Horrible Trauma Cases in Iraq

Atrios links the Washington Post story everyone’s talking about today about the horrific injuries that the military hospitals in Iraq are dealing with and the trauma it is causing for the doctors and surgical teams. Atrios says:

This stuff is just so horrible. I really hope Kerry gets out in front of this and proposes massive increases in VA funds. You can have my goddamn tax cut back. I’d rather pay out the money that way and get some quality care for these people than throw it into their change cups a few years from now.

I hate what these bastards have done, and I hate that they’d rather bankrupt the government than take care of the mess they’ve made. Assholes.

Which I think rather misses the point of the article. The problem isn’t lack of funds, it’s that these guys are surviving hideous injuries that would have killed them just a few years ago.

More and more in Iraq, combat surgeons say, the wounds involve severe damage to the head and eyes — injuries that leave soldiers brain damaged or blind, or both, and the doctors who see them first struggling against despair.

For months the gravest wounds have been caused by roadside bombs — improvised explosives that negate the protection of Kevlar helmets by blowing shrapnel and dirt upward into the face. In addition, firefights with guerrillas have surged recently, causing a sharp rise in gunshot wounds to the only vital area not protected by body armor.

The neurosurgeons at the 31st Combat Support Hospital measure the damage in the number of skulls they remove to get to the injured brain inside, a procedure known as a craniotomy. “We’ve done more in eight weeks than the previous neurosurgery team did in eight months,” Poffenbarger said. “So there’s been a change in the intensity level of the war.”

With advanced surgical techniques and the military’s capability for moving casualties from the field to the hospital in record quick times, they are saving people with devastating brain injuries and people who are blinded and disfigured and paralyzed. There is nothing more money can do for injuries like this, which is what the doctors in the article point out.

“See all that dark stuff? That’s dead brain,” he said. “That ain’t gonna regenerate. And that’s not uncommon. That’s really not uncommon. We do craniotomies on average, lately, of one a day.”

“We can save you,” the surgeon said. “You might not be what you were.”

Accurate statistics are not yet available on recovery from this new round of battlefield brain injuries, an obstacle that frustrates combat surgeons. But judging by medical literature and surgeons’ experience with their own patients “three or four months from now 50 to 60 percent will be functional and doing things,” said Maj. Richard Gullick.

“Functional,” he said, means “up and around, but with pretty significant disabilities,” including paralysis.

‘Broken soldiers’

The remaining 40 percent to 50 percent of patients include those whom the surgeons send to Europe, and on to the United States, with no prospect of regaining consciousness. The practice, subject to review after gathering feedback from families, assumes that loved ones will find value in holding the soldier’s hand before confronting the decision to remove life support.

“I’m actually glad I’m here and not at home, tending to all the social issues with all these broken soldiers,” Carroll said.

But the toll on the combat medical staff is itself acute, and unrelenting.

In a comprehensive Army survey of troop morale across Iraq, taken in September, the unit with the lowest spirits was the one that ran the combat hospitals until the 31st arrived in late January. The three months since then have been substantially more intense.

“We’ve all reached our saturation for drama trauma,” said Maj. Greg Kidwell, head nurse in the emergency room.

The real solution to this problem is to get those Americans out of Iraq, not to throw money at yet another government program. Besides, if you want the best of care for these broken people why would you send them to a shabby hospital system like the VA anyway? Why throw money at the VA when there are thousands of state of the art hospitals all over the US? Let them go to real doctors at real hospitals, not government facilities which are all run as efficiently as Amtrak. Better yet, bring them home before any more get hurt.

Anyway, the point is, even if you gave the VA billions, it won’t help. The cases that are demoralizing the doctors are the hopeless ones like brain injuries and missing eyes. These are permanent disabilities. No amount of money will replace eyes or fix an injured brain or spine. A significant number of these soldiers are making the return trip only so their families can see them one last time before they pull the plug.