This is part three of a three-part series entitled "The Lifeline" where LA Times Reporter David Zucchino and photographer Rick Loomis follow five wounded troops through a system of military medical care more advanced than in any previous conflict. This series is not for the "faint of heart" and is very graphic, as are the accompanying slides and interactives that can be seen by clicking on the original link. Kudos to these reporters entering this touchy area and at the same time letting us meet, firsthand, another group of military heroes--the medics, the surgeons, the orthopedists, the opthmalogists, and all the rest of the medical staff that are there to take care of our boys.
part one is found at: http://www.marine-corps-news.com/2006/04/bringing_back_the_wounded_with.htm
part two is found at: http://www.marine-corps-news.com/2006/04/the_journey_through_trauma.htm
LAST OF THREE PARTS
THE LIFELINE
New Battle on the Home Front
When wounded U.S. troops return from Iraq, nearly everything has changed. Except, for many, the drive to keep on fighting.
http://www.latimes.com/news/nationworld/nation/la-na-wounded4apr04,0,3527872.story?coll=la-home-headlines
By David Zucchino
Times Staff Writer
April 4, 2006
The vision in Vincent Worrell's left eye was blurry. The hearing in his left ear was bad. Two of his upper teeth were missing. There was a hole in his left shoulder, a surgical scar on his lip, shrapnel in his face and a metal pin in his left thumb.
Still, it was a very good day. He found a simple joy in being able to push his 5-year-old daughter, Indra, on a park swing. It was a blessing to hold hands under the trees with his wife, Jayme.
Just five weeks had passed since a roadside bomb blew shrapnel and grit into Worrell, an Army staff sergeant, as he walked on patrol Nov. 6 in Iraq. Now his little girl clung to his arm, as if she were afraid he would evaporate if she let go. That week, she had drawn ink spots on her hand and wrapped it in a white towel to imitate her father's shrapnel wounds.
"Daddy's girl," her mother said.
About 500 miles north, in Manheim, Pa., snow crunched underfoot as Marine Lance Cpl. Ryan Buchter, 20, struggled to walk on his wounded leg without a cane. On Nov. 8, an insurgent's grenade ripped apart his left leg and sent shrapnel whistling into his nostrils.
He was pacing outside his parents' small-frame house, which was filled with fruit baskets and letters — some from strangers — welcoming him home. From time to time, he would pick shrapnel out of his leg. His girlfriend, Erin Culley, used her fingernail to scrape tiny slivers of metal from his face.
Ryan's father, Douglas Buchter, 41, an Army National Guard sergeant whose unit is scheduled to head to Iraq in the fall, predicted that his son would heal in time to serve there with him. Despite Ryan's wounds, Douglas said he believed the Marine Corps was the best thing that ever happened to his son.
"He left here a boy," he said, slapping Ryan's shoulder, "and he came home a man."
When the wounded come home from Iraq, nothing is as it once was. They look different, of course — pocked with shrapnel scars and surgical incisions, sore and tentative, and carrying the memory of that moment, just before the blast or bullet, when they were still whole.
Their families are different. Mothers and fathers and girlfriends and wives become nurturers and caregivers, their daily routines upended and their relationships forever altered. They change bandages, fetch medication, drive to hospitals, and walk their loved ones through months of physical therapy and rehabilitation.
Aggressive and driven in Iraq, the wounded become dependent and distracted back home. Hometowns and living rooms feel different. Friends have moved away. Children have grown. Iraq was terrifying and dangerous, but it became fulfilling and familiar.
The wounded are relieved to be back with their families. Though thankful to be alive, they're burdened by a sense of unease. Vincent Worrell felt it, and Ryan Buchter too. So did three others wounded over a four-day period in November — Marine 2nd Lt. Mike Geiger and Marine Lance Cpl. Francisco Ponceherbozo in California and Army Spc. Joshua Griffin in Texas.
They call it RTD — return to duty. They couldn't wait to get back to Iraq.
At 11 p.m. on Veterans Day, Douglas and Tracy Buchter drove three hours from Pennsylvania to Andrews Air Force Base outside Washington, D.C. They had been told to meet their wounded son at the airport.
They stood on the tarmac at 2 a.m., waiting for Ryan to be taken off a military plane from Germany. Instead, a flight surgeon told them that he was being flown to a hospital at Camp Lejeune, N.C., for more surgery.
The Buchters climbed back into the car and drove eight hours to North Carolina.
They had been agonizing over their son's condition since Ryan called and told his father: "Pop! I've been … fragged! The freakin' Iraqis fragged me! I'm in so much freakin' pain!"
The phone connection was so distorted that Douglas didn't learn how seriously his son was hurt. The last thing he heard was: "Tell Mom I have 10 fingers and 10 toes."
After hours of trying, Douglas finally reached a nurse at the U.S. military hospital in Landstuhl, Germany, who told him something he did not want to hear: Ryan's badly swollen leg might have to be amputated. Douglas began making arrangements to fly to Germany.
Then Douglas got another disturbing call, from a Marine officer at Camp Lejeune who said Ryan had been wounded in both legs. Cut off from information, thousands of miles away, Douglas and Tracy felt helpless and confused.
"The worst thing was knowing he was in that much pain and we couldn't be there to do anything," Douglas recalled later. "At the point they said he was going to lose his leg — that's when it hit me the most."
Now, as the Buchters were escorted to their son's room at the Camp Lejeune hospital, Douglas told his wife, "Look, just be prepared for the worst."
Then they saw him. Ryan's leg was heavily bandaged and his face was bruised and swollen, but he was smiling and alert. His other leg was fine. For the first time, the Buchters let themselves believe that their son had been returned to them nearly whole.
Two days later, surgeons operated again on Ryan's leg. Afterward, they told his parents that his leg would heal.
Three days after that, the Buchters drove their son home.
In Pennsylvania, rumors were spreading about Ryan Buchter's injuries. He was something of a local celebrity around Manheim — a returning war hero and the star defensive end on a state championship football team two years earlier.
There was talk that Buchter had lost his leg, or foot, or hand or eye. He was already walking on his injured leg. He decided to set things straight by walking, without his cane, into the locker room of his former high school team before a Friday night game.
He let everyone see that he still had his leg, hand and eye. He thanked them for their cards and fruit baskets, and told the players to go out and win the game. They did.
For many weeks after that, Buchter hobbled up and down the stairs, exercising his damaged leg. He did squat thrusts too. On some days, shrapnel broke through the skin and Buchter plucked it out with his fingers. He would have to pass medical and physical boards to return to active duty.
Those boards are less demanding now than in previous wars. Confronted by the largest number of wounded since Vietnam, and by troop shortages due to low recruiting and retention numbers, the military has eased restrictions on the wounded returning to duty.
Soldiers who would have been medically retired in previous wars are now returning to combat units or to administrative jobs. A few soldiers and Marines with prosthetic arms or legs have returned to combat in Iraq. In all, 54% of wounded troops have returned to duty.
At the same time, more soldiers are surviving their wounds than in any previous conflict in American history. With four high-tech combat hospitals on the front lines and medevac helicopters on call 24 hours a day, no wounded American in Iraq is more than 30 minutes from the finest medical treatment in U.S. combat history.
The Buchters were confident Ryan would recover full use of his leg and pass his boards. He was progressing rapidly through physical therapy.
"They gave him a cane, but he hasn't hardly needed it," his father said. "He just uses it to swat at the cat."
As his leg grew stronger over the winter, Buchter stayed in touch with his buddies in Iraq through e-mails and phone calls. He knew he would not return to duty before his unit got back home. But he also knew the unit was scheduled to redeploy to Iraq next year. Surely, he thought, he would be ready by then — and return to serve alongside his father.
He longed for his buddies in Iraq, where he had turned 20 the day he arrived last summer. They were like family. His platoon leader had broken down when he thought the roadside bomb had killed Buchter.
"When we're actually over there it's not, 'Oh, I'm fighting for my country,' " Buchter said. "It's, 'I'm fighting for the guy next to me.' "
Hanging on his bedroom wall was his No. 57 football jersey, next to the Marine Corps colors. There were piles of letters from schoolchildren at his old elementary school, and a colorful "Get Well Ryan" poster.
He wanted to go back for them, he said — and for his parents and his fellow Marines and everyone in little Manheim who looked up to him. "I want to be a role model," he said, and began another clumsy workout up and down the stairs.
Last week, Buchter was back at Camp Lejeune to greet his buddies as they returned from Iraq. Two had been wounded in the same grenade attack that felled him. Everyone compared war wounds, and all agreed that Buchter's were the worst. "Oh, man, that's a nasty scar," Lance Cpl. Francisco Devila said of Buchter's leg; Devila was wounded in the shoulder by some of the same shrapnel that tore through Buchter's body.
Buchter was elated to be reunited with his friends and living with them in the barracks. Even so, he felt anxious and isolated. Still limping, he was unable to join them in morning PT — physical training — or pickup football games. Because he was not back on duty, he could not wear his Marine uniform.
And because Buchter was undergoing physical therapy, he was not eligible for leave. All of his friends were getting 30-day leaves. Devila was begging him to fly home to Miami with him.
There was just one way to get leave, Buchter figured: He quit going to physical therapy.
Vincent Worrell's wounds required him to visit four specialists at Womack Army Medical Center on the sprawling Ft. Bragg reservation in North Carolina. He saw a dentist for teeth implants, an orthopedist for his hand, an ophthalmologist for his eye, and an ear, nose and throat specialist for his ear.
He was working hard to be whole again — for himself, for his family, and for the men he left behind in Iraq. Being a soldier defined him, ever since he joined the Army to escape a dead-end job as a restaurant cook in a little Wisconsin town, where he and Jayme had been high school sweethearts.
"I don't want to sound like a psychopath or anything," he said, "but I like having a rifle in my hands and doing my job. I like being a leader, leading soldiers, making a difference in the world."
He glanced at his wife. "It drives me nuts that I'm here and they're still over there in harm's way," he said.
Jayme understood. Her husband had quickly returned to duty after earning his first Purple Heart in 2005 for being shot in the leg. She knew he would find a way to go back this time too. She believed in the mission in Iraq, and in Vincent.
"That's where he needs to be right now," she said. "It's not if he gets deployed again, it's when. And they need him there."
For now, she appreciated every minute he spent at home. After three tours of Iraq, he was home for the holidays for the first time in three years.
Worrell, 25, was struck by how fast he had healed. The instant he was sent flying by the roadside bomb, he recalled, "I honestly thought I was going to die."
But now, after surgeries in Iraq, Germany and the U.S., plus his ongoing therapy, he thought he would come out fine. "It's just amazing," he said. "My lips got sewn up. All my teeth are capped. I'm getting [teeth] implants. My hand's great."
By last week, shrapnel had been surgically removed from his hand. He'll need surgery in May to seal a hole in his eardrum. The teeth implants will take months, beginning with bone grafts, then steel pins, then new teeth.
Jayme was still recovering from the terrifying, and baffling, day in November when she first heard that her husband had been wounded. Like many spouses, she had received fragmentary and contradictory reports, compounded by rumors that he had lost an eye or a hand.
It wasn't until she got the official call from a lieutenant at Ft. Bragg that she learned the true nature of his injuries. He had not lost an eye. His ballistic goggles had saved his vision.
"Once I learned he was alive and coming home, there was no call to be upset. It was wasted emotion," she said.
After two ordeals in 11 months, she had inured herself to trauma. With her husband now healing, she was able to joke about it. The first time Vincent was wounded, she said, a neighbor baked lasagna for her. This time, a friend sent a floral basket.
"So we figure the next Purple Heart, I'm going to get some steak knives and work my way up to the encyclopedia set … and then the Ford Bronco," she said.
"Or a brand-new Expedition or something," Vincent said.
In February, the couple did receive a prize of sorts. They found out that Jayme was pregnant with their second child.
"Our Purple Heart baby," she said.
In Vista, Calif., outside Camp Pendleton, Mike Geiger, 24, used crutches to navigate his two-story apartment.
His right foot had been broken in several places when his Humvee hit a land mine in western Iraq on Nov. 7 as Geiger handed out leaflets advising Iraqis how to avoid being killed at U.S. military checkpoints.
As he lay bleeding, he said, he never stopped believing that he would not only survive, but also recover and serve again. He had endured seven surgeries on three continents, and faced months more of physical therapy. A piece of shrapnel was still working its way through his lip. He fully intended to rejoin the platoon of 38 Marines he commanded. He longed to complete an unbroken tour in Iraq.
But he was suffering now — not from pain or physical therapy, but from a peculiar form of guilt.
"I'm home with my loved ones, living the good life," he said, picking at a plate of fresh fruit. It was a gorgeous winter day in Vista, and brilliant morning sunshine lighted up a wall of photos showing Geiger and Navy Ensign Kate Shawhan, his fiancee, in uniform. "I just have this anxious feeling that I'm letting my Marines down while they're in danger."
Dr. James Geiger understood his son's compulsion to return to the place where he was nearly killed. He's a former military medical officer who trained Special Forces medics.
"The first time Mike's commander in Iraq called to check on him, Mike was asking if he could get back to Iraq with a cast on," James said. "That's my son."
James said he and his wife, Patricia, were uneasy about their son's return to war, but they supported his decision. It took a while for Patricia, a retired nurse, to recover from the shock of her son's wounding, her husband said.
"But after that," he said, "she wanted to kill whoever did it."
Shawhan, a Navy nurse, surprised Mike by greeting him on the tarmac when he arrived at Andrews Air Force Base from Germany. She accompanied him on a military transport back to Camp Pendleton, where she worked on a ward one floor below Geiger's hospital room.
He was an outpatient now, returning for physical therapy three times a week. Because of the pain in his foot, he had developed a limp that he was working to eliminate. He was off crutches most days, but still needed a walking boot and a crutch to walk any significant distance.
Iraq was never far from his thoughts. Nine days after he was wounded, he got bad news from the front: Sgt. Jeremy Murray, a platoon mate who had helped treat Geiger minutes after he was wounded, had been killed by a roadside bomb.
Murray's widow visited Geiger in the hospital at Camp Pendleton. They tried to console one another. "I told her he died doing what he was meant to do — leading Marines in combat," he said.
Murray's death made Geiger all the more eager to return, to lead his men again, to protect them from danger. Often, he stared at a snapshot of Murray on his laptop. It showed the sergeant grinning, holding his weapon across his chest and posing with Geiger and other Marines a few yards from where Geiger was later wounded.
Two weeks ago, Geiger was walking well enough to qualify for light duty. He began wearing his Marine uniform again — just in time to greet his buddies when his unit returns from Iraq this week.
Geiger did a few calculations: He expects to have surgery next month to shave down a damaged toe bone that causes pain and prevents normal heel-to-toe motion. Once free of pain, he figured, he would soon learn to walk normally.
He was certain that by April 2007, when his unit is scheduled to return to Iraq, he would be a fully healed, battle-ready Marine combat commander.
In Pasadena, Francisco Ponceherbozo lay on a daybed in his parents' bungalow, staring at a hole in his left foot. It had been the size of a silver dollar when an explosion knocked him off his feet Nov. 5 as his unit cleared farmhouses of insurgents in western Iraq.
The wound bled so much and hurt so badly that he feared he would never walk again, but now the hole had healed to the size of a dime. Ponceherbozo was tracking the healing by taking periodic photos of his foot with his cellphone.
He was walking on crutches. A shrapnel wound in his shoulder had healed. The ugly, black-framed military glasses he wore at the hospital in Iraq had been replaced by stylish spectacles, a Christmas gift from his mother.
The corporal's Marine uniform and cap were stuffed into a bedside basket, next to a clumsy silver brace and boot he must wear when he walks. On his bedside was a plastic pill jar containing the dark gray shrapnel that surgeons in Iraq had removed from his foot.
He was determined to rejoin his unit when he is able to walk normally. He did not consider himself a victim, or even a particularly unfortunate young man. Twelve members of his battalion died in Iraq during his month there.
"I'm lucky," he said, dabbing at his puckered wound with a saline solution. "I could have no foot at all right now."
He had been surprised by the speed and efficiency of his medical care in Iraq. Medics treated him moments after the explosion, and he was loaded onto a medevac helicopter right away. He spent a day at the Air Force hospital in Iraq, a few days at a military hospital in Germany, and then he was back home.
"My medical care was outstanding," Ponceherbozo said. "I felt like a king in the hospital — anything I wanted, I got."
But he felt cheated out of his combat tour. In Iraq for one month, he was just minutes into his first combat operation when he went down. He felt somehow incomplete, as a man and a Marine.
Now, with his doctors predicting it would be another six months before he walked normally again, he realized that his unit would be home long before he was fit for duty. But he was certain he would recover in time for the next deployment to Iraq. He had time. He was only 20 years old.
His parents were not pleased with his desire to return, but they supported his decision, just as they reluctantly supported his decision to join the Marines rather than go to college.
Ponceherbozo's stepfather, Larry Whitley, a former Army National Guard captain who works as a credit manager, has doubts about the war in Iraq.
"I have my misgivings — whether the war was necessary — but I don't let it conflict with what Franco needs to do," he said. "It's his job, and serving is what he wants to do. We don't really feel good about it, but we have to let him go, with our blessings."
The military had treated the family well, Whitley said, except for the call they received from a Marine officer informing them that Ponceherbozo had suffered a "minor mishap" and had returned to his unit. Their son was actually undergoing surgery in Iraq at the time.
Ponceherbozo's mother, Ana Maria Whitley, said she lost 10 pounds the week he was wounded. She was still racked with worry — for her son's health and for her daughter, Elsie, 23, a Marine lance corporal who didn't return from Iraq until last week.
Ana Maria and her children were born in Peru and have lived in the U.S. for 12 years. She had barely heard of the Marine Corps before her children enlisted. Now, despite her fears for her children's safety, she loved the Corps. She was relieved when her daughter's commander, after hearing of her brother's wounds, told Elsie that she would no longer have to go out on dangerous convoy runs.
"My kids are proud Marines," she said, "and I'm a proud Marine mom."
She feared that as soon as her daughter came home, her son would be working his way back to full-time duty and, eventually, to combat.
"It's in his blood now," she said.
For now, Whitley loved having Ponceherbozo around the house on weekends, when he came home from physical therapy at Camp Pendleton. Without his battle fatigues and weapon, he was just her son again: a young man with a sore foot, working his cellphone, watching TV, hanging with his friends.
"He may be a Marine," his mother said, "but he's still my baby."
In San Antonio, Joshua Griffin limped through the lobby of a guesthouse at Brooke Army Medical Center. His jaw was held together by three plates and 12 screws. A rod and four screws held fast his broken right leg. A bandage covered burns on his cheek. Two bottom teeth had been knocked out.
A roadside bomb made from three 155-mm artillery shells had upended the armored Humvee that Griffin was driving on Nov. 6. The sergeant in the front passenger seat was killed. Griffin's convoy had been moving from town to town, handing out teddy bears and soccer balls to children.
Griffin survived grueling surgeries in two states and two foreign countries. He'd had ample time to think about all that had befallen him. He harbored no particular enmity, he said, for those who had built the bomb that shattered his life at age 18. But his memories of the attack were still vivid, and he struggled to push them aside.
"I try not to think about it as much now," he said, his voice still hoarse after a month with a tracheotomy tube in his throat. "I'm trying to adapt to the future and not dwell on the past."
Griffin rubbed the rough burns on his cheeks. He is tall and rangy, with a broad, open face. He was satisfied with his treatment, he said. He paused and added: "But it's not a part of my life I'd care to repeat."
The only thing he cared to remember was his sister's face when he arrived from Iraq at the U.S. military hospital in Landstuhl. Army Pvt. Megan Griffin, stationed in Germany, had rushed to meet him, and her presence at his bedside was a balm to him.
Inside the hospital guesthouse, Griffin sat down stiffly at a bank of computers reserved for wounded soldiers. He pulled up photos of his red, bloated face taken by a nurse at the hospital in Germany.
"Oh, man, I'm looking pretty ragged there," he said.
He looked much better now. Even with his wounds, he looked athletic in his jeans and T-shirt; he turned 19 two days before Christmas. The pain in his shattered leg was tolerable now, and his doctors told him he was on his way to recovery.
Still, Griffin could not shake the memory of Sgt. 1st Class James F. Hayes, who had been beside him in the Humvee's front seat when the bomb exploded. It haunted him that the sergeant had died while he had survived. He had always intended to make the Army a career. Now he wasn't so certain about signing up again when his enlistment ended in two years.
His wounds gave him time to think about what it meant to be in the military in a time of war. It wasn't what happened to him that really mattered, he decided. It was what had happened to the sergeant beside him and what, at any moment, could happen to all those he had left behind.
He was uncomfortable being so far from his fellow soldiers in Iraq — men he had come to love like brothers. Griffin had wanted to be a soldier since he was 5 years old. He signed up at 17, prompted by the Sept. 11 attacks, which he had watched on television in his school library.
"I always loved my country, always wanted to defend it — with my life if necessary," he said.
From the hospital guesthouse, Griffin phoned his sergeant major and asked about rejoining his unit in Taji, in north-central Iraq. The sergeant told him that as soon as he healed and passed his medical boards, he could go back. The news lifted the soldier's spirits, and even with his wired jaw and burned cheek, he was able to smile.
By early March, Griffin was well enough to fly to Ft. Campbell, Ky., where he had been cleared to prepare to rejoin his artillery unit in Iraq. He had not yet told his mother that he was going back; he was trying to figure out the best way to break it to her.
Every other day, Griffin sweated through physical therapy at the Ft. Campbell hospital, strengthening his weakened quadriceps muscle so that he could run normally again. Soon, a military dentist will drill holes into his gums and replace his two missing teeth.
Within a month, he was certain he would be healthy enough to pass his final physical exam, the last barrier to his redeployment. In a few short weeks, he believed, he would be back at war — a split-second from danger but never more than 30 minutes from salvation.