THE PRICE WE PAY

From Iraq:

"We're saving more people than should be saved, probably," Lt. Col. Robert Carroll said. "We're saving severely injured people. Legs. Eyes. Part of the brain."

Carroll, an eye surgeon from Waynesville, Mo., sat at his desk during a rare slow night last Wednesday and called up a digital photo on his laptop computer. The image was of a brain opened for surgery earlier that day, the skull neatly lifted away, most of the organ healthy and pink. But a thumb-sized section behind the ear was gray.

"See all that dark stuff? That's dead brain," he said. "That ain't gonna regenerate. And that's not uncommon. That's really not uncommon. We do craniotomies on average, lately, of one a day."

"We can save you," the surgeon said. "You might not be what you were."

Accurate statistics are not yet available on recovery from this new round of battlefield brain injuries, an obstacle that frustrates combat surgeons. But judging by medical literature and surgeons' experience with their own patients "three or four months from now 50 to 60 percent will be functional and doing things," said Maj. Richard Gullick.

"Functional," he said, means "up and around, but with pretty significant disabilities," including paralysis.

'Broken soldiers'
The remaining 40 percent to 50 percent of patients include those whom the surgeons send to Europe, and on to the United States, with no prospect of regaining consciousness. The practice, subject to review after gathering feedback from families, assumes that loved ones will find value in holding the soldier's hand before confronting the decision to remove life support.

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