The Braden Files
Curiosities of mathematics, history, parachuting, etc……

The Best And the Brightest

About a year ago, I opened an e-mail from thinking it was just another blast to the Society of Vascular Surgery’s (SVS) membership regarding the vascular surgery issue of the day. Instead, it was a request from the U.S. Army, which had contacted the SVS to request help from volunteer vascular surgeons. The war in Iraq had depleted the domestic supply of active-duty vascular surgeons and volunteers were needed to cover U.S. Army hospitals until the Iraq hostilities ended or calmed down. Without really thinking about it and without talking to my wife or partners, both of which I should have done, I replied ‘yes’ and clicked ‘send.’ I will explain later why I was so quick to volunteer.

Originally, I was told that I would be sent to El Paso, Texas, or Washington State, but somewhere along the way the army changed its mind and sent the civilian volunteers to Landstuhl Regional Medical Center (LRMC) adjacent to Ramstein Air Base in Germany. Landstuhl is the major evacuation hospital for Iraq, Afghanistan and Kuwait. Major vascular injuries are addressed ‘down range’ or ‘in theater’ and then sent immediately to Landstuhl for follow-up care before being transported back to Walter Reed Army Medical Center or Brooke Army Medical Center (BAMC) in the United States. It is not unusual for a severely injured soldier to be stabilized in Iraq, transported via C-17 cargo plane to Landstuhl for additional surgery, and then back onto a C-17 bound for either Walter Reed or BAMC, all while intubated and all within 48 hours.

This tiny tour of duty, however, only emphasized for me the magnitude of the sacrifice that others make in service to their country. It also laid to rest the popular portrayal in the press of soldiers as being dead-enders with no other career prospects. For the life of me, I can’t understand how investigative journalists appear blinded to the extraordinary courage and patriotism prevalent in our volunteer army. Mandatory military service should be required if for no other reason than to personally acquaint the rest of us with some of America’s finest men and women. Maybe a little something would rub off.

For many of the soldiers I met on the base, joining the military was like entering the family business, where many before them had served for generations. For others, the military made economic sense because of free educational and career opportunities with good benefits and early, well-compensated retirement. Many enlisted as unadulterated expressions of patriotism. I didn’t meet any refugees from real life in need of personality reconstruction. The army doesn’t want reclamation jobs. Most agreed that a sense of service to country was a necessary prerequisite to endure the sacrifices inherent in military life. If leaving for a few weeks made me a little uneasy for a variety of reasons, I could just imagine what it must be like for a 22-year-old to leave a wife and young baby for the uncertainties of war.

I wondered about the psychological requirements necessary to take care of patients with the kind of mutilation all too common in the Iraq War. Advances in surgical care have improved survival even with massive injuries that leave survivors with extraordinary disfigurement and disability. Military surgery in this kind of setting is clearly a younger person’s game, not only because of the incredible energy required, but also because it takes a younger, agile mind and spirit to sublimate the horrors of war into something more palatable, like the intense satisfaction of working in such a highly charged and dynamic environment. For older people like me, there was no useful distraction from the stark finality of unimaginable injuries. I knew I was only seeing one side of the story, but I felt my worldview threatened by the carnage in front of

I went to Landstuhl because I was led to believe that the army needed me and I was thrilled I had something to give. Instead, I got a great gift in return, one that will stay with me for the rest of my life. I got to work with men and women who, by demeanor and deed, reaffirmed my belief that we live in the greatest country on Earth. The people I met — enlisted men and women and officers — populate a world defined by duty, courage, honor and selfless service to their country. I find it the height of irony that political candidates bellowing for change and service to country overlook the million-plus who are already doing that and more in the military.

When I graduated from Yale more than 40 years ago, we were told we were the ‘best and the brightest.’ I don’t think so. We were neither. The best and the brightest had been kicked off campus, as an honest expression of antiwar activism, or so we were told. In truth, it was because the honest and purposeful culture of the military world was an embarrassment to the partisan and fragmented life on campus, where it’s difficult to navigate without spin and you can never really put your finger on the truth. The military should open itself up to average citizens like me so that upon request, a citizen has the opportunity to see firsthand the remarkable culture of the military that for some reason is hidden from most of us. It was an unexpected joy indeed to finally catch up with the real ‘best and the brightest’ at Landstuhl Regional
Medical Center in Germany.

Full story here.

David V. Cossman MD
(Dr. Cossman is a vascular surgeon in Los Angeles)


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