Spring 2018

Crucible of Conflict


The Cost of Conflict Issue

  • by George Q. Daley
  • 2 minute read

It’s a paradox: in settings where lives are shattered, medicine improves.

Many have addressed this incongruity. Atul Gawande, MD ’94, for instance, wrote about it in an article penned more than a decade ago for the New England Journal of Medicine. Compared with this nation’s earlier conflicts, he noted, mortality rates for military personnel in Iraq and Afghanistan had decreased dramatically. In Vietnam, for example, 24 percent of those who sustained injuries died. By contrast, in Iraq and Afghanistan, only one in every ten military personnel who was injured perished. Mortality rates have improved over the years; a 2018 Journal of Defence and Peace Economicsanalysis finds that survival rates in Afghanistan are now nearly 92 percent.

HMS alumni who have served this country have been among those who, when faced with the traumas inflicted by combat, innovated and improved techniques in order to save lives. Those improvements were then used to advance patient care—and were passed along to new generations of physicians.

This dedication to serving medicine and country continues on our campus. Students like Joshua Caldwell, MD 2019, Jonathon Florance, MD 2020, Gregory Galeazzi, MD 2021, Zachary Johannesson, MD 2021, and Zheala Qayyum, MMSc 2019, are veterans of either Iraq or Afghanistan. Others, like Bridget Matsas, MD 2021, a graduate of West Point studying medicine on a military scholarship, intend to dedicate several years to military service after graduating from HMS. Many also carve out time to serve in the National Guard.

Recently, Florance, Johannesson, and Matsas helped found the Civilian-Military Collaborative at HMS, a student interest group that aims to make HMS a leader for civilian-military translational expertise in areas such as trauma care and humanitarian and disaster response. The students say the collaboration, like medicine and the military, allows them to work as a team, united in their commitment to selfless service.

Like so many of the HMS student initiatives I’ve had the privilege of witnessing, this collaborative is tied to a national movement, one that would integrate military and civilian trauma systems. This effort, enunciated in a 2016 report from the National Academies of Sciences, Engineering, and Medicine, aims to achieve “zero preventable deaths after injury” by ensuring that “lessons learned from the military’s experiences in Afghanistan and Iraq are sustained and built on for future combat operations—and that they are translated into the civilian system.” HMS leadership is in evidence in this initiative, too: The recommendations were crafted by a group led by Donald Berwick, MD ’72, and including Cato Laurencin, MD ’84.

At HMS, we pride ourselves on building leaders in medicine. But we also take pride in watching those leaders shape our profession, our nation, and our world.