Military Medicine Is Making A Difference In Iraq
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From NEJM: Casualties of War — Military Care for the Wounded from Iraq and Afghanistan
""Though firepower has increased, lethality has decreased. In World War II, 30 percent of the Americans injured in combat died.3 In Vietnam, the proportion dropped to 24 percent. In the war in Iraq and Afghanistan, about 10 percent of those injured have died. At least as many U.S. soldiers have been injured in combat in this war as in the Revolutionary War, the War of 1812, or the first five years of the Vietnam conflict, from 1961 through 1965 (see table). This can no longer be described as a small or contained conflict. But a far larger proportion of soldiers are surviving their injuries.
"It is too early to make a definitive pronouncement that medical care is responsible for this difference. With the war ongoing and still intense, data on the severity of injuries, the care provided, and the outcomes are necessarily fragmentary. But from the data made available for this report and discussions with surgical teams that have returned home, a suggestive picture has emerged. It depicts a military medical system that has made fundamental — and apparently effective — changes in the strategies and systems of battle care, even since the Persian Gulf War.""
"It is too early to make a definitive pronouncement that medical care is responsible for this difference. With the war ongoing and still intense, data on the severity of injuries, the care provided, and the outcomes are necessarily fragmentary. But from the data made available for this report and discussions with surgical teams that have returned home, a suggestive picture has emerged. It depicts a military medical system that has made fundamental — and apparently effective — changes in the strategies and systems of battle care, even since the Persian Gulf War.""
And, near the end, this tidbit about updated contingency plans for registration of health care workers:
""Interest in joining the reserves has dropped precipitously. President George W. Bush has flatly declared that there will be no draft. However, the Selective Service, the U.S. agency that maintains draft preparations in case of a national emergency, has recently updated a plan to allow the rapid registration of 3.4 million health care workers 18 to 44 years of age. The Department of Defense has indicated that it will rely on improved financial incentives to attract more medical professionals. Whether this strategy can succeed remains unknown. The pay has never been competitive. One now faces a near-certain likelihood of leaving one's family for duty overseas. And without question, the work is dangerous.""
A former teacher and Army Reserve Anesthesiologist, Rod Calverley, suggested that since the military had become an instrument of foreign policy rather than being used just to protect the homeland, perhaps I should not join the reserves and tend to my young marriage and likely family instead. After 9/11, I think he'd be advising me otherwise...and to put my money where my mouth is.
