RUTHFULLY YOURS

Congressman Bob Filner, together with PETA, wants to replace with simulators military Corpsmen’s “live tissue trauma training” on pigs. Filner’s proposal is a “pig in a poke”, experience and science not supporting his drastic change in military training. But, Filner is running for mayor of San Diego and this is the type of issue that appeals to his liberal base, regardless of the peril to Marines wounded on the battlefield. It may be that after much further research that some pigs may be saved, but until then Filner’s politics are “a pig too far.”
Several years ago, while building a structure with a diverse group of men, a pallet fell on to the leg of an elderly man. I ran over, lifted off the pallet, raised the man in my arms and kept him talking so he wouldn’t go into shock. His leg was bleeding profusely. Standing around us, the group included several medical doctors, doing nothing. I told one to cut away his trouser leg, put on a tourniquet and apply a compress, which he then did. Fortunately, once the bleeding was slowed by the tourniquet and compress, it did not turn out to be a severed artery. Fifteen or twenty minutes later an ambulance arrived, the medic commenting that it was good the correct immediate treatment was applied, and they took the conscious elderly man away to the hospital.
After, the doctor asked me how I knew what to do. I replied that in my youth I took training in the Scouts, took Red Cross First Aid courses, and had training in the Marine Corps, all in “field conditions”, all of that over forty to fifty years ago, and had to use it numerous times since. The doctor, much younger than I, obviously trained more intensely and more recently, told me that he’d never been in a trauma situation outside a hospital and was “frozen” until I started giving orders.
On a tract of private land zoned agricultural near rural Alpine, near San Diego City, “live tissue trauma training” of Navy Corpsmen and some Marines uses “several” anesthetized pigs who are shot, stabbed and given other wounds. A neighbor complained, PETA jumped in with a complaint, and a local TV station sent a helicopter over the training for a video that it used in a February 16 report on what it called a “controversial military training exercise.”
Although it is not in his Congressional District, liberal Democrat Congressman Bob Filner weighed in:

Democratic Congressman and San Diego mayoral candidate Bob Filner has proposed legislation that would phase out military trauma training on pigs by the year 2014.
“It’s just disturbing to have to watch a video like this, when not only are we using ineffective methods but the animals are clearly suffering…We have technology now that can adequately simulate the human body, simulate the liquid blood, the kind of wounds that are created, and it’s far more effective.”

The Marine Corps Training & Education spokesman, 1^st Lt Brian Villiard, on the contrary, said,

From anecdotal evidence from individuals who have received live tissue training and then had to provide battlefield care to a wounded service member, they will tell you the same thing, that the live tissue training was absolutely invaluable to preparing them to handle that stressful situation.

In 2009, a similar complaint was lodged against “live tissue trauma training” with pigs at a farm in Valley Center, north of the city of San Diego. Bob Filner was one of those who complained in a letter to the Army, which “says that use of medical simulators and placing troops in hospital emergency rooms can readily replace the current practice.” Valley Center is within San Diego County Congressman Darryl Issa’s District. Issa said, “Our Marines will see their comrades’ blood in real combat — they need to be prepared for real-life trauma.” Congressman Duncan Hunter Jr., in whose District is the Alpine farm, agreed with Issa in 2009: “If it saves lives, it’s important,” common-sensibly adding, “It’s not harming any people — they’re pigs.” The news report continues,

San Diego County animal services officials last week witnessed the training with pigs and say it is conducted humanely. “No laws were being broken,” the county said in a written statement. “The pigs … are subject to guidelines approved and regulated by the United States Department of Agriculture Animal and Plant Health Inspection Service. The pigs were anesthetized without regaining consciousness during the training exercise and were euthanized at the end of the exercise.

The Senate Armed Services Committee, then, reported in 2010, “According to the Department [of Defense], simulators currently lack sufficient realism and the ability to replicate combat wounds and the associated emotional stressors combat medics face on the battlefield.” Accordingly, “the [Senate Armed Services] committee also believes that the use of animals in combat trauma training remains appropriate for critical/high-risk medical procedures, until such time that alternatives are developed to provide combat medics a better training experience that more closely replicates the combat wounds and emotional stressors encountered on the battlefield.”
A recent Air Force “randomized objective” test, published in May 2011, of 24 trainees in two battlefield procedures, comparing live tissue versus simulator training, then a week later on human cadavers, found a faster completion in a cricothyroidotomy (emergency tracheotomy) among those trained on live tissue of a pig and slightly slower in a  thoracostomy (chest tube). “Trends suggest a possible difference, but the number of cadavers required to reach greater than 95 per cent statistical confidence prohibited continuation of the study.” Further, neither the training nor testing of this small group occurred under field or battlefield conditions, which would significantly affect the outcomes.
This experienced lab researcher wrote in 2011 that “the continued use of animals for LTTT [live tissue trauma training] and MMR [military medical research] is justified.”
Congressman Filner would cut short a proven training method before adequate objective analyses can be made.     
At a Special Operations website, discussing the TV report on the “live tissue training” near Alpine, there’s these real life experiences:

I assisted on 2 of those types of sessions, along with running a bunch of training labs for MD surgeons along similar lines…Cadaver training is useful but there’s just no substitute for a living cardiopulmonary system, muscle twitches, vasospasm tearing at your ligatures, and so on.

Another, identifying himself as “Medic 09”, said,

I don’t know about this particular exercise; but I sure as hell know about treating combat wounded and a bit about medic education. There is NO substitute for real tissue, bone, and blood. Nothing will get you ready for it in the field, but previous contact.
I was part of a group that trained for a day in disaster medicine at the medical simulation center at Tel Hashomer in Israel a few years back. Excellent set-up, and well used to train medical personnel of all sorts. But it just wasn’t the same, and can’t be. And that was an expensive, intense experience which far exceeds what standard simulators touted by the inexperienced fools provide. There are so many subtle factors that weren’t even mentioned, like textures and smells. I remember wanting to heave my dinner the first time I was called forward to a live wounded soldier. Might’ve been worse without some previous contacts.
I’m not willing for even one soldier/sailor/airman to get even slightly compromised care just because someone values animals more than people. I wish more medical personnel were trained this way.

Darryl Issa served in an Explosive Ordinance Disposal unit in the Army. Duncan Hunter served as a Marine, twice in Iraq and once in Afghanistan, combat decorated. Bob Filner served as a young civil rights marcher in the mid-‘60s. Filner is currently running to be mayor of San Diego City, where the military is a major servicemember and economic presence. Filner has been very strong on obtaining care for injured veterans, but on this issue of preventing worse wound injuries his supporters come from those most critical of the wars in Iraq and Afghanistan and of the military’s missions and ethos. That shows in his stance on this issue, which might be called “a pig too far.”