Malala Yousufzai was shot in the head by a religious fanatic and Gabby Giffords was shot in the head by some-other-kind of fanatic. By all rights, they should be dead but they both seem to be prospering (prospering being a relative term here, I am sure that it has not been a net positive experience).

As an aside, I hold the position the anybody who tries to kill another human being is crazy. That may be my main definition of crazy, any body who thinks they have the right to kill somebody else is crazy. I suspect that alot of PTSD is otherwise sane people being forced to kill other human beings which is why drone pilots, living and working near Syracuse New York, get PTSD. End aside.

How disheartening that must be for the madmen that pulled the trigger on Malala, she is now a world wide celebrity living in England and he is living a life of an hunted animal. And poor, smiley,   Jared Lee Loughner after everybody argued over his sanity – in public – he will be spending life in prison without parole, reading about how terrific Giffords is. The new technology used to save both Malala and Gabby – if I may be presumptuous enough to use their first names – is a collateral benefit of our wars in the Gulf and Afghanistan.

In the Civil War, if somebody was wounded, they had only about a 40% chance of living. Those were the days before anesthesia or antibiotics like penicillin but it was also before IED’s or hollow-point bullets. In World War II, the odds climbed to about 70%. Now, in Afghanistan, it is better than 80%. With Malala and Gabby, it is 100%. Much of this is because of how fast we can get wounded people to help, but it is also because, once we get them to help, the doctors have learned so much about stopping the damage from getting worse and, then, repairing the damage.

It is extraordinary how far these little wars have pushed trauma medicine. I still don’t think they are worth it, though.