Transformation of combat casualty care, advances in military healthcare focus of new book

More than 110 authors contributed to 44 chapters in the new Borden Institute book, “Out of the Crucible:  How the U.S. Military Transformed Combat Casualty Care in Iraq and Afghanistan.”  Dr. Art Kellermann, dean of USU’s F. Edward Hebert School of Medicine, and Navy Capt. (Dr.) Eric Elster, chair of the USU-WRNMMC Department of Surgery, co-edited the book.  (Image credit: courtesy of Borden Institute)
 By Sharon Holland

Advances in medicine that dramatically improved warfighter survival and recovery in America’s most recent wars are the focus of a new book, “Out of the Crucible: How the U.S. Military Transformed Combat Casualty Care in Iraq and Afghanistan,” just published by the Army’s Borden Institute. These advances in technology, products, and patient care during Operation Enduring Freedom and Operation Iraqi Freedom were driven by military health professionals determined to exceed what modern medicine thought was possible.

During the Wars in Iraq and Afghanistan (circa 2001-2014), the U.S. military completely transformed its approach to combat casualty care. By doing so, it achieved the lowest death rate from battlefield wounds in the history of warfare. Although this is one of the most remarkable achievements in the history of American medicine, few outside the armed forces (and a small number of civilian trauma and emergency care specialists) understand the magnitude of what was done. Fewer still know how it was done.

Military medical personnel remove a patient from a helicopter
Air Force Senior Airman Austin Hess, Ghazni Forward Surgical Team medical technician, and Air Force Staff Sergeant Shante’ Lopez carry a liter with an American Soldier from a MEDEVAC helicopter to Forward Operating Base Ghazni. April 22, 2010.  (Image credit: Tech. Sgt. James May)

Dr. Arthur L. Kellermann, dean of the F. Edward Hebert School of Medicine at the Uniformed Services University of the Health Sciences (USU), and Navy Capt. (Dr.) Eric Elster, chair of the USU-Walter Reed National Military Medical Center Department of Surgery, are co-editors of the book, which tells that story. Out of the Crucible includes 44 chapters by 110 world-renowned experts that are interspersed throughout the book with dramatic photographs and powerful first-person stories told by individuals who served during the conflicts or who benefited from these advances.

The book is divided into three sections:

• “Foundations” provides a brief history of America’s military health system, and explains how the education and research infrastructure put in place before September 11, 2001 set the stage for the advances
• “Innovations” describes 27 distinct technologies, products and changes in healthcare delivery that dramatically improved warfighter survival and recovery
• “Challenges” considers the operational obstacles and threats future war might bring, and examines nine promising areas of research aimed at optimizing warfighter health and resilience and further advancing combat casualty care

Medical personeel, some in scrubs, some in military fatigues, in a field operating room
US Army Major Neil McMullin, assigned to a forward surgical team, holds bags of saline while Majors Brian Helsel and Matthew Hueman clean a humerus fracture of an Afghanistan National Army Soldier at Field Operating Base Shank, Afghanistan, November 7, 2009. (Image credit: Spc. Richard Jones)

“Few Americans outside the surgical and emergency medicine communities know this story. I hope we can do justice to all who worked so hard and gave so much to achieve the highest rate of survival from combat injuries in the history of warfare,” said retired Army Lt. Gen. (Dr.) Eric Schoomaker, former U.S. Army Surgeon General and one of the book’s authors.

Want the book?

Download a free PDF from the Borden Institute.

Active duty military medical personnel: get your free copy by completing this online order form.

Available soon in hardback or paperback through the Government Printing Office’s U.S. Government Bookstore.