FRANKFURT, GERMANY, NOV. 7 -- More than 1,100 U.S. servicemen suffering from orthopedic, internal or psychiatric problems have been flown from Saudi Arabia to military hospitals here since Operation Desert Shield began three months ago, hospital officials said today.
Medical evacuation flights from the Persian Gulf to Germany arrive nightly, often with a dozen or more injured Americans aboard.
Although the majority of the cases are orthopedic injuries resulting from training or sports accidents, some of the soldiers also complain of anxiety and stress resulting from the long, uncertain wait in the desert.
"We're seeing problems with separation from family, the demands of being in the desert," said Lt. Col. Neil Horowitz, chief of psychological services at the Air Force's 7100th Combat Support Wing Medical Center in Wiesbaden.
"There are no dramatic cases, but people are just real unhappy about being away from home, working real long days in a very difficult environment," Horowitz added.
Nearly all of the patients taken to Germany will not return to the gulf, but are sent back to the United States after a week or two here.
At the Frankfurt Army Regional Medical Center, where most of the Desert Shield patients stay, the bulk of the returning soldiers are people like Staff Sgt. Robert Lawton, 27, who fractured his kneecap when he got caught between two fellow soldiers in a training exercise, or Sgt. John Swanson, 26, who broke his right foot in five places when a forklift accidentally ran over him.
"I have not seen anything we would not expect to see at Fort Hood," said Col. Richard Kirchdoerfer, commander of the Medical Center.
Most patients who are flown to Germany have received initial treatment at temporary medical units in Saudi Arabia or on hospital ships in the gulf region.
Almost half of the 799 gulf patients who have come to Frankfurt are in the orthopedic section, doctors said. The Air Force facility at Wiesbaden, which has admitted 380 Desert Shield troops, has a similar breakdown of injuries.
"It's the usual range of sports and training cases that you'd see at any base," said Maj. Mark Turner, an orthopedic surgeon. "Maybe it's a little more because the training is more intense down there."
The daily influx of new patients -- up 22 percent from the July pre-Desert Shield figures -- has meant longer hours for physicians here, as well as for the staff of a hospital whose peacetime mission has come to be similar to that of a general hospital back home -- including space and staff dedicated to neonatal and gynecological care.
Frankfurt Medical Center has an orthopedic staff of five surgeons, most of whom have been working virtually around the clock in recent weeks. Turner said that many orthopedic patients report impatience with the work in the gulf. "People are getting bored," he said.
"There's some understandable frustration," said Capt. Mark Elam, an internist at the hospital who has seen largely respiratory problems such as asthma. "It's been going on since August and nothing's happening there."
But some soldiers are anxious to return to service in Saudi Arabia. "You get homesick in the gulf," Sgt. Lawton said, "but I've had much rougher assignments than this. Panama was a lot rougher, a lot scarier than this. I wouldn't say we're having a blast down there, but it's okay. Our TV sets arrived just before I got hurt."
Because Lawton's fracture will take several weeks to heal, the Army wanted to send him home, ending his Saudi tour after nine weeks. Lawton persuaded his commanders to consider sending him back to the gulf, where his wife is also stationed, after convalescence.
"My guys depend on me," he said. "I was sent there to do a job and I'd like to do it. I'd feel funny just going back to the U.S. I was screaming at my guys, 'Don't nobody get hurt,' and I kind of feel I let them down by getting hurt myself."
Lawton, a practical nurse in a medical unit, said some of his soldiers had pay and family problems, "but we made sure those were fixed before we got to Saudi."
Lawton's enthusiasm for the Saudi duty is not universal. Some patients complain that they sorely miss their families. Others are worried about the prospect of war.
"When they come to us, they're very stressed out," Col. Horowitz said. "Mostly it's concerns about feeling out of touch. If you were from Wiesbaden or Kansas City and you broke your leg, you'd be unhappy and distressed, but you'd have support and family. In the gulf, they don't."
The psychologist said many soldiers in the gulf are particularly susceptible to stress-related problems because "these are by and large not combat-hardened people. They do a lot of pacing and thinking. There's a lot of anxiety, feelings of loneliness and helplessness."
Commanders try to fight against such reactions by keeping troops busy with long hours of training. But if war breaks out, psychologists and social workers at military facilities here expect large numbers of stress-related injuries.
In the event of war, medical facilities would take on additional staff and expand to neighboring buildings to handle casualties.
Horowitz recounted that of the first 1,500 Israeli casualties in the Six-Day War in 1967, 900 suffered from combat-related stress. The Army treatment program is intended to ease the symptoms of stress without unduly stigmatizing the troops.
"You want to give them the expectation of a return to duty," he said. "You don't want them to feel they have to return home labeled as a psychiatric casualty."