Military Trauma Surgeon Rates 10 Battle Wounds In Movies & TV | How Real Is It? | Insider

Hey! Hey! Look at me! Now, the only thing I hate when they make

movies

is that every time you suffer some kind of injury to your torso, they make you spit up blood, and that doesn't happen. You don't vomit blood from getting shot in the stomach or anything like that. Hello, my name is Peter Rhee. I served in the

military

for 24 years and am a

trauma

surgeon

. I was one of the first

surgeon

s in Afghanistan. Today we will look at scenes of

battle

wounds

in

movies

and judge how

real

they are. This is a

real

ly good scene.

When that explosion occurred in slow motion, you could see the boot flying directly toward the camera. It's a little unusual from an injury standpoint. A projectile falling to the ground would rip off his legs that way. Because seeing bilateral thigh-high amputees has been a really recent injury that we've never seen before in previous wars. We didn't really see bilateral above-knee amputations. Before, in the other war movies, they stepped on Claymores and land mines. And those were actually meant to take off your foot and ankle, so the medics would come out, and then you would shoot the medics and cause more casualties.

So it wasn't actually supposed to be a fatal wound. Theirs was shattered below the knee, but it was obviously going to be similar to what we were seeing in Iraq, where they were just building these huge bombs and burying them in the ground. We only saw legs flying through the sky. I could last three hours with tourniquets. Blood loss is the number one preventable loss we want to avoid. Some of the soldiers even use tourniquets when they go out. In reality, what we are recommending and what we teach is that they put your own tourniquets on you.

Tourniquets are problematic because if you don't put them on correctly and if they aren't as tight as possible, you will bleed more and bleed out. When you put it on, you have to commit to it. You have to go deep. And I'm telling you, putting on a tourniquet will be the most painful thing you'll experience in about three or four minutes. It's like your leg falls off. So it is something that is done as a last resort. It will save lives, but you have to try. Otherwise, you will bleed more. Desmond: Here comes the morphine, here comes the morphine.

It's going to take effect very quickly, Ralph. Let's get you changed. In the old days, morphine was good. We got scared because morphine can definitely kill you. If you take a person who has low blood pressure, not much blood circulating, and then you give it to them, then it can depress your heart function and then you can die. You would also stop breathing. So we've actually abandoned morphine in the field. We use a new drug called ketamine. While it relieves a lot of pain, it does not reduce blood pressure. That's the reason we use it. Doctors can do a lot and are vitally important, but in many movies I think the audience doesn't understand that a doctor is not a

trauma

surgeon.

The trauma surgeon obviously went to medical school, did five years of general surgery and then two years of training as a trauma surgeon. So, seven years of training, as a neurosurgeon. The doctor's job is to deliver them to us. Not for holding things in the field. It's pretty good. I'd say he would give it a 9. Now we know that IV bags really hurt him. We no longer use crystalloid solutions in trauma, even when blood pressure drops. Studies have shown us that people who do not receive these IV bags have a better chance of surviving. If you give them that liquid, their blood pressure increases and then you bleed more.

Back then, that was the only way we did it. We are just finally recognizing that the salt water solution is nothing like blood. I think he put a mosquito clip in his mouth to do it. That was putting me off a little. I could see that doing it with bare hands is a possibility. We used to do a lot of this with our bare hands. And when I started my residency, we also did it with bare hands. So that's not too unrealistic. That area is called junctional bleeding and you cannot put a tourniquet on it. So we're still trying to come up with ways to stop the bleeding when you get shot in the groin or the armpit, because you can't put a tourniquet in the armpit.

I have it. It's coming back in! Wait! Wait! This was not a good scene for me. I have used it many times for training. The way they made the artery, clamping the artery, etc. For surgeons and people who do vascular surgery, it wasn't very realistic. It's kind of chaotic. Obviously someone had a flashlight on there. That's the reason we always have headlights on our heads. For the traumas that exist, it doesn't take much. You just need some basic retractors. You have to have good lighting. And then the second thing is you have to have suction. If you don't have suction nowadays, it's very difficult to work with just sponges and ways to absorb things.

For what I do, you don't need a lot of things. So that's a major problem. The

wounds

were fine. I would give this about a 6. Expectant. Routine. Priority. He's gone. It's a great movie. It's pretty well done. Triage in the field is very different than triage when you go to a medical company. You don't actually do much of this during the heat of

battle

. It's usually once the initial gunfight is over. There are four categories when we do the classification. So he went through all four. Dead, expectant, they need your help and then they will be fine.

The guy is screaming and yelling. If they're screaming, they're fine. So it's a routine. And then she had a boy who is a priority. And then that guy was already dead. Confirming that someone has died in a few seconds is not easy. I was in Ramadi when 200 people were bombed at once with a single bomb. 70 of these casualties came directly to us. I just entered, and everyone enters one by one. And I was the classification officer. The first Marine I met was expectant, but he couldn't be sure because he only had literally four or five seconds to decide if he was dead or not.

And there was no way we could use our resources to work on them. So what you are doing is trying to select the easy saves. So you don't want to spend too much time on it, which is very different from what we do in civilian trauma. In civilian trauma, we work with a tough team of 12 people on top of one person for hours on end. And that's not something you can do in the

military

. I would give it a 9. Jesus! Bring it inside! Bring it inside! I said put his guts in now! What they are trying to show is an evisceration.

Then, a guy was hit, they took enemy fire, high-velocity weapons, AK-47s, and they were hit. And then you gut your organs. They're trying to push it in. You can not do it. It doesn't work that way. The ones I saw were AK-47 exit wounds through a small hole the size of a plum. You will push everything because you feel pressure while grunting and moaning from the pain. And then you can't put it back in because it just comes back out. So unless they are chemically paralyzed by intubating them, it's a waste of time. In the case of penetrating wounds, when we talk about gunshot wounds and things like that, the main thing is to bring them to me as soon as you can and stop the bleeding.

If it's not your heart and major vessels, we can save you. If you don't hit them, we can repair the rest. Hey! Hey! Look at me! Now, the only thing I hate when they make movies is that every time you suffer some kind of injury to your torso they make you spit up blood. And that doesn't happen. Unless you get shot in the mouth or have something sticking through your cheeks and throat, high up. You don't vomit blood from getting shot in the stomach or anything like that. Ready! Let's move! The only thing I like is that they show how difficult it is to move a heavy body.

These are 200 to 300 pound masses that you must drag. And two guys doing these things is not that easy to do. I think that part is well done. You would never drop a bird when there is fire. And a bird is not going to come down to evacuate the wounded when they are going to shoot a 40 million dollar bird in the air. You will only land when it is a truly safe landing zone. I'd give it about a 6. Hawkeye: You operate a human time bomb while your life flashes in front of you, and you promise God whatever he wants if it keeps your patient from exploding in your face.

There they are applying spinal anesthesia. I like how he inserts the needle and how he injects. They did this in the Korean War. Back then they used a lot of regional anesthesia. OK. Get it out of here. So, he was obviously shot in the buttocks region, in the pelvis region, and he has a live round of ammunition there. So this is a real scenario. This happens. I think it's a rifle grenade they fired. And normally that wouldn't fit into it, because it doesn't have a sharp point or anything like that. But rocket-powered RPGs, as they call them, we actually had during the Freedom War.

There is a complete protocol about this. They are generally taken far from the hospital, in a fortified area. Take a volunteer. You say, "Who volunteers to receive this medal?" Because if you come out alive, you get a medal. And then you try to minimize the number of people who go out. The chances of it going off if it hasn't gone off at the time are small, but you want to minimize the risks of doing things like that. I think there was a story in 2006 in Afghanistan, Major John Oh, a medic who graduated from West Point, who had a guy with an RPG in his pelvis.

I think the grenade part wasn't there, but the tail was sticking out of it. They took a six-man team and took it out. Then that happens. My experience in the army, in the war, was exactly like "M*A*S*H." The mud, the dirt, the people, the stories were exactly like "M*A*S*H." And it was a lot of fun to be there helping the troops. You can help people who were injured. So that's the fun part. The clothes they wear, all of that is quite realistic. I give this one a 9 1/2. Yes, I hate this part.

If a guy at that close range shoots you with an AK-47 with a 7.6 bullet, that will destroy you. But I mean it was really peripheral. So somehow he received the slightest of injuries. But then they show that image of the right lower lobe's own disproportion with a little air. And what they're trying to show is something called tension pneumothorax. The lung collapses into a tiny thing. And then if the air keeps doing it, you get so much pressure that it pushes on the heart and the heart doesn't fill. Then your blood pressure drops and you could die from it.

That's what they're trying to imitate here. And this is really weird. Usually, if you have a hole in your lung, it bubbles out. Usually it is always full of blood and blood comes out. In a situation like that, you would have no breath sounds on one side and you would have them on the other. But we know that even with stethoscopes, doing this is very tricky. Because when you put it on the side that has tension, you can still hear the other side of the lung. So we've learned that that physical exam isn't very good. At that time during that war, they wouldn't have this Veress needle, that special needle that he was using in this scene.

There are many problems with that approach. It's a sharp needle. It can cause many injuries to the lungs. And the way he spins it, it doesn't really relieve it. And it wasn't the best. It had a three-way stopcock. That is a shape that has a valve. It is not an automatic valve. It is something that has to be opened and closed in one direction or another. Sitting with this hard needle in your chest and walking around fully awake and alert and tensing it every few minutes is very far-fetched. From a medical perspective, the way they did the wounds and all that, I'd give it a 2 1/2.

Stay with me. Talk to me, guys, talk to me. What happened? Oh shit, is that Kirk? There's some realism there. This is an outpost. This looks like an army. So, the base station of the Italian army. The military usually has a doctor or a physician's assistant. Usually with so many straps and stuff, the unit they're in, the housing unit they're in, is just paper thin. Then the bullets would go through there. They should be a little more fortified with Hesco's earthen barriers. You realize that the guy is trapping another guy because he's not breathing well and they're about to do CPR on him.

We don't do that out there. If they need CPR, it's a waste of time, because they need blood. Medevac won't arrive for a few hours, which means he needs fresh blood if he wants to live. This is the only thing we can do. We are not sterile and cannot test for disease. Our fresh blood is all we can do to save him. Gloves again, with bloody hands. That's not really realistic. They have gloves on right now. When I got out, we started doing this for the first time. In fact, we started using fresh, warm whole blood, which is miraculous.

It's incredibly miraculous. We can't do that in the civilian world, but we did do it in a mobile blood bank. In my unit at Ramadi Charlie Med, a shop with two surgeons, we also had 60 to 70 doctors with us. The base was about 600 people. So we went to the dining room and there was aguy yelling, "Walking blood bank." Everyone was spitting out their food, lining up at my medical company, and checking their ID badges. They lay down on the ground. They would prick them and take out a bag of blood. We would do a little test to see if they were compatible when we used it.

So from that perspective, it's true. There are too few mistakes they made here to dramatize it, and they can get away with it for most people. But you wouldn't walk up to them and give them your blood while standing and stuff like that. At least they're wearing the right uniform. So I give them 7. Take the plasma. Hey! Hey, give us a hand! It turns out that he miraculously has a plasma bottle and rubber tubes. That's what they use. Plasma bottle. It wasn't clear, normally it was a little yellow. Blood is drawn and then if you put it in a machine and spin it around, all the red blood cells are weighed.

They come out, and that's what we call, their concentrated red blood cells; a thin layer of white blood cells; and the rest of the water, which contains proteins, is called plasma. And it has all these proteins called factors, which also help stop bleeding. And it's a very, very good resuscitation tool, much, much better than using the IV bags, saline, and lactated Ringer's that we used in Vietnam. I like the idea that they introduced the plasma. I would give it a 6, 7. Medical: blood pressure 80 over 60, pulse 112, severe burns, dyspnea, signs of shock. We have to deal with enemy combatants.

We'd have Soldier A and the guy who shot Soldier A. We'd take care of both of them. We could take care of the civilians. I took care of 6 year old children with a large piece of metal sticking out of their neck. Fortunately, he did not touch her spinal cord. Burns from explosions are common. When there are civilians, they burn them. The military did not see many burns because, I repeat, you are always in the vehicles. The setup is pretty realistic depending on where you are. You know, they come in on stretchers like that. The field hospital has, you know, a ton of doctors and triage and care areas compared to a very small area forward.

Two ring units in the field, 5 milligrams of morphine administered. Where is it burned? The total body surface area burned, I estimate 45%. The acting, the tremors, the seizures. I don't know what that was all about. You would see a person who has burns on the thoracic and front extremities, which is quite severe, probably closer to 80%, 90%. But then he asks the other guy where he was burned. He's looking at the person and the guy says "legs." Well, it's obvious to the viewer that he's burned out, you know, everywhere. The dialogue wasn't really realistic or funny to me. And everything was very written.

I just didn't enjoy this part at all. If there was a way to screw it up, they screwed it up for some reason. So I give it a 5. Stay with me, Smurf. Keep talking. Keep making noises for me, okay? I see it. The medical care was good. It's exactly what I should have done. I was happy with that. She packed it. She dressed him. She tried a tourniquet. And sometimes they still bleed out. So that was believable. Come on, Smurf. Normally you want to put the tourniquet on the face and say when you put the tourniquet on.

We normally use black markers for that, Sharpies. I want to know if that tourniquet has been on for five minutes or 45 minutes. If it's been on for two hours, you'll have a dead leg that you'll have to cut off. Vietnam War, a United States Huey helicopter appears and takes her to the top of that place. And for her to get there with pressure, that's doable and doable, strategically it just didn't make much sense. I'm going to say that because, you know, the medical part was pretty decent, I'd give it a 5, 6. You know what I thought was more accurate?

The top three, I'd say, were "Saving Private Ryan," "Hacksaw Ridge," and "M*A*S*H." Thanks for seeing it. If you enjoyed this video, click the link above.