long, but good read
Better stats. Landstuhl is the first step in the long journey home for David Coleman and the nearly 9,500 other soldiers who have been wounded in Iraq and Afghanistan. Unbeknown to them, they are part of a great experiment in military medicine. Soldiers today are far more likely to survive battle than in any other war in American history. In World War II, 1 in 3 casualties died. Even in the relatively bloodless 1991 Gulf War, 147 were killed in battle, 467 wounded in action. In Iraq and Afghanistan, however, 98 percent of those wounded have survived. "Mortality is down about 22 percent" compared with the first Gulf War, says Dale Smith, chairman of medical history at the Uniformed Services University of the Health Sciences. He credits better protection for soldiers, as well as improved medical care. "It's phenomenal progress, at phenomenal expense."
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If the rapid evacuations are one of the big medical success stories of this war, another is improved body armor, which physicians credit with much of the reduced death rate. Flak jackets have been used for decades, but even in the 1991 Gulf War, they weren't capable of stopping high-velocity rifle rounds. Now they do. "It is also different because soldiers wear it," says Army Col. David Burris, a trauma surgeon and interim chairman of surgery at the Uniformed Services University of the Health Sciences. "It's thrilling. I'd much rather prevent an injury than fix it."
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But the vests don't prevent all injuries. Because arms and legs aren't protected, extremity injuries like Coleman's now account for some 70 percent of battlefield wounds. Surgeons say the damage is comparable to a catastrophic machinery accident back home. At least 152 soldiers have had limbs amputated; the number of traumatic brain injuries is also up. But it's as yet impossible to tell if those injury rates have increased, partly because the number of survivors has risen, skewing the statistics, and because the Army is compiling its trauma registry from paper records. One wounded soldier could have records at three or four places in Iraq and could arrive at Landstuhl with medical records and X-rays on his Army blanket or with no records at all.
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More-stable patients like Coleman are carried off buses on litters. Those with bad backs and other less pressing health problems--the "disease nonbattle injury" cases, which make up the bulk of troop loss in any war, far more than from enemy fire--walk off the bus themselves and are handed a list of their doctor appointments and a phone card so they can call home.
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Soldiers were suffering devastating eye injuries from shrapnel, but doctors realized such injuries could be prevented if the soldiers wore sunglasses with shatterproof polycarbonate lenses, such as WileyXs. "Most of the injuries were from people who got sweaty and took their glasses off for one second," says James Burden, one of four ophthalmologists at Landstuhl. Once the Army distributed posters with gruesome injury photos, the sunglasses stayed on. Says Burden: "We've seen injuries drop dramatically."
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