From
The Washington Post - July 20, 2003
AFTER THE WAR, THE WARD
Wounded in Iraq,
Soldiers Stop at Walter Reed Hospital to Heal
by Anne Hull and Tamara
Jones
Washington Post Staff
Writers
The
taxicab pulls up to the curb of Walter Reed Army
Medical Center. Pfc. Garth Stewart slides into
the back seat. A nurse stows his duffel bag in
the trunk and offers 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 Garth's pocket if he
needs them on 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 600 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 43-day 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 ball of
blue pajamas, so miserable and angry that the
nurses stayed clear of his room. Second Lt. John
Fernandez, the West Point graduate, was beginning
married life from a wheelchair. Pfc. Danny
Roberts was wishing for Faulkner instead of a
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 6.
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 and the
blinds drawn. 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 regiment 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. Yet Iraq turned out to be messier than
he thought. He saw charred bodies with skin
melted off, and a grotesque assemblage of dead
Iraqi soldiers who had barreled their car into an
American tank.
On
April 5, his unit was on 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 in 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 replay in 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.
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 prosthetic 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 the doctor who
changes his bandage.
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. Wincing, he manages an appreciative
smile.
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 John's
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 Crowe 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 a chair beside each
soldier's bed. 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 worry 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.
Salvation
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 milkshakes are just an excuse to
talk and counsel. Mayer arrives this Saturday
with his box full of frosty shakes, but when he
knocks on Garth's door, the room is dark, as
usual, and Garth refuses the shake. Too rich. Any
chance of a Mountain Dew, Garth 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 goddam
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 on his mind:
"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,"
Garth says.
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
gets a day pass, and he and his mother head to
Wheaton Plaza Mall. 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.
Discharge
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.
"Gramps!"
"Johnny,
Johnny." Frank Fernandez, 81, is a veteran
himself, a Navy man who survived the bombing of
Pearl Harbor.
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.
A
fat C-141 rumbles to a halt at Andrews Air Force
Base. A gangplank is lowered from the belly of
the plane, and the Army's latest casualties from
Iraq hobble or are carried to a waiting white
bus, their gear still covered with fine desert
dust.
These
medevac flights are now so routine that no
cameras, no VIPs, await the wounded. Their
welcome home happens at Walter Reed Army Medical
Center, the nation's biggest military hospital,
where doctors and nurses in camouflage fatigues
wait at the curb to whisk the newest patients to
the large exam room on the second floor. Here the
soldiers are triaged with swift precision:
"I
need 10 of morphine!" a doctor calls out.
"Are
you weak in your right hand?" another asks.
"Where
does it hurt you now?"
A
20-year-old private moans. In Baghdad, he camped
out in a bathroom of Saddam Hussein's palace,
stacking his Chips Ahoy on the shelves above the
gold-ingot faucets. Now he lies on a gurney with
shrapnel in his belly, beneath a balloon that
says, "You're the Best!"
Upstairs
on the orthopedics ward, the beds are already
filled with recovering casualties from the war in
Iraq. There are different battles being fought on
Ward 57, more private struggles. It's not about
victory, but coping. Not about war, but its
aftermath.
First
Lt. John Fernandez is a veteran of Iraq and by
now a veteran of Ward 57, too. He reports to an
exam room early one morning for his twice-daily
dressing change. The former West Point athlete is
25, a newlywed whose wife, Kristi, hasn't left
his side since he arrived at Walter Reed six
weeks earlier. They had been married less than a
month when John shipped out. His hospital room
would become their first home together; the
nurses looked the other way when Kristi, 22,
moved a cot next to John's bed against hospital
regulations.
Their
usual wisecracking is on mute this morning, their
faces drawn. John hoists himself onto an exam
table and the doctors begin scrutinizing what is
left of his legs.
"I
felt sick yesterday," John announces.
"My glands are swollen."
"Any
fever, chills?" Ken Taylor wants to know.
The chief orthopedics resident swabs his
patient's surgical wounds with iodine. John is
missing his foot and ankle on one side, most of
his lower leg on the other. He knows that any
infection in his body might find its way to his
legs, putting him at risk for higher amputations.
He already has had a dozen operations.
Surgeon
Donald Gajewski notices some redness and leakage
around the sutures on the left stump and Taylor
searches for a sterile pad so he can clean it.
"They're in that cabinet," Kristi says,
pointing. By now, she knows this exam room like
her own kitchen.
As
the headlines shift from the war in Iraq to the
rebuilding of Iraq, a similar theme emerges at
Walter Reed. Joe Miller, the prosthetist who will
craft John's artificial sockets, joins the
doctors in the exam room to decide whether John
is ready to be sized.
"I
think we can start the right side," Miller
offers. John can barely manage a wan smile at
this consolation prize. "My stupid foot
hurts again," he mutters. The severed nerves
in his legs are sending frantic signals to body
parts no longer there. Phantom pain, it's called,
but there is nothing imaginary about it. John is
in constant agony. His nonexistent feet throb.
His lost toes burn. "Like Fred Flintstone
when he stubs his toe?" Kristi wants to
know, imagining a red-hot pulse. "Exactly
like that," John says. Painkillers are
useless.
Miller
heads for the door, reminding John to come to the
prosthetics lab first thing the next morning so
he can make a plaster mold of his right leg. The
doctors interrupt. They'll want to see him first.
And don't eat anything the night before, Taylor
and Gajewski advise. If that oozing doesn't clear
up on the left side, they're going to have to
operate again to check for infection.
So
there's a chance he'll have a new leg tomorrow.
And
a chance he'll lose more of the other.
An
Impatient Soldier
Garth
Stewart is no favorite among the nursing staff of
Ward 57. They bring Jell-O, he wants applesauce.
But the mortar gunner who lost part of his left
leg to a land mine near Baghdad isn't trying to
be the perfect patient. He just wants to be the
perfect soldier. That means getting out of Walter
Reed, his home for the past three weeks.
"I
hate this place," Garth, 20, said. "I'm
sick of being sick."
Garth
doesn't want to wait for the Army's bureaucracy
to decide whether he's fit for combat. He's ready
to buy his own plane ticket back to Iraq to
rejoin the 3rd Infantry Division. Even the
dullest moments of war -- playing chess in his
armored vehicle on the convoy to the Euphrates --
were exhilarating. He was part of something
larger than himself. Now he watches cartoons from
his hospital bed.
He's
got to
make himself strong again. One morning he lowers
himself into his wheelchair to go to a physical
therapy appointment on the third floor. For the
wounded soldiers on 57, physical therapy is a
confrontation with pain and humiliation. In their
minds, the soldiers are still elite athletes
capable of marching 15 miles with 40-pound
rucksacks. PT is the hard truth, with three-pound
dumbbells.
Garth
scans the room for Isatta Cooks, the physical
therapist who works with amputees. She smiles
when she sees him. Cooks, 28, is the rare
employee at Walter Reed who does not find Garth
prickly. Not that their relationship has always
been smooth. Cooks once innocently started,
"When you were in the Army . . . "
"I
am in
the Army," Garth snapped.
And
yet he has earned her admiration. One of the
tools she uses is a full-length mirror. It helps
the soldiers see how their bodies are leaning as
they get used to having only one leg or one arm.
Some of the new amputees refuse to look.
When
Cooks led Garth to the mirror, he stared, as if
trying to burn the image into his mind.
Today,
Cooks wants Garth to practice walking. Sweat has
gathered on his forehead from doing a set of
leg-lifts and push-ups. Cooks hands Garth a pair
of crutches. He blows a puff of air from his
cheeks and stands. Cooks buckles a harness around
his waist so she can pull him upright if he loses
his balance.
Taking
a step, Garth extends his stump as if he still
had a leg and foot. "Good, Garth,"
Cooks says, walking alongside. Garth travels 30
feet and then proceeds out the front door of the
PT room. A man sitting in the lobby averts his
gaze into a magazine, not lifting his eyes until
Garth passes.
Garth
makes it back to the table and lies down, winded.
Cooks touches his bandaged stump. Garth gasps.
"Ow, ow, ow, what are you doing?" he
asks, desperately. He exhales and stares at the
ceiling. He can feel someone watching him. A girl
with auburn hair has paused beside his table. She
is struggling on her own crutches. Garth reaches
out, placing his large hand on her small one.
A
Visit From Hulk
A
blast injury is like no other wound, a war unto
itself. The tremendous force of a land mine
shears soft tissue from bone, then reverberates
through the skeleton with an energy that has
nowhere to go but up. The brain bears the final
insult, whiplashing inside the skull. Hitting the
ground hard can also cause a blast victim's brain
to swell, bleed or tear without any outward sign
of a head wound. When a land mine or grenade or
mortar detonates, the sound waves alone can cause
concussion.
Danny
Roberts, 26, is wheeling himself to the Traumatic
Brain Injury unit, one gleaming hall down from
his room on Ward 57. "There's nothing wrong
with me," he fumes. The slight reservist
from Green Bay, Wis., had just been getting his
life on track, tending bar part-time and settling
on a major -- education -- when his Army reserve
unit, the 890th Transportation Division out of
Hobart, Ind., was deployed. He went to war with
paperback classics in his duffel bag, never fired
his weapon, then was blown sky-high by a land
mine while just standing around talking to his
buddies one afternoon. His left foot is gone.
Now
a neurologist will flip through a tablet of
drawings: What's this, and this, and this? he
asks. A bench, a tripod, a seahorse. Danny is
usually so good-natured that nurses on Ward 57
drop by his room even on their breaks to chat.
But today he's exasperated, his lips pressed
tightly together. He is sure his nagging
headaches are a side effect of his meds, that's
all.
Deborah
Warden and her associates patiently explain to
Danny that concussions can be mild; he may not
even realize he has any symptoms. They cover his
eyes and ask him to identify smells: coffee,
oranges. They break a cotton swab in half and tap
his palm with the cotton, then the stick. Which
is soft, Danny? Which is sharp?
A
technician attaches electrodes to Danny's scalp.
An electroencephalogram will chart any abnormal
brain waves. Verbal and written tests will chart
concentration and memory. Once that's done,
doctors have promised discharge. Goodbye, Walter
Reed, after 24 days.
When
the examiners take a break, Danny goes AWOL. He
rolls back to his room. Hulk Hogan is coming to
visit! "I'll be there for that," he
says.
Minutes
later, Hulk barrels into Danny's room, all
cartoon swagger.
"We
just wanna thank you guys for going over and
protecting us," the wrestler booms. "We
love you, brother."
He
glances at Danny's stump. "They'll fix that
flat tire and get you runnin' again," he
says.
"Put
me in a headlock," Danny begs. His mother
has a camera ready.
Hogan
declines, but poses with his arm around him
instead.
Word
comes that a medevac plane departing Andrews Air
Force Base the next morning can ferry Danny and
his mom to Wisconsin. The brain team will call
him with their findings, and he can get an
artificial foot at the Veterans Administration
hospital in Milwaukee.
When
Taylor comes to say goodbye at dawn, the
orthopedist finds his cheeriest patient in a
tearful fury. The charge nurse is insisting that
he cannot go because he needs valid military ID
to board the plane. Danny's was shredded by the
blast.
"You
have any other ID? Driver's license?" Taylor
asks.
Danny
shakes his head. "They're saying it's my
fault, that I should've taken the initiative! I
can't walk
up there." He jerks his head toward the
nurses' station. " It's their
job."
"You're
absolutely right," Taylor soothes.
He
confronts the stubborn charge nurse: This is
ridiculous, he says. Danny didn't need ID to be
flown here and shouldn't need it to leave. Just
send him to Andrews, they'll let him on. "I
doubt it," the nurse says. But she hands
Danny a lunch sack filled with narcotics and his
blue plastic hospital card. "Maybe that will
work," she suggests. Nancy Roberts points
out that her son has his dog tags tattooed on his
chest -- what more ID could anyone want?
Taylor
and Danny exchange goodbyes, and Taylor studies
him for a moment.
"You're
the most down you've been since you came
here," he ventures.
"I
know. Just frustrated."
"It's
the system. All right, my friend . . . "
Downstairs,
they load Danny onto a litter and a couple of
uniformed soldiers carry him through the lobby to
the white shuttle bus idling outside. At Andrews,
no one demands proof that Danny Roberts is a
soldier.
World
Without Sleep
Walter
Reed, named after the Army major who proved that
yellow fever was transmitted by mosquitoes,
launched into operational tempo the day the war
in Iraq started. The pace didn't slow when the
war ended.
Some
soldiers have been patients of 57 for so long
that they are treating the nurses' station like a
concierge desk. They request Chinese take-out
menus and the number for pizza delivery.
"They think this is a hotel," one nurse
says. "I keep tellin' them it's a
hospital."
Which
no one really can forget. A team of Army
psychiatrists visits the soldiers daily. They
ask: Are you sleeping? Are you eating? Are you
dreaming?
Most
of the soldiers swear the war left no
psychological imprints, such as the lieutenant
who is such a charming cut-up that he invites his
doctors home to Houston for margaritas.
"Every day above ground for that guy is a
celebration," comments a hospital staff
member.
Then
why can't the soldier sleep at night? A
psychiatrist teaches him hypnosis. Imagine you
are on a beach, the doctor says. Breathe.
Sleep
is just as elusive for the nurses in the crush of
overtime hours. They talk about sleep constantly.
"I close the Venetian blinds, put on the
siesta mask and earplugs; then the silence drives
me crazy," one nurse tells another during
dinner break.
Taylor's
pager goes off so frequently that his 4-year-old
son knows what the sound means. "Are the
soldiers hurt?" the boy asks. "Do they
need you?"
"Yeah,
buddy, they do," Taylor answers before
returning to Walter Reed for another numbing
stretch.
He
considers the soldiers his brothers and sisters,
"not just a payment on my boat."
That
sense of brotherhood overrides all sense of
exhaustion on Ward 57. Jim Mayer, a Vietnam
veteran and double amputee, is known as Milkshake
Man because he brings McDonald's milkshakes to
the soldiers several times a week. Garth Stewart
has become a buddy. He loves hearing about
Vietnam.
But
one night, when Mayer walks into Garth's room,
it's empty and smells of cleaning solvents. Garth
has been discharged.
Mayer
feels his eyes welling up. Then he reminds
himself: This is a good
day.
Holding
Tight
Gajewski
unwraps the bandage from John's worrisome left
stump. Kristi hovers protectively. The surgeon
takes a cotton-tipped swab and pokes beneath the
black sutures. A thin red line of blood wells to
the surface. Gajewski smiles.
"That's
what we wanna see. We want to see that skin edge
healing. Dead, unhealthy tissue doesn't bleed. We
just had a little skin-edge necrosis is all. I
can't get the applicator in deep there, and
that's a good sign."
"You
already had us in tears last night!" Kristi
blurts out, relieved.
"I
was in tears!" the
doctor counters.
The
Fernandezes head for the hospital cafeteria.
Standing in line for omelets, Kristi rubs the
burred back of her husband's head, and he leans
in to nuzzle her. She stoops to wheelchair-level,
and they kiss. This isn't how they were supposed
to start their life together. They had a
five-year plan: She would finish school, get into
public health administration. He would finish his
Army tour in 2006, then put his degree in systems
engineering to work in the civilian sector.
They'd start a family.
War
fast-forwarded their lives. John decided to apply
for medical retirement; he'll look for work as an
engineer. Kristi will have to plunge into the job
market. Where they live will be a matter of
accessibility; even the little choices, like who
drives, are dictated by injury. They have to
compromise their very closeness: John's
relentless pain makes sharing a bed impossible
for now.
Yet
they insist that they're coping just fine. Kristi
hasn't fallen apart, not once. "I'm still
waiting for it." No looking back is their
attitude. "If this had to happen to
anyone," Kristi says, "I'm glad it's
us." Because they can handle it, she is
sure.
"All
I see when I look at him is John."
For
his part, John speaks of what happened to him
with an engineer's cool regard. He is a
mathematical problem -- man, minus legs -- with a
mechanical solution. Even though the explosion
that killed three men beside him remains under
investigation as a possible friendly-fire
accident, John is unwavering in his support of
the war. "It could happen in any war,"
he says. "It's war. It's not a pretty
thing."
The
hospital staff marvels at the resilience of John
and Kristi Fernandez, at the tight net beneath
their trapeze act. But among themselves, the
doctors and nurses who have treated traumatic
injuries for decades question whether the young
lovers can bear the stress over the long term.
"Is their relationship going to survive
this?" Taylor wonders aloud.
On
the most important day of his new life so far,
John nearly misses the appointment to get his
first artificial limb when a fellow amputee -- a
sixtyish stranger -- blocks his wheelchair in the
hall and begins spouting advice. John and Kristi
listen with polite impatience. The man is
diabetic. Once he's out of earshot, they hurry to
Miller's lab. "Nothing he said
applied," John observes. "I know!"
Kristi nearly shouts. "It wasn't vascular,
it was a bomb!"
Joe
Miller greets them with the foot he ordered for
John from a catalogue.
"What
exact type of foot is this?" John wants to
know. "Is it flexible? How does it work?
What about lateral distribution weight?"
"This
is a dynamic response foot," Miller says.
"A special keel gives you ankle motion
without having a true joint."
John
has brought a new sneaker for the new foot.
Kristi pulls it out of her ever-expanding tote
bag, which also contains sterile gauze, John's
pills and lip gloss.
A
thick silicone stocking slips over John's stump.
A brass pin on the bottom will screw into the
plastic socket Miller has crafted, which in turn
fastens onto the artificial foot. "Does it
hurt?" Kristi wonders.
"No,
I'm all right," John assures her.
"I
forgot what you look like with legs!" she
says happily.
Miller
leads the way to a practice walkway flanked by
parallel railings. He warns John to take it easy,
that he may feel dizzy.
For
the first time since he was wounded, John
Fernandez stands.
"I'm
going to be a lot taller!" he discovers,
laughing. The prosthesis has added two inches to
his 5-foot-8 frame.
"Oh,
I like it when you stand up," Kristi says
flirtatiously.
The
parallel bars shake from the force of John's
grip, and Miller asks if he's okay, can he
manage. And John answers the way he always does.
"Yeah,
I'm all right."
Memories
of War
When
Garth Stewart was in Iraq, he would lie under
camouflage netting and listen to the plastic
leaves rattling in the wind. He'd close his eyes
and imagine he was at home in the woods in
Minnesota.
But
back in Stillwater, all Garth can think about is
Iraq. His mom works in the bakery at a grocery
store, so he has the apartment to himself most of
the day. Fitted with a new prosthesis, he
practices walking with his cane. He plays video
games and reads Marcus Aurelius.
His
friends throw a party in his honor. Garth holds
everyone spellbound with his stories from Iraq.
He removes his prosthesis to let people see. A
guy drinks beer from the hollow socket.
Garth
keeps in touch with the Milkshake Man. Jim Mayer
encourages Garth to visit Ward 57 someday to
speak to new amputees. At first, Garth recoils.
That hospital represents nothing but pain. But
the idea starts to grow on him.
Stillwater
is green and hot, cut in two by the majestic St.
Croix River where Garth swam as a kid. One
afternoon, a friend picks him up and she drives
him to the river. Garth limps as he makes his way
toward the water. "It's not much
farther," his friend says, looking back to
make sure Garth is okay.
The
two of them lie on a rock in the sun, Garth's
silver prosthetic ankle glinting in the sun.
Canoeists paddle by and birds fly overhead.
"I came back here and people think the
Iraqis just surrendered," Garth says.
"The TV didn't show anything. I saw bodies.
Melted bodies. Skulls. Bodies with the skin
falling off. We got to Karbala and we started
fighting the Republican Guard. Those guys don't
want to take no for an answer."
His
feelings about the war remain mixed. But there is
no doubt surrounding his desire to be a soldier
again.
Finally
he gets the news he's been waiting for. Garth is
told to report back to Fort Benning, Ga., home of
the 3rd Infantry Division.
A
Future in Flux
Danny
Roberts is home alone in his new ground-floor
rental outside Green Bay when the three boxes
arrive from Iraq, emissaries from a distant
dreamscape. Danny tears into them, dirt and sand
spilling everywhere. My stuff
! All his Army gear, plus
his CD player, the last disc he listened to still
inside.
In
Wisconsin, Danny is unsettled, scattered. Waiting
for a new foot, still unable to put weight on his
other leg with its mangled heel, he can't reach
the cupboards so his girlfriend has to put dishes
out for him each day before going to work.
For
now, he spends hours watching TV or reading or
playing video games. Doctors told him it would
improve his concentration.
Tests
revealed mild brain trauma, after all. Which bums
Danny out, despite assurances it will heal on its
own within a few months. Sometimes he forgets
where he put things, or who called or visited him
that day.
He
joins a chapter of Purple Heart veterans, and
they push his wheelchair in the Memorial Day
parade.
The
Veterans Administration is trying to determine
what kind of vocational training would suit him,
but Danny is convinced they screwed up the test
results. "You have no reading
comprehension," he remembers the VA lady
telling him. He is still incredulous. "All I
know how to do is read!" Does this mean they
won't pay for him to get the English degree he
wants? He sweet-talks the VA lady into retesting
him, and plans to re-enroll in college this fall.
He's applying for a discharge from the Army.
Maybe
he won't teach, after all. Maybe he'll buy land
in the Colorado Rockies. He knows a tiny town
called Alma where they're always desperate to
fill the lone policeman's job. He imagines
himself the peacekeeper in that cool, quiet
place.
Jennifer
Love Hewitt keeps calling. The actress kissed
Danny's forehead when she visited Ward 57. Now
she wants him to participate in an MTV
documentary. Sure, he tells her.
Danny
is still trying to sort out what he thinks about
this war. "I want the world to be a better
place," he muses. "We gotta focus on
homelessness, on education. We spend more money
on guns and tobacco than we do on
education."
He
records a new message on his answering machine.
Danny's voice sounds rushed, like he's worried
that time will run out. Well before the beep, he
offers a hurried signoff.
"Peace"
is what he says.
Reporting
for Duty
Fort
Benning is just like Garth remembered: scrubby
little sand hills and Georgia pines, with hot
asphalt roads slashing the landscape of flat
buildings. One thing is different: No one is
here. Garth passes his barracks. The parking lot
is empty. All 4,500 soldiers in the 3rd Brigade
are still deployed.
He
knows it's up to the Army to decide his
assignment, but Garth wants to convince the
medical review board he can be a ground-pounder
again.
A
cab drops him off and he walks into battalion
headquarters. Behind a desk, the weekend duty
sergeant is playing video games. Garth introduces
himself. "I was wounded in Iraq," he
says. "I need a place to stay tonight."
The
sergeant dials someone on the phone. "Hey,
we got a WIA here," he says.
"Hey,"
Garth says, pleased at the heroic-sounding
acronym. "I guess I am a Wounded In
Action."
Three
hours later, another sergeant arrives to welcome
him back and announce that a room in the barracks
awaits him. Instead of the fourth floor where he
used to live, he's getting a spot on the first
floor where the noncommissioned officers are
housed.
Garth's
jaw drops. "No stairs!" he says.
He
arrives in his new barracks and sits down on the
bed. After 16 hours of wearing his prosthesis,
his leg is throbbing. He lays his cane aside and
looks around. There are fresh sheets on his bunk
and the room has been stocked with toilet paper,
bottled water and a few candy bars.
"Outstanding,"
he says.
Graduation
Day
John
Fernandez returns to West Point at the invitation
of Vice President Cheney. It is graduation day,
and he is a guest of honor. Only 48 hours
earlier, he was at Walter Reed getting his second
foot attached.
For
the first time since the war, John is back in
uniform, crisp in his Army dress blues,
spit-shined shoes on plastic feet. He gazes from
his wheelchair at the perfect rows of proud
cadets; only two years have gone by since he was
one, too. John begins steeling himself, a soldier
with a mission. As the opening bars of "The
Star-Spangled Banner" fill the stadium, John
rises from his wheelchair, up through the
blinding pain. With Kristi holding him tight, he
stands tall for just a few shaky minutes, and
salutes his flag.
Story: ©
2003 The Washington Post Company. All Rights
Reserved.
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