Steve Silberman has turned in a fantastic long feature for Wired Magazine in which he describes the way that the advances in body armor (which doesn't cover legs or arms) has created a new cohort of disabled veterans with missing or badly disabled limbs. Concomittant with this is the rise of terrible, chronic pain, something that is being treated with new technology that blocks specific nerve-endings. This is a disturbing, fascinating piece.
The blocks used by Buckenmaier and his team are made possible by the recent invention of small, microprocessor-controlled pumps which bathe nerves in nonaddictive drugs that discourage the transmission of pain signals. The pumps also can be used for weeks after surgery, enabling soldiers to adjust the level of medication themselves as they need it.
For soldiers evacuated from the battlefield, the advantages of nerve blocks over traditional methods of pain control are clear. The wounded troops flying in and out of Landstuhl are often in misery or a narcotized stupor, while those treated with blocks remain awake and pain-free despite massive injuries.
This new war on pain is the brainchild of John Chiles, the Army's chief anesthesiologist. "Places like Duke were doing great things with peripheral nerve blocks, but they had fallen by the wayside in the Army," he says. "I wanted us to be on the cusp of these advances." The Walter Reed program is supported by grants from the Murtha Neuroscience and Pain Institute, founded by the US representative from Pennsylvania. John Murtha, who was wounded in combat in Vietnam, visits the troops once a week at Walter Reed.
