By Fred Tasker, The Miami Herald
Mar. 25–Jason Walsh, 35, a U.S. Army Reserve surgeon whose civilian practice is in Scotts Bluff, Neb., pop. 14,000, was counting on the mean streets of Miami to give him some good trauma surgery practice before his unit heads to Iraq.
Miami didn’t disappoint.
Between 10 p.m. and midnight Friday, Walsh’s 22-person Forward Surgical Team, practicing at Miami’s Ryder Trauma Center, handled a pedestrian hit by a car; a young woman knocked unconscious when she fell out of a fast-moving golf cart; a Key Largo biker who ran into a car; a 90-year-old man found face down in his room; a man stabbed in the thigh; and two Miami-Dade police officers in a car crash, one of whom had to be extricated by the Jaws of Life.
“We might get three or four traumas in a week in Scotts Bluff,” Walsh, an Army major, said. “You guys get it all.”
That’s why the 948th Forward Surgical Team, based in Smithfield, Mich., is putting in two weeks of last-minute team training in Miami.
It might seem a dubious civic distinction. The Army has chosen the Ryder Trauma Center at the University of Miami/Jackson Memorial Medical Center to train military surgeons, registered nurses and medics bound for Iraq or Afghanistan. It’s because of the center’s excellent reputation — and the likelihood that Miami will provide a big range of trauma on which to practice.
“It has the mix we need — penetrating traumas and blunt traumas, gunshots, knives,” said Donald Robinson, assistant professor of surgery at the University of Miami Miller School of Medicine and a U.S. Army lieutenant colonel on active duty. “We see 4,000 major traumas a year here; it’s one of the busiest centers in the U.S.”
REAL IS ‘BETTER’
In two intense weeks at Ryder, the team gets classes, clinical work and simulated combat surgery scenes, including lifelike mannequins covered in “moulage,” or fake movie blood, a nursing staff yelling at them and stereo speakers blaring battle sounds from Mel Gibson’s 2002 movie We Were Soldiers.
“But the real patients are better,” Robinson said. “Being able to touch real tissue, being put under stress. What we see in Iraq is polytrauma — blunt trauma, blast penetration, flash burns, metal fragments.”
The 948th Forward Surgical Team is a U.S. Army Reserve unit made up mostly of men and women with medical backgrounds, although nothing compared to what they will face in Iraq. Its leader, Lt. Col. Robert Monson, is a nurse anesthetist in Provo, Utah, usually handling dental and cosmetic cases; Staff Sgt. Johann Worch, the unit’s administrator, copes with knee abrasions and head lice as a school nurse in Franklin County, Ohio.
They get Army medical training during the one weekend a month and two weeks per summer they spend on active duty as reservists. They have come together here as a unit to learn the teamwork they will need in Iraq. Their team will go into combat with an Army brigade there, often directly under fire, setting up operating rooms in tents.
Their mission is to stabilize wounded soldiers, removing damaged organs if needed, then send them back to bigger Combat Support Hospitals.
“Our job is to battle chaos,” said Maj. Brad West, public information officer for the 11-person U.S. Army team stationed at Ryder to train 10 to 14 units like the 948th per year.
BY THE NUMBERS
The teamwork shows as Walsh’s crew swings into action over the 16-year-old girl hit by a car. As surgeon and leader, Walsh is asking the moaning girl what happened, what she ate and drank that day, where it hurts. Intensive care nurse David Jewett, a captain, is hooking her up to monitors. Right medic Porfirio Montes III, an Army specialist, is hooking up an IV. Left medic Jeremy Campbell, also a specialist, is taking blood for tests.
To fight the chaos and panic of combat situations, it’s very much by the numbers. Team members glance up at lists of duties taped to the walls.
“The biggest difference between civilian trauma and military trauma is speed,” Robinson said. “We train them to understand that speed.”
“These are superb doctors,” said Dr. Jeffrey Augenstein, UM professor of surgery and director of the Ryder Trauma Center. “But they might have been doing gall bladder surgery or hernia repair for 10 years.”
“I’ve been in the Army 21 years, and this is the best training I’ve had,” said Capt. Christopher Mullen, an intensive care nurse with the 948th.
Such programs as this, plus faster transportation from the battlefield to the hospital, have sharply cut the percentage of injured soldiers who die in Iraq and Afghanistan. A study in the New England Journal of Medicine said about 10 percent of U.S. soldiers injured in Iraq have died from their wounds, compared to 24 percent in Vietnam.
In Iraq, more than 3,200 U.S. military members have been killed and 23,000 wounded in combat — with another 25,000 impacted by nonhostile accidents or diseases.
The training in Miami is aimed at reducing that.
“It’s a sad commentary that Miami has these problems,” Augenstein said. “But we’re blessed that we can create this kind of training. We’re honored to do it.”
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Copyright (c) 2007, The Miami Herald
Distributed by McClatchy-Tribune Business News.
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