ideatrash

Writing, publishing, geekdom, and errata.

Trainees: My experience treating recruits in the Army medical system

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I wrote this in 2000.  I believe it was published in 2001 in the Fort Leonard Wood base newspaper.  I can only hope that things have changed since then.




We treat them like shit, you know. 

It's not often consciously thought about - the way we treat those trainees who aren't going to make it, even though we've all seen them, we've all dealt with them. In my nearly three years here, I've seen a lot of them. 

I am a nuclear medicine technologist, and for those of you who don't know what that means, suffice it to say that I'm one of the people who does bone scans - a diagnostic test that definitively tells us whether or not someone has a stress fracture; a bone injury that's caused by repetitive stress rather than a sharp break like a "normal" broken bone. In the civilian world, it's rather rare for a test as expensive as a bone scan to be done for stress fractures; patients are normally told to take it easy and stay off of it. 

Over half of my patients on Fort Leonard Wood have been trainees, seeing whether or not they have stress fractures. 

Or rather, to see whether or not they're "faking it". 

Sometimes, a drill sergeant will actually accompany the trainee when they come to thier appointment; often this is accompanied by an aside that can be paraphrased as "they've been faking it for weeks". 

Every one of those patients have had a real injury. 

A lot of them do, actually - when I did a review of our trainee patients, I found that over ninety percent of them had bone injuries (which isn't even saying the other ten percent weren't hurt - just that it wasn't the bones). Why or how so many trainees have been hurt isn't what bothers me, though - the kind of conditions that cause stress injuries are set up from before they even meet the recruiter, let alone reach Basic training. 

What bothers me is the attitude that many of my fellow permanent party soldiers have towards these trainees: They tend to assume the trainee is faking an injury, or treat injured trainees (especially those going to be chaptered) as if they're useless, a waste of space. 

I had my own failing with this when I was working as an X-ray technician at a CTMC in Korea. I X-rayed one Korean soldier at least ten different times over two weeks; the doctor there was looking for air inside the chest wall ("spontaneous pneumothorax" to be technical). They all came back negative, film after film, and finally I voiced the opinion, rather loudly, that he was faking it. 

That day's film clearly showed, even to my eye, the injury the doctor was looking for. 

I am aware of the demands of the training environment, and how trainees must be pushed past what they thought they could perform. I am well aware of that minority that try to escape training by "riding" sick call. But this is not nearly as stupid as the way we, as an Army, treat those who are being recycled in their class or being chaptered out of the military because of an injury. 

They are used to perform menial jobs until they're chaptered or while they're recuperating - sometimes without regard to the profiles (or "codes") that have been prescribed by a physician. They are treated as if they are useless - and I've heard many accounts of trainees actually being told that. Of being treated as less than human, simply because they've been hurt. 

Again, I can understand the mentality that creates this environment. We want to reward those who can make it, those who succeed - but this doesn't mean we have to ridicule or insult those who, for whatever reason, can't. 

Think about this, my fellow soldiers. They - the ones who do not make it - are the ones who will go back to civilian life. They - not the graduates - are the ones who will be among civilians, their peers.

 Our recruitment pool. 

It's a well-established fact that people will relate a negative experience to more people than a positive one. It's also known that word-of-mouth is an even more powerful method of advertising than magazine, television, or radio ads. 

By demeaning those who simply don't make the cut, we are inadvertently projecting a powerful image to the civilian population - to those who our recruiters are trying to entice to enlist. It is not a positive one. 

I've met nearly every trainee that was chaptered at Fort Leonard Wood due to stress fractures during my time here. I've talked to many of them. While there were some that just wanted out, the vast majority of them were truly motivated - at least initially. They wanted to be soldiers. They wanted to succeed. They were scared that their own bodies could keep them from graduating. 

I saw a saddening number of them lose that motivation as they waited for chapters. I saw them become demoralized. I saw them grow bitter towards the military because of the way they were treated.
I have no doubt what those potential soldiers told their friends when they returned home. 

While I was in Korea, we were constantly reminded that we, as soldiers and American citizens, were representatives of both our country and the military. That how we acted shaped how people would feel about both America and the U.S. Army. 

Perhaps it's time for us to recognize that here at home as well.

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My favorite picture from a virtual world

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Blood Bowl, Hansel & Gretel, and Knights of Badassdom: Bloody fun stuff

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This last weekend (what with all the snow and such) meant I had a lot of time.  I decided to spend some of it with Blood Bowl and so-bad-they're-good movies.



First, Blood Bowl.  Blood Bowl is pretty much the only sports game I've ever been interested in.  I managed to get it working on WINE (use PlayOnLinux, install DX9, DX3D, and NET 2.0, then follow these directions before launching and you should be good to go.  (Note:  For linux users, I've been having to explicitly state (instead of "system default") what my audio output device is for POL lately.  Not sure why, but it's not a big deal once you know about it.)

Quite frankly, getting Blood Bowl online (even the Chaos edition instead of the Legendary Edition) is way cheaper than getting the actual board game.  Last I checked, LE was $20 on Steam, and Chaos Edition was $30.  The board game regularly runs $100.... so yeah, it's like super discounted.  And it's a heck of a lot easier than dealing with the rules for the board game, so win-win there.

Blood Bowl is theoretically in the Warhammer 40K universe, but who gives a crap.  It's what football should be, including big spiky weapons, fatalities, and more.   As they say in the Steam description:  "Inspired by the Warhammer Fantasy world, Blood Bowl is an ultra-violent combination of strategy and sports games."

Oh yeah.

Then movies.  I watched two movies this weekend I want to make mention of, because both fell into the so-bad-they're-awesome category.



First, Hansel and Gretel:  Witch Hunters.  Really, just read this io9 post, because I agree with it wholeheartedly.  The movie is so campy it's awesome.  Turn off your brain, turn on your "HOLY CRAP AN AUTOMATIC CROSSBOW IS AWESOME", and you'll enjoy yourself.  And besides, Gemma Arterton is freaking smokin'  I mean, damn son, smoking.





Second, check out The Knights of Badassdom.  Let's make no mistake, this movie is not "good" in any kind of critical sense.  But damn, son, is this movie fun.  Peter Dinklage does a great performance, and while the plot takes a while to find its horror-comedy feet, it's a fun time throughout.

I could never quite tell if it fell on the Big Bang Theory or Community side of "making fun of nerds" or "nerds making fun of nerds" continuum;  I'm going to choose the latter simply because, well, Summer Glau.

It was a fun romp, and while it didn't quite reach the level of either The Gamers or The Gamers: Hands of Fate in terms of really respecting us nerds, it definitely acknowledged us sufficiently to make me a happy camper.

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Want to make shoveling snow easier next time? I have the answer for you.

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If you're in the US, you probably had to shovel snow this weekend.

And it probably was awful for you.   But it wasn't that bad for me.

Here's why:  Stout's BackSaver Grip.


I purchased one of these back in 2007, and it's why I don't need a snowblower.

Seriously.  You screw it on (hardware comes with it) to the handle of ANY tool - snow shovel, regular shovel, rake, whatever - and it makes doing the job a ton easier.


This thing is just wonderful.  You can get it at a bunch of retail stores, or order from Amazon or directly from the company.


[Edit:  I really think this is an awesome thing, and seriously reccomend it. I don't do paid endorsements]

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I listen to them snicker.

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I wrote this in 1999 while I was still active duty, where it was published (though slightly edited) for the base newspaper at Fort Leonard Wood.


I listen to them snicker, and I wonder if they’re hiding something. I want to believe that; I want to believe that they’re trying to protect themselves from some pain through biting sarcasm. I’m just not sure that I can. 

That night swims through my mind; I could barely walk into the mini-PX to buy the pills. I know my eyes were red from tears; I know my stare went straight through people to somewhere that didn’t exist. Nobody noticed. I didn’t give them much of a chance.

 He talks about high-risk behaviors, about how a beer or two after work is just fine, but how a six pack or two a night is a risk behavior. Behind me, I hear an E-7 say, “Hell, that’s just getting warmed up,” and I remember.

I know why the guy across the hall ended up in rehab instead of me; I never made the mistake of pissing on someone’s door. Other than that, there wasn’t much difference between us. He had his own personal problems a thousand miles away, his family back at home. I had an infant son, a wife busy trying to smoke pot and fuck her life away, and a doomed relationship here I’d carefully constructed for myself. We both drank a lot. I was just a loner about it. I wasn’t drunk when I tried; but it couldn’t have helped my judgement.

I haven’t told my parents yet, four years later. The closest I’ve come to publicly “outing” myself about this before was at a suicide prevention class I taught earlier this year.

I hear the whispered comments you make, the accusations that those people are weak, that if they can’t hack it they shouldn’t be in the Army, and I wonder if you know that you’re talking about me. I wonder if you know that you’re setting an example for your junior soldiers. I wonder if you know you’re setting an example for me.

I think I’m over it now. Recently I was put under general anesthesia, and I wasn’t scared. I would have been a year ago. I certainly was back then.

My fingers were cold, and I had dozed. The pills were doing something, and it suddenly hit me that this was real, and the adrenaline was like a wall pushing me up, up the hill into the TMC, where I proceeded to scare the hell out of everyone I’d worked with for most of a year. 

I think I managed to apologize to most of them before I left Korea.

I think about the KATUSA who blew his brains out down by the MP station that year; about the harrowing quality of his mother’s wails echoing through the halls. I remember the other guy who swallowed too many pills. I hadn’t liked him – and remembered that as I helped them carry the stretcher out of the second floor, as I heard the medic in the back of the ambulance say – no, scream – that he wasn’t breathing.

I think about the eyes of my fellow soldiers when I came back. I think about the eyes of my son now.

I’ve done a lot since then, since what the psychologists decided to call a suicidal gesture. I like to think that I’ve helped people, that I’ve made a contribution to people’s lives. I have a few good examples of people – NCOs and civilians – that I try to emulate, and sometimes I succeed. I hope that I affect some of my subordinates the way they – some of my earliest examples of senior NCOs – affected me.

I see you, sergeant. I see you snicker at yet another suicide prevention class, and I hope that it’s a defense mechanism, that you’ve lost someone close to you before. That you won’t let yourself think about it rationally, and joke to keep the pain at bay.

I hope… but I can’t believe it.

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Ash Wednesday

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Today is the day that I remind myself exactly what I screwed up, and how much I screwed up, and what could be happening today instead of what is.

Because I let my own emotions get away with me.

I let my lizard brain take over, screaming fear and anxiety and fear for weeks at a time.  And I couldn't hear or comprehend anything else.

I will not let that happen again.

Even if it doesn't fix anything now.

Today is a day of penance.

[Edit for clarity of intent:  After penance comes forgiveness. At least for yourself.]

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Jasper the Colossal and HeShe/DC: Two bands you want to catch live.

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Saw two great bands over this weekend - one that I've known for a while but has only gotten better, and one I was just introduced to.

We'll start with the one that was new to me:  HeShe/DC. 

Yes, I know.  They are exactly what they sound like.

https://www.facebook.com/heshedc

I am not a huge AC/DC fan.  I mean, I'm familiar with the band, vaguely familiar with the lineup changes, and won't turn it off if it comes on the radio, but that's about it.

But damn if they didn't pull off the music (and attitude) to perfection.  They sounded really, really good.  And damn, it was fun.  When a cover band does a good enough job that someone who isn't really a fan of the original band suddenly likes the songs more? 

Yeah.  That's some high praise there, my droogs.

And the crossdressing bit for my LGBT folks?  Well, aside from the fact that one of the band members really reminds me of Eddie Izzard, it was just a thing.  Maybe it started out as a gimmick, maybe it's not.  But while it was a fun thing, I didn't get any sense it was a making fun of thing.

Find HeShe/DC on Facebook here.



The other band I saw this weekend was Jasper the Colossal.  I first ran across this band almost four years ago, but haven't had the chance to see them since their Kickstarter (which led to the album Liar) almost two years ago. 


While they've had a little bit of a lineup change, I gotta say that my initial enthusiastic review is out of date.

They were good then.  Now, these women have simply gotten excellent.  If you've heard (or liked) Tilt, The Ninja Dolls, or Visqueen, you'll like Jasper The Colossal.

Their show last night was super-tight, featuring some of their new work.  I'm really looking forward to the stuff they're putting together for their next album.  If you have a chance to catch them live, it's a show you don't want to miss.

(Columbus folks:  That's this weekend.

Find Jasper The Colossal on Facebook, Twitter, Bandcamp, and Reverbnation

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He does not know the meaning of Valentine's Day

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Happy Valentine's Day
My son does not know the true meaning of Valentine’s Day.

It’s strange, hearing that phrase in February. We’re so used to hearing it at Christmastime, with continual exhortations about the “reason for the season”, that it seems odd to refer to the “true meaning” of any other holiday. But the strangeness of it doesn’t change reality at all.

We saw the valentines at the local mega-store; the type of cards that show up after the New Year’s decorations come down, the kind that parents dutifully buy year after year for their children to distribute in classroom parties.

Last year we had made our own cards, scanning pictures of wildlife and creating cheesy captions to go with them (an orange orangutan proclaiming “I’d go ape for you, Valentine!”). This year, though, has been busier than last, and besides, we both like the utterly insane Australian naturalist (and his crocodilian friends) that graced the cards.

Even though they were little more than scraps of colored paper, they met with my son’s approval, and so they ended up in our cart.

In my adult life, I have only gotten valentines from relatives. I remember going through old cards when I moved out of my parent’s house. Many of them I saved – and still have, somewhat amazed that there were a cards wishing a three-year-old with my name Happy Birthday, or Merry Christmas. I remember tossing out those class-distributed valentines from people I now barely remember, watching them arc a pathetic path through the air towards the trashcan that they usually missed. I regret throwing them away.

When we got home, he pulled the box of cards out and inspected it carefully. Among the benefits of living in a rural area like this one is class size – there’s only sixteen students in his classroom. My son has progressed well beyond simple math like that, especially when there’s goodies involved.

“Dad!” he said, “there’s more cards than people in my class! I can send the rest to me!”

My wife (now ex-, or as ex- as possible when a child is involved) never gave me a valentine, even when we were married. This – unlike so many other things – was not her fault. I always told her that I didn’t want one, that I didn’t believe in Valentine’s Day, that it was a loathsome holiday of spending excess, little more.

I was lying. It was an act – an affectation adopted after years of geekish solitude and holidays spent alone. Yet somehow, unfairly, I felt she should have known.

“No!”

He dropped the box in shock – he hadn’t expected this kind of outburst.

“You don’t send valentines to yourself! That’s not what Valentine’s Day is about! Don’t you know the reason for Valentine’s Day?”

Embarrassed, he whispered. “No.”

The rehearsed answer, the one I’ve practiced so long that I almost believe it, streams from my lips: “Some people believe that Valentine’s Day is just commercialism and trite sentimentality. It’s just another excuse for big companies – and everyone else – to guilt-trip you into buying cards and flowers and candy you don’t need in a desperate attempt to convince someone else that you love them – and hope they send you something so you know they love you back.”

His face is unreadable. He’s seven, he doesn’t deserve hearing the result of my decades of (mostly self-inflicted) anguish. Besides, even if I’m right, that doesn’t mean that something more can’t come out of the holiday. So I take a deep breath, and try again.

“But most people believe that somehow, despite all the commercialism and stupid cards and fattening candy and flowers that die, the true spirit of love shines through. They say that Valentine’s Day is not only a celebration of romantic love, but of the friendly love of all humans. The kind of love that God has for the world.”

He wipes a little tear from his eye – how did I not notice that I had made him cry? – and asks, “Do you believe that, Daddy?”

The television plays in the next room; the network news has just come on. Interspersed between commercials are the stories, the stories of human hatred, the stories of human greed. Stories of pain and suffering over differences of opinion, stories of death over something as transitory as land and money. Stories where innocents are hurt, maimed, die, and no-one moves to intervene.

From a strictly biological point of view, “love” can be quantified as a hormonal reaction, as neurons firing in specified predetermined patterns. Whenever we fall in love, all other relationships pale in comparison – until that one is over, and then we question whether we ever were in love to begin with. Sometimes it seems as though love is little more than a self-delusion… but yet we believe in love and believe in its power.

A friend of mine once stated that his religious belief could be summed up in one sentence: “I believe because I believe.” No amount of proof could ever verify his belief for anyone but himself, but he knew it to be true, beyond any facts and figures. He knew it to be true in his soul.

“Of course I believe that,” I tell my son, trying to forget the heart-shaped scrap of paper I had thrown in the trash years ago, a valentine I had sent myself in fear that no-one else would give me one.

Of course I believe in love. This time it’s the real thing.

Really.


I wrote this in 2001.  It's still true as well.

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The defining characteristic of Lawful Good

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The defining characteristic of Lawful Good is that the well-being of others - even others that the person in question has never met - is treated as a real and important concern.

Discuss.



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It Looks Like Myst: A Reflection on the Grand Canyon

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This was originally written around 1999.

It still holds true.


 
It looks like Myst.

I'm staring out at the Grand Canyon, one of the most breathtaking natural wonders of the world, hearing the early morning symphony of Japanese spoken by tourists fulfilling the camera-wielding stereotype. The light slants through awe-inspiring formations of colored rock, and all that comes to mind is that it reminds me of Myst.


Or Riven. Let's not be old-fashioned about this. If I squint hard enough I can see the slight QuickTime distortion around the occasional swift or crow.


This is nothing compared to the lack of interest shown by my five-year old son. Right now he's playing with a two-dollar die-cast jeep (as far removed from its origins as the tourists) by the side of the trail, utterly unimpressed with the grandeur laid out before him.


Sure, I got a "cool" out of him, and he'll sometimes say "whoa" as a new formation comes into view, but he can't quite seem to figure out what all the fuss is about. Sometimes I hear the beweeoo! or bdoosh! of imaginary alien invaders turning the park into rubble - but mostly he just seems bored.


Bored! Here!


Look out there, son! See the beauty?


Yesterday, in an attempt to help him understand that the power of this place is not just in the visceral now, I led him in an imagination exercise. We sat upon the rocks, and I had him close his eyes against the summer sun, pretending that we sat upon a level plain millions of years ago. We imagined days, seasons, years, millennia ticking by in seconds as the Colorado slowly dug miles into the plateau. Imagining the generations, civilizations, species that have come and gone as this place came to be, the massive stretch of time that is revealed by the slow action of rock on water.


Finally, I had him open his eyes and gaze at the breathtaking sight, hoping he'd see it with this new understanding of its history.


"Wow!" he said, and my heart swelled. He got it! He appreciates it!


"Everything looks blue!"


I fought the sighs as I explained that his eyes had just gotten used to the red light filtered by his eyelids, and they were just overcompensating now that they were seeing blue again. They'd do that anywhere - that's not what was special here.


As a result, he spent a large part of the day shutting his eyes, trying to make everything look blue.


Right now, he informs me that his jeep is being destroyed by massive flows of lava - I'm sure with hyperrealistic computer graphics, with aliens and dinosaurs just over the horizon.


I sigh, trying to take in the landscape, determined that at least one of us will enjoy the natural beauty.


Damn.


It reminds me of Myst.
















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The danger of (emotional) self-diagnosis

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It's true - medical folks tend to hate WebMD and Google.

There's a really simple reason why.  It's known to everybody who has taken a class in psychology or medicine:   We tend to diagnose ourselves with things we don't actually have.

And while the internet does great things for those of us who have weird medical conditions (I'm among the people who had restless legs diagnosed for me, rather than diagnosing it myself), it also means that people routinely present themselves to a medical professional already sure of what they have self-diagnosed.

Pro tip here:  If you've gotten your diagnosis from the internet, you're probably wrong.

Lots of medical conditions share symptoms.  That's why I'm seeing a neurologist now and getting an EMG next week;  it's to help differentiate out why I have the RLS that I do... because the treatment is going to be radically different depending on what's causing it.

And the same thing goes with almost any other condition.

Self-example:  I don't have Asperger's.  I'm not on the autism spectrum.  But I seem to experience sensory overload in a way that is similar to those who have Asperger's.

Sometimes the tips and advice that Aspie folks give can help.  Sometimes it doesn't - because I don't actually have Asperger's.

I think this gets really dangerous when you start diagnosing your relationships yourself via the Internet.

For example, "Five Powerful Ways Abusive Narcissists Get Inside Your Head".   It's a great post, and got a lot of traction for a short while.

But really, narcissists only compose approximately 6.2% of the population.

You probably aren't in (or haven't been) in a relationship with a narcissist.

But you might have been in a relationship with someone who shared some of those tendencies.

Again, this can be useful.  Again for a self-example, I can see where I've behaved similarly to the "lovebombing" technique narcissists use in the idealization phase.   And so I can work on myself so that I don't unintentionally manipulate people I care about.

But that's not the same thing as calling me a narcissist.  Because large chunks (like, the rest of the article) don't apply to me.

And that's really the point I want to make here. It can be good to get a label on something that you didn't identify before. I know when I first realized that "codependent" characterized a past relationship, it really helped me get a handle on it. It helped me realize that I'm not crazy. Likewise with the RLS, or even more importantly, the sensory overload. Knowing that something is real can give you the power you need to make the situation better.

There's a lot of good information out there on how to be a better person, and how to avoid people who are really toxic, or who insist on a drama triangle.   Really.  It's great information.  And you definitely have to keep and enforce your boundaries.

At the same time, we have to be careful to not quickly diagnose others - especially the people that we care about - into categories that they don't really belong in. It's tempting to apply labels to ourselves to deflect blame and responsibility. It's tempting to apply labels to others to assign blame and responsibility.

I ran into this with my youngest son.  I kept watching for the violent and antisocial behaviors that my older son had exhibited.  I was so vigilant for the same problems that I'd seize upon any evidence as definitive proof. It can become a self-fulfilling prophecy. I would see what I was looking for, not what was actually in front of me.

It took a lot of hard work to unlearn that habit.  To treat my younger son as the person he really is instead of the person I was afraid that he was.

I'm not saying this as some kind of holier-than-thou guru.

I'm saying this as someone who has screwed this up.

And whenever I've reacted to my fears instead of the person in front of me, it's never gone well.

And I worry that in the midst of the good work of rooting out the manipulators and the bullshit artists and the players... that we'll start to overdiagnose the people who really care about us.

And we'll react to imagined fears we read about instead of reacting to real people in front of us.

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...

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There is nothing quite as horrible as realizing you unintentionally destroyed what you most wanted.

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Get over 60 stories and help a family - but only before 9pm EST TODAY!

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This (2 Feb 2015) is your LAST CHANCE to get an exclusive digital copy of Life After Ashes, now with over sixty authors, cover artwork by Steven Gilberts, and interior art from James Ng!

Remember, this campaign ends at 9:53pm EST TODAY, so this is literally your LAST CHANCE to get a copy of this book.  To get your copy (and many more backer rewards) head to http://bit.ly/helpVetandKids right now.

The current list of authors (there may even be more!) and stories follows!

  • Tobias Buckell "A Jar of Goodwill"
  • Joseph Mulak "A Tad Bit Ghostly"
  • Paul Genesse "Almost Brothers"
  • Rob Hamm "Are You There? Are You Safe? Is the Flock Safe?"
  • Juliette Wade "At Cross Purposes"
  • Gary Braunbeck "Attack of the Giant Deformed Mutant Cannibalistic Gnashing Slobberers from Planet Cygnus X-2.73:  A Love Story"
  • Daniel Robichaud "Autumn Jitters"
  • Roland Mann "Broken Down Truck"
  • Alasdair Stuart "Calliope's Storm"
  • Kathleen Watness "Crossroads"
  • Laura Resnick "Dopplegangsters"
  • Alexis A. Hunter "Dying Mother"
  • Tim Waggoner "Embrace the Serpent"
  • Steve Lickman "Fangirl"
  • Donald J. Bingle "Father's Day"
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  • Justin Swapp "Mayan Blood"
  • T. Lee Harris "Messing With Mother Nature"
  • Jackie Gamber "Mirror Mirror"
  • Nisi Shawl "Momi Watu"
  • Heidi Ruby Miller "Mr. Johnson's Boy"
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  • Beth Wodzinski "One Tiny Misstep (In Bed)"
  • Addie J. King "Poltergeist on Aisle Fourteen"
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  • E. Chris Garrison "Seelie Goose"
  • K.W. Taylor "She Lets Her Ladder Down"
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  • S. J. Chambers "Vintage Scenes #3: Morellino di Scansano, 2011 Vendemmia"
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  • Mary Garber "Worthy"
Remember, you can only get this anthology by donating at http://bit.ly/helpVetandKids TODAY.  Don't wait!

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