Friday, February 18, 2011

Caring for wounded vets

Marine Lance Cpl. James Blake Miller, photographed by Luis Sinco of the Los Angeles Times. More on the photo HERE

I was talking to a friend the other day and remembered some of the veterans I met during a series of stories a few years ago.

(By the way, one of the best pieces on returning veterans and PTSD is "The Marlboro Marine" by Luis Sinco.)

I met with soldiers at Brook Army Medical Center in San Antonio, at a conference in Florida and at Fort Knox, Ky., on the way to writing about the care of wounded soldiers.

Here is one of those stories. I've never forgotten these soldiers.

Tending to our wounded; Some vets face tangle of red tape

JOHN STRAUSS. Indianapolis Star

ORLANDO -- Chief Warrant Officer Cody Sharp, an Army helicopter pilot in Iraq, got used to people shooting at him.

In April, his Kiowa Warrior had been taking fire all day.

"Baghdad was crazy that day," he said. "But I didn't look at it as being dangerous. It was just part of the job."

He spotted a dozen men with AK-47 rifles and rocket-propelled grenades and dropped the helicopter's nose, preparing to fire. At the last second, he turned away -- an old woman and a child were near the gunmen.

In the moment that he spared their lives, his changed forever. Gunfire enveloped his cockpit, seriously wounding him and forcing his helicopter down.

More than seven months later at the Road to Recovery Conference here for wounded veterans, Sharp, 41, a south Texas native still unable to use his deeply scarred left arm, talked about the day matter-of-factly.

For Sharp and about 10,000 other wounded vets, memories of combat can be troubling. But the more immediate problem isn't the past -- it's the future.

Conflicts in Iraq and Afghanistan have produced the highest number of U.S. casualties in two generations.

Those conflicts have borne a new generation of wounded -- many of them from National Guard or reserve units -- who face a lifetime of painful reminders of their time at war.

The Vietnam War, when 153,000 soldiers were wounded before it ended nearly 30 years ago, was the last time this many American soldiers returned home to recover from the wounds of war.

Veterans advocates and some soldiers say the system that is supposed to care for the injured is buckling under the strain.

The Defense Department, in a casualty report this past week, listed 1,069 troops killed in action, 10,177 wounded in action and 367 who died in noncombat situations out of 300,000 troops who have been deployed in Iraq and Afghanistan operations. Soldiers with Indiana ties account for 41 of the deaths. The Defense Department reports also show 189 Hoosiers among the wounded as of the end of November.

In the first Gulf War, from 1990 to 1991, U.S. and coalition forces quickly turned back an Iraqi occupation force from Kuwait in open terrain, without the costly house-to-house urban fighting going on today.

That war claimed 382 American soldiers' lives, including 12 from Indiana, and wounded 467 out of a force of 584,000.

The war in Vietnam claimed 58,000 U.S. lives, including 1,485 from Indiana, out of 3.4 million soldiers who served in Southeast Asia.

More wounded are expected in Iraq as the U.S. fighting force grows from about 130,000 to 150,000.

Short on protection

A conflict that was expected to end quickly has stretched into 21 months, fraying the military supply line in other ways.

The troops are said to be short of advanced body armor and armored vehicles. In a rare moment of wartime candor between soldiers and the chain of command, troops at a town hall-style meeting with Defense Secretary Donald Rumsfeld in Kuwait on Wednesday aired a blunt range of complaints about equipment and extended deployments.

That many of the wounded have made it home alive at all is a success. Body armor, extraordinary advances in field medicine and rapid evacuation to hospitals have saved thousands.

The New England Journal of Medicine this past week showed the impact of advances: In World War II, 70 percent of wounded Americans survived. In Vietnam, 76 percent; and in Iraq and Afghanistan, the survival rate is 90 percent.

Dr. Atul Gawande, a surgeon at Brigham and Women's Hospital in Boston, wrote the article after researching military medicine and the system for rapid battlefield response, which includes surgical kits carried in backpacks.

"As lifesaving as the new strategies have been, teams have been forced to confront numerous unanticipated circumstances," he wrote. "The war has gone on far longer than planned, the volume of wounded soldiers has increased, and the nature of the injuries has changed."

Gawande found that, while more soldiers are surviving because of body armor, their unprotected limbs are often severely damaged.

Bureaucratic maze

The growing legion of survivors, many with injuries that will require a lifetime of care, often emerge from the fog of war into a tangle of red tape that is the veterans-care bureaucracy.

The five-day meeting at Walt Disney World, which ends today, was sponsored by the Coalition to Salute America's Heroes. The gathering was organized to provide information and guidance to about 150 wounded soldiers and to help them understand a system that often leaves them in limbo for as long as four months awaiting disability benefits.

"It's a good thing that the men and women called up to serve didn't say, 'I'll get back to you in 120 days,' " Army Staff Sgt. Mike Sutherland, of San Antonio, said in one session.

Later, in the same emotional meeting, Spc. David Calhoun, of Ludowici, Ga., who lost the use of his legs in a mine explosion, held up his Purple Heart medal.

"This is the medal that no one wants to get," he said. "It's nice, but it won't feed my family."

Army Reserve Sgt. Chris Leverkuhn, of Lafayette, who lost part of his right leg in a January ambush west of Baghdad, said he expects to learn next month the amount of his disability benefits.

He's heard disappointment from other soldiers about the red tape they faced in the disability benefits system.

"They figure out how much they think you deserve for everything that's wrong with you," he said. "Sometimes, it's a ridiculous number they give you."

Army pilot Sharp, a 15-year veteran based at Schofield Army Barracks in Hawaii, never thought about disability payments before his own injury.

"You don't worry about that when you're in the Army and out doing your job," he said. "Nobody ever talks to you about that, and you don't discuss it.

"So the next thing that happens, you're in a hospital. You're worried about getting well and seeing your family. And the next step after that is, 'OK, now what do I do?'

"That's where I am now, and I really don't have a clue."

David Autry, spokesman for the Disabled American Veterans, said from his office in Washington that such complaints are common and stemmed in part from an overworked, underfunded system.

"There is a lot of red tape, and benefits are not automatically bestowed on you," he said. "You have to apply for them, and you have to be deemed worthy, through an eligibility process that is sometimes quite confusing and daunting."

Helping wounded soldiers understand their benefits and the programs available for them would go a long way, Autry said.

In one recent sign of progress, the Department of Labor has developed the Transition Assistance Program, which provides career counseling and help with job searches, including resume preparation.

John Molino, a deputy undersecretary of defense attending the conference, acknowledged there have been many complaints and said the Pentagon would work with groups like the coalition to support veterans.

"We need to join hands," he said. "We will not work as adversaries. We will work as partners, and we'll stay focused on who we're trying to help -- the service members who have been injured."

For its part, the Department of Veterans Affairs claims dramatic improvements the past three years.

"The department has begun the largest and most extensive restructuring of its health care system in history," a report from the agency says. "The claims backlog has been significantly reduced; claims processing has nearly doubled; waiting times for appointments have decreased."

Indeed, not every soldier was critical.

Former Sgt. Mary Herrera, wounded near Fallujah while serving with an Army Reserve military police unit from Phoenix, said the system had worked for her, and she had received her benefits.

Herrera, 23, was a turret gunner on a Humvee when her convoy was ambushed by rifle fire, rocket-propelled grenades and mines in November 2003.

She lost the use of her right arm, received a medical discharge and plans to attend Rice University in Houston, where she now lives.

'It's not just you'

Herrera thought some soldiers at the conference were unfairly critical of the disability benefits process. "It helps to be patient and understand that it's not just you," she said. "There are a lot of people to take care of."

What the returning wounded need, she said, is a better understanding of their options and the help that's available for them in returning to civilian life.

Many of the most horribly wounded have found in each other a way to move toward the rest of their lives.
Robert "B.J." Jackson, of Des Moines, Iowa, was wounded severely while serving with a military police unit of the Iowa National Guard.

As he lay in a coma at Brooke Army Medical Center in San Antonio, his wife, Abby, approached a vet in a wheelchair to ask a pointed question: "How does it feel to lose a leg?"

The man seemed surprised, and she explained, "My husband has lost both his legs, and I just want to know what he's going to go through."

Jackson, 23, said the other soldier instantly became his guide and support through the tough recovery.

"He came to my bed every day. He was by my side through everything."

Jackson has done the same for others. And although he could hide his prosthetic legs under pants, he chose to wear shorts at the conference, as something of a statement.

He has decorated the plastic and metal limbs in flaglike, red, white and blue designs. Another set of his legs is decorated with NASCAR logos saluting his racing heroes.

"A lot of these soldiers have injuries and scars that they can't cover up -- so why should I?" he said.

"Actually, a lot of people you talk to here wear their scars with pride. We didn't go over there to get injured. But we did get hurt, and we wake up every day and make the best of it."

- John Strauss, Dec 12, 2004. pg. A.1

Where vets can find help

The United States has 25 million living military veterans, about three-quarters of whom served in wartime.

About 70 million people, about a quarter of the U.S. population, are potentially eligible for Veterans Affairs benefits because they are veterans, family members or survivors of veterans.

Where to find help

* U.S. Department of Veterans Affairs, (800) 827-1000, The Web site includes a list of service organizations to help former soldiers.

* Disabled American Veterans, (859) 441-7300, Nonprofit organization of 1.2 million members founded in 1920 and dedicated to building better lives for disabled veterans and their families.

Source: Department of Veterans Affairs, Disabled American Veterans

VA disability benefits
About 2.5 million U.S. veterans receive disability compensation.

Basic disability benefits range from $106 monthly (for those rated 10 percent disabled), to $2,239 (100 percent disabled).

Additional allowances are made for those with dependents and for those whose disability leaves them unable to work or who need assistance with daily living. Such factors can increase compensation to as much as $6,404 monthly.

Disability benefits are not subject to federal or state income tax and are adjusted to reflect cost-of-living increases.

Source: Department of Veterans Affairs
Survival rates

A total of 11,246 soldiers have been wounded or killed in action in the Iraq and Afghanistan conflicts. The percentage of U.S. soldiers who survived their wounds:*
Iraq and Afghanistan conflicts - 90%
Persian Gulf War - 76%
Vietnam War - 76%
Korean War - 75%
World War II - 70%
World War I - 79%
* Casualty figures for the Iraq and Afghanistan conflicts are as of Friday.
Sources: Department of Defense, The New England Journal of Medicine

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