A trip from Iraq aboard a flying ICU

LANDSTUHL, Germany -- On the five-hour flight from a frontline airfield in Iraq to a US military hospital in Germany, a dozen doctors, nurses and therapists attended to the badly wounded ABC News anchor Bob Woodruff and cameraman Doug Vogt.

The medical team formed a mobile intensive care unit toward the rear of the giant C-17 Air Force transport jet to care for the injured journalists throughout the trip, monitoring their heartbeat, breathing, and blood pressure.

Woodruff's and Vogt's wounds from a roadside bomb north of Baghdad on Sunday are typical of those suffered by the US military in Iraq. The journalists' swift transfer from the battlefield to more sophisticated medical care in Landstuhl highlights a new emergency medical process that officials say has dramatically reduced combat fatalities during the Iraq war.

''What you saw is why these two guys are alive, and why so many of our soldiers are still alive," said Dr. Laurence Ronan, a Massachusetts General Hospital internist who was on the flight that carried Vogt and Woodruff out of Iraq. ''It is amazing, cutting edge medicine."

A Globe reporter and photographer were given access by the US military to observe the emergency treatment process last week on their way to Iraq with Ronan, and traveled out of Iraq on the same flight that evacuated Woodruff and Vogt.

The US military hospital commander at Landstuhl, Army Colonel W. Bryan Gamble, said yesterday that the two journalists were ''very seriously injured but stable," and were undergoing further tests to determine treatment.

Gamble, a surgeon, said a new approach called a Critical Care Air Transport Team was developed to treat those wounded in the Iraq war and care for them during their transfer, with the goal of greatly diminishing the time between battlefield injury and treatment in specialized trauma facilities and, ultimately, the United States.

''They take people who couldn't be evacuated in prior conflicts," said Gamble. ''The idea is to get people here, to a highly technical trauma center, within 24 hours from the time they were hurt. Then the goal is to get them evacuated to the States within 48 to 72 hours. It involves all four branches of the military. It is the model of integration."

Gamble said that during the Vietnam War it typically took about 45 days from battlefield to a US hospital. Today, that process is down to a few days, he said.

Gamble said that of the roughly 30,000 injuries the Landstuhl hospital has treated during the Iraq war, about 5,000 of them were serious combat wounds. That compares to about 4,700 total casualties during the Gulf War, most of which were accidents related to moving troops in and out of the region, he said. Gamble said the hospital in Landstuhl, which treats military members and civilian contractors from coalition countries, treated more than 180 casualties in a single day, after the United Nations complex in Baghdad was bombed in August 2003.

On Sunday, Woodruff and Vogt were traveling in a convoy near the town of Taji, 25 miles north of Baghdad, riding in a US-armored Humvee before transferring to an Iraqi mechanized vehicle at the head of the convoy. They were filming from the rear of the vehicle when the bomb went off. Both sustained head wounds, and Woodruff suffered other broken bones.

They were rushed to the Combat Support Hospital at Balad, 50 miles north of Baghdad, one of five such hospitals in Iraq.

They were stabilized and prepared for the flight to Landstuhl in a matter of hours. Gamble said the typical military patient spends only about 48 to 72 hours in Landstuhl before being transported, again by C-17, to Andrews Air Force Base and then Walter Reed Hospital in Washington, D.C.

Gamble said Woodruff and Vogt would be transferred to ''the best possible facility for their wounds in the United States," but said it was not clear where that would be.

At the military base, ABC news producer Vinnie Malhotra stood somberly to one side as doctors and nurses strapped his two colleagues in for the flight. Their heads were swathed in white gauze, and they were heavily sedated. ''They're hanging in there," said a distraught Malhotra, who was working with Woodruff and Vogt when the roadside bomb hit their convoy and accompanied them on the flight.

The flight also carried a soldier who was seriously wounded in an attack in Mosul and 14 other less seriously wounded US soldiers.

Gamble, 49, was less than clinical in explaining the medical care given to soldiers on a regular basis, and the treatment given to Woodruff and Vogt yesterday.

''This is how we love them," said Gamble. ''This is how we take care of our warriors."

Gamble said each patient at the hospital is given a quilt handmade by volunteers, most of whom are from the United States. He said morale was high, and the staff unusually motivated. He said of the 328 Army reservists who just spent a year working at the hospital, 110 have volunteered to stay on an extra year, while about 50 have volunteered to stay on a third year -- leaving behind more lucrative jobs in the United States.

''We have people here who come in on days off. I can't help but be humbled by what goes on here," said Gamble, who grew up in Trumbull, Conn., and describes himself as the son ''of a guy born and raised in Waltham, and a mom who was two-toilet Irish from Jamaica Plain."

Gamble had just taken a break to visit his family in Virginia over the weekend when he learned of the injuries to Woodruff and Vogt while watching television. He jumped on the next flight to Ramstein Air Base to return to the hospital to oversee their treatment.

Surveying his humming hospital last Thursday, Gamble reflected on the differences in medicine, and responsibilities, since his five-year surgical residency at St. Elizabeth's Hospital in Brighton in the early 1980s.

''You know," he said, hands on hips, ''it's a long way from St. E's."