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FATHER OF THE MODERN VA SPEAKS ON WAR AND

MEDICINE -- Dr. Kenneth Kizer: The unprecedented

survival rate of casualties in the Iraq War is attributable

to rapid mobilization of battlefront medical care

For more about Dr. Kenneth Kizer, use the VA Watchdog search engine... click here...
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Story here... http://www.stanfo
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Story below:

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Kizer speaks on war and medicine

JERRY LEE/The Stanford Daily

Kenneth Kizer, former undersecretary of health at the Department of Veteran’s Affairs, spoke to a packed audience at Clark Auditorium yesterday on the topic of “How War is Changing Medicine.” The presentation featured a three-guest panel that discussed in detail the ramifications of the wars in Iraq and Afghanistan on the U.S. healthcare system.

Kizer was joined by Assistant Professor of Psychiatry Craig Rosen and Professor of Orthopedic Surgery Eugene Carragee. Kitzer opened with a discussion of the contributions of war and conflict to medicine. Starting with the ancient Roman health figure Galen — who contributed to early studies of anatomy — he demonstrated how modern military engagements like WWII, the Korean War and Vietnam have enhanced our understanding of medicine through the treatment of large numbers of casualties.

“The hyperbaric needle was a Civil War invention,” Kizer said. “Blood transfusion . . . was developed and pioneered during the Spanish American War.”

Kizer said the Iraq War has been fundamentally different from both a medical and a technological perspective. According to Kizer, the unprecedented survival rate of casualties in the Iraq War is attributable to rapid mobilization of battlefront medical care. The survival rate, however, has created unique challenges to health policy as injured veterans return home.

“The signature injury of this conflict is traumatic brain injury,” Kizer said. “What is the baseline, and how do we manage these folks with often very subjective and vacillating symptoms that are impairing functioning is a challenge when as many as 30 percent of troops are thought to have traumatic brain injury.”

Rosen highlighted that extended tours of duty in urban combat are creating new approaches in treating mental illness like Post Traumatic Stress Disorder (PTSD). He also said the Iraq War has seen novel approaches to tackling mental illness like new screening procedures, a renewed pursuit of investigating military sexual trauma and changing how patients view their illness.

Significant challenges remain, however, especially in improving veterans’ quality of life.

“One huge area we have not addressed very well is recovery in work functioning and how to help people to be economically self-sufficient,” Rosen said. “The jury is out whether this is going to be a lifelong disability or whether you’ll be able to transition into work.”

Carragee went on to demonstrate statistical changes in the types of wartime injury. According to Carragee, military injuries now more closely resemble civilian disability injuries. The lingering effects of the war can be found in soldiers affected by diseases like musculoskeletal diseases, pain syndrome and psychological stress. The numbers of such cases have risen, especially as the war transitions from offensive combat operations to a counter-insurgency occupation.

Carragee suggested that military leaders ultimately need to change the way they view the relationship between war and psychological trauma.

“Exposure to combat is nearly always a psychological trauma,” he said. “But people wring their hands at the beginning of every war and ask ‘Will this be a problem?’”

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