Saturday, July 24, 2004

IRAQ: Injured UND student returning

Posted on Thu, Jul. 24, 2003
IRAQ: Injured UND student returning
Soldier had planned on returning to school after deployment ends
By Sarah Jimenez
Herald Staff Writer

Family friend Dianne Pearson said she hated to see 22-year-old UND student Brandon Erickson injured in Iraq, but she's thankful he'll be coming home soon.

"I'm glad that he's still with us," Pearson said Wednesday. "It's something he'll recover from, and he has a lot of support from family."

Erickson, a member of the North Dakota Army National Guard, was wounded Tuesday by attackers using rocket-propelled grenades along the road between Balad, 50 miles north of Baghdad and Ramadi, 60 miles west of the capital, military officials said.

[partial text only; follow link for full article]

Thursday, July 22, 2004


JULY 22, 2004
Chairman Smith and Members of the Committee, I am Charles Scoville, The Program Manager for The U.S. Army Amputee Patient Care Program. Thank you for inviting me to appear before your committee today to discuss the care of our Service Members and Veterans’ who have lost a limb. The Global War on Terrorism is causing a surge in combat injuries involving amputations of major limbs. Over 144 service members have lost one or more limbs as a direct result of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) (120 Army, 20 Marine, 2 Navy and 2 Air Force). Approximately 85% sustained a single limb amputation while 15% have lost multiple limbs. The Walter Reed Army Medical Center (WRAMC) has provided care for 120 military personnel and 1 civilian. Thirty-five percent of all amputations from OIF/OEF involve the loss of an upper-extremity, as compared to approximately 5% in the civilian sector. This presents a unique population for the integrated care within the Department of Veteran’s Affairs (VA) and Department of Defense (DoD) health care systems.

During WWI 1.2 % of all wounded in action (WIA) sustained a major limb amputation, in WWII the rate remained the same 1.2 %, and in the Korean War 1.4% of all WIA sustained a major limb amputation. During the current conflict, amputations account for 2.4% of all WIA. This may be due to an increased survival rate secondary to the effectiveness of the protective vests. During WWII and the Korean War injuries to the torso accounted for 15% of all injuries, during OIF they account for only 7% of all injuries.

In December of 2001, projecting the potential for a large number of amputee patients, LTG Peake, then Surgeon General of the United States Army, directed the development of an amputee patient care program. This program addresses the entire spectrum of amputee patient care from time of injury on the battlefield through the evacuation process to the CONUS facilities that will care for these service members and through the integration of care within the VA’s Health Care System. It also includes the training of deploying surgeons in the “Extremity War Trauma Surgery Course” a 6-hour training program that addresses the management of the unique aspects of wounding patterns created by blasts. The amputee patient care program also includes the training in advanced prosthetics and rehabilitation methodologies to the allied health care providers who will work with these patients as they return to the various Medical Treatment Facilities across the nation.

The combat injured amputee in many ways presents a unique patient population that the military and VA’s health care systems are specifically prepared to address. Amputations caused by blast injuries present a more complex wounding pattern and are more difficult to treat than amputations resulting from disease or other trauma. Blast injuries may involve loss or injury of multiple limbs, head trauma, injury to eyesight, etc. In addition, military amputees are typically young, healthy individuals who maintained a high state of physical fitness before injury. They have a higher propensity for returning to their pre-injury levels of physical activity. Reaching these goals requires advanced prosthetic equipment and higher levels of training.

Appropriate amputee patient care demands highly specialized care from an experienced, multi-disciplinary team of surgeons, prosthetists, physical and occupational therapists, psychologists, psychiatrists, nurses, social workers, nutritionists, and other specialists. The VA has worked very closely with the DoD and the Army Amputee Patient Care Program to meet the needs of our patients. VA’s Social Workers, Benefits Counselors, Vocational Education and Rehabilitation Counselors and Researchers have been detailed to WRAMC in support of the care of our amputee patients, as well as all other soldiers who are patients in our hospital and facing the transition of care into the VA’ s Health Care System.

Our mission is to rehabilitate military amputee patients to the highest possible level of physical function so that the loss of a limb does not prevent them from returning to our active duty forces. Likewise, if they elect not to return to the active duty forces, they are able to make that decision based upon factors other than the loss of a limb, and they are functioning at a level where they can carry on a full, active and productive life.

Military amputee care requires solid research and application of technological advances in a well-coordinated effort between the DoD, VA, and civilian counterparts. There have been several recent advances in prosthetics that have been integral to the return of our patients to the highest levels of activity. For above elbow amputees, the Utah3 Arm permits simultaneous motion of the elbow and hand or elbow and wrist. This is coupled with the SensorSpeed Hand, a device that has sensors in the fingertips that detects if an object is present and will maintain a steady pressure on the object so that it is not dropped or crushed without requiring the individual to consciously monitor the object. This myoelectric hand is also several times faster than other devices currently available, and is fast enough to permit our patients to be able to throw and catch with their prosthetic hand. For the above knee amputee, the C-Leg, which has a computer chip in the knee that monitors motion 50 times a second, and hydraulically assists in ambulation, greatly aids in their ambulation. While the US Military is among the first to receive many of these devices, the VA has also made these devices available for their patients, where appropriate. Also, the VA and the DoD have worked closely together to ensure that the patients have access to necessary maintenance and services for these prosthetic devices, regardless of their geographical location.

As advances in prosthetics and treatment approaches become available it is imperative that we develop sound, scientific rationale for utilization of these devices and approaches. The amputee patient care program at WRAMC is one focal point for DoD and VA researchers working collaboratively to develop common methodologies to advance rehabilitation programs and prosthetic capabilities. The VA has detailed researchers to this facility to closely coordinate our efforts in determining best practices, evaluating the cost-effectiveness, and advancing the care of our amputee patients. Also integral to this program is the dissemination of this information through publications in referenced journals and presentations at national and international conferences, to effect changes that will benefit all amputee patients.

The return of our amputee patients to a full and productive life involves a commitment and partnership by the DoD and the VA. Both the Clinical and the Research arms of the VHA have been tremendous in their cooperation with our amputee patient care program staff. They have facilitated care for the Active Duty service member while home on convalescent leave, shared their expertise through conferences and Quality Enhancement Research Initiative (QUERI) Workshops, and worked side-by-side with our health care providers to assist our patients as they continue their care through the DoD and VA health care systems. Because of this continual interaction between the VA and DoD, the patients leaving WRAMC may be confident that the care they receive as they transition into the VA’s Health Care System will be the same world-leading level regardless of where they travel.

To facilitate both the research and clinical aspects related to amputee patient care, the US Army has worked in collaboration with the VA to develop an amputee patient registry. This database is currently available to designated health care providers within the WRAMC Health Care System on the Intranet. This database incorporated many of the outcomes measures identified by the VA as significant for long-term patient management, and has data entry tables specific to both VA and DoD requirements. We are currently completing the administrative requirements to provide access via a secure internet link and mechanisms of access for the VA Health Care System are currently being finalized.

Mr. Chairman and members of the committee, thank you for your continued commitment and support to the quality care for our Armed Forces Service Members.

Tuesday, July 20, 2004

SHeDAISY honors amputee vets of Iraq (7/20/2004)

SHeDAISY honors amputee vets of Iraq

By Sandra Jontz, Stars and Stripes
European edition, Tuesday, July 20, 2004

Sandra Jontz / S&S
From left, SHeDAISY’s Kelsi, Kassidy and Kristyn Osborn sign autographs for 15 soldiers wounded in Iraq, who were unable to attend the country rock group’s Sunday concert in Alexandria, Va. At the last minute, the soldiers, all amputees, could not get a medical release to attend the concert, hosted by a Washington country radio station. So instead, Lt. Col. Mike Bills, deputy chief for the Army’s DS3 program, or Disabled Soldier Support System, got the sister trio to sign photographs for the soldiers, recuperating at Walter Reed Army Medical Center in Washington.

ALEXANDRIA, Va. — The show went on — even if the guests of honor weren’t there.

At the last moment, 15 soldiers, all amputees wounded in Iraq, didn’t get the medical release to attend a benefit concert by country-rock band SHeDAISY, held, in part, in their honor.

But the sister trio went on.

Originally a free show for loyal listeners of a Washington, D.C., country station, Sunday’s event turned into a concert to honor amputees recuperating at Walter Reed Army Medical Center with a free show and backstage time with SHeDAISY’s Kelsi, Kassidy and Kristyn Osborn.

Then word came the troops didn’t get the medical nod of approval.

[partial text only; follow link for full article]

The war after the war

The war after the war
The Soldiers of Ward 57
Anne Hull and Tamara Jones
Washington Post Staff Writers
July 20, 2003

The taxicab pulls up to the curb of Walter Reed Army Medical Center, and Pfc. Garth Stewart slides into the back seat. A nurse stows his duffel bag in the trunk, offering her last advice. "Move your leg around on the flight," she says.

The American flag hangs slack on the flagpole. Garth lays his crutches across his lap. The lanky 20-year-old soldier from Minnesota rubs the place where his leg was amputated. The throbbing alternates with jolts that feel like electrical shocks. Two Percocets are in his pocket for the plane ride home.

As the cab cuts through Rock Creek Park, Garth rolls down the window to smell the forest. After weeks of hospital food and disinfectant, he breathes deeply. He rips the plastic hospital ID bracelet from his wrist and crumples it in a ball.

The bed that Garth left behind on Ward 57 will be filled by day's end. Even though major combat operations in Iraq are over, the wounded keep arriving. Twice a week, transport planes land at Andrews Air Force Base, bringing fresh casualties. Accidents, ambushes, pockets of resistance. Nearly 650 soldiers have passed through Walter Reed during Operation Iraqi Freedom, more than half of them since the conflict was officially declared over.

On TV, the war was a rout, with infrared tanks rolling toward Baghdad on a desert soundstage. But the permanent realities unfold more quietly on Georgia Avenue NW, behind the black iron gates of the nation's largest military hospital.

Here, the battle shifts from hot sand to polished hallways, and the broad ambitions of global security are replaced by the singular mission of saving a leg. Ward 57, the hospital's orthopedics wing, is the busiest. High-tech body armor spared lives but not necessarily limbs.

The night President Bush declared the end of major combat, the soldiers on Ward 57 slept, unaware of victory.

Garth Stewart was curled in a miserable ball of blue pajamas.

First Lt. John Fernandez, the West Point graduate, was beginning married life from a wheelchair.

Pfc. Danny Roberts was wishing for Faulkner instead of a glossy guide about adapting to limb loss.

Their war was not yet over
Walter Reed has been treating wounded soldiers since the beginning of the century, expanding and contracting with the rhythms of war. During World War I, the number of patient beds grew from 80 to 2,500 in a matter of months. Three generations later, the soldiers from Operation Iraqi Freedom arrive, some so fresh from the battlefield they still have dirt and blood beneath their fingernails.

Each morning, across the sprawling grounds of the 147-acre compound, reveille is sounded at 6. But up on the hospital's fifth floor on Ward 57, the fluorescent dawn is indistinguishable from the fluorescent night. Two long halls flank the nurse's desk, the command center of the ward. Doctors begin their morning rounds at dawn.

In Room 5714, Garth Stewart is sleeping when three doctors arrive. One of them reaches for a light switch, and before Garth can shield his eyes, his room is flash-blasted in white.

"Can we take a look at the leg?"

Garth flips back the bedsheet. His desert tan has gone sallow. His GI buzz cut is a woolly disgrace. Even in this condition, he wishes for a decent soldier's haircut. The drugs have made his stomach cramp so much that he stays curled on his side. Now, with the doctors hovering, he tries to straighten out his 6-foot-4 frame. His amputated leg won't lie down. It trembles in midair.

A doctor works quickly, unwrapping the bandage and then the white gauze. Garth watches as they probe the black caterpillar of sutures on his bulbous stump. He moans. The stump begins to shake violently. "I'm gonna get sick," he says.

"You want your bucket?"

Garth reaches for the container. "I can't do this much longer," he says, holding his hand over his eyes.

"We're almost finished," the doctor tells him.

"No," Garth says, "not that, everything. I can't take it any more."

They leave him in darkness, with his bucket. Only four weeks earlier, Garth was a mortar man with the 1st Battalion of the 3rd Brigade, 3rd Infantry Division. "You get out of high school and you join the Army, or you get out of high school and live in your parents' basement," he says. He chose Fort Benning over Stillwater, Minn.

For someone who signed up for four years of regimen and order, Garth was unusually iconoclastic. Tattooed on his chest was a line from the novel "Fahrenheit 451" by Ray Bradbury: "If they give you ruled paper, write the other way." And yet he loved the discipline of Army life. At Fort Benning, he competed on the martial arts team. Because he was a Minnesotan who called sodas "sweet fizzies," some of the guys nicknamed him "Sweet Fizzies, King of Fighters."

Garth was so eager for the fight in Iraq that he bought a high-powered custom scope for his rifle. He used it only once, to shoot out some factory windows. But Iraq turned out to be messier than he thought. He saw charred bodies, and a grotesque assemblage of dead Iraqi soldiers who had barreled their car into an American tank.

On April 5, his unit was on the Karbala highway when some of the guys stopped to pose for a picture in front of a sign that said "BAGHDAD." Garth and a buddy decided to inspect a nearby bunker. The explosion blew both of them down. Garth's left boot was a wreck, and a chunk was missing from his lower leg. His other leg had a softball-size hole in the calf. A medic told him he'd probably lose a big toe.

He had surgeries in Kuwait and Germany, each time losing more of his foot. At Walter Reed, the orthopedic team decided that his leg needed to be amputated at mid-shin so he could fit into the highest functioning prosthesis.

Now, Dilaudid drips through his intravenous line, along with so many other drugs that he is too sick to eat anything but crackers.

Scenes from the war drift through his head. When he was in Iraq, an Army general came up to his company and said, "Man, we gotta stop Saddam. He boils little girls in acid." The statement struck Garth as "hilarious propaganda."

But lying in bed, he can't stop remembering all the Iraqi people who came out of their houses to shake the hands of the American troops.

Garth tries to make sense of things. "Any beautiful and scornful poem you read about war, it's about the horrible randomality of war," he says. The same Special Forces medic who treated Garth and his buddy after they stepped on the land mine was shot by a sniper two days later south of Baghdad. Now that same medic is on Ward 57, minus his right leg.

Ironies of War
Even with the war officially over, Ward 57 is filled to capacity. Officers are forced to share rooms with enlisted soldiers. "I've got a full-bird colonel in with a private," the charge nurse says one morning, scanning the room assignments with frustration. "Out of respect, he should have his own room."

"Oh, cry me a river," another nurse says.

The famous POW, Pfc. Jessica Lynch, is in a private room at the end of a hallway on 57, with a military police officer seated outside her door. In the rest of the ward, doors are open, visitors flowing in and out. All day long, soldiers buzz the intercom at the nurse's station.

Yeah, when you get a chance, I just spilled something over me.

Yes, ma'am, I need a Percocet.

Uh, can I have a blanket, please?

Yes, ma'am, I was using the urinal and . . . I need a new pair of pants.

In his room, Danny Roberts squints through eyeglasses that survived Iraq without a scratch. The aspiring English teacher in him has to appreciate such irony, same with the half-finished copy of William Faulkner's "As I Lay Dying" he had in his truck the day his feet got blown to pieces. Reading helps break the boredom now. Danny props himself against the pillows and jots reminders in a green spiral notebook: Call bank to replace the ATM card blown up in Iraq with his wallet; order tickets for the Red Hot Chili Peppers concert; get checked for anemia.

He's always been pale and skinny, not the brawny soldier pictured on recruiting posters. Still, he loved the Army so much he had a replica of his dog tags tattooed around his neck after leaving active duty and going to the reserves. Civilian life was a tough adjustment. Danny managed a band for a while, then moved to Hollywood, then New Orleans, partied too hard, went home to Wisconsin and started tending bar and going to college part time. Then his reserve unit was activated, and 26-year-old Danny was en route to Iraq.

He was part of a supply convoy, hauling food and water. He went through his brief war listening to New Age music on his headphones to tune out the ugliness around him. There were wild dogs, that searing white heat, enraged Iraqi boys who would mob the slow-moving convoy, hurling bricks at the hated American faces. Danny never so much as chambered a round in his own weapon. And then one afternoon, he stepped on a land mine.

At Walter Reed, surgeons operated four times just to clean out the wounds. Danny's right heel had been torn off and was replaced with a metal plate. Two toes were missing on his left foot, and the others had to be amputated. As he was healing from that surgery, doctors delivered more bad news: The explosive had destroyed tendons, too, causing the left foot to flop uselessly. He would never be able to walk on it, and it would lose circulation and eventually have to come off anyway. A prosthesis would give him far more mobility. It was up to him whether to amputate now or wait it out. Go ahead, Danny told them, then wept alone in his room that night.

Danny is now the model patient, always chipper and polite. Thank you so much, he tells the nurse bringing pain medication. "Awesome work," he congratulates his surgeon. He urges the bleary-eyed residents to get some sleep.

One morning, an intern unwraps his bandages, causing Danny to grip the bed rails in pain. "Oh, Danny Boy," she begins to sing, trying to distract him. He manages an appreciative smile even as he winces.

The Honeymooners
By the time he reached Walter Reed, John Fernandez had made a vow. "I'm not going to feel sorry for myself," he swore. Not when three men around him, including the gunner he tried to save, came home in body bags. "I'm here and I'm alive and I'm going to walk out of this place."

His hospital room is the first home he and his 22-year-old wife, Kristi, have shared as husband and wife. Kristi has moved a cot into his room. They hold court bedside, John recounting his story to visiting dignitaries, buddies and hospital staff. "I don't have any problems talking about it," he reassures the curious. His 13th Field Artillery unit was pushing toward Baghdad when an explosion blew John from his cot as he slept by his Humvee the night of April 3, less than 20 miles from the Iraqi capital.

"I woke up. My legs were numb," he recalls. "I took off the sleeping bag and I screamed." His feet were bloody pulp. The Humvee was in flames, spewing fuel. Patches of fire burned around the wounded soldiers. "I crawled away, calling for my gunner. He called back. His legs were bad, pretty much blown off. So I threw my flak vest down on him, put my M-16 on his chest and started dragging him." Help arrived, and the gunner was carried off. Two more soldiers -- just kids, John thought -- appeared through the smoke. The Humvee exploded, throwing all of them to the ground again. His rescuers began to panic.

"Calm down, it's okay," John remembers telling them. "Just grab my legs, not my feet." At the mobile Army hospital, one of the senior sergeants burst into tears. "Don't worry about it," John heard himself saying. "I'm okay."

Arriving at Walter Reed, feet swathed in thick bandages, he figured he was in for some serious reconstructive surgery.

But the wounds were grievous, and infection set in.

Twelve surgeries later, John Fernandez is a double amputee.

Surgeons sawed off one leg just below the knee, the other a couple of inches above the ankle. His wife of three months insists that nothing has changed between them, and talks about dancing together at the big wedding postponed by war. The surgeons agree: Anything is possible. People climb mountains, ski, run marathons on state-of-the-art artificial legs. John had always been an avid athlete -- lacrosse, basketball, soccer, hunting, fishing, you name it.

Kristi had been waiting at the curb when they unloaded John's stretcher at Walter Reed. She remembers seeing his smile first, running to kiss him, to say "I love you" over and over through happy tears.

The honeymooners in Room 5711 quickly became the darlings of Ward 57. Encamped in the small room, they crack jokes in their Long Island accents and beg visitors from back home to bring fresh bagels. They draw a cartoon of John on the nurse's dryboard, with the proclamation: "I am the Spanish Thunder." That was his nickname as captain of the Army lacrosse team. John used to have legs like tree trunks.

The swelling is going down on his two stumps, and doctors hope to start fitting him for artificial limbs soon. The rehabilitation specialist, Jeffrey Gambel, says that John should eventually be able to bear weight on the longer stump, which will mean he won't have to put on both prostheses to get to the bathroom in the middle of the night. "It will be very hard to walk on," Gambel cautions, "like a cone."

"Like a pirate," John suggests. He and Kristi burst into laughter, sharing the same ludicrous thought:

"Halloween!" they hoot almost simultaneously. No need to worry about a costume this year.

Celebrity City
America is sending cookies and Hickory Farms baskets to Ward 57. Orioles tickets and NASCAR passes arrive. Sheryl Crow brings her guitar and sings for each soldier. Michael Jordan is as fast on hospital linoleum as he is on the basketball court: Here's an autographed cap and whoosh, he's gone. Kelsey Grammer pulls up a chair bedside. They are too young to remember Bo Derek; ("What's '10'?" a soldier asks after being introduced to the movie star.) But they thoroughly appreciate Jennifer Love Hewitt.

The staff on 57 worries about the attention being showered on the soldiers. What happens when they are no longer in the spotlight? Gambel watches as country singer Chely Wright and her entourage give each soldier a yellow rosebud. "They are told they're heroes, and they get home and they don't feel like heroes," Gambel says. "They feel like some dumb guy who stepped on a land mine."

So many celebrities and politicians arrive that a 28-year-old Special Forces medic whose left leg was amputated hangs a NO VISITORS sign on his door. The phrase "Thank you for your sacrifice" has lost its meaning, he says. "It's like someone saying 'Happy Birthday' or 'Merry Christmas.' "

One Sunday afternoon, the nurse's station on 57 gets word that Secretary of Defense Donald H. Rumsfeld is coming for a visit. Counters are scrubbed, a hot rod magazine on the front desk gets stashed and nurses patrol the halls, making sure patients and rooms are presentable. An hour later, Rumsfeld cancels. He has a cold.

Of all the specialists who puzzle over Garth Stewart, of all the expensive drugs dripping into his veins, nothing brings relief. The stomach cramps and constipation persist. Instead of getting better, he's getting worse. And then his magic bullet arrives.

The remedy comes from an unlikely deliverer known as the Milkshake Man. Jim Mayer is a veteran who lost both legs in Vietnam. Several times a week, he brings McDonald's milkshakes to the amputees on Ward 57. The visits are just an excuse to talk and counsel. Mayer arrives this Saturday afternoon but Garth refuses the shake. Too rich. Any chance of a Mountain Dew, he asks. Mayer heads downstairs to the commissary.

The super-caffeinated soda does it. Caffeine! The next day, Garth is sitting up in bed. His blinds are open. "Mountain Dew saved my goddamn life," he says, his voice deep and robust. Suddenly, he is ravenous. "Domino's keeps showing this commercial for Cinna Stix," he says. "You dip them in icing. Man, I want some."

When six Washington Redskinettes push through the double doors of Ward 57, wearing maroon sparkle bras and hot pants, Garth is waiting. "You guys are so cute," he practically shouts. One of the cheerleaders touches his stump. Garth says, "So many people look at this as you are less of a man. You should see the dignity of the guys who come in here to visit me. They roll up pants, and they are standing on plaster."

A day after the Redskinettes visit, Walter Reed's highest commanders come to bestow military honors. After the VIPs leave, Garth sits in bed, a gold medal pinned to his pajama top and an empty delivery box on the sheet beside him.

"Quite a day, man," he says. "Pizza and a Purple Heart."

The next morning, he's wide awake when the doctors arrive for rounds. Freshly barbered, he looks like a soldier again, which is what he wants to be as soon as he can escape the captivity of Walter Reed. He has one question: "When can I get out?"

"I think a week is certainly feasible," a physician, Ken Taylor, says, checking for signs that the skin flap is healing.

Garth says how badly he wants to rejoin his unit in Iraq. "This is something I'm really serious about, doc."

Taylor stays focused on Garth's stitches. "An amputation is not a death sentence as far as the Army's concerned," he says. "We've got two four-star generals with amputations. It's hard for me to say if you'd be a ground-pounder again, an infantryman, but I don't rule it out."

Garth continues to press. "I mean, if someone came and got me, could the Army stop me from leaving?"

Taylor pauses, holding the gauze in his hand. The 37-year-old Army major is unshaven. He has worked all night, and his long day in the operating room starts in 45 minutes. But he remains calmly intent on Garth. "You're itching to get out of here, and I'm itching to launch you," he says. "The fact that you're even saying that is fantastic. You were this guy curled up in a ball two days ago who didn't want the light turned on."

"You're on the fence right now," he says gently. "I can't pop your hood and look inside and tell you what's going on today to know what I have to do to get you out of here. The human condition is not like that. We're on your side. You buyin' what I'm sayin'?"

Garth folds his hands behind his head. "Yeah."

When Taylor leaves, Garth comes up with the idea to buy his own plane ticket back to Iraq. He can't stand the idea of the 3rd Infantry Division over there without him.

Trip to the Mall
Danny's little green notebook is full of his scrawled reminders now. There's a lot to think about, plans to make. He and his girlfriend, Mindy, will need a new apartment, ground floor. And transportation -- he sold his beater of a pickup truck before going off to war. Will a wheelchair fit in Mindy's Kia? He fantasizes about buying a bass guitar once he gets home to Green Bay, too.

In the haze of painkillers and too many different people trying to brief him on Army policy, the economics of being a disabled reservist confuse Danny. There are forms to complete, boards to convene, hearings to go through before the Army decides what his status will be and what kind of compensation he will get. The process can takes months. His head hurts. He thinks it must be the meds.

"I'm not one to gouge the system," he says, "but everyone's told me I already paid a big price and deserve what I can get."

His mother, Nancy, arrives from Green Bay with Mindy, a blur of hugs and held-back tears. Nancy brings her son's favorite chocolate chip cookies, homemade.

Mindy Bosse, a 20-year-old juggling two waitressing jobs and college, has final exams back home and can only stay the weekend. She'll start hunting for a new place for them to live, but Danny needs to get money for the security deposit out of his Wisconsin bank account, and the bank doesn't seem to understand that his ATM card and identification are now confetti in the Iraqi desert.

Danny remembers what happened to him April 9 with the kind of vivid detail so common among wounded soldiers that doctors have a term for it: flashbulb memory.

His convoy was exploring an abandoned Iraqi air base. Danny kept finding souvenirs: an Iraqi beret emblazoned with an eagle, a gas mask, the blouse from an Iraqi uniform. Best of all, there was a hardcover book with an autographed photo of Saddam Hussein inside.

Wow, he thought, this is my lucky day.

Two hours later, he was having a cigarette with a few buddies. He kept bouncing the heel of one combat boot off the toe of his other boot, an old habit. He figures now that this mindless motion set off the land mine beneath him. Three others were hurt, none as badly as Danny. He can still see the speckles of blood on a buddy's shirt. "It was my fault," he would later sob to doctors, who noted the crying jags in his chart as they transferred him from Kuwait to Germany to Walter Reed.

Now he is getting a fresh cast on his shattered heel.

"Ankle up, ankle up, ankle up," the technician says.

"I'm trying," Danny apologizes. The procedure causes pain not only in the heel but also in the severed nerves that have gone haywire on the opposite stump, where his left foot was amputated just above the ankle. He squeezes his eyes tight and grimaces, but doesn't complain.

He massages his stump.

"Your body gets used to pain," the cast tech offers.

"I've definitely gotten used to pain."

He scores a day pass, and he and his mother head to the nearest mall, in Wheaton. But that first excursion outside the cocoon of Walter Reed leaves Danny depleted physically and emotionally. The wheelchair they have given him was clearly intended for a large and husky man; Danny is neither. Maneuvering through crowds of shoppers, and up and down inclines, is a lot trickier than a hospital's wide, level halls. And then there are the stares. The adults quickly avert their eyes, but the kids ask straight-out what happened to his foot. Accustomed to living in a ward full of amputees, Danny didn't think to cover up the raw red stump when he ventured out.

He returns to Walter Reed bone tired. Nothing to write in the green notebook today. In a small voice, he asks everyone -- his mom, the social worker, the nurses -- to leave him alone for a while.

It's too hard to concentrate, and these headaches won't go away. Worried doctors schedule him for a battery of tests.

Across the ward, John Fernandez is packing up. His orthopedist, Donald Gajewski, is so pleased with the way John's wounds are healing, and how well John has managed on his day passes outside the hospital with Kristi, that he offers a deal: Discharge to Fisher House, a small inn on the hospital grounds for patients' families. But they need to return for daily dressing changes and physical therapy. The prosthetics lab will be able to start casting John for artificial limbs once his swelling has gone down.

"Take it easy," Gajewski cautions, "you're still healing."

The nurses cluster around as they leave, offering a round of applause.

At Fisher House, they are in the dining room eating lunch when John's grandparents arrive from Long Island.


"Johnny, Johnny." Frank Fernandez, 81, is a veteran himself, a Navy man who survived the bombing of Pearl Harbor and then had two torpedoed ships sink beneath him. He spent 33 hours in the water and won't go swimming to this day.

Mary Fernandez, 74, bustles through the door.

"I brought cookies from New York!" She kisses John. "How you feel? You're still pale."

"No, I'm great. I'm fine."

"Your eyes. You always have lively eyes. Your eyes are pale."

Frank agrees.

"You need more color," he concludes. "Color, color, color. That's the name of the game. Color! Before you know it, you'll be shootin' baskets. You know, why not?"

John smiles.

"Right now it still hurts," he tells them.

"It has to hurt," his grandmother clucks.

"Let it heal, John," his grandfather says softly. "Let it heal."

John and Kristi excuse themselves for a nap, and only after they leave the room does his grandmother's smile begin to tremble. Tears slip down her face.

New Arrivals
Nighttime on Ward 57. The rooms are quiet except for the beep of morphine pumps and the sound of a lone TV.

Downstairs, the triage room is bracing for an influx of new casualties. An hour ago, another medevac plane landed at Andrews Air Force Base.

Saturday, July 17, 2004

Soldier vows life will go on despite injury

Soldier vows life will go on despite injury

By Staff Sgt. Cheryl Hackley
National Guard Bureau

ARLINGTON, Va. (7/16/2004) — Today, one can turn on the news and hear how many of America’s brave men and women have made the ultimate sacrifice, their lives, in the war on terrorism. That number is well over 800 and climbs higher on almost a daily basis. But there are also those unknown numbers of men and women who have returned from the war with injuries. Here is the story of one man, a Soldier who lost his leg in Operation Iraqi Freedom, but not his will to live.

Austin Philips was 20 when he joined the Army National Guard. He was working at a Wal-Mart distribution center loading and unloading trailers, but wanted to earn some extra money. He learned about the Guard from a friend, and in 1997 enlisted as a mortar Soldier with Charlie Co. 1st Battalion, 153rd Infantry, 39th Brigade, Mena, Ark.

[partial text only; follow link for full article]

Wednesday, July 07, 2004

Numbers Update: 144 total, 85% single limb, 15% multiple

The Global War on Terrorism is causing a surge in combat injuries involving amputations of major limbs. Over 144 service members have lost one or more limbs as a direct result of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) (120 Army, 20 Marine, 2 Navy and 2 Air Force). Approximately 85% sustained a single limb amputation while 15% have lost multiple limbs. The Walter Reed Army Medical Center (WRAMC) has provided care for 120 military personnel and 1 civilian. Thirty-five percent of all amputations from OIF/OEF involve the loss of an upper-extremity, as compared to approximately 5% in the civilian sector.

Thursday, July 01, 2004

Humanitarian Mission Shows Iraqis' Prosthetics Needs (July 2004)

July 2004
Humanitarian Mission Shows Iraqis' Prosthetics Needs - Sandra Basu

U.S. soldier Lucas Wilson (l) and
Iraqi amputee Basim Ameer
WASHINGTON-Seven Iraqis who were fitted with prosthetic hands in the United States in April to replace limbs that had been chopped off at orders by Saddam Hussein, represent only the tip of a massive medical problem in Iraq, according to physicians.

Dr. Sabah al-Rubayi, the director of medical services for the handicapped for the Baghdad Ministry of Health who accompanied the Iraqis to the U.S. for the surgeries, says that there is a multitude of Iraqis with severed limbs. He knows that it is not possible for every Iraqi to come to the U.S. to be fitted with prosthetics, like these seven, but he is hoping that Iraq will have the medical capability of its own to help Iraqis who are in need of prosthetic limbs.

[partial text only; follow link for full article]