Former US Navy Commander (and trauma surgeon) Dr. Carlos Brown was deployed to Ramadi, Iraq in 2006, and at the urging of his tech-savvy brother, chronicled his experience on a video blog, Trapper Los MD. It provides a close, raw view behind the scenes of a MASH unit in the war. As a comparison, the typical trauma center input in the US is 15 patients over 24 hours, but in Iraq you may get 50 patients in 15 minutes.
Brown had a hard time deciding what he could put in the blog posts, and then decided that the right filter was that if his kids could see it, then he'd put it into the blog. Even so, some of the photos and video footage presented here at SXSW 2008 are utterly gory - washing out exploded knees after mortar rounds, cutting off feet after stepping onto an IED, etc. He would never have captured this information if his brother hadn't set up the video camera and blog for him before deployment. Visit his site if you're ready for the raw experience, or watch his final video here if you'd like a more sanitized view:
Dr. Brown is still struck by how barbaric the surgery conditions were. Using hammers and chisels to open up a chest cavity; putting in bone screws by hand rather than with a power drill; and so on. No cleanup crew in the surgical area. The surgeons often have to turn the room over themselves. "You do the best you can with what you're given." And tourniquets aren't used much here at home, but they are utterly life-saving in the war zone.
Even simple things like blood and plasma aren't available. Instead, you access the 'walking blood bank' of soldiers on base - announce that you need 40 people to show up with O-negative, and people show up to donate. Interestingly, the soldiers freely donate without knowing if the donation is going to an American soldier or to an Iraqi.
Some other facets of daily MASH life struck me:
- The intensive care unit was a bunch of army cots crammed into what looked like a storage locker.
- Post-operative soldiers are kept in body bags to keep them warm when being transported via air.
- Every evening transport was shot at, so they tried to only transport wounded during the day.
There's also the added pressure of an audience, as surgery tends to happen as the rest of an injured soldier's unit looks on. We're all so fortunate that people are willing to do this in service to our country. Why can't we serve them better?
Side note: Though the chain of command could have shut down Dr. Brown's blog at any time, they never did. Soldiers' access to these types of services has since been shut down for security reasons, so they have no way of freely interacting with their support communities at home. Isn't there an alternative that our government can permit?