SPRINGFIELD, Ohio — He's an assistant clinical professor of surgery at Wright State University and director of the cleft lip and palate clinic at Children's Medical Center in Dayton.

He's also both a reconstructive and plastic surgeon.

But what Dr. Steven Schmidt is best known for in this area is being the surgeon who took care of Dr. Johannes Christian after a rock thrown from a Clark County overpass smashed Christian's face and head and blinded the Columbus minister.

The Centerville-based surgeon and U.S. Air Force veteran gave us his take on work done by his colleagues from another era: The surgeons at Wakeman General Convalescent Hospital at Camp Atterbury, Ind., who treated the soldiers disfigured and maimed in World War II.

The case descriptions, photos and drawings he's evaluating come from an album belonging to Springfielder Carl Emory, (See article on Page B1.)

Schmidt's overall assessment?

"It really is amazing the stuff they did with limited technology."

But that's only touching the surface.

And for surgeons, it's what's under the surface that's most interesting.

Major burns

"Even though there's been a lot of advances ... this is one of the areas where these are still very difficult to deal with, Schmidt said, looking at a face disfigured in a fire. "He survived the injury, and now what?"

To help restore some sense of normalcy, the surgeon at Wakeman first tried to remove as much scar tissue as possible from the face.

Next, he tried to give the face a new coating of skin taken from the soldier's back.

The plan was to cut a big flap — what the surgeon at Wakeman described as "the largest that has been attempted."

The skin would remain attached to the back and face for a time so the blood supply from the back would keep it alive until new vessels started feeding it from the face.

Once bonded, the skin would be separated from the back and trimmed to fit.

"Burns like this are still very difficult to deal with today," Schmidt said.

Dancing skin

Moving skin from one spot to another is common in the Wakeman descriptions. Schmidt said the technique was called "waltzing" after the dance.

"I've never done one of these, because we do microscopic transfer," he explained.

In that current technique, he is able to take a portion of skin from any other part of the body, affix it to a new location, then immediately establish a blood supply by sewing a blood vessel in the new location to vessels in the skin taken from the old.

The "microscopic" part of the microscopic transfer is his use of a microscope so that he can see to do the surgery attaching the blood vessels.

A two-step waltz

For a Wakeman patient with a disfiguring injury on the right side of his face, a two-stage waltz was planned.

In the first stage, a role of skin from the abdomen was attached to the patient's arm.

Once the skin had an adequate blood supply from the arm, it was separated from the abdomen and "waltzed" up to the injured portion of the face. There, it again was held in place until it developed the adequate blood supply at that site.

The difficulty, Schmidt said, is that it takes weeks for the skin in each step of the waltz to establish a blood supply, making the repair a long, drawn-out process.

Another difficulty with the face injury case involves the damaged bone.

"We would have cat scans, and we would put those bones together" with plates and other hardware, he said. Lacking that technology, "they probably wired them together. It's not rigid, and it doesn't work as well," he said.

But it was what they could do.

A nosy Italian

A soldier whose perforated nose led the surgeon at Wakeman to fill the old with skin from the soldier's inner arm reminded Schmidt of a bit of technique history.

In part because of an Italian custom of the 1700s to cut off the nose of a person who offended you, an Italian physician named Tagliacozzi "figured out that using the skin from the inside of the upper arm" could be used to make such a repair.

"He did it on the inside of the upper arm and just tied the arm on and elevated the inner arm and sewed it on to the nose. It's a little uncomfortable for a couple weeks. But it worked, and it worked pretty well."

Schmidt himself used that technique on a nose injury caused by a self-inflicted gunshot.

The technique is "fairly versatile" and "fairly reliable," he said. "It just takes a really long time."

A bone bridge

"Back then, this is a tough one," Schmidt said, looking at a soldier whose chin was shattered by a sniper's bullet.

"His lower jaw is mostly gone. He probably has a little piece up in here," Schmidt said.

Even though the skin is intact, with the jaw gone, not only is eating a problem for the soldier, the missing jaw causes the tongue to sit at the back of the throat, threatening to obstruct the airway.

The first step is to waltz skin from the belly to the jaw to provide some tissue to bridge the gap.

"Then what you're going to do is put in a bone graft from the hip" into that skin to form a chin, Schmidt says.

The bone graft on top of the skin waltzing "is taking years." to execute, he said.

Not only that, the chances of successfully transplanting a large enough bone into the chin to bridge the gap were "marginal at best," Schmidt said.

For the bone to live, there has to be adequate blood supply, and establishing that over such a long gap can be difficult.

Today, the procedure has a much better chance because surgeons can transfer bone, skin and vessels together, then anchor them to existing bone with plates and hardware.

It's a "big day," Schmidt said — an 8- or 10-hour surgery he's done for people with self-inflicted gunshot wounds.

But the procedure works.

A lack of nerve

Although the chunk of skin blown off a soldier's arm on Utah Beach could as reliably been replaced in the 1940s as it is today, "his nerve isn't fixed," Schmidt said, examining the case.

Without the nerve repair, the soldier would have lost function in his fingers, and the likely would have started to claw, Schmidt said.

Today's tendon transfers and nerve grafts could address those problems, he said, and produce a better result.

Skull session

"This is kind of a tough case," Schmidt said, looking at a man whose skin had been burned away from a portion of his skull.

"You can't put a skin graft on bare bone," Schmidt said, because there would be no blood supply to keep it alive.

"So what they do is they take off the outer layer of bone, so the marrow is exposed, and that will grow some tissue, which will support a skin graft."

"We do that on occasion, but not very often," he said.

The solution today would be either to rotate the scalp to cover the gap or get tissue from elsewhere and establish a blood supply to it to make the graft work.

The old solution "doesn't look pretty," Schmidt said, but the patch was successful.

A fine mesh

For another soldier missing a piece of skull, the solution in those days was a titanium plate, Schmidt said.

"This isn't that different that we put in today," he said.

But there's an important variation.

Instead of using a plate, surgeons use a titanium mesh that acts as structure or lattice on to which new bone can take root.

"The bone can actually grow into it," Schmidt said.

When it does, the mesh is integrated into the body, something that cannot happen with the plate, which is large enough that it will always be, to the body, a kind of foreign object.

As good as it gets

"This actually is a really nice result," Schmidt said of a facial repaired after being hit by a rifle grenade.

"They essentially did a fat graft from the abdomen and just filled in the big defect."

Because it has a rich blood supply, "the face is about the only place you can do that easily," Schmidt said. "It's able to revascularize."

"This is as good as anything we can do now. We probably would have done something a little more elegant," he said, "but the end result is really good."  Tom Stafford, Springfield News Sun - Springfield,OH,USA

February 14, 2005 - Medallions a way of saying thanks to WWII vets

N-E/Forrest Berkshire James A. Jones, who served in the 48th Infantry Division of the Pennsylvania National Guard as a second lieutenant during World War II, salutes the flag Sunday during a ceremony honoring World War II veterans.

What more is there to be said about World War II veterans?

In one sense, perhaps only two words which can't be said enough: Thank you.

In another sense, more words than any one person could say and words that could only be said by the veterans themselves: their stories about what they lived through.

The "thank-yous" were ample Sunday at the last of a series of presentations of the Patriot Medallion of Honor and Remembrance to Hardin County World War II vets. The medallion was commissioned by the Non-Commissioned Officers Association in commemoration of last year's 60th anniversary of the end of the war.

Local resident Lela Boix saw an advertisement for it in an NCOA magazine her husband Ben receives. She decided then that the all the surviving men and women from this county who served in the war should have one, and she set about finding sponsors.

One of those was the Elizabethtown-Hardin County Chamber of Commerce, which hosted the ceremony at Pritchard Community Center, where about 400 people were in attendance.

Since June, about 220 of the medals have been distributed, and 85 more veterans were slated to receive one Sunday. Not all of those were able to make it, though.

Boix said during the program that just about every day, she sees an obituary for another World War II veteran.

"I'm glad we decided to do this, because time is running out."

The name, rank, unit and branch of service was called out as each World War II veteran made his (and in one case, her) way from seats facing the stage to seats set aside just for them, facing the audience.

As cadets from the North Hardin High School ROTC offered their arms to assist those less able to walk on their own, those who could seemed to walk with a particularly quick, purposeful step, as if to show their pride that they still had that spryness in them.

Guest speakers included Sgt. Maj. Tony Rose, Gen. Thomas Lynch, U.S. Rep. Ron Lewis, Elizabethtown Mayor David Willmoth and Paul Schlisser, NCOA representative for Kentucky.

All but Rose, who greeted each person as they started up the center aisle, helped distribute the medallions.

"Because of them, you went on standing free today," Rose told the audience after the last of the presentations.

Those at the podium spoke of courageousness, about never forgetting the sacrifices made or that freedom isn't free.

Willmoth urged friends and family to record — by writing, audiotaping, filming or whatever means — the veterans' stories.

He also encouraged the vets to share "some of the things you experienced … to leave it for other generations to know what went on …, so they can know how exactly you felt and what your families went through."

He said now that the Hardin County History Museum is open, that is at least one place that those memories could be conserved.

Rex Thompson of Radcliff does tell his wife of nearly six years, Mildred, about what he and others went through at Okinawa, Japan, and the Philippines as part of the 728th Amphibious unit of the Army, but she said she hasn't been keeping a record of it.

Being at the ceremony "made me appreciate how they fought for the freedom we're enjoying today."

Her husband said the event was "a good remembrance of what we went through, and it's good to see so many of us alive. … It's just a joy for me to be here and talk to so many of the guys who've been where I've been."

Jane Davis, the sole female, was in the Army Nurses Corps in 1945, stationed at Camp Atterbury, Ind., at Wakeman General Hospital.

"We just got some terrible cases. It was heart rending. It was difficult for me to keep from expressing my emotions. … But I wouldn't take anything for that experience." (By MELINDA J. OVERSTREET, The News-Enterprise , Hardin County, Ky)

By KRISTIN HARTY

LOOKING BACK -- Sixty years later, Dalton Eastus, 83, shares his memories of the D-Day invasion of June 6, 1944. As a 23-year-old private, Eastus was in the first wave of the 4th Infantry division to come ashore at Utah Beach.

Dalton Eastus did not get seasick during the crossing.

a wartime photo of Eastus, along with two of the medals he earned.

The Marion native was 23 years old on the morning of June 6, 1944, when he crossed the English Channel with the Army's 4th Infantry Division aboard an amphibious landing vehicle.

He was well-fed and well-trained but frightened as the boat bounced toward the coast of France.

He was to land at the place code-named Utah Beach in Normandy, where soldiers would participate in one of the largest military invasions the world has ever known.

His and the 326,00 other Allied soldiers' mission: to free France from Nazi occupation and hasten the end of World War II.

Eastus did not expect to survive.

"Everything was in confusion, of course," said Eastus, 83, 1709 Wabash Road. "Everybody was mixed up, and, matter of fact, we landed two miles from where we were supposed to land. ... You're kind of in a state of -- oh, what would you call it -- I don't know, you're not thinking too clearly."

A retired meter reader and customer service representative for Indiana-Michigan Electric (now American Electric Power), where he worked for 31 years, Eastus hasn't talked much about his wartime experiences. He never has told his story to the local newspaper.

Last week, as the 60th anniversary of D-Day approached, Eastus recounted some of what happened to him in the war. He did not share everything he'd witnessed.

"I saw scenes that I wouldn't repeat to anybody -- things that happened," said Eastus. At his North Marion home, he sat in a recliner and rocked, ready to respond to more questions.

Despite the Bronze Star and Purple Heart hanging on his living room wall, Eastus doesn't consider himself a hero. He was "just infantry, just a foot soldier," he said.

He was working at Farnsworth Television and Radio (the former RCA) in October 1943 when he was drafted into the Army. He trained for almost a year in Florida and England to prepare for an amphibious invasion.

"You have the landing companies, you run up on the beaches, then you run out like you're making an invasion and all that, see?" said Eastus, father of two and grandfather of four. "As a matter of fact, we had one exercise called Tiger. ... They had some German U-boats out there. We lost 800 men in that practice. They thought we were going to make the invasion, see?"

When D-Day finally came 60 years ago today, the weather was cold, and the English Channel was choppy. Though many soldiers got seasick, Eastus had a stomach of steel.

"We had so much of that training that we were getting used to it," he said. The night before, soldiers "didn't sleep much. They fed you good meals and showed you movies and all that kind of stuff. Get your mind off it."

Aboard his amphibious craft were about 20 soldiers and one LIFE photographer, Eastus said. Their objective: storm Utah Beach and eventually take the Port of Cherbourg, located on the far western edge of the Normandy coast.

Soldiers hit the beach at 6:30 a.m. Though historians say fighting was fiercest at Omaha Beach, Eastus said resistance was heavy at Utah.

"All kinds (of fire)," he said. "Mortar fire, .88 fire. The Germans had what they call .88s. And the machine gun and rifle fire. We kind of surprised the Germans in a way. Matter of fact, the German troops were on maneuvers. When we landed, we overrun their kitchens. The food was on their stoves, hot. So we really took them by surprise."

For three days, Eastus and his squad of 12 men didn't eat or sleep.

"The first three days, it was continuous movement," he said. "Matter of fact, you could go to sleep standing up. Some people don't believe that, but it can happen. It happened to me. For three days and three nights, there was no letup. We got a presidential citation for that."

By the end of Day 3, nine of the 12 men in Eastus' squad were dead.

"They say Utah Beach was kind of easy, but I don't know," Eastus said.

By Day 5 of fighting, the war was over for him. Shrapnel wounded him June 10 as soldiers fought their way toward Montebourg.

"In my left foot, right leg, and in the back," he said, adding that he doesn't know whether the shrapnel was from a mortar or a grenade. "I just felt like when I got hit my left foot was gone. But it was the heel bone."

He was shipped to England for a few days, then home to Camp Atterbury south of Indianapolis. It took him nearly a year to recover, and he was honorably discharged from the Army on May 12, 1945.

"He's still carrying shrapnel around in his body," said Betty Eastus, his wife of 58 years. She and her daughter, Melinda, created a corner on the living room wall that contains Eastus' military memorabilia: his medals, two photographs of him in uniform, his dog tags and an M1 Garand rifle just like the one he carried in battle.

A member of the Disabled American Veterans, Veterans of Foreign Wars and the Purple Heart Association, Eastus has never been back to Normandy.

He has always wanted to go.

"Oh, I don't know, just reminisce, I guess," Eastus said, adding that he is proud of his military service, "in a way, I suppose.