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Thanks to our veterans

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    Thanks to our veterans

    This is a post that I wrote a couple of years ago. KLD provided additional facts. Newbies may not have seen it and for others I think it is worth rereading.

    November 11th is the day we honor our veterans for their patriotism, and for their sacrifices made while preserving liberty, freedom, and peace not only for our country, but around the world. There are, however, other contributions our servicemen and women have made that are often overlooked.

    When studying the history of medicine, one finds a striking relationship between war and major advancements in medicine. For example, the hospital concept was developed by the Romans to provide an efficient means of treating the large number of legionaries wounded in battle. Such advancements have continued to result from major wars right up to the present.

    In the United States, the Civil War resulted in an unparalleled number of battlefield injuries, and restoring the battlefield victims became a national priority. Without returning as many as possible to productivity the nationion's economy would have been devastated. Thus, the rudiments of rehabilitation were born. World War I brought another large influx of war wounded to this country and efforts were expanded. It was recognized that those with severe disabilities could benefit from an array of services, such as physical and occupational therapy, and vocational training.

    Among the World War I battlefield injured were a significant number of soldiers with spinal injuries who survived long enough to reach hospitals in England. That gave rise to more rigorous study of the medical treatments and outcomes in areas ranging from spinal surgery to urinary tract management. Intermittent catheterization and suprapubic catheters were experimented with. In one instance, surgeons removed a bullet from a partially divided cord and transplanted the spinal cord of a rabbit into the separated ends in an attempt to provide a cure. Although this procedure was criticized, it provides insight into the role war wounded have often played in the advancement of medicine in general and in the advancement of spinal cord injury treatment specifically. In effect, they have served as involuntary research subjects. When physicians and other practitioners are suddenly faced with substantial numbers of persons for whom there is no established effective treatment and are destined to die, desperate measures become acceptable. Additionally, the clustering of substantial numbers of persons with similar injuries enables quick comparison of results. Sadly, despite the heroic measures to save them, only about 20 percent of the WW I spinal cord injured soldiers survived more than two weeks. Of those remaining, only 30 percent lasted more than four years.

    World War II, however, was a milestone in the treatment of spinal cord injuries. Because of the advent of sulfa drugs, penicillin and improvements in battlefield medicine, those with spinal cord injuries began surviving and arriving at military hospitals in large numbers. It is difficult to find a hard number of the sci that resulted from the war, but it was at least in the low thousands.

    Physicians scrambled to get a grip on this severely disabled population. Through a combination of trial and error, intuition, and the best practices they could glean from journals, they began using interdisciplinary teams of therapists, physicians, and nurses to treat these servicemen. Notable were two urologists, Estin Comarr, and Ernest Bors, who were serving in military hospitals and who developed more effective ways of dealing with urological management. Two other notables, Air Force physician Howard Rusk and Navy physician Henry Kessler developed and refined therapeutic approaches and goals used in treating this population. Because of these efforts, the majority of those sustaining spinal cord injuries in World War II were surviving 20 years later.

    Following the war, these physicians applied the knowledge they acquired working with veterans to the civilian population. Dr. Rusk, for example, had a regular column in the New York Times which he used to promote the rehabilitation concepts that had been developed and refined for treating the war injured servicemen.

    The war-injured veterans also have helped to confront society over its habitual victim blaming and other pernicious attitudes toward persons with disabilities. It is difficult to suggest that a veteran has been injured as a result of punishment by God for some misdeed or that our veterans are disabled because they were irresponsible. Moreover, when returning to their communities, these veterans rejected the traditional shut-in or invalid role in which people with severe disabilities were forced to assume as a result of traditional attitudes. Quickly they became leaders in advocating for accommodation of their disabilities by the public, providing a foundation for the ADA movement. They served as role models demonstrating that there can be life after disability. As spinal cord injured persons, we are grateful for the contributions our veterans have made that extended well beyond the call of duty. Our lives have been both extended and enriched because of them.

    Here are some additional facts contributed by KLD

    I think it also bears pointing out a few additional facts regarding the WWII era:

    Sir Ludwig Guttman, in England, started the first SCI hospital at Stoke-Mandeville primarily for the treatment of British WWII military SCI survivors. He invented intermittent cath, the interdisciplinary model of care, wrote the first scholarly article on AD, and essentially invented wheelchair competitive sports (the Stoke-Mandeville Games, which eventually became the Paralympics.

    Those SCI veterans who survived WWII and made it back to the USA were nearly all with paraplegic injuries. Virtually all those with tetraplegic injuries died while still in Europe or the Pacific. This includes 5 star general George Patton, who sustained a SCI in a car crash shortly after VE-Day in Belgium, and who died from pneumonia and sepsis 10 days later. The survivors were primarly placed in the "back wards" of VA and military hospitals, told they would at best live 2-3 years, and that they would be kept comfortable until they died. They were told that any rehab, therapy, or purchase of DME for them would be a waste of time and money.

    SCI care for USA Veterans occurred ONLY because of some very couragous and motivated SCI Veterans who formed the Paralyzed Veterans of America (PVA) in 1946, with its primary purpose to improve the lot of paralyzed Veterans of WWII. They lobbied Congress to do something. One of the smartest things they did was to get the Reader's Digest to run an article about them, and how some of the most severely injured Veterans of WWII were getting such crappy care. This generated a letter writing campaign to Congress, and and one of their actions was to find and detail Dr. Bors (mentioned above) to study with Dr. Guttman in England. He then returned to the USA and established the very first SCI Center in the USA at the Birmingham Army Hospital in Van Nuys, CA in 1948. That unit later became the first VA SCI Center (now at the Long Beach, CA VAMC). Shortly thereafter, several other SCI Centers opened in places such as Chicago, Boston, and Memphis. There are now 23 VA SCI Centers in the USA.

    If you want to learn a little more about the first SCI unit in the USA mentioned above, you can check out the 1950 film "The Men" starring an unknown method actor named Marlon Brando, who prepared for the film by living on that early unit for a month before production started.

    The PVA today continues to be a major driving force for improvement of the quality of care and life, as well as for research, in spinal cord injury and disease, both for Veterans and non-Veterans. If anyone gets asked to testify before Congress on SCI related issues, or attend a symposium at the White House or any Executive branch department, you can guarantee that the PVA will be on the list of invitees.

    We all owe a debt of gratitude to our SCI Veterans, especially on Veterans' Day.
    Last edited by SCIfor55+yrs.; 11 Nov 2015, 11:12 AM.
    You will find a guide to preserving shoulder function @

    See my personal webpage @

    Thanks for the reprise of this post SCI55.

    And thanks to all of our veterans.

    All the best,
    GJ & NL
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      Thank you to all the Veterans who I have been honored to serve over my last 27 years working in a VA SCI Center.

      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.