Battle of Cambrai Remembered 100 Years Later for Combined Arms Use

By David Vergun Army News Service

WASHINGTON, Nov. 22, 2017 — The first American units saw action in World War I during the battle of Cambrai, France, Nov. 20-Dec. 7, 1917. The same battle also showcased the first large-scale effective use of combined arms, marking an evolution in warfare, said Brian F. Neumann, a historian and World War I subject matter expert with the U.S. Army Center of Military History.

The battle began with a successful British offensive against the Germans, Neumann said.

Success of the offensive, he said, was due to the effective coordination of combined arms, which included infantry, artillery, tanks and combat air support. All were used to overrun the German trench lines in the vicinity of the northern French town of Cambrai.

The use of combined arms gave the battlefield more of a three-dimensional look, with air, tanks and artillery all supporting infantry, along with some cavalry support, he said.

The British employed several hundred tanks, which were used to overrun the German trenches and tear holes through their lines, he said. It was the most significant utilization of tanks to date.

The Americans

The Army's role in the fighting was fairly limited, he said, noting that it consisted of soldiers from the 11th, 12th and 14th Engineer Regiments, who were engaged in railway construction work behind the trench lines in support of the British.

Although America's role in the battle was limited, the news that soldiers were finally engaged in a major battle for the first time since war was declared in April made headlines and boosted morale on the home front, he said.

By Nov. 30, the British had essentially outrun their supply lines and artillery support, and that's when the Germans mounted a successful counterattack, Neumann said.

Luck for the Army engineers ran out on that day as well, when the Germans overran their area, resulting in 28 U.S. casualties.

The survivors regrouped and were reorganized into reserve infantry with their main effort being to build trenches and help the British to stabilize their lines, he said.

The Battle of Cambrai, though heralded for successful use of combined arms, was actually a fairly typical World War I battle in that a successful offensive was then met by a successful counteroffensive, with the lines between friend and foe not shifting that much and a lot of casualties taken on both sides: around 45,000 on each side, he said.

Although America had declared war against Germany seven months earlier, the American Army wasn't yet ready for large-scale combat operations, Neumann said.

While the roughly four U.S. combat divisions in France were still in training in late 1917, he said, they would see plenty of action in 1918.

Marshall Center Hosts Security Policy Seminar for Romanian Parliamentarians

By Christine June George C. Marshall European Center for Security Studies

GARMISCH-PARTENKIRCHEN, Germany, Nov. 22, 2017 — Romania has the highest growth in defense spending in Eastern Europe after achieving NATO’s goal of spending two percent of its gross domestic product on its defense budget this year.

To learn how to effectively spend this money to protect their fellow citizens, parliamentarians from the Committee for Defense, Public Order and National Security of the Chamber of Deputies of Romania looked to the George C. Marshall European Center for Security Studies. The Marshall Center is a German-American international security and defense studies institute here.

Romania’s Important Role

“Romania is experiencing very strong economic growth, which was one of the things discussed here the last two days,” said Matthew Rhodes, director of the Marshall Center’s Central and South Eastern Europe Non-Resident Program.

Rhodes and his team hosted a tailored seminar in security policy for 13 members from this committee Nov. 16-17.

“This seminar was important because of the role that Romania plays within its neighborhood, and the broader security effect it has even beyond its own borders,” Rhodes said. “Romania shows particular commitment to building a strong partnership with the United States, Germany and NATO.”

Europe’s Current Security Challenges

A majority of the seminar topics were requested by the committee, said Keith Dayton, the Marshall Center director.

“These topics reflect the multiple current security challenges that Europe is facing, as well as the particular roles of parliaments in addressing them,” Dayton said. “We often speak now about different kinds of threats along the eastern and southern flanks of Europe, and Romania’s history and geographic location connect it to both.”

He cited the fact that Romania shares borders with Ukraine and Moldova, whose conflicts with Russia have shaken assumptions about a peaceful post-Cold War order in Europe.

Topics included the role of parliament in defense budgeting and planning, state secrecy versus transparency, approaches to good governance to counter corruption, cyber security and energy security.

“We had very concrete discussions about energy related matters and security in the Black Sea Region,” said Dorel Caprar, chairman of the Defense, Public Order and National Security Committee of the Chamber of Deputies of Romania. “This is important because in the future, vital decisions will have to be made in parliament.”

Encouraging Productive Democratic Partnerships

Caprar said they learned new and useful information on topics that the committee comes across daily in their work, like how to purchase equipment for the armed forces, how to decide on a supplier for military equipment and how to liaison with foreign companies investing in the defense sector.

“We also learned more about our strategic partners within NATO, the European Union and the U.S.,” Caprar added. Romania joined NATO in 2004 and the EU in 2007.

“Seminars like this one are welcomed for members of parliament because in our legislative work, we come across many of the issues and problems that we need to regulate,” he said.

The Marshall Center hosts tailored seminars for parliament members of countries not only from the Central and South Eastern Europe, but also from Central Asia and Black Sea Eurasia.

“These seminars certainly play into our overall mission to encourage productive democratic partnerships in the security and defense fields,” said Rhodes, who added that two to three seminars like this one are held every year at the Marshall Center for countries in the Central and South Eastern Europe.

“It’s important to include parliaments in our outreach programs,” he said, “as they play an important role in overseeing defense in passing legislation that affects the ability of their countries to respond to security challenges.”

Poly Trauma Department Doctors Celebrate 10 Years of Caring for Patients

By Shannon Collins DoD News, Defense Media Activity

WASHINGTON, Nov. 22, 2017 — The Naval Medical Center San Diego’s Comprehensive Combat and Complex Casualty Care, or C5, celebrated its 10th anniversary in October.

NMC-SD is one of three hospitals in the Defense Department providing rehabilitation care to service members who are severely injured or ill, especially in overseas operations. The other two are Walter Reed National Military Medical Center in Bethesda, Maryland, which also works with the National Intrepid Center of Excellence, and San Antonio Military Medical Center, which used to be called Brooke Army Medical Center.

C5 is a program of care that manages severely or ill patients from medical evacuation through inpatient care, outpatient rehabilitation and eventual return to active duty or transition from the military. Program components include: trauma service, which coordinates the overall inpatient clinical management of the injured service member; orthopedic, reconstructive plastic surgery and wound care; amputee care, prosthetics and rehabilitation; physical, occupational and recreational therapy; mental health assessments and care; traumatic brain injury care; pastoral care and counseling; and family support and career transition services.

“We are a multidisciplinary, one-stop shop and if it’s not within C5, we simply just get on the phone and call the specialist we need,” said Navy Lt. Cmdr. (Dr.) Carter Sigmon, acting department head and medical director of the C5 department.

Since 2007, C5 has taken care of approximately 3,500 patients, “approximately … 20 percent of all the active duty [Operation Iraqi Freedom, Operation Enduring Freedom and Operation New Dawn] service members with war-related limb amputations,” he said. Sigmon said over the years, the mission has evolved and now the team sees service members with injuries from vehicular and training accidents.

Jackie Moore, a former Army major, helped stand up the C5 program. She had served as a physical therapist at Walter Reed and brought what she knew over to NMC-SD. “I was sent out here special to get C5 started,” she said.

“Nothing existed out here so we were instrumental in developing the program and setting it up how we wanted to, based on our experience that we had from Walter Reed,” Moore said. “When we first stood it up, there were a lot of service members coming back with combat injuries, primarily amputations, so when it began, that was our focus. Over time, it morphed into more poly trauma. We are the rehabilitation experts here at Naval Medical Center San Diego in poly trauma rehab.”

Project Care

Navy Capt. (Dr.) Craig Salt, founder and director of Project Care, plastic surgeon, said Project Care, under C5, is the only one of its kind in the DoD. “Project Care is a multidisciplinary medical and surgical program designed to facilitate the restorative care of patients who have been traumatically disfigured,” he said. “We take people who have varying degrees of trauma and then we work to revise, repair and replace what has been damaged or lost versus the traditional rehab model. We look at the patient, top to bottom, figure out what they’ve lost, what their disfigurement is, what their cosmetic deformity is, and then in conjunction with all the other rehab that’s happening, we work to repair, replace and correct deformities.”

He said this can be anything from using lasers on scars to a hand transplant and the disciplines include plastic surgery, dermatology, orthopedic hand surgery, oculoplastic, ophthalmology, ENT fascial plastics, and reconstructive urology.

“The rehab center and all the different disciplines at this hospital are working to get the patient the best possible recovery we can get them so we’re committed to providing the medical and surgical care and psychological support. So whatever’s wrong with them and whatever they’ve lost, we’re going to see to it they get the best possible functional recovery, the best psychological recovery and the best aesthetic result they can get,” he said. “Everybody in the hospital that can help the patient look better, feel better, recover, function, whatever, is involved in their care, and we coordinate all of that. All of us in the program are really passionate about that goal.”

One-Stop Shop

Dr. Chad Rodarmer, the traumatic brain injury program manager for C5, served 24 years in the Army as an enlisted field artilleryman, a physical therapist and health care administer, retiring as a major. He said because patients with TBI may require specialists ranging from speech language pathology to vestibular therapy to audiology, he works to coordinate the patient’s care within C5.

“On a weekly basis, we have our interdisciplinary team conference, and we bring up the patients currently enrolled and talk about when someone’s due for their follow up, what the plan is, how good they are at meeting the goals we and the patients have set. We can see their progress. We get together regularly to make sure we’re all on the same sheet of music and moving toward the same goals,” he said.

Rodarmer said they’ll also have support groups and bring in subject matter experts to talk to the patients to help alleviate anxieties such as going back to school while having a TBI.

Patient Care

Navy Petty Officer 1st Class Jordan True, a master at arms stationed at Naval Weapons Station Seal Beach, California, was injured Aug. 12, 2016, in a motorcycle accident.

“They told me I had a traumatic brain injury, a lot of internal organ injuries, broken ribs, a spinal injury and that my foot was crushed. I knew I might have to amputate it,” he said. “They flew my parents out here from Iowa because I had a less than 40 percent chance that I was going to live. They helped me make some long-term decisions.”

He’s working with the C5 prosthetics department to get a brace for his leg and with physical therapy so that he can begin running again. He said each of the doctors and staff he has worked with has taken the time to help him, especially since he has to drive down to make his appointments.

“Here, they have a day dedicated to primary care or Project Care. Me coming down from Long Beach, they would help me out,” he said. “I would ask one of the doctors if they would be willing to do one of these appointments on one of these days, and they were really flexible with me and helped me reduce a lot of stress, especially since southern California traffic is harder for me than it used to be. Any time I need a referral for anything closer to Long Beach, they would get it in. It didn’t matter who was doing it. It would get done really quickly. I was excited about that.”

True said what he liked most if that even though he was being stubborn about trying some of the services C5 offered, the doctors kept encouraging him to try them until he did. “They didn’t give up on me,” he said. “Especially the speech therapy, they just kept pushing me and that helped me go back to school and now I have a 4.0 GPA. They actually listen to what your issues are. I was taking a neuropsych exam one day and this person stayed like an hour and a half late just so I could finish my test so I wouldn’t have to reschedule and drive back down. It really made my life easier. My neuropsychologist, he was looking things up for me, like how I can get take the LSAT and get a private room.”

Navy Seaman Chris Krobath, an aviation electronics mate, is also a patient assigned to NMC-SD. He has a below the knee amputation on his left side from a motorcycle accident. He said his leg was amputated in May 2016 and after going into rehabilitation in June, he had his first leg. He’s been working with physical therapist Moore.

“They are all really helpful,” he said. “If I ever have a problem with anything, I can just come here to physical therapy or to prosthetics, and they’re always willing to help me. It’s pretty cool. It’s convenient to have everything together.”

Brian Zalewski, head of the prosthetics department at NMC-SD, said the artificial limb is a “unique and customized process” and that he and his team make every effort to cast the patients and turn around with a socket in the same day or the next day.

Zalewski said they’ve had unique challenges along the way. “We had the first bilateral above the knee amputee come out of here and go back and do a deployment which was incredible,” he said. “Our approach here is that everything’s custom.

“We work closely with the manufacturer,” he continued. “We had a Navy diver who wanted to stay on active duty. His list of requirements, he had to be able to walk to the water, get in the water and put on fins. Well that’s pretty hard to do with one type of leg so we worked with a manufacturer to make a foot with a button you push so that it goes flat and then you put the fin on it so you can dive. We did some testing, and it worked great.”

Zalewski said the diver went out and performed some missions and then called and asked about pressurization with deep dive.

“I told him, ‘You’re the only one who’s doing this so you tell us, and we’ll write the text book later. You’re the one pushing the limits,’” Zalewski said. He said he’s had a lot of patients he and his team have worked with who’ve received customized prosthetics from his team and who continue pushing the limits from climbing Mount Everest to competing in the Paralympics.

“We’re providing a multidisciplinary approach because our ability to work with other providers to take care of the whole patient, from the mental side to the physical side and constantly addressing those needs so that they’re not sitting there wondering what they could be doing or if they could be getting something better,” Zalewski said. “We never just give them a device and say, ‘Here you go, enjoy that.’ It doesn’t work that way. We’ll give you so much more to make you that much better. It’s a whole approach and practice from a team of medical professionals.”