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Memorial Day – California Society of Plastic Surgeons Keynote Address

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May 27, 2013

Lafayette Hillside Memorial - Lafayette, CA

Lafayette Hillside Memorial – Lafayette, CA The 2007 photo in Wikipedia has 3569 crosses. The picture above was taken this morning, Memorial Day 2013. Currently there are 6749 crosses, each representing a soldier who has lost his life. Click on picture above to visit the Lafayette Hillside Memorial Wikipedia page.

The annual California Society of Plastic Surgeons (CSPS) meeting in San Francisco wraps up today, on this Memorial Day weekend. The most impactful presentation by far was the Keynote Address. Warning: some of the details of the talk, even without the pictures, are graphic.

CSPS Keynote Address

This year’s keynote address, was the inaugural Garry Brody, MD Family Lecture. Dr. Brody himself made the selection, and provided the introduction for a presentation perfect not only for the audience of California Plastic Surgeons, but for the Memorial Day weekend. I commend Dr. Brody on his excellent choice.

Remembering Memorial Day

I’ve written about Memorial Day before in the post: Remembering on Memorial Day. While the holiday is in honor of those who have died in the service of our country, the CSPS Keynote focused on those wounded warriors who went to the brink, and who were brought back by a highly skilled and dedicated team of professionals. Soldiers, as close to death as is possible, are healed to the best of man’s ability, by an extraordinary collaboration of humans and machines.

Military Trauma Care

When you think about Plastic Surgery, military trauma care is likely not your first or even second thought. It is certainly a far cry from my Walnut Creek Plastic Surgery practice, but military plastic surgeons are called upon to repair some extreme injuries. For example, the injury from an IED (improvised explosive device) makes the horrible injuries that kept me up all hours during my general surgery training in Sacramento and Stockton seem quite manageable. IEDs are extremely powerful, and account for many of the injuries seen in Afghanistan to soldiers and civilians alike.

A Real Hero

Enter our keynote speaker: plastic surgeon Dr. Ian Valerio, MD, MS, MBA, LCDR, MC, USN ( <- all those letters mean something important! ). His very graphic presentation shed light on how our most seriously injured soldiers are cared for. He covered everything from the battlefield injury through recovery. The military's planning for stabilizing, evacuating, treating and rehabilitating our wounded warriors is extraordinary, and second to none. He has personally helped our soldiers everywhere from forward operating hospitals to stateside. But you may be asking, "How does a plastic surgeon contribute?"

How a Plastic Surgeon Contributes

I don’t have enough space here to describe even the small number of examples of care included in Dr. Valerio’s presentation. As a member of the military, he not only puts other soldiers back together, but he is a soldier himself. He performs doctor duties as well as guard duty, and I would not mess with his surgical tech either. She’s in charge of a 50 caliber machine gun.

As a doctor, he is required to care for insurgents as well as coalition troops. One photo, showing a well armed soldier seemingly out of place in the operating room, makes perfect sense when the patient may well wake up and try to kill his doctors. These are hostile conditions.

Salvaging Limbs

Salvaging Limbs, a brutal term for trying to patch up the worst extremity injuries. Plastic Surgeons work with Trauma Surgeons, Neurosurgeons and Orthopedic Surgeons, to save life and limb. Plastic surgeons, like Dr. Valerio, and many others at our nation’s military hospitals home and abroad, are called up to reconstruct soft tissue coverage (muscle and skin) from head to toe, and improve the function of the body, especially the function of injured limbs.

(reader caution advised) One particularly graphic example was of a soldier hit by an IED. His legs were blown-off, and not salvageable. Additionally, his hand was severely injured, including the loss of his thumb. One of my mentors, and the “The Father of Microsurgery”, San Francisco Plastic Surgeon Dr. Harry J. Bunke, would have been particularly proud. Dr. Bunke was the first to describe transplanting the great toe onto the hand to replace a lost thumb. Dr. Valerio saved the soldier’s great toe, and transplanted it temporarily onto an uninjured area of the forearm. Upon returning to the US, the hand was properly prepared to receive the toe as a replacement for the soldier’s lost thumb. This may seem gruesome, but a hand without a thumb is only half a hand, while hand with a great toe transplantation is a hand. With time the great toe thins and looks more and more like a thumb, and with careful rehabilitation, the hand can function nearly normally.

Honoring Those Who Have Made the Ultimate Sacrifice

I want to say, “Thank you.” Thank you to our military families, and to all those who have made the ultimate sacrifice for our country. If you are wondering what you can do to help, there are many options. Simple things like saying thank you, attending a memorial service or just hanging a flag up for the day are appreciated. There many ways to contribute time or money to non-profits that support our troops and their families. One such group I support is the Navy Seal Foundation, but there are many others.

If you are looking for somewhere to pay your respects today, check you local news for a tribute near you. Below is a list of some of the Memorial Day Celebrations from around the Greater San Francisco Bay Area going on today:

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