How does one prepare for Afghanistan? One could visit a local Sufi shrine, offer prayers to the saint, and tie a colored yarn on one of the branches of the nearby holy chenar, asking for peace to accompany one’s travels. In the past I have tied strings to the grills of saints’ tombs. But this time I referred to my files, extracting two thick folders, both containing the words, “Afghanistan,” and another file with the New Yorker articles, written by Jon Lee Anderson.

A similarity exists in reconnecting with torn-out or Xeroxed papers in my files and a pilgrimage to a Sufi shrine. Both are sites where the seeker can, using the past, look for a way forward. One depends on the written word and the other the ecstasy of belief. Each will yield answers, but I’m sure the seeker at the saint’s grave will feel more secure than I.

I’m not talking about an immediate personal security, but rather the security of an intact country. All the recent talk about woman’s rights is an unfortunate distraction and will not lead to a way forward. Being a woman I feel a traitor saying this. But re-reading the history of the country, weighing the dynamics that have sustained a culture that has allowed its adherents to throttle every foreign attempt to reconfigure its myths and rearrange its core, I think we need to take a step back. Look at the time when Afghanistan fell apart and re-group from there. That time is not the rebellion of April of 78 or the Soviet invasion of December of 79, but the 50s attempt to modernize the country. I know most people, most Afghans included, would object, but to pretend that we are dealing with anything remotely touching the 21st C. is to obscure the issues. The same issues that caused the problems in the 1950s plague the Afghans now. Changes in the rest of the world— the issues of women and human rights— are beside the point and only make working out the basics impossible.

Embedded in one of my files is a reprint from The Atlantic Online, an article from November 1985 titled, “The Ordeal of Afghanistan,” by the British military historian John Keegan. Keegan is the sort of writer who, through immaculate writing and his respect for facts, makes you think that what you are reading approaches genius. Though almost 25 years old, and written before the Soviets departed and before anyone even heard of the Taliban, his command of the Afghan situation in 1985 deserves to be looked at in terms of today.

I am packed, armored with my reading. My Farsi language tapes are back on the shelf with all the other language tapes I “study” as my travels move me. I can count to twenty with, I think, a respectable accent, though why I would need to do this, other than to entertain children escapes me at the moment. After all I always carry a pen and note pad; no monetary transactions need other than this. I have packed the Dari primer Judy Forbes gave me in 2005. I promise to use it. But I have made that promise before

The half drunk bottle of Sauvignon Blanc will still be in the fridge when I return in 6 weeks. I left a similar bottle when I was last in Afghanistan 3 years ago and returned for a welcoming glass along with bacon and eggs.

During the final stages of writing and publishing A Leg to Stand On I was sure that no one could ever convince me to write another book of this sort again. That is probably true. The culprit in any future “convincing” schemes will in fact be me. My threshold for holding back with the pen is far lower than I thought and the frustrations a mite less so in retrospect.

After giving a talk to a group of Billings operating room nurses last week, I reviewed the presentation and made some changes. The nurses’ questions let me know there was much more that should have been addressed. But even more, their e-mailed comments showed how important the pictures were in making the problem real to them. I kicked myself for all the times the camera had remained in my pocket, instead of acting as witness. I also kick myself for all my unasked probing questions, held back for fear of appearing to focus inhumanly on dingy problems that might have reflected poorly on the culture or inadequate institutions .

Reading Dowden’s book, Africa--Altered States, Ordinary Miracles, I saw other aspects of the problem of trauma that I had failed to address. I couldn’t help myself. Scribbled note started to accumulate on my desk, new files have appeared in my computer filled with another set of questions, inconvenient statements, telling quotes.

There is much I left out that I should have addressed in the book. I didn’t write enough about money in A Leg to Stand On. Little about funding of SIGN or even surgical care. I didn’t discuss in any depth the gap in finances that fuel the divide between the haves and haves nots. They need to be addressed, with a look both to the haves and the have-nots.

I just finished reading an article in Clinical Orthopaedics and Related Research by Spiegel, et al. titled “Topics in Global Public Health.” The main points are no different from dozens of articles about global orthopaedic trauma I’ve been reading the past couple years. The few available statistics are the same in every paper of this sort, partly because there are only a few. The repeated numbers take on the character of “Stalin numbers.” (to paraphrase the dictator: 20 million dead is a statistic; one person’s death is a cause to grieve) The millions begin to mean nothing; they are inconceivable. How many times must these same huge figures be trotted out on stage, applauded, and quickly forgotten? How does one make the point?

There is only one way: to tell true stories.