A CONFLICT'S PAINFUL LEGACY: Thousands have come home from Iraq injured, sometimes severely. Here are the stories of three Marines' struggle to heal.
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/01/14/MNGBHNIHR71.DTL
John Koopman, Chronicle Staff Writer
Sunday, January 14, 2007
Faoa Apineru should be dead.
In May 2005, he was in a humvee driving down a road in Iraq near the Syrian border when a roadside bomb went off right next to him. The blast was enormous. A shard of metal pierced his face and rattled around his brainpan. He was flown to a hospital in Fallujah, then to another one in Germany and to Bethesda, Md. After many surgeries to fix his brain and face, Apineru made his way to the Veterans Affairs Palo Alto Health Care System hospital for treatment and rehabilitation.
He couldn't move. He couldn't speak. He was barely alive.
It's a far cry from the burly, strapping Marine who now lives in a tidy townhouse near Moffett Field. The guy with the broad shoulders and easy laugh, a pinch of tobacco under his lip and a big, scarred, shaved head.
Apineru, whom everyone calls "AP," is living on his own and loving it. He can cook for himself, go to a movie, hang out with friends, have a good time.
He's not fully recovered from his wounds. He suffers from severe post-traumatic stress disorder, which is compounded by his brain injury. He still goes to therapy and he talks with counselors at the PTSD center regularly. Not long ago, he had an episode; he saw someone on the side of the road. Looked like an insurgent, like the one who tried to kill him with a horrible bomb, and he had bad thoughts. Thoughts that required another trip to the PTSD center.
"They're the only ones who really know what's going on with me," he said.
The VA hospital in Palo Alto has a lot of people like AP. Mostly men and some women who were injured while in uniform, most of them from Iraq or Afghanistan. The VA has a polytrauma center, so troops with more than one injury can get help for all their problems, and a brain injury rehabilitation unit, called BIRU, for the guys who took one to the head.
He hangs out with other wounded Marines. Cpl. Jason Poole, who also had a severe head wound and nearly died, is his best friend.
"I don't have much family around here, so the Marines are my family," AP said. "That's what attracted me to them in the first place. It reminds me of my culture."
Most of the guys share the common bond of having been wounded by roadside bombs in Iraq. Guys like Angel Gomez, who was unhurt except for that one piece of shrapnel that hit his head and took a good chunk of his skull with it. And Tim Jeffers, who lost his legs, an eye, a finger and a small piece of skull.
They're all in a program -- called Marine 4 Life -- designed to help wounded Marines get back on their feet and into the civilian world.
The program's Western region is run by a reserve captain from San Francisco, Nina D'Amato.
"The Marine Corps has an ethos, 'You don't leave people behind,' " said D'Amato, a public school math teacher when she's not wearing a uniform. "The Marine Corps asked these men and women to perform some very intense things. The Marine Corps is not going to turn their back on them when they come back wounded."
It's a tough, slow road and not for the weak. Some have horrible wounds, lost limbs and memories. They spend months, years, in the hospital. And while different programs give money to bring family members close by, there are a lot of long, lonely days spent in the company of doctors, nurses and each other.
About six months ago, AP had recovered sufficiently to move into his own apartment, a townhouse that is part of base housing for Moffett Field. And he's taking small steps toward independence.
His apartment is clean and neat. He has a massive television that dwarfs his small living room. He's got gadgets and toys and a wall of photos showing his rehabilitation and important people he's met while in the hospital.
For AP, moving out of the hospital was a big deal. It makes him feel relatively normal again to do little things, like making his own food, going shopping, taking in a movie -- things he did without thinking long ago, before the injuries.
AP was no kid when he got hit. He'd spent 10 years in the Marines by then and was a staff sergeant. Still, he has three U.S. flags tacked to his walls, along with all sorts of Marine paraphernalia.
AP grew up in Samoa. That's about all he remembers from his childhood. The explosion took away most of his memories.
Picture it: You are an adult in your 20s and you have no recollection of where you grew up, who were your best friends, or your first kiss.
AP's mother told him he had gotten into a lot of trouble when he was growing up. His father thought the Marines would be a good place for him to learn discipline and stay out of trouble. He found out later that his grandfather had served in the Marines in World War II.
AP joined the corps in 1996 and worked his way up to communications chief for his unit.
He was in Iraq only once. At least, he thinks so. He doesn't remember any other tours. He has trouble remembering how to spell his name.
Everyone has his or her demons in rehab. For AP, it's the nightmares.
"After the injury, I always think there's people against me," he said. "I know it's not true; I know I'm in the U.S. But that feeling will get me off guard whenever I have pain, or especially when I go to sleep because I have nightmares. My nightmares are so real, I can feel it, I can smell it."
He dreams about getting hit. The dream is always the same. The only variation is when it starts and when it ends.
In May 2005, AP was in Anbar province with the Marines. He'd been going out on a lot of patrols. Too many. The days were long, and filled with the stress of knowing a bomb could go off at any time. One of his buddies said, hey, take the day off, you're working too hard.
AP didn't listen. And that's why he feels some sense of regret, or remorse. If he'd only listened.
They'd gone out on a convoy. Two 7-ton trucks, then AP's humvee, then more vehicles. It was another hot, sunny day in Iraq. The road had just been cleared and the convoy moved along briskly.
AP has the explosion on video. After the bomb went off, Marines scoured the area looking for the triggerman. They went through a house nearby and found cameras and disks. On one was a montage of various attacks on American units. Insurgent groups post the videos on the Internet. They're not hard to find.
AP plugs a thumb drive into his laptop and watches the shaky image. With an Arabic song as soundtrack, you can see the big trucks driving along the long, dusty road. A humvee comes along and is immediately enveloped in a blinding flash, smoke, dirt and debris.
"The first thing I remember is screaming. I remember trying to stop screaming. You know, that Marine Corps crap about not showing your feelings. Then I heard my Marines. They were doing the same thing. They were screaming, too. So I let go and it went blank. Then I heard my Marines yelling, 'AP! AP!' and they were trying to pull me out of the vehicle. Then I went blank again."
AP went in and out of consciousness. He remembers someone trying to cut off his bloody uniform, and saying that he didn't appear to be hurt.
He thought he was shaken but physically fine. He took off his protective glasses and looked in what was left of the humvee's side mirror. Blood sprayed from his nose and a big gash close to his ear.
"I just thought, 'Oh my God. I'm f -- ed,' " he said.
He thought maybe the gash was just a deep scratch. He tried to stem the flow of blood with his finger. His finger sunk in deep.
"I remember getting cold, real cold, even though it was hot outside as hell," he said. "I remember my lance corporal talking to me, saying, 'Come on, AP, the chopper is coming. It won't be much longer.' But I couldn't really hear anything. My hearing was blocked. I saw everything in black and white."
AP wasn't listening to the medic or the other Marines. But his training kicked in when his lieutenant came over and told him to stay awake.
"I kept thinking, 'This is a lieutenant in the Marine Corps, I better do what he says. Thank God he did that."
AP couldn't talk. His jaw was broken. The lieutenant told him to squeeze his hand if he understood what was being said. AP squeezed. Hard. Another lieutenant came over and started praying for him. AP says he prayed, too, for the lieutenant.
AP was in a coma for eight days.
That was weird, too. He could feel people's presence and hear them talking. He wanted to tell everyone he was OK, but no words came out.
When he finally came to, he had no idea where he was. He was alone in a room. His hands were tied down.
A nurse came in and saw he was conscious. She called others into his room and when someone talked to him, he recognized an American accent. He spotted a man wearing the chevrons of a Marine gunnery sergeant. Finally, something he recognized. He relaxed. He didn't know it at the time, but he was at the Naval Hospital in Bethesda, Md.
His mother and sister were there, too.
"Who the hell are those people?" he asked a medic.
"Dude, that's your mom," the man replied.
"What's a mom?" AP asked.
He was sent to Palo Alto for rehabilitation in June 2005. He had to learn how to walk and talk and remember again.
It was a long and difficult road. AP hated the hospital. He hated the smell. He sprayed cologne everywhere to get the stink of antiseptic out of his nostrils. He took test after test, and was frustrated that he could no longer think the way he used to think and remember the simplest things.
He stayed up late at night, going over and over the tests until the nurses forced him to stop, to try to sleep. He was moved to a different hospital, but he kept running away. There's a reason for that, one he's reluctant to share because people think he's nuts.
"I'm seeing people, you know, who are dead already," he said. Not guys he knew. People he never met before.
He tried to leave the hospital several times, even under threat of disciplinary action. But he didn't care. He wanted out.
"I kept running away because I was afraid I would hurt a nurse," he said. "They keep coming to check on me every two hours. Every time they touch the door, I'm up, because I can hear them. Plus all these nightmares. I don't know what's real and what's a dream."
That's when the doctors realized AP was also suffering from severe PTSD. He was referred to the PTSD center and he got the therapy he needed.
For now, that's enough. The future is on hold. AP still goes to the center. He says he still has some things to work on.
"Every time I have pain or nightmares, it triggers something," he said. "I know I'm going to be like this the rest of my life."
One who’s just getting out
Angel Gomez just wants to drive.
That's what he was doing when he got hit in March 2005: driving a 7-ton truck in the city of Ramadi. A piece of shrapnel hit his head just behind the ear. It took off a big chunk of skull.
When he got to Palo Alto, he was barely alive. Couldn't walk. Could barely talk. His family wondered if he would ever recover.
Gomez has had surgery to replace a portion of his skull. For a long time, he wore a bicycle helmet to protect his unprotected brain. Now, his head is intact and the only sign of his injury is a long, ragged scar that goes up over his crown and back down toward his neck, a little like a ram's horn. His hair is growing longer and covers most of the scar. He wears a cap most of the time.
But the brain injury has caused physical problems. He can move his right shoulder, but his hand doesn't work. He can walk now, but he needs a brace on his right leg. He's not sure if he'll ever regain full movement on his right side.
Gomez has a sweet smile and bright eyes. He speaks haltingly, and peppers his sentences with "you know," "like" and "whatever." He will be in the middle of a sentence and stop because the right word, an easy word, simply vanishes from his vocabulary without warning.
Angel was on his second tour when he was injured. He was driving a truck in and around the city of Ramadi, the capital of Anbar province and home to some of the fiercest fighting of the war.
He drove the big trucks, moving Marines and supplies around the city. He was there for about a month and a half before the explosion tore apart his truck. Gomez thinks he was taking a unit of Marines on a raid. "We were going and going and all of a sudden, I got hit."
Does he remember it?
"Oh yeah, I remember it," he said.
Gomez was behind the wheel when the blast hit. The explosion rocked the truck, but didn't knock it over. A jagged shard of metal flew through the air and hit him in the head. He was otherwise unhurt.
"I was really dazed, you know," he said. "I was like, 'Whoa, what happened?' "
His good friend, Jesse Aguilar, ran to the vehicle to check him out.
"I saw his face," Gomez said. "He was shocked or whatever. I guess he thought I was gonna die.
"My brain was like showing and stuff. I didn't know."
Gomez said his skull looked like an egg does when it's dropped on the floor. He had pieces of skull in his brain.
Gomez stayed awake as the corpsmen and Marines put him in a humvee and drove to an aid station. He said a medic had to prevent him from touching his head, so he wouldn't hurt himself any further.
After that, Gomez slipped in and out of consciousness. "It was just like an on and off button," he said, like an electrical circuit with bad wiring. He kept going in and out, and when he was conscious, he had no idea what was going on or where he was.
He was in a coma for 14 days. He was flown to Germany and from there to Bethesda. That's where he woke up.
His mother, father, sister and brother were there, but he didn't recognize any of them.
"I had some horrible dreams when I was in the coma," he said. "One of the dreams I still remember, I was dreaming that somebody was chopping all my body into pieces. I was just like, 'Whoa!'
"I also dreamed I was in the hospital and one of my feet was missing," he said. "When I woke up, I looked to see if I still had my feet."
By the time Gomez got to Palo Alto, he knew who people were, but he didn't know their names. Not even his parents.
He still has a problem with words sometimes. He knows things, but the names and titles escape him.
But mostly, he just wants to drive.
He has a nice Chevy truck at home -- a 2003 S-10 -- and that's what he misses most. In the meantime, he practices in a driving simulator at the VA center, and occasionally drives around the parking lot when he can get someone to go with him.
Gomez wants to go to college, to get married, to have kids. His girlfriend has stuck with him throughout the ordeal.
"I'm getting better, but it's slow," he said. "It's really, really slow. But I'm going to make it. I'll feel good about myself."
A couple of weeks ago, Gomez was discharged from the hospital. He moved into an apartment nearby so he could take a bus to the hospital for therapy. But he was itching to drive. He just wanted to get into his truck and hold the wheel in his hands. And move.
Shortly after he moved into his new apartment, he was on the bus, talking to his girlfriend on his cell phone, and he had a seizure. He lay on the floor of the bus, jerking uncontrollably, as his brain fought with itself.
His dreams of driving again went out the window that day. The doctors say he'll need another six months before he can even think about getting behind the wheel of a vehicle again.
"Angel is frustrated and that's understandable," Capt. D'Amato of Marine 4 Life said. "But he also recognizes that it could have been a lot worse. He could have been driving when this happened and gotten killed, or killed someone else.
"Angel took an enormous step by moving into his own apartment and when he's ready, he'll drive again. That represents freedom to him."
One who still has a long way to go
At 22, Tim Jeffers is learning to walk.
He's missing both legs just above the knee. He has high-tech prosthetic legs with feet encased in new black-suede tennis shoes.
Rehabilitation for him -- getting out of the hospital and on his own -- will take some time.
He lost both his legs just above the knee. He lost a finger, his right eye and a chunk of skull just above his right temple. The wound healed but swelling remains, causing his head to be misshapen. He often wears a bicycle helmet to protect his brain.
The Marines transferred Jeffers' brother, Chris, to a local reserve unit so he could help Jeffers out and have family nearby. Chris Jeffers spends at least one day a week helping his brother in rehabilitation exercises. He's learned how to help put on Tim Jeffers' new legs; he needs a tight seal so the prosthetic legs stay firmly in place when he tries to walk. Right now, Tim Jeffers uses a walker when he practices.
"The physical therapist has been after me to try to walk on my own, but I'm a little fearful," Jeffers said with a grin. "But I think the fear is justified. I mean, that's a lot of pain if I take a fall now and land on my face, you know?"
Jeffers recently had surgery to implant a synthetic piece of bone into his skull. A couple of days later, he developed an infection and the piece had to be removed.
It will be another six months before the doctors try that procedure again.
Jeffers joined the Marines in November 2002.
"I always wanted to," he said. "Maybe it was the poster I saw, that Marine in the dress blues. They're kinda like badass. I just took an interest in it. I learned about it, found out it was the hardest, so I wanted to do that."
Jeffers said his dad didn't want him to join the corps but he didn't stop him. "My mom was worried about me going, but she wanted me to do what I wanted to do," he said.
Boot camp was tough, he said, but he didn't want to give up. "There were times it almost broke me down, but I wasn't going to let some guys who didn't even know me change who I was," he said.
That attitude has carried into his rehabilitation. Jeffers is a small man with a quiet voice, but it is filled with determination.
"I'm the same guy I always was," he said, sitting in his wheelchair and playing with a prosthetic foot.
Jeffers was a convoy commander in Iraq, and had been in-country about four months when he got hit. It was May 18.
"We were in a convoy, running along," he said. "Over the radio, someone said an IED went off between a military vehicle and civilian contractor vehicle with us. We were at a security halt, to make sure nothing else happened.
"I was at a T-intersection at the halt, so I was looking around. There was some trash in the area, so I was looking to see if there were any loose wires sticking out. I turned around and there were two mufflers in the middle of the road. And then, "Bang." One of them blew up."
Jeffers was about 3 feet from the bomb when it exploded. His legs were mangled and the bomb blew out his eye. It took out a small piece of his skull.
"I was awake the whole time waiting for the helo," he said. "I was yelling and screaming and swearing. That's all I remember. Three or three and half weeks later, I woke up."
He doesn't remember going to a surgical hospital at the American base at Al Asad.
The blast didn't take off his legs, but they were mangled. "As far as I know, I got my first amputation in Al Asad," he said. "I don't know how many amputations total I had. I think there were about four, going higher and higher on the legs.
"The next thing I remember is waking up in the hospital with my dad's face over me. He was telling me to blink once for no and twice for yes, and asking if I could hear him. So I blinked twice. I kinda knew why I was in there, even though it took me a couple of minutes to figure it out."
Jeffers was at Bethesda for about two months. He left in the middle of July to go to Palo Alto.
He wants to go to college and study math. He's a studious-looking man and very articulate. D'Amato brings him Sudoku puzzles to help pass the time and keep his mind sharp.
"Tim will probably teach math some day," D'Amato said. "He's got the intelligence and the drive.
"He can do anything he puts his mind to, no doubt about it."