(AP) With its quiet, winding halls, Landstuhl Regional Medical Center at first looks like just another community hospital. But it has become a front line in the Iraq and Afghan wars thousands of miles away.
The patients — young soldiers with faces lacerated by flying glass and shrapnel from exploding roadside bombs, others missing a leg or arm — shuffle by, heading for an appointment or checkup. At this military hospital, there is a constant stream of new faces.
An average of 23 patients arrive each day — most from Iraq, where more than 12,350 soldiers, sailors, Marines, and airmen have been injured since the U.S.-led war began in March 2003. The flow can spike sharply, as it did during the battle for Fallujah: 537 over two days.
Fighting in Afghanistan adds more patients. Since troops arrived there in October 2001, 455 have been wounded in action through early this May, almost all of them coming to Landstuhl with injuries and wounds not normally found in a civilian hospital.
In civilian medicine, “a blast injury is a very rare event,” said Army Col. Rhonda Cornum, the hospital’s medical director. “Unfortunately, it’s a very common thing here.”
It’s not just common, it’s a near daily diagnosis, said Cornum, a former POW in the first Gulf war who is wrapping up nearly two years as head of the biggest overseas U.S. military hospital and preparing to return to the United States.
There was a time, years ago, when Landstuhl had to justify its existence. No longer.
“Things have changed. We used to get as many trauma victims in a year from Europe and Africa as we now do a day,” Cornum said.
Though major combat in Iraq was declared over in May 2003, daily attacks by a stubborn insurgency has kept the hospital, nestled among thick woods on a hilltop that overlooks this small town, busy day and night.
Troops from Iraq arrive with a host of injuries — eyes damaged by roadside bombs or limbs shredded beyond repair — along with maladies more common to a community hospital such as heart attacks, hammer toes, and kidney stones.
The staff doesn’t expect a slowdown.
“This place is just not what it once was,” said U.S. Air Force Col. Todd Hess, the chief deputy commander of clinical services.
He’s spent nearly eight years at the hospital, and has seen it go from having to justify keeping its doors open to becoming almost a household name. “We’ve been in Doonesbury and we were on ‘The West Wing’ last night,” he said, referring to the comic strip and television show.
For the 300,000 military personnel stationed in Europe, Landstuhl has been the top hospital since 1953. It provides cancer treatment, birth and neonatal care, as well as neurosurgery and burn units.
Iraq isn’t the hospital’s first crisis. In 1987, it treated 500 people injured at the Ramstein Air Show disaster. During the first Gulf war, more than 4,000 soldiers were brought in, and 800 from Somalia in the 1990s.
Overseas, Landstuhl is often the first stop for soldiers injured by bullets, bombs, or exploding tires.
Since the invasion of Iraq, Hess, an ophthalmologist, said about 200 soldiers have been treated for eye injuries caused by roadside bombs.
Sgt. Steven Allen, a 22-year-old from Thawville, Ill., was getting ready to leave for Walter Reed Army Medical Center in Washington, D.C., after a five-day stay.
While traveling with his unit, the 57th Transport Company, he was hit by gunfire from insurgents that blew a hole in his right arm and shredded his right hand. It was amputated.
“I was out of the kill zone and on a bird within six hours,” he said, his damaged arm swathed in white bandages and cradled in a sling. “It was my second tour in Iraq.”
Others, such as Spc. Jason Delfosse, of the 82nd Airborne Division, come to get treatment for noncombat-related ills. “I was here for kidney stones,” he said, holding his crimson paratrooper beret. “I’m going to Afghanistan to rejoin my unit.”
The hospital faced a severe test this past fall, handling a wave of casualties when coalition forces mounted assaults against insurgents in Fallujah.
Head Nurse Maj. Kendra Whyatt, of Greenwood, Miss., said it was massive. “We woke up,” she said. “For two or three days, we were going 24 hours.”
Soldiers with severe injuries are sent to a combat support hospital for a maximum of three days. If more advanced care is needed, they go to Landstuhl and in some cases onward to Walter Reed or Brooke Army Medical Center in San Antonio, Texas.
In January, Dr. Atul Gawande wrote in the New England Journal of Medicine that the average time from the battlefield to the United States for U.S. troops is less than four days, compared with 45 days during Vietnam.