Team Infidel
Forum Spin Doctor
Seattle Times
April 19, 2007
By Denis D. Gray, Associated Press
QALAT, Afghanistan — It was a dream job for a sports-medicine specialist: repairing the battered knees and shoulders of the Cincinnati Bengals and other athletes. Major trauma was defined as missing a season to injury.
Two years later in Afghanistan, the trauma Capt. Richard Slusher confronts now carries the gravity of life or death.
One recent morning, Slusher could do nothing to save an 8-year-old boy, carried in after his brain was shattered by a bomb — unexploded ordnance litters the landscape here.
Hours earlier, Slusher and a fellow surgeon, Col. Kenneth Azarow, a 47-year-old from Tacoma, amputated the legs of an Afghan policeman scythed down by a roadside bomb. Four others, riddled with shrapnel, lay nearby. A sixth was dead.
It's a long way from small-incision, computer-guided arthroscopic surgery on a linebacker's knee to "blood, tissue, bones, everything blowing up in your face."
"I'm not used to people dying on me," the 37-year-old orthopedic surgeon said.
And things aren't likely to ease up during the second half of his yearlong tour with the Army's 541st Forward Surgical Team.
"I expect this will be a very busy spring and summer. We're getting ready," said Azarow, echoing warnings that Taliban insurgents soon will intensify ambushes, raids and bombings.
The 10-man unit is half the size of a standard Army surgical team. It treats U.S., coalition and Afghan military personnel as well as civilians. "Anyone who needs our help," Azarow said.
A U.S. soldier seriously wounded at one of Zabul's remote bases can be flown by helicopter to the team at Qalat, the provincial capital, and within an hour undergo surgery and be airlifted out, first to the coalition air base at Kandahar and then to a major military hospital in Germany. All within 24 hours.
"We don't have the capability to support a critically injured patient for more than a couple of hours," Azarow said. "Here, we do life- and limb-sparing surgery — stop bleeding, control contamination, stabilize the patient."
As a comment on the medical situation in the dirt-poor province, Azarow said his understaffed unit, housed in two small rooms, is the most sophisticated facility in Zabul.
Azarow said the biggest fear is that the unit will be overwhelmed by casualties. That's nearly happened several times.
In February, nine seriously injured soldiers were rushed in from the crash in Zabul of a U.S. Chinook helicopter in which eight troops died. Within eight hours, all nine, including ones with severed spinal cords, were evacuated — and they survived.
More recently, 17 Afghan soldiers caught in a deadly Taliban ambush swamped the facility. Azarow, then the only surgeon, rapidly operated on three of the critically wounded while outsiders at the base — helicopter fuelers, Dutch communication specialists, Romanian medics — reinforced his overtaxed men.
"If you don't work as a team, you are truly lost," said Azarow, one of only two pediatric surgeons among the roughly 4,200 physicians on active U.S. Army duty. Twenty-six doctors are serving in Afghanistan.
Almost everyone on the team comes from an airborne unit, carrying some of the esprit of elite paratroopers, whom Slusher doctored at Fort Bragg, N.C., on his last assignment. ("An 18,000-man football team; they're crazy," he said.)
Prior to that, the regular Army officer had his year in the field of dreams — a break from normal Army duty for a sports medicine fellowship with the NFL football team and others in Cincinnati. Slusher loved it so much that after 17 years in the service he is planning to retire and go into a private sports-medicine practice.
"I assisted in many of the surgeries that got some of the players back on the field. That was a very satisfying experience for me, to see a person get back to doing what they enjoy doing," he said. "The experience of getting a soldier back on the battlefield is also the same. Seeing a child injured and getting him or her back to their family is more gratifying."
Slusher doesn't regret the year in Afghanistan, although he and Azarow say recruitment and retention of doctors has become harder because of the long deployments to overseas war zones.
"Most folks are fine with their initial deployment; it is the second and third that become extremely difficult for a variety of reasons, some personal and some professional," Azarow said.
To ensure it has enough medical personnel, the Army is offering bonuses and helps pay off student loans in exchange for commitments. For example, the National Guard is offering health-care professionals $30,000 in bonuses for three-year commitments.
Back in the OR, Slusher unwraps the bandaged legs of a severely wounded victim. Both are a mash of shredded flesh, tendons and exposed bones. A foot dangles on the end of the victim's left leg, and Slusher cuts if off with a scalpel, placing it in a blue plastic wash bowl.
A grinding sound then cuts through the room as Slusher and Azarow bend over the patient, neatly amputating both his legs below the knee with a wire saw.
All five that night are saved.
"Unless you come to us totally mangled, destined to die, you are not going to die," Slusher said. "This is our storming the hill, taking the objective. We are proud of that."
April 19, 2007
By Denis D. Gray, Associated Press
QALAT, Afghanistan — It was a dream job for a sports-medicine specialist: repairing the battered knees and shoulders of the Cincinnati Bengals and other athletes. Major trauma was defined as missing a season to injury.
Two years later in Afghanistan, the trauma Capt. Richard Slusher confronts now carries the gravity of life or death.
One recent morning, Slusher could do nothing to save an 8-year-old boy, carried in after his brain was shattered by a bomb — unexploded ordnance litters the landscape here.
Hours earlier, Slusher and a fellow surgeon, Col. Kenneth Azarow, a 47-year-old from Tacoma, amputated the legs of an Afghan policeman scythed down by a roadside bomb. Four others, riddled with shrapnel, lay nearby. A sixth was dead.
It's a long way from small-incision, computer-guided arthroscopic surgery on a linebacker's knee to "blood, tissue, bones, everything blowing up in your face."
"I'm not used to people dying on me," the 37-year-old orthopedic surgeon said.
And things aren't likely to ease up during the second half of his yearlong tour with the Army's 541st Forward Surgical Team.
"I expect this will be a very busy spring and summer. We're getting ready," said Azarow, echoing warnings that Taliban insurgents soon will intensify ambushes, raids and bombings.
The 10-man unit is half the size of a standard Army surgical team. It treats U.S., coalition and Afghan military personnel as well as civilians. "Anyone who needs our help," Azarow said.
A U.S. soldier seriously wounded at one of Zabul's remote bases can be flown by helicopter to the team at Qalat, the provincial capital, and within an hour undergo surgery and be airlifted out, first to the coalition air base at Kandahar and then to a major military hospital in Germany. All within 24 hours.
"We don't have the capability to support a critically injured patient for more than a couple of hours," Azarow said. "Here, we do life- and limb-sparing surgery — stop bleeding, control contamination, stabilize the patient."
As a comment on the medical situation in the dirt-poor province, Azarow said his understaffed unit, housed in two small rooms, is the most sophisticated facility in Zabul.
Azarow said the biggest fear is that the unit will be overwhelmed by casualties. That's nearly happened several times.
In February, nine seriously injured soldiers were rushed in from the crash in Zabul of a U.S. Chinook helicopter in which eight troops died. Within eight hours, all nine, including ones with severed spinal cords, were evacuated — and they survived.
More recently, 17 Afghan soldiers caught in a deadly Taliban ambush swamped the facility. Azarow, then the only surgeon, rapidly operated on three of the critically wounded while outsiders at the base — helicopter fuelers, Dutch communication specialists, Romanian medics — reinforced his overtaxed men.
"If you don't work as a team, you are truly lost," said Azarow, one of only two pediatric surgeons among the roughly 4,200 physicians on active U.S. Army duty. Twenty-six doctors are serving in Afghanistan.
Almost everyone on the team comes from an airborne unit, carrying some of the esprit of elite paratroopers, whom Slusher doctored at Fort Bragg, N.C., on his last assignment. ("An 18,000-man football team; they're crazy," he said.)
Prior to that, the regular Army officer had his year in the field of dreams — a break from normal Army duty for a sports medicine fellowship with the NFL football team and others in Cincinnati. Slusher loved it so much that after 17 years in the service he is planning to retire and go into a private sports-medicine practice.
"I assisted in many of the surgeries that got some of the players back on the field. That was a very satisfying experience for me, to see a person get back to doing what they enjoy doing," he said. "The experience of getting a soldier back on the battlefield is also the same. Seeing a child injured and getting him or her back to their family is more gratifying."
Slusher doesn't regret the year in Afghanistan, although he and Azarow say recruitment and retention of doctors has become harder because of the long deployments to overseas war zones.
"Most folks are fine with their initial deployment; it is the second and third that become extremely difficult for a variety of reasons, some personal and some professional," Azarow said.
To ensure it has enough medical personnel, the Army is offering bonuses and helps pay off student loans in exchange for commitments. For example, the National Guard is offering health-care professionals $30,000 in bonuses for three-year commitments.
Back in the OR, Slusher unwraps the bandaged legs of a severely wounded victim. Both are a mash of shredded flesh, tendons and exposed bones. A foot dangles on the end of the victim's left leg, and Slusher cuts if off with a scalpel, placing it in a blue plastic wash bowl.
A grinding sound then cuts through the room as Slusher and Azarow bend over the patient, neatly amputating both his legs below the knee with a wire saw.
All five that night are saved.
"Unless you come to us totally mangled, destined to die, you are not going to die," Slusher said. "This is our storming the hill, taking the objective. We are proud of that."