Monday, March 30, 2009

Last week I participated in a medical meeting and was too busy to write a blog. It was an interesting meeting for Physicians Assistants in Orthopedics. One of the other speakers at the meeting was an orthopedic surgeon who had been a trauma orthopedic surgeon in Iraq and treated many wounded during his tour of duty. We talked about the types on injuries he treated and I recollected the type of injuries during Viet Nam.

He treated practically no gunshot wounds in Iraq. Most of the injuries he encountered were horrible extremity injuries from explosions related to roadside bombs. The soldiers had on body armor and helmets that protected the trunk of their bodies and heads. Because of the armor they survived injury that would have caused immediate death. The extremities were so mangled there was hardly any tissue to work with, and amputations were his main operation. In Viet Nam, the lack of body armor resulted in injury to vital parts of the trunk and head. Death was primarily the result of gunshot wounds.

Each war has its unique way of reducing the population. It started with clubs and has gone all the way to the atomic bomb and guiding missiles by computers. World War I had some of the greatest advances and introduced the airplane, machine guns and poisonous gas. World War II, of course, introduced us to the atomic bomb. Several counties have this ultimate weapon of mass destruction and, fortunately, are reluctant to use it. The worry is that some of the insane fanatics may develop the weapon. We now have the ability to destroy the planet.

The Civil War was one of the most interesting and most deadly of wars. Over 600,000 men died in that conflict. Over half died of disease and wounds. Doctors had no idea that germs caused disease and they operated with dirty hands and instruments. As a result of the contaminated wounds sepsis developed and the poor soldier died. Medical ignorance was the main cause of death. The gunshot wound was the primary instrument of death. The amputation of an extremity carried an 85% mortality because of sepsis.

It seems safe sitting here on the porch with the best in modern medicine not far down the road. It also seems like a long way from a war zone. I try not to think about the possibility of a well-placed atomic warhead being detonated in a place like Fort Hood. At least, I would probably be vaporized and not have to endure the mangling, suffered by our poor troops in Iraq.


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