Boulder Daily Camera
Saturday 5 April 2003
"These are young children; 18, 19, 20 with arms and legs blown off. That is the reality."
Friday morning: 57 dead; 16 missing; 7 captured.
The daily White House press briefings and fuzzy real-time TV reports fall far short of conveying the brutality of war, says Boulder neurosurgeon Gene Bolles.
Bolles spent Thursday hunched over an operating table at Germany's Landstuhl Regional Medical Center, repairing the broken back of Army Pfc. Jessica Lynch, who was rescued from an Iraqi hospital this week. The 19-year-old soldier will require aggressive rehabilitation, Bolles said, but is expected to recover well one success story in a war full of tragedy.
"It really is disgustingly sanitized on television," said Bolles, who has spent the last 16 months as chief of neurosurgery at Landstuhl, the destination for the war's most wounded soldiers.
As of Friday, 281 patients had been brought to Landstuhl since Operation Iraqi Freedom started, and plane-loads are arriving regularly.
"We have had a number of really horrific injuries now from the war. They have lost arms, legs, hands, they have been burned, they have had significant brain injuries and peripheral nerve damage. These are young kids that are going to be, in some regards, changed for life. I don't feel that people realize that."
Bolles, 66, had a private practice in Boulder for 32 years before taking the job at Landstuhl. The U.S. military was short on neurosurgeons after Sept. 11, 2001 having scaled down its medical staff in response to a shrinking troop population in the '90s and was looking for an experienced civilian doctor willing to work as a contractor for a few years, said Lt. Colonel Bill Monacci, consultant to the Army Surgeon General for neurosurgery.
Bolles, a self-described "pacifist," found his patriotic juices flowing in the aftermath of the terrorist attacks, so he postponed his retirement and took the job to help out with Operation Enduring Freedom, the war on terrorism in Afghanistan.
"I was looking for any way to help out," said Bolles. "Not to fight a war necessarily, but to help out."
He is one of only a handful of civilian doctors among the mostly military staff at Landstuhl, the largest military hospital outside the United States. Until this week, he was the only neurosurgeon, taking anyone with back, neck, spine or head injuries.
While Monacci said he thinks the number of wounded has been relatively low given the scope of the war, Bolles has handled an increasingly heavy workload exceptionally well, he said.
"It is a tough situation. He probably thought it was going to be a bit of a slow-down from his practice, but I imagine it is a little busier than he planned for," Monacci said.
Bolles said despite media images that may lead the public to believe otherwise, he and the other doctors at Landstuhl have been busy for months.
Before the war began, the hospital already had treated 300 U.S. soldiers from Kuwait and surrounding areas, wounded in car accidents, windstorms and during training exercises. A brutal sandstorm landed five soldiers on Bolles' operating table. The wind blew a tent pole through the skull of one soldier and toppled heavy equipment onto another, fracturing his spine, he said.
Still affected by the carnage he saw as a division flight surgeon during the Vietnam War, Bolles said he is particularly troubled by the injuries he has seen coming from Operation Iraqi Freedom, a war he doesn't necessarily support.
"I am opposed to any war," he said. "I am doing what I am doing because I am a doctor, not because I have a political agenda."
He spent three hours in the operating room one morning last week removing bullet fragments, blood and brain matter from two young soldiers who each had been shot in the head. One will recover nicely, Bolles said; the other will have permanent neurological damage.
Another of his patients, wounded in a grenade battle, died on the operating table. "These are young children; 18, 19, 20 with arms and legs blown off. That is the reality," said Bolles.
Lt. Col. John Ogle, a Longmont emergency room doctor and flight surgeon for the National Guard, agrees that the public is not always given an accurate count of military injuries. But he says that is because an accurate number is often hard to come by: What exactly constitutes wounded?
"I would not call the war coverage sanitized," he said. "Everybody knows that there are casualties over there, mostly Iraqi. What has not been stressed enough is what it was like in the previous 12 years of Saddam's regime."
As things heat up on the battlefield, Bolles' workload is getting heavier.
Soldiers arrive daily in C-141 transport planes after the eight-hour flight from Iraq: 46 on Friday, 39 today, 38 on Sunday, 25 on Monday.
To brace for the flood of patients, the hospital has doubled its capacity to 322 beds and called up 600 medical reservists, including two more neurosurgeons. Bolles admitted four new patients Friday and was preparing to go back into the emergency room that night.
"The feeling here originally was, this is going to be over in a couple days," Bolles said.
His work is rewarding: He recently received a letter from a soldier who suffered a severe brain injury in a bomb blast in Afghanistan a few months ago. He'd recovered well and is getting married.
Working on the recently rescued Pfc. Lynch, who is not much older than Bolles' own daughter, was particularly rewarding, yet troubling.
"Nineteen years old and she's out there carrying a big gun," he said.
His assignment with Landstuhl should expire within a year or two, but Bolles has no plans to retire. Instead, he's looking into signing up with the relief agency Doctors without Borders.
"I could feel just as needed if I were in Iraq taking care of the people there who needed my services," he said.
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