With over 17,000 American troops and 100,000 Iraqi already injured, Wounded is tragically relevant.  This timely account—a powerful reminder of the physical, financial, and psychological costs of war—will only grow more important as soldiers continue to return home.

The excerpts are telling…

Page 16…

There isn’t all that much a nineteen-year-old can say about dying.  Few in an RTC think of death. They might think about getting wounded, but not being killed. When you are young and in the Marines, death is for someone else.  But his friends had been there in the morning and gone that night. Paul missed them and was terribly troubled as he helped the captain box up their gear and belongings, that he knew something, something important, that none of their families knew, that no one who had cared for them or loved them or waited for them, knew or could even have guessed.  And that seemed wrong. The real meaning of those deaths and of loss would come later.              

Page 41…

It is not the devil, but the truth, that is in the details.  Deaths have traditionally been viewed as a measure of potential victory or personal danger in any military conflict. With our current war in Iraq, the number of U.S. dead is now over 2,000.  The Pentagon and those who have championed this war have used the relatively small number of deaths compared with the number of troops at risk as a sign not only of how well we are doing but of the limited risk faced by our combat and support units.

            But in this war the use of death as a function of peril is not only deceptive, it’s delusional. Death in Iraq is no longer the real measure of risk. The story of this war cannot be told solely in the count of its dead. Whatever else may be said about the war in Iraq and Afghanistan, it is more a war of cripples and disabilities than it is a war of death.

            We were driving off the base to buy a few cans of soda from the peddlers on the street. A hand grenade came through the window and landed on the radio between me and my buddy who was driving. I could see the spoon was gone and a little smoke was coming out the top. Just as I grabbed for it, my buddy hit the gas and rammed the truck in front of us, trying to get us out of there. The grenade fell between my legs on the floor. I grabbed for it again and had it six inches off the ground when it exploded.

Page 43…

No military likes to advertise their failures, nor their weakness, but the present U.S. administration has proved particularly reticent to dwell on the very existence of casualties—whether in its reluctance to allow photographs of caskets returning home or its objections to TV programs in which the names of the dead are read. But the numbers of wounded are virtually never mentioned and on those rare occasions when those numbers are released, no details are given as to types or severity of the injuries or to the causes, whether friendly fire, lack of adequate body armor, or vehicles that have not been properly up-armored.

            But the real risk of this war can’t be hidden. As of November 2004, there were 10,726 casualties. By the time you read this, the number of wounded will be well over 30,000. And more importantly, 80 percent will be the result of IEDs and roadside bombs that are becoming more sophisticated and more powerful every month.

            A close reading of the data released by the Department of Defense indicates that approximately 6 percent of those wounded are amputees. By itself, this is twice the percentage of any of our past military conflicts, with foot and leg amputations being slightly more common than amputations involving the upper extremities. The number of amputees as a percentage of the wounded has not been so high among American troops since the first years of the Civil War.

Page 68…

Final Pathological Diagnosis

EXTERNAL EXAMINATION

            The body is that of a well-developed, well-nourished, Hispanic American in her early twenties, exhibiting the typical physical findings of a severe blast injury. There is obvious external head trauma with a dislocated jaw, enucleated left eye, and evusled left maxillary sinus. There are numerous fragmentation wounds on the face and neck. The right leg and the left foot are missing and there is evidence of second and third-degree burns of the arms and hands. Despite a collapsed right lung, there are no marks, cuts, or abrasions on the trunk or torso from the chin down to the groin in areas known to be protected by body armor. The brain itself is markedly swollen, with areas of punctate hemorrhages over the cortex, along with extensive areas of bruising over the visual cortex and left frontal lobe.

Page 98…

The statistics on the number of Iraqi civilians killed or wounded, even estimates, are notoriously absent from official documents as well as news dispatches or interviews from the front lines of the war. There has been no administrative attempt to index or order the so-called collateral damage. Still, those deaths and injuries—particularly of women and children killed in the large sweeps through towns and villages and at roadblocks—have taken their own unique and unexpected psychological toll on the older U.S. troops, particularly those who are parents themselves. It is this group of Reservists and National Guard troops who experience flashbacks and late episodes of PTSD after being confronted with the mangled bodies of civilians caught in the cross hairs of insurgent or friendly fire.

            We were supposed to be in a secure area. Hell, we’re a maintenance unit. We set up the roadblock. The sedan didn’t stop. It looked like a lot of people in the backseat. Someone yelled, “Gun.” You don’t have a lot of time to decide. Fifty-caliber rounds can do an awful lot of damage to a Toyota. When we opened the back door, one of the guys started to throw up. There were three little girls in the back seat. Two were cut in half and the third was missing her head…

Page 110…

“There is no one with a lawn service who knows or writes to anyone in Iraq or Afghanistan.” —CONVERSATION, ORTHOPEDIC SURGEON, THIRD ARMORED CAVALRY

            …General Abrams came to view Vietnam as a war being fought by an army cut off from the population it served.  What Abrams saw was that by late 1969 the majority of combat units in Vietnam were made up of blacks from Cleveland, Detroit, and Philadelphia, Hispanics from Texas and California, and poor Southern whites.  Abrams understood the inequality in all this and realized that this kind of smoldering demographic, barely working in a country at peace, would never work in a country involved in a deadly war going badly.

            He became convinced that it was the separation of those who serve from those being served that had opened up the country to divisiveness and the military to a conflict that had not been well thought out and so was ultimately doomed to failure.  General Abrams was well aware that the Vietnam draft had skewed conscription to the poor and disenfranchised and away from those in positions of power, prestige, wealth, and privilege.  The pain and suffering were simply not being shared between the risk takers and those who had put the country at risk.  Abrams was aware of the long history of inequities in conscription, going back to the Civil War and Congress’s 1863 legislation that allowed draftees to hire substitutes, paying a $300 fee to avoid the whole conscription process.

            There had been nothing as egregious nor as flagrant as a $300 exception during the Vietnam War, but in a more sophisticated way, those kind of exemptions did exist.  By 1968 there was no end to the numbers and types of military deferments.  There were undergraduate deferments for college and graduate school deferments.  There were deferments for enlistment in the National Guard and Reserve units, there were medical deferments if you were connected enough to have a specialist document that you did have a certain degree of scoliosis that did, or might or would lead to, back pain under the stress and strain of military duty, not to mention that flat feet and sever nearsightedness.

            But the single most egregious example of protecting the privileged from the risks of going to war was the decision by Robert S. McNamara, the Secretary of defense under President Lyndon B. Johnson and one of the architects of our involvement in Vietnam, to lower the IW standards of potential draftees.  This led to an additional 100,000 troops with borderline intelligence going off to fight for their country.  These soldiers were called—with both sympathy and derision by those who had to train and then watch over them and then fight with them—“McNamara’s 100,000”…

Page 132…

A government might refuse to allow photographs of returning caskets, might pull programs off TV that present the reading of the names of those already killed, or attack anyone who refuses to repeat all the "happy talk” of a war on course. But it doesn’t work. Dying is not easy to manipulate. With death you can’t pretend.

             The wounded are another matter. Those numbers can still be spun or ignored, the consequences discounted or put off into the future. But in this war that is a big mistake. Wounds, too, can be forever. And like deaths on our other battlefields become the metaphor for all that is happening. Ask any neurologist...