Saturday, February 7, 2009

The Truth is Ugly

Yesterday found me sitting in the Veterans Hospital in Richmond, waiting for a physical therapy appointment for a years-old injury that nobody will concede will probably never go away. Despite the unlikelihood of improvement, I figured I’d give it a try.

When the physical therapist strolled off to print a list of exercises for me, I sat on the king-sized platform in the training area and waited. There were a number of other patients. Three men, specifically, caught my attention.

Their forearm tattoos, bracelets and t-shirts indicated they were all Army Rangers at one time – some of the military’s toughest of the tough, highly trained and highly competent. Yet those times were clearly in the past. The three that sat, wheeled, and crutched before me were anything but tough men. Each bore the sign of long hospital stays. Their skin was pale and vitamin D deficient. Their muscles were badly atrophied from long, bed-ridden recoveries. Thin legs, gaunt faces, unshaven with small, delicate-looking arms that appeared unable to lift even the lightest objects. Severe muscle atrophy left one of these three in a wheelchair.

The therapist was rolling up the man’s pajama pants leg and assisting with fitting him with a lower-leg “cast” that supported otherwise terribly weak limbs. After putting it on his shin and ankle, he strapped it in, gave the soldier two crutches, and helped him stand from his wheelchair. Five minutes and one hundred feet later, he had slumped back in the chair, clutching his lower back in agony. The therapist congratulated him on his performance with the “Canadian Crutches,” and how remarkably upright he was walking – especially considering how weak his legs are. The soldier, regardless of how well he was doing or not, was noticeably interested in improving. He was motivated. He wanted to walk again. Despite his pain, he persisted. He asked good questions, fought through his fatigue, and kept on going.

One of the other men, similarly emaciated, slender, and in pajamas, worked on a weight machine with another physical therapist. He didn’t speak much – if at all. He looked grumpy – and like he badly needed a cigarette. When the physical therapist asked what exercise he wanted to do next, the soldier grumbled, “nothing,” which earned him a frustrated response from the therapist.

“Of course. That’s all you want to do – nothing.”

Their session ended a moment later when the soldier answered his cell phone and wandered off – speaking in an eastern European language I didn’t recognize. The therapist lowered his head and wandered off. I doubt he’s used to argumentative patients.

The third soldier was, by far, the worst. He wore a crash helmet – a glorified bicycle helmet that in the past would have sent me into gales of laughter. This time, however, no. He wear this device out necessity. One more fall, one more jostle to his head, and he would probably suffer irreparable damage – if he had not already.

The man’s parents stood next to him and he sat there – staring out from under his helmet listlessly. As I watched, the physical therapist explained the nature of his condition to the man’s parents – easily in their late fifties and wondering how it is their once-successful soldier son is back in their care. I saw no anger in their faces, though, only deep love and concern for their child.

“He has something called spatial neglect,” explained the therapist. “When I tell him to turn right, he does. But when I tell him to turn left, he just keeps on turning. His brain can’t distinguish how far he’s gone.”

His parents listened in silence. The soldier remained silent, too.

He continued : “But what’s very important to remember is that he’s not doing this on purpose. He can’t distinguish these things yet. So we have to help him.” The man’s parents nodded in agreement. The concern that registered on their faces seemed to exceed the love. They were heartbroken and their adult son set next to them, unspeaking, wearing a crash helmet.

All three of these patients, judging by their behavior, the bald patches on their scalps and the fresh cars, were victims of IEDs and traumatic brain injuries (TBIs). All were now somewhere on the road to whatever recovery medical professionals reasonably expected from them. One was unduly argumentative and disinterested. Another, resolved but still wheelchair bound. The third wore a helmet to prevent any more destructive damage to his brain. ALL three were younger than me – active duty warriors now reduced to weak patients struggling to learn to walk, speak, and even act normally.

I felt that I, having suffered no significant combat-related injury, had no place in this facility. I listened to my therapist, gathered up the paperwork he gave me, and retreated. In the hall, the soldier with the helmet was receiving walking practice with his mother on one arm and the therapist on the other. I carefully edged around them, chastising myself for not being more thankful that I can walk. In the hall, I passed the crippled soldier, wheeling along as he chatted with the grumpy soldier. Around me were other young men – mostly pushed by young doctors or quiet parents. An unmanned, electronic medical cart annoyingly nosed across the corridor. “Warning, crossing hall…”

As I drove home, I thought about my friend Jay from my platoon in Weapons Company. After being blown up and temporarily knocked out a few times on our first tour, he wasn’t doing all that well. He still struggled with his memory. A couple years after his TBIs and the ensuing battery of tests, he confided in me in day:

“Dude, I can’t even remember my own father’s funeral. I know it happened, and I know I was there, but I can’t remember anything about it. When it was, where it was, and what happened. My own freaking father.”

Copyright © 2009, Ben Shaw
All Rights Reserved


  1. Powerful. Very powerful. Done about as well as it could be done.

  2. You gave us a rare glimpse into a world that many of us will never see. Their physical challenges are obvious but their mental challenges...indescribable.