Our soldiers and the orthopedic surgeons who care for them

ByJohn D. Kelly IV, MD

Last week, thanks to the invitation of my good friend, Col. Richard Schaefer, MD, I had the profound privilege of visiting our wounded warriors at Walter Reed National Military Medical Center in Bethesda, Md. My tour of the facility where our wounded soldiers are treated was overwhelming. I returned from my visit with renewed respect for our servicemen and reverence for our military orthopedic surgeons.

Our young infantry soldiers are subject to combat blast injuries from improvised explosive devices (IEDs) that are engineered to maim and inflict devastating injuries to their victims. Kevlar armor usually protects the torso well, but leaves limbs vulnerable. The energy imparted by the dreaded IEDs creates blast injuries magnitudes more severe than those seen in previous military conflicts. As a result, more than 1,400 service members have required major limb amputations due to battle wounds sustained in both Iraq and Afghanistan.

Nearly one-quarter of amputees incurred the loss of multiple limbs. The increase in ground operations in Afghanistan has resulted in a sharp increase in the prevalence of bilateral transfemoral (BTF) amputations. Indeed, much of the labor of the Orthopedic Service at Walter Reed is devoted to limb salvage and amputation revision.

My heart sank when I beheld the amputee clinic where dozens of young soldiers seek to restore themselves to function after losing one or more limbs. One young man especially touched my heart. Clearly in his early 20s, he had lost both legs and one arm, and incurred a brain injury with vision loss. Imagine the challenges this young man faces daily. Merely evading depression would be a major triumph indeed.

Thankfully, our servicemen are resilient beyond measure. The determination, positivity and frank enthusiasm the young soldiers displayed in accommodating their new bodies was breathtaking. I recall one young man steadfastly walking up a ramp — quite well I may add — with his recently acquired bilateral above-the-knee prostheses. Another soldier was actually running laps on a track with his “new legs.” Other young heroes were trying out their “shorties” — the truncated limbs BTF amputees first don before advancing to more sophisticated prostheses. Many others were practicing the use of their new myoelectric arms.

The unparalleled resolve of our wounded has resulted in a full 15% of amputee soldiers returning to their previous units engaging in full duty. This incredible fact is also a testament to the devotion and skill of the surgeons and prosthetists who serve our young men with such distinction. Our wounded warriors and our brothers in orthopedic surgery who care for them deserve our utmost respect.

We can all in some measure give back to the young men and women who sacrifice life and limb for our freedom. Each of us can all make a difference, and I ask our readers to consider the following behaviors.

Expend extra effort in praising or offering a word of thanks to our soldiers when encountered at work or in public. Even soldiers who have never experienced injury have likely witnessed extraordinary violence unfit for humans to behold.
Help the loved ones of our military by accepting TRICARE. Although the monetary reimbursement may be meager, the satisfaction of caring for our military families is invaluable and deeply appreciated.
Support all educational efforts of the Society of Military Orthopedic Surgeons (SOMOS). Volunteer your time and energy to help share your knowledge with military orthopedists not afforded the same educational opportunities you may have enjoyed.
Offer your services, albeit part-time, to the Veterans Administration. Any loss of income will be more than offset by the fulfillment of helping to mend our emeritus warriors.

War is hell, but we would all do well to acknowledge and meditate on the profound suffering our military endure for our freedom. And please, pray for all the saints at Walter Reed who care for them.