DAYTON, Ohio — Combat medics call it the golden hour. If a seriously injured patient is stabilized in that crucial period, chances of survival increase dramatically.
Lance Cpl. Larry Draughn’s hour was about up.
“I felt my body slipping away,” said Draughn, who grew up in Vandalia and Dayton and now lives in Fairborn. “The guy I considered my best friend, I called him over and told him to tell my wife and my kid that I love them and I’m sorry I wasn’t coming home.”
Draughn’s Marine squad was patrolling near the town of Now Zad, Afghanistan, on May 30, 2009, when the then 21-year-old stepped on an improvised explosive device in an area of Helmand Province that was largely controlled by Taliban insurgents.
Draughn remembers running across an opening and then seeing his legs in a ditch.
“I hit the ground and I looked over to make sure no one else was hurt,” he recalled. “I realized I couldn’t hold my gun because both my hands were shattered. I yelled to my squad leader and radio operator and told them to help me, that I was dying. And that was when they realized I had gotten hit.”
Draughn is one of 20,000 servicemembers wounded in action in Afghanistan. Thanks to the quick actions of his squad and others that day, he didn’t become one of the 2,300 from the United States who have died in Operation Enduring Freedom, the name given the now nearly 13-year-old Afghanistan war.
Draughn lost both legs and suffered multiple hand wounds, including the loss of two fingers that required his surgeon at Bagram Airfield hospital to insert pins or wires into the fingers to hold them extended and roughly aligned. He spent two and a half years in physical therapy and training at Walter Reed Army Medical Center in Washington, D.C., before moving back full-time to Ohio.
His story illustrates what is possible even when catastrophic injuries leave a body far from whole.
Draughn, who in another era or another war might have died on the battlefield, was among the first in the nation to be fitted with a bionic prosthetic ankle, and he is embarking on a new career path: as a professional fisherman.
“I get a chance to chase my dream and become a professional bass angler,” Draughn said. “I can do the stuff I love to do. And the only obstacle I have is just in my mind.”
Draughn — called “Little Larry” by his family — was a 14-year-old student at Smith Middle School in Vandalia on Sept. 11, 2001, when al-Qaida terrorists hijacked four commercial airliners and attacked the United States.
“I was actually sitting in my literature class and they turned on the TV just as the second plane hit the World Trade Center,” he said.
A little more than five years later he joined the Marine Corps as an infantryman, entering boot camp at Parris Island on Jan. 1, 2007. After getting sent to Iraq in 2008, Draughn was deployed to Afghanistan in May of 2009.
Twenty-one days after arriving in the country, his squad set up for an ambush in an otherwise picturesque edge of town where mud brick homes butt up against farm fields and tree groves.
Draughn remembers: “I led off with my left foot and as I stretched away to run…”
No one from his unit saw what happened.
“My whole life literally flashed in front of me,” Draughn said. “I could see my son laughing. I could see my wife; my dad. I could see all their pictures flashing in my mind — the good moments. It’s probably the craziest thing I’ve ever seen in my life.”
Miraculously, his head, torso and internal organs — largely protected by body armor — suffered little damage. But he was losing blood fast from where his legs were severed.
More than 90 percent of American casualties die within the first hour of being severely wounded without receiving advanced trauma care, according to a 2006 Institute for National Strategic Studies report; in the first 30 minutes, it’s 67 percent. Of those who die, an estimated half bleed to death.
“With a big enough arterial injury, you can bleed out in just a couple of minutes” said Air Force Lt. Col. Brandon Horne of Oakwood, a combat surgeon who saw about 450 patients, including Draughn, in six months at the Craig Joint Theater Hospital at Bagram Airfield north of Kabul. Horne, an orthopedic surgeon, currently practices at Wright-Patterson Air Force Base Medical Center.
“The sooner you can start definitive care in that golden hour the better folks do,” Horne said. “The sooner we get to them, get the resuscitation going, get blood back into them, stop bleeding, get oxygen in them, the better those other tissues do. You have less overall damage to the body as a consequence of the trauma.”
The orthopedic surgeon estimated amputations accounted for about 10 percent of his cases at Bagram.
Wounds to extremities can be very survivable, according to a 2013 report prepared by the U.S. Central Command Pre-Trauma Care Assessment Team, but the key is getting through that golden hour.
For Daughn, the window was fast closing.
“They put the tourniquets on and tried to control the bleeding as much as they could and got me on the stretcher and started carrying me out,” he said. “I was actually able to fight and stay awake and basically fight for my life.”
‘The last thing I remember’
The nearly unconscious Marine was carried on a litter for at least 45 minutes. “Two of the guys never let go of the stretcher the whole time,” said Draughn, called “Squish” by the squad. “They had to lift me over the top of walls, over the top of rock piles. Those guys are my heroes.”
“I remember my eyes rolling back inside my head and my corpsman would slap me across the face to bring me back to. It got to the point five minutes before we got to the vehicle I felt my body slipping away.”
The litter-bearers lifted Draughn into a “doc in a box,” an armored mobile trauma bay developed just the year before. Aboard was a battlefield doctor, more corpsmen, and advanced equipment to help stabilize him.
“They stripped all my stuff off,” Draughn said. “That was the last thing I remember.”
He awoke briefly at the Bagram hospital, where he’d been flown by helicopter. He remembers a battalion commander trying to get Draughn’s wife, Kaytlin, on the phone, but he blacked out before the call could go through.
At Bagram, Draughn’s surgeons did a number of procedures, including cleaning his wounds, tying off his arteries and getting him stable enough so that he could be transported, first to Landstuhl Regional Medical Center in Germany and then stateside.
“I’ve met him twice, but he doesn’t remember the first time,” said Horne, who has an entry in his moleskin-covered case log: June 1, 2009; Marine Lance Cpl. Larry Draughn.
Infection was a huge concern.
“It’s not just the fragments from the actual IED device,” Horne said. “When that blast occurs it picks up dirt, and rocks, everything from the ground. It picks up other debris and blows it into people’s bodies. So you find you spend a lot of time cleaning up lots and lots of little small wounds just to hopefully prevent infection.”
As a general rule surgeons at Bagram don’t close up patients’ wounds, Horne said. Injured tissues can evolve over time. What looks to be healthy tissue one day may be dead tissue a couple days hence and need to be removed by the next surgeon.
“It’s a continuum of care all the way through. The idea is that every time they go to the next echelon there’s increased capability,” Horne said. “A key part of that is the rapid movement of the patient from where they’re injured through the system to the place where they can get their definitive care.”
‘You’re not in heaven’
Draughn was in a medically-induced coma on the flight from Bagram to Ramstein Air Base in Germany, where the Landstuhl Regional Medical Center is located. When he awakened he saw two nurses.
“One was a blond the other brunette. Both had their hands on my shoulder. I remember waking up and asking them if I was in heaven,” he said. “I remember them smiling ear-to-ear saying, ‘Nope, you’re not in heaven’.”
Draughn underwent more surgeries at Landstuhl to remove damaged tissue before flying home.
In the four days since losing both lower legs, Draughn had traveled about 7,600 miles — by truck, helicopter and two transport planes. By contrast, wounded soldiers during the Vietnam War typically took a month to reach American soil. The enhanced ability to move patients to where they can get the most help is one of the reasons so many servicemembers have survived catastrophic injuries.
Despite the seriousness of his wounds, Draughn said he spent just the first 15 days in a hospital bed.
“That’s attributed to me wanting to be with my little boy,” he said.
His son, Garon, now 5 years old, wasn’t the only one happy to see him.
“The first time I came home they had a big military escort for me: a big homecoming,” Draughn said. “Thousands of people lined the streets in Fairborn and welcomed me home which was actually amazing.”
In the years since, he’s focused on his family, his recovery and his fishing. The bionic prosthetic ankle gives him mobility but is a bit of a hindrence in his new job: because of the high-tech electronics, he can’t get it wet.
‘Well-oiled machine’ worked
Daughn and Horne, his surgeon at Bagram, met at Wright-Patterson Air Force Base Medical Center about two years ago.
This time Draughn was conscious — and soon in tears. He had no idea the doctor who helped save his life in Afghanistan (along with many others) was stationed in his hometown in Ohio.
Draughn credits Horne, his fellow corpsmen and the entire care system, including the “doc in a box”, for his survival.
“If that well-oiled machine didn’t work, there wouldn’t have been much they could do to save me. I didn’t have long to live,” Draughn said. “Without the technology these days and putting a surgeon in the back of a jacked-up armored vehicle, I wouldn’t be here talking about it.”
The Draughns’ daughter, Addison, turned 1 on Wednesday. Since retiring as a Marine corporal and coming home for good, Draughn has set up his own business and collected sponsors, among them Legend Boats and Berkley. His dream is to compete in the Bassmaster Classic fishing tournament.
At their chance meeting at Wright-Patt, Draughn didn’t have much time to talk to Horne. He had to get back to work.
“To me that’s phenomenal, to have seen you back in Bagram, and have seen the injuries, then you come in here in a hurry wanting one little thing taken care of so you can get back to fishing,” Horne told his former patient. “That’s fantastic.”