The History Of Combat Medics
War generates many harsh realities and traumatizing situations. Combat medics train to help those suffering from the most grievous injuries and mortifying conditions that most people could never comprehend. The combat medic field goes back thousands of years to the ancient Greeks and Egyptians.
The bygone Greek physician Hippocrates, for which the Hippocratic Oath is named, advised, “‘He who would become a surgeon, let him join an army and follow it.” From time immemorial to today, combat medics worked furiously to save the lives of those they could and ease the passing of those they could not. Procedures have greatly improved but the ethos remained the same. Here are the stories and practices combat medics have experienced the world over.
The Dark Ages
A medic converses with a wounded soldiers during World War I. Circa 1915 (Wikicommons)
A century and a half ago, during the Civil War, medics possessed very few choices when it came to grievous injuries. A field tent where the injured were taken held little more than bandages, chloroform (if available), morphine, opium, and of course, whiskey. Their “surgical kit” included little more than amputation knives and handsaws.
The cinematic portrayal of soldiers writhing and screaming as doctors removed a limb rarely occurred. According to English professor, Jane E. Schultz, "Ninety-five percent of the time, they used chloroform or ether. They were dosed lightly, as the operations were brief. The light anesthesia, not pain, caused the patients to move about while insensible."
Simple, Incremental Improvement
The simple act of tying off a wound became a life saving technique in the field.
Napoleon Bonaparte’s chief surgeon, Dominique Jean Larrey, made simple but radical changes that greatly improved the survival rate of soldiers. He instituted a horse drawn wagon for the injured, a presage of the ambulance, treating soldiers away from battle lines. Larrey created the then-radical change of triaging patients, which meant treating them by severity of their wounds rather than their rank.
Today, that remains a standard operating procedure. The forward-thinking surgeon elected to immediately amputate damaged limbs rather than let infection set in. All of these improvements were quickly adopted and eventually updated as doctors learned new techniques often established in the field.
World War I
Sometimes medic would have to treat the enemy. Here a french medic treats a German solider during WWI. (allthatsinteresting)
At the turn of the 20th century, the U.S. and British army medical corps ranked as the best in the world, likely thanks to years of practice. However, nothing could prepare them for the atrocities of World War I. Due to trench warfare, medical officers were posted in the heart of the fighting. The trenches were roughly two feet wide at the bottom, four at the top, and six feet deep, giving field medics little space to operate in the waterlogged gullies from hell. Fire steps were cut out of the walls a foot off the ground, to keep the wounded dry and out of the way of fighting soldiers.
Making Due
Plastic surgery was actually born out of reconstructive surgery for soldiers.
In the nook of the fire step, wounds were cleaned, dead tissue cut away, bandages applied, and broken limbs splinted. If available, tetanus shots were given as medics waited for stretcher-bearers (who suffered incredibly high casualty rates) to take the wounded to first aid posts away from the fighting. There the wounded were separated into three groups: the less seriously wounded (dubbed the "walking wounded"), those needing emergency care to survive, and ‘hopeless cases’ who were given morphine or chloroform to ease their final moments.
First Hand Experience
Plasma greatly helped medics save lives in the field. (getty)
Dr. John Hayward, a doctor for 20 years, volunteered to help in WWI. This is a brief glimpse of what he saw. “It was extraordinary that in this charnel tent of pain and misery there was silence, and no outward expression of moans or groans or complaints. The badly shocked had passed beyond it; others appeared numbed, or too tired to complain, or so exhausted that they slept as they stood.”
“The effect of transfusion was in some cases miraculous. I have seen men already like corpses, blanched and collapsed, pulseless and with just perceptible breathing, within two hours of transfusion sitting up in bed smoking, and exchanging jokes before they went to the operating table.” Blood transfusion saved many lives during WWI and World War II, so many that doctors developed a means to separate plasma from whole blood. That advancement gave field medics the ability to stabilize wounds without whole blood.
Major Improvements
Our modern day ambulances arose from the need to get wounded seriously medical attention more quickly.
Thanks to improved transfusions the death rate for wounded dropped from 8.1% in WWI to 4.4% during WWII. Another major step forward became the increased focus on transferring the wounded to a field hospital or as the army informally calls it, the “scoop and run.” Many years after the World Wars, the Pentagon put a directive in place that “required that every deployed American be within sixty minutes of higher-level care, usually at a surgical hospital.” Since 2000, some 60,000 troops sustained injuries in combat and 53,000 or 91% made it home alive. In Vietnam, that number stood at 75%.
Painful Realities
A medic helps a wounded soldier during WWII. (getty)
Despite the many improvements made in the medical care of soldiers, the agonizing nature of field care persists. Here’s a snapshot of the experiences of Micheal Bailey, a medic who served in the Middle East:
A .50 cal round had "cooked off" and hit his leg. I started shoving gauze in the half dollar sized exit wound in the back of his leg. "Oh God! Stop! Please! Stop Doc!" he screamed.
I gritted my teeth and tried to ignore him. You have to plug these wounds. A tourniquet simply won't do it. Plugging it will prevent infection, speed the healing, and is one of the quickest ways to start clotting in, but it hurts so much. And so on this day, I put a man through unbelievable amounts of agony to save him. If you can imagine, an abrasion that's getting cleaned, but far worse because it’s inside your body. I put half a roll into his leg which probably only took 15-30 seconds. But it's 15-30 seconds that are seared into my memory.
By far the worst thing every medic is trained for, but truly dreads, we call The Choice. There is no formal name for it, aside from who lives, and who dies. I have heard men ask me, "Am I going to be ok?" You never say no, but you never tell the truth. Sometimes you don't speak, but more often than not you lie. You can't tell a man who's scared to death that he has only a few minutes to live.
The Destruction Of War
The ugliness of war will never change.
We can make all the medical improvements under the sun. However, the painful reality of war stays the same.
