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thedrifter
08-09-09, 08:24 AM
MILITARY: Marine Corps lifts veil on 'live tissue training'

Valley Center grove hosts wounding, repairing of pigs later euthanized

MARK WALKER - mlwalker@nctimes.com | Posted: Saturday, August 8, 2009 8:20 pm

Marine Capt. Doug Verbaauw laid on the ground with his right ear pressed to the snout of "General Dude," a pig he and five of his men were attempting to keep alive.

Verbaauw listened intently to make sure the 140-pound animal resting on a litter beneath camouflage netting was still breathing after he five other Marines applied tourniquets and dressings to several deep cuts.

"Come on buddy, stay with us," Verbaauw urged the pig, announcing a short time later to his men that their "patient" was OK.

Verbaauw, a veteran of two Iraq deployments, and two dozen other Camp Pendleton infantry troops were on the last of four days of combat trauma training that culminated with the purposeful wounding of anesthetized and unconscious pigs at a Valley Center avocado grove.

When the day was done, more than a dozen pigs had been sliced open, shot and suffered partial amputations in the "live tissue" training exercise the military maintains is invaluable preparation for saving lives on the battlefield.

No pigs ever regained consciousness during the exercises and none appeared to be in distress, a result of massive doses of the anesthesia and pain killers that block their nerve signals.

Medics and front-line troops who have had the training maintain that using pigs to simulate battlefield carnage from bullets and the roadside bombs that are ubiquitous in Iraq, and in Afghanistan, provide the best preparation to save lives.

Animal rights groups and others disagree, contending it's inhumane and unnecessary in this high-tech age when sophisticated mannequins and simulators are available. One of the groups, People for the Ethical Treatment of Animals, says it is organizing a public protest for Wednesday at the main gate into Camp Pendleton.

Veil lifted

The Marine Corps last week agreed to lift the veil on its version of the controversial training that has been quietly taking place in North County since 2006.

That quiet was shattered last month when a noise complaint was filed against the avocado grove owner, Escondido police Officer Dave Bishop, a retired Marine 1st sergeant who allows use of his 17-acre hilltop property free of charge.

"I can't do enough for these young Marines and this helps saves lives," said Bishop, who also is a member of the Escondido police SWAT team and has undergone the training. "I could care less about political correctness."

The complaint stemmed from simulated battled sounds used in the training. It also led to inquiries that revealed what's been taking place on Bishop's grove, resulting in Camp Pendleton officials and the private company that provides the training, Deployment Medicine International of Gig Harbor, Wash., to invite three reporters to attend its classes and observe what takes place with the pigs.

The access came with two stipulations: No photographs of the swine or Deployment Medicine instructors or use of their names, the latter condition intended to protect them from harassment by opponents of the practice.

Deployment Medicine is one of a handful of private contractors in the U.S. providing the training to Marine Corps, Army and Special Forces troops. It averages $6 million to $10 million a year in contracts, a company official said, including a $1 million contract with Camp Pendleton to train more than 1,300 Marines and sailors this year.

The company conducts the training on private land because those in charge of the 125,000-acre Camp Pendleton decided when it began that they wanted to keep it off the base to avoid animal rights groups massing at their gates.

'Absolutely vital'

While the Marine Corps and Deployment Medicine staunchly defend the use of pigs, the discovery that the "live tissue" training was taking place in a pastoral, secluded agricultural area is fueling a local controversy on what until now had been a more academic debate over its appropriateness.

That debate is as intense today as when it began, with opponents pointing out that only 5 percent of U.S. medical schools use live animals and increasingly rely on mannequins and simulators.

Opponents just last month petitioned the Defense Department to ban the use of live animals. A group of congressman, including Rep. Bob Filner, D-San Diego, also recently wrote the Pentagon asking for a report on the use of live animals and asking why mannequins and simulators aren't enough.

In a written statement Friday, a Defense Department spokesman said it closely monitors all training using live animals.

"The DOD takes animal treatment issues very seriously and we go to great lengths to ensure all animals involved in DOD-funded research or training receive humane care at all times," U.S. Navy Cmdr. Darryn James said.

"Our policy is to minimize the use of animals whenever possible, and alternative methods such as computer simulations are used extensively," he said. "However, these alternatives do not always provide the best results needed for DoD researchers and medical personnel to save the lives and prevent injuries to our troops."

The Marine Corps agrees with animal rights activists to a point, using a variety of realistic mannequins inside a mock Camp Pendleton triage station as part of its training. But it is also steadfast in the efficacy of the "live tissue" training, saying that nothing can replace the physical and psychological reality of treating maimed pigs that have been shot, sliced and stabbed.

"It's absolutely vital to prepare troops for what they are going to see on the battlefield," said Cmdr. Brian Schumacher, the 1st Marine Division's top medical officer. "We need to baptize them and show them what they could encounter. As much as simulators are good, they don't capture the reality of a true-life situation the way this training does.

"You can't replicate the visceral feeling with a simulator."

Almost the real thing

But simulators are an integral part of the training. On Wednesday, a group of freshly minted Navy doctors got a taste of the chaos of treating battlefield wounds at a mock aid station on Camp Pendleton, another aspect of the combat trauma training.

Several mannequins, each costing about $80,000, sported a variety of wounds needing immediate attention. As the doctors rushed into the darkened station ---- complete with simulated smoke, pounding noise and shouts from the trainers ---- they were sprayed with faux blood.

Illuminated only with light sticks, the doctors were split into teams to assess each patient and stop massive blood flows and repair blocked airways. Not all succeeded, and one doctor who in effect gave up on one patient to treat another later was sharply chastised.

"I would never walk away from a wounded Marine," the trainer, Corpsman Andrew Chase, told the doctor.

Chase and 19 other combat-experienced corpsmen train new corpsmen for the 25,000-member 1st Marine Division as well as visiting military medical students and physicians.

"We can simulate things to an extent, but you can't replace the live tissue training," Chase said. "I know people think that it's terrible to be using pigs, but they're giving their lives for us and we respect that."

Empowerment

The vast majority of battlefield injuries are penetrating wounds from bullets and bomb fragments, unlike the civilian world, where about 70 percent of patients brought to trauma centers are suffering from blunt force trauma, most a result of motor vehicle accidents, according to Deployment Medicine instructors.

The classroom work included pictures of severely wounded troops and were shown, instructors said, not for the shock value but to help prepare the infantry Marines for the horrific sights they may encounter.

"This is a warfighter empowerment course," an instructor named Kato told the troops on the opening day of their course work. "When you guys leave here, you will be ... experts in hemorrhage control."

And that's crucial when massive blood loss is the chief killer in Iraq and Afghanistan.

The classroom work focused on proper use and application of tourniquets and clearing breathing passages. Instructors repeatedly stressed that the types of wounds suffered in combat are far different than the bulk seen in hospital trauma centers.

The troops repeatedly practiced with tourniquets, eventually reducing the time to apply them from about 2 minutes to 30 seconds.

They also learned that large, gaping wounds can be repaired with pressure, gauze and clotting agents.

"A gauze applied without pressure is nothing more than wound decoration," Kato told them. "If there's no gauze available, use strips of a shirt or socks. Pack the wound to the bone."

He repeatedly urged speed in attending to a wound.

"In bleeding, there's the quick and the dead," Kato said. "If you're not quick, your buddy is dead. Be deliberate, be aggressive."

'Warfighter brother'

When they arrived at Bishop's property Thursday morning, the Marines and a dozen doctors who also attended found fully anesthetized pigs laid out on litters. The pigs, most 3 to 5 months old and purchased from local livestock farms, were wrapped in foil-like blankets to maintain their body temperature.

Deployment Medicine teachers such as the colorful Kato, a Special Forces veteran, said in his classroom lectures and again Thursday that the pigs should be considered a "downed, warfighter brother" and treated with the utmost respect and honor.

"The wounds you see today will mimic exactly what you see downrange," Kato said in reference to the battlefield.

The Marines and a group of 12 doctors were split into teams and encouraged to name their pigs to personalize them, hence the naming of General Dude and in another case, Private Ryan.

The morning exercises included slicing femoral arteries in the groin and having the troops work as fast as possible to stop the bleeding. It also included working to plug "sucking chest wounds" and dealing with exposed entrails by washing them with water and repacking them inside the pig and dressing the wound.

"Mannequins don't bleed like this," Kato said during a break. "This is the money part of the instruction and why live tissue training is so important."

Kato said teaching troops to overcome "blood fright" and work as a team in an "intimate ballet" to treat a casualty is his reward.

"It's all about hard-wiring these guys," he said.

In the afternoon, the troops dealt with battlefield scenarios while dressed in full "battle rattle" with their protective vests and Kevlar helmets. Deployment Medicine instructors took a fresh batch of anesthetized pigs, placed them in a steep area of Bishop's grove and administered a variety of gunshot wounds that a company official said mimicked bomb injuries.

The exercise was a simulation of penetrating wounds that under the scenario were said to be the result of a suicide bomber. The Marines, sweaty and straining from the heat and weight of their gear, were ordered to respond to the bombing, assess their "patients" and treat the wounds.

After a couple of minutes, they were told to move the wounded because of an impending attack, a simulation of "care under fire." They lifted their litters and moved about 150 yards uphill to a shaded area, where each pig's wounds were reassessed and an officer went from litter to litter to fill out a report that would be handed over when the wounded were evacuated to aid stations.

As the field training neared an end, Verbaauw said it was an invaluable experience and summed up what instructors and Marine Corps officials say is their ultimate goal.

"I feel a lot more confident that I will be able to help save injured Marines," he said. "I'm not going to be freaking out so much."

Call staff writer Mark Walker at 760-740-3529.

Ellie