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A Fighting Chance

This segment was originally broadcast on Oct. 29, 2006. It was updated on June 28, 2007.

Twenty-first century science and old fashioned guts are revolutionizing combat medicine for our troops. In Iraq, the medical units made famous by "MASH" have been retired in favor of new combat hospitals set up in the midst of the action.

One thing that hasn't changed though is the courage of the medics, doctors and nurses who are saving lives like never before. Last year, 60 Minutes correspondent Scott Pelley went to see the action up-close. The team came across two wounded Americans, Marine Corporals Kenny Lyon and Brad Fulks.

You wouldn't have expected either to have survived what happened to them. Their families agreed to let 60 Minutes tell the story of how today's combat medicine gave both men a fighting chance.

Kenny Lyon, from Maryland, was one gifted mechanic. He was outside, trying to fix his broken down armored vehicle, when a mortar exploded. By the time he reached the hospital, half his blood was gone already.

His pressure was critically low and his life was slipping away though three lacerated arteries and too many wounds to count.

Shrapnel had torn into his head, neck, both legs, and both arms. His left foot was turning white because there was no circulation.

"It's a battle, y'know. Sometimes people are fighting to die on the table desperately," says Paulette Schank, a lieutenant colonel in the Air Force Reserve. Back in the states, she's a nurse-anesthetist in a hospital near Philadelphia.

"Did you say that some people come in fighting to die?" Pelley asks Schank.

"Meaning their body is going further and further down the wrong direction," she explains. "They need us to be able to resuscitate them so we can stop that negative spiral downward so that we go back to the spiral of life."

Schank supervised the operating rooms of the Air Force theater hospital. This is the war's busiest trauma center, an encampment of 32 tents on the Balad Air Base north of Baghdad.

The 332nd Expeditionary Group has 400 staff and more than 300 trauma patients a month. To be close to the patients, the hospital is close to the battle. In the background, the sound of incoming helicopters with wounded soldiers onboard beats against the tent canvas like an alarm.

Asked whether she feels a sense of dread about what she is going to face once the helicopter lands, Schank says, "I think of it more — it's the next challenge that's coming though the door. To ward off that ugly death man who wants to take away your person and it's your job to make sure he's not successful today."

The day Kenny Lyon was wounded another Marine, Brad Fulks, was hit by a roadside bomb. Fulks is from West Virginia, a two-time state boxing champion suddenly in the fight of his life the day before his 23rd birthday.

Cpl. Fulks made it to the Army's 10th combat support hospital in Baghdad.

Lieutenant Colonel Warren Dorlac flew in with a team just for Fulks. Dr. Dorlac is chief of trauma at the giant American Medical Center in Landstuhl, Germany. He's one of the military's top doctors. He came himself because of Fulks' condition. Fulks lost a lung, his kidneys are failing, and half is body is burned.

"I think his overall prognosis, just from his burn alone, is actually very good," Dorlac says, even though Fulks was burned extensively. "The problem with this patient is that he has a number of other severe injuries—the biggest being the problem with his one lung."

As sick as Cpl. Fulks is, Dorlac is moving him to Germany. The life support gear the medical staff uses is so advanced, some of it isn't available in the United States yet. And at the same time Fulks is flying to Germany, special medical teams from Texas and Maryland are flying to Germany to meet him.

"At what point do you say to yourself, 'We can't save this life'?" Pelley asks Dr. Dorlac.

"You know, we don't make that decision. We go full court press on everybody," he explains.

That full court press starts with the quick response of MedEvac helicopters, in essence flying emergency rooms. Staff Sergeant Danny Stevenson is a flight medic with the Army's 57th Medical Evacuation Company. Back on September 11th, 2001, he was a staff medic at the Pentagon, treating the wounded. After 9/11, he asked the Army to send him overseas.

"They called you, you don't have back up. You are the back up. So if you can't get the job done nobody else can. It's a lot of pressure. And I can handle that kind of pressure," Stevenson says.

Helicopter units like this are spread out all over Iraq so that no injured man or woman is more than 20 or 25 minutes from their reach. It's all about what the doctors call the "golden hour," that first hour after injury, when a Marine or a soldier can easily bleed to death. Speed is everything.

The MedEvac helicopters are sometimes fired on. And there's always the possibility of ambush on the ground.

Asked if he ever gets scared, Stevenson says, "I don't get scared."

"No, come on now. Everybody gets scared," Pelley says.

"I mean some stuff freaks me out sometimes. But I mean if you freak out on the scene, you're just going to lose control of it. And if you lose control of it, you're gonna die," he says.

"No one dies on the back of my helicopter. I'll do CPR all the way until the end. They die in the hospital. And that's where it stays," Stevenson says.

He vows to keep the injured alive. "I breathe for 'em, I beat for 'em, I do everything I can for 'em."

Back in the hospital, Kenny Lyon, the mechanic from Maryland who had lost so much blood, had moved into the operating room.

Five surgeons worked from head to toe. They pumped in blood, 10 units, 20 units, 30 units and more. They couldn't stop the bleeding in his left leg. Nurse Paulette Schank watched the amputation.

"It's ugly. This is the ugly side of war. But at least they can control the bleeding now. At least he has a better chance of survival," she says.

It is a better chance but Lyon ran through all the blood they had. A call went out for donors.

Schank was first in line. "Our job is to resuscitate to allow the surgeons time to stop the bleeding. And you try but it's so hard. And sometimes you're not successful and it hurts. You feel like you let that soldier down, you know. The wicked death spiral won in that event and you fought so hard, we fight so hard against him winning and sometimes he wins," she says.

Maybe it was Schank's blood that made a difference. But more blood bought more time, and Lyon's surgery would go on for hours.

That same night, Brad Fulks, the fighter from West Virginia, was loaded onto a C-17 cargo plane, rigged for intensive care, and bound for Germany.

Fulks was improving. "Actually from the time we picked him up at the combat support hospital, slowly along the way he's been continuously improving," says Dr. Dorlac.

Some patients, sedated, will never know they were on the flight — others can't seem to leave their memories behind. The setup on these planes is a big innovation. Doctors have even performed surgery onboard. In Vietnam it took about 40 days for the wounded to get to the states. Now it's as little as three days.

Back in the hospital, Pelley found that nearly half the patients aren't Americans at all. Many are Iraqi civilians, like a boy named Anas, who was wounded in a bombing, and a teenage girl who came in with a head wound. They took her to the CT scanner and found shrapnel had cut across her brain. There was nothing they could do for her but offer a last touch before dying.

60 Minutes found Anas a few days later. He was doing much better under the care of Dr. Adnan Rabie, an American who grew up in Iraq.

"It is very sad, actually, to see all of these casualties of war. Innocent people. But that's a heavy price this country paying for peace and democracy, I think," Dr. Rabie says.

Asked if he thinks it's worth it, Dr. Rabie says, "I think so."

"Not for – in this generation. Maybe for the next generation," he says.

Brad Fulks, the burned Marine from West Virginia, made it to Germany. Days later, he was well enough to fly to the Army Burn Center in Texas where he was reunited with his family. Dr. Dorlac says by that point, Fulks' care involved a dozen aircraft and maybe a thousand Air Force personnel.

"No one would want to, care to, put a price tag on this, but just to get a sense of the scope, it probably isn't unreasonable to believe a million dollars was spent on this young man to save his life," Pelley remarks.

"I'd say that's probably a good conservative number," Dorlac replies.

Still, all the effort wasn't enough. Eighteen days after he was wounded, Brad Fulks, like many burn patients, lost his life to an infection, leaving behind his parents and two sisters.

For Kenny Lyon, it's a different story – he got through his surgery. Within five days, he was back in the states. It has been hard and he has been lucky. Lyon was taken to the Walter Reed Army Medical Center in Washington, D.C.

He's working with an artificial leg, and has nerve damage in both arms. Part of his tongue is gone and a wire is holding his jaw together.

"How much do you think you're gonna get back?" Pelley asks.

"I'm gonna get everything back," Lyon says. "That's my goal right now. I'm gonna fight to retain everything I had before."

Asked how it feels to be in his skin right now, Lyon says, "I'm just happy. I love coming here every day and doing my therapy and pushing myself and every day I get stronger and better and faster and I can use my hands more and I'm having fun."

"You're having fun?" Pelley asks.

"Why not? What else am I going to do? I might as well make the best of my situation. I mean I'm better I'm alive. It's all down hill from here. It's all gravy."

Kenny Lyon joins nearly 9,000 Americans who have survived severe wounds in Iraq. The military says it's the best survival rate in history. But Paulette Schank told 60 Minutes it's not the survivors she remembers so much as the patients she has lost. Like a sergeant who died a few months ago — one of those who never quite leaves her.

"You've been defeated, you know, you've let that person down on the table," Schank tells Pelley. "I still talk to them up there and say 'I need your strength with me today. Sergeant so-and-so, I really need your strength with me.' And I'll say his name."

Schank says she remembers the names. At that point in the interview, the sound of a helicopter could be heard.

"And I'll think of my sergeant," Schank adds, preparing for the next patient.
Produced By Solly Granatstein

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