The Painful Truth

Here’s a decent article about a new form of anesthesia called a continuous peripheral nerve block that some doctors think is a better alternative to general or local anesthesia for injury recovery. Sort of an epidural block for Purple Heart recipients.

It’s good reading, and it seems to make sense. Except for this part:

The good news is that fewer GIs are dying of their injuries than in any modern conflict. In Vietnam, one out of every three soldiers hurt in combat was shipped home in a body bag. In Iraq, it’s one in eight. Credit the use of body armor and a dramatic increase in the speed of the Air Force’s evacuation chain – the relays of Black Hawk helicopters and transport jets that ferry the wounded from the front lines to Landstuhl Regional Medical Center in Germany, where soldiers receive care before being sent on to hospitals like Walter Reed Army Medical Center in Washington, DC.

The bad news is pain. The injuries suffered by those who survive are more severe than in previous conflicts. High-velocity bullets, rocket-propelled grenades, and so-called improvised explosive devices cause tissue damage that is particularly excruciating. Although Interceptor body armor and Kevlar helmets are highly effective at deflecting AK-47 rounds and RPG shrapnel away from the “kill zones” of the torso and head, soldiers’ arms and legs are left unshielded for the sake of mobility. The success of body armor has had the unintended effect of creating a new class of survivable physical trauma. Operation Iraqi Freedom has become a war on the extremities – a litany of exploded muscles, shattered bones, and severed limbs. [emphasis mine]

Just how is it that injuries are “more severe than in previous conflicts”?

There’s no doubt that there are more wounded soldiers that survive than previously. But are their injuries really more “excruciating”?

Ah, the good old days:
Back when combat injuries didn’t hurt so much.


  1. But are their injuries really more ‘excruciating’?’ Maybe you were joking . . . but in case you weren’t: I think the point of the article was that, in the old days soldiers had excrutiating injuries and they died within hours. Now, they have excrutiating injuries that they survive. I’m sure they are happy to be alive, but it creates new treatment complications . . . the need to treat high levels of pain while minimizing the risks associated with anasthetics and pain-killers.

  2. No, Chuck: They very clearly said the the weaponry in use today makes injuries that are ‘particularly excruciating’. I pointed out the fact that more wounded soldiers survive and live with their injuries. And yes, that is something that must be taken into consideration when working on long-term care solutions. However, writing that things hurt more today may possibly give someone the false impression that things, you know, hurt more today. AK-47 bullets, RPGs, and ‘so-called’ IEDs are more ‘excruciating’ than the weapons of wars past? That’s stupid.

  3. Murdoc, I think any misunderstanding of the information in the article is a matter of the author’s semantics rather than a misinterpretation by individual readers. In other words, I believe both Chuck and you are correct. WOW, with that type of ‘logic’ I should apply for a job with The United Nations!

  4. Toejam and Chuck: I’m not arguing that the article isn’t about the great(er) numbers of injured soldiers with long-term pain problems, as Chuck said. In fact, I wrote that it was a good read ‘except’ for that passage that clearly said today’s weapons creat more excruciating injuries. However, my entire post and point was about that passage. They were very clear and they wrote it in one of the first couple paragraphs of a rather long article. Sort of to ‘punch it up a bit’, maybe. And it’s stupid. That’s what I was pointing out. So yes, Chuck and I are both right. Toejam, I’d vote for you for UN Secretary General any day. Of course, at this point I’d vote for just about anyone not currently in the UN for nearly any UN position…

  5. Thanks for the vote of confidence Murdoc. However, I don’t think I’m really up to the high moral standards required to replace ‘Annan the Sham and the Pharaohs’! Betcha you don’t remember that 60’s group!

  6. Murdoc: What Chuck said was exactly what I intended to say, with apologies for my probably muddled syntax. And the doctors at Walter Reed — who, you know, have a lot of experience in dealing with combat injuries — told me that because the bullets from the latest generation of weapons are designed to fly faster than the ones employed in previous wars, they shatter bones more extensively and create a form of injury known as ‘massive soft-tissue derangement’ which is indeed particularly painful if you survive. So that’s where I was coming from there. Thanks for your interest in the article.