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LANDSTUHL, Germany — After suffering severe injuries from a roadside bomb blast in Iraq on Nov. 9, Army Staff Sgt. Jonathon L. Martin died on Thanksgiving. The 33-year-old soldier, husband and father of three passed away at a university hospital in Regensburg, Germany, almost a four-hour drive east of Landstuhl Regional Medical Center.Nearly all U.S. soldiers wounded in Iraq and Afghanistan are treated at Landstuhl, the largest American hospital outside the U.S., before being flown to the States. But some of them are treated at German hospitals when highly specialized care is required.

Martin suffered a punctured lung, lost his left leg, and broke his pelvis, arm, and nose from the explosion, according to a Toledo, Ohio, TV station. Martin initially was treated at Landstuhl but was transferred to Regensburg because he was on a device called the Novalung, developed at the Regensburg hospital.

War wounded are sent to other hospitals around Germany about once or twice a month when a casualty needs critical sub-specialty care — such as angiography (blood vessel studies), heart surgery or brain surgery — that is not available at Landstuhl. The hospitals are in Homburg, Koblenz and Ludwigshafen.Also, coalition troops initially taken to Landstuhl are sent to German hospitals for burn care.The relationship between Landstuhl and Homburg goes back at least 40 years, said Dr. Tim Pohlemann, a trauma surgeon and professor at Saarland University Hospital in Homburg, less than a 30-minute drive from Landstuhl.“We have functioned more or less as a back-up institution for special injuries, for special medical situations which could not be handled in the Landstuhl medical center,” he said. “This was more intense before Iraq started. We had quite a number of patient exchanges when it was just Afghanistan.”Still, in very special situations, as when patients require neurosurgery, the wounded are transferred to Homburg, Pohlemann said. Landstuhl does not have such capabilities because the care required in such instances is highly specialized and wounds requiring such care occur infrequently.If Landstuhl housed doctors with those specialties, their skills would erode because wounded needing those treatments arrive only once a month or once every other month, said Army Col. Brian Lein, Landstuhl’s commander.“We have looked and we have expanded our services significantly since the start of the war,” he said. “… We used to have to send everyone to Homburg who needed dialysis. Now we’ve got a doctor who went out and trained on how to do dialysis. We have a dialysis unit here. We have a dialysis nurse here. … The last time we dialyzed somebody, I think, was in late August, early September.”A full-time dialysis doctor doing nothing but dialysis and a dedicated dialysis team at Landstuhl “wouldn’t be doing a whole lot,” Lein said. The same would apply for a heart team at Landstuhl, he said.The level of care at the German hospitals is on par with treatment at stateside military hospitals, Lein said.“We know the care the Germans provide is equal to the same care that we would expect out of Walter Reed and Brooke Army Medical Center,” he said. “They’re providing that level of care, that level of follow-up, that level of ongoing care for our warriors and their families.”

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