Why Some Military Docs Are Tuning Out "Baghdad ER"

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With its stark, graphic images of injured soldiers and their colleagues who tend to them, the HBO documentary "Baghdad ER" is in many ways a tribute to the brave, tireless doctors at the United States Army's 86th Combat Support Hospital in Iraq. But not all Iraq combat surgeons think the film — which includes images of a soldier being carried from a helicopter, his face burned beyond recognition — is such a good idea. Last week Dr. Joseph Brennan, who is an Air Force Colonel, received an email directed to all Armed Forces medical personnel warning of the potential traumatic effects the film's graphic content may have on service members and their families.

"I'm not going to watch it. And I told my children they won't watch it either," Brennan, a head and neck surgeon who served at the Air Force Theater Hospital in Balad, Iraq during 2004 and 2005, said last week. Brennan's tour coincided with the Fallujah offensive in November 2004, one of the most lethal months of the war, and a period when his hospital treated more than 600 patients, performing more than 500 surgeries. "War is the most horrible thing there is. People get killed. People get blown up, mangled. I know people are going to say that people need to see the reality of that. The bottom line is: it's going to cause a lot of pain," says Brennan. "It's just sensationalism. I think it's HBO and they're trying to get viewers. And they're going to shock them anyway they can."

Some of Brennan's colleagues don't take the same view. Colonel Donald Jenkins, who served with Brennan and currently oversees U.S. military trauma care in Iraq and Afghanistan, sees benefits in the exposure. "I think it's really good for the families of the medics, nurses, and physicians to see this from another perspective," he says, and the families of those deployed "can be comforted by knowing what fantastic trauma care is available to their kids." Another possible result, Jenkins sees, is the film's potential as a recruitment tool for military medicine. "I believe people are motivated when they see what it is that we're doing over there," he says.

Motivated, but perhaps also haunted. The looking-glass quality of images of the wounded and dying, after all, makes for a difficult paradox. Military public affairs officers must make a tradeoff when granting media embedded access within medical units. While it is an opportunity to see the successes of military medicine -- one highly touted fact is that 90 percent of the wounded in Iraq survive -- it is also the chance to witness the emotional and physical suffering of the those injured, fatally or not.

"Baghdad ER's" film makers Jon Alpert and Matthew O'Neill spent two months in Baghdad's Green Zone where the 86th CSH was located. Through the film, the camera pans from moments of levity to moments of sorrow; from a surgeon cracking a joke while stitching entrails together in the operating room to a wounded soldier confiding in his friend that he can't close his eyes without seeing the missing face of their Humvee driver killed in an explosion earlier that day.

O'Neill said he and the producers were perplexed at what they perceived as a withdrawal of support by the Pentagon for the film, which premiered last week at the National Museum of American History. Paul Boyce, a Pentagon spokesperson, pointed out that 40 members of the unit attended the premiere and the film was also screened at 22 military installations. "Every person in uniform we've spoken to has said that we've presented the truth," O'Neill says.

That may well be true. But even some seasoned combat surgeons are wary to revisit the truth. ""I would encourage my family to watch. I have mixed feelings about watching it myself, because I already know what it's like," says Lieutenant Colonel Michael Eppinger, a cardiothoracic surgeon who also served at Balad in 2004 and 2005. "I'm very happy that I had the opportunity to go over there and take care of people. And I'll go back again when I get sent. But there are still things that I remember that bother me."

Still overall, Eppinger feels that the public exposure of combat trauma has implicit benefits. "It's worse if you don't show it," he says. "I'm all in favor of anything that tells the truth and lets people know what it's really like. It's better to have the knowledge before you sign up." Even if the people who were already over there might prefer to forget it.