Caring For Wounded Soldiers From the Wars in Iraq and Afghanistan
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SPOKESPERSON: Let’s do this right.
TOM BEARDEN: Nearly every day, military buses pull up to the Landstuhl Medical Center in Germany. Inside are wounded soldiers who just hours earlier were in Iraq.
Twenty-one year old Spec. Jason Strand arrived less than 48 hours after he was hit by mortar fragments while changing the track on his Bradley fighting vehicle near Samarra.
SPOKESPERSON: Welcome to Germany.
TOM BEARDEN: His injuries are typical of the wounds being inflicted in this war: shrapnel in his lower extremities. So just hours after being wheeled into the hospital –
SPOKESPERSON: Relatively speaking, this is — you know, this is a pretty minor –
TOM BEARDEN: — he was in surgery to have the wound cleaned and sewn up.
SPOKESPERSON: And then you can put as much weight as you want on the crutches, okay?
TOM BEARDEN: And less than 24 hours after that, he was up and learning to use crutches.
SPOKESPERSON: Go ahead and put a little weight on it.
TOM BEARDEN: The emphasis here is on speed, and it makes for an almost surreal experience for soldiers.
SPEC. JASON STRAND: You know, it’s kind of like a dream. I’d say after, you know, after the whole, like, night’s sleep I’ve gotten, I’ve come to grips with it. I’m back in Germany; I’m out of the theater. It’s kind of comforting.
TOM BEARDEN: Over the last two years, the Landstuhl Regional Medical Center has treated more than 20,000 service members wounded in Iraq and in Afghanistan. Thanks to new techniques and new technologies, the medical system has achieved an extraordinary survival rate.
Overall, 90 percent of soldiers wounded in Iraq survive. In Vietnam, only 76 percent of the wounded did so. What’s made the difference is the rapid evacuation from the battlefield to small, highly mobile field hospitals. The patient is then evacuated several more times for further treatment along the way.
LT. COL. GINA DORLAC: We’re doing a lot more of something called damage control surgery, which is where the patients are initially stabilized and resuscitated and the emergent life-saving procedures are done to stop contamination, to stop bleeding. But the final procedure is not completed at that time.
TOM BEARDEN: Lt. Col. Gina Dorlac is the physician in charge of the so-called Critical Care Air Transport teams. She and other doctors at Landstuhl track soldiers via a new computer system.
As soon as a soldier is treated in Iraq, information is entered into a database describing the soldier’s injuries and the medical treatment he or she receives every step along this continuum of care.
SPOKESPERSON: Are you hit anywhere else, other than the leg?
SOLDIER: Both of the backs of my legs are hurting.
TOM BEARDEN: After being stabilized at that initial stop, the wounded are taken to larger medical facilities still in Iraq, where a more thorough cleaning is done. The wound is usually packed with sterile gauze but not stitched shut, so that doctors at the next stop don’t have to re-open the wound.
The patients are then loaded onto cargo planes for a five-hour ride to Germany; 48 beds can be set up in the center, with ambulatory patients on the side. Pretty tight quarters in here.
AIRMAN JARED YOUNG, U.S. Air Force: Yes, very much so.– when you have a lot of patients coming in here, I think you’d fit about one hundred or so – one hundred to two hundred patients on the side. So when you’re packed out, it’s hard to move around in emergencies.
TOM BEARDEN: Airman Jared Young helps monitor the patients in these flying ICUs during the trip to Ramstein Air Base. The wounded then have a 30-minute ride to the Landstuhl Hospital.
They are greeted by a team of nurses, doctors and chaplains from all branches of the military who are ready to treat both the physical and emotional wounds the soldiers have endured.
SPOKESPERSON: Watch his right leg.
TOM BEARDEN: Air Force Major Timothy Woods is one of the general surgeons at Landstuhl. He credits the high survival rate to the rapid evacuation and multi-layered care given. But he says it’s also due to the Kevlar vests worn by many of the soldiers.
MAJOR TIMOTHY WOODS: We do know that the majority of our injuries are the upper extremity, lower extremities and the head and neck. The chest and abdominal cavity have been almost spared through most of the wounds that we have suffered here in Iraq.
TOM BEARDEN: What should we do to prevent the kind of injuries that you’re seeing? Is there additional body armor perhaps needed?
MAJOR TIMOTHY WOODS: There’s no question that these guys are going to get better protection in the years to come. We’re already seeing some early modifications. They’re not out down in Iraq yet. They’re only in a trial mode right now.
But the research that we’re actually doing here at Landstuhl and some of the research that they’re doing in the states at Walter Reed Medical Center should provide some more modifications of this Kevlar.
MAJOR KENDRA WHYATT: Good morning. How you doing?
MAJOR KENDRA WHYATT: Good. So I understand we’ve been bumped for the flight again.
PATIENT: That’s what I heard.
MAJOR KENDRA WHYATT: Okay.
TOM BEARDEN: Although most soldiers only stay at this army facility for a few days, the process of beginning long-term emotional healing begins at Landstuhl. Major Kendra Whyatt says she spends almost half her time just listening to the soldiers.
MAJOR KENDRA WHYATT: Some of them will discuss their fears, their concerns, you know, what they saw, how they felt about where they were and everything that was going on at the time of their injury.
If they’ve had significant injuries, like amputations, they really want to know, number one, you know, does this mean the end of the road for me in the military? What’s available for me and what’s next?
SPOKESMAN: In the computer, make the adjustment. That should change the batch profile on it, or not?
TOM BEARDEN: Soldiers are now surviving wounds that would have killed them outright in earlier wars. But that also means some will have very difficult lives in the future; amputations account for 2.5 percent of all wounded, a rate double that of World War II.
Hundreds of soldiers have been severely burned, and some initial reports indicate that soldiers have suffered eye injuries at a rate far higher than any previous war. Those are facts that former Landstuhl Surgeon Gene Bolles thinks the American public hasn’t quite grasped.
DR. GENE BOLLES: The average American has not really witnessed the horrifying aspects of war, except from a distance, except from reading, except from what they may see on television. And we aren’t showing very much here.
TOM BEARDEN: Bolles is currently a neurosurgeon at Denver’s public hospital. But for two years he was the lead neurosurgeon at Landstuhl, overseeing the care of thousands of soldiers. He has 30 years of surgical experience and was a flight surgeon in Vietnam. He’s also tended to war victims in Kosovo. He says that what he saw at Landstuhl was far worse than anything he witnessed before.
DR. GENE BOLLES: What I saw there was — constantly in our intensive care units were these very badly injured young men and women with often only one extremity, severe burns, blinded — just severely, severely injured people.
I’ve had soldiers breaking down in tears, having to — becoming very emotional as they would tell me some of the things they were seeing and what bothered them. I’ve heard so much of that come from the soldiers it’s taken a while for me to have a good night’s sleep. And I still am restless at times just because of all these stories that I’ve heard and just some of the things I’ve seen.
TOM BEARDEN: Dr. Dorlac concedes that the severity of wounds from this war is something Americans will have to face.
LT. COL. GINA DORLAC: Having more patients evacuated back who survive but with amputations, that is going to be a bigger, long-term — certainly a challenge for their lives and financially, fiscally a challenge to the taxpayers, how that’s going to be supported. But it’s a life, so I think it’s still the best thing.
SPOKESPERSON: Where are you from in the states?
STAFF SGT. WILLIAM LALLEMENT: Well, I’m originally from Pittsburgh, but I’m stationed out of Fort Riley, Kansas.
TOM BEARDEN: Staff Sgt. William Lallement’s life is likely forever changed. He is a tank commander with 19 years in the Army.
SPOKESMAN: Pray. Father in heaven, I pray that you’ll be with the sergeant here.
TOM BEARDEN: A sniper’s bullet went through his chest and shattered his arm bones when came under fire in Sadr City. He and his family are hopeful doctors can reconstruct the bone so that he can continue his military career.
STAFF SGT WILLIAM LALLEMENT: Every day, I call my wife.
TOM BEARDEN: What are they telling you?
STAFF SGT WILLIAM LALLEMENT: Hold on one second. They tell me to keep up my faith and put my trust in God, and he will heal me.
TOM BEARDEN: And, surprisingly, he wishes he could return to duty in Iraq.
STAFF SGT WILLIAM LALLEMENT: I want to because I think my soldiers over there need me. And if, you know, I get well enough, I wouldn’t hesitate to go back and be with my troops.
TOM BEARDEN: For those soldiers who arrive at Landstuhl with less serious injuries, close to half are sent back to duty within 72 hours. Spec. Jason Strand was scheduled to return to the First Infantry Division within days, but he won’t have to go back to Iraq to do so. The division’s tour of combat duty is over for now, and they will rejoin him in their bases in Germany in the coming weeks.