Second of two articles
A fat C-141 rumbles to a halt at Andrews Air Force Base. A gangplank is lowered from the belly of the plane, and the Army's latest casualties from Iraq hobble or are carried to a waiting white bus, their gear still covered with fine desert dust.
These medevac flights are now so routine that no cameras, no VIPs, await the wounded. Their welcome home happens at Walter Reed Army Medical Center, the nation's biggest military hospital, where doctors and nurses in camouflage fatigues wait at the curb to whisk the newest patients to the large exam room on the second floor. Here the soldiers are triaged with swift precision:
Danny Roberts is hooked up to an electroencephalogram, which will measure his brain activity to determine the extent of any damage to his brain.
(Photos Michael Lutzky -- The Washington Post)
"I need 10 of morphine!" a doctor calls out.
"Are you weak in your right hand?" another asks.
"Where does it hurt you now?"
A 20-year-old private moans. In Baghdad, he camped out in a bathroom of Saddam Hussein's palace, stacking his Chips Ahoy on the shelves above the gold-ingot faucets. Now he lies on a gurney with shrapnel in his belly, beneath a balloon that says, "You're the Best!"
Upstairs on the orthopedics ward, the beds are already filled with recovering casualties from the war in Iraq. There are different battles being fought on Ward 57, more private struggles. It's not about victory, but coping. Not about war, but its aftermath.
First Lt. John Fernandez is a veteran of Iraq and by now a veteran of Ward 57, too. He reports to an exam room early one morning for his twice-daily dressing change. The former West Point athlete is 25, a newlywed whose wife, Kristi, hasn't left his side since he arrived at Walter Reed six weeks earlier. They had been married less than a month when John shipped out. His hospital room would become their first home together; the nurses looked the other way when Kristi, 22, moved a cot next to John's bed against hospital regulations.
Their usual wisecracking is on mute this morning, their faces drawn. John hoists himself onto an exam table and the doctors begin scrutinizing what is left of his legs.
"I felt sick yesterday," John announces. "My glands are swollen."
"Any fever, chills?" Ken Taylor wants to know. The chief orthopedics resident swabs his patient's surgical wounds with iodine. John is missing his foot and ankle on one side, most of his lower leg on the other. He knows that any infection in his body might find its way to his legs, putting him at risk for higher amputations. He already has had a dozen operations.
Surgeon Donald Gajewski notices some redness and leakage around the sutures on the left stump and Taylor searches for a sterile pad so he can clean it. "They're in that cabinet," Kristi says, pointing. By now, she knows this exam room like her own kitchen.
As the headlines shift from the war in Iraq to the rebuilding of Iraq, a similar theme emerges at Walter Reed. Joe Miller, the prosthetist who will craft John's artificial sockets, joins the doctors in the exam room to decide whether John is ready to be sized.
"I think we can start the right side," Miller offers. John can barely manage a wan smile at this consolation prize. "My stupid foot hurts again," he mutters. The severed nerves in his legs are sending frantic signals to body parts no longer there. Phantom pain, it's called, but there is nothing imaginary about it. John is in constant agony. His nonexistent feet throb. His lost toes burn. "Like Fred Flintstone when he stubs his toe?" Kristi wants to know, imagining a red-hot pulse. "Exactly like that," John says. Painkillers are useless.
Miller heads for the door, reminding John to come to the prosthetics lab first thing the next morning so he can make a plaster mold of his right leg. The doctors interrupt. They'll want to see him first. And don't eat anything the night before, Taylor and Gajewski advise. If that oozing doesn't clear up on the left side, they're going to have to operate again to check for infection.
So there's a chance he'll have a new leg tomorrow.
And a chance he'll lose more of the other.
An Impatient Soldier
Garth Stewart is no favorite among the nursing staff of Ward 57. They bring Jell-O, he wants applesauce. But the mortar gunner who lost part of his left leg to a land mine near Baghdad isn't trying to be the perfect patient. He just wants to be the perfect soldier. That means getting out of Walter Reed, his home for the past three weeks.
"I hate this place," Garth, 20, said. "I'm sick of being sick."
Garth doesn't want to wait for the Army's bureaucracy to decide whether he's fit for combat. He's ready to buy his own plane ticket back to Iraq to rejoin the 3rd Infantry Division. Even the dullest moments of war -- playing chess in his armored vehicle on the convoy to the Euphrates -- were exhilarating. He was part of something larger than himself. Now he watches cartoons from his hospital bed.
He's got to make himself strong again. One morning he lowers himself into his wheelchair to go to a physical therapy appointment on the third floor. For the wounded soldiers on 57, physical therapy is a confrontation with pain and humiliation. In their minds, the soldiers are still elite athletes capable of marching 15 miles with 40-pound rucksacks. PT is the hard truth, with three-pound dumbbells.
Garth scans the room for Isatta Cooks, the physical therapist who works with amputees. She smiles when she sees him. Cooks, 28, is the rare employee at Walter Reed who does not find Garth prickly. Not that their relationship has always been smooth. Cooks once innocently started, "When you were in the Army . . . "