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Sanjay Gupta MD

Iraq War Veteran Fighting for Veterans' Rights; Knife in the Head on the Streets of Baghdad; Rules of War for Doctors

Aired November 10, 2007 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

SANJAY GUPTA, HOST: This is HOUSE CALL for Veterans Day weekend. And we're making the rounds this morning of some of the most intriguing medical stories to come out of the war zone.
First up, a double amputee Iraq War veteran fighting for veterans' rights. We will update "Tammy's War." Then a knife in the head on the streets of Baghdad. One soldier's amazing story of survival.

Plus, we'll sit down with a trauma surgeon who's just returned from his second tour in Iraq.

And finally, the rules of war for doctors. An emotional interview with a military psychologist.

Let's get it all started, though, with a story I've been following for more than a year. Major Tammy Duckworth was a chopper pilot who lost both legs while serving in Iraq. Her body has healed, thanks to her care at Walter Reed Hospital, but her injury was only the beginning of a fight for herself and the health of other veterans.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Army Major Tammy Duckworth of the Illinois National Guard, who on this day is testifying before the Senate Veterans Affairs Committee.

TAMMY DUCKWORTH, IRAQ WAR VETERAN: The VA system is simply not ready. And they don't have time to catch up.

GUPTA: An alarming indictment coming from a double amputee, now the director of the Illinois Department of Veterans Affairs. Are you optimistic about the future for our veterans?

DUCKWORTH: No. I think we have a big fight ahead of us.

GUPTA: For Tammy, the fight began November 12th, 2004 in the cockpit of a Blackhawk helicopter just north of Baghdad. On her last flight of the day with Dan Millburg (ph), the pilot in command.

UNIDENTIFIED MALE: I'm thinking this is great, 15 more minutes we'll be home, have some chow. Nobody sees us, nobody has any clue we're even here. Then all of a sudden, boom.

DUCKWORTH: Then I remember a big orange fireball in my face.

GUPTA: A rocket-propelled grenade ripped through her body.

DUCKWORTH: And I don't remember my physical feelings, other than absolute frustration that the pedals of the aircraft were not responding to me pushing on them.

GUPTA: The pedals weren't responding. Why?

DUCKWORTH: I didn't have any legs.

UNIDENTIFIED MALE: She slumped over up against the instrument panel. Didn't seem like Tammy. She didn't have a smile on her face. She wasn't talking. I thought she was dead. And -- yes.

DUCKWORTH: Check the engine.

GUPTA: And three years after her helicopter was shot down in Iraq, Tammy Duckworth refuses to give up flying.

Some would say, Tammy, it's too dangerous, too risky. Don't do this anymore. And what would you say to them?

DUCKWORTH: I don't think it's dangerous or risky at all. I drive. I do everything that I do. And flying a Blackhawk in combat wasn't exactly the safest thing to do either.

GUPTA: That's a very good point.

DUCKWORTH: Some momentum. This brings joy back into my life. It gives me a sense of, OK, I'm regaining what I've lost.

GUPTA: Tammy can't pilot a helicopter until she first proves herself in a plane. And for now, she flies with an instructor.

DUCKWORTH: Every time I get in a plane and I fly somewhere, I think I should be at the controls.

GUPTA: Today, Tammy gets her wish and her wings.

(END VIDEOTAPE)

GUPTA: And you can look for more of Tammy's story on CNN next weekend as I host a special called "Broken Government." That's at 8:00 and 11:00 p.m. Eastern Time.

You know, we've seen some amazing stories of survival coming out of the war zone, but a recent one made us all take notice. Elizabeth Cohen has more about an extreme operation for an extreme injury in the nick of time.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): If there are average days in Iraq, July 2nd of this year started out as one with 118th military police company. Sergeant Dan Powers led his squad of 13 men to the scene of yet another explosion on the streets of Baghdad. They finished questioning the Iraqi police and were walking back to their trucks when all of a sudden...

SGT. DAN POWERS, U.S. ARMY: It was like bam. It was really loud. And I had blood all over my armor.

COHEN: At first, Powers thought he'd been shot, but it was no bullet. It was this, a nine-inch knife had gone halfway through his head. Another MP wrestled down the attacker. And Powers kept doing his job. So, you have a knife sticking out of your head and you're watching this guy who stabbed you.

POWERS: I was covering him with my M-4.

COHEN: So you have a knife sticking out of your head, and yet you've got your gun aimed at this prisoner?

POWERS: Mm-hmm.

COHEN: Powers said he had no idea he had a knife in his head until his buddies pointed it out. After bandaging the wound, they whisked him to the green zone and then rushed him by helicopter to a state-of-the-art military hospital 50 miles north of Baghdad. They called ahead warning a stabbing victim was on the way.

LT. COL. DR., RICHARD TEFF, NEUROSURGEON: We had no idea that it was going to be such a big, shiny German knife.

UNIDENTIFIED MALE: Our neurosurgeon's on his way down, OK?

COHEN: Lieutenant Colonel Richard Teff was one of the neurosurgeons in the operating room. And you're getting a first hand look. Here's Powers just as he arrived in the OR. Amazingly, he chatted with his doctors.

POWERS: Lucky to be alive. I know that.

COHEN: But an X-ray revealed his situation was really quite dire. The knife has miraculously just missed his brain, settling in his sinus cavity. But the tip of the knife nicked his carotid artery. And it was like a finger in a dike. Remove it, and he could bleed to death. The surgeon's only option was to slowly pull the knife out and see what happened.

TEFF: We just prayed and pulled it out. And frankly, I was a little surprised. I didn't think it was going to bleed the way it did, but when it started bleeding, we had to act quickly.

COHEN: Powers lost 40 percent of the blood in his body.

TEFF: That was the moment when I -- they call that a heart attack moment when I was concerned that he might die right there on the table in front of us.

(END VIDEOTAPE)

GUPTA: Wow. What a remarkable story. Thanks, Elizabeth. And as Elizabeth reported, the sergeant with the knife in his head was taken to a state-of-the-art trauma unit north of Baghdad called Balad.

And joining us today is trauma surgeon and Army Major Dr. Ken Wilson, who returned about a week ago from serving with the 948th Forward Surgical Team in Iraq. Welcome back safely, first of all.

MAJOR KEN WILSON, U.S. ARMY RESERVE: Appreciate it. Thank you for having me.

GUPTA: I was out there, as you know, a couple years ago. What's it like out there now?

WILSON: I think the amount of violence, the amount of attacks that actually take place on the bases has increased. You know, being a surgeon, we're not out in the field. We're actually inside the wire. But there's a lot of duck and cover from incoming mortar attacks and direct fire.

GUPTA: When patients come into the hospital or to the medical unit, how do you triage there - is it - you know, in terms of deciding who gets treated when? Is it the same as a hospital here?

WILSON: No, it's a little different. One thing is the degree of injuries. In an urban center here in Atlanta, you may have one injury. But in the field, you may have a combination of injuries, a limb that is severely injured, a burn injury, as well as maybe a closed head injury.

You have limited amount of resources, limited amount of blood, limited amount of surgeons. So a lot of times, the decision that you're making is who's salvageable. So the patients who are the most salvageable at times will be the ones who get the operation, not necessarily the one who's the most injured.

GUPTA: I imagine it must be difficult as a trauma surgeon to know that if that patient was in a state of the art hospital here in the States, you could save them. But in Iraq, with less resources, sometimes you can't.

WILSON: Yes, that is true. I was in Balad, as you mentioned, the last piece, where they have a lot of the specialty care for one month. But I spent the remainder of my tour at a very peripheral base down in Al-Kut, Iraq where we had to make those decisions because we just didn't have the resources to save everyone or have the transport to get everyone to Baghdad in a timely fashion. So there were times when we had to pronounce people who we felt if we had been in a major center like Balad or Baghdad that we could have saved.

GUPTA: And that's got to be extremely difficult. You actually helped construct a hospital there in Al-Kut. What was that like?

WILSON: Yes, when we arrived, Al-Kut is about 70 miles south of Baghdad and about 30 miles from the Iranian border. And when we arrived, we had a building that we inherited that was in complete disrepair. The gym, which was adjacent to the hospital, had the misfortune of having a couple of mortar holes in it. So we (INAUDIBLE) that building, took the lights, the electronic devices, and carried them across the rubble to the hospital. After a few days of elbow grease and blowing a few circuits, we had a functioning operating room.

GUPTA: Now that's got to be pretty satisfying to actually create an operating room in the middle of the desert, where something like that didn't exist.

WILSON: The mission of the Fourth Surgical Team is we can't move the hardened facility to the patients, so we move the team out there. And so, to have a hospital that is ready to go to patch up the bleeding, you know, split the fracture and then have you resuscitated and go to Baghdad is extremely rewarding. So yes, the hospital was something that was almost a miracle for a lot of people.

GUPTA: Yes, I imagine. And of course, you know, being so far forward of course puts you at risk and your team at risk at times as well. But there's got to be some incredible moments. I know you took care of an Iraqi girl out there. What happened to her? What did you do?

WILSON: I was in Balad when she arrived. And the vast majority of my time in Balad was spent in the intensive care unit. She was shot as she was caught in between an armed conflict between two families. She was hit in the abdomen. Major Matt Senna (ph) in Balad took her to the operating room, where she had a portion of her liver removed, a portion of her small bowel. She lost her spleen. She lost her left kidney.

So you have a little girl coming to the intensive care unit in extremis. There's no dialysis in the country. So if she loses that one kidney, she's going to die. So we spent the vast majority of the night trying to jump-start that kidney, so to speak, keep her alive on the ventilator. She did survive the night. She did have a couple of more surgeries. She did survive that.

And I think the most rewarding part is seeing her mother, who doesn't speak, you know, a word of English, who's looking at these bells and whistles and clearly very tearful about her daughter, moved from being tearful to extremely joyous, you know, at the end of this. You know, something that you just never forget.

GUPTA: Ken Wilson, congratulations. Amazing work you're doing out there. Are you going to be going back?

WILSON: Hopefully no time soon, but when my number's called again, I'll be more than happy to go again.

GUPTA: All right, well, we wish you safety and good return as well. Thank you, Dr. Ken Wilson.

And there's still much more to come still ahead on this special edition of HOUSE CALL for Veterans Day, especially -- including some tributes to the medical personnel who care for our troops.

And a look at the mental wounds of war as well, as a Navy psychologist lets us in on some tragic rules of engagement. (BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: There are two rules of war. Rule number one is that young men die. And rule number two is that doctors can't change rule number one.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

GUPTA: Military doctors have a difficult role -- trying to fix the physical and mental wounds of war. Now when the Iraq War first started back in 2003, I traveled with the Alpha surgical unit with the 1st Marine Expeditionary Force as they pushed towards Baghdad. I had the honor to work side by side with the Navy doctors that care for the Marines.

Navy psychologist Dr. Heidi Kraft deployed with that same unit in Iraq about a year later. She's written a book about her experiences called "Rule Number Two -- Lessons I Learned in a Combat Hospital." We recently sat down with Dr. Kraft to hear a story we'll never forget.

(BEGIN VIDEOTAPE)

DR. HEIDI KRAFT, NAVY PSYCHOLOGIST: There are two rules of war. Rule number one is that young men die. And rule number two is that doctors can't change rule number one. My book is based on that idea.

I am a clinical psychologist and spent nine years active duty in the U.S. Navy as a psychologist. During 2004, I deployed as part of Alpha surgical company with 1st Marine Expeditionary Force to Iraq.

We are responsible for the acute care and trauma treatment of all of the Marines operating in our area. They came with the express purpose of staying functional so they could stay with their unit, so they could do their jobs.

I did not have one person in almost eight months tell me they wanted to go home. I think that everyone that wears the uniform knows that there's a possibility that we will have to deploy. That being said, as a mother of young children, it was certainly a sad couple of days as I prepared. I only had 10 days' notice.

So, I think -- I sort of in those days of getting ready, I think I sort of grieved in advance for what I would miss. In March of 2004, we had what I believe still is probably our worst mass casualty. At one point, we had 14 patients coming in the door. And one of those people was a young Marine corporal, who had a very significant head injury.

He was moved to the area that we call the expectant room. So I was there when Corporal Dunham was in that room. I sat down and took his hand. I didn't leave again. I couldn't leave at that point. Still haven't quite been able to really explain why. He was breathing and his heart was still beating. And we were giving him medicine and talking to him and telling him how proud we were of him. He had thrown himself on a grenade to save the two Marines that were with him. He was subsequently nominated for and awarded the congressional medal of honor for that action. And we didn't know that. But we still told him how proud we were. And I'm so glad we said that because I believe he heard us. I'm positive he heard us.

Then he squeezed my hand. And as a psychologist, I know this could be a reflex. So I didn't say anything for a minute and sat there and waited. And then he did it again. So I got right down in his ear, and I said, all right, Marine, here's the deal. If you can hear my voice, I need you to squeeze my hand again. And he squeezed so hard that he pulled me down so that my face came down on his shoulder. So we called for all the physicians of the company. They came running. And he was by then -- his eyes were reacting, his feet were reacting. He was responding to commands.

For the next half hour, they let me stay with him, the ICU team. And I kept holding his hand and he kept squeezing. And everybody was so just manic with excitement and really just what a miracle.

I think we were all at that point still really hoping he was going to make it. I kept having these wonderful fantasies of meeting him someday and talking to him. And then one day I came out of church, actually. It was a Sunday. And one of my chiefs was waiting for me to tell me that Bethesda had called and that he had died.

My hope for this book is that the stories within the covers are stories of sacrifice and courage and friendship of a group of people that happen to be in the desert at the same time I was. I hope that those stories will give people just a small idea of the type of people that serve in our Marine Corps and our Navy.

(END VIDEOTAPE)

GUPTA: Well, Dr. Kraft has returned to civilian life, but she still treats Marines and sailors at the U.S. Navy's combat stress control program in San Diego. And she is in touch with Corporal Jason Dunham's family and credits his mom, Deb Dunham, for encouraging her to write the book.

Coming up on HOUSE CALL, the benefits of exercise in the war zone. Our "Fit Nation" in uniform. And later in the show, your stories of unsung military heroes.

(COMMERCIAL BREAK)

COHEN: One of the biggest challenges for any parent is knowing when to call the pediatrician. Well, we spoke with pediatricians who talked about several conditions that look really bizarre and get parents really freaked out, but in fact, they're harmless. I go over these conditions in my column "The Empowered Patient" on CNN.com/health and I'm going to talk about a few of them right now. The first one is baby acne. When babies get to be just a few weeks old, sometimes they break out in acne just like a teenager. And some parents think they need to use special soaps or astringents.

But the pediatricians we talked to said don't do anything, it's not worrisome at all and it will go away soon.

Another one is crossed eyes. Some babies are born, their eyes look into each other on occasion. And it can look very strange. But again, this is something that goes away.

And the third one is something that really can get parents anxious, especially parents of little boys. And that is that their newborn baby actually has pretty big breasts. And the reason for that is those babies spent nine months bathed in their mother's hormones, so they come out with a little bit of a chest. That does go away and it's nothing to worry about.

The bottom line here is that if a parent experiences some of these conditions with their newborn, they should go ahead and call their pediatrician, but they should also know that everything is going to be OK.

(COMMERCIAL BREAK)

GUPTA: We talk a lot about the benefits of exercise in our "Fit Nation" segment every week, but what about those trying to stay fit in the war zone? Nearly every base in Iraq and Afghanistan has fitness facilities. And they're usually set up quickly after the base is established.

In fact, these are some photos of some of the facilities in Iraq. Weight training and running are mainstays of the exercise. But so are fitness contests like marathons and power lifting tournaments. Imagine running a marathon in a war zone.

We talked to a Marine security battalion commander who makes fitness a priority for himself and his Marines. He says adrenaline will only get you so far and combat is no excuse to quit exercising. But rather, to exercise even more.

In a harsh environment like Iraq, mental and physical toughness must be maintained. According to the V.A., an exercise program is a great way to alleviate the effects of post traumatic stress disorder, which is important because as many as 18 percent of our returning veterans suffer from PTSD.

Now still to come on HOUSE CALL, some personal tributes to the people who care for the fallen. The military medical heroes.

(COMMERCIAL BREAK)

GUPTA: We've spent time on this Veterans Day HOUSE CALL show looking at some of the doctors making a difference in the war zone. And on cnn.com this week, we asked for your stories of other military medical heroes. Thanks to all of you who sent in your tributes. We'd like to share a couple of them now.

The first is from Airman 1st Class Courtney Carpenter. And she writes this. "I want to recognize the entire staff at Malcolm Grow Medical Center at the Andrews Air Force Base in Maryland. This is where patients returning from overseas are first seen in the U.S. The doctors, nurses and techs do an unbelievable job." Thanks, Courtney.

And Air Force Fight Medic Edgar Abileno sent us these photos of the U.S. Air Force Aero Medical Evacuation Unit, which transports patients out of Iraq and Afghanistan. Edgar says they usually work 18 hour days and hardly complain. The group has been through numerous deployments, but they keep volunteering to do more. And even though a lot of the patients call them heroes, the doctors, nurses and medics say they're just doing their job.

Thanks to all the veterans who have done their jobs. And that's it for HOUSE CALL. Thanks for watching. I'm Dr. Sanjay Gupta. Stay tune now for more news on CNN starting right now.

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