As Congresswoman Gabby Giffords lay bleeding, with what was a fatal wound not long ago, she was about to benefit from the interaction of civilian and military medicine. Her survival to this day is vivid testimony to the effectiveness of our Department of Defense and civilian medical communities not just to patient care but to the dissemination of information and training. The US Navy at Bethesda is damaging this cooperation through its actions in Bethesda, Maryland.
Wars in Iraq and Afghanistan produce injuries of horrific complexity. However, military medicine is reducing casualty death rates to unheard of levels. The Military isn't doing it alone but rather in some partnerships with several other medical centers in the nation. Centers of excellence throughout the Department of Defense (DoD) and government bring the very best military and civilian researchers and health care providers together producing once unimaginable progress. This ongoing process from cancer and trauma to orthopedic research and treatment strengthens both systems and institutionalizes experiences and knowledge.
In Tucson, Giffords was transported to the emergency room and subsequent care of Dr. Peter Rhee, a retired 24-year experienced Navy surgeon. He is now a Professor of Medicine at the University of Arizona. Dr. Rhee gained experience in military and civilian hospitals as far apart as Los Angeles and Afghanistan. A January 11 story by the Arizona Health Sciences Center, University of Arizona, illustrates the close military and civilian health care ties in certain areas.
"...Because Giffords' husband is active duty Navy personnel as well as an astronaut, the resources of the entire military were made available to UMC, Rhee said. He invited two experts to consult on Giffords' case.
Dr. James M. Ecklund, medical director of neurosciences, Inova Health System; medical director of neurosurgery, Inova Health System; chairman, Department of Neurosciences, Inova Fairfax Hospital, said the care Giffords received saved her life.
"Everything we've seen reflects the highest quality care," Ecklund said. "Dr. Rhee's team's aggressive resuscitation and Dr. Lemole's team's precise surgical intervention saved her life. Her ICU care is equally outstanding, providing the optimum environment for brain healing."
Dr. and Col. Geoffrey Ling, interim chair of neurology, Uniformed Services University of the Health Sciences, canceled a mission to Afghanistan to consult on Gifford's case. He also reiterated the seriousness of her injury.
"She was shot. The bullet did enter her skull; the bullet did traverse through her brain and then exited out the back leaving behind some fragments of bone, so she is critically ill," Ling said. "The good news is that she is, in fact, thriving under the very good - excellent - care here at the University of Arizona." ..."
Fewer US citizens from all walks of life die from wounds or debilitating diseases because of close cooperation between the military and civilian sectors. Department of Defense health care fostered this interaction following the Civil War and with ground work laid by Dr. Walter Reed. Rhee and Ecklund, former chief of neurosurgery at Walter Reed Army Medical Center and now retired, are also Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine graduates.
The New Walter Reed National Military Medical Center is aptly named for the Army surgeon who championed the approach so visible in that Arizona emergency room. From the days when sickness and disease caused more casualties than combat to today, military medicine supports civilian medicine while simultaneously drawing support from it.
Navy Eviction Notice
The outrageously expensive debacle (approaching $2 billion when complete) establishing WRNMMC at Bethesda, Maryland continues unabated and unapologetic. Now Navy leaders at Bethesda are blithely dismantling decades old ties to the National Cancer Institute (NCI), a leading cancer research/treatment institution, located literally across from the new WRNMMC. This world renowned institute supports cancer research and treatment throughout the health care and education communities. Since military and veterans are felt by many to encounter higher cancer rates, diagnosis and treatment are vital concerns to return highly trained service members back to the field.
Taking advantage of the Holiday season, on 28 December 2010, a Navy commander signed an "eviction notice" ordering NCI to vacate its facilities on Naval Support Activity Bethesda campus by 1 February 2011. With no prior notice, the Navy ends an over 30-year relationship with an insulting and abrupt eviction. Granted space is tight and too tight to live up to the fabrication that the Navy base will meet the BRAC deadline. Why didn't the space issues come out initially?
The outrageous eviction notice is not surprising from this growing debacle. Infection-spreading two person rooms, operating rooms far from ready, wounded troops turfed out to civilian hospitals far from their military families, and massive access construction just as 3,000 plus additional employees and patients appear all blend into this growing military health care tsunami due to crash on unsuspecting patients and staff late this summer.
Reportedly, a senior Navy officer at Bethesda reminded a senior Joint Task Force officer complaining of a lack of coordination with WRNMMC by Navy Bethesda replied: " This joint facility ends at the dry wall anything else is Navy." Whether truly accurate or not, the quote identifies the root cause at the new Walter Reed; the Navy health care leadership at Bethesda and the Pentagon are unable to play well with others. The JTF CAPMED is trying, but the leadership there faces the aforementioned problems while some in the Navy feed DoD the message that the JTF CAPMED should be disestablished. In the meantime, a world-class medical center is caught in the middle of this morass.
The sick and wounded from the entire military family deserve better from the Navy and DoD. A six-month extension to BRAC for completion of the Walter Reed National Military Medical Center should allow many of the challenges facing WRNMMC to be solved in good order in spite of obstructionist Navy senior health care leaders outside of the JTF CAPMED.