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BROKEN, SCARRED AND STILL FIGHTING -- Three stories

that look at how the Indianapolis VA's Polytrauma

Network Site cares for wounded veterans.

 

 

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First story here... http://www.indystar.com/apps/
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Story below:

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Broken, scarred, and still fighting

Hoosiers Portray Woods and Nick Bennett survived injuries that would have killed them in past wars, but now they struggle to rebuild shattered minds and bodies. It's the new cost of war, being paid across the country.

By Phil Richards
phil.richards@indystar.com

When Portray Woods finally stirred and opened his eyes after two months in a coma, it was to the sweetest greeting. His 4-year-old daughter Dameir held his hand. She was singing their song, the song he had taught her: "You Are My Sunshine."

Dameir climbed into Woods' bed and hugged him. Family members ringed his room at the Minneapolis VA Medical Center.
Welcome home, Portray; but it was a rude awakening, too.

Woods couldn't join in song. He couldn't speak, and beyond that his right arm and left thumb were gone. Much of the left, front quadrant of his skull had been blown away. He was blind in his left eye. He was paralyzed on his right side. He couldn't walk.

"I ain't going to lie. I was scared," said Woods, 35, a now-retired Army sergeant first class who was savaged by a roadside bomb in Baghdad in the spring of 2004. "It hurt me. I couldn't do nothing. Everything was scrambled."

Nick Bennett has been there, too. Through two hazy, painful months at the National Naval Medical Center at Bethesda, Md. Through 27 surgical procedures. Through septic shock and infection. Through the agony and joy of homecoming, including a highlight almost identical to Woods': 11-year-old daughter Amber climbing into bed with him.

"When I stepped off that plane," Bennett recalled, "my kids were looking at me: 'How can I hug you? You're different.'

"That's where the guilt comes in. They didn't sign up for this. My kids shouldn't have to bear these wounds."

These two Hoosiers, like other patients of a "polytrauma" unit at the Roudebush VA Medical Center on West 10th Street, are daily reminders that the Iraq war, 6,500 miles away, is right here among us in Indianapolis. And they are more than that. Woods and Bennett and thousands like them nationwide also embody the new cost of war, a cost that will linger long after the fighting ends.

Protected by improved body armor and benefiting from more immediate and advanced medical care, U.S. troops wounded in Iraq and Afghanistan are surviving more grievous injuries and at a far higher rate than in any previous American war. This presents the nation a sobering challenge: to treat and rehabilitate these broken men and women, to restore them to as normal a life as possible.

It is a challenge as profound as the wounds are deep.

"The person I was," said Bennett, "died that day."

It was Veterans Day. Nov. 11, 2004. Bennett, a Niles, Mich., native who moved to Indiana in 1985 and lives in Franklin, was on gate guard duty at a Marine forward operating base outside Baghdad.
He heard the distinctive whistle. Incoming. The 107mm rocket hit 15 meters off his left shoulder. It failed to detonate but shattered and showered Bennett with jagged metal.

The warhead gouged a soup-can-sized hole through his upper right leg. The shell casing carved his right shoulder to the bone. Shrapnel splattered his upper left arm and back and chipped a bone in his spine. The back of his left hand was peeled away; tendons were shredded, and four bones in his wrist were shattered. The impact slammed Bennett into a nearby Humvee and knocked him unconscious.

That's what passes for good fortune in Iraq.

"I should have been instantly pink-misted," said Bennett, 37, who had flown into Baghdad on his 35th birthday. "They should have been washing down the parking lot."

Seven months earlier, on a reconnaissance patrol in Baghdad, Woods had switched positions with his good friend Staff Sgt. Hubert Caesar. Woods took the hatch and manned the .50-caliber machine gun. Caesar, who would lose his right leg above the knee in the attack, drove the Humvee. That was the last thing Woods remembers. Next, his daughter was singing to him in Minneapolis.

Soon after that, Woods would hear that he'd never walk again, never talk again, never again see out of his left eye.

In addition to more obvious physical injuries, both men suffered traumatic brain injury, Woods to a greater degree. Traumatic brain injury is the signature wound of the war on terror. It is the result of compression blast syndrome inflicted by insurgents' weapons of choice, improvised explosive devices and rocket-propelled grenades, and is the most common wound among those suffering from polytrauma, or multiple grievous injuries.

Injury statistics vary widely, but through June more than 1,500 returned servicemen and women have been treated in the Department of Veterans Affairs polytrauma system of care.

Initially the VA used its four primary hospitals for these patients but starting in December 2005, 22 Polytrauma Network Sites were created, one in each VA region around the country. The idea was that by treating patients closer to home, they would heal more readily and be better reintegrated into family and society.

The Roudebush polytrauma site officially opened a year ago next week. It provides virtually all the medical, rehabilitative and mental health services available at the four primary VA hospitals, and also coordinates treatment with specialists around the Indianapolis metro area, from social workers to physical therapists to dermatologists and plastic surgeons.

Yet doctors stress that despite the comprehensive support network and tremendous medical advances, polytrauma patients face monumental obstacles.

"Most have very long-term needs, and some will be seeing us for the rest of their lives," said Dr. Andrea Conti, chief of the Roudebush polytrauma site.

Refusing to give up

When Essie Edwards first saw Portray, she would not have recognized her son but for the basketball tattoo on his arm. The Fort Wayne native spent a year in hospitals before being released and coming to Roudebush.

"They had given up on him at Walter Reed (Army Medical Center in Washington, D.C.). That's why they shipped him (to Minneapolis)," said Woods' sister, Shanta Springer, a manager at Safeco Insurance in Indianapolis. "He was in a vegetative state. They told us to look for a home for him."

The family resolutely refused. It closed ranks around Woods. It supported him. It prayed.

Edwards recalled therapists working with her son. They would hold up a picture of a chair. Then a bed. He could identify neither. Edwards would slip out into the hallway and wipe away tears.
Several family members were praying one day as Woods was prepped for surgery. As they left the room, he smiled. He waved. "Mommy," he said.

It was his first word.

"Everybody broke down then," Edwards said.

Family was always there. When Paul Springer heard that his brother couldn't walk, he booked the first flight he could get from Little Rock, Ark., to Minneapolis. Springer is a youth counselor, running boot camps for troubled teens. He played drill sergeant with his brother. He confronted him in his wheelchair.

"What's this you can't walk?" Springer demanded. "You stand up and walk."

"Oh, man," Woods remembered thinking, "here we go."

"Come on," Springer challenged. "We've got all day. I'm not going anywhere. You stand up and walk."

Woods swallowed his panic. He struggled to his feet. He shuffled a few tentative baby steps. He walked.

He has been on the road to recovery ever since.

At first Edwards had to bathe, feed and speak for her son. She moved from Fort Wayne to Indianapolis, into daughter Shanta's house, where Woods lived after transferring to Roudebush. Mother and son remain a team, but Woods makes gains in self-sufficiency almost daily.

He played basketball at Fort Wayne Northrup High School and at Olney (Ill.) Central Community College. At Walter Reed, he was fitted with a state-of-the-art prosthetic right arm and at Roudebush a left thumb, and he attacks occupational therapy with the determination of an athlete.

Woods used to be right-handed. Now, the firing of muscles in his biceps activates electrodes that control his prosthetic right arm and hand. His face a mask of concentration, he works with occupational therapist Bill Hammer, placing cubes and checkers in a paper cup, then picking up the cup. The objective is to some day refine the movements to the point that Woods can pick up an egg without cracking it, or pick it up, crack it and cook it.

Woods brings the same want-to spirit to his thrice-weekly sessions with speech pathologist Kathy Krueger. They started with vowels. Then simple words and associations. Speech is thought and thought is speech.

Woods is mastering both. He is reading. He writes cursive with his left hand. He works as a volunteer at Roudebush's information desk. He has regained vision in his left eye. He walks with the easy grace of an athlete, and at 6-foot-2, 210 pounds, looks the part. This patient who would never talk again recently ventured into public speaking.

"Remarkable," Krueger said. "The brain is so complex; it's a universe of connections. Essentially, we're making new brain pathways and associations and connections."

Woods still struggles with many day-to-day concerns. Memory is an issue; he manages his life with a Palm Pilot. His sister has power of attorney and attends to his financial, legal and business matters. His mother is always there to help.

Both serve as his chauffeur. Woods has failed his driver's license test three times but vows he will pass it soon. He is happy, excited, determined. He hopes someday to fully recover his cognitive abilities. He hopes someday to be on his own. No one knows what's possible; Woods and other severe traumatic brain injury patients like him are trekking a new frontier.

"It's a day at a time," he said. "Got to take it a step at a time."

"It's all good"

Like Woods, Bennett is redefining himself. He is seeking his boundaries, the limits of his new life. He is trying to push beyond, expand them, grow.

The two men have become friends at Roudebush. They have much in common. Both come from strong, close families. Both have profound Christian convictions. Both feel a strong obligation to comrades in arms.

Bennett is a de facto spokesman for the polytrauma program. He has given perhaps 30 speeches; at schools and churches, to community and social groups. Bennett was the lone Iraq veteran speaking at a black-tie fundraiser this spring in Birmingham, Ala., for a national program for wounded veterans. He was introduced by Sen. Jeff Sessions, R-Ala., and in turn introduced Rep. Spencer Bachus, R-Ala. In his own speech, Bennett told a rapt audience:

"Being in the military, our identity is one of strength and invincibility. Being wounded, we are robbed of that identity and wander through life trying to figure out who we are."

Woods and Bennett also both have children, and, like so many Iraq/Afghanistan veterans, both have suffered broken marriages. Woods' ex-wife told him she wanted a divorce while he was in the Minneapolis hospital. Bennett's divorce is in its final stages.
Yet profound differences stamp the two men.

Until March, Woods knew nothing of the eight men his platoon lost over the two weeks after he was wounded. His pain is evident when he talks about his buddies, but his spirit, his thousand-watt smile, are undiminished.

Despite his divorce, throughout strenuous physical and mental rehabilitation, Woods remains the same relentlessly cheerful person he was before that day in Baghdad. He suffers no depression, has no nightmares, flashbacks or panic attacks.
Bennett, a staff sergeant who remains on active duty pending a medical board's determination of his level of disability, is haunted by them all.

His stubborn mantra is, "It's all good." He stuck by it resolutely when he began sharing his experience and his life with The Star in September. He was strong. He was wounded but unshaken.

He was a Marine.

As trust with the reporter gradually built, the cracks began to show. Through them seeped the pain, the survivor's guilt, the fear of savage memories and the uncertainty of an unknowable future. "Demons," Bennett calls them. They come mostly at night, when he is alone in his house in Franklin.

It might be the boom and rumble of a thunderstorm, or a glimpse in the mirror of the many scars concealed by street clothes. "Quasimodo," Bennett calls himself, a reference to the hideously disfigured hunchback of Notre Dame. "It's all good" doesn't work when you're lying alone in a dark bedroom, wondering where you fit in, wondering if you fit in.

"I think he's still got deep, deep hurts," said his father, Mike Bennett, dairy manager at a Southside O'Malia's.

"A lot of days I don't know if I'm going to make it," Nick said. "It's the whole gamut, A to Z. It goes to I'm never going to be happy in life, the demons of always living in pain and loneliness."

Bennett left home in late December. He didn't know where he belonged but felt it no longer was there. Friends say Bennett's wife, Yvonne, and their three children, Chris, 18, Caleb, 16, and Amber, 14, were devastated. Yvonne, a Marine Corps veteran of Kosovo, chose not to speak of it publicly and asked that the children's privacy be respected. The family remains in New Whiteland.

There is ache on both sides. Between active-duty Marine Corps stints that ended in 1994 and began again in 2004, Bennett was a stay-at-home dad. His kids were his life. The separation sears.

Stress and loneliness have worn on him. He has lost 45 pounds since December; at 5-foot-5, 162 pounds, he weighs a few pounds less than when he enlisted in the corps as a 17-year-old out of high school.

Bennett is not all doom and gloom. Far from it. He has a warm manner. He is a stimulating conversationalist and an incessant tease.

He remains engaged with his children: camping, movies, lunch or dinner out, but it isn't what he wants, everything he wants.
"I know I have to get better," he said. "I know at this point my head is screwed up and I have to get better for my kids. I pray every night that my relationship with them is strong enough to do that and it's going to be all right in the end."

In May, Bennett made a decision. Enough, he declared.

He hopes his April 13 surgery, his 27th, was the last. He believes his hand and his other wounds are as good as they will get. So no more doctor's appointments. No more therapy sessions. No more talks with his psychiatrist. No more Roudebush, as deep as his feelings of love and gratitude are to the many people there who helped put him back together.

Time to move on. Time to confront his demons. On his own.

New life in a new home

Hopes, dreams and therapy aren't the only components of brighter futures. There are bricks and mortar, lumber and nails. Both men move on in new surroundings.

Next month, Woods, his mother and his sister will move into a 3,000-square-foot home he had built in Pike Township. There are bedrooms for his children, Dameir, 7, and Jayden, 5, who live with their mother in Colorado but visit Woods a half-dozen times a year and stay as long as several weeks.

Woods' house is his castle. It is a culmination and a celebration. It is a milestone on the journey that has brought him so far. It's a base from which to continue his recovery.

Bennett moved into an older home in June. It needs some work. He works on it; it works on him.

"This house is giving him some purpose in his life and it keeps him busy; there's so much he wants to do," said Jean Bennett, Nick's mother. "Buying this house was a good thing."

On a recent weekday morning, Nick stood in his front hallway. He leaned heavily on the wall. Then, with a pencil, he began writing on it.

The hall, he explained, is Iraq, the entryway into his new life. He wrote the names of his buddies from the 4th Battalion, 24th Marine Regiment, their Iraqi interpreter, the corpsman who treated him after he was hit and the Marines who huddled around and kept him calm and awake, then carried him to the ambulance. He wrote "Rocket Man," the nickname he's given the unknown insurgent who launched the rocket that maimed him.

He moved into the living room. The dedications continued from wall to wall. On one he wrote the names of his children, his parents and family members. On another, the names of the kids he used to supervise as youth minister at Southwood Assembly of God. On a third, the doctors, nurses, therapists and all the others who've helped rebuild him. And on the fourth, the names of his unit's killed in action.

The room was thick with emotion, echoes of broken sentences and drying tears. Bennett later would paint the walls, all cream-colored except the vivid red that would cover his fallen comrades. He explained that the process will embed the names into his being.

"This is a room of love and laughter, and it can play a part in who I am," he said. "There are days I wish I could get the joy and laughter back in my soul."

Paint and pain and memories, love and joy and anger and anguish, hurt and hope. It's a powerful, perilous mix, and perhaps without meaning to, Bennett crystallized it all in a breath.

"I want to get my house in order," he said, "for my kids."

Baghdad is 6,500 miles from Indianapolis, but for many the road back is not so easy to measure. It's a long, hard road, whether it is Woods struggling to master his myoelectric arm and wondering whether he will ever again drive or manage a checking account, or Bennett grappling with his demons.

For all they have suffered, for all they continue to deal with three years after they were wounded, both men say they would do it again, they would go back to Iraq.

Today, they press forward.

Call Star reporter Phil Richards at (317) 444-6408.

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Second story here... http://www.indystar.com/apps/
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Two who heal from the heart

Dozens of VA doctors and specialists can be involved in the therapy of a single polytrauma patient. Here are two hands-on helpers whose personal touch will never be forgotten.

Kathy Krueger didn't restore the love between Portray Woods and his two young children, but she gave him something nearly as dear: the ability to express it.

"She taught me how to talk again," Woods said. "I love my kids to death, but I couldn't talk to them. Everything she told me, I did it. I love it. I'm getting better and better. I keep learning new stuff."

Woods could utter only a few words when he arrived at Roudebush VA Medical Center in April 2005. Krueger, a VA speech pathologist, began with the basics. She and Woods worked on vowels. Then speech and associations, listening, focus, reading.

Doctors had told Woods' family that he would never speak again. Now he's telling his story to audiences and being saluted by standing ovations.

"Portray inspires me," Krueger said. "We learn from each other all the time.

"He was one of our first polytrauma outpatients, and his improvement is remarkable. I see it every day."

Krueger, 62, knows what to look for. She has been working for the VA for 32 years, the past 12 at Roudebush.

The attraction was natural. Her grandfather was a veteran who was treated at the VA hospital in Minneapolis. So was her late father, who retired from the Naval Reserve as a captain.

Soldiers in past American wars didn't survive brain injuries as grievous as Woods'. That's why Krueger can't say how far the 35-year-old might come, how aging might affect his cognitive and speech recovery. It's unknown territory.

But she is as grateful to him and he is to her. In a sense, working with him honors her father.

"I feel good about the VA and helping someone like Portray," said Krueger, a Kokomo native who grew up in Minneapolis. "I was never in the service, but it feels like I can serve in this way."

Nick Bennett had heard the horror stories. He wanted nothing to do with the VA medical service. Then he met Cheryl Proper.

"She was the first person I was introduced to at the VA," said Bennett, who arrived at Roudebush in January 2005. "Before they set up the polytrauma unit, she ran the show, and I'll love her forever. When I needed therapy or an appointment or I was just scared, all I had to do was call Cheryl. She was always there."

Proper, a 54-year-old Indianapolis native, serves as a combat veterans coordinator with Roudebush's polytrauma unit. It is her job to make the transition from active duty into the VA system as seamless as possible for wounded warriors.

She has the credentials. Not only is Proper a registered nurse with 17 years of VA employment experience, she retired in May as a lieutenant colonel after 261/2 years in the Army Reserve. She served an 18-month tour in Kuwait and Iraq in 2003-04; no break, no vacation, no rest and recuperation. She did five months' duty at notorious Abu Ghraib prison.

She served. She knows. She came home from Iraq wanting to drive down the middle of the road to avoid the ever-present threat of improvised explosive devices.

"All of a sudden I'm not just an old-lady nurse talking to these guys," she said.

In post-deployment debriefings, Proper encounters a lot of post traumatic stress disorder and other mental health issues. Some seek help. Others avoid it.

"The sooner somebody gets in and gets going, the sooner they move on in life and get better," she said. "The first thing they need to do is realize they need help."

 

Phil Richards

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How Roudebush treats the severel wounded

Who comes here?

In 2005, the Department of Veterans Affairs established four polytrauma centers -- in Minneapolis; Palo Alto, Calif.; Tampa, Fla.; and Richmond, Va. -- to treat the most severely injured troops from Iraq and Afghanistan. Ten months later, the establishment of 22 Polytrauma Network Sites was undertaken, one in each VA region, so that patients could be treated closer to home.

At an initial cost of $500,000, the Roudebush Polytrauma Network Site, at the Roudebush VA Medical Center in Downtown Indianapolis, opened Aug. 18, 2006, to serve servicemen and women in Indiana, most of Michigan and part of Illinois. Currently, the Roudebush site serves 130 patients, 30 percent on active duty, the rest veterans.

What are the most common wounds?

Polytrauma refers to multiple injuries, some possibly life-threatening, and usually includes injuries to the brain, called traumatic brain injury. The other most common ailments are orthopedic injuries and psychological issues.

What kind of treatment is given?

With a dedicated polytrauma staff of 35 and ready access to all doctors and services at Roudebush, the Polytrauma Network Site does "everything but amputations," said Andy Brown, supervisor of physical medicine and rehabilitation. That includes surgery, prosthetic and orthotic services, rehabilitation and mental health treatment.

Most patients are treated on an outpatient basis; of the unit's 11 beds, no more than three have been filled at one time. With the site coordinating, an outpatient might work with as many as a dozen specialists around the metro area concurrently -- for instance, a primary care doctor, a rehabilitation doctor, a psychiatrist, a social worker, and occupational, physical and speech therapists.

How long does treatment take?

Some patients are treated for as little as a few days. Others might need outpatient treatment for the rest of their lives.

How do patients get to Roudebush?

Nick Bennett and Portray Woods went through the typical treatment sequence after being wounded in Iraq. After emergency onsite aid, they were stabilized at an in-country battalion or regional military hospital, then sent to the U.S. military hospital at Landstuhl, Germany, for further treatment.

When they were sufficiently stabilized, Bennett, a Marine, was flown to the National Naval Medical Center in Bethesda, Md., and Woods to Walter Reed Army Medical Center in Washington, D.C. Bennett was transferred from Bethesda to Roudebush, while Woods went from Walter Reed to Minneapolis, a primary polytrauma center, back to Walter Reed and eventually to Roudebush.

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Larry Scott  --