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Army Inks War Surgery Book

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The New York Times

Published: August 5, 2008

The pictures show shredded limbs, burned faces, profusely bleeding wounds. The subjects are mostly American GIs, but they include Iraqis and Afghans, some of them young children.

They appear in a new book, "War Surgery in Afghanistan and Iraq: A Series of Cases, 2003-2007," quietly issued by the U.S. Army - the first guidebook of new techniques for American battlefield surgeons to be published while the wars it analyzes are still being fought.

Its 83 case descriptions from 53 battlefield doctors are clinical and bone dry, but the gruesome photographs illustrate the grim nature of today's wars, in which more are hurt by explosions than by bullets, and body armor leaves many alive but maimed.

And the cases detail important advances in treating blast amputations, massive bleeding, bomb concussions and other front-line trauma.

It can be ordered from the Government Printing Office for $71; Amazon.com lists it as out of stock, but the Borden Institute, the Army medical office that published it, said thousands more copies would be printed.

"I'm ashamed to say that there were folks even in the medical department who said, 'Over my dead body will American civilians see this,'" said David Lounsbury, one of the book's three authors. Lounsbury, 58, an internist and retired colonel, took part in the 1991 and 2003 invasions of Iraq and was the editor of military medicine textbooks at Walter Reed Army Medical Center.

"The average Joe Surgeon, civilian or military, has never seen this stuff," Lounsbury said. "Yeah, they've seen guys shot in the chest. But the kind of ferocious blast, burn and penetrating trauma that's part of the modern IED wound is like nothing they've seen, even in a Manhattan emergency room. It's a shocking, heart-stopping, eye-opening kind of thing. And they need to see this on the plane before they get there, because there's a learning curve to this."

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