U.S. Army soldiers run towards a UH-60 Black Hawk helicopter as they are extracted after completing an aerial traffic control point mission near Tall Afar, Iraq, on June 5, 2006
Dead and injured are the byproducts of war. If you were seriously injured in combat from the Korean War to the Gulf War, there was a 25% chance that you would die. The miracle from Iraq is that the 25% rate is reduced to an incredible ten (10) percent. This is astonishing, incredible; there are not enough superlative words to heap on this achievement. What I did not understand was why this incredible accomplishment is played down by the Bush Regime. I thought the answer was the new and constantly modified body armor but now I know the whole story.
I received a book for the holidays: Better: A Surgeon's Notes on Performance written by Atul Gawande, a young Boston surgeon. Dr. Gawande explains the real story. Here, I found the percentages above and, although he is almost certainly not aware of it, he explains why the Bush Regime plays down their magnificent accomplishment. Rumsfeld, failed Secretary of Defense, is at fault. As told by Dr. Gawande, Walter Reed medical staff early on worked diligently to achieve the best results with their limited resources. How?
And what they described revealed an intriguing effort to do something we in civilian medicine do spottily at best: to make a science of performance, to investigate and improve how well they use the knowledge and technologies they already have at hand. The doctors told me of simple, almost banal changes that produced enormous improvements.
(Better, A Surgeon's Notes on Performance, pages 55, 56)
Walter Reed leadership at all levels took a book from the military fighter force. What created the overwhelming US military air superiority was superior equipment but, as important, an absolutely ruthless analysis of performance. No egos were spared, none. The goal was absolute perfection but the perfection of tiny steps. Interestingly, this approach made both the units and the process strong, binding everyone from mechanics and administration to aircrew almost as tight as family. The approach produced progress and success. I am not a surgeon but I do have hundreds of hours of flight time and time in those little debriefing rooms. The process works and optimizes the use of your strengths and helps develop new equipment and procedures.
The combined "Top Gun" and "Red Flag" of the military medical world, Walter Reed is the only remaining United States medical facility with the critical mass of medical and military professionals at all levels (medics, research specialists, doctors, nurses and other healthcare specialists) able to develop the program described by Dr. Gawande. Having the ability is one thing; having the courage to shake up a whole military medical establishment is another. The military serving at Walter Reed have the courage. They pursued absolute perfection implementing the perfection of tiny steps. They were and are wildly successful and the number of combat injured who died fell from 25% to an amazing 10%. Could this really be true? I contacted people, not just at Walter Reed but in Iraq and those recently retired. This incredible feat is true.
Their reward for this outstanding achievement? The entire team is being dismantled and the critical mass required to accomplish great things dispersed to the winds. Brownie and Tenant got medals. I realize incompetence is the single word identifier for the Bush Administration but I didn't realize that they pursued it so aggressively. Sadly, in the next conflict, the death rate for our wounded will again approach 25%. Meanwhile Rumsfeld is gone but his acolyte, David Chu, and of course Dick Cheney continue destroying military healthcare.
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