Scarred Beneath the Skin
Saturday, February 4, 2006
Brian Radke was celebrating his 31st birthday at Walter Reed Army Medical Center when he chomped into a grilled cheese sandwich and bit something that was neither grilled nor cheese.
It was sharp, round and hard as a BB, and it had dislodged from his throat.
"Shrapnel," the Army specialist told his wife that December morning, after he'd spit it into his palm.
"There's my birthday present," Nova Radke remembered him saying.
When U.S. service members or civilians such as Bob Woodruff of ABC News are injured or killed in Iraq, official accounts often blame roadside bombs and improvised explosive devices, or IEDs. But many times it's the searing hot, sharp-edged, comes-in-all-sizes shards of metal and debris known as shrapnel that actually cause the wounds.
Walter Reed is full of soldiers whose bodies are riddled with shrapnel. Many carry around the fragments doctors have left inside them to work their way out over time. Removing embedded shrapnel, doctors say, can do more harm than good. And the body can "tolerate it fairly well," said Col. Russell Martin, the general surgeon consultant to the Army surgeon general.
With IEDs a leading cause of injury, the Iraq war is producing a generation of veterans who not only have scars and prostheses for limbs but also whose skin seems as bumpy as Braille and looks as if someone dotted it with black marker. Some carry so much metal that they set off detectors at airports. Magnetic resonance imaging machines must be avoided because the magnetic force will yank the metal right out of them.
Glance at Radke's pockmarked face, and you can see the pieces doctors left behind. Run your fingers over his throat, just above where the body armor stopped, and you can feel them.
In October, the Humvee that Radke, a member of the Arizona National Guard, was riding in was hit by an IED in Iraq. He said surgeons removed from his body more than 100 pieces of shrapnel, which he keeps as souvenirs. The rest have begun to emerge on their own. There were the splinters that burst from his face like blood blisters, the quarter-size piece a doctor yanked out of his neck with tweezers and the one he coughed up that had come loose in his throat.
Shrapnel wounds have been part of combat for more than 200 years, since Henry Shrapnel, a British artillery officer, designed an explosive canister that sent metal balls flying during the Napoleonic wars.
"It has probably become the single best man-killer, barring a nuclear weapon," said Dale C. Smith, chairman of the Department of Medical History at Uniformed Services University of the Health Sciences.
Shrapnel often comes in metallic scraps that get scattered at terrifying velocity in an explosion. But during a blast, anything can become a dangerous projectile. Martin has pulled out bits of rock, glass, wood -- and once, even a part of a circuit board that he presumed came from the cell phone used to detonate the bomb.