Medical Treatment Advances Help Injured Soldiers
RENEE MONTAGNE, host:
This is MORNING EDITION from NPR News. I'm Renee Montagne here in Los Angeles.
STEVE INSKEEP, host:
And I'm Steve Inskeep in Baghdad.
We're about to follow the lives of two American soldiers wounded in an ambush here in Iraq. After that attack outside Fallujah, they've taken an emotional and physical odyssey through the military medical system, from military hospitals in Iraq, to Germany, to Texas, where the two soldiers are now recovering.
Even in Vietnam it could take six weeks to get a wounded soldier home to a hospital. Today, rapid treatment and transport can save an arm, or a leg, or a life.
But as NPR Pentagon correspondent John Hendren reports, survival can also be an ordeal.
JOHN HENDREN reporting:
I first meet Private John Kelleher(ph) in early March, as a helicopter drops him off at a tented military hospital in Balad, Iraq. It's just a few hours since a makeshift landmine erupted beneath a 250 gallon fuel tank of the truck he was driving with his sergeant, Robert Cuthbertson(ph).
Kelleher is now lying on a gurney, talking casually, although he's got a dislocated shoulder and second and third degree burns on his hands and face.
Pvt. JOHN KELLEHER (United States Army, Iraq): I'm kind of banged up all around.
HENDREN: The blast blew him through the armored door and onto the sand outside.
Roadside bombs had not been a big concern when Kelleher and Cuthbertson served their first tour in Iraq in 2003. Now they're the number one threat to American troops.
Up close, Kelleher says, they're disorienting, painful, and insanely loud.
Pvt. KELLEHER: I was driving down the road and then all of a sudden there was fire and pain all around, and I was on the ground. Tires blew. When we took off, I looked back at it. It was, it was just all on fire. The whole thing was engulfed.
HENDREN: The sergeant is less fortunate. Cuthbertson, known to the troops as Sgt. Cut, lies unconscious down the hall in a nearby shipping container that serves as an operating room.
A machine helps him breathe. He's bloated and badly burned over 30 percent of his body.
Air Force Major Paul Gleason is an orthopedic surgeon. He fears Sgt. Cut could lose both hands and a foot. The tissues are so swollen that they're choking off the blood supply. If that happens, the tissues die.
So Gleason performs a phasciotomy(ph), releasing the pressure by cutting into Cuthbertson's arms and legs. Gleason stands in the OR doorway afterwards, still in his scrubs and mask. He says the operation went well.
HENDREN: Is he going to be able to keep all his extremities?
Maj. PAUL GLEASON (Orthopedic Surgeon): Right now it's a little early to tell what's going to survive and what's not going to survive. I don't have a crystal ball, but we did what we had to do today to keep the arm and the muscles alive.
HENDREN: After the surgery, Cuthbertson, still unconscious, on a ventilator, and wrapped like a mummy, is loaded onto an ambulance. Then we roll off in a C-17 cargo plane that serves as a flying hospital for up to three dozen patients.
It's been less than two days since their truck blew up, and they're already out of Iraq. The next day, at the military hospital at Landstuhl, Germany, Kelleher is up and walking the halls.
Pvt. KELLEHER: I hurt. I ache. I feel like I got into a fight with a fire breathing grizzly bear. But it could have been a lot worse. I've got a little bit of a limp and my ribs hurt a little bit. And I'm burned up a little bit.
HENDREN: Cuthbertson remains unconscious. One of his doctors, Air Force Lt. Col. Geena Dorlok(ph), says it's still not clear if he'll lose any limbs.
Lt. Col. GEENA DORLOK (Physician, United States Air Force): He may lose further tissue in those areas. It's too soon to say on that.
HENDREN: And how serious are those burns?
Lt. Col. DORLOK: They're serious. Those areas that are full thickness, that are third degree, will have to have some sort of skin grafting eventually. And that's a prolonged process in specialty centers to get good coverage of those areas and prevent infections along the way.
HENDREN: The two soldiers take separate planes and meet up weeks later at Brooke Army Medical Center in San Antonio, Texas, the military's top burn center.
Cuthbertson has gone from mummified to emaciated. He's dropped 40 pounds. He's groggy but conscious, drugged and, his physical therapists say, masking serious pain. It's the first time the two soldiers can speak about the bomb that brought them both here.
Sgt. ROBERT CUTHBERTSON (United States Army): I heard a pop, and I seen a lot of bright orange. I jumped out, and I looked at myself and I could see that I was kind of on fire, my feet were on fire. And my vest and everything was on fire. So I rolled around in the sand, trying to put it out. Specialist Kelleher said he couldn't feel his legs. I could hear rounds popping and stuff, and I noticed it was the rounds in the truck that were cooking off from the fire.
Pvt. KELLEHER: I saw him put himself out, and then he walked across the street to make sure that I was all right. And that was the most amazing thing I've ever seen in my life. Because, I mean, he was pretty burnt and pretty hurt.
HENDREN: He still is. Cuthbertson's doctors say Gleason's surgery saved his hands and foot. But his chest, legs, and back are raw from being harvested for skin grafts needed to cover 20 percent of his body.
Beneath the bandages, raw tendons and flesh remain uncovered. He endures painful physical therapy so he can bend his fingers, and he wears a shaving cream-like foam on his singed ears. When a lump of foam falls off, he asks his wife what it is. He's afraid it's his ear. Maria Cuthbertson remembers getting the call from Cut's commander.
Ms. MARIA CUTHBERTSON (Wife of Wounded U.S. Soldier): You can tell when it's a call from overseas. I just knew and my heart just dropped and I was, like, oh, my goodness, what happened? But, yeah, once he told me he was okay and that he was still alive, that's all I needed to know is he's alive. Whatever happens after this, we can handle.
HENDREN: Cuthbertson is a feat of modern military medicine, yet typical of the burn patients at Brooke. As he speaks, another young patient sits looking out the hospital window. After extensive skin grafts, amputations and other surgeries, this man has somehow survived burns over 95 percent of his body.
Military surgeons say troops are surviving with far more serious injuries than ever before because the military medical system is faster than ever, not just at getting them help, but at getting them all the way to the OR. In Vietnam, one in five OR patients died of their wounds. The rate is now one in 10. But that means that for some who do survive, the ordeal is only beginning.
Lt. Col. GLENN WOODSON (Army Chaplain, Landstuhl Army Medical Center, Germany): The injuries that you're talking about, they cause a tremendous amount of individual grief.
HENDREN: Lt. Col. Glenn Woodson is a Methodist pastor who left his church in Kalispell, Montana to work full-time as an Army chaplain at Landstuhl.
Lt. Col. WOODSON: There are times, there are plenty of times where there's nothing really that I can say. I have no answers. I cannot tell them why this has happened to them or to one of their loved ones. My hope is that there won't be an epidemic of post-traumatic stress disorder.
HENDREN: Cuthbertson and Kelleher are showing some typical signs of post-combat stress.
Sgt. CUTHBERTSON: For a while there I could, like, smell my hair burning and stuff like that. Cars would go over, like, a manhole, and the metal-to-metal sound would make me jump a little bit. To tell you the truth, I'm never going to forget what that truck looked like. I'm never going to forget what happened. I mean, I can still see fire coming through the dashboard.
HENDREN: Despite the obstacles, Cuthbertson knows what he's going to do now. His father retired from the Air Force. His grandfather, sister, and wife Maria all served in the Army. Now, at 30, with 12 years in the service, even though he can't stand in the sun for two years, and won't be able to serve abroad for five, because of his injuries, he still wants to go back.
Sgt. CUTHBERTSON: I want to continue on with the Army. You know, I never questioned why, why I was here. It's just you're there at that time and at the place and, you know, stuff just happens. I just happened to be, you know, in that area at that time when it happened. That never changed my thinking of why I joined the Army or anything like that.
HENDREN: His mother, an immigrant from Thailand, sits in his hospital room with his wife Maria. She's less than thrilled with her son's plans.
Ms. CUTHBERTSON (Mother of Wounded U.S. Soldier): He want to be in the Army. He love it.
HENDREN: So, did you love it when he joined?
Ms. CUTHBERTSON: No. I'm not going to lie. No. I support him, but I pray hard every day.
HENDREN: Kelleher is another story. The 26-year-old from Fort Townsend, Washington doesn't want to go back to the Army unless he can perform at the same level. And after his experience in Iraq, he's not planning to go into the family business.
Pvt. KELLEHER: The only kind of family business my family has ever been like pretty deep-rooted in is, like, fire-fighting. No, that's not happening. I'd rather go back to Iraq than go jump in a burning building. I just think it's a bad idea.
HENDREN: As I leave them in San Antonio, Cuthbertson has times of walking and laughing, but remains in an intensive care ward. Kelleher is living as an outpatient near the hospital, preparing for a month-long leave to visit his family near Seattle. Kelleher and Cuthbertson are among nearly 18,000 U.S. troops who have been wounded since the U.S. invasion of Iraq began in March of 2003.
John Hendren, NPR News.