National Defence committee  I can speak only to my own experience on that. I thought it was very smooth. It helped that the trauma and the specialist community in Canada is actually fairly small. The people I deployed with were people I knew from the academic environment in Canada anyway, so it was very easy to integrate them.

National Defence committee  There was very little comparison in terms of the sheer number of injuries. Obviously, in Bosnia, thank goodness, there weren't too many Canadian casualties. Also, in terms of the mechanism, there were no blast injuries—at least when I was deployed there. It was mostly road traffic accidents and the occasional gunshot wound, whereas the norm in Kandahar was severe blast injuries and gunshot wounds.

National Defence committee  If you're referring to programs or care for the ill and injured acutely, I think so. And this is what I do. I can compare to a level one trauma standard in Toronto, where I work; you have to understand that when you're at Sunnybrook, it's Canada's largest and first trauma centre, but we do other things, including cancer care, so the resources are divided.

National Defence committee  It does, and I've actually been involved with that project, if it's the same project that I'm thinking about. This is a project on automated ultrasound diagnosis in the field. The researcher is trying to come up with an algorithm for looking for specific diagnoses in the field.

National Defence committee  Yes, Role 3 was a joint medical, multinational facility. Each nation would work as part of a team, and we would take our turn on the rotation. Obviously, if we weren't on one night but heard that a Canadian Forces member had been injured, we would always come in, because we obviously felt a special attachment.

National Defence committee  It would depend on the severity of the injuries. If they were severely injured, we would usually stabilize them; we would have to stabilize them within the first 24 hours. The pattern then would be an air evacuation to Germany within 24 hours after a request for an air evac. They would stay at the Role 3 for a very short period of time.

National Defence committee  It was a U.S. Army and Air Force tertiary-level hospital in Germany. They'd be cared for there until they were again deemed to be stable for transport, and then a Canadian Forces medical specialist team would come and bring them back to Canada.

National Defence committee  It was improved in many different ways. Purely from the actual structure of the building.... I was the first to arrive in 2006, so I took over from the U.S. combat support hospital that it was. At the time it was a small plywood shack, which I'm sure you've seen pictures of, with one OR.

National Defence committee  There was always a CT scan machine, as far back as early 2006, the difference was in the type of scanner. There was a two-slice scanner in 2006 that evolved to a two-slice and a sixteen-slice—that refers to the speed at which it can scan. An MRI machine showed up in 2011 from the U.S.

National Defence committee  The study that I quoted, about two deaths out of 63, was actually in the first 20 months of the war. In fact, it's important to realize that almost all the deaths that occurred from Kandahar occurred in the pre-hospital setting. The tactical combat casualty care that we had implemented, which is a pre-hospital way of caring for patients, was actually well entrenched at that time already.

National Defence committee  You can call me Homer, if you'd like.

National Defence committee  Because I'm a surgeon, I'm speaking of trauma in the physical sense.

National Defence committee  First of all, I do clinical research within the Canadian Forces Health Services, but my research tends to focus on pre-hospital physical trauma care and in-hospital trauma care, and how we stop bleeding. I did one study that looked at the causes of death within the Canadian Forces over a 20-year period.

National Defence committee  No, I have not done a study on that.

National Defence committee  We work very closely with our allies, to the point where, let's say—because you can't be on call every night—perhaps if there were two of us, we'd be on call every second night, as the primary surgeon or the primary person to resuscitate the trauma patient.