Friday, Nov. 11, 2011

It Takes a Platoon: One Warrior's Road to Recovery

Sergeant First Class Travis Parker never saw the bomb that nearly killed him. He didn't even hear it. He was leaning forward, looking out the window where he thought a bomb might be hidden when a blast wave crashed through his armored vehicle beneath his feet. "I felt like I got hit with a baseball bat all over my body at one time," Parker says. He was stunned by the explosion, but not all that surprised. The narrow road his platoon was patrolling wound through nearly impenetrable orchards in the Arghandab River Valley of southern Afghanistan. It was the perfect place for an ambush: one way in; one way out.

Parker's platoon hauled the crew from the mangled vehicle–the driver with the broken legs, the gunner with the cracked ribs and finally Parker, the patrol commander. Within an hour, he was at the trauma center at Kandahar Airfield where he would learn he had broken bones in his back and a fractured calcaneus — in English, a shattered heel bone. It was his first stop on a journey that would end at Brooke Army Medical Center—BAMC, as the Army calls it – a compact campus about five miles from downtown San Antonio.

BAMC is one of the front lines of America's third war: the struggle to heal survivors of Iraq and Afghanistan, many of whom suffered injuries that in any past conflict might have killed them. A severely wounded service member is usually sent to one of three places: Walter Reed National Military Medical Center in Maryland, Naval Medical Center San Diego (known in the Navy as "Balboa Hospital"), and BAMC in Texas. Of the nearly 47,000 troops wounded the past decade, BAMC has treated close to 4,400 of the most grievously injured, those with severe burns, mangled limbs and serious brain injuries.

In 2007, BAMC opened the Center for the Intrepid, a state of the art rehabilitation facility for amputees and patients with salvaged limbs. Teams of doctors, physical therapists and prosthetic engineers push the warriors, as they call them, not just to return to some semblance of a life, but to be as active as they were before their injury. Many of the warriors with missing limbs are training for triathlons and races; they work out on climbing walls and an indoor surf tank. Parker was an avid runner before he was injured and hoped he could return to the road. Ten years ago, that might have been a lot to hope for, but after a decade of medical advancements driven by horrific injuries, BAMC is the place to make it happen.

For Parker, late September was supposed to be a happy time. Three months after the surgery to repair his crushed heel, he had planned to take his first steps, and he was expecting a visit from an old friend. When I was a young lieutenant commanding a platoon in southern Baghdad, Parker was my wingman. We fought together on more than 100 combat patrols. During a nasty firefight in February 2006, he saved my life, running through heavy enemy fire to bring my crew more ammunition when we nearly ran out. Ever the sergeant looking out for his troops, the day he landed in Texas after being wounded Parker asked me to write about his experience. "If one other guy with this injury reads that and it helps them, I'll have done my job," he said.

We planned my visit for when Parker hoped to be starting rehabilitation. His back had healed enough so he was no longer in a brace, but just before I arrived, he got some devastating news about his broken heel. "If you took a raw egg and you dropped it, the calcaneus is much like that," explains Col. James Ficke, BAMC's chief of orthopedic surgery, who operated on Parker. "The heel breaks in many pieces and we put it back together." Only after the surgery, the last part of the incision wouldn't close, despite efforts for more than a month. "Just like in a battle, you have a course of action for every decision point," Ficke says. "Same thing in the process of recovery. We've gone through a couple of different spots where there's a decision point. We're at one now. And the best course of action is to go back to surgery."

Parker worried about what Ficke might find when he removed the plate. If the bone hadn't healed properly, he would be destined to suffer from arthritis and perhaps never run again. "If I can run, I can do everything else I want to do," Parker says, "go hiking with Kim, lead my soldiers through another firefight if I have to. Everything I want to do depends on if I can run. And if not, I'm accepting the fact that kayaking might be the only thing I ever get done in life." Success would mean he could return to his troops, to the job that's a core part of his identity. Failure would mean rebuilding his life in a new way.

Parker spent his final night before surgery chatting with younger wounded troops. He acted unconcerned about the next morning, at least around the younger warriors, but later, he admitted he was scared about how the surgery would turn out. I was scared too. Even though we hadn't been in a combat zone together for more than two years, he will always be my wingman. We never made a formal pact when we shipped out to Baghdad many years ago, but I think we both understood that we'd lay down our lives for each other if that was required. Parker more than held up his end of that bargain. When I needed him, he came. No questions.

And now, as he faced one of the biggest moments of his life, there was nothing to do but tell bad jokes and try to keep his spirits high. One can wish and hope, but I've believed for a long time that hope is not a method. Depending on your religious beliefs, you can pray. But when the praying is done, all there is to do is wait. You can believe in your heart that it will turn out okay. But Parker and I have been through enough, together and each on our own, to know that many stories don't have happy endings.

On Friday morning, Kim pushed Parker in his wheel chair from his room, across a large parking lot and into the main hospital. His face was stoic; ignore the wheel chair and large boot covering his foot and Parker could have been standing in the commander's hatch of a Bradley, scanning a road outside Baghdad like I saw so many times, years ago. When it was time for him to go back to the operating room, Parker gave me a hug. "Let's get this done," he said. "I'll see you on the flip side."

It wasn't until nearly 5 pm when Kim texted that Parker was out of surgery. By the time I made it back to his room he was awake and laughing. A nerve block prevented any pain to his foot. "But when this thing wears off" Parker said trailing off, knowing that the next few days would be tough ones. Just after midnight, Dr. Ficke arrived with the news: the shattered bone had healed as well as he had hoped, and after removing the plates and screws, he was able to close the wound. After another month or so to let the holes mend where the screws had been, he predicted Parker would be starting to walk, the first step on his way back to running.

The morning after surgery, Parker was ebullient as he sat in a lounge on the hospital's fourth floor. Every once in a while, he grimaced in pain and occasionally hit the button dispensing more painkillers. "The best pain management tool is distraction," he said. "Keep the conversation going; keep telling jokes. I don't care how bad they are."

In the early afternoon, someone new rolled into the lounge, also in a wheel chair. Staff Sgt. William Navarro was one of nine new wounded troops who had arrived on a plane in the middle of the night. Navarro had been commanding a vehicle that was hit by a roadside bomb in eastern Afghanistan. When Parker asked about his right foot which was bandaged, Navarro replied, "I have a fractured calcaneus." Parker's eyes widened. "That's exactly what I have too," he said.

Parker ran through his treatment, the surgeries and the setbacks. "How long?" was all Navarro wanted to know. The words three months seemed to smack him in the face. "It's going to be long and painful, but they'll do everything they can for you," Parker said. "You'll be frustrated when things don't go fast enough, but stick with what they have you do. They'll push you as hard as you can go."

Navarro rolled his wheel chair to the door. "My foot's killing me. I'm going to head out," he said. "Hey brother, what room are you in?" Parker asked him. When Navarro told him, Parker said, "I'll stop by and see you later." Navarro nodded then wheeled himself out the door and slowly down the hallway.

My last night at BAMC, I stayed with Parker late into the night. His pain blocker had worn off and the pain was coming in waves. We flipped through Facebook galleries on his iPad and talked about friends from the platoon and where they were: Joe is in Missouri and about to become a staff sergeant; Brad is in Afghanistan, a one man-one canine bomb-detecting team with his dog Cody; Chris, who spotted the enemy the night of the big firefight left the Army and is out on the road, a free spirit, and we get messages from him from time to time.

About 1 am, Travis finally managed to doze off. I stayed up checking emails, watching the Ipad rise and fall on his chest, hoping his short sleep was untroubled. He would need the sleep in the days and weeks ahead as he stepped off on the next chapter in his long journey.