the end of the year there in 11. And then we came home and peddle farted around in England for a couple of years and then separated active duty and transitioned to the guard. And where are you now? So I am stuck plumb in in the center of the armpit of Indiana and southwest Indiana in a town called Jasper we're about 70 miles west of Louisville, Louisville, just across the across the Ohio River into Indiana is my hometown and that's where basically all of our people are all of our family. Save a few lives still live there. So when we separated active duty coming from England, it was a little overwhelming because we didn't really have a home base and we didn't really know where we wanted to home base. You know, my girls were older at that point and we had had them away from family for eight and a half years with from San Antonio and training over to England. So my wife, I could tell she, I mean, she really wanted to go home. And there's always a draw to home even when there's nothing to do at home because your people were there. So I transitioned from active duty into the Kentucky Air National Guard, where I am a member of the surf p, which you are the commander of yours, you are opposite me, but you were dumb enough to slot into command slot. And I have been smart enough to avoid that sucker like the plague. So that's where we are. Yeah, so I'm working full time in my er, and then part time, still in the combat boots.

Torree McGowan: 6:42

There are a lot of our colleagues that were in kind of the same class that we were that same cohort of military Doc's that went to Iraq. And then there were a bunch that went to Afghanistan, and then there's a much smaller group that went to both wars. And you and I are part of that small group.

Steve Sample: 7:01

Yeah, I guess I never really thought about that until you said that. Yeah, I guess most of my friends probably just did one. Yeah. Yeah, they most of them got to at least one place. But I guess yeah, we were the we were the lucky chosen few that got to hit both areas of operation for sure. I thought it was an interesting contrast that that I noticed between those two different wars. It's funny how your perspective changes when you get a new point of view. I remember dropping into a lot airbase and thinking oh my god, this is the biggest shithole on the planet Earth. I can't believe I'm gonna live here for the next six or seven months. Oh my god, I want to go home I want to go home. When we landed in the middle of like a brutal four day stand storm, you couldn't see literally 100 feet in front of your face. And we were just covered in dust I was every night like you take your clothes off and your shirt is tucked down and you're wearing underwear and somehow you still have sand in your tank. And it's like what is happening here. But then again, you know, we're on like Saddam's old military base, where they trained Olympic swimmers, and so we had access to an outdoor Olympic pool. You know, and there was a movie theater with the marble lobby, velvet curtains that

Torree McGowan: 8:17

Yeah, caught on fire while I was there in

Steve Sample: 8:22

Nice. No, I didn't. I never experienced a fire though. I was afraid that the balcony was going to fall straight the hell down.

Torree McGowan: 8:28

They wouldn't let anybody in the balcony anymore because it was unsafe.

Steve Sample: 8:31

Yeah. Is that right? Yeah. Yeah. So we, so I went over there. And I spent the whole, the whole deployment thinking, My God, this is awful. And then a year and a half later, I landed in Bagram Airfield in Afghanistan, and I was like, I literally have nothing to say bad about Ballade now like a lot is it feels looking back, like I had a vacation. I know I didn't, I took mortar fire all day, every day. And I saw the craziest shit I've ever seen in my life. But the living conditions were wildly different In comparison, from place to place, and just the sense of security and safety and, and all that felt felt really, really different to me, for sure. I had that same feeling. And I put it a little differently because I said, Man, I bitched about the accommodations and bilad and I said, you know, my, my, to our containerized units, the walls were really thin and I could hear my neighbor. And then I got to bother. My neighbor was told my neighbor was totally having sex next door. I heard that stuff. You know who you are. If you're listening. You weren't a doctor. But if you find this podcast, I heard you.

Torree McGowan: 9:44

One of my neighbors sneezed one time when I was on Skype with my husband, and Tim said Bless you. But I'll tell him next door. And then I got to Bagram, and met my six roommates in the Letterman dorm where we lived five six people to a room with no privacy at all. And I said you know what? I'm done bitching because they can send me somewhere worse.

Steve Sample: 10:10

I didn't live in a dorm. I lived in one of those little shithole B huts the plywood boxes with the 10 roofs and the Jerry rigged wiring. Yeah, it was like I could I could stand in my room and I could touch all four walls with my wingspan you know, and

Torree McGowan: 10:25

everybody makes fun of the five footer right up until

Steve Sample: 10:28

Yep, yep, yep. No, I yeah, my head and my feet were basically touching, you know, basically touching the whole time. But yeah, it was it was way worse. It was so much worse. It was so crowded on Bodrum. I mean, I say I'm not a military guy. I've been wearing the boots for 20 years. So clearly, I'm a military guy. But prior to joining with the hpsp scholarship, I had zero military experience my grandparents my both my granddad were drafted into World War Two and they did their time and were were two and then they were gone. But there was no career military. I wasn't an academy kid or use kids. I didn't know shit. And I was just a, I was a kid, I signed that scholarship primarily, you know, I was as patriotic as the next guy. But the military had never even crossed my radar. And then I found myself getting ready to start medical school and and at a state school with a tuition of 40 to five a year with a three year old and a six month old. And I flipped the I was like, Oh my god, how the hell am I gonna do this? My wife was a brand new nurse and I was like, we're, we're gonna be broke. And I heard about the scholarship, you know, and I signed the scholarship I signed. After I did my due diligence, I talked to a few military Doc's and they were like, Look, man, you know, we don't make sure the money's terrible, but we take care, we take care of amazing people, a couple times a year, you get to go to Central America and take care of the kids. You know, and I'm not religious, but the idea of mission work. And that medical mission speaks to me. And I was like, Yeah, man, I wanna I can do that. And so we decided to do it. So I signed, I signed my contract on May. In May of 2001. The world was a piece. Every every doctor, every career military physician that I talked to, had never seen any kind of action. And then the week before Black Monday in medical school, which most of us of any age I don't know if they still have Black Monday, but that's the first day of brutality that you get in your first set of exams. We were all in lockdown at the school studying and we watched those towers come down real time. And I remember sitting there and I was sitting next to a guy named Tonio Daniel, and he had just done the Navy hpsp scholarship. And when the first tower fell, we looked at each other and I went, shit, dude, we're going to war over this was like somebody who's gonna pay for this. And we were like, you know, we were kind of in that, like, is this gonna change my life? And, you know, I don't think so. My wife called me panicking. She's like, Oh my god, they're gonna pull you out of med school and send you to war. And I'm like, Look, I and I told him I'm like, I'm not a soldier. I've got no value to the US military right now. I've got a frickin biology degree with a chemistry minor, and I don't have shit about medicine yet. I was like, in my only experience with war was the Gulf War, which happened when I was a sophomore junior in high school, and we went over there and kick their ass and we were gone in like, two weeks, nobody died, and it was over. And I was like, that's what we're gonna do. We're gonna go bomb the shit out of somebody. And then we're gonna come home and then we're done. And who the hell had any idea that literally like nine years from the damn day, I'm dropping into a war zone in the same damn war we've been in for ever. You know, it was just it was a, it was a mindfuck. Really? Just I because if you'd have told me, if you'd have told me in May of 2001 Hey, man, there's a real good chance you're going to go to war with little kids. And you're going to take rocket fire, and all that stuff, cuz I'm not a country. Boy. I'm not a tough guy. I mean, I grew up in a frickin little like, lower middle class, kind of suburbia kind of thing. And I was a science geek. And I was like, what the free I was like, I go to war. But here it is twice, you know. So it's funny how life hits you. It's amazing. I just got through talking to a class of local kids who were interested in health care professions. And I realized I looked out and I was like, Oh my god, I was like, none of these kids were alive when 911 happened. Yet it has yet that day is still shaping their world. You know, as far as inflection points, you know, my parents inflection point with JFK. My inflection point was 911. And these kids their inflection point is stupid, frickin COVID. You know, there's always going to be a before and after, in hindsight, to circle back, Bagram Air Base compared to Joint Base Balad or camp Anaconda, if you're army was friggin awesome. And boggers so it's

Torree McGowan: 14:52

Yes. Balad was like a country club compared to Bagram.

Steve Sample: 14:56

For sure. You know, and I beg you know, I, I was happy, I guess, going EMEDs into the big bases because I was like, you know, I'll be safer there is definitely safer than frickin driving and convoys and stuff. But what they don't tell you is that when your whole world shrinks to a two block radius, your your frickin hooch, to the hospital, to the dining to the dining tent, to the damn gym tent. And then you just walk that same little triangle every single day for seven months. So both deployments I was begging, like about halfway through, I was begging my commanders. I was making up jobs, trying to get them to send me outside the wire. But it is Groundhog's Day, every single day there and I remember you marked time

Torree McGowan: 15:43

Yeah, based on the meals. Even if you weren't hungry, you went to the DFAC just to see what was there. Surf and turf day on Fridays. That's how time passes.

Steve Sample: 15:54

So I marked my time in meals per week because I was a night shifter so the DFACs were not open. So I, I basically shifted my entire 24 hour clock so I let I treated my nightshift as if it was a day shift so I would get off work, I would come home, I would read a little bit and then I would get up and I go to the gym for an hour. And then I would usually take the bus down the road to like in blood, I would take the bus down to the pool, I would swim a mile, and then I would read until I got tired. So I wouldn't go to bed till around noon ish probably after my shift and I would just sleep until nine. And I get up in a shower and I'd shave and I go to work at 11 and so one day a week I would get up extra early we try to it was my read usually I made it my rest day from the gym and I would get I would go to sleep a little earlier and I get up and I would go have dinner with Craig Goolsbee who was over there so I would meet them and we would go across base to like the nicer dining facility and we would do that so i'm mark that I had a one weekly meal other than that I was eating salads from the defect that were brought over to me So yeah, it's a good weight loss program. My Christ y'all who are listening to this if you find pictures of me on the internet, I'm going to tell you right now getting kind of sloppy, I've got old man boobs and back fat but my god coming home from Iraq and Afghanistan I I was something I will tell you, I told my wife I was like, before I went, you know, my fitness goals when I went to Iraq the first time or to be able to do five pull ups. Excuse me, I was an old married man. Because I could do zero. And I've my my stretch goal that I joked with my wife is that I was going to have one of those Damn V's that went from your hips down into your pants, and she was like, Uh huh. And yes, she couldn't keep her hands off of me. Yeah, it was something. It was awesome. It lasted. It lasted about a month and a half. And then I was back again. But until I went to Afghanistan that I was skinny again. So now I'm away fat again. So well.

Torree McGowan: 18:32

I remember Roy Johnson replacing in Balad. Big angry. For those of you out there, I'm sure many of you know, the good Dr. Johnson. When he got there, he was so big, that I and Marissa George, who was one of my medics were able to get in his pants big. So I got in one leg. Marissa gotten the other leg and we were able to tie the waist around the both of us. And he lost like a human and a half while he was there. Deployment is like fat camp. It's terrible. There's nothing to do but workd out.

Steve Sample: 19:09

That was, you know, and honest to God, you know, the whole the screwed up thing that only people who have been deployed will understand, because I hated every second of it. Every second I hate it. I could not wait every day I was I had the little countdown timer on my computer that made me want to lose my mind. I couldn't wait to get out. I couldn't wait to come home, I couldn't wait to come home, I couldn't wait to come home. And then I got back home. And a big part of me was like yeah, I should go back. Like I have no idea what the human psychology is of that it may be because because I am like an add person who is kind of scattered and everything and having that kind of forced. There's not shit to do. So you got to take it and you make your schedule and you do it. But it's the only time I've had any degree of self discipline real self discipline in my in my entire life, not even my adult life. And there's something to be said for that, you know, you go over there and all of a sudden, you don't have to clean up your kids shit. You know your wife is taking care of stuff at home and you literally are only responsible for your own self and to not kill anybody at work and hopefully save some lives and the simplicity is is it's alluring. I mean don't get me wrong. I mean I've thought about volunteering to go back which is freaking nuts. But I thought about it. Yeah, I don't think my civilian job would like that too much. If I said hey, I'm volunteering to go to Afghanistan. Though Those days are over. We'll get to that I guess. I think you hit it on the head that simplicity there's just nothing else that you have to do. Somebody feed you somebody does your laundry if you want to get really fancy laundry but

Torree McGowan: 20:59

Bagram felt a lot more More unsafe to me

Steve Sample: 21:02

Oh way more unsafe. And I thought about what was different about that because we got rocketed in bilad for sure, all the time. And we had those awesome guns that were serious. Yeah. Oh, that, that that that was from a CRAM going off about 10 feet from me on the first day in country. It will be with me until I die. I will never forget that. But I think, you know, Iraq was my first deployment. So I felt inherently unsafe all the time. And me and my buddies. Like the first time I made my way to the dining facility. And I walked back the the mortar had landed, literally directly where we had been standing not five minutes, it was right. On the other side, you know, those little concrete blast walls that they're the barriers that they have landed on the one outside of his hooge and two army kids got their Purple Hearts on r&r in Ballade that day when I'm dropped along and the other one had a chunk torn out of his ass from frag but so immediately we spent the next like week like like looking at the sky like it was going to fall on us all the time. But then you know, you get used to that kind of you know when mortars fall and mortars fall and mortars fall you cannot maintain that level of vigilance over a sustained period of time so by the end we sit on the roof smoking cigars watching them come in you know same thing in Afghanistan and but there was always that degree you know, there were there's layers to come into the hospital you had to you cross the gate and there was a Ugandan guy, guard checking your ID and then you came in the hospital and if you had a weapon you had to DRM yourself and you showed your ID again to a US soldier and you went in there and so you felt reasonably safe on the inside in the in the the the ancillary staff to the hospital the cleaning people and the and stuff like that these are they were all third country nationals so they were you know, from wherever I mean, there were I think there were a fair number from the Philippines and yeah, and then and all around and then I got to Afghanistan and when I went to work I just rolled up in the back door, nobody was checking shit on anybody. There were no guards there was no security process. And then our our ancillary staff were legit Afghans so in the you know, the difference between the war in Iraq which was theoretically a war against a regime like a more of a traditional war, this whole Afghanistan deal was supposed to be winning hearts and minds and trying to nation build like we are want to do in the United States and and so instead of almost never seeing an Iraqi, other than an injured Iraqi, right, like they're Afghans everywhere, and I remember when we came to base we had our generals briefing that first day and he was like, let we let on 7000 a day 7000 coming through those front gates, we estimate eight to eight to 10% are bad, and keep your keep you watch your six basically. And I was I was like, I was like, that means that they are estimating like what that we've got, you know, 600 to 1000 bad guys on base every day who who may not have the ability to do any real damage, but maybe looking for it. Maybe you're looking for a way to do it or maybe gathering Intel or this and that and then you know, you go into the hospital and then all of your extra employees are Afghan nationals. Not that I have anything against Afghans, all the Afghans I've met with glorious people, they the ones we took care of his patients, we're so thankful but in that situation wearing the uniform of a occupying force and and stuff and then they'd be around and it occurred to me, you know, because they they color coded their badges. If you were a green they had some free rein if they were red. They had to be escorted all the time. But then I realized all of my cleaning people at the hospital had Red badges but they didn't have escorts like interact when they brought in Iraqis, man, they had frickin armed guards standing around them when they were working. And, and I went one day and I was like, Who? Who is the escort for these people? And they were like, oh, once I dropped off here, you all are all sort of considered to be their escorts. And I was like, what I was like, I'm not watching that careful. I was like, you know, and I felt this overwhelming sense of kind of, like being unsafe, because I was like, you know, when they call the trauma alert, when they when they nine lined in and three or four Blackhawks landed, the entirety of the hospital converges on the trauma bay, right? And I was like, holy shit, wouldn't that be a time for a bad actor to come in and detonate some shit in the trauma bay, not only would they kill the ones that they missed out in the field, but then they could take out all the freakin docks and medics, you talked about a morale boost for them. And I was like, Man, this is bullshit. So I didn't love that. And then of course, the base was overcrowded. And there were 7000. And I remember just, I remember having that kind of that constant sense of underlying stress and anxiety. I remember like, you know, when truckloads of, of the people would drive by the street, I remember I would just subconsciously, as the truck pass duck behind the glass wall, like just kind of curve a weight curve away from the street to the other side of the concrete barrier, because there was always a piece of me thinking that truck might blow up, you know, and that, where's your as out? That's one of the hardest things. Right?

Torree McGowan: 27:37

When I got home from both of those deployments, it felt so unsafe to not have anything to hide behind. Yeah, yeah, just walk into a building and not have a place. Not have to, like weave your way through blast walls to get into the door. That felt really unsafe.

Steve Sample: 27:54

right. Coming Home is weird. Like, coming home isn't all it's cracked up to be? In fact, I think, and I think a lot of people would probably be surprised to hear me say that, but coming home is hard. It's hard to shit. It may be the hardest part of the, it's probably the second hardest part to leaving, honestly, to me, you know, because it's just, it's a mess. You're trying to come into a situation that has been running fine without you, thank you very much. And, you know, you're walking into new routines, routines that are working for what is happening, and then you come in and say, Oh, I'm gonna do it this way. And they're like, and so there's, there's that immediate, that kind of both, both irritation at you for trying to change things, but also expecting you to come back in and say, Okay, you've been gone six months, you're up to bat, it's your turn. You're not you're not prepared, you know, and you being a mom, I'm certain that our experiences are different, or different, but it's like you're up to bat you're like, Oh, I don't know how to swing anymore. I don't know. I don't know how to do this. And I don't know if I have the emotional capacity to do this.

Torree McGowan: 28:58

Oh, no, it was very much for me because when I left, the first time Chase was four months old. He rolled over one time before I left. And so I left a kid that you could literally put on the ground and come back five minutes later and he was still there. And I came home to a toddler.

Steve Sample: 29:16

Was he walking?

Torree McGowan: 29:18

He did not. Chase didn't walk until he was 18 months old. Kellan on the other hand... Kellan was seven months when I left and then I came home when he was 13 months. And Tim was really funny because he told me no Kellan didn't walk either. And I was like, bullshit. That kid ran the day I got home so he was definitely walking before I got there. Neither one of my kids wanted me to hold them.

Steve Sample: 29:41

Yeah, he's like who that Who are you? Who are you? I mean, the four month olds like Who the hell are you? You're like a random face. I saw him on Skype or some shit with a bad connection.

Torree McGowan: 29:50

Right? Yeah, cuz I Skyped with them every day. And there's actually this wonderful picture that somebody caught on a old school camera phone the day I came into the airport. And you can see, Tim has chase in his arms. And Chase has his hand on my face. And it's touching my face. And that's all he wanted to do for the first two or three days was touched my face because that's all he knew of me.

Steve Sample: 30:14

Yeah, I did. So I couldn't Skype my family every day. I learned that fairly early on into my first deployment. Because it made me profoundly and like hopelessly depressed, because I had that little countdown box and we get on and it was like, Hi, hi, Hey, everybody. What did you do today? And they're like, oh, did you do and I'm like, Oh, the same shit I did yesterday. And the everyday skypes actually made my time feel longer. So I separated and so I'd wait three, four or five days sometimes, even though I didn't have anything to do and I wanted to talk to him, but I didn't have anything to say.And so when I when I was able to break it down into chunks of time, like with the Skype day, then then actual real measurable time had passed. And I, you know, I just got lost in the days for a while and you know, and thank God I joined the Air Force because I mean our army brothers were going over there for freakin 12 to 18 months and I do. I don't know how I, you know, I say I couldn't do it. If you'd asked me before I went to Iraq, could I go to her every six months? I'd be like, Hell no, I did it. But man, that would have sucked, at least I'm sure I could have done it. But I'm glad I didn't know.

Torree McGowan: 31:26

The part I really couldn't have done was the r&r. There is no way I could go home for two weeks.

Steve Sample: 31:31

Oh, go home and come back. No way. Man. I would have had to have met a neutral location or something maybe like flown into Europe or something I could not have gone back to my house, you would have had to drag me out of there with the friggin MPs to get to get me back on a plane.

Torree McGowan: 31:44

Let's talk a little bit about what you remember about Afghanistan. I had a patient asked me this question the other day, and it really kind of caught me off guard because everybody likes to ask. Oh, you were in Afghanistan. Did you see any crazy stuff? People love to ask me? Did you kill anybody? And my answer is not intentionally.

Steve Sample: 32:03

Yeah, hope not. Maybe it's possible.

Torree McGowan: 32:05

But this gentleman asked me what did you miss about it? And that really kind of set me back to make me think because there are definitely parts of Afghanistan that were beautiful. I absolutely missed the people that I was there with and and as we have watched Kabul falling I reached out to a lot of the people that I was deployed with, and that was wonderful to kind of reconnect. But what do you miss about Afghanistan?

Steve Sample: 32:31

You know, I mean, like I was never a military guy, somehow some by some weird thing I still wear the boots 20 years later so even though in a lot of things compared to your average military person, like I might be politically different, or emotionally different or something like that. I love my brothers and sisters in uniform so I miss my people. I'm still friends, fake friends on the internet. I don't see any of them anymore of course, but I've watched some of my young medics that were over there so I was you know, at that point in time I'm like 3435 years old, and these 19 year old medics now I'm watching them build their families on the internet and stuff and it's pretty wild. Watching like the the the the people that in my mind are kids and then they're getting wrinkles around their eyes and which you know, of course what that says about me but so I definitely I missed the people and certainly though it was brutal, you know, I think that the way I piss off my partners a lot in my nursing staff at work about the way I practice medicine because I'm as wordy with my patients as I am on this podcast right now. I'm a teacher and I really like to see and I like to talk and I like to meet and understand and this and that and, and so and I know that even though the the faces have all blended together over the years of my patients, I know that I did good things for people who really needed it at the time. You know, I know I was able to, to stop and and you're not every time I'm sure but there were times where I was able to shut the trauma bay out from them and connect with them as a human and and even if it was just me standing between them and they're and they're blown up legs so that they couldn't see them and holding their hand and giving them some morphine and stuff. I got to do some some stuff that I'm really proud of, you know, and I got to lay my hands on some people that you know there are people hopefully here today that are still seeing their families that if I had not come into their life, maybe they wouldn't have been. Now the good news is is in government services, emergency medicine were all bad so really any of us could have done it but those were mine. Those were my people. And I have you know I feel connected to them even though again they're blurred they're gone their names are gone. I don't remember a single name. I'm not sure that I ever learned them because when they come they all come at the same time right so you don't just get one you get the six and and so you're running around trying to do what you can do but those those moments when the trauma bay activated, even though it was terrifying and profoundly sad. Man it like I mean that's what we do right? I mean, I mean that that is what we do we you know er Doc's, we you know we tend to be cowboys or we thought were thought of as cowboys and then we go out in the community and you know, a large percentage of my population that I take care of her at a 90 year old, COPD patients or or chronic kidney failure patients but you don't get into er because you love taking care of kidney failure or or COPD you get into it because you want to reach in and you want to jerk somebody out from the jaws of death and you and and know that you touch somebody in a way that most people can't, the what we can do when we are at our best would make almost anybody else shit their pants. And you know, the only people who wouldn't or the trauma surgeons that the other people in the trauma bay with us really, it's just a different world and so, so I'm proud I'm proud of that clearly, I guess but, but that is what I miss. And now being the night shift or I did not get as much into the you know, if you were out and about during the day, I didn't get a whole lot of the culture, I didn't get to meet a lot as many locals as I would have liked, certainly as I would have if I was outside the wire, but so really, it's, it's what I did for our people, and knowing that I gave equivalent care to not just my soldiers, right, not just the US military. I know that if you brought in an Afghan who was blown up, we were dumping every single resource into them that we did everything. So we really lived the mission of medicine and reached out. And it was hard. I remember the first time I took care of it was actually a bad guy in a rack. You know, I mean, he had just, he had fired rockets at the base or something like that. And he blew his thumb off, or something on his like something malfunction, they brought him into me. And the human me was like this. You know what, why isn't somebody shooting him? Why the hell are you making me come over here and take care of that. But when you can shut that humanity down, and you can turn the I mean, doctors and humans go hand in hand, but that anger and you can just reach in and go, You know what? This guy thinks he's the good guy. You know, he, he thinks we're the bad guys. We're in his country. We're on you know. And so we're all kind of he's a, he's a puppet on a string, just like we're puppets on a string. And we both have to believe that we're the good guys. Right? Because the shit that we do on both sides. If you didn't think that you had righteousness on your side, it'd be hard to sleep.

Torree McGowan: 37:46

Yeah, very much. So no, I think you're right. I think that I've always thought of it as the dirty little secret of deployment, which is, the medicine is the most fun you'll ever have professionally. And by far, the best sense of mission, the best sense of teamwork. And it's the emergency department we all wish we could live in because they're right, right? There were two things that gave me huge satisfaction there. One of them was triaging patients back to the clinic. And saying, you don't need to be here, man. Yeah, and every now and then somebody would go to the hospital commander and complain that we wouldn't see him. And I'd say, well, no we will. Somebody will see you. It's just not the emergency department. And to have our hospital commander stand up this, you know, Sergeant that thought that he deserved emergency department care, and yell at him for 10 minutes about this is a trauma asset and unless you're dying, you don't belong in there. Right? That made me very happy in my heart. The other thing that I really loved was somebody in Bagram when I was there,

Steve Sample: 38:52

Ain't no EMTALA in Bagram.

Torree McGowan: 38:55

Somebody stocked us with band aids that were Garfield band aids. Oh, nice. And it gives me so much satisfaction to tell someone. I am in the busiest and most capable trauma bay in the world. And the most important intervention I can do for you, the only thing you need is a Garfield band aid.

Steve Sample: 39:18

Yeah, it's weird times, to super weird times.

Torree McGowan: 39:22

So over the last couple of weeks have definitely been a lot watching that all fall. How has that been for you?

Steve Sample: 39:31

So it actually so I was actually out of the country. When it all went down. And I was relatively I was up in the the Italian Alps. My daughter was abroad all summer. And we went over to meet her before she came home. So we were offline for several days. And so I came back into the country really, in the middle of a whole bunch of rage, and shock and anger. And I was like, What the hell I am. And I know we're leaving Afghanistan. I mean, Trump made it very clear, we're getting out. And I'm setting it up to where there's no option to not get out. So we knew we were leaving. And I was like, great, we're leaving. And, and then it was this, this whole, like this media blitz and this and that we're leaving people behind and this and that, and honestly, Christ. I don't know what to think about it. For somebody who's a news junkie, I've almost studiously avoided reading anything seriously about it. Like I've seen some peripheral stuff. I've been real busy at work. And and I don't know that I want to I don't know how much I want to know. Because, you know, everything you see is going to be skewed from some perspective. So what I tell people, when they bitch about us leaving Afghans and how this all fell, I was like, first of all, anybody who's ever set foot in that country, and seeing what this word is, knows that it was going to be a shit show from the jump. We were never going to get out clean, like this was never going to be cleaned. We spent 20 years training up an army that none of the people who were training them Did you know and we were leaving a country where unfortunately grift and corruption are baked into the to the governmental systems, that's how it works. We were never going to leave now, if we're leaving interpreters behind fucking pissed, because the terms are awesome. And the terps were made promises, they risked their lives for us. You know, and so if we made promises that we haven't kept, we need to hold our politicians feet to the fire no matter what party you're in, or anything, but what I see really is a lot of just like we always see a lot of political grandstanding and people taking shots. And potshots instead of saying, hey, how can we do this better? So I am glad that we got over 100,000 people out or whatever. And the next question I ask people who are clearly making a political point is how many refugees Would you like to take into your, into your town? Because the same people who are bitching about us leaving people behind our showing people on you know, a plane full of broke so terrified Afghans on a c 17? saying, Do you want this plane landing in your neighborhood? It's like, we're they're leaving them? Or they're coming home, you know, so. So I just, I don't know why I would expect this not to be made political because everything is political. Now, even a goddamn infectious disease has become a political weapon. So if that is, you know, war is going to be in war is always political. So all I really had to say about it is is it was always going to be a cluster. It could not have not been a cluster couldn't have been less of a cluster. Probably that's the nature of a cluster. But I know that what I did there still mattered. Yeah, you know, so what I did there touched people in the right way. Now, you can have political arguments of should we have been there? Hey, we were there. 20 years? Probably damn not right. I mean, 20 years long time to be in an occupying force. So you either have to decide, are we going to annex Afghanistan, and we're going to live there forever? Or are we gonna get the hell out of there. So once we decide you're going to get the hell out, you want to get out as quickly as you can. But I know that I took care of my patients, the way I was trained to do, by some of the smartest people I know. And I did it well, and I did it with compassion. So overall, I don't have a lot of that underlying anks that I hear coming out of a lot of servicemembers. I just, I feel like, Yeah, man, this was always gonna suck. But we did, what I did what my what my er did touch people in a good way.

Torree McGowan: 43:22

So I think that's a really good perspective. And I agree, I think I remember being over there. And, you know, we talked about it before those 7000 Afghans a day that were on the base, maybe only eight to 10% of them were bad guys, and the rest of them were just trying to live their life. But I am certain that they were selling intelligence and doing what they could to try to make it be okay when we left, because we knew we were leaving. They knew we were leaving.

Steve Sample: 43:49

Yeah. We all know we were leaving at some point. I mean, I'll be honest to God, I was shocked that we were there as long as we were because I'll be honest with you after 911 when I got to Iraq, I was ready to go. Honestly, I was pissed. I mean, I was like, let's go kill them all. And this guy sent me you know, I was Midwestern fucking redneck, and I was ready to go kill some people. And I got over there. And my first patient of my first night shift was a kid who rolled in, we were dead. We were just sitting around looking at looking at the wall. And they called it a nine line and they brought in this Black Hawk, and there was this kid on my patient was a kid from West Texas. And he was like 1920 years old. And he had been blown up. his left leg was gone above the knee. his right leg was below the knee. I remember that very clearly. And his tourniquets had been up for like two hours, which is crazy tourniquet time, he was miserable. You know, and so we were loading him up with dope and everything. And I was trying to talk to him and distract him waiting for the OR so they can clean them up. And we were shooting the shit and I was like, Hey, man, I was like, you know, and he was stationed up there. He was a West Texas boy and I remember talking to him and I said, Hey, man, I said winter in friggin fort Wainwright must suck for a Texas boy right? And he and the kid was like, he goes, man, he goes, I love it. He was like I snow ski I snow she like I just love outdoor winter sports and this and that, you know, and I looked down, his legs are fucking exploded. And like, it took the piss right out of me, man. When he went back to the when he went back to the or I went back to my office, and I just shut the door and I frickin cried for like, 10 minutes. Like, he was like, you know, you know, when I was crying for him, and I was like, I was I had just gotten there. And I was crying for me. I was like, fucking I want to be here anymore. And that and I was like, What? And then I got this overwhelming panic. I'm like, what are we doing here? Like, what what is our endgame here? Because, because nothing that we are doing. Nothing in my mind at that time was worth this one kid's legs, you know? But then you see, I mean, people ask me, sometimes, you know, the average ER doctor sees, you know, maybe a couple of real deal amputations in their lifetime. How many you think we've seen? I mean, how many do you think we Really, I mean, like it's got a number in the hundreds, right after two deployments, like hundreds of hundreds of exploded apartment syndrome. Yeah, compartment syndrome with the fasciotomy is and

Torree McGowan: 46:12

when my orthopods won't believe me, and I call them and I say I have a compartment syndrome, you need to come see and they're like, No, you don't. I'm like,

Steve Sample: 46:21

like, 37,000 Yeah, but I mean, you know it. And I was just like, shit, man. And so I got a lot more moderated in my thinking of how we approach international affairs and politics like so. I used to love the fact that the United States likes to saber rattle. And I hate it now. Like, I hate it. I'm like, man, because I've seen what is on the other end of that stick and I see you know, it's easy to go look, we're flying RF fucking 20 twos over the over the football stadium and proud to be an American and Lee Greenwood still singing that goddamn song. And but, but there are, there are freaking broken bodies on the other end of that sword. And you can only touch so many before you're like, whoa, whoa. So certainly I am not a pacifist. And I know that well applied force is a is a good is a good thing. But man I don't like I don't like to. I don't like that man. You don't have to you don't have to scream, you're badass for people to know you're a badass. And so I just, I got really antsy internally around the time, when we were all the shit at the end of the trailer middle towards the end of the Trump administration when they were we were talking about going to war with Iran now. You know, and you started getting all those little tingles of anxiety. You're like, Oh, my God, it because you remember, like, as Afghanistan was spinning up, you knew what was coming. And I just hated all the people are like, yeah, let's bomb the shit out of them. But there's kids on the ground. So not that you should never go to war. But my god, you should apply it, you should apply it very judiciously. And you should know that there's a cost at the far end of that, that somebody's in a cost that frankly, it is easy for us as a country to save a rattle because what less than 1% of us serve, right. So there's really, the the consequences of war are insulated in these small communities, usually communities that are in generally poor, you know, people, so they're these isolated pockets where they lost a bunch of kids to this war. And then there are neighborhoods where nobody knows anybody who's ever strapped on a combat boot. And unfortunately, Those sons of bitches are the ones making decisions where you and I go a lot of the time, so. So yeah, so I am, I'm certainly not a pacifist, but I am I'm certainly not a war Hawk anymore. I used to be there were those times certainly those kids who were you know, multiple limit beauties. We had a we had a night one night where we sent we sent these guys to Germany, we evacuated, I think it was, it was three guys, but there were only four limbs left between the three. And, and you're like, Oh my god, like, what are we doing? What it's like because it's like you Well, we're really freaking good at this whole, like, treat stabilize trauma. I mean, it's the civilian, the civilian world that the trauma world would flip the hell out if they saw how good the military is at that. I mean, the fact that those kids could they see a flashlight, they wake up in Walter Reed, it's like three days later, they've already had five surgeries. You know, and, and they wake up and their wife standing over him. I mean, first of all, can you imagine the mindfuck that that is like you're on patrol, and now you're laying in a bed with your wife over you and you're missing two or three body parts. And it's like, like, I can't even on the outside, it feels like no, maybe I'd rather be dead. But clearly, there's a strong genetic way to live. And I'm hopeful that most of these guys are happy we did what we did for him was really cool. You got to see that the advantage of working day shift, it was advantages you had to see clipboards and generals the advantages you got to see it like that, and I could see that much.

Torree McGowan: 50:04

Yes, I having to do the dog and pony show stopped. I did get to put the wrestler Chris Masters in a headlock. And he's such a good dude that my arm almost wouldn't go around him. So I've got this great picture of me barely getting my arms around this guy's neck. That's like, I don't know the size.

Steve Sample: 50:23

Awesome. I saw the Chairman of the Joint Chiefs walk through the ER with David Blaine. The magician. Nice. Yeah. It's like the most powerful military guy in the world in the world and David Blaine street magician.

Torree McGowan: 50:39

And anything else I've kept you an awful long time.

Steve Sample: 50:42

And I think you and I know you'll probably want to edit this whole thing down to about 10 minutes. Yeah, no, it's awesome to catch up. No, I'm always happy to run my mouth ever have lots of thoughts and sometimes they come out in a jumbled mess. But But yeah, no. Overall, you know, my daughter is Pre medical pre medical right now. And despite what you may hear from me, if we're sitting around drinking beers, you may hear me bitching about the military and bitching about this and bitching about that. But I was talking to my daughter the other day about potentially trying to hpsp scholarship for medical school, and she was like, Hell no, I'm not doing that. But, yeah, I mean, there's a lot of honor and what we did, I mean, there's a lot of bullshit, even what we do. You know, there's a lot of bullshit in the National Guard, there's, you know, it seems like in the National Guard, it's even more bullshit just because it's concentrated instead of like, spread out over 365 days is spread over like, a weekend, a month. And so all that computer training that all you active duty people, hey, we've got to do that, like in a day and a half. And it's, you're fighting for Internet access, and all that stuff, but But looking back in my life, my bank account is not happy that I serve, but I'm proud. I'm proud of my service. While still, I mean, I'm thinking about I'm at 20 years, I'm over 20 years and due for retirement, and I'm thinking about transitioning over to the reserve next year. So even though my body and my mind keep telling me to get the hell out and retire for some reason, I just can't seem to quit. So we'll see. We'll see to be determined. I've got a few months to make that call.

Torree McGowan: 52:19

Yeah, it's hard to walk away from it when it's been part of us for so long.

Steve Sample: 52:24

Yeah, yeah. My whole adult life. I was a baby when I joined

Torree McGowan: 52:27

that feeling of we did some really important stuff is there?

Steve Sample: 52:32

We did, we did. And, you know, no matter what's in that, I think that's the beauty of being in military medicine. Because you don't have to get caught up with what's going down on goods going down on the street, who's taking what rocket what what civilian fall outs are. We're just there to catch the broken people and put them back together and there's always going to be honor in that. I think