Saturday 29 June 2013

Soldier Reno Roethle hopes to 'erase' battle scars with reconstructive surgery

PHOENIX - A Valley doctor will try to give a wounded soldier his old face back with reconstructive surgery set for Thursday.

Reno Roethle was 19 years when his vehicle hit an explosive device in Afghanistan shattering half his face. "It's like reading a book, you don't realize it really happened," said Reno.

That was seven years ago, but after several surgeries his lower lip still needs some help. It's made up mostly of skin from his forearm so the color is more pale than red. And his lip is slightly misshapen which lets saliva slip out from time to time.

To bring his old smile back, an organization called RAW stepped in. RAW stands for Rebuilding America's Warriors . The group is dedicated to erasing physical battle scars through reconstructive surgery for soldiers who can't afford it.

They do it with the help of doctors willing to offer their services like Scottsdale plastic surgeon Salvatore Lettiri from Maricopa Medical Center. "We're going to do some little things like bring the tone back in his lip by using some tendons and better the color by using his gums," said Dr. Lettiri.

"It's like being born again," said Reno who will need a full day in the hospital to recover from the surgery.

But he is one step closer to seeing his old smile again.


http://www.abc15.com/dpp/news/region_phoenix_metro/north_phoenix/Soldier-Reno-Roethle-hopes-to-erase-battle-scars-with-reconstructive-surgery

WIFE OF A WOUNDED SOLDIER: SURGERY


Left is pre-op and right is post op. The gray area is where there is a hole in the bone from the screw.

I hate that almost seven years after an IED blasted through my husband’s body, he still needs surgery to repair the damage.

Last Friday Bryan underwent his 16th surgery since the blast. But this time, we are blessed that the procedure was minor and his recovery, unlike previous times, was fairly short. Doctors removed a screw in his left heel that was inserted during a previous surgery and had begun backing out of his foot. The doctor didn’t want it removed until we could feel the head of the screw on the surface of Bryan’s skin. If it broke the skin, it can cause an infection. Since our baby girl is coming in September we decided it was time to get it taken care of.

Luckily, this surgery was fairly minor compared to his previous ones. He did have to stop taking his anti-inflammatory medication as it makes his blood thin and increases the risk of excessive bleeding in surgery. Without the medicine, he was in a lot of pain the week before surgery and had quite a bit of swelling. We thought the medication wasn’t that effective anymore but once he was off we realized it was working more than we thought.

During the pre-op appointment I warned the doctor that Bryan tends to be aggressive and combative when he comes out of anesthesia. He asked if Bryan has PTSD and we said “yes.” The doctor said that it is normal for vets with PTSD to be combative after anesthesia because it taps in to their psyche and stirs up those suppressed memories. This was the first time I had heard this but it makes sense as to why he is this way when normally he is very calm.

On the day of the procedure we left home by 6 a.m. and he was in surgery by 8:15. The nurses kept me informed and the resident met with me when they finished. He said the screw was lifted up from where it was backing out and it was fairly easy to remove. He said Bryan should have less pain now but it is hard to say since he also suffers from arthritis in the same place. We decided ahead of time to leave the rest of the hardware in because to remove it would mean a much longer recovery time.

The post-op nurse said Bryan was nice when he woke up and that he was worried he hadn’t been nice to her. He is so sweet. When I was able to finally see him, he kissed me and immediately put his hand on my belly. I have real issues going in to post-op rooms with all the equipment and people lying there. There was blood on his blanket and I tried not to focus on the fact that they cut him open. I have a weak stomach and seeing my husband is pain makes it that much worse. It brings up too many memories of our time at Walter Reed.

It has been a long road of 16 surgeries but his recovery is getting shorter, and better and with each surgery he grows stronger and more ready to welcome our wonderful baby this fall.
 
 
Friday, June 28, 2013

A whole new face: Transplant joy for hero soldier whose face was destroyed in car crash

  • Mitch Hunter destroyed his face saving a woman's life ten years ago
  • Former soldier has undergone 20 corrective procedures
  • Given new face - including eyelids, lips, muscles and nerves - in 14-hour op
  • Can now smile again and feel the breeze on his face

  • When Mitch Hunter walked down the street, children hid behind their mothers because they were scared of what they saw.
    On becoming a father himself, he decided to have a face transplant, because he didn’t want his own son to be afraid of him.
    Mr Hunter, a former soldier whose face was destroyed saving a woman’s life, can now smile again, feel the breeze on his face and warmth of his wife’s kiss.
    New life: Mitch Hunter sits with his son Clayton and girlfriend Katarina following the amazing procedure to rebuilt his face and help him lead a more normal life
    New life: Mitch Hunter sits with his son Clayton and girlfriend Katarina following the amazing procedure to rebuilt his face and help him lead a more normal life
    And he can walk down the street without children shouting, staring and hiding in fear.
    Mr Hunter, 30, of Indianapolis, is one of the first people in the world to be given a whole new face.
    His face was destroyed when, as a young solider, he heroically saved the life of a woman 10 years ago.
    When the car he was in smashed into a 10,000 volt electrical pylon, he pushed the woman, who was also in the crash, out of harm’s way, and thousands of volts of electricity surged through his body, severely burning his face.
    He then went through at least 20 corrective operations, with skin taken from his thighs and elsewhere in his body used to patch him up, but the results were far from satisfactory.
    The disfigurement scared children and fascinated adults, who stared at him when he ventured outside.
    He had no normal sensation in his face and had lost the bulk of his lips and so his girlfriend Katarina had never kissed him on the lips.
    The 30-year-old, pictured left as a soldier before the accident which destroyed his face, was left with horrific injuries and needing skin grafts following a car crash in which he saved a woman's life.
    The 30-year-old, pictured left as a soldier before the accident which destroyed his face, was left with horrific injuries and needing skin grafts following a car crash in which he saved a woman's life.
    When he and Katarina had a son, he decided it was finally time to get a new face.
    He said: ‘I’ve had kids hide and run behind their moms because they were so scared when they saw me.

    'It's amazing how much sensation I've gained back in such a short space of time'
    ‘That was hard to cope with because my friends started having kids, then my brother had a kid.
    ‘Then I had Clayton and I didn’t want kids to be afraid of me any more.’
    On Sunday, BBC2 documentary Frontline Medicine will tell the story of the 14 hour operation, in which he was given an entire new face, including eyelids, lips, muscles of facial animation and the nerves that power them and provide sensation.
    Painstaking micro-vascular surgery was needed to attach the two main arteries to the new face, allowing Mr Hunter’s heart to start supplying it with blood.
    Getting ready: Dr Donald Annino Jr, right, chats through the marathon procedure with Mr Hunter, left, before he goes under anaesthetic at the Boston hospital
    Getting ready: Dr Donald Annino Jr, right, chats through the marathon procedure with Mr Hunter, left, before he goes under anaesthetic at the Boston hospital
    Transformation: Mitch, pictured during the documentary which followed his operation, said he can now feel the breeze on his face and his girlfriend's kiss.
    Transformation: Mitch, pictured during the documentary which followed his operation, said he can now feel the breeze on his face and his girlfriend's kiss.
    Overjoyed: Mr Hunter with his three-month-old son Clayton said he hoped the procedure would transform his life
    Overjoyed: Mr Hunter, pictured with his son Clayton, said he hoped the procedure would transform his life
    Five months after the U.S. military-funded operation at Brigham & Women’s Hospital in Boston and Mr Hunter is starting to see some of his old features starting to come through as the swelling subsides.
    His speech is rapidly improving and he is able to do simple things like smile, purse his lips and scrunch his eyes. He can feel his son touch his face and can also do something he couldn’t do even before the accident - grow a beard.
    He said: ‘This face is really starting to feel more and more like mine every day and the sensation that I’ve gained back is just extraordinary.
    ‘I can feel the breeze on my face now. I can feel heat. It’s just amazing how much sensation I’ve gained back in such a short time.’
    Epic: The team of more than 30 physicians, nurses, anaesthesiologists and residents worked for more than 14 hours to replace Mr Hunter's face
    Epic: The team of more than 30 physicians, nurses, anaesthesiologists and residents worked for more than 14 hours to replace Mr Hunter's face
     
    Permanent reminder: Mitch still has scars on his head following the micro-vascular surgery to rebuilt his appearance
    Permanent reminder: Mitch still has scars on his head following the micro-vascular surgery to rebuild his appearance
    Peter Butler, who hopes to carry out Britain’s first face transplant at London’s Royal Free Hospital, believes the technique could one day benefit millions around the world.
    He said: ‘There are a quarter of a million people in the UK with severe facial disfigurement for whom reconstructive surgery has not worked.
    ‘They get stared at and they don’t blend into a crowd. That’s what most of them want, just to be normal.’

    http://www.dailymail.co.uk/health/article-2066384/Ex-Soldier-Mitch-Hunter-gets-new-face-14-hour-operation-10-years-having-destroyed.html

    Hooks, handsaws and forceps: The grisly photos that show how soldiers gritted their teeth for surgery in the American Civil War

    When a soldier is injured on the battlefield today he can expect the most sophisticated first aid.
    But medical treatment for troops has not always been so advanced, as these incredible pictures from the American Civil War show, originally featured on cbsnews.com.
    The images take you back 150 years to show the kind of gruesome emergency surgery that wounded soldiers had come to expect.
    A blood-curdling range of saws, knives and sharp hooks were used to administer much-needed surgery to maimed fighters.
    Gruesome: Private George W. Lemon, who was shot in the leg at the 1864 Battle of the Wilderness 1864. Captured by Confederates, treatment of his wounds was delayed and he suffered repeated infections. His leg was finally amputated
    Gruesome: Private George W. Lemon, who was shot in the leg at the 1864 Battle of the Wilderness 1864. Captured by Confederates, treatment of his wounds was delayed and he suffered repeated infections. His leg was finally amputated

    Photographic record: Here is Private George W. Lemon after his successful amputation
    Photographic record: Here is Private George W. Lemon after his successful amputation
    But rather than being comfortably anaesthetised, the soldiers had to grit their teeth through the pain of having their limbs amputated.
    The images from the National Museum of Civil War Medicine show how fallen fighters often faced the kind of slipshod treatment more likely to be found in horror films.
    Their treatment is a far cry from the kind of high-tech care such as flying-helicopters and battlefield operating theatres that injured soldiers can receive in modern warfare.
    The museum's pictures show how fallen troops even underwent the gruelling procedures without antibiotics, which often led to more life-threatening infections.
    Low tech: This large single-edged amputation knife was used to cut through skin and muscle in circular amputations
    Low tech: This large single-edged amputation knife was used to cut through skin and muscle in circular amputations
    Heavy duty: After skin and muscle had been were severed, this amputation saw - made with a steel blade and an ebony wooden handle - cut through bones
    Heavy duty: After skin and muscle had been were severed, this amputation saw - made with a steel blade and an ebony wooden handle - cut through bones
    A tenaculum was used in amputations for pulling the arteries out from the stump so that they could be tied off
    A tenaculum was used in amputations for pulling the arteries out from the stump so that they could be tied off
    Pain control was limited to doses of opium while surgeons seemed more intent on hacking off limbs than actually trying to save them.
    One soldier, private George W. Lemon, was shot in the leg at the 1864 Battle of the Wilderness in 1864 but after the wound became infected he had to have his limb amputated.
    A primitive amputation saw similar to one used by carpenters would have been used to hack through Mr Lemon's flesh and bone.
    The agonising surgery would finally have been completed with a tenaculum hook which was used for pulling the arteries out from the stump so that they could be tied off.
    In this sepia photo, a group of medical students and professors dissect a cadaver. In the civil war era, most advances in medical knowledge came through the examination of dead bodies, of which there were plenty
    In this sepia photo, a group of medical students and professors dissect a cadaver. In the civil war era, most advances in medical knowledge came through the examination of dead bodies, of which there were plenty
    In this July 1863 photo, an amputation is being performed in front of a hospital tent in Gettysburg
    In this July 1863 photo, an amputation is being performed in front of a hospital tent in Gettysburg. About three quarters of all operations performed during the war - roughly 60,000 surgeries - were amputations
    A hospital ward in a convalescent camp in Alexandria, Virginia, pictured in the 1860s. In crowded camp conditions, infectious diseases spread rampantly and took more lives than battlefield injuries
    A hospital ward in a convalescent camp in Alexandria, Virginia, pictured in the 1860s. In crowded camp conditions, infectious diseases spread rampantly and took more lives than battlefield injuries
    Another sepia photograph from the era shows a group of medical students practising on a corpse the kind of manoeuvres they would used in the battlefield.
    A black and white image from July 1863 shows an amputation being performed in front of a hospital tent in Gettysburg.
    Many of the 60,000 operations performed during the civil war were amputations. Surgeons would use different knives, saws and even forceps for the procedures.
    The patients would be knocked out with heavy doses of opium so that they did not feel the pain.
    This is page from 'A Manual of Military Surgery' from the Surgeon General's Office, 1863
    Chloroform in a medicine tin found in a U.S. Medical Dept. hospital knapsack. It was used as an anesthetic during many surgeries
    Left is a page from 'A Manual of Military Surgery' from the Surgeon General's Office, 1863. Right, chloroform in a medicine tin found in a hospital knapsack. It was used as an anesthetic during many surgeries
    Surgeons carried around kits like this one, equipped with an amputation saw, knives, forceps and other surgical equipment
    Surgeons carried around kits like this one, equipped with an amputation saw, knives, forceps and other surgical equipment
    Invalid feeder: Porcelain cups like these were used in hospitals to feed liquids to helpless patients
    Invalid feeder: Porcelain cups like these were used in hospitals to feed liquids to helpless patients
    Open wide: This instrument is called a tooth key and was used for pulling teeth
    Open wide: This instrument is called a tooth key and was used for pulling teeth
    The American Civil began in 1861 when 11 southern states declared their independence from the U.S. and called themselves the 'the Confederacy'.
    Bloody fighting with 21 northern states where slavery had been abolished continued for four years until the Confederacy finally surrounded in 1865.
    The war was the first industrial scale conflict and led to the deaths of over half a million men, with another half million wounded.
    This prosthetic leg made of wood is a full left leg, articulated at the knee, with a leather shoe covering the foot. It still retains some of the original flesh-colored paint
    This prosthetic leg made of wood is a full left leg, articulated at the knee, with a leather shoe covering the foot. It still retains some of the original flesh-colored paint
    This apothecary chest contains medicines in paper envelopes and glass medicine bottles
    This apothecary chest contains medicines in paper envelopes and glass medicine bottles
    This canteen held quinine, which was essential in treating malaria
    This canteen held quinine, which was essential in treating malaria

    Civil War ambulances were typically equipped with two of these water kegs, issued by the U.S. Medical Dept
    Civil War ambulances were typically equipped with two of these water kegs, issued by the U.S. Medical Dept

    This instrument, a fleam, was used for bloodletting. The U-shaped blade is spring-loaded and activated by the trigger above it. The depth of the cut can be regulated by a screw at the base of the lever
    This instrument, a fleam, was used for bloodletting. The U-shaped blade is spring-loaded and activated by the trigger above it. The depth of the cut can be regulated by a screw at the base of the lever
    Spiral tourniquets were used during amputations to stem bleeding. The cloth strap would be wrapped around the limb, and the metal screw tightened until the blood flow slowed
    Spiral tourniquets were used during amputations to stem bleeding. The cloth strap would be wrapped around the limb, and the metal screw tightened until the blood flow slowed
    This bottle contains Dover's Powder, a mix of opium and ipecac that was used to relieve pain and induce sweating
    Opium was often used as a medication for pain, coughs, and diarrhea
    Left, this bottle contains Dover's Powder, a mix of opium and ipecac used to relieve pain and induce sweating. Right, opium was often used as a medication for pain, coughs, and diarrhea

    This carved wooden leg splint was used to stabilise a broken lower leg
    This carved wooden leg splint was used to stabilise a broken lower leg

    This metacarpal saw was used for cutting through smaller bones like fingers, toes, hands, wrists, and ribs
    This metacarpal saw was used for cutting through smaller bones like fingers, toes, hands, wrists, and ribs
    This is a wooden stethoscope - the flat end was placed on the patient's back or chest and the cupped end is the ear-piece
    This is a wooden stethoscope - the flat end was placed on the patient's back or chest and the cupped end is the ear-piece

    This coffin was designed to keep dead bodies fresh. The lower portion was designed to hold ice. The small door at the head of the coffin could be lifted to identify the body inside
    This coffin was designed to keep dead bodies fresh. The lower portion was designed to hold ice. The small door at the head of the coffin could be lifted to identify the body inside

    An admission ticket to a class at Jefferson Medical College in Philadelphia in 1853, for an anatomy class. These tickets were purchased by medical students
    An admission ticket to a class at Jefferson Medical College in Philadelphia in 1853, for an anatomy class. These tickets were purchased by medical students

    Calomel was used as a remedy for diarrhea and dysentary. Its only drawback was that it contained highly poisonous mercury
    Calomel was used as a remedy for diarrhea and dysentary. Its only drawback was that it contained highly poisonous mercury

    'Spiritus Frumenti' was medicinal alcohol. This tin was part of a hospital knapsack made by the U.S. Medical Dept. which was carried onto the battlefield
    'Spiritus Frumenti' was medicinal alcohol. This tin was part of a hospital knapsack made by the U.S. Medical Dept. which was carried onto the battlefield

    An ivory tongue depressor. Though today's are disposable, tongue depressors were reused in the Civil War era
    An ivory tongue depressor. Though today's are disposable, tongue depressors were reused in the Civil War era

    This February 1964 photo shows the entrance to the field hospital at Brandy Station, Virginia. The white structures on each side are the hospital tents.
    This February 1964 photo shows the entrance to the field hospital at Brandy Station, Virginia. The white structures on each side are the hospital tents.

    This picture shows a prosthetics factory in the late 1800s. Almost 150 patents were issued for artificial limb designs between 1861 and 1873
    This picture shows a prosthetics factory in the late 1800s. Almost 150 patents were issued for artificial limb designs between 1861 and 1873

    These illustrations are titled 'Hospital Train from Chattanooga to Nashville' and 'The Interior of a Hospital Car' from Harper's Weekly, February 27, 1864. Many wounded soldiers were transported by trains
    These illustrations are titled 'Hospital Train from Chattanooga to Nashville' and 'The Interior of a Hospital Car' from Harper's Weekly, February 27, 1864. Many wounded soldiers were transported by trains

    This April 1862 print shows the 'Interior of a Sanitary Steamer'. Where transportation by train was not practical, medical evacuations were done by boat
    This April 1862 print shows the 'Interior of a Sanitary Steamer'. Where transportation by train was not practical, medical evacuations were done by boat

    This June 7, 1862, print shows the surgical ward at the general hospital in Fort Monroe, Virginia
    This June 7, 1862, print shows the surgical ward at the general hospital in Fort Monroe, Virginia

    This photograph was made from an 1888 glass plate negative and shows a Civil War veteran's wound. The subject is Sergeant George Ekert, colour bearer, 74th Reg. Pa. Volunteers
    This photograph was made from an 1888 glass plate negative and shows a Civil War veteran's wound. The subject is Sergeant George Ekert, colour bearer, 74th Reg. Pa. Volunteers

    http://www.dailymail.co.uk/news/article-2021188/Civil-war-surgery-The-grisly-photos-wounded-soldiers-treated.html

    Wounded warrior's pioneering surgery: Soldier who lost all four limbs in blast given double arm transplant

    Brendan Marrocco
    Hope: Brandan shows off his arms

    Sergeant Brendan Marrocco, who suffered the devastating injuries in a roadside bomb blast in 2009, said his new arms “already move a little"
     
    The first US soldier to survive after losing all four limbs in the Iraq war has been given a double arm transplant.
     
    Sergeant Brendan Marrocco, who suffered the devastating injuries in a roadside bomb blast in 2009, said his new arms “already move a little”.
     
    Brendan was also given bone marrow from the dead donor of the arms and doctors hope this will help his body accept the limbs with the minimum need for medication.
     
    Father Alex said: “He was really excited to get the new arms.”
     
    And New Yorker Brendan, 26, added last night: “It’s given me a lot of hope for the future.
     
    “I feel like I’m getting a second chance to start over after I got hurt, so I’m just excited for the future now.
     
    “I was feeling great before this and I’m feeling a lot better now. I was living life as a happy kid before.
     
    "Now I can move my elbow, which is mine, the one I had before. I can rotate a little bit.”
    Doctors in Baltimore performed the 13-hour operation a month ago.
    Brendan Marrocco
    Excited for the future: Brandan is delighted with his new arms

    But plastic surgery expert Dr W.P. Andrew Lee, who pioneered the ­technique, said it could take years to learn how much movement Brendan will get out of his new limbs.
     
    Dr Lee explained: “The maximum speed is an inch a month for nerve regeneration. We’re easily looking at a couple of years until the full extent of recovery is known.”
     
    Brendan added: “The right arm doesn’t have much movement but we’re pretty hopeful we’ll get some ­movement out of it.”
     
    Brendan’s dad also revealed there had been four similar operations since his son’s in December.
     
    The military is sponsoring the surgery to help wounded troops after about 300 suffered the loss of limbs in recent conflicts.
     
    All the transplant recipients are said to have done well with most able to take just one anti-rejection drug.
     
    Transplant patients usually need to take a mix of medication.
     
    Brendan has been hailed as a hero in his home country and has been in the public eye many times.
     
    When he and other disabled soldiers visited the September 11 Memorial on American Independence Day last year, brave Brendan revealed how he had no regrets about his military service.
     
    He said: “I wouldn’t change it in any way. I feel great. I’m still the same person.”
     
    On Facebook, he describes himself as a “wounded warrior … very wounded.”

    WAR SURGERY

    Syria: veteran French surgeon saves lives after 44 years in world's war zones

     
    'We are just here to help in some way', says Dr Jacques Bérès, 71, pressed into action within hours of arriving in Homs area
    Demonstrators protest against Syria's President Bashar al-Assad in Homs
     
    Syrian people protest against president Bashar al-Assad in Homs. Photograph: Reuters
    When Dr Jacques Bérès crossed into Syria by truck last week, his hulking suitcase full of surgical kit was perched against an awkward cargo – two dozen rocket launchers.
     
    The retired French surgeon – who has volunteered his services in nearly every major global conflict since Vietnam in 1968 – said he rarely had to share transport with gunrunners on his mercy missions. But nothing about this war in Syria seems to be going to script.
     
    "It's not good," Bérès said of his arrival. "In principle, it is forbidden for humanitarian people to travel with weapons. But it is their country and their war. We are the observers. We are just here to help in some way."
     
    But on Saturday, even as diplomats sought UN backing for an Arab plan to end the bloodshed, reports came from the state-run news agency that a senior army general had been assassinated in Damascus, the first killing of a military figure in the Syrian capital since the uprising began in March last year.
     
    As Syrian forces continued the week-long siege of Homs with a rocket bombardment of its opposition neighbourhoods, violence reaching the capital was a new development.
     
    The UN estimates that 5,400 people have been killed in Syria since the uprising began, but it stopped counting in January and hundreds are reported to have died since.
     
    In the three days that the 71-year-old orthopaedic surgeon Bérès has been near Homs, he has been at the centre of an escalating uprising. Hours after arriving on Thursday he helped to save the life of a gunshot victim and gave first aid to five seriously wounded opposition fighters.
     
    On Saturday he operated on a civilian shot in the leg, as the victim's family and Free Syrian Army soldiers waited anxiously outside. The fighting has seen opposition fighters launching attacks last week against key government posts.
     
    But the destruction during the past week of the two most prominent resistance hubs in Homs, Baba Amr and al-Khalidiyah, had its effect in the city's outskirts, where residents are waiting for an invasion.
     
    "It's 100% certain that they will do the same here that they have done in Homs," said Abu Mahmoud, a Free Syrian Army captain, as he arrived at a clinic. "We know they are coming and we are preparing for them. We only have light weapons," he said, pointing at the webbing around his waist that carried five ammunition clips for a Kalashnikov and a hand grenade.
     
    Only six weeks ago, this hard-bitten rebel was a career officer in the Syrian army. "But they wanted us to kill our own people, our own families," he said, standing in the muddy courtyard of the improvised clinic. "I waited for the chance to run. There were a group of officers who they thought were going to escape and a military firing squad killed 17 of us. I got away."
     
    Abu Mahmoud is a recent defector; he waited for almost 10 months before fleeing and was party to some of the most prominent operations of the regime crackdown, in Idlib, Deraa and Homs. But the time it took him to defect is not being held against him in his home town, where he is now one of the Free Syrian Army's local leaders.
     
    "Every officer like him had three people from Assad's army watching him," said the lead physician at the clinic, Dr Qassem. "He couldn't run. If he did, he would have been killed."
     
    Captain Mahmoud offered a warning: "In Homs they are firing from the hospital and other high ground. Here, they are only five or six kilometres away, in the military firing range. They have positions on every exit from town and some units are less than one kilometre away."
     
    He picked up a box of medicines, turned for the gate and left.
     
    Minutes later the wounded civilian arrived, blood pouring from a bullet wound above his right knee.
     
    Dr Bérès has personal experience in treating such injuries; he has been shot three times himself. One bullet in Monrovia claimed a finger, another in Chechnya caused a deep wound to his side, and a third in Sudan left his right arm scarred. "It is normal to treat such things," he said. "Very normal. I have been doing it all my life."
     
    His war wounds have won him kudos among the band of medics at the clinic. All of them fled the nearby state-run hospital, which is now being used as a firing position by the Syrian army. "They know where we are and we are all wanted," said Dr Qassem. "I don't know why they haven't bombed us yet. We saw what happened to the clinics in Homs."
     
    Frontline medics have been killed and wounded in Homs and their facilities and dispensaries have been hit by mortars and rockets. So, too, has a hospital. The opposition-held sectors of the city have been battered into submission by the eight-day barrage.
     
    Few people are making it out of the satellite towns and villages that spill north to Hama, or south towards Lebanon. "We still can't get there," said one medical worker. We want to go very much, but the roads are not safe."
     
    So, too, does Bérès. "The symbolism is very strong," he said of the presence of foreign doctors in a war zone. "People here are happy to meet a surgeon from a well-developed country who just wants to be with them. "It seems to be a war here, yes. But I don't know if it's a continuation of the (Arab) spring, or a religious war between the Alawite and the Sunni people."
     
    For Bérès, some 44 years in the field, including 10 trips to the war zones of Lebanon, Gaza, the Balkans, Ivory Coast, Afghanistan and Iraq, interspersed with time at Paris hospitals, have chipped away at the ideals he first brought to the profession. "Humanity is not drifting away, but it's not improving," he said.
     
    As he prepared to move on into Homs itself, which could for him be perhaps his last stop on a long road of humanitarian help, he delivered a prediction that seemed to echo around this place, in the hinterland of civil war. "I am not optimistic about Syria," he said gravely. "It is a very difficult situation."
     

    'I contemplated suicide loads of times': Jodie Marsh breaks down on television as she talks of being bullied at school

    She's spoken previously about her difficulty when she was bullied during her time at secondary school


    But the pain of the bullying is still very raw for Jodie Marsh, who broke down in tears on live television this morning when she recalled she was nearly driven to suicide by the constant teasing at her school.

    Jodie, who admitted she was 'terrified' when girls began kicking footballs at her head, made the admissions ahead of her Channel 5 documentary, Bullied: My Secret Past.


     

    Emotional: Jodie Marsh broke down on This Morning today as she recalled how bullies nearly drove her to commit suicide at secondary school

    Emotional: Jodie Marsh broke down on This Morning today as she recalled how bullies nearly drove her to commit suicide at secondary school

    She said: 'My bullying at school changed my life. I only do what I do now because of being bullied. I decided to become a model to prove to my bullies that I wasn't ugly.

    'After I broke my nose in a hockey accident, they started picking on my nose and then I got called ugly and big nose, dodgy nose and all sorts of things right the way through secondary school.

    'By the end of my time secondary school I didn't have a single friend there. I was a complete loner at school. I used to go and hide in the library at lunchtimes.'

    Struggling: Jodie spoke about her trouble with bullies ahead of a new documentary that will be airing on Wednesday night

    Struggling: Jodie spoke about her trouble with bullies ahead of a new documentary that will be airing on Wednesday night

    Overcome: Jodie struggled to control her emotions during the interview on the ITV programme

    Overcome: Jodie struggled to control her emotions during the interview on the ITV programme

    When Phillip Schofield asked her if she had ever thought about taking her own life, Jodie struggled to compose herself before answering - breaking down in tears as she recalled the desperate times.

    She said: 'I contemplated suicide loads of times. I wanted to be a vet and I would have gone off to university and done that and that was my plan in life. 

    'And I was 15 years old when I wrote in my diary that I was going to be a model and prove these bullies wrong - I'd made my mind up at 15.'

    Smiling through: Jodie had appeared in good spirits as she arrived at the ITV studios this morning for her interviewSmiling through: Jodie had appeared in good spirits as she arrived at the ITV studios this morning for her interview
    Smiling through: Jodie had appeared in good spirits as she arrived at the ITV studios this morning for her interview

    And Jodie added that despite her tears, she is feeling much happier about things.

    She said: 'I still get abuse now on my own social networking sites, but I'm actually the happiest I have ever been in life.'
    Jodie, 33, also revealed that making the documentary was incredibly important for her.

    Asked if she had hesitated when asked to do the documentary, Jodie said: 'I didn't hesitate at all. I've wanted to make this show for 10 years because it's so important.'


    http://www.dailymail.co.uk/tvshowbiz/article-2090585/Jodie-Marsh-breaks-This-Morning-talks-suicide-bullied-school.html