Winning is the science of being totally prepared

Editor-in-Chief, Chester ‘Trip’ Buckenmaier III, MD, COL, MC, USA

When this issue of US Medicine reaches our readers, we will be well into the holiday season and drawing 2011 to a close. Like many, I often find myself using this time of year to reflect on the previous 12 months, new directions, challenges, successes and failures. It would be hard for any federal-medicine practitioner not to pause and reflect on marking the 10-year anniversary of 9/11 this past September. So much of my life, professionally and personally, has been defined by that event.

It was no small shock when I realized the United States has been in continuous conflict for more than half of my military career. The wars in Iraq and Afghanistan have been the longest in our nation’s history. I was at the end of my professional training at Duke University as a fellow in acute-pain medicine and regional anesthesia when the planes crashed into Twin Towers, the Pentagon and the field in Stonycreek, PA. My professional activities have been molded and defined by those events ever since.

To many federal-medicine practitioners who deal routinely with the horror and tragedy that armed conflict brings on human lives, war is humanity at its worst and should be avoided with the utmost vigor of our intellect and faculties. Nonetheless, the political reality of war is real, and the role federal medicine plays, “to support and defend the Constitution of the United States against all enemies, foreign and domestic,” is honorable and vital to our nation’s freedom. War is a catalyst for change, and perhaps nowhere in the field of human endeavor is this change more apparent and positive than in the field of medicine.

I have committed the sin of pride many times within this column and will do so once again. I have been amazed at the accomplishments of federal medicine in responding to two conflicts half a world away, yet achieving an extraordinary statistic: Fewer than 10% of wounded warriors die as a result of their wounds.

All of this has been accomplished by volunteers to the federal medicine system responding to an unprecedented type of warfare – global insurgency. Advancements in our understanding of post-traumatic stress, traumatic brain injury, and pain management will revolutionize the way medicine is practiced in this country in the 21st century. The military-trauma management and evacuation system has been a tremendous success story in medical coordination of care and logistics. If anything positive can come from war, the great strides forward by federal medicine surely are on this short list.

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