RIYADH, Saudi Arabia -- Senior medical officers in the Persian Gulf say they are prepared to treat heavy casualties in the event of combat, but many of the doctors and nurses who will handle patients say they lack important medical supplies and modern equipment.
Casualty estimates, as well as numbers of hospital beds and medical personnel, are among the Pentagon's most closely held secrets.
But military medical planners say they are relying on a range of equipment -- from scores of 50-bed mobile Air Force field hospitals to fully equipped 1,000-bed Navy hospital ships -- in preparation for the "worst case," an outcome that some experts say could result in as many as 10,000 to 20,000 American wounded and dead among the 430,000 troops expected to be deployed by the end of the month.
"We've been ready to manage the patients from the beginning," Col. Robert P. Belihar, the military's senior medical officer in the gulf, said in an interview. "Each and every day of this operation, the medical community has asked the question 'What if?' and then planned accordingly. We'll have thousands and thousands of beds."
Some doctors and nurses here have expressed concern that official assurances are undercut by a shortage of specialized surgeons and nurses as well as basic supplies.
Although they say they are confident that they can provide basic medical care, a number of doctors and nurses warn that they are still without essential equipment, even though a war against Iraq may be only weeks, or even days, away. And some say they are being cut out of essential planning.
"We'll end up practicing medicine as it was practiced in the '50s or '60s," said a Navy surgeon, Lt. Cmdr. Bob Lynch of Cincinnati, who has been frustrated by his inability to obtain advanced sutures for use in his mobile operating room.
"I don't think anybody is going to die because I don't have the sutures, but I could operate faster with them," he said.
Five months after the first deployment of U.S. troops to the gulf, the Army is just now replacing the last of its Vietnam War-era field hospitals with larger, better-equipped units.
The Navy has two 1,000-bed hospital ships off Bahrain. But at current staffing levels, the ships have only three-quarters of their full complement of doctors and nurses and, for now, each can handle about 500 patients at a time.
Navy officials say that ship staffing is planned with a built-in ability to expand quickly.
Other medical abilities are stretched to capacity. The military, which has already stepped up blood drives at 84 installations around the country, has for the first time tapped civilian blood banks in the United States for contributions of 2,000 units a week.