Ah whew! It is the early afternoon and we actually finished out scheduled cases before midnight for once! That's even with Vascular surgeon M. on call, but I won't dwell on the point because that would tempt the fates to deliver a influx of patients. I operated on two men this morning who had been injured a few days ago, but needed their wounds washed and their open abdomens reconstructed step by step. Before that, I started the morning operating on two youngsters with burns. Both have been with us several days. One is still severly ill and spends his days in the intensive care unit, hooked up to life support. The other is on the ward and is able to take a few hesitating steps, flexing his burned legs. We are encouraging him to eat more protein so that his body can heal his opened layers of skin. He has beautiful long eyelashes and large round dark eyes. His father has bronzed skin that wrinkles around his mouth an eyes when he smiles. His face is roughened with sun and age and he wraps his head in white. Whenever I visit, he gives me a thumbs up and looks to me inquiring with his creased eyes if his boy is improving. I return the thumbs up and say "Zien", for "good" one of the few Arabic words that my age-addled brain has been able to commit to memory.
Each day our crew sedates these boys and I scrub the dead material off of their burns. Today was a good day. I did not see masses of gangrenous skin threatening infection. The wounds seeped bright red blood as I scraped, signaling to me that there was healthy blood flow that might in time heal the skin whole again. They will not be well until I give them adequate coverage, a new layer to defend them against the bacteria in our environment and keep in necessary hydration. Soon I will place skin grafts, shaved off of their own healthy skin, to further their healing.
The boy in the intensive care unit is more severly burned over more than half of his body. There are fewer patches of healthy skin available to us to move over the burns. Just today we received a shipment of artificial skin substitute from friends at a military burn hospital back home. I called them for help in the middle of the night and they hustled to help us out. I am hoping that this artificial skin will help tide this unfortunate boy over and give his body a chance to recover from the initial shock of the injury. It take a huge effort from many of our hospital's staff to give these kids the care they need. I am in awe of the dedication and professionalism of my colleagues. I don't know the future, but as long as they stay alive, I'll do my best to get them coverage.
Some of you really responded to the story abut the military working dogs. Tara Parker-Pope of the NY Times emailed me a great story about stray cats in Baghdad called "Nine Lives: What Cats Know About the War".
When I transported a patient to the Combat Support Hospital in Baghdad a few years ago, I spent the wee hours waiting for a helicopter in the recreation room in the basement. Every few moments, a cat would come in the ceiling level window, make a mad dash for a morsel of food to steal, then head back out. I didn't see any rats, at least!
I hear "Trauma call in the ER, times five" so I'll sign off for now. Time to fly M.'s flag.
Take care and be safe!
LTC Christopher P. Coppola, USAF
APO AE 09315-9997