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January/February 2005

By Chris Wolski

A Sacred Duty

Whether you support the war in Iraq or not, there is one sad fact that hawks and doves can agree on—war can be a waste of political capital, military materiel, and, most of all, human potential.

One of the few pieces of good news to come out of the grim and mounting Operation Iraqi Freedom casualty lists is that 90% of the 11,592 casualties¹ have survived their wounds and are now in the care of stateside military and civilian medical personnel. Because many of these service personnel have sustained horrific, life-changing injuries in the form of multiple amputations and head trauma, the role of rehabilitation medicine—particularly in the military—has changed accordingly. With astounding results.

As Col Robert R. Granville, Jr, MD, director of amputee services at Brooke Army Medical Center (BAMC), San Antonio, recently told me, many of these severely injured men and women are recovering from their wounds, and are returning to active duty. Several of Granville’s patients, including a special forces weapons expert who suffered a trans-radial amputation, are going back into the war zones of Iraq and Afghanistan as combatants.

Granville’s colleague, Col Leonard I. Cancio, OTR/L, MPH, CHT, SP, chief of occupational therapy at BAMC, adds that the large number of both upper and lower extremity amputations of Iraqi-based personnel is fueling renewed interest in the kind of prosthetic technology that will make amputations and other traumatic injuries less life-altering and more life-enhancing.

And this is where rehabilitation medicine in and out of the military setting is already changing. Granville sees the way rehab is changing as one of expectations. As he and his colleagues have shown, human potential—the thing most wasted in war—can be saved by raising the bar and pushing patients to return not only to their fullest function, but ever closer to “normal” functioning.

What the legacy of Iraq will mean for our country and the rest of the world is in doubt, but the medical legacy is already being written and it is an encouraging one. With the advances that military medicine is poised to make in the area of prosthetics and other areas of rehabilitative care, the day of the career-ending industrial accident may be a thing of the past. If there is any way rehab professionals can assist in the war in Iraq and make the carnage worth the sacrifices our brave men and women are making daily, it is in learning the lesson of military medicine and push their patients—be they wounded reservists who have returned to civilian life or injured factory workers—to their highest potential.

By doing that, the civilian PT can ensure that there was meaning in the sacrifice that those under arms have made. In the war on terror, if there is such a thing as a sacred duty for a PT, then this should be it.

--Chris Wolski

Reference
1. US casualty status. Washington, DC: Department of Defense; 2005. Available at: http://www.defenselink.mil/news/casualty.pdf. Accessed January 7, 2005.

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