Wednesday, December 24, 2003

Injured Troops Return from Iraq; New Medic Training Reducing Combat Deaths

Injured Troops Return from Iraq; New Medic Training Reducing Combat Deaths

Aired December 24, 2003 - 22:00 ET

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

AARON BROWN, HOST: Good evening again from New York. I'm Aaron Brown.Of all the pieces we do on the program, and all the stories we tell, few have touched a nerve quite like the ones you're about to see. We know this because you've told us so in your letters and e- mails and phone calls. We also know because when the tape rolls and the pictures play and the stories unfold, it is tough to watch sometimes and it is impossible to turn away.The stories reported by NEWSNIGHT'S Beth Nissen concern people, mostly young people, who have sacrificed much, and the men and women who make it their duty to help them. They are the wounded and the injured of the American combat operations, and the doctors and the nurses and the therapists who tend to them. These are sad stories, some of them terribly so. Yet what moves us more has little to do with sadness and more to do with strength and heart and hope. So war stories in a moment. War stories with a difference. First, a news update. 

(NEWSBREAK)

BROWN: Back on the first of May on board the "USS Abraham Lincoln," President Bush declared that major combat operations in Iraq have ended. No one knew then how the fighting would continue or escalate for weeks and months to come. That is one kind of battle in this war.Another kind is being fought every day, fought by servicemen and women who have been injured or wounded. A long fight. Back to health and full function or as close to it as they can get. It is their stories we focus on now in Beth Nissen's reporting. 

BETH NISSEN, CNN CORRESPONDENT: When we did this first story in May, the Pentagon reported 495 U.S. troops wounded in action in Iraq, another 66 were listed as injured in non-hostile incidents, such as military vehicle accidents, accidents in camp.The most seriously wounded of these casualties were medivaced back to the U.S. Most to Walter Reed Army Medical Center in Washington, D.C. We took a camera crew to Walter Reed and reported the first in what was to become a six month series of stories on the wounded and injured from Operation Iraqi Freedom.

(BEGIN VIDEOTAPE)

NISSEN (voice-over): Specialist Jason Blakemore of the 101st Airborne has injuries typical of those suffered by U.S. troops in Operation Iraqi Freedom. 

SPC. JASON BLAKEMORE, 101st AIRBORNE: A grenade was thrown over the wall and exploded between five and eight meters from me. I counted 47 pieces of shrapnel that had actually entered my body. And most of them were very small, about the size of a BB. No bigger than a dime. 

NISSEN: Yet large enough to do serious damage. 

BLAKEMORE: One of the pieces came down and nicked an artery in my -- under my clavicle and punctured my lung. 

NISSEN: He was lucky. Medics got him into a helicopter into a field hospital in less than an hour. Surgeons in the field and at military hospitals in the U.S. say the war wounded fell into two groups: those with internal injuries and those with fractured limbs. 

LT. COL. WILLIAM DOUKAS, MD, CHIEF OF ORTHOPEDICS, WALTER REED MEDICAL CENTER: We've seen everything from blast injuries, to gunshot wounds, to motor vehicle accidents. 

NISSEN: That's how Private First Class Richard Michael was hurt. His Humvee slam into another military truck on an Iraqi road at night. 

PFC RICHARD MICHAEL, U.S. ARMY: I broke my humorous, which also damaged the radial nerve. I ruptured my spleen. And they also took it out. I've got a compound fracture of my femur and a compound fracture of my tib-fib. 

NISSEN: Like Private Michael, many of those injured in Iraq have needed multiple surgeries to pin fractured bones, repair major organs and arteries. Recovery time varies. Many of those injured seriously enough to be sent back to U.S. hospitals are facing months of rehab. 

MICHAEL: They said it could take up to a year, year and a half, to fully recover. And they don't even know if it will fully actually recover. I'll get most of it back, but I don't know if it will ever be the same. 

COL. CRAIG SHRIVER, MD, CHIEF OF GENERAL SURGERY, WALTER REED ARMY MEDICAL CENTER: These patients will have some discomfort and pains that come up further on down the line, probably throughout the rest of their lives. And every time that occurs, it will bring back the memories of why this happened, and the battles and so forth. 

NISSEN: The medical staff at Walter Reed is deeply concerned about injury related psychological trauma and works with every patient to reduce depression, flashbacks. Private Michael has been spared those. Like Private Jessica Lynch, he has no memory of the moment of injury. 

MICHAEL: So that helps a lot, you know. I won't have that actual terrifying memory, you know, in my mind. 

NISSEN: Private Blakemore does. He keenly remembers those first eternal minutes of terror after the grenade blast. 

BLAKEMORE: It's very scary, not knowing if you're going to get to see your family again, not knowing if you're only going to have one arm, or if you're only going to have one leg, or one foot. It's very scary. 

DOUKAS: They have psychological hurdles to overcome. And they are in a fight for their own destiny in that regard. 

NISSEN: The combat phase of Operation Iraqi Freedom is over, but surgeons, physical therapists, and trauma counselors say injured soldiers are still fighting. 

SHRIVER: They're fighting for physical recovery. They're fighting for mental recovery. They are fighting every day. It's not over for them. 

NISSEN: And may not be for many years.Beth Nissen, CNN, Washington, D.C.

(END VIDEOTAPE) 

BROWN: When we come back, the central hub and way station for casualties. We'll visit with the doctors and nurses and patients at Landstuhl Regional Medical Center in Germany. A break first from New York. This is NEWSNIGHT.

(COMMERCIAL BREAK)

BROWN: More than 8,000 American military men and women have now been medivaced out of the theater of operations for a variety of reasons. Everything from sprained ankles and kidney stones, to the destruction done by snipers and RPGs and roadside bombs.The injured are taken from forward field hospitals to Baghdad or to Kuwait, then on to Germany to Landstuhl Regional Medical Center just south of Frankfurt. We went to Landstuhl in September. And even then, it was one of the busiest trauma centers in the world. On any given day, the work is heart-wrenching, difficult, and vital. It is not, however, pretty. We warn you. Some of the images in this story are quite graphic. 

(BEGIN VIDEOTAPE)

NISSEN (voice-over): They keep coming -- the medivac planes from Baghdad and Kuwait. 

COL. RHONDA CORNUM, MD, COMMANDER, LANDSTUHL REGIONAL MEDICAL CENTER: We get medivac aircraft every day. Sometimes they come with one or two patients. Sometimes it's an aircraft that has 60. 

NISSEN: Since the start of the war, more than 6,600 uniformed men and women from Operation Iraqi Freedom have been treated here at Landstuhl Regional Medical Center. They keep coming, a steady stream of the accidentally injured and the sick. A steady stream of service members with battle injuries months after the major fighting stopped. 

CORNUM: Since the end of major combat, we really have had an increase in our total patient load. Not only have we had more patients total, but the severity of either their injuries or their illnesses has been greater. 

NISSEN: That's because of blast injuries from rocket propelled grenades and IEDs, the improvised explosive devices taking an almost daily toll on convoys and units in Iraq. An IED blast hit specialist Joshua Gearing. 

UNIDENTIFIED MALE: Can you hear that louder in one ear? 

JOSHUA GEARING: I've lost about 60 percent of my hearing. It got half my wrist blown off on the left side. My right arm shattered the bone right here, just basically the elbow itself. 

NISSEN: Sergeant Mariah Lee has photos on his laptop of what an enemy RPG did to his truck.

SGT. MARIAH LEE, U.S. ARMY: That's where I was sitting.

NISSEN: And graphic photos of what the blasts did to his foot. 

LEE: It was like two to three centimeters of the Achilles tendon was basically taken out by the blast itself and left a nice size hole in there. They said, expect a long recovery. And you know, I definitely expect that. It's not -- no overnight fix. 

NISSEN: Many injuries seen at Landstuhl are much more serious. 

UNIDENTIFIED MALE: We see a lot of amputations, some of which are done by the blast itself, some of which are done because they're not salvageable limbs. We see a fair number of head injuries, both penetrating head injuries from shrapnel, and closed head injuries from sort of concussions. These are life altering and sometimes life ending events for some really brave kids. 

JOYCE GRAY, INJURED'S MOTHER: We thought it was over. We thought the war was over. And to me, it seems like they're getting hurt worse. 

NISSEN: Joyce and Alan Gray were flown by the military from Illinois to Landstuhl after being told that their son, an Army corporal, had a life threatening blast injury to his upper leg. 

ALAN GRAY, INJURED'S FATHER: We had received a call from the Army. And that our boy had been injured.

NISSEN: Their son was taken to one of Landstuhl's eight ORs, all operating on 12 hour shifts, almost around the clock. Surgeons stopped the bleeding, saved Corporal Gray's life, did what they could to save his mangled leg. A. 

GRAY: It's looking good. We're hoping and praying that it stays that way, because if it stays that way, then he won't lose his leg. But if, you know, if it changes...J. 

GRAY: Then they might not have enough tissue to wrap around the bone. A. GRAY: I didn't think he was going to make it. Oh, mercy.

NISSEN: Almost all those who make it to Landstuhl, do make it. Of more than 6,000 Operation Iraqi Freedom patients treated here, only two have died. 

CORNUM: We are very proud of what we've been able to accomplish here. People really see the mission. I mean, they really see that every day, they're saving lives. 

NISSEN: Most of the military's sick and wounded stay at Landstuhl for only a few days, a few weeks at most. A small number, about one in 10, are treated and returned to active duty in Iraq. Most are sent on to hospitals in the U.S., such as Walter Reed in Washington, D.C., for further surgery, treatment, rehab.Clearing Landstuhl's wards, it's ICU, it's ORS, it's recovery rooms for the next wave of patients from Iraq. They keep coming, the medivac flights from Baghdad and Kuwait. They keep coming, the casualties of war.

(END VIDEOTAPE)

NISSEN: It's something most journalists learn early in their careers. There are no issues, only people. First at Walter Reed and then at Landstuhl, we reported on the growing number of U.S. military casualties in Iraq by telling the stories of people who'd been wounded or injured.But we met other people in the wards and ERs and the Ors, who are a vital part of the story. The doctors, the surgeons, the nurses who are giving so much of themselves to save, to salvage the lives of the wounded and injured and sick.

(BEGIN VIDEOTAPE)

NISSEN (voice-over): Major combat may be over in Iraq, but not here. At Landstuhl Regional Medical Center in Germany, Army and Air Force medical teams are still fighting hard every day to save the lives, the limbs, the prospects of those medivaced in from Baghdad and Kuwait. 

LT. COL. RONALD PLACE, MD, CHIEF DIVISION OF SURGERY, LANDSTUHL REGIONAL MEDICAL CENTER: If anything, we're seeing more patients now than we were during the actual combat phase. 

NISSEN: Landstuhl's eight ORs operate on 12-hour shifts, almost around the clock. 

LT. COL. ELIZABETH BOWIE, HEAD OPERATING ROOM NURSE: We have done as many as 32 surgical cases per day, depending on what's going on in Iraq. 

NISSEN: Landstuhl's nurses see it all. 

UNIDENTIFIED FEMALE: Extremities, fractures, amputations. 

STAFF SGT. ARTHUR TIMMS, ICU NURSE: Heat stroke, heat exhaustion. 

UNIDENTIFIED FEMALE: Gunshot wounds, shrapnel wounds, motor vehicle accidents. 

NISSEN: Many here worry that they are starting to wear down, to show the strain of seeing incoming casualties almost every day for six months. Many of the wounded have serious blast wounds, head injuries. 

TIMMS: The hardest part is to see them when they first get here. You try not to let your emotions come out when you see how badly they're hurt. 

NISSEN: Emotions are very close to the surface. 

UNIDENTIFIED MALE: Bad days are, you know, these young soldiers with horrible injuries. And they're just kids. 

NISSEN: It is wrenchingly hard for even battle-hardened commanders. 

CORNUM: I mean, I've pulled people out of wrecked helicopters and dead people. And they were people I knew sometimes. But somehow, when you get to the operating room and you're getting gravel out of some kid's leg, and he's younger than yours, that's really hard. 

MAJ. FELICIA HOPKINS, ICU CHAPLAIN, LANDSTUHL REGIONAL MEDICAL CENTER: Staff experiences trauma also. People see us in uniforms and think we're just kind of -- so systemic. We do everything in route, step, route, step, route step. What you're really seeing is the person in the uniform, the mother who may be a surgeon, the nurse who is a single parent who has a teenager that she left behind. 

NISSEN: Work in the wards is especially hard for reservists, such as Staff Sergeant Arthur Timms. He painfully misses his wife, the two teenagers and a four-year-old he left back home and may not see for a year. Work in the ICU, he says, helps give him perspective. 

TIMMS: I can't complain. I mean, when you think about complaining, just open one of those doors and look in one of those beds. 

NISSEN: Those beds are always full. As fast as Landstuhl stabilizes patients and air vacs them to military hospitals in the U.S., there's another planeload of incoming wounded. Regular stress counseling sessions help staffers cope. Doctors and nurses say they also draw courage from their patients, who often set an example of selflessness, of greater concern for their buddies than themselves. 

CORNUM: A guy will come in, and he is -- a part of his foot's missing. And his question is what happened to the guys that I was with? That's their biggest concern. They are great Americans. 

NISSEN: Almost every day, more of those Americans arrive. Landstuhl staffers start another hard 12-hour shift, trying to stabilize the patients, support each other, fulfill their mission. 

MAJ. STEPHEN LINEX, CRITICAL CARE NURSE: These kids are over there, doing their best. They deserve to have us do our best. So we're just going to try and keep taking the best care of them that we possibly can, try to put them back together. 

NISSEN: And keep working toward the day when the buses no longer come, when the last casualty is treated and on the way home.Beth Nissen, CNN, Landstuhl, Germany. 

(END VIDEOTAPE)

BROWN: In a moment, the next step. One of the toughest on the way home. Break first from New York. This is NEWSNIGHT.

(COMMERCIAL BREAK)

BROWN: Over the summer, the tenor of the war in Iraq changed. There were more and more attacks on U.S. troops. First weekly, then almost daily. Attacks using RPGs and homemade bombs.And there is a terrible truth here. The new Kevlar body armor has saved many lives, but it is body armor. It protects only the torso, not the limbs. The result has been the greatest number of amputees the military has seen since Vietnam. And many of them are sent to Walter Reed to Ward 57. 

(BEGIN VIDEOTAPE)

NISSEN (voice-over): They are airvaced here to Walter Reed Medical Center, to Ward 57, the orthopedic ward, where specialists work to heal, to save shattered arms, crushed legs. 

1ST LT. RONALD STEPHENS, ACTING HEAD NURSE, WARD 57: We are very busy. Currently we have 24 beds assigned, and we have 24 beds that are full. 

NISSEN: In one of those beds, Specialist Chris Atherton, who lost much of his left arm July 26, when an RPG hit his Humvee. 

SPC CHRIS ATHERTON, U.S. ARMY: It's a weird feeling, because I feel like my hand's still there and I can move it, but it's not there. 

NISSEN: Just down the hall in Ward 57, Staff Sergeant Ryan Kelly, whose lower right leg was mangled in a bomb attack on his convoy July 14th. 

STAFF SPC. RYAN KELLY, U.S. ARMY: They attempted to save it, but hey weren't able to. They tried for I think six hours is what I was told. And then, when I woke up, the leg was gone. 

NISSEN: Walter Reed has treated 24 amputees from Operation Iraqi Freedom in the medical center's new $3 million amputee center. The priority after surgery? Quickly replace what's been lost with a state of the art prosthetic limb, custom fit with the help of 3D computer imaging. Once measured, most amputees get their prosthesis within days. 

KELLY: Oh, I'm so excited, because I'm ready to get my leg, ready to get walking again, and ready to get back to work. 

NISSEN: Doctors and nurses here say that attitude is common. Amputees are almost incredibly positive, despite grievous injuries. 

UNIDENTIFIED MALE: I think they would have some anger towards it, but most of them, it doesn't. I mean, they're soldiers. 

NISSEN: Anger, bitterness, depression. All may hit later. But in the weeks after being wounded, most amputees are overwhelmed with their good fortune that their injuries weren't worse. 

KELLY: The simple fact that it's a below the knee amputation makes me extremely lucky, because I'm only compensating for one joint. I got to compensate for an ankle. 

NISSEN: The amputees are grateful, as GIs say, to be above ground. 

ATHERTON: I'm good. I am happy I'm alive. 

NISSEN: But their lives are drastically different. Amputees go to regular therapy sessions, occupational therapy, psychological therapy. Gradually, they give voice to their worries, their fears. 

COL. RICK MALONE, MD, ASSISTANT CHIEF OF PSYCHIATRY: A lot of the people who come back having lost limbs, they're afraid of sexuality, for example. What is it going to be like, you know, rejoining their spouse? Another common reaction is how are my kids going to react? 

NISSEN: Specialist Atherton has thought a lot about his two- month-old daughter, born after he was deployed to Iraq. He's sad to think he'll never hold her in both arms. He's hoping that won't matter to her. 

ATHERTON: I think it will be the same. I think she'll look at me the same, as a father. That's what's most important, you know. 

NISSEN: Having only one arm won't change his plans to go back to school, become a history teacher. Having only one leg won't change Staff Sergeant Ryan's plans to work as an EMS for a fire department and continue weekend service in the Army Reserve. 

KELLY: I'm going to hit a point a few months down the road where I'm going to be walking and doing everything like I used to. And I'm going to say, you know, no big deal. 

NISSEN: Yet Walter Reed staffers say they hope no one shrugs off what these soldiers have been through, what they've suffered. 

UNIDENTIFIED MALE: I think that makes a big difference in how they adapt long-term. I wonder if five or ten years from now, the -- you know, people in their home towns are going to recognize the sacrifice that they made, and there's still going to be that appreciation. 

NISSEN: Appreciation for how many lives have been changed, forever reshaped by the war still being fought in Iraq.

(END VIDEOTAPE)

NISSEN: Since World War II, amputations have been almost emblematic war wounds. Those of a certain age remember the double amputee in the 1946 film, "The Best Years of our Lives."But amputation such a critical and permanent injury, is relatively rare Another critical and permanent injury is more common, burns. About 10 percent of the injuries in modern wars are from burns. Operation Iraqi Freedom is no exception.Burn injuries are often life threatening, always life altering. They are difficult to treat, difficult to heal. And we should warn you, can be difficult to look at.

(BEGIN VIDEOTAPE)

NISSEN (voice-over): It is one of the most dangerous forces troops face in Iraq. Not just enemy fire, but fire itself. Burn injuries from grenade blasts, explosions, flaming fuel can be so critical that special burn flight teams are constantly on call to medivac the most seriously burn injured to Brook Army Medical Center in San Antonio. The burns teams have been brought in 67 of the burn injured from Iraq so far. 

UNIDENTIFIED MALE: The severity of injuries that you see in a burn center is amazing. I mean, you won't see it anywhere else. It's amazing what the body can put up with and still function. 

NISSEN: Specialist Aaron Coates is amazed he is alive after a rocket-propelled grenade hit the fuel truck he was driving near Kirkuk August 30th. 

SPC AARON COATES, U.S. ARMY: I am burned from my fingertips, up to just past my elbows on this end. And this one, I was burned from my fingertips, all the way up to my shoulder. This one I had burns all the way down to the bone. The bone itself was burnt. So they had to amputate six of my fingers. And all five of the single just nip the tips on these two. 

NISSEN: Specialist Gabriel Gariga suffered second and third degree burns over 53 percent of his body when two humvees collided and ignited at a checkpoint just south of Baghdad July 14th. 

SPC. GABRIEL GARIGA: My clothes were all charred from you know, it was burned off. And my burned skin was hanging off. And I just -- it just looked bad from what I could see on myself. 

NISSEN: Burns are often as bad is they look. The skin is a vital organ, the body's largest. 

LT. COL. LEE CANCIO, MD, DIRECTOR, U.S. ARMY BURN UNIT: We don't fully appreciate what the skin does for us until we see a major burn. Once the skin is damaged or gone, it's not possible for the body to prevent bacteria from invading from the outside in. 

NISSEN: Burn wound care is a constant battle against infection, involving daily dressing changes, cleaning wounds, wrapping wounds. It is some of the most difficult nursing work there is. 

CAPT. DENNIS ESTRADA, ASSISTANT HEAD NURSE, BURN UNIT: You touched them, it hurts. You bathe them, it hurts. 

UNIDENTIFIED MALE: And you have to scrub, of course, to get any dead skin off. And when you do that, it's just painful. ESTRADA: And I say, if you have to scream or whatever, please do it. But unfortunately, it's something that we have to do. 

NISSEN: So is surgery. Specialist Gariga has had 20 operations so far, many to cut patches of unburned skin from his back and graft them onto his burned legs, arms, and hands. Surgery is followed by intensive often painful physical therapy. 

MAJ. WILLIAM AIKEN, HEAD NURSE, BURN UNIT: You start an immediate rehab, get their hands moving, get their shoulders moving, because if that skin tightens up, they can't -- you know, they can't comb their hair, they can't brush their teeth, they can't open a door, they can't use their hands in activities of daily living.

UNIDENTIFIED FEMALE: Did you get it?

NISSEN: Most of the Operation Iraqi Freedom patients have burns to their hands, arms, and legs. Specialist Edward Stevenson's lower legs were burned almost to the bone when his convoy hit two explosive devices near Tikrit October 1. 

SPC. EDWARD STEPHENSON, ARMY: The pain's a constant thing. I have pain all the time. You know, they give me medication. And it dulls the pain, which helps. But it's always there.

NISSEN: Not all of his pain is physical.

STEPHENSON: I've had a lot of flashbacks and nightmares. All I remember is hearing my two friends screaming. I myself was screaming, because my hands were starting to melt due to the heat. 

NISSEN: The burn unit team knows burns leave psychological scars as well as physical ones. 

MAJ. SANDRA WANER, MD, BURN SURGEON: It's very psychologically traumatizing, because it's disfiguring. They have scars every day they'll look at that. That will never be completely normal. They'll be reminded of that every day. 

NISSEN: Yet, nurses and doctors here say most of the young soldiers on the unit are remarkably resilient, positive. 

UNIDENTIFIED MALE: I've got the attitude, I can't go back and glue my fingers back on, I know that. There's no point in sitting here worrying about it. 

UNIDENTIFIED MALE: I don't regret this happening. I don't regret going to Iraq or anything. I feel like I served my country. You know, I've been through the worst; it can only get better. 

NISSEN: Day by day, step by step. Beth Nissen, CNN, San Antonio, Texas. 

(END VIDEOTAPE)

BROWN: When we come back, it wasn't the life he would have chosen. But now a young man is fighting and learning how to live all over again. The story of Luis Calderon. Around the world, this is NEWSNIGHT.

(COMMERCIAL BREAK)

BROWN: We try to pay close attention to the e-mails we get from viewers. And in August, we received one from Luis Calderon, the father, the proud father he wrote, of a son who had been critically injured in Tikrit in an accident. For several weeks, Luis the son was in intensive care at Walter Reed, just down the hall from the only casualty of this war whose name most Americans know: Jessica Lynch. It was hard for Luis the father to see the media focus so completely on Private Lynch and her unit. "They are recognized, deservedly so, as heroes," he wrote to us. "But my heart cries out, what about Luis?" So this story is about Luis. 

(BEGIN VIDEOTAPE)

NISSEN: The photos of Luis Calderon in the family album are like those of thousands of other young men. Luis as a star fullback in high school. Luis and his wife Darlene on their wedding day. The pictures change after his enlistment in the Army. His deployment to Iraq as a tank mechanic with the 4th Infantry. Then in one snap, the image is changed from this, to this. Luis' father got the phone call from Iraq May 5. 

LUIS CALDERON, FATHER: The individual identified himself as the Army captain. So that almost killed me right there. But then he said that my son had just suffered an accident. 

NISSEN: An accident involving Luis' 70-ton armored vehicle and one of the hundreds of walls in Iraq painted with the image of Saddam Hussein and systematically destroyed by U.S. troops. 

SPC. LUIS CALDERON, 4TH INFANTRY DIVISION: We saw two murals with Saddam's picture on it. So then we got the permission to knock them down, because we had some heavy armored vehicles. 

NISSEN: But when Luis rammed into the wall, it broke in half and fell forward on his tank. A crush of debris slammed through the open hatch, breaking his neck, damaging his spinal cord near the base of the neck. 

CALDERON, FATHER: They're saying he's a complete quadriplegic. In other words, he's not going to have full function of all four extremities. 

NISSEN: After more than two months in intensive care at Walter Reed Army Medical Center in Washington, Luis was finally stabilized and transferred to the spinal cord injury center at the V.A. hospital in Miami. Doctors and physical therapists here are working to increase the limited movement he has in his shoulders and upper arms. 

DR. ALBERTO MARTINEZ ARIZALA, CHIEF, SPINAL CORD INJURY CENTER, MIAMI V.A. HOSPITAL: The central nervous system, specifically the spinal cord, has some inherent capacity to heal itself. But it does so poorly. We're hopeful with time that he'll regain function. 

NISSEN: After three months of painful effort, Luis has made progress. Using an arm brace he can now move the joystick on a motorized wheelchair. Although he cannot move his hands, his fingers. 

CALDERON, SON: Working with my hands, really that's the hardest thing for now for me. My personal goal is to just move my hands. And if I move my hands, I will be the happiest guy. 

NISSEN: It as constant struggle for him, balancing hope that he'll improve with accepting and learning to live with his injuries. 

CALDERON, SON: I haven't accepted I'm a quad yet. I can't believe it. I'm in a dream still. I don't know. A big maybe.

NISSEN: He has been depressed. He has been angry at fate, at himself for miscalculating how the wall would fall. Yet he says he has no regrets about enlisting, about serving in Iraq. 

CALDERON, SON: I was just a soldier. I was just doing my job. 

NISSEN: Luis' father, a retired 31-year veteran of the Air Force, is proud of his son and wishes others were, too. Operation Iraqi Freedom casualties injured in accidents, he says, are overlooked, don't qualify for Purple Hearts, don't get the media attention given to those wounded in combat. 

CALDERON, FATHER: He was in the same danger. He was in the same danger every day. He was eating the same sand, in the same heat, with the same enemy. What was different? Doesn't my son get any kind of recognition? I don't mean a parade with confetti and a national hero. No, just a pat on the back, job well done. 

NISSEN: It matters, he says, when members of the community, like these children from a local grade school, come by with cards full of glitter and encouragement. It would matter, he says, if more administration officials visited those injured while in service to their country. 

CALDERON, FATHER: Give these kids some love, because they will never know that anybody cared if nobody tells them. Somebody has to tell them. 

(END VIDEOTAPE)

NISSEN: As we continue to report the story, the numbers of the wounded and hurt from Operation Iraqi Freedom are still climbing. The total of those wounded in action is nearing 2,000. Almost 350 others have been injured in non-combat incidents, accidents. But the numbers of those affected by these war wounds and injuries is much higher. For every private first class or specialist fighting to recover at Walter Reed or Brooke Army Medical Center, there's a mother, or a father, or a wife at the side of the bed, or in the physical therapy room. They, too, have been through great pain. They, too, are trying to recover. 

(BEGIN VIDEOTAPE)

NISSEN (voice-over): It is an under recognized form of collateral damage: the trauma suffered by the families of the war wounded and injured. A battalion of mothers, fathers, and nearly half the U.S. Armed forces married, spouses and children. Darlene is the wife of specialist Luis Calderon, injured May 5 in Tikrit. 

DARLENE CALDERON, WIFE OF INJURED SOLDIER: Everything's changed drastically in our lives now. My whole life is centered now around the hospital. I'm here every day. I bring him fluid every day. Seven days a week, I'm here. 

NISSEN: So are the parents of Specialist Calderon, one of the most grievously injured soldiers thus far in Operation Iraqi Freedom. Luis' neck was broken and his spinal cord damaged when a wall fell on the tank he was driving, leaving him a quadriplegic at 22. It is hard for his father to see Luis, who was once so fast on the football field, now unable to move his hands, his legs. 

CALDERON, FATHER: When you as a father see that it just breaks your heart. But then, you know, you gather yourself and then you say, "Hey, if he's coping with it I sure as heck have to cope with it." 

NISSEN: Coping can mean upheaval for the entire family. To be with their son, Luis' parents moved to the U.S. from Puerto Rico. His father, an experienced facilities manager, took the first job he could find: as an electrician in the V.A. hospital in Miami where his son is being treated. 

CALDERON, FATHER: I only have one priority in this world now, just one. And it's Luis. 

NISSEN: His family's devotion has helped steady Luis, has restored his crushed spirits. 

CALDERON, SON: I used to pray every day, every day, every day. They always thought that you're going to be all right, you're going to be all right. Don't worry about this. We're going to be there for you. 

NISSEN: Family support can help the seriously injured, medically, psychologically. 

ARIZALA: This is a major ordeal. It helps to have people help you, you know, get through this. Doing it alone is very, very hard. 

WANEK: That support is extremely important. Extremely important to their long-term how they do. 

NISSEN: Many of the wounded face long months of rehab, years of adjustment. Corporal Robert Jackson, known as B.J., is in his third month of rehab at Brooke Army medical center in San Antonio. He lost his lower legs and was seriously burned on his hands and arms in a grenade attack in August. 

CPT. ROBERT JACKSON, ARMY, NATIONAL GUARD: I get a lot of assistance from my wife. I can't do anything. Can't, like, get up and walk to the kitchen to get something. 

NISSEN: Jackson's wife Abby, a nursing student, is now a full- time nurse to her husband. She coaches him through daily physical therapy exercises. She also feeds him through a stomach tube, helps him bathe, dress, move. 

ABBY JACKSON, WIFE OF INJURED SOLDIER: Some nights when I get into bed I'm like, oh. You know, I don't know if it's so much for me. I think it's so much more frustration for my husband. Because I see how much he wants to do and things he would like to do with the kids. 

NISSEN: Two little girls, one nearly 3, the other just a year old. B.J. can do little to help Abby with the children. R.

 JACKSON: Can't hold them, pick them up and hold them. Because my hands don't move, and I have a tube in my stomach. So it's hard to set them on my lap. 

NISSEN: It's also been hard to see their reaction to his injuries. Their daughter, Berlynn (ph), was distressed to see daddy so hurt. A. 

JACKSON: It took her two days before she would go near his wheelchair. She was really scared. And sometimes now, she's afraid she's going to hurt him. She always says, "Me no hurt you." 

NISSEN: Doctors and therapists say just being with children, with loved ones, motivates patients such as B.J. to get stronger, recover faster. 

WANEK: It's important to these guys, they come back and know that they are loved, they're appreciated for what sacrifice they made, and that's acknowledged. 

NISSEN: A key step in helping them move on in lives much changed. Beth Nissen, CNN, San Antonio. 

(END VIDEOTAPE)

BROWN: Ahead on NEWSNIGHT, one reason why families get their sons and daughters back alive. The 91 Whiskeys and their work in the field. This is NEWSNIGHT.

(COMMERCIAL BREAK)

NISSEN: Medics are a relatively modern invention. In ancient times, most wounded SOLDIERS lay where they fell. By Napoleon's time, there were litter bearers who picked up casualties after the battle. Medics in World War I were the first to get substantial field training. And by World War II, a wounded G.I. had an 80 percent chance of surviving if he was treated by a medic within an hour. Every war from Korea to Operation Desert Storm has seen general improvement in the training of combat medics. But this war has seen a breakthrough. Civilians might call them super medics. In military lingo, they're the 91 Whiskeys. 

(BEGIN VIDEOTAPE)

NISSEN (voice-over): At Fort Sam Houston in San Antonio, Texas, soldiers drill for a biochem attack, practice how to take care of themselves on the battlefield, and how to take care of others: the wounded, the injured. These are the Army's newest combat medics. Military designation, 91Ws, or 91 Whiskeys. The most advanced combat medics ever fielded by the U.S. military. 

LT. COL. BRUCE MCVEIGH, BATTALION COMMANDER, 222ND MEDICAL BATTALION: Before, they were trained at very rudimentary levels. Basic putting on bandages, pressure dressings, stop the bleeding. Now we're teaching them to manage the airway, manage the bleeding, and also be able to learn the procedures they need to get that soldier packaged up and evacuated back to the next level of care. 

UNIDENTIFIED MALE: Did you all save some of those bodies?

NISSEN: In 16 intensive weeks of classroom work and practice drills, 91 Whiskey trainees certify as full-fledged EMTs. 

UNIDENTIFIED MALE: How are you doing? My name's Eric. 

NISSEN: They learn how to intubate (ph) patients, insert IVs, start medications. 

MASTER SGT. ROGER THOMPSON, ARMY: A lot of these young soldiers who are going to go right to Iraq. That's why every soldier that we send out has to be pretty much ready to step out the door and do their job day one. 

UNIDENTIFIED MALE: The pressure up here. That's it. That's it.

NISSEN: 91 Whiskeys practice on each other. They practice basic nursing care on patients at nearby Brooke Army Medical Center, taking vital signs. 

UNIDENTIFIED MALE: RPB 149 over 84.

NISSEN: Doing patient assessments, some on casualties from Operation Iraqi Freedom. 

UNIDENTIFIED MALE: Does it hurt at all? 

PVT. 2 JASON GUTIERREZ, 91 

WHISKEY: It's so much information you've got to keep in your mind. It feels like a year's worth of training crammed into, like, 16 weeks. 

NISSEN: The emphasis is on hands-on training. More critical procedures are practiced on human simulators, computerized mannequins with working lungs, circulation, human skeletal structures. 

UNIDENTIFIED MALE: You will feel for the fourth rib.

NISSEN: Computers monitor and control the simulator's breathing, pulse rate, bleeding, which change in response to the treatment. 

UNIDENTIFIED MALE: OK. You've got open fractures.

NISSEN: All treatments are recorded by a human controller, who reviews how well the trainees manage to do in ten minutes in the dark. 

UNIDENTIFIED MALE: I would wait for a sling for the attitude of your patient. Before those other things, you've got to stop the bleeding on your patient. 

UNIDENTIFIED MALE: Has bleeding been controlled? 

NISSEN: The simulated injuries are typical of the most serious wounds seen in Iraq: open fractures, burns, amputations. 

LT. COL. ERIN EDGAR, DIRECTOR, COMBAT MEDIC TRAINING: Soldiers still die in combat the same ways they always have. We're trying to prevent those causes of death that are preventable. Largely bleeding from limbs, you know, controlling bleeding and managing airways and breathing. 

NISSEN: And medics have to learn to do that under combat conditions. Exercises are designed to simulate the chaos, the confusion of an active battlefield. 

UNIDENTIFIED FEMALE: I'm feeling a pulse on this patient! 

NISSEN: Noise levels, stress levels, are high. 

UNIDENTIFIED MALE: How long you going to take? He's dying! 

SPC. CHARLES SCOGGINS, 91 

WHISKEY: You've got bodies laying all around. Some are dead. Some are alive. If this person is alive, you've got to treat them. You've got to do what you can to keep them alive and move to the next person. PVT. 2 

SHAUNTELYA TYLER, 91 

WHISKEY: If you can't work under pressure, you have people out there who are depending on you, and you're going to let them die. 

EDGAR: You can never replicate the real thing. But I think we get them to the point where they have a pretty good idea of what's expected of them. 

NISSEN: Nothing does that as effectively as the last phase of training, a week in the field. 

UNIDENTIFIED MALE: Hold up. Hold up. 

NISSEN: 91 Whiskeys go on patrol, respond to calls for help. 

UNIDENTIFIED MALE: Blackhawk down! 

UNIDENTIFIED MALE: My arm! 

UNIDENTIFIED MALE: We've wasted too much time, let's go! Let's go.

UNIDENTIFIED FEMALE: You guys have everybody out? 

UNIDENTIFIED MALE: Let's go! Let's go! 

UNIDENTIFIED FEMALE: An amputation over here. This soldier has a head wound. 

UNIDENTIFIED MALE: Hurry up. You need to do a rapid assessment. 

UNIDENTIFIED MALE: Incoming! 

UNIDENTIFIED FEMALE: Make sure you roll him over, and make sure he has no injuries on his back. 

UNIDENTIFIED MALE: You are not moving fast enough! 

UNIDENTIFIED FEMALE: One, two, three.

UNIDENTIFIED MALE: Let's move, let's move, come on. 

UNIDENTIFIED MALE: Let's go! 

UNIDENTIFIED MALE: Pick it up! 

NISSEN: They try to remember all they've been taught: reassure the patient. 

UNIDENTIFIED FEMALE: Hang in there, come on, stay with me. 

NISSEN: Reassess the patient. 

UNIDENTIFIED FEMALE: Check his airway, breathing, and circulation. 

TAYLOR: I don't know I know it but I know I do. I learned it, they said it. I'm grasped it, and I'm using it. 

NISSEN: So are the 91 Whiskeys already deployed in combat. Anecdotal reports from the field give graduates of the two-year-old program, plus the forward field hospitals, credit for saving hundreds of lives. 

EDGAR: The chances that America's sons and daughters are going to come home alive from these deployments are better now. They're doing a great job out there. 

NISSEN: Beth Nissen, CNN, San Antonio. 

(END VIDEOTAPE)

BROWN: We'll wrap up this special edition of NEWSNIGHT in just a moment. 

(COMMERCIAL BREAK)

BROWN: We've got a couple of minutes. Let's talk about a couple of things. We've seen the devastating injuries that many of these young men and women have suffered. We've seen the kind of medical care they get. What kind of emotional care do they get? Because some of these injuries, the burns, the amputations, have profound emotional impact. 

NISSEN: It's interesting, the figures out of Landstuhl, the No. 1 category of injury being treated is fractures. No. 2 category is psychiatric disorders. People who are so disturbed by what they've seen, that they need to be medivaced out of the field of combat. When you're in the wards at Walter Reed, at Brooke Army Medical Center, you would expect a certain level of depression, of anger, even of bitterness. That often happens in the days immediately following injury and often happens years later. But in the weeks following injury, there is enormous, heartening, good, positive attitude that comes out, almost unbelievably so. 

BROWN: This -- I remember this. One of the young men in one of the stories talks about he suffered this horrible injury. And he talks about feeling guilty that he's not with his unit. He really wants to go back with his unit. 

NISSEN: I make that a standard question I would ask every patient. If you could be transported anywhere right now, where would you go? And without exception, they said back to their unit, back to Iraq. Even ones who have suffered the most grievous injuries. 

BROWN: And will their care go on for as long as they need it? 

NISSEN: Yes, in the V.A. system, which is well equipped to do that and is a better system than its reputation would suggest. Many of these centers, like the spinal cord injury center located in Miami, are at the forefront of treating amputations and in developing prosthetic devices. 

BROWN: Thank you for your work tonight, and thank you for your work on this series of stories, which I think has touched all the people who watched the program over the last six months. They've been extraordinary. 

NISSEN: Thank you. 

BROWN: Thank you, Beth Nissen. Good to have you with us tonight. That's our report. We'll see you again next time. Until then, good night for all of us at NEWSNIGHT.

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