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Reports from AUSA Medical Symposium and Exposition
07/03/2007
- Peake: Army has Revolutionized Medical Care – Warrior Care
- Mental Health Issues Should Not be a Stigma
- Walter Reed will be ‘Best Hospital in the World’
Peake: Army has Revolutionized Medical Care – Warrior Care
“The Army has revolutionized medical care – warrior care -- and this is your calling 24/7,” a former Army surgeon general said.
Speaking at the Association of the United States Army’s Medical Symposium and Exhibition June 18 at the Henry Gonzalez Convention Center in San Antonio, Lt. Gen. James B. Peake, USA, Ret., told the over- 1,200 medical personnel attending the four-day event, today “we are not in a static environment, and we keep learning to serve the needs of our soldiers – all across the Army,” not just in Iraq and Afghanistan.
Peake, who also served as commander of the Army Medical Command, said that the global war on terrorism has added new dimensions to military medicine and in-theater combat mortality and battlefield casualties.
But, because of the “revolution in today’s military medicine,” there is half the mortality rate today – due to combat casualties sustained in Iraq and Afghanistan – from those received in Vietnam and World War II.
Illustrating this point, Peake said that during World War II, battle casualties accounted for 23.7 percent killed in action, in Vietnam 21.3 percent and in Iraq and Afghanistan 12.5 percent.
Those dieing from wounds: in WW II, 3.4 percent; Vietnam, 3.5 percent; and in Iraq and Afghanistan, 4.1 percent.
The total mortality rate: 22.8 percent, WW II; 16.5 percent, Vietnam; and 8.8 percent in Afghanistan and Iraq.
This 50 percent drop in the total mortality rate is attributed to a great extent to “integrating the fox hole into the hospital … for strategic evacuation [of the injured] 12 to 48 hours – door to door … ICU [intensive car unit] to ICU,” Peake said.
According to Peake, in Vietnam, a great deal of convalescent care was done in theater, but today – during Operation Iraqi Freedom and Operation Enduring Freedom – strategic evacuation of the wounded, coupled with the expert medical care given by Army medics in their areas of responsibility, have contributed immeasurably to revolutionizing warrior medical care and the survivability of our soldiers.
One statistic that is up from previous wars, is the number of injuries caused by explosions – “not [from] your average land mine,” Peake said.
Up 10 percent in the global war on terrorism, and basically caused by IEDs – improvised explosive devices -- these injuries cause loss of limbs and require immediate medical attention and evacuation.
The IED, a bomb found on roads, roadsides or in cars and trucks, “is a significant change of how things have evolved on the battlefield,” Peake said.
Adding, “IEDs have us focusing on amputees,” and the care and rehabilitation of soldiers who have suffered the loss of one or more limbs has been so effective and successful that “to quote a report from ABC World News: ‘Walter Reed [Army Medical Center] is turning amputees into world-class athletes.’”
This type of injury, Peake said, “challenges our medical teams -- learning the lessons of war all over again. We innovate once we re-learn the lessons we have learned before.”
A new facility for wounded warriors, The Center for the Intrepid, a 60,000 square foot, state-of the-art physical rehabilitation center, opened on the grounds of the Brooke Army Hospital, Fort Sam Houston, Texas, in January. (See story “Intrepid Center for rehab opens at Fort Sam,” AUSA NEWS, March 2007.)
Initially focusing on amputees and burn patients injured in the global war on terrorism, the center may expand in the future to encompass retirees, family member and friends.
Also dedicated at the same time were two new 21-room Fisher Houses, bringing the total at Brooke to four, for the families of the wounded warriors.
Gen. Gordon R. Sullivan, USA, Ret., AUSA president, and Lt. Gen. Ted Stroup, USA, Ret., Association vice president for education, traveled to Fort Sam Houston, June 19, toured the Intrepid Center and visited wounded warriors and staff members, including Dr. Rebecca Hooper, a retired Army colonel, the center’s program director, and Col. John Shero, the hospital’s deputy chief for administration.
Following the visit, Sullivan presented a $20,000 check, on behalf of the Association’s membership, to Inge Godfrey, manager of the Fisher Houses, to support “the troops and their families who have sacrificed so much for their country,” Sullivan said.
Prior to Peake’s talk, attendees heard a video presentation from the Army chief of staff, Gen. George W. Casey Jr., who said to the assembled members of the Army’s medical community: “You are here for the troops, for the U.S. Army – active, National Guard, Army Reserve, civilians and families.
“Well done. We are enormously proud of you.”
“These are strong words from the chief,” Sullivan said, “we are proud of you. I have two words for you – ‘Thank you.’”
Lt. Gen. Gale S. Pollock, acting surgeon general and the deputy surgeon general and chief of the Army Nurse Corps, praised the Army Medical Department by saying, “AMEDD soldiers are doing incredible things.”
For example, she said that during the war on terror, Army medics have received six Silver Stars, 74 Bronze Stars and 41 with V device, 493 Purple Hearts, 22 Air Medals with V device, two Joint Service Commendation Medals with V device and 151 Army Commendation Medals with V device.
She added, “117 medics have lost their lives, one during this conference.”
“Army medics,” Pollock said, “Are setting the health-care standard not only for the Army, but for the nation.”
Speaking at the command’s noncommissioned officers’ special track session moderated by Command Sgt. Maj. David Eddy, U.S. Army Medical Command, Pollock said to the NCOs, “You are our eyes and ears. You are out there everyday with our soldiers and their families. … We need to take the time to take care of ourselves – to re-charge our batteries.”
Adding, “I need input from you to make a better Medical Department. I need to know your proposed solution. You are my solution.”
Peake, who is now the chief medical director and chief operating officer for QTC Management, Inc., concluded his remarks saying, “The face of Army medicine is all over the world. See you on the high ground.”
The AUSA’s Institute of Land Warfare Medical Symposium and Exposition – A Professional Development Forum – titled “Army Medicine: Revolutionizing Warrior Care,” -- was produced by the Association’s Industry Affairs Directorate.
Mental Health Issues Should Not be a Stigma
The new assistant secretary of defense for health affairs said he wants to reduce the stigma associated with mental health issues so service members are comfortable seeking help.
S. Ward Casscells, who succeeded William Winkenwerder in April for the overall leadership of the Military Health System, said the World Health Organization has projected that depression will be the leading cause of death worldwide by the year 2010.
Speaking June 20 at the Association of the United States Army’s Medical Symposium and Exhibition in San Antonia, Texas, Casscells said depression leads to other health issues – not just suicides – and service members need more choices for mental health solutions.
“I don’t think we can underestimate how important mental health will be going forward in the next couple years and the next couple decades,” Casscells said.
Depression is a “major trigger” of homicide, suicide, heart attacks, cardiac arrest and stroke, and also people simply neglecting basic health care like flu shots, he said.
The Military Health System has an unprecedented opportunity.
Casscells also mentioned how 200 mental health providers were recently brought on board in the Army by Maj. Gen. Gale Pollock, acting Army surgeon general.
“The Army is leading the way,” he said.
With ongoing operations in Iraq and Afghanistan, service members are also dealing with Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD), Casscells said.
“TBI and PTSD – this is job number one for me now,” Casscells said.
Soldiers filling out post-deployment health assessments shouldn’t look at the questions as free tickets home – instead of marking “No” to the questions and being afraid a red flag will be raised, it’s OK to answer “Yes” to some of the questions, he said.
Soldiers should be made aware of the network of 1-800 and 1-866 hotlines they can call and web-based chat they can use to cope with situations, he said.
He also wants soldiers to be contacted if they haven’t checked in for a post-deployment health reassessment.
“We need to reach out to those people … to get everybody accounted for so someone’s not out there struggling,” he said. “I think we’ll get some volunteers to call people in six months and say, ‘How are you doing? -- We haven’t heard from you.’”
Mental health issues can also affect family members, he said.
During a visit to Fort Bragg, N.C., Casscells, who is a doctor, met with three wives whose husbands were killed in fighting overseas, and they said they expected their husband’s “battle buddy” to contact them when they got home. They wanted to hear how their husbands died for their own peace of mind and pass that on their children, and it’s important for battle buddies to tell those stories.
Walter Reed will be ‘Best Hospital in the World’
S. Ward Casscells, assistant secretary of defense for health affairs, vowed that the new Walter Reed National Military Medical Center to open in Bethesda, Md., will be “the best hospital in the world.”
Based on recommendations from the Base Realignment and Closure (BRAC) process, the Walter Reed Army Medical Center is moving to the location of the National Naval Medical Center in Bethesda and will transform into a multi-service facility.
The BRAC recommendation wasn’t about saving money, Casscells said. “It’s about having the best medical center” for all service members and their families.
Speaking in San Antonio, Texas, at the Association of the United States Army’s Medical Symposium and Exhibition, Casscells said he will be “building bridges” outside the Department of Defense with organizations such as the Department of Health, the National Institutes of Health and Human Services and the World Health Organization to continue improving medical care.
But he cautioned there are some areas they can’t count on for research, and a joint military medical community will be relied on to expand health care.
Military patients aren’t facing the same things as patients in the civilian world and therefore need more specialized care.
He wants the new facility in Bethesda to be “the best place for healing.”
Casscells, a medical doctor, was appointed to his current position in April, and is an Army Reserve colonel.
He was mobilized in 2005 and assisted in the Army’s response to Hurricanes Katrina and Rita, and in 2006, he deployed to Iraq as the liaison from Multinational Force-Iraq to Ambassador Zalmay Khalilzad.
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