Second United States Revision of the Emergency War Surgery NATO Handbook/Foreword

The success of any military health care system in wartime is directly related to the number of casualties adequately treated and returned to duty with their units. This must be accomplished as soon and as far forward in the theater of operations as possible.

The Second Battle of Bull Run near Manassas, Virginia, was one of the major engagements of the United States Civil War. Three days after that great battle, three thousand wounded men still lay on the field. Relatives travelled to the front and took their loved ones home for treatment rather than leave them to the uncertainties of military medicine. We have made phenomenal progress in the century since that battle occurred.

I have had the privilege of being a physician for early forty years. Half of that time was spent on active duty in the military services and the other half was spent in the civilian sector. I have participated in the delivery of health care in every conceivable setting: in a battlefield tent in Korea; on a hospital ship; in an air squadron; from austere county and state hospitals to large, glossy high technology institutions. I have seen people strive for, and achieve, excellence in all those setting. I see it now in the military health care system, and no one is more proud than I of the accomplishments ad the quality of that system and of the special type of men and women who makes the system work. Our system is not without its problems and its frustrations. It takes a long time for equipment to be delivered; the personnel system doesn't always provide the proper mix of people in a timely manner to get the job done; but with rare exceptions, the medical mission is accomplished in exceptional fashion.

This handbook should serve as a constant reminder that ours is a high calling. We are here to save lives, not to destroy them. We are committed to the future, not the past, and to the primary mission of military medicine, with is to keep the soldiers, sailors, airmen, and marines alive and whole: in the words of Abraham Lincoln, to minister to "him who has bore the brunt of battle."

This revised edition represents the contributions of talented and gifted health professionals from the military services as well as from the civilian sector. All who contributed have the grateful appreciation of the editorial board for the enthusiasm, dedication, and perseverance which made this revision possible.

William Mayer, M.D. Assistant Secretary of Defense (Health Affairs)