USNS Comfort 2009


The following is my best recollection using journal, photographs, personal experiences to share an unforgettable journey taking me through the heart of Central America, sharing the ins/outs through the sensory systems of The Traveling Pharmacist. Countries were good to me and my travel party and I’m grateful for the lessons the land, my friends, colleagues & the natives have taught me.

Several life lessons which my dense head picked up whilst I traveled through these countries:

  • Different cultures adapt different meanings, traditions. You don’t know it all.
  • Life is not fair. Not everyone lives in America.
  • Groupthink. It’s not just for corporations or fraternities.
  • The best way to learn about others is to travel with them. Do it!
  • If we’re here today and gone tomorrow, live in the moment.  NOW.  Life’s too short.
  • Stay away from mefloquine, it’s a horrid drug.
  • US Government takes care of their own. Seriously, it’s not such a bad gig.

Itinerary:  Trip June 18th- July 26th 2009

Day 1-4 Guatemala

Day 5-17 USNS Comfort à El Salvador

Day 18-31 USNS Comfort à Nicaragua

Day 32-36 Panama & Canal Transit

Day 37-40 USNS Comfort Transit Trip à Ft. Lauderdale & US Reception

Note:  This whole trip was not a typical traveling adventure à this mission had a purpose; to provide free health-care for specific country populations.  El Salvador, Nicaragua both were active mission sites in which our days were not free to our own devices.  Check the descriptions of these countries for a teaser taste of the culture & lifestyle. Our travel group was mostly confined to health site compounds or approved areas.  Don’t forget the toilet paper when you’re traveling – seriously.


Guatemala – Chichicastenango (famous Mayan marketplace), pan de Mayan, Lake Atitlan, distinct colors/patterns, street vendors, Antigua burritos (circa de OnVisa Travel Agency), Volcano Pacaya, Handmade Musical Instruments (flutes, Guatemalan slit drums)

El Salvador – Tipico restaurante, papusa, cheap lunch platos, natives

Nicaragua – Luxurious Hotel Villas del Cortijo, excellent food, mommons, street vendors, natives, Gallo Pinto

Panama – Nightlife (People), Veneto Hotel/Casino (hotspot), Nikko’s 24 Hour Diner, street vendors, Old Ruins, Panamá Viejo’s National Handicrafts Market, “Old Town” – Casco Viejo, natives

Day 5-40 USNS Comfort

Floor Plan

03 (Sundeck/Flight deck)

02 (Chow/Internet Room)

01 (Pharmacy)

Main Deck (Gym)

1 (Gym)



4 (CIV racks)

“Chow” Meal Schedule

Breakfast:  6-7:30

Lunch: 11-12:30

Dinner: 4:30-6

“I’m on a boat!”

First AM, I awoke around 0645 to a loud speaker scrambling to breakfast which consisted of eggs, bacon, hash browns & oatmeal.  The ship was large & repeatedly I gotten lost over the first few days.  Culture aboard the ship was its own character created by a mixture of military culture & civilian ignorance.  Our very patient Lieutenant oriented us to the pharmacy side on day one and introduced us to the team.  Pharmacy consisted of five civilians, a mixture of Air Force, Navy personnel, US Public Health Service (FDA) & outside volunteers during busy prepackaging days.  With the abundance of potential malaria-transmitting mosquitoes on land, we sprayed our uniforms with concentrated DEET which remained intact in the fiber for 5 laundry washes.

Pharmacy’s computer system had very basic dos-like interface similar to VISTA at the VA hospital.  Health-care treatment is not very complex on the ship.  Pain is limited to care with IBU, APAP, morphine, Vicodin, toradol.  Labs were not drawn aboard, care was just conservative (ie. toradol x3 30mg max dose).  Rocking on the boat was intrinsically nulled through usage of Transdermal Scopolamine or qday Bonine.  The ship had three gyms to enjoy – cardio room, weight room, hybrid room w/ classes including extreme P90X, yoga, spin & abs.

On the ship our pharmacy responsibilities were interestingly extensive and not limited to pharmacy – we served the ship’s crew for all Rx/OTC meds (including handing out DEET cream/sunscreen/chapstick), packaged medications for transfer shipment to land, restocked medications, disposed of expired meds, make/breakdown pallets of drugs, some drug counseling, educational components w/ the pharmacy interns, stored medical labels of varying languages (Creole, Espanol), found various means for “bags” to package Rx, prepared different IV bags or syringes for injection.  Some days during the busy pre-packaging rush, we had groups of individuals from other NGOS or departments with as many people as 15-20 filling bags of meds, printing labels and arranging the efficient transfer of medication.  My consecutive best was filling 24,000 APAP in sets of 30 stuffing bags, both paper & plastic using staples (ran out of bagging supplies).  We as a team swept the floors and kept the ship tidy, joined human chains for movement of supplies, “volunteered” for 3-hour working parties (ie. Take new shipment of food from helicopter “helo” à refrigerator/freezer).  During downtime we played card games including thirteen & UNO, watched our extensive supply of movies (thanks to Chief of Pharmacy), listened to audiotapes on various subjects, educated ourselves, went on random runs, joined fitness classes, got lost on the ship, assisted with other departments and gossiped accordingly,.

My experience on the ship was a difficult transition for the first few weeks as a civilian conforming to a watered-down military lifestyle of sub-par, preservative-injected nutrition and set rules/regulations.  Entering the ship with disemboweled bowels from eating gourmet Guatemalan food fresh off the streets and refusing antibiotics led to improper electrolytes, severe diarrhea including bloating & cramping.  Eventually I found my best tool on board to counter dehydration was Powerade… sadly there was a 2 week period on the ship when my #1 source of fiber was found in Pop-Tarts… seriously (5g per serving, “Wheat P-T”). Certain points during the mission, I also ate Docusate like an eighty year old man to help with my constipation.

Also, I hate mefloquine – one evening I took the pill & went for a nap.  Slept in majorly diaphoretic state w/ vivid hallucinations – I experienced swimming through some color fields and later had a conversation with some man who acted civil and then told me “I’m going to shoot you now and you’re going to die.”  Strangely, I knew this wasn’t real in my dream-like state and no fear swept over me – I then awoke with a burning in my esophagus, crazily nauseated and head spun.  Needless to say, that day I went to sickbay and picked up a prescription for Doxy… which went unused.  In ways, I’m a bad, non-compliant pharmacist: thank God malaria seemed to bypass me!

Avoid Mefloquine – Seriously

Each day every person was required to report to several mustering periods (meetings) – the premise is understood though application is pointless at times with nothing new to report.  Each morning at 0830 we were required to report to radiology lab where pharmacy, radiology, lab and other ancillary services met, reporting new data and verifying no one fell off of the ship the night before.  Thanks to my alarm which died frequently using fresh batteries and believed there a day consisted of 22 hours in a day, I was not always timely… at all.  Moments like these I was grateful to the Universe that I was not military and I could hide behind my civilian incompetence.

Each evening at 2030, we met with our UCSD group to discuss travel logistics, volunteer opportunities, and various topics which came up at the time.  At 2000, we met in the Mess Deck for operational updates including weather, ocean forecast & mission updates (stories, country statistics, etc).  With work, three meals each day, the gym, our meetings, hitting the pharmacy books, enjoying the ocean, exercise classes & various projects throughout the day, we had our work cut out for us on a daily basis!  There was administrative paperwork and special OPS questions to answer – getting registered aboard the ship was time consuming & pretentious.  We answered several questions with our own situational answers about events which previously occurred in the rare instance we are taken hostage and our identity can be confirmed with these answers… don’t make these stories up huh? I doubt I can remember some of these scenarios!

As I got oriented to the ship, I found my way around and lived every day as I could.  I took advantage of the free hair-cuts and got a bald eagle look every 3-4 days.  Generally I used the laundry room when it was allowed, but sometimes I cheated accidentally and washed on days when it wasn’t rank appropriate.  Oops.  We found locations in various areas where we could escape the madness of the pharmacy area and study medicine with the pharm interns.  During this time I was preparing for my pharmacist boards which provided a wonderful opportunity to sit & review while blessing onward the knowledge.  We covered subjects including ACS (UA.NSTEMI.STEMI), HLD, DM, HF, IHD, Psychiatric Disorders, Gout, OA, RA, Kidney Failure to name a few – the interns were so eager to learn which created a pleasurable atmosphere!

Sights around the perimeter of the ship varied extraordinarily: the ebb & calm of a quiet deep-blue ocean, the random floating sea-turtle or the paddle of the occasional group of dolphins made for interesting variance.  The ocean hued from soft green, deep sea blue and even a gorgeous calming purple in the setting of the sun.  At all hours, the quiet splashing of the waves against COMFORT and her greatness would soothe a challenging day – during the pitch-black evenings, the ocean was the only sound present in desolate areas of the ship which viewed through human eyes as continuous black and white patterns stretching ever into the distance.  Sunrise or sunset demonstrates intense explosive colors which appeared so vividly as if they had never been seen before by man – perhaps the intensity was associated with the alignment of the latitude close to the equator?  During days of operation, RIBs or Hospitality boats were lowered from the vast deck of COMFORT into the great Pacific or Atlantic filled with excited people returning to land with intention to save the world one patient case at a time.  From the first splash of the ship hitting the ocean, to the renewed rip of an engine kicking over, we laid back as the mini-boats skipped waves as the illusion of the months collected together into an unforgettable experience.

Internet on the ship or “Ship Internet” sucked as we digressed into the days of the 4800 baud.  I wished for a 56k modem which would have checked my email at far higher speeds.  Forget social networking sites, email alone took me about 25-30 minutes to log in and check my email messages.  Uploading pictures!?  Game over – we comparatively had no internet.

Each day helicopters wouldbe in operation transporting supplies, individuals leaving from land back to COMFORT where maintenance was taken daily to ensure safe travels.  The uppermost deck deemed “Flight Deck” was off-limits when copters were in-transit.  One incredible late-evening I had wandered into the outdoor sanctity of nowhere amiss the Flight Deck.  During a lone practicing yoga night, the rain came down calmly on me while the distant flood lights were turned on emitted a powerful, calming glow.  A helicopter then landed and was “operated” on while I kept my calm practice amidst the pitch blackness of the sky & ocean breeze.  In the faint background I was able to hear the spinning blades of the helo against the yells of men and envision the halo of light surrounding the helicopter.  Some days I managed to watch the helo land in close proximity against the clear blue skies watching the blades rotate at ridiculous gravity-defying speeds.

As we transit aboard COMFORT views included Cuba from afar, agricultural land off El Salvador, different islands & ports.  We had transit through the Panama Canal, a feat which took our slow-moving hospital ship 8 hours to successfully complete.  This extraordinary man-made wonder allows 2 oceans of varying heights to equalize through the use of floodgates and GALLONS of water to raise one sea level to the other, allowing for Pacific travelers to meet the Atlantic.  Panama Canal had much construction within clear view from COMFORT.  The canal offered incredible scenery during its passing and we crossed many other ships along the way.  Sights included signs stating your distance through the canal, schools of children along the sides & tourists atop of buildings waving goodbye to our ship.  In fact, we had allies amongst COMFORT whom departed in Panama that traveled all the way to the Canal to properly wave us goodbye!!  And that’s how we saw LH & BB again during that 8 hour journey through the canal!

COMFORT was a vast hospital ship not grafted for combat.  On it’s surface at all hours sailors stood both aft (back) and forward guarding large stationary guns with gnarly calipers I can’t pronounce to ensure the safety of the ship.  The calming entertainment for these men and women I was told is the occasional flock of seagulls, a quiet sunset or sunrise against the soft clouds & the passing of civilian ships or land.  Through the bravery of these soldiers, I had felt safe to serve our international patients.

Rotation of the civilian groups came and went, at times about 30 civilians from our own UCSD organization served – each country offered a different influx or out surge of individuals.  As soon as you met someone, they were out of your life only to exist in their own reality and contact through email and as a memory until you meet again.  In fact, each several days or weeks provided new peoples entrance or exodus.  These individuals spanned from all over the US: California to Florida, Dominican Republic, Panama, Columbia.  As far as collectively, we met persons from Holland, Dutch Army, Canada, Nicaragua, Puerto Rico, and the list goes on.  Differences were put aside as we served our host nation citizens for an altruistic purpose.

Had the opportunity to suit up in scrubs at 0630 to sit in on 0645 surgeries.  The first surgery was an elderly 68 year old having a vaginal prolapse resection – effectively boring and uninteresting.  Next was a microlabroscopic cholecystectomy, which was a removal of the gall bladder and the common bile duct with the aids of microscopic tools and large television screens – it was like watching (and performing) a surgery on the big screen!  The microscopic tools allowed for small slits into the persons abdominal cavity while the surgery took place.  Unfortunately one thing which added to the excitement were the complications which occurred – not all the common bile duct was removed before the patient was restitched and they had to bust out the cleavers to open her back up.  The whole operating team consisting of several surgerical techs, two surgical MDs (one in training), another observer and my anesthesiology buddy “Mr. Wakey Wakey” was slightly unraveled after the 5 hour surgery.  They opened her up… wide up with organs well exposed, blood scattered accordingly with various layers of the abdominal cavity folded over exposing layers of skin & lipid – the outcome was a success after the end!  Aside from some scars and heated times, the surgery went well, ML survived and with some minor pain control & few morphine doses, she is now to be eventually pain free from her gallbladder!

Good job Deutch team! :)

Each day provided a new individual or group to listen, learn or chat with during lunch or dinner at the Chow Deck.  One was never sure as to what the day’s events would consist of until the evening was done – from grubbing with nurses from various countries or trainee doctors over meals of questionable content (not all of them were that bad…) to an hour watching a sunset and racing over a spin cycling class didn’t seem that uncommon.  The exercise classes and workout mentality were absolutely productive – had I not ate excessively and unhealthy, I’d probably have gained major muscle weight as opposed to not-muscle weight.

MRE’s on the fly were sadly one of our major sources of protein on some days in between meals.  MRE!? – “Meal Ready To Eat”

What the hell is that?  Government rationed meals through the DOD which might possibly be able to survive a nuclear blast.  Hearsay states these meals are good for decades… these things are fascinating.  Equipped with H2O, a person in the field can eat a warm meal simply by adding water to the hydrogen sulfide heater – the chemical reaction releases a foul-scented gas and releases large amounts of heat to cook the food in minutes.  I was fascinated by these; some were tasty, others bland, and some resembled the taste of bile & food getting regurgitated after a night complete of few too many alcoholic drinks.

Had the lovely opportunity to act as a member of “working party” – the individual who named militant was grossly misinformed about the content of this event!  About 25 individuals were assigned to necessary grunt labor for the good of the community.  Our assignment was to move approximately 20 pallets of boxed fruits, vegetables & meats from the deck where they were heloed to COMFORT & broken down to storage on the 2nd floor via pallets.  Human chains were produced to store the supplies neatly stacked into the refrigerator or freezer to allow for smooth unloading.  Three hours of twisting and turning with heavy 15-30 lb boxes led to rock-hard obliques and interesting dynamics between individuals of various departments.  In fact, I liked having an opportunity to work with enlisted sailors – though I’m a civilian pharmacist, I was able to do the dirty work without any complaints and earned respect from the individuals I worked with.  Besides, I had been blessed with the opportunity to see how much fresh melons, strawberries, peppers, papayas, mangos, steaks, chicken, shrimp we REALLY had!

See-Off parties – with the constant ebb of individuals joining and parting from COMFORT, it seemed like we had see off parties every two weeks or so.  Reconvening for group photographs with whoever was still around, steak & lobster dinner (during the lucky rotations), toasts and subtle Navy recruitment while being presented with a certificate of appreciation from the US government & long all-nighters with your fellow journey-men/women.  Not to mention power-points of glorious memories marked in history – our successful history!  After one see-off group, we met up late in the CIV racks after lights were out and uncovered a gigantic watermelon which was “smuggled” onboard.  This piece of fruit was incredibly large (probably 2.5-3 feet) and we were able to conjure up a cleaver to divide this thing.  After the operation upstairs to the kitchen where the knife was contracted, we actually donated half the proceeds and about 6 of us got our pig on with the juiciest watermelon ever.  Thank you El Salvador for your generous sweets!

Culture of the helos: something about the helicopters seemed to intrigue my group of travelers.  When they were not used for transportation, they were a show & tell for the community and had constant maintenance thrust upon them from washing & cleaning to replacing older parts or scraping rust.  Some evenings during downtime, civilians and related parties were able to climb around on the helicopters, chill inside of them and become one with the copter.  Helicopters were generally in operation from the EARLY AM until very late in the evening… I never did get to ride one; guess I need to volunteer again next year!

During our time amongst the ship, one of our department heads received a promotion from Commander to Captain – dressed in his finest military whites, our team cheered him on throughout the speech and ceremony.  Funny thing about the navy tradition, when you get promoted: it’s party time and you’re buying.  That’s how it all happened in Panama…  Politics/ranking in military is an interesting concept – one AM we had a visit from a 2 star general from SOUTHCOM and another from the Surgeon General of USA.  The attention and gravitation of energy swiftly changes around these folks with earned respect.  Some times gentlemen are referred to by their ranks and not names as ranking in the navy is focused in great detail.

Histology & microbial labs were interesting, seeing a pet worm named Ernesto growing in a jar from a patient in Columbia.  During my time in microbial lab, McQueen gave me a quick review in Microbiology 101 & I saw the behind the scenes of declassified STD outbreaks, stats of illnesses and the culturing process.  Not to mention fecal matter grown to culture for bacterial infection proving the outbreak of salmonella & shigella on the ship.  In histology I saw sliced tumors through microscopes and macroscopic chunks and even help set up wax slides of prepared samples for imaging.  The opportunity provided me to create a replica of my hand using scalding liquid wax which provided about an hour of my entertainment.

Hoisting of the anchor during transitions of inertia seemed to be a time when masses gathered around the hull of the ship.  It actually was an unspoken celebrated ritual to finish one additional part of the mission existing in transition off to the next.  The anchor was slowly lifted via crank & large chains from the ocean floor covered in sand & soot.  High pressured water hoses were used to spray off all the debris – with the anchor fully retracted, the ship is ready to sail!  This led to our first shifting of location El Salvador à Nicaragua.

Fire & disaster drills took place once, sometimes twice per country.  Strict rules were instigated, long sleeves & cover (crown cap) at all times, life jacket strapped & ready to roll.  Disaster was called and off to muster in Radiology lab to make sure everyone is accounted for.  Once our smaller group is compiled, the ship heads up to flight deck; quite a sight for masses of people all wearing orange reflective life jackets swarming the top of the ship, surrounding the helicopter each forming their own organized groups where again – everyone is accounted for.  Disaster days seem to wipe out the productivity of the day, but they’redefinitely interesting the first time around.

The exercise classes were phenomenal aboard the ship, taught by people from all walks of the world.  Each person provided their own flavor to the exercise class and taught in different ways.  My favorite training during the duration of my travels was a variation of P90X (Personal 90 Day Extreme Workout) taught by Singer.  The premise of P90X was muscle confusion, spanning a full body workout in 60 minutes using calisthenics.  You’d train your legs for 3 sets, jump to chest exercises for 3 sets, and next handle your shoulders returning back chest & legs.  Do this for 3 sets with 10-15 seconds between set and using only your own body weight and you officially got your butt kicked by P90X.

Zumba was an interesting class – one which combined dancing with beautiful women and a fabulous cardiovascular workout.  The music infused Latin influences and some upbeat club bangers.  In any case, everyone parades around CASREC, learning new steps with little regard to how much you cannot dance.  This class conflicted with my P90X class but I enjoyed half the class twice and highly recommend it.

Yoga provided the greatest experience whilst exercising aboard COMFORT – led by Project HOPE volunteers each class.  We met out underneath the stars, or underneath the gentle rain on the slippery sundeck with limited lights, under the slight roll the engine, rocking from the seas while we stood tall on one leg claiming tree pose.  Allow a picture to be painted: One early evening a light storm came in – as we stand in pose, facing straight ahead toward the helicopter in front of the gentle floodlights creating a friendly aura about the body of the black bird.  To our right side, the ocean was apparent, nothing but black and white wash against the black sky, dancing against the side of the ship.  When I looked over to the left, lightening rained down at a constant pattern without a hint of disruptive thunder.  At this time I had to smile & laugh thinking… wow.

How many people experience this?  We are blessed doing yoga on top of a naval hospital ship, in the middle of the Pacific Ocean.  Pitch black, silence under the motors of COMFORT, lightening to our port side, rolling seas to our starboard side, helos to our front and sailors to our aft.  As I thought this, I felt the rain hit my head, my arms, standing strong on one foot while the ship rocks from side to side.  Moment by moment, living in NOW.

Spin was a nice cardiovascular workout but after the death-like benefits of P90X everything was second-to-none.  Generally we’d start at a reasonable resistance and we’d climb up til we could hardly pump, alternate legs, stand up on the bike or even duel each other in races just because.  Intense.  Abs class was probably the reason I’d eat 5000 calories a day (seriously!?) and didn’t gain too much weight or get fat.  We did about 6-10 exercises focused on abdominals (sometimes we did one which strengthened the back for push-pull dynamics).  On the ship, I exercised at least 6 days a week – definitely working out kept me busy & sane.

Over the course of the mission, I incurred several injuries, first was tendonitis secondary to our rags (sleeping quarters) & second was when I rolled my ankle in Nicaragua on my way to RON.  The physicians saw me right away, wrote me medical notes excusing me from work which I didn’t follow (ie. working party), gave me 3200mg IBU qday & got me three sessions of PT.  Physical Therapy was complex regiments, including simple & advanced techniques: stretch-bands, massage therapy, exercises, ultra-sound waves & my favorite E-Stim (electric stimulation).  The sound waves penetrated the skin to reduce internal inflammation markers while E-Stim sent jolts contracting the muscle leaving the knots relaxed after treatment.  Absolutely awesome treatment technology, highly effective – recommend the E-Stim ;)

US Government takes care of their own. All this cost me nothing and this treatment was provided to me after meeting with a physician at no hassle.  No insurance bullshit, no “Is this medically necessary?” Fears & Gage just did their jobs and after 2 weeks of therapy, my shoulder was repaired like new.  Have to laugh that my name was entered into the government system incorrectly after I repeated my name twice and finally handed him my passport.  Still my middle name had replaced my last name and changes we unable to be made… government efficiency?  While I was on the ship, I was also very fortunate to receive free dental care.  And I mean free as in free.  X-ray to see my teeth and their filling condition, I had one amalgam filling deteriorating à it was then removed, replaced with a ceramic cap based on expert opinions same day.  They even cleaned my teeth using some brown gunk which ended converting my smile to a sexy white.  All service with a smile in a day with the navy!

Through all the subtleties, life became routine and the military way of life was comfortable – civilian life truly seemed a way of the past.  Different random activities broke the monotony of the days and made for interesting experiences.  Upon leaving Nicaragua & headed through the canal, a smaller sister American ship met up with us to provide restocking & fueling supplies.  Headed same speed, same course, riding parallel in the early afternoon, the ship shot off a supply hose which about 50 volunteers helped to heave into the ship, dragging the fuel line to the ship and allowing stability for the on-the-go refuel.  The ship simultaneously had helos transfer pallets of food & supplies for a three hour restock job to prepare our trip back to the Americas.

Some days we would play hookie, escape from our respective areas during slow periods and rally up the troops for some hockey games on sundeck.  Bare shoes w/ hockey stick in hands, we’d run around shooting balls into the opponent’s net until the webbing in our hands was bruised. We generally played about 3 games to 10 points and switched teams frequently.

We enjoyed some evenings with the American Air Force band playing such songs as Smooth by Carlos Santana & Beat It by Michael Jackson.  Music produced by the band had an instant morale boosting effect aboard the ship, they were great people too (we played hockey w/ them).  The singer had a beautiful voice and she really moved the crowds.  One evening, there was even a competition of an “American Idol” US Navy style which really was a lot of fun with impromptu dancing.  Another incredible experience was watching movies on the flight deck.  With chocolate and other unhealthy snacks in hand, around 2100 we met on top of the boat in pitch blackness, pulled up hundreds of chairs and watched Valkyrie up against the wall of the helo hangar with full surround sound.  Imagine a drive-in movie environment except US Navy style.

Last day on the ship church services had a mixed Catholic/Jewish ceremony on the flight deck at around 1000 amiss the beautiful Caribbean sun.  We gathered to share stories, songs, memories, prayers and listen to the AF band play different songs sharing the experiences with our newfound friends & appreciating the accomplishments of the previous four months.  During our final day of service and prior to disembarking back to America, our pharmacy team presented us volunteer pharmacists with plaques of appreciation, certificate of services & several pictures, posters and signed cards for us listing memories and personal messages.  The trip had final come to a close and life had some how seemed different.

As the days working aboard USNS COMFORT continued, I felt less & less on vacation and dove deeper into my pharmacy related practice.  The experience of working aboard the ship with such unprecedented group of individuals led to a nice transition period from student to professional in diverse cross training.  Towards the end of the journey, I felt… I’m ready to practice pharmacy.  My busiest day I personally had filled with my team about 6500 medications.  Our single site best for ONE DAY was 8494 scripts at Somotillo, Nicaragua.  Yeah – wow.  GJ Tim, good job!

Steel Beach

I hadn’t realized the Panama Canal was such a big deal.  At the time of the mission, I simply thought we simply pass from the Atlantic to the Pacific Ocean.  Hooray!  Excuse my ignorance as I went outside to watch the “event”.  Signs stating the meters of our distance traveled through the canal were along our sides, beautiful landscaping, buildings and dam structures were surrounding us.  USNS COMFORT was almost as wide as the Canal itself, which had two passages connecting the oceans.  While we were passing through on this day, construction was up in full fledge and they were widening the canal!  Each side of the ship boasts different, new sights of the canal.  After passing through the first gate, watching the dam close and the gates flood with water until the boat was of the same water level as the Atlantic Ocean was an experience in itself!  Then the ocean built of equal levels opened its gates as we officially Pacific -> Atlantic.

It’s done!  I thought “Wow that was cool, but why does everyone rave about that?”  Little did I realize, the trip through the canal is more than the entrance but rather a 77 kilometer (48 miles) journey in of itself which took us 8 hours to triumph!  Panama Canal was greenery, buildings and bustling construction, blue deep aqua – fresh ocean water differential, bus pulley system w/ ropes aligned with our ship, tropical surrounding islands & racing boats through the canal was the Canal Experience.  During this time of Steel Beach holiday, the ship was permitted liberty as of 1000.  Everyone was dressed in their PT clothes, hopping around the ship from floor to floor, taking photos or videos of the sights, sounds, & experience.  Perhaps the craziest thing of the whole day was seeing our friends LH & BB on a distant neighboring building waving frantically goodbye to us, through the canal as they had promised.

At this time all day, it was a day on the ship beach.  Activities of all types we occurring on the flight deck – no copters came in and out today, just leisure.  Applying sunscreen twice, I still fried like a lobster while I laid on the sundeck catching an hour of tropicalsun.  Several three wheelers were delivered to the deck, one wheel in the front, two wheels in the back; each styled like a low rider.  I spent about an hour carving corners in the middle of basketball games, kick-back sessions and grubbing on snacks making tight turns on two wheels and screwing around to my maximal ability.  In the latter afternoon, a few of the guys crept off the flight deck and hit the sun deck – we scrounged up some random hockey gear, a few goal nets and this shapes how I played street hockey for the first time in years on the Atlantic Ocean.  Boy I did just fine!  Food was actually amazing – burgers, hot dogs, baked beans & salad for lunch and BBQ ribs, Indian curried chicken w/ beans for dinner.  After grubbing, some of the copter fellas and I threw the football on the flight deck for an hour until the sun went into the water.  After the tossfest, we enjoyed the first comedy show of a succession of several occurred where I laughed my ass off for a whole hour.  The first gentlemen had a strung out presentation & energy and had a great skit about when he was younger his entertainment came from dropping acid in his room while playing tetris with his lego set.  Maybe you had to be there? Second comedian came from West Virginia and had us going the whole half hour, he was hilarious.  As the day slowly wound to the end, we had realized that we would soon be home in America.  Just 4 days!

Day 40 Ft. Lauderdale, FL (Port Everglades)

The final evening I had snuck outside to the sundeck where I enjoyed the peace & quiet, did some meditation, saw four shooting stars & watched the sunrise.  My body felt beat up after laying out on that half busted wooden sunchair until the sun awoke from the ocean and spread a gorgeous orange/purple glow throughout the sky & water.  Walking around the ship feeling alive again, rejuvenated to have returned to my home, my country, the United States of America.  Our ship pulled into the Port Everglades, Pier #26 located in Fort Lauderdale and the scenery was a sight to behold.  Truly, we had made it home!

After walking around the outside and making rounds saying goodbyes, we grabbed our last 6am breakfast and head over to pharmacy.  This was a bittersweet day – though it was what we had been aching for over weeks, this effectively was the end of my illusion living aboard USNS COMFORT – today we were to part ways and I am to absorb all the experiences, both the good and the bad, to walk away as a stronger individual w/ something great under my belt.

After reporting to pharmacy for our last time, my team of interns and I were presented with plaques of accomplishment from the pharmacy staff for our time, hard work and interest in the medical mission “Continuing Promise 2009”.  It was truly heartwarming as we prepared our bags of travel gear to head off our separate ways.

As I made my rounds throughout the ship I bumped into two of the major Chiefs & Commanders from the mission who informed me of all the opportunities available with the US Navy and pharmacists.  Military life was easy as I was told the keys to success: “Do what you’re told, shut the fuck up, drink the kool-aid & shave your head”.  After listening wholeheartedly, I skipped ship as my grandmother was ½ hr early to pick me up for our last event and grabbed her to bring her aboard ship while I grabbed my stuff.  One more optional event stood between me & civilian life – an organization had hosted a welcome home reception for the sailors in Los Olas in front of a nice hotel.  Dressed in our finest clothes, we were soon on our way to “Broward Navy Days”.

As I brought Grandma aboard ship, she in her youth was like a celebrity.  Military opened doors for her and helped her up the ramp as we climbed a hundred feet to the ship.  As we walked towards pharmacy to collect my belongings, the Captain & Commanders of the ship were awlking with the Congressman of Florida down our hallway.  I stepped aside with grandma in a corridor to allow the paparazzi and top dogs to pass.

Next thing I know my grandmother said hello to the Congressman, gave him a kiss and I was interviewed with flashing cameras to my left and right about my services aboard the ship as a volunteer pharmacist.  Gave handshakes, told them a little about my background, services rendered and was next interviewed about what my next steps in life were.  As soon as I was approached, the experience was over.

We grabbed my belongings, I showed grandma our pharmacy briefly & introduced her to our staff and we packed up my four large cases of belongings & gifts in the Lincoln Towncar.  Several buses were waiting outside the perimeter to take us to Los Olas & we hopped on a bus in a hurry and waited like crazy.  Off we went.

The reception (nice try!) definitely had a cute set up – in the middle of a patio out front of a nice hotel, a small cabana with free drinks (EtOH/Juice) was set up with outside standing tables and several chairs.  Everyone seemed to post up in small groups with their friends, enjoying a few drinks, relaxing underneath the soft sky… which soon began to rain.  This reception offered free drinks for starving military, but the food (which was really not good) cost an arm & a leg – $6 for two chicken tenders (not tender) or some conch w/ some crusty French fries.  After about an hour of conversation, good-byes & photos, grandma and I hit the bus back along the A1A toward pier #26.

We decided that Grandma deserved a little tour along the ship – she had never been on a Naval ship.  After the tour she said she would have married a sailor had she known.  I took her aboard the ramp once more, following the rear in-case she slipped as the ramp was steep.  Along the main floor, CASREC was set up for Tiger Days (the ship was to set sail with sailors & their families to Norfolk, VA) and had each medical department set-up for show & tours.

As we walked through CASREC, grandma gasped that there was a man with tubes just laying next to a machine – I told her I was sure that no sick patients were still aboard the ship.  She insisted and as we stepped closer we discovered – the mannequin!  “Holy Toledo” she responded!  I walked her around each floor, got her some visual posters from the MWR Funboss, took her around to the various gyms, showed her the operating rooms, took her outside around the perimeter of the ship overlooking the port and even “treated her to a gourmet dinner” on the mess deck.  After dinner, I took her outside on the flight deck where she commented on the helicopter stating it looked like it couldn’t fly – I had to laugh.  It is a helicopter.

After a lot of walking around through my favorite places on the ship, I realized it really was over.  Grandma was tired and it was time for me to retire in Florida and prepare for my pharmacy board exams.  We had REALLY done it – mission complete!  From the flight deck through the elevator walking out the ramp to the ground level of the harbor, we head back to the car in the early evening ready for the next phase of life.


Things on the ship weren’t always wonderful.  There were a number of NGOs aboard the ship whom generally had high morale – members of the military had varying outlooks of the mission.  Some were forced to deployment with family & children at home for the duration of the stay and were miserable as a result.  Times inside pharmacy between missions or during downtime ranged from pleasant to less than.  Differences in rank led to politics, tension or dissatisfaction during some periods.  Others hated the military which they dedicated their lives to; some were bitter about a difficult or underappreciated job.  I remember having a very deep conversation with an enlisted marine who was a sentry guard “Moses”.  Moses had a negative outlook on the military and was not happy as he was trained to fight ruthlessly and was stuck on the hospital ship as an armed sentry.  “Nothing is going to happen on this ship while people are dying in Afghanistan, I could be fighting there.”  He explained to me he lives aboard the ship 24/7 on guard at post, without having the utility to deliver any direct patient care – a boring, useless mission through his eyes.  As we spoke, I assured him that his role on the ship is why I felt comfortable in foreign lands allowing me to serve patients.

Not everyone aboard was honest or humble during the time on the ship.  I left my MP3 Player on the ground by my bunk and as a result it was stolen towards the end the ship during a bunk cleaning.  Having distinct colored headphones, ironically after a late start the day after theft, I went into our bunk’s head (restroom) and saw an enlisted naval officer with my headphones.  After calling him out on it and denying the accusation (couldn’t have been me, I was only here yesterday for fifteen minutes) I made a useless report w/ his name in hopes that future theft would be avoided.

Since my travels to Central America, I don’t complain about the temperature being too hot.  Our most record-breaking temperature during our stay was 117 degrees F.  The humidity far surpasses even that of Florida in its summer months and its far cooler in Florida.  Minutes outside will lead to sweating, cooking & sunburn… and simply puts CA to shame in the murderous heat department.  During the day you will be surrounded by small flies, stung my mosquitoes possibly carrying malaria and there were periods of 3-4 days when I didn’t have a shower.  At the time I was super grateful for deodorant (which I stopped using when I discovered Himalayan Rock Salt).

Perspective is perhaps the most valuable thing I’ve gained from this trip.  For instance, complaining about how “crappy the MRE” meal is.  And then being begged by a native for a supplement from your MRE and how it was thoroughly enjoyed – it’s all perspective.  I remember seeing small gnats & flies swarm around young children’s eyes without any reaction to them as though it were normal.  The pesky bugs annoyed the hell out of me and caused me frequent itching amongst the heat of the nations.  These people do not know any better and hence just play with the cards their given.  Even in poor health, lack of luxuries, cell phones or even basic sustenance, it’s not uncommon to find these people happy.  One lesson that these gracious folk have taught me is happiness comes from within, not externally.  For the impressive size of smiles on the faces for those who have next to nothing, who live in a land of such uncomfortable temperature without cars or efficient methods of travel with limited food/drinks and much more physical day to day labor… I learned true happiness comes from within & the company you keep around you.  Be grateful for what you have; from a Nicaraguan standpoint of materials and viewpoint, I am a king in my homeland.

Own your possessions; don’t let your possessions own you.  If you truly don’t understand this concept, go travel to a third world country for a month.  I promise this lesson is worth more cash than what you may have earned with your career during that time.  Possibly worth your weight in gold :)

Happy travels and thousand blessings,

“Dr. Nick”

Nick M. Berry, Pharm. D

Compassionate Lover & Human Being