How War Brings About Medical Advances - Part IV


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Marines with the 2nd Marine Expeditionary Brigade, RCT 2nd Battalion 8th Marines Echo Co. move into position while they were under enemy fire in Mian Poshteh, Afghanistan.

So, how did medicine evolve so rapidly that the chance of dying in the war in Afghanistan shrank to ten percent?

Most medical advances in war usually happen by accident, with a military doc facing a traumatically injured patient he’s not sure how to fix, according to Dr. Fred Mading, a Navy veteran (and my brother-in-law). Fred told me the doctor or medic tries everything he or she can think of, until something works.

This was how a life-saving technique unique to the wars in Afghanistan and Iraq came into practice.

Medics and military doctors deployed to Iraq in 2003 saw a startling different kind of war than had ever been fought before in American history. For the first time, brain injuries became the most common injury – far more common than chest and stomach wounds.

During the Vietnam War, getting a traumatic brain injury could be a death sentence. The medical technology simply didn’t exist yet. Historian Scott McGaugh explains:

“In Vietnam, about 12 percent of all injuries had involved the brain, and more than 70 percent of those were fatal.”

Because of the advancement of body armor, and the enemies’ use of improvised explosive devices as the weapon of choice, brain injuries became the signature wounds of the wars in Iraq and Afghanistan.

Military doctors soon discovered that the most dangerous aspect of getting your skull pieced by a bullet or hit by shrapnel was not the initial injury. Rather it was the intracranial pressure that would follow in the hours after the initial wound.

An injured brain swells, and that swelling gray matter has nowhere to go but towards the bottom of the skull. That puts pressure on the brain stem - the part of the brain that controls breathing and heartbeat. A damaged brain stem can lead to coma and eventually death.

So, military doctors wondered, how to relieve the pressure within the soldier’s skull without killing him?

To be continued tomorrow...

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