On This Memorial Day, Let's Spend Some Thoughts on the Wounded

Borrowed from David Wood in the Huffington Post:

American soldiers and Marines walking combat patrols in Afghanistan have suffered a surge of gruesome injuries, losing one or both legs and often their genitals to crude homemade bombs Taliban insurgents bury in dirt roads and pathways.

In some cases, American military surgeons tell The Huffington Post, these traumatic amputations occur so close to soldiers’ hips that it is difficult to fit prosthetic legs, severely limiting the patients’ future mobility and rehabilitation. In addition, the loss of sexual function for formerly healthy young men in their early 20s causes severe anxiety and depression and can wreck new marriages.

The latest wave of severe injuries comes after Gen. David Petraeus ordered U.S. troops in Afghanistan last year to get out of their protective armored vehicles and start walking. "Patrol on foot whenever possible and engage the population," he directed in guidance to his troops last August.

The order was hailed as an essential counterinsurgency tactic used to get closer to the people, pick up intelligence more effectively and demonstrate American resolve to protect local villagers from Taliban insurgents.

But the enemy -- as Petraeus himself is fond of saying -- gets a vote, and the insurgents have attacked the dismounted patrols with a vengeance, planting lethal bombs inches beneath the dusty soil where a footstep can detonate them in blinding flashes.

Insurgents often make the bombs using a plastic bucket packed with explosive ammonium nitrite fertilizer and a simple "trigger" made with two sticks of wood or a discarded plastic bottle that completes a circuit and detonates when crushed. The crude components make the bombs more difficult to detect than those once made with metal parts.

Improvised explosive device (IED) attacks against dismounted troops have skyrocketed, from five in April 2009 to 210 in April 2010 to 376 this past April, according to data gathered and analyzed by the Pentagon’s counter-IED agency, the Joint IED Defeat Organization.

Because dismounted troops walk with their weapons held out in front of them, an IED detonation often blows off the extended arm as well as both legs, according to Army medical staff.

..... the sheer number of IED attacks means that even as troops find more of the bombs, casualties still skyrocket because of all of the devices left undiscovered. IED attacks have caused casualties to dismounted U.S. and allied troops to rise....

Dr. Paul Pasquina, chief of orthopedics and rehabilitation at Walter Reed Army Medical Center in Washington, D.C., told The Huffington Post:

We’ve seen a dramatic increase in the number of service members who have not only amputations above the knee but what we call hip disarticulation, meaning they have no femur at all.

So not only are they losing their legs, but half of their pelvis. And we’ve seen a dramatic increase in the numbers of casualties returning with testicular injuries or genital loss, and that has severe life-long implications.....

Soldiers and Marines arriving at Walter Reed with both legs blown off usually suffer other extensive injuries. Shrapnel perforates the abdomen, dirt and filth are driven deep into wounds and soft tissue; in some cases, the explosion tears away large patches of skin in an injury called "de-gloving." Heterotopic ossification, or bone growth in fleshy areas, can severely hamper the use of artificial limbs. Infections set in; blood clots can form. And in most cases, the patient arrives with moderate to severe traumatic brain injury, which can hamper rehabilitation.

Pasquina again:

There’s just challenge after challenge, sad story after sad story But at the same time we have had remarkable success, and pretty much 90 percent of it is attributed to the courage our service members have, their determination to recover and reintegrate back into society.

But the loss of sexual function can be "devastating," said Bo Bergeron, chief of physical therapy at Walter Reed. "It’s a pretty big issue when a guy finds out he can’t have any more kids -- and the spouse is sitting there," she told The Huffington Post. In common cases where a young wife has quit her job and flown with the kids a thousand miles to sit at the bedside of her now-disabled husband, "the family situation already is pretty tenuous. It’s just very very difficult," she said. The divorce rate among married patients is above 50 percent.

There's a lot more in David Wood's article. On this Memorial Day, I challenge readers to read the whole thing.