The Doctor who Invented Triage (Dominique Jean Larrey, France)

Quick answer: Who invented battlefield triage?

Dominique Jean Larrey, Napoleon's surgeon. Before him, wounded soldiers lay where they fell until battle ended. Larrey brought care forward with his flying ambulances and treated men by severity of wound, not rank. At Borodino in 1812, he performed about two hundred amputations in twenty-four hours.

Outside Borodino in September 1812, Dominique Jean Larrey stands in a tent soaked in blood after a battle that left 70,000 men dead or wounded in a single day. A soldier comes in with a shattered leg. Larrey has perhaps forty-five minutes before infection makes it hopeless. Eleven minutes later, the man is in an assistant's hands. “Next.” Larrey did that about two hundred times before sleeping, and treated more than two thousand men in the days that followed. Before him, wounded soldiers lay where they fell until the battle ended, and by the time anyone reached them, wounds were septic. Larrey decided speed was a form of mercy and brought care to the front with his flying ambulances. Then he did something harder. He ranked patients by the severity of the wound, not the rank of the man. That meant trusting people closest to the problem to decide, even that a general would wait. He held that line for twenty years.

Why it matters for leaders: Allocate help by real need, not by who's asking, and trust people closest to the problem to make the call.

Q: What problem did Larrey solve?

A: Wounded soldiers waited hours or days for help, and by then wounds were septic; he decided speed was a form of mercy.

Q: Why did triage require delegation?

A: Front lines moved too fast for orders from headquarters, so assistants in ambulances had to decide, even that a general would wait.

Read the full essay on Substack → https://heroespath.substack.com/p/the-doctor-who-invented-triage-dominique

By John Fenzel, founder and CEO of Heroes' Path Foundation