Museum exhibit looks at advances in prosthetics since Civil War

Monday, August 28, 2006
Museum exhibit looks at advances in prosthetics since Civil War
Visit the Soldiers & Sailors National Military Museum Memorial

Marine Cpl. John Chmill, who is one of more than 20,000 soldiers wounded since 2001 while serving in Iraq and Afghanistan, stands on his porch in Carrick next to his Marine flag.

By Paula Reed WardPittsburgh Post-Gazette

U.S. Marine Corps Cpl. John Chmill was driving a personnel truck loaded down with about 30 troops along a road in Ramadi, Iraq, when he pulled around a bend and saw a police car sitting in the island in the middle of the road.
Before he knew it, the car crashed into the truck -- his side -- and blew up, setting off a fire ball and flying shrapnel that left Cpl. Chmill without his left eye and three fingers on his left hand.
"I remember glancing at my hand in the truck," he said. "My fingers were still there, but barely connected."

A prosthetic arm from 1880. This arm can not only be flexed at the elbow, it also has hidden springs inside the fingers. It is among replacement limbs going on display at Soldiers & Sailors National Military Museum and Monument.

He was 22 years old, single and "disfigured for life."
"That was the first thing I thought about when it happened," said Cpl. Chmill, recounting that November 2004 day. "Then I thought, I've got to get out of this truck before I worry about being single for life."

He climbed out of the truck's turret and lay on the ground until someone came to his aid and he was taken back to his base. Later he was flown to Baghdad, then Germany, then to the National Naval Medical Center in Bethesda, Md.

He now has an acrylic eye that he can put in or take out in mere seconds, and he's waiting for a prosthetic hand that will give him better use.
Cpl. Chmill is just one of more than 20,000 soldiers who have been wounded fighting in Iraq and Afghanistan since 2001. Of those, 460 have undergone amputations, and of those, at least 78 have lost multiple limbs.

On Friday, Soldiers & Sailors National Military Museum & Memorial will hold the grand opening for its newest exhibit, "Beyond the Battlefield," which looks at what soldiers like Cpl. Chmill face after returning from battle with missing limbs.

The display -- spread between two large glass cases -- features prosthetic limbs that date to the Civil War, the tools field surgeons used to remove damaged body parts, and interesting facts about how prosthetic technology has changed.

Though prosthetics dating to the Middle Ages have been found, it was during the Civil War, when some 180,000 amputations were performed, that replacing those lost limbs became a regular practice, said Drew Buffat, the director of prosthetics for De La Torre Orthotics and Prosthetics Inc. in Blawnox.

A poster titled "The Empty Sleeve" is part of the exhibit. An empty sleeve was regarded as a badge of honor during the Civil War.
The human cost of war.
The likelihood of surviving battlefield wounds, as cited by the American Academy of Orthopaedic Surgeons:
69.7 percent in World War II.
76.4 percent in the Vietnam War.
90.4 percent in the current war in Iraq.
As of Thursday, 2,610 American troops had been killed in Iraq, and 19,609 had been wounded; 328 had been killed in Afghanistan and 879 had been wounded.
Source: U.S. Departmentof Defense
Back then, he said, replacement arms and legs were made of wood and were heavy and cumbersome.

"From that point on, it was a slow progression of advancement," Mr. Buffat said.
In the 20 years he's been in the field, Mr. Buffat said, he has seen materials evolve from wood and plastic to carbon fiber and titanium. Where there used to be only two or three kinds of prosthetic feet available, there are now 40 or 50 different models.

"The war in Iraq has really brought it to the forefront again," he said.
Computerized microprocessors that are available now can control the hydraulics in prosthetic limbs to provide "stumble recovery" and help prevent the wearer from falling.
"There's a lot of thought that goes into each step," Mr. Buffat said. "They're not as mentally exhausted from worrying about falling."

Though much has changed in the technology of prosthetics, what hasn't changed is the adjustment returning soldiers must make to cope with their lost limbs.
There are physical problems to overcome -- often the skin around the remaining stump is sensitive and can break down easily under a prosthesis, sometimes requiring more surgery. And there are emotional problems to overcome -- feeling like less of a person and coping with the loss of independence or mobility.

In Pittsburgh, there are only four amputees from Iraq and Afghanistan receiving treatment at the VA Pittsburgh Healthcare System, said Dr. Katherine Flood, a staff physiatrist, or physician who specializes in physical medicine and rehabilitation. There are many more, though, from World War II and Vietnam who are treated there.

Amputees returning from current world conflicts, though, are often not limited only to losing limbs, Dr. Flood said. Many are blind or suffer from traumatic brain injuries.
For any soldier returning with such serious problems, one of the most important factors in recovery, she said, is having a strong psychological and social support system. Under those circumstances, the person can often achieve recovery in a year or two.
"I think people are incredibly adaptable," she said. "It's a marvel to me."

On the spectrum, adjusting to the loss of a lower limb is done more easily than losing a hand or arm, Dr. Flood said.
The reason, she said, is that the foot and leg are used for gross motor skills, while the hand has sensory input, which is harder to compensate for with a prosthesis.
For Cpl. Chmill, adjusting to losing a large portion of his left hand was much harder than accepting that he had lost an eye. He has trouble gripping with his left hand, which makes tying his shoes and opening jars and other containers difficult.
Cpl. Chmill can drive a golf ball 150 yards -- not something, he said, that will get him on the PGA Tour, but pretty good nonetheless.

Carolyn Haser, artistic director at Soldiers & Sailors National Military Museum and Memorial, looks over the "Beyond the Battlefield" display, which will have a grand opening Friday with a wine and cheese reception.Click photo for larger image.
He recently bought a house in Carrick and is a senior at the University of Pittsburgh, majoring in communications and economics.

In September, he's scheduled to have plastic surgery to try to remove some of the "tattooing," or blue scarring around his lost eye.
"You can tell they want to ask questions. A lot of people are curious what happened. A lot of people are afraid to ask," Cpl. Chmill said. "People are really nervous to ask the wrong question and offend you, which I don't mind, because I'd be curious, too."
Unlike during the Civil War or World War II, today's soldiers are in a gross minority, said George Wunderlich, the executive director of the National Museum of Civil War Medicine in Frederick, Md.

Many people may not know a single soldier fighting in Iraq, he said.
"What we see today is less of a personal connection with these men," he said. "They're not always people we know."

In the World War II generation, for example, it wasn't unusual to see a young man missing a limb or disfigured from his injuries.
"We don't have the experience in dealing with it anymore like we did before," Mr. Wunderlich said.

But, one thing that has evolved -- at least since the turmoil of the Vietnam War -- is that people are able to separate their distaste for war from the individual warrior.
Cpl. Chmill has experienced nothing but positive reactions since his return.
"I think the amount of respect I've been shown is amazing," he said.
That respect and gratitude is what the exhibit at Soldiers & Sailors is designed to elicit, said Carolyn Haser, the artistic director there.

"At Soldiers & Sailors, we remember those that gave their lives, but we have to remember the boys who come back," she said. "I hope, if anything, it inspires someone to thank a vet."

"Hopefully, we have a generation that looks on these people and appreciates the sacrifice," added Ron Gancas, president and chief executive officer at the museum.
The grand opening for "Beyond the Battlefield" at Soldiers & Sailors National Military Museum & Memorial in Oakland will be from 5:30 to 7:30 p.m. Friday. It will include a wine and cheese reception as well as a presentation by the museum president and CEO.