Book Displays: 11.24 Wartime Medical Care and Military Health

Soon after the Japanese attacked Pearl Harbor on December 7, 1941, they also attacked U.S. military installations in the Philippines. For the army and navy nurses stationed there, what had been a peaceful outpost quickly turned into a raging war zone. When the U.S. and Philippine forces retreated to the Bataan Peninsula and the fortress island of Corregidor, the nurses followed them to the field hospitals to care for the wounded. Persevering through enemy assault and imprisonment, these heroic women became angels of mercy amid the war in the Pacific.

 Begun in 1959 as a result of the Southeast Asia Treaty Organization, the Thailand SEATO Cholera Research Project in Bangkok, later the Medical Research Laboratory, and finally, AFRIMS (in 1977), was a collaborative research effort between the US Army Medical Department and the Royal Thai Army. Throughout the institute's history, US Army and Thai doctors jointly pursued research and therapy for illnesses that threatened both US troops and Thai citizens, such as cholera, malaria, opisthorchiasis, dengue, Japanese B encephalitis, hepatitis, enteric infections, and HIV/AIDS, as documented in these photographs.

"I had the idea to make a comic about your experience of PTSD. I'd like to understand more about it and I think it could help other people too." In this illustrated conversation between Samuel C. Williams and his friend, Matt, they talk candidly about Matt's struggles with post-traumatic stress disorder. From scoping out quick exits in coffee shops to re-experiencing traumatic events through triggers as seemingly insignificant as a sound or smell, Matt describes his unique experiences of the condition, how he has learnt to cope with it, and his new career path. This comic will offer support and understanding to anyone who has been affected by PTSD no matter what the cause.

Chimborazo Hospital, just outside Richmond, Virginia, served as the Confederacy's largest hospital for four years. During this time, it treated nearly eighty thousand patients, boasting a mortality rate of just over 11 percent. This book, the first full-length study of a facility that was vital to the Southern war effort, tells the story of those who lived and worked at Chimborazo. Organized by Dr. James Brown McCaw, Chimborazo was an innovative hospital with well-trained physicians, efficient stewards, and a unique supply system. Physicians had access to the latest medical knowledge and specialists in Richmond. The hospital soon became a model for other facilities. The hospital's clinical reputation grew as it established connections with the Medical College of Virginia and hosted several drug and treatment trials requested by the Confederate Medical Department. In fascinating detail, Chimborazo recounts the issues, trials, and triumphs of a Civil War hospital. Based on an extensive study of hospital and Confederate Medical Department records found at the National Archives, along with other primary sources, the study includes information on the patients, hospital stewards, matrons, and slaves who served as support staff. Since Chimborazo was designated as an independent army post, the book discusses other features of its organization, staff, and supply system as well. This careful examination describes the challenges facing the hospital and reveals the humanity of those who lived and worked there.  

A biography telling the life story of Clara Barton, who served as a Civil War nurse, and started the American Red Cross. Written in graphic-novel format.

In this lucid and cogently-argued book, Christine Hallett explores the nature of the practices developed by nurses and their volunteer-assistants during the First World War. She argues that nurses found meaning in their complex and stressful work by identifying it as a process of 'containing trauma'. Broad in its scope and detailed in its research, the book analyses the work of nurses from Britain, Australia, New Zealand, Canada, South Africa and the United States of America. It draws on highly personal writings: letters and diaries drawn from archives and libraries throughout the world. This wide-ranging book explores a range of treatment scenarios, from the Western and Eastern Fronts to the Eastern Mediterranean, Mesopotamia and India. It considers both the efforts of nurses to provide physical, emotional and moral containment to their patients, and the work they did to maintain their own physical and emotional integrity.

During World War II, Mom Chung's was the place to be in San Francisco. Soldiers, movie stars, and politicians gathered at her home to socialize, to show their dedication to the Allied cause, and to express their affection for Dr. Margaret Chung (1889-1959). The first known American-born Chinese female physician, Chung established one of the first Western medical clinics in San Francisco's Chinatown in the 1920s. She also became a prominent celebrity and behind-the-scenes political broker during World War II. Chung gained national fame when she began "adopting" thousands of soldiers, sailors, and flyboys, including Ronald Reagan, Admiral Chester W. Nimitz, and Admiral William F. Halsey, Jr. A pioneer in both professional and political realms, Chung experimented in her personal life as well. She adopted masculine dress and had romantic relationships with other women, such as writer Elsa Gidlow and entertainer Sophie Tucker. This is the first biography to explore Margaret Chung's remarkable and complex life. It brings alive the bohemian and queer social milieus of Hollywood and San Francisco as well as the wartime celebrity community Chung cultivated. Her life affords a rare glimpse into the possibilities of traversing racial, gender, and sexual boundaries of American society from the late Victorian era through the early Cold War period.

Black soldiers in the American Civil War were far more likely to die of disease than were white soldiers. In Intensely Human, historian Margaret Humphreys explores why this uneven mortality occurred and how it was interpreted at the time. In doing so, she uncovers the perspectives of mid-nineteenth-century physicians and others who were eager to implicate the so-called innate inferiority of the black body. In the archival collections of the U.S. Sanitary Commission, Humphreys found evidence that the high death rate among black soldiers resulted from malnourishment, inadequate shelter and clothing, inferior medical attention, and assignments to hazardous environments. While some observant physicians of the day attributed the black soldiers' high mortality rate to these circumstances, few medical professionals--on either side of the conflict--were prepared to challenge the "biological evidence" of white superiority. Humphreys shows how, despite sympathetic and responsible physicians' efforts to expose the truth, the stereotype of black biological inferiority prevailed during the war and after.

An inspiring graphic novel about Jane Kendeigh, a nurse who helped wounded soldiers in combat zones during World War II. During World War II, the United States' fight against the Japanese on islands in the Pacific was intense and deadly. To help respond to casualties in battle, the U.S. Navy trained 122 nurses to aid wounded soldiers in combat zones. The first nurse to do so was Jane Kendeigh, a twenty-two-year-old woman from Ohio. In March 1945, Kendeigh's first assignment was to help soldiers fighting in the Battle of Iwo Jima--a fierce battle with many casualties. With bravery and determination, she and other nurses helped thousands of soldiers in that battle--and many more in the Battle of Okinawa. In this full-color graphic novel, discover more about this courageous nurse who braved the battlefield to help U.S. soldiers. Other Women Warriors of World War II:Angels of Bataan and Corregidor: The Heroic Nurses of World War IIThe Courageous Six Triple Eight: The All-Black Female Battalion of World War IIDaring Women of D-Day: Bold Spies of World War IIElizebeth Friedman: Expert Codebreaker of World War IINancy Wake: Fearless Spy of World War IISophie Scholl: Daring Activist of World War IIVirginia Hall: Clever Spy of World War II

"An estimated 19,000 rapes and sexual assaults took place in the military last year. Every one of them represents a monstrous crime made much worse by the sense of betrayal that accompanied it. That so few victims--just one in seven--report these crimes underscores the utter lack of trust that pervades military culture." -- Retired Gen. Loree Sutton and Garry Trudeau, in a Washington Post OpEd, June 29, 2013 The first time B.D. encounters command-rape survivor Melissa Wheeler in the waiting room at the VA Center, he has no idea what to make of the scowling former chopper mechanic. But in the months that follow, witnessing Mel's pain and her healing process help him with his own, and B.D. ends up a staunch and encouraging ally. With the help of VA counselors Cora and Elias, Wheeler is able to reframe her experience and move forward to the point where she re-ups and re-deploys, though the trauma and betrayal continue to haunt her. She and battlebud Roz masterfully manage a perilous rescue op of a downed USO chopper, and in the new post-DADT world the now-out Roz and her now-superior ("That's SERGEANT bitch to you!") help wind down US ops in Afghanistan. Returning stateside, Mel's final obstacle is her father's cluelessness--and a widespread reluctance to hear the truth of her story. As always, Trudeau manages to find humor and humanity in even a tale of suffering, and sheds serious light on one of the most pressing and undermining problems in our military today.

American women did more than pursue roles as soldiers, doctors, and nurses during World War I. Mobilizing Minerva: American Women in the First World War reveals women's motivations for fighting for full citizenship rights both on and off the battlefield. The war provided chances for women to participate in the military, but also in other male-dominated career paths. Intense discussions of rape, methods of protecting women, and proper gender roles abound as Kimberly Jensen draws from rich case studies to show how female thinkers and activists wove wartime choices into long-standing debates about woman suffrage and economic parity. The war created new urgency in these debates, and Jensen forcefully presents the case of women participants and activists: women's involvement in the obligation of citizens to defend the state validated their right of full female citizenship.

Publishes selections from the memoirs of Ellen N. La Motte & Mary Borden, two of the best known American nurses who wrote about their experiences working in the same field hospital on the Western Front during World War I. Simultaneous hardcover.

Winner, 2010 Lavinia L. Dock Award, American Association for the History of NursingAn American Journal of Nursing Book of the Year in History and Public Policy "'I never got a chance to be a girl,' Kate O'Hare Palmer lamented, thirty-four years after her tour as an army nurse in Vietnam. Although proud of having served, she felt that the war she never understood had robbed her of her innocence and forced her to grow up too quickly. As depicted in a photograph taken late in her tour, long hours in the operating room exhausted her both physically and mentally. Her tired eyes and gaunt face reflected th e weariness she felt after treating countless patients, some dying, some maimed, all, like her, forever changed. Still, she learned to work harder and faster than she thought she could, to trust her nursing skills, and to live independently. She developed a way to balance the dangers and benefits of being a woman in the army and in the war. Only fourteen months long, her tour in Vietnam profoundly affected her life and her beliefs." Such vivid personal accounts abound in historian Kara Dixon Vuic's compelling look at the experiences of army nurses in the Vietnam War. Drawing on more than 100 interviews, Vuic allows the nurses to tell their own captivating stories, from their reasons for joining the military to the physical and emotional demands of a horrific war and postwar debates about how to commemorate their service. Vuic also explores the gender issues that arose when a male-dominated army actively recruited and employed the services of 5,000 nurses in the midst of a growing feminist movement and a changing nursing profession. Women drawn to the army's patriotic promise faced disturbing realities in the virtually all-male hospitals of South Vietnam. Men who joined the nurse corps ran headlong into the army's belief that women should nurse and men should fight. Officer, Nurse, Woman brings to light the nearly forgotten contributions of brave nurses who risked their lives to bring medical care to soldiers during a terrible--and divisive--war.

Dr. Dave Hnida's devastating and inspiring account follows a group of brilliant and committed doctors who staff a combat hospital in Iraq and achieve an astounding survival rate as they forge deep and lasting bonds based on friendship, good humor, and fidelity to the well-being of the American soldier. IN 2004, at the age of forty-eight, Dr. Dave Hnida, a family physician from Littleton, Colorado, volunteered to be deployed to Iraq and spent a tour of duty as a battalion surgeon with a combat unit. In 2007, he went back--this time as a trauma chief at one of the busiest Combat Support Hospitals (CSH) during the Surge. In an environment that was nothing less than a modern-day M*A*S*H, the doctors' main objective was simple: Get 'em in, get 'em out. The only CSH staffed by reservists-- who tended to be older, more-experienced doctors disdainful of authority--the 399th soon became a medevac destination of choice because of its high survival rate, an astounding ninety-eight percent. This was fast-food medicine at its best: working in a series of tents connected to the occasional run-down building, Dr. Hnida and his fellow doctors raced to keep the wounded alive until they could be airlifted out of Iraq for more extensive repairs. Here the Hippocratic Oath superseded that of the pledge to Uncle Sam; if you got the red-carpet helicopter ride, his team took care of you, no questions asked. On one stretcher there might be a critically injured American soldier while three feet away lay the insurgent, shot in the head, who planted the IED that inflicted those wounds. But there was levity amid the chaos. On call round-the-clock with an unrelenting caseload, the doctors' prescription for sanity included jokes, pranks, and misbehavior. Dr. Hnida's deployment was filled with colorful characters and gifted surgeons, a diverse group who became trusted friends as together they dealt with the psychological toll of seeing the casualties of war firsthand. In a conflict with no easy answers and even less good news, Paradise General gives us something that we can all believe in--the story of an ordinary citizen turned volunteer soldier trying to make a difference. With honesty and candor, and an off-the-wall, self-deprecating humor that sustained him and his battle buddies through their darkest hours, Dr. Hnida delivers a devastating and inspiring account of his CSH tour and an unparalleled look at medical care during an unscripted war.

The psychological toll of war is vast, and the social costs of war's psychiatric casualties extend even further. Yet military mental health care suffers from extensive waiting lists, organizational scandals, spikes in veteran suicide, narcotic overprescription, shortages of mental health professionals, and inadequate treatment. The prevalence of conditions such as post-traumatic stress disorder is often underestimated, and there remains entrenched stigma and fear of being diagnosed. Even more alarming is how the military dismisses or conceals the significance and extent of the mental health crisis. The trauma experts Mark C. Russell and Charles Figley offer an impassioned and meticulous critique of the systemic failures in military mental health care in the United States. They examine the persistent disconnect between war culture, which valorizes an appearance of strength and seeks to purge weakness, and the science and treatment of trauma. Instead of reckoning with the mental health crisis, the military has neglected the needs of service members. It has discharged, prosecuted, and incarcerated a large number of people struggling with the psychological realities of war, and it has inflicted humiliation, ridicule, and shame on many more. Through a far-reaching historical account, Russell and Figley detail how the military has perpetuated a self-inflicted crisis. The book concludes with actionable prescriptions for change and a comprehensive approach to significantly improving military mental health.

Singelin's PTSD is an adult fiction graphic novel that grapples with the reality of being a war veteran about a traumatized war vet who must fend for herself against all odds. After returning home from an unpopular war, Jun becomes an outsider in an indifferent world. Alone, desperate, and suffering from wounds both mental and physical, she seeks relief in the illicit drugs she manages to purchase or steal. Jun's tough exterior served her well in combat, but she'll need to nurture her vulnerability and humanity to survive at home. With the support of her fellow vets, the kindness of a stranger who refuses to turn away, and the companionship of a dog named Red, Jun learns to navigate the psychological trauma that she experienced in the war.

Adele Levine's days rehabilitating amputee soldiers at Walter Reed were intense, chaotic and heart-breaking, but they were also filled with camaraderie and unlikely humour. Working in a glassed-in gymnasium, Levine, her colleagues and their patients were constantly on display to tour groups, politicians and celebrities. Some would tear up openly at the sight, but inside the glass and out of earshot, the P.T.s and the rowdy patients cracked jokes, played pranks and compared stumps as they worked to not only walk again, but to run. Deeply humane and absorbing.

Signature Wound: Rocking TBI is Pulitzer Prize-winner Garry Trudeau's third collection of Doonesbury comics examining the effects of combat on soldiers in Iraq. Signature Wound: Rocking TBI completes a trilogy of Doonesbury books that examines the impact of combat on American soldiers in Iraq. A twist of fate brings B. D. to the bedside of SFC Leo Deluca (a.k.a. Toggle), a young HUMV driver and headbanger whose love of ear-bleed battle music had sonically distracted him enough to get his vehicle blown up. Missing an eye and suffering from aphasia, Toggle fights to recover from traumatic brain injury (TBI), a journey of recovery that brings out the best in B. D., his former commander. Toggle's tattooed, metalhead mom initially has reservations about his improbable Facebook romance with an MIT tech-head named Alex, but love blooms. As this engaging story unfolds, Toggle finds himself drawn toward a career in the recording industry, undaunted by the limitations of the New Normal that now defines his life. Crafted with the same kind of insight, humor, and respect that prompted the Pentagon and the VA to host signings of the two previous books in the trilogy, Signature Wound is a perceptive and timely look at the contemporary soldier's experience.

Carol Tyler chronicles her fraught relationship to her father, Charles, a WWII veteran, and how the war affected lives through both childhood and adulthood. You'll Never Know is also a tribute to servicemen and women, dramatising the traumatic effects of the war on the Greatest Generation and those who followed. Her father's memories are woven into her own, which span her Catholic, Midwestern childhood; her troubled marriage; her daughter's struggles and her efforts to care for her aging parents.

"Bill" McDermott's tale of action as a combat surgeon in World War II is set against the dramatic events of the Allied invasion of Europe and the liberation of the Nazi concentration camp at Ebensee. Dr. McDermott's book originated when he found in his attic, a trunk of letters - scores of them - sent home to his young wife Blanche back in Massachusetts. These letters and observations result in a fast-paced narrative, giving an "on the spot" quality as the story unfolds. The illustrations throughout - some startling snapshotstaken at the time by the author - give an immediacy to the narrative. Maps, an index and a list of sources are included.

After the battle of Antietam in 1862, Harriet Eaton traveled to Virginia from her home in Portland, Maine, to care for soldiers in the Army of the Potomac. Portland's Free Street Baptist Church, with liberal ties to abolition, established the Maine Camp Hospital Association and made the widowed Eaton its relief agent in the field. One of many Christians who believed that patriotic activism could redeem the nation, Eaton quickly learned that war was no respecter of religious principles.Doing the work of nurse and provisioner, Eaton tended wounded men and those with smallpox and diphtheria during two tours of duty. She preferred the first tour, which ended after the battle of Chancellorsville in 1863, to the second, more sedentary, assignment at City Point, Virginia, in 1864. There the impositions of federal bureaucracy standardized patient care at the expense of more direct communication with soldiers. Eaton deplored the arrogance of U.S. Sanitary Commissioners whom she believed saw state benevolent groups as competitors for supplies.Eaton struggled with the disruptions of transience, scarcely sleeping in the same place twice, but found the politics of daily toil even more challenging. Conflict between Eaton and co-worker Isabella Fogg erupted almost immediately over issues of propriety; the souring working conditions leading to Fogg's ouster from Maine state relief efforts by late 1863. Though Eaton praised some of the surgeons with whom she worked, she labeled others charlatans whose neglect had deadly implications for the rank and file. If she saw villainy, she also saw opportunities to convert soldiers and developed an intense spiritual connection with a private, which appears to have led to a postwar liaison.Published here for the first time, the uncensored nursing diary is a rarity among medical accounts of the war, showing Eaton to be an astute observer of human nature and not as straight-laced as we might have thought. This hardcover edition includes an extensive introduction from the editor, transcriptions of relevant letters and newspaper articles, and a thoroughly researched biographical dictionary of the people mentioned in the diary.

Veteran Suicide: A Public Health Imperative educates readers on the critical issue of veteran suicide that has become a national imperative. Eighteen veterans kill themselves daily. An average of one active-duty GI commits suicide every 1.1 days. More GIs deployed to Iraq and Afghanistan will die from suicide than from combat. These troubling facts are undeniable. Published with assistance from the Veterans Administration, this collection of papers offers peer reviewed research from the leading experts from public health, clinical, and scientific communities. Some of the topics include: * Surveillance of Suicide and Suicide Attempts Among Veterans * Suicide Prevention for Veterans and Active Duty Personnel * Preventing Suicide by Preventing Lethal Injury * Estimating the Risk of Suicide Among US Veterans: * Suicide Prevention Is a Winnable Battle * Facilitating Treatment Engagement During High-Risk Transition Periods "The research represented by the collection of manuscripts included in this volume is an important step towards addressing the national problem of suicide and a reminder that even one death by suicide is too many." Janet Kemp, RN, Ph.D. -- VA National Mental Health Program Director, Suicide Prevention and Community Engagement

For thousands of young Americans, after the shock of 9/11, there was Ar Ramadi, Baghdad, Abu Ghraib and then the war in Iraq. Then came the trauma. Olivier Morel gave them a voice in his compelling documentary On the Bridge. Walking Wounded is the story of Morel getting close to the young vets, their troubled experience and their lives after the war. He and artist Mael relate through these veterans the impossible return of those who aspire to get back to a normal life.

With US soldiers stationed around the world and engaged in multiple conflicts, Americans will be forced for the foreseeable future to come to terms with those permanently disabled in battle. At the moment, we accept rehabilitation as the proper social and cultural response to the wounded, swiftly returning injured combatants to their civilian lives. But this was not always the case, as Beth Linker reveals in her provocative new book, War's Waste.   Linker explains how, before entering World War I, the United States sought a way to avoid the enormous cost of providing injured soldiers with pensions, which it had done since the Revolutionary War. Emboldened by their faith in the new social and medical sciences, reformers pushed rehabilitation as a means to "rebuild" disabled soldiers, relieving the nation of a monetary burden and easing the decision to enter the Great War. Linker's narrative moves from the professional development of orthopedic surgeons and physical therapists to the curative workshops, or hospital spaces where disabled soldiers learned how to repair automobiles as well as their own artificial limbs. The story culminates in the postwar establishment of the Veterans Administration, one of the greatest legacies to come out of the First World War.

"This is a gripping book. Elizabeth Norman presents a war story in which the main characters never kill one of the enemy, or even shoot at him, but are nevertheless heroes. . . . First on Bataan, then moved to Corregidor, they were under almost constant shell fire, were always hungry, close to starvation, had horrendous diseases to deal with despite a shortage or even a complete lack of proper medicines, getting little or no sleep, nothing in the way of recreation--yet they were a true band of angels, inspiring all the men whom they were there to help. In a squalid prison camp, they remained giants, despite their small size. . . . They were the bravest of the brave, who endured unspeakable pain and torture. Americans today should thank God we had such women."     --Stephen E. Ambrose We Band of Angelsis the story of women searching for adventure, caught up in the drama and danger of war.          On the same day the Japanese Imperial Navy launched its surprise attack on Pearl Harbor in Hawaii, it also struck American bases in the Far East, chief among them the Philippines. That raid led to the first major land battle for America in World War II and, in the end, to the largest defeat and surrender of American forces. Caught up in all of this were ninety-nine Army and Navy nurses--the first unit of American women ever sent into the middle of a battle.          The "Angels of Bataan and Corregidor"--as the newspapers called them--became the only group of American women captured and imprisoned by an enemy. And the story of their trials on a bloody battlefield, their desperate flight to avoid capture and their ultimate surrender, imprisonment, liberation and homecoming is a story of endurance, professionalism and raw pluck.          Along the way, they helped build and staff hospitals in the middle of a malaria-infested jungle on the peninsula of Bataan. Then, short of supplies and medicine, they worked around the clock in the operating rooms and open-air wards, dealing with gaping wounds and gangrenous limbs, ministering to the wounded, the sick, the dying.          A few fell in love, only to lose their men to the enemy. Finally, on the tiny island of Corregidor in Manila Bay, the Japanese took them prisoner. For three long years in an internment camp--years marked by loneliness and starvation--they kept to their mission and stuck together. In the end, it was this loyalty, this sense of purpose, womanhood and honor, that both challenged and saved them.          Through interviews with survivors and through unpublished letters, diaries and journals, Elizabeth M. Norman vividly re-creates that time, telling the story in richly drawn portraits and in a dramatic narrative delivered in the voices of the women who were there.

War creates many individual and family tragedies. To a child, war may mean not having enough to eat and feeling sick. To a woman, it may mean persistent threat of physical or sexual assault. To an older person, it may mean there is no available medical care and no available medicine to control diabetes and high blood pressure. To a displaced person, it may mean separation from family members. To a military veteran, it may mean recurring nightmares. And to those whose parents, spouse, siblings, children, or other family members or friends were killed, it may mean eternal grief.

Navy Medicine in Vietnam begins and ends with a humanitarian operation—the first, in 1954, after the French were defeated, when refugees fled to South Vietnam to escape from the communist regime in the North; and the second, in 1975, after the fall of Saigon and the final stage of America’s exit that entailed a massive helicopter evacuation of American staff and selected Vietnamese and their families from South Vietnam. In both cases the Navy provided medical support to avert the spread of disease and tend to basic medical needs. Between those dates, 1954 and 1975, Navy medical personnel responded to the buildup and intensifying combat operations by taking a multipronged approach in treating casualties. Helicopter medical evacuations, triaging, and a system of moving casualties from short-term to long-term care meant higher rates of survival and targeted care. Poignant recollections of the medical personnel serving in Vietnam, recorded by author Jan Herman, historian of the Navy Medical Department, are a reminder of the great sacrifices these men and women made for their country and their patients.

Out of the How the U.S. Military Transformed Combat Casualty Care in Iraq and Afghanistan edited by Arthur L. Kellermann, MD and MPH, and Eric Elster, MD is now available by the US Army, Borden Institute. This comprehensive resource, part of the renowned Textbooks of Military Medicine series , documents one of the most extraordinary achievements in the history of American medicine - the dramatic advances in combat casualty care developed during Operations Enduring Freedom and Operation Iraqi Freedom. Each chapter is written by one or more military health professionals who played an important role in bringing the advancement to America's military health system. Written in plain English and amply illustrated with informative figures and photographs, Out of the Crucible engages and informs the American public and policy makers about how America's military health system, devised, tested and widely adopted numerous inventions, innovations, technologies that collectively produced the highest survival rate from battlefield trauma in the history of warfare.

For over 25 years, Landstuhl Regional Medical Center (LRMC) has served as a model of "selfless service," stepping up to the demands of a suddenly increased rate of traumatically injured service members arriving from the battlefield. From Operations Desert Storm/Desert Shield; through the attacks in Somalia, the Khobar Towers, and USS Cole; to the recent conflicts in Afghanistan and Iraq, LRMC has stood at the forefront of military healthcare, receiving our Nation's and our partners' wounded and ill from battlefields and contingencies across multiple theaters. From a community hospital providing routine healthcare delivery to personnel stationed in Europe and their families before 9/11, LRMC transitioned into a Level 1, triservice, integrated trauma center, providing lifesaving care to tens of thousands of evacuated service members, in addition to handling all the associated needs of these patients, from payroll assistance to chaplain services, service and unit liaison support, and veteran service organization support, as well as delivering ongoing healthcare to beneficiaries across Europe, Africa, and Asia.

The goal of this text is to share the lessons learned by LRMC staff in converting from a peacetime to wartime footing, serving as a guide for US military hospitals in similar situations in the future. The innovations and solutions planned and implemented so successfully by LRMC staff will assist future military medical and line leaders in maintaining the highest quality of healthcare services for future generations of our service men and women in combat, improving upon the historically high survival rates seen in these conflicts.

Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.

This volume in the Borden Institute's history series will describe forward US Army surgery from the 1700s to the present time. The book will look at advances in medicine and surgery that improved the lot of the American soldier. In particular, the book will examine the impact of disease upon troop strength, which had special impact in the Revolutionary War through the post-Civil War period. Forward surgery in the modern sense came of age in World War I. The challenge of so many different theaters of conflict in World War II will be examined from the portable surgical hospital of the China-Burma-India Theater of Operations to the surgical evacuation hospital teams of the European Theater of Operations. The evolving care models will feature the story of the Korean War mobile army surgical hospital. The defining performance of helicopter air evacuation in Vietnam, along with improved surgical techniques, will be discussed. Finally, the many advances of forward surgery from the post-Vietnam era to the present will be presented.