23 December, 2005

Travelogue II: The VA Hospital, pt. 2

Part 1 is here.

The laughter and easy camaraderie from the SUV spilled into the hospital as we loaded the laptop boxes onto carts and headed to the office where they would be kept while we enjoyed lunch. With our laughter and jokes ringing down the hallways, we were probably the noisiest people in the building!

Probably due to Dr. Perlin's recent involvement with it, the hospital was a real showcase. It had been recently remodeled, and its centerpiece was a lovely, spacious canteen that was structured like a mall food court. It was very nice just to sit and enjoy the view from the two-story windows along one entire wall.

By its very nature, a VA hospital has a different feel from a major medical center like Walter Reed. The VA hospital is where people go for very long-term care. Unlike Walter Reed, where many of the patients are going to make full or near-full recoveries, the vast majority of patients in a VA hospital have very long roads ahead of them and many will count themselves extremely lucky if they recover enough to lead completely "normal" or independent lives. Because of that, there is not the inspirational feel that visitors to places like Walter Reed describe, places where everybody seems to be talking as if they are going to make a full recovery and rejoin their unit (even if they aren't, the dream seems possible). Instead, the severe injuries of patients in the VA hospital mean they are going to be transitioning to civilian life.

We were to meet patients from the hospital's Polytrauma Unit, a new concept for the VA hospitals. This is a purposely-small unit for newly-wounded veterans who have more than one serious injury, such as a head injury plus paralysis, or TBI (Traumatic Brain Injury) and limb damage. Many of the patients had recently arrived from Walter Reed and are now facing months and months of therapy and rehabilitation work.

We were given a tour of the Polytrauma unit, and saw that it is made as "homey" as possible and that patients are encouraged to try to do everyday tasks such as laundry and food prep in facilities that are right in their unit. They also have multi-patient rooms that the unit director said have been great for their young patients' morale, as they play and talk together a great deal.

For the presentation of the laptops, the recipients were gathered in a small room. Only one was sitting in a regular chair. The rest were in wheelchairs of various types, including large reclining ones for two patients whose injuries were so severe they couldn't communicate with much effectiveness. Most of the patients who were in standard wheelchairs obviously had paralysis of some kind, and one was missing a significant portion of his head . They all had one or more family members clustered around them, many who were obviously parents, as the patients were so amazingly young. They were all male and, except for the military haircuts, they looked just like any patients with severe injuries or disabilities that you might see at any rehabilitation hospital.

I again was uncertain, and stood near the door, watching as things developed. Speeches were made by the MOPH Commander and the hospital director, but I hardly know what was said. I had wanted to be a nurse when I was younger, so the medical/physical aspects of the patients' injuries didn't faze me a bit. It was something else that shocked me. I looked at their young faces and was overwhelmed with the realization that not too long ago these had been the kind of big, strong men I had been seeing on the news, whose blogs I'd been reading, who I had been writing to in Iraq and Afghanistan, whose skill I had been so admiring of and so grateful for. But now they were weak, broken, and even helpless in some cases.

Strangely, I didn't feel the urge to cry. I guess my brain just could hardly comprehend the contrast. I felt a wave of numbing sorrow crash over me, as I took the experience of helplessness CPT Ziegenfuss had described living with before he made significant improvement, and magnified it exponentially to cover all the hundreds and even thousands who were just like the seven men in that room.

I was struck with the further realization that on the individual level of each person in that room, nothing they had accomplished could possibly be worth the horror they had experienced and the terribly hard futures they faced. This doesn't mean that their service and sacrifice were not important and necessary, but I was smacked with the re-realization that war is fought on the group level, but suffered on the individual level (I don't know if I've expressed my meaning well, but I'm doing the best I can).

This isn't the way it's supposed to be! Big strong soldiers are not supposed to come back to us in pieces!!! But yet they do, and these men willingly enlisted or re-enlisted after 9-11, knowing what the possibilities would be. I finally had to shove these thoughts aside because I couldn't be calm and smiling while thinking such things. Squaring my shoulders, I just refused to think about anything more than the present; the future was too sad, and the past too shocking.

The men from MOPH began moving around the room, handing out phone cards. I again thought of how the older generation was embracing the younger one, the hand of one who had "been there," being extended to those who were still reeling from their experiences. My respect for those two men continued to grow.

As the laptops were unwrapped, one was thrust into my hands. I looked around the room and chickened out: instead of boldly approaching the person I was nearest too, walked up to a man on the outer edge of the room who looked almost uninjured and squatted down next to his wheelchair. I asked him if he wanted a laptop, and he gave me an enthusiastic yes. Raising the lid, I handed it to him and told him it was the result of many donations, an expression of hundreds of people who loved him and appreciated what he had done for us. I said that I knew it was "only a computer," and that I wished I had a magic wand to fix everything, but that we hoped that this computer would bring him joy and satisfaction. It had already been turned on, and his hands shook as he haltingly stroked the keys and touchpad mouse. He watched the screen the whole time, smiling. He didn't seem very talkative, so I soon moved on.

The next person I approached with a laptop was one of the patients who had extremely debilitating injuries. He was in a reclining wheelchair, and both ankles were in casts, with ugly scars running up his calves. During the speeches, I had watched him suffering severe muscle spasms that I knew were painful, as his mother held his head in her hands so that he cold see what was happening. From observing all of this, and noticing his eyes didn't focus very well and hearing him grunt, I knew he likely had severe nerve/brain damage. Silently chastising myself for having previously chickened out, I walked right up and sat down next to his chair. Though he did not turn towards me, I told him the laptop was for him, and asked his mother where I should put it. Supporting his head and turning it to me, his mother told me to place it on his lap and show him the screen. I really couldn't tell if he knew what was going on or not. His mother spoke to him as she might a child, pointing out the objects on the screen, and talking about how exciting it was. She supported his hand as he seemed to strain to move his spasmed fist towards the laptop. It seemed that she almost forgot I was there, so I said something about the laptop being an expression of gratitude and love, then moved on. However, I noticed the very young woman sitting on the other side of him from where I had sat, and made a note to talk to her later.

All of the laptops had been distributed by then, and cookies and soda were brought out for patients and visitors alike (Otis Spunkmeyer cookies, yum!). I saw the man missing a part of his skull talking to someone, and so went over to meet him. His body language and appearance made me guess he was about 19 or 20 years old. He looked familiar to me, and I believe I may have seen somewhere a news article about him that included a picture. Just above his eyebrow from the front of his head to the back, and from near the center of his head to his right temble, there was nothing. It was as if someone had cut a wedge out of his head. Yet he talked and laughed, and his facial expressions were so animated and normal that when I looked at his face it somehow didn't seem weird at all that about 20% of his head was missing. While his speech was somewhat halting at times, it didn't seem abnormal, though he seemed to have a bit of anxiety. Not surprisingly, his left side was paralyzed due to the damage to the right side of his brain.

With great instensity, he clutched his laptop to his chest as I approached. He was worried that we hadn't given him the power cords and various accessories for his laptop, and I had to reassure him several times that they were in a box that would be sent to his room as soon as we were done. Once he was convinced on that count, he suddenly looked up at me and said, "Are you a Marine? Is your family in the Marines?" When I had to report I was a total civilian, his expression fell like a stone and he looked at the floor. I felt awful, so I told him that I had several Marine friends. He continued to look at the floor. I added, "Though I haven't met many, every Marine I've known has been an extra-special person." He looked up a little. I continued, "So, I tend to like Marines a lot. I have a real soft spot in my heart for Marines. They're very special." His head snapped up, and he said a quiet but long, "ooh-rah," as he grinned. That smile made me feel like someone had given me a million bucks!

I talked very briefly with a few other patients who were either not very communicative or were well-attended by other people. I then remembered my vow to spend some time with the young woman I'd noticed. Talking to her was heart-breaking, and for the first (but not the last) time on this trip I nearly lost my composure.

More about that later.

Part 3

Link in Mudville Gazette's Open Post