http://www.latimes.com/news/nationworld/iraq/la-120804casualties_lat,0,927164,print.story?coll=la-home-headlinesA severe shortage of surgeons in Iraq has left U.S. Army medical teams in the country scrambling to handle the largest number of casualties since the Vietnam War, the New England Journal of Medicine will report Thursday.
Despite the numbers — the Army has fewer than 50 general surgeons and 15 orthopedic surgeons in Iraq at any one time — advances in battlefield surgical techniques and care mean a greater percentage of soldiers wounded in Iraq and Afghanistan are surviving their injuries than in any previous American conflict.
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Blast injuries from suicide bombs and land mines are up substantially in recent months and have proved particularly difficult to treat without risking infection, Gawande writes. Eye injuries have caused blindness among a dismaying number of soldiers. And Kevlar body armor, which early in the war proved dramatically effective in preventing torso injuries, provides inadequate protection against bomb blasts.
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With just 120 general surgeons on active duty, the Army has been forced to use urologists, plastic surgeons and cardiothoracic surgeons to conduct general surgery on soldiers in Iraq. Many surgeons have been deployed for more than two years in Iraq, and military planners are contemplating pressing some to return again, Gawande writes.
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With no clear directive from the Pentagon on treating civilians, some doctors refuse to help even pediatric patients, for fear the children could be booby-trapped with bombs, Gawande writes.
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