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The back of the envelope is calculated in blood

5 o'clock, December 8, 2004

From Salon:

For every American soldier killed in Iraq, nine others have been wounded and survived — the highest rate of any war in U.S. history. It isn’t that their injuries were less serious, a new report says. In fact, some young soldiers and Marines have had faces, arms and legs blown off and are now returning home badly maimed. But they have survived thanks, in part, to armor-like vests and fast treatment from doctors on the move with surgical kits in backpacks.

“This is unprecedented. People who lose not just one but two or three extremities are people who just have not survived in the past,” said Dr. Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston who researched military medicine and wrote about it in Thursday's New England Journal of Medicine.

The back of the envelope (all numbers are approximate):

  • Ratio of wounded to killed in Afghanistan/Iraq: 10:1.
  • Ratio of wounded to killed in Vietnam: 3:1.
  • Total killed in Vietnam: 50,000.
  • Total casualties in Vietnam (10 years): 200,000. (Calculated.)
  • Avg. casualties per year in Vietnam: 20,000. (Calculated.)
  • Total casualties in Afghanistan/Iraq (18 mos.): 11,300.
  • Avg. casualties per year in Afghanistan/Iraq: 7,500. (Calculated.)
  • Peak number of US troops in Vietnam: 500,000.
  • Peak number of US troops in Afghanistan/Iraq: 150,000.
  • Avg. casualties per 1000 soldiers per year, Vietnam: 40. (Calculated.)
  • Avg. casualties per 1000 soldiers per year, Afghanistan/Iraq: 50. (Calculated.)

So the good news is that body armor, battlefield medicine, medical evacuation services, and general trauma care are much better.

The bad news is that the fighting is just about as bad, if not worse.

Support the troops.

Comments

A possible ameliorating factor is this: it is unlikely that the intensity of combat in vietnam was constant. It is also unlikely that the intensity of combat in Iraq/Afghanistan is constant. If we are currently in the most intense period of said combat, and you're comparing that against the average in Vietnam, the comparison is problematic.

That's a gigantic assumption though.

—— aphrael, 11:09 AM, Thursday, December 9, 2004

Gawande's full paper is online. (PDF)

—— Martin, 3:50 AM, Friday, December 10, 2004