The Pentagon says that medical readiness was a casualty of downsizing healthcare
Todd Rasmussen: From Afghanistan to the U.S. Air Force – A Memo Memoir with a Soldier and a Family
The Air Force put Todd Rasmussen through medical school and he intended to stay in the service for a while and then start his own practice. He started his military career as a vascular surgeon in Northern Virginia, a few weeks before Sept. 11, 2001.
You could smell the smoke from the Pentagon. I thought, boy, my military career as a surgeon … it’s gonna be vastly different than what I expected,” he recalls.
Rasmussen deployed six times between 2005 and 2012. Medics used cargo straps as tourniquets when he was in Iraq on his first tour. New concrete floors, a fullyequipped hospital and access to the CT Scans were all he had to offer in his last tour in Afghanistan. The wars came to a close. The progress slid back for him.
How U.S. Medical Care Could Have Helped a Soldier During World War II: A Case Study of the Stabilization Pentagon
He says it’s difficult to admit we let someone down and that someone was a U.S. service member. It’s hard to admit that we could have done better. I think that the only worse thing is not admitting it.
Before the wars ended the Pentagon attempted to tame massive healthcare costs by pushing military care into the private sector for family members.
One US service member came to us by helicopter, it was from the front lines. And he had been operated on by a small group of surgeons near the front line. I think the assumption was that we would need to amputate this limb because of the extent of the soft tissue injury in the thigh,” he says.
A wound like that in the past would have left no option but to amputate the leg. On closer inspection though, Rasmussen saw that the front-line doctors had used a temporary shunt in a new way. Essentially, they stuck a plastic straw into the thigh to keep blood flowing around the wound, saving the leg.
According to a memo from the Department of Defense, outsourcing didn’t save money but hurt readiness. The so-called “stabilization memo” directs the Pentagon to reverse course, to bring more medical care back to its hospitals on base and increase medical staff, both to keep America’s standing army fit for duty and to make sure enough military doctors and nurses are trained up for a possible future war.
The military’s medical school, which trains up military doctors, and preserves medical advances like those made in the wars of Iraq and Afghanistan, could be close under an idea floated by Pentagon officials. “I mean, why do we need a military medical academy?” The man makes fun of himself.
“They achieved the highest rate of survival from battlefield wounds in the history of warfare. They were able to save many people during the conflict, says Dr. Art Kellerman, dean of the Uniform Services University of the Health Sciences.
Kellerman frames it as a national security priority. He says as much as a helmet or flak jacket, the success of U.S. military medicine gave troops confidence to rush into a firefight, knowing they would probably survive. U.S. allies joined in the fight because a medevac would fly to them within 30 minutes if they got blown up. Kellerman said that the people in the fight believed they’d live well.
They were able to rehabilitate wounded warriors after they were injured. And many of them were able to return to duty and others were able to return home to be with their families and to function for the rest of their careers. He says that some of them are members of Congress.
The golden hour of the U.S. war is not the next war: Military strategists say it’s not the enemy’s enemy
Generals try to fight again but America’s next war may be different, say military strategists. In Iraq and Afghanistan, the golden hour was possible because the U.S. had air superiority; the enemy had no planes or helicopters.
“Sooner or later, somewhere, we’re not going to have air superiority. And I don’t care if we think we are, we should plan for not having it,” says Dr. Sean Murphy, who served 44 years and retired in 2021 as Air Force deputy surgeon general.
We have realized that it will be hard for us to get to the golden hour if we go to theaters like the Pacific and peer-to-peer fights. So if we’re not going to be able to get a surgeon or somebody to the golden hour, then what we have to do is … to make everybody a medic,” he says.
“The most important fighting system we have is the human system. It’s not a plane or a ship or a tank,” says Rasmussen. He says he witnessed that many times when he served.
US Air Force Deputy Surgeon General Sean Murphy, who served 44 years and retired in 2021, has said, “In Iraq and Afghanistan, the golden hour was possible because the US had air superiority; the enemy had no planes or helicopters.” Murphy added, “And I don’t care if we think we are, we should plan for not having it.”