The Wounded Come Home

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When the wounded come home, they are rarely greeted with waving flags and parades. Maimed soldiers are routinely flown from Iraq to Landstuhl Regional Medical Center in Germany, where they are stabilized before heading to the U.S. The most seriously injured are flown to Andrews Air Force Base, outside Washington, usually on nighttime flights, and then transported to Walter Reed Army Medical Center in Washington or Bethesda Naval Hospital in Maryland. "The wounded are brought back after midnight, making sure the press does not see the planes coming in with the wounded," said Democratic Senator Patrick Leahy of Vermont on Oct. 16 on the Senate floor.

In World War II, about 1 in 3 U.S. casualties died. During the next three wars--Korea, Vietnam and the Gulf--about 1 in 4 died. In the current war, about 1 of every 8 wounded soldiers have died.

Half of battlefield deaths occur within 30 minutes of wounding, largely on account of blood loss. But survival rates skyrocket if a casualty can get to a medical facility within the so-called golden hour after an injury. There are four major U.S. military medical outposts in Iraq, and the medical corps' critical mission is to keep wounded soldiers alive until they can be taken to one of them.

So far, a key rescue unit has a sterling record. The 159th Medical Company (Air Ambulance) has whisked more than 3,600 injured and ill troops to medical help with only a handful dying along the way. "We've given people a lot of tomorrows," says Major Arthur Jackson, chief of the unit's Baghdad squad. But many will face grim times. "People say, 'Well, he didn't die,'" says Captain Todd Farrell, a 159th helicopter pilot. "But a lot of these guys have an arm blown off or their leg blown off below the femur. Their lives are still going to suck."

At the front these days, small mobile surgical teams travel with combat forces. Navy Captain H.R. Bohman, a surgeon, was one of an eight-member medical team that did surgery 8 miles from Baghdad--the closest American operating room to the city--as the Iraqi capital fell to U.S. forces in early April. "We can document at least four Marines who are alive today who would have died if they'd had to be sent back as far as we were sending people back in the first Gulf War," says Bohman, a 30-year Navy veteran.

Such units generally consist of a trauma surgeon, an orthopedic surgeon, an emergency physician, an anesthetist, nurses and technicians. They carry with them a rudimentary field hospital in 70-lb. rucksacks. Their supplies include 5-lb. portable ultrasound units that allow quick and accurate diagnosis of internal bleeding and collapsed lungs. The ultrasound devices also can be used to locate shrapnel deeply buried in a thigh or torso. The teams also carry football-size electronic equipment for monitoring a patient's vital signs, small anesthetic-delivery devices and portable ventilators that help a wounded soldier breathe.