Posted on 01/14/2004 5:45:02 PM PST by joesnuffy
War and Disabilities
Michael Arnold Glueck and Robert J. Cihak Wednesday, Jan. 14, 2004
New Diagnoses and Strategies Create Both Short- and Long-term Problems for Medicine and the Military
War is hell and becoming even more hellish. The "advancement" of technology has provided new ways to live and terrible ways to die. Those who live because of body armor now face hellish injuries to what's left of limbs and looks. These in turn provide new challenges to medicine and the military.
The Body Armor Trap
While there has been a generational decline in infantry skills, the American infantry still widely outclasses anything the Iraqis can give back. The widespread use of body armor and infantry fighting vehicles has only increased the American advantage.
The Iraqis respond by using mines (improvised explosive devices in Pentagonese) and rocket-propelled grenades. By historical standards, they don't kill a lot of people. They don't have to; they produce catastrophic wounds.
According to Erin Solaro, a Washington, D.C.-based writer whose thesis examined the relationship between casualties and combat effectiveness and who is a member of the Coalition for a Realistic Foreign Policy, it used to be that, if injured, a lot of troops would pray for a million-dollar wound. This was a wound that would get them off the line and into a clean, dry bed in a warm hospital with regular meals, at least for a while, hopefully doing (relatively) little permanent damage.
Solaro further notes that the injured soldiers might convalesce at a training depot, where they were a lesson to the new recruits to take war seriously while they passed on the lessons that can be learned only by surviving combat. Others would serve in a rear-echelon billet somewhere, again an object lesson to those REMFs (rear echelon mother ****ers) about the brutal consequences of combat.
The catastrophic wounds we are seeing today mean that there is a smaller core of combat-wounded veterans for new soldiers to coalesce around. What this does to the morale of the soldiers is not difficult to guess. Wounds are always bad, but there's a difference between a through-and-through gunshot wound and losing a hand, or both. This kind of stress, especially in a situation where the enemy is often using civilians as cover, produces psychiatric casualties as well.
Long-term Costs
The long-term costs of these wounds are immense: first, last and always to the service member. It is very difficult to go from being fit, strong and aggressive to being a young man who is blinded, or a young woman who has lost both her legs.
Surgery has become extremely technical and effective – and very expensive. New limbs incorporating microprocessors can cost tens of thousands of dollars each. All this is followed by rehabilitation, technical training and disability payments.
And, finally, there are the inestimable and intangible social and family costs.
Solutions
There are no short-term solutions. Improving infantry training throughout the Army, and not merely for troops coded as infantry – including women, traditionally barred by law and custom from serving as infantry, who now serve – will probably help by making people better soldiers.
And we will be in Iraq and Afghanistan for at least a decade, and perhaps a generation. We broke them, we own them, and we must patrol vigorously and actively from bases to screen and develop the new militaries.
And at the same time, we must ease the strain on both our active and reserve forces while developing real homeland defense capabilities. The New Year's flight cancellations in all likelihood thwarted an attempt to airburst a hijacked aircraft containing a radioactive device over Washington, D.C. Sooner or later, our enemies will get lucky.
The Draft?
In his article "Saddam in the Slammer, So Why Are We on Orange?" David Hackworth revealed that between 14,000 and 22,000 troops have been medically evacuated from Iraq since the war began, approximately 3,700 of whom had been killed and wounded in action. Daniel Zwerdling of National Public Radio has put the number of wounded alone at 9,000, which would explain the range of Col. Hackworth's numbers.
Given that we have approximately 135,000 troops in Iraq, these are terrifying numbers. We are running out of fresh troops, and combing fit soldiers out of rear areas for formal infantry conversion training will help only so much.
Many op-ed writers opine that the Army cannot survive this kind of strain without a draft, but it must be the right sort of draft: one with a bare minimum of exemptions, that doesn't let the Left hide behind the unearned moral authority of protesting it while the Right simply refuses to be drafted; one that is designed to protect the homeland because it understands that draftees cannot be sent all places to do everything.
All of these distressing issues raise many formidable challenges – for medicine and the military – which will be explored in depth in future columns.
Editor's Note: Michael Arnold Glueck, M.D., wrote this week's commentary.
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Michael Arnold Glueck, M.D., is a multiple-award-winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a past president of the Association of American Physicians and Surgeons.
Contact Drs. Glueck and Cihak by e-mail.
Editor's note: Is America prepared for the next war? Click here now!
Given that we have approximately 135,000 troops in Iraq, these are terrifying numbers. "
If the figure of 9,000 is correct, it is not spread out over the the present count of 135,000, but rather all who have been through Iraq. Say, at a guess 400,000.
You really have to wonder about a Doctor that uses NPR as a source, for anything, and who can't get his statistics right.
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