Wednesday, March 9, 2011

Some Things Change, Some Things Remain The Same

The turnover process is in full swing. Our relieving team is getting used to their drastically changed roles in medical care, that is relative to what they have been practicing at home. In the midst of this, the war goes on, the casualties continue to come in, and the stories unfold with ever new twists.

At the beginning of the week, a local national came in with a gunshot wound. He had climbed up onto a coalition vehicle and begun to attack it...with rocks. He was then shot by the vehicle's gunner. However, if you are inclined to feel uneasy about that, this tidbit clouds the scenario. The man was carrying identification that was obviously faked. He was a graying, wrinkled, middle-aged man with an id card that said he was twenty. Intelligence fingerprinted him and tried to identify him. He will survive. Maybe, if we are lucky, he will also answer some questions.

Two days later an ANA troop arrived with gunshot wound to the abdomen. His bowel was protruding out the front of the abdomen. The local ANA liason officer, who is Afghani, spoke to the unit members who came in with the patient and immediately reported the wound to be self inflicted. Unfortunately, the entry wound was actually in the back, the exit wound being the larger hole in the front. Once again in this war, clarity proves elusive.

In any event, Paul and Ted, operating together for what may prove to be the final time in theater, removed sections of the soldier's bowel and stopped bleeding while the new team observed operating room procedures, blood banking, patient movement, and the administrative flow. Real trauma is far more effective lesson than training scenarios. Hopefully, the opportunity will serve the new team well.

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