A military hospital's all-encompassing mission
Sunday, December 26, 2010
AT KANDAHAR AIRFIELD, AFGHANISTAN Most of the time, this war-theater hospital crackles with danger and expertise, its staff members working to keep alive people who would be dead if they ended up almost anywhere else in the world.
But some of the time, often in the morning, it's quiet and almost empty, except for a few recuperating Afghans stoically watched over by family members and, today, a young girl in a pink robe exploring the corridor outside her room in a wheelchair.
The hospital, which opened in May and is owned by NATO, is an odd mix of urgency and relaxation. It features patients whose stays inside its $40 million walls are both shorter and longer than any in contemporary U.S. hospitals.
American soldiers critically injured on the battlefield spend only a day or two here, many unconscious and on ventilators, before being sent to Bagram air base, then to a hospital in Germany and on to the United States.
At the other end of the continuum are the Afghans who make up about half the patients.
They also come aboard medevac helicopters. They get the same immediate treatment as U.S. soldiers. Then they stay, often for weeks, until they are well enough to be transferred to a nearby Afghan hospital or discharged.
Some are Afghan soldiers or members of the national police. Many, however, are civilians or Taliban insurgents. It's often difficult to tell the latter two apart, and to the workers at the hospital, which is run by the U.S. Navy, it's largely irrelevant.
Pediatricians in war zone
About 15 percent of the patients are children. Most are here because of the consequences of war. But there's also a steady trickle of patients who have cerebral malaria, burns from kitchen fires, car accidents, snake bites and obstetrical calamities or have fallen from roofs, where families sleep in hot weather.
"Those are probably the hardest cases, when the kids come in," said Cmdr. Eric Peterson, 40, an emergency nurse. "I don't think people expect that when they come over here."
The Navy did expect it, and planned for it.
"This is the first time the Navy has sent a pediatrician as part of a wartime role," said Capt. Jon Woods, 45, a pediatric intensive care physician. "It is a recognized part of our mission."
'New paradigm' in care
Pediatrics isn't the only addition to what is considered possible and necessary in war-zone medicine. The hospital also has an interventional radiologist, who can snake catheters into bleeding sites that surgeons cannot reach. It has a 64-slice CAT scanner that would be the envy of any radiology department in the United States. It has a neurosurgeon.