By HAL BROWN
The hostilities in Iraq are being caused by the disease of religious and ethnic hate and the United States has decided to be the doctor. But the doctors are dying. This is a time for a dose of the bitter medicine of hard cold logic.
The principles of emergency medical rescue and of medical triage, as applied in the battlefield must be used by Congress.
Rescue, where heroes get medals
Since Caesar’s time medals for valor have been awarded to soldiers who risked their lives to save their comrades. Under battlefield conditions the gut wrenching decision soldiers sometimes face is whether they should try to save a wounded soldier when there is a high likelihood they too will be wounded and also need rescuing.
Triage, where unsung heroes toil
Triage literally means to separate out, but in the 1930’s began to be used by the military to describe the way wounded soldiers were dealt with when there were more injured troops than personnel to treat them. The term then moved to general emergency medicine.
Critically wounded soldiers were given comfort and little else, even denied morphine if it was in short supply. The less severely wounded who could wait for medical attention would be shunted aside with the minimal attention, sometimes just enough needed to stop a wound from bleeding.
Corpsmen and medics would devote their greatest effort to those likely to have their lives saved by medical intervention. Soldier’s limbs that could be preserved if time wasn’t a factor were sometimes amputated because other soldiers whose lives hung in the balance needed intensive medical attention.
The soldiers who still make triage decision are heroes in their own right.
In 1971, when I ran a mental health center, I started one of the first outreach programs for Vietnam veterans with PTSD. I met a combat corpsman who sat with a member of his unit who’d been hit in the head by an unexploded rocket propelled grenade (RPG). It had lodged in his skull in such a way that he retained some consciousness despite being pumped with morphine. The chances of it being removed without exploding were remote, and the victim knew this.
This brave corpsman volunteered to talk to his fellow soldier while ordinance experts rigged wires to extract the RPG from a safe distance. He was the last person this man talked to.
Medical triage is still practiced on the battlefield. But it is very different now. Because of body armor and rapid evacuation where state of the art medical facilities can be reached within the so-called golden hour, virtually all American soldiers who can survive their wounds, do survive them.
Iraq itself is now mortally wounded like the soldier hit with the RPG. We are faced with recognizing that it’s prudent to declare the patient beyond hope. It has become likely that Iraq will have to blow apart before it can put itself together.
By HAL BROWN
The Republicans and President Bush say that twenty-one thousand additional “doctors” will do the job, that the United States and Iraqi army and police can staff the blood soaked emergency room Iraq has become.
This is now a war about saving Iraq from Iraqis, and to a far lesser extent, killing a few al-Qaeda fighters who are being created faster then they can be eliminated.
The former is a just cause, but it is futile. The later is a skirmish in the war on terror.
It’s wishful thing, and worse, it is instilling false hope, to suggest that 21,500 new troops, new doctors, can save this patient.
(Hal Brown is a clinical social worker and former mental health center director who is mostly retired from his private psychotherapy practice. He writes on the psychopathology of public figures and other topics that pique his interest. He can be found online at www.stressline.com)