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From Wounds, Inner Strength

At Walter Reed Army Medical Center, Eric DeSarme adjusts a prosthesis for Hilbert Caesar, who lost a leg in Iraq.
At Walter Reed Army Medical Center, Eric DeSarme adjusts a prosthesis for Hilbert Caesar, who lost a leg in Iraq. (By James A. Parcell -- The Washington Post)

He was out on patrol in the self-propelled gun when the explosion occurred April 18, 2004. When the black smoke cleared, he looked down at his leg. It was flipped backward and "just dangling by the skin," he said. "It was severed at three different places in the knee. . . . The bone was splintered in different places. I knew there was no way they could put that back together."

He tried to hand his machine gun to a comrade but realized it was bent. He could hear gunfire and yelled for the hatches to be closed. He thought: "Oh, man. This is it. My life is over."

But it wasn't. The insurgents who staged the ambush melted away. He was medevaced to safety, and six days after the attack, he arrived at Walter Reed.

There, he was all right, except when he was alone. Then he would worry about the pain -- and the future. He was an athlete but realized that he might never run again. He wondered how women would react to a man with an amputated leg. It was depressing. Again, he said he would think, "My life is over."

A few days after he reached Walter Reed, he got more bad news: Eight men from his platoon had been killed by a car bomb in Baghdad. They were men he knew. One, in particular, had been a role model. "I was really devastated," he said.

Not all mental health experts believe in post-traumatic growth. Some think such positive attitudes simply stem from individual resilience or a natural course of psychological recovery.

George Bonnano, a psychologist at Teachers College, Columbia University, is skeptical of the growth theory. He said such reactions to trauma are better explained by personal resilience.

"I'm saying most people are able to maintain equilibrium pretty well after a traumatic event," he said. In addition, "it's fine to just recover," he said. "Bad things happen, and we get over them. We get better, and we put it behind us, and we move on."

In the weeks after his arrival at Walter Reed, Caesar met other severely injured soldiers and heard stories about their recoveries. "You start to build your confidence up," he said. "You start to shift focus.

"I'm a positive person," he said. "I try to look for the best. It could be worse. I lost a few friends out there. I made it back with just one missing limb, and I'm grateful for that. I'm thankful for just being here. Period."

At the same time, he said, he believes that he has changed. "It makes me appreciate life a whole lot more. . . . I'm looking forward to settling down, having a family."

Caesar said he has a friend who lost both arms in the war. Caesar said his friend once told him: "I would give anything to lose a leg. I would give both of my legs to have one of my arms" to be able to hold a child someday, should he ever become a father.

"Things like that make you think," Caesar said. "I can't complain. I haven't lost enough to complain."

Since being wounded, Caesar became a U.S. citizen last year, participated in three marathons using a racing wheelchair that he pedals with his hands, left the Army in January and landed a job with the U.S. Department of Veterans Affairs.

His leg still bothers him, and he walks with a pronounced limp.

At times, the opaque plastic socket of his artificial limb, which fits over his stump, lacerates his skin. The stump hurts when the thigh bone pokes against the skin. And he still gets down when he thinks about his dead buddies.

"It was a long journey back," he said. "I'm still not fully there. I'm still not 100 percent. I'm never going to be 100 percent. But at the same time, I can get as close to it as possible."

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