Ranks of amputees have risen steadily in 8 years of war

By Christian Davenport
Washington Post Staff Writer
Sunday, March 21, 2010; C01

Aug. 11, 2009, Afghanistan: After the blast, something didn't feel right, so 1st Lt. Joe Guyton looked down. Through the swirling dust, he glimpsed the white of his left shinbone. His right leg was gone, instantly vaporized, his uniform abruptly ending at the knee.

The pain would hit at any moment. He knew that. But for now, just after a bomb rocked his convoy while on patrol in Kandahar province, he was so amped up on adrenaline that he felt nothing more than an odd discomfort.

Don't look down, he told himself. Don't think about it.

Guyton, a recently married 28-year-old with soft blue eyes and red hair, had to hurry before he would be overwhelmed with agony. He shouted to his fellow soldiers to keep moving through the danger zone, to keep an eye out for the enemy, to report their wounds -- as he finally did himself. Soon, two soldiers were wrapping his legs in tourniquets.

He woke up in a military hospital in Germany.

Guyton, from Burke, became one of nearly 1,000 service members who have suffered amputations in the wars in Iraq and Afghanistan -- wars that, thanks to advances in battlefield medicine, are measured as much by wheelchairs and prosthetics as tombstones.

In the years since the Sept. 11, 2001, attacks, 967 American service members have lost at least one limb, as of March 1. Of them, 229 have lost more than one. The number of amputees mounted steadily as the U.S. military stormed into Afghanistan in late 2001, then focused on Iraq -- with an invasion in 2003 and a "surge" in 2007. More recently, the number has edged up again as the Obama administration has pumped more troops into Afghanistan.

These amputees are a fraternity of survivors whose private battles on the road, from blood-fresh wound to leather-tough scar, span the eight years of war. From Ground Zero to Baghdad to Afghanistan's Marja, their stories are reminders of conflicts that have lasted long enough for some amputees to be running marathons now, even as their newest brethren struggle with their prosthetics. Some are immobilized by depression, while others boldly venture into a world where children point at them and adults avert their gaze.

* * *

Dec. 16, 2001, Afghanistan: Cpl. Chris Chandler and his fellow Marines were among the first troops to arrive in Afghanistan. They had watched the twin towers fall while aboard a ship in Australia, then powered across the globe, and now they were here to get al-Qaeda leader Osama bin Laden and rout the Taliban.

"Everyone knew why we were there, what we were doing," Chandler said. "It was good to have some action."

For months, they helped secure villages and gather intelligence. And when there was a call to clear out some buildings, Chandler and his fellow scouts volunteered. Walking through what was supposed to be a cleared minefield in Kandahar province, Chandler stepped on an explosive and lost his left foot.

He became one of three amputees to land at Walter Reed Army Medical Center that month -- the war's first such casualties.

What he wanted most was for life to get back to normal again, to simply resume. He wanted to run. He wanted to stay in the Corps, maybe even return to Afghanistan.

Was any of that possible?

He had no idea. This was all new -- for him and for a country that had been jolted into combat and was unprepared to handle a generation of wounded warriors.

* * *

July 14, 2003, Iraq: Ryan Kelly thought that he had missed the war. He landed in Iraq in April, a month after the military launched its "shock and awe" push into the country and just before President George W. Bush declared that "major combat operations in Iraq have ended."

Kelly, 29, had served in Bosnia and thought his Iraq tour was going to end similarly, a combat-free mission focused on peacekeeping and nation-building. Troops would erect schools and hospitals, without worry, and then head home.

"We missed the initial invasion, and a lot of us were disappointed that we missed the big show," he said. "The war was over."

Iraq didn't feel terribly dangerous. Rarely did insurgents open fire; when they did, troops would joke about the errant potshots. The words "improvised explosive device" had only recently crept into soldiers' lingo.

"We went through Ramadi and Fallujah in unarmored Humvees day and night," Kelly said. "I didn't feel threatened."

But after a couple of months, soldiers started getting hit. There were stories of bombs buried along roads, hidden amid trash, even stuffed into dog carcasses. A rocket-propelled grenade nearly screamed into the window of Kelly's makeshift office.

Then, while he drove on a highway south of Baghdad, a makeshift bomb exploded near his Humvee, which didn't even have doors let alone protective armor. A piece of shrapnel the size of a TV remote control took his right leg off below the knee.

By then, a small but growing group of amputees had assembled at Walter Reed, which had taken on the feel of a wartime hospital. Patients took it upon themselves to let the new arrivals know that they were not alone. Which is exactly why the Air Force officer popped by Kelly's room.

He wore a pilot's flight suit and walked with no perceptible limp; he had to show Kelly his prosthetic before Kelly believed that the officer, too, had lost a leg. Kelly told him that he had wanted desperately to fly helicopters in the Army but was denied because of poor eyesight. The officer said he'd flown before he lost his leg, and would again.

That didn't seem impossible to Kelly, who at the time harbored his own ambition: to get back to his fellow soldiers in Iraq before their tour ended. It was perhaps delusional, but "that's what got me up in the morning," he said.

But then he needed more surgery, and the Army wasn't keen on sending a one-legged soldier to the front line. When his unit came home without him, it finally hit Kelly that he was no longer going to be a soldier.

But maybe he could fly.

His friends and family thought this was another quixotic quest that would end in disappointment. But it gave him a new purpose. In civilian life, he would be a pilot. This was another reason to get well.

Once he was discharged from Walter Reed and out of the Army, he had Lasik surgery to fix his eyesight. Then, a few months after learning to walk again, he began to learn how to fly.

Now the retired staff sergeant lives near Austin and flies helicopters for oil companies, ferrying supplies and equipment to rigs in the Gulf of Mexico. The jagged piece of shrapnel that took his leg off -- and still has a bit of his uniform melted to it -- hangs on his wall like a trophy.

* * *

May 7, 2007, Iraq: By the time Lt. Col. Gregory Gadson got to Iraq, it was not merely dangerous but out of control. Bush had ordered a surge as a last-ditch effort to tamp down the violence. Gadson's unit would play a key role in that.

By now, the Army had incorporated extensive training on IEDs into pre-deployment exercises, turning soldiers into human bomb detectors who could spot disturbed patches of earth, a protruding wire, anything suspicious.

"The first time we drove into Baghdad, I was like, 'Holy cow,' " said Gadson, who is now 44 and lives at Fort Belvoir. "Suspicious? I mean, everything is suspicious. It seemed like you could spend a whole day just trying to figure out what was a threat and what wasn't, and you wouldn't get anything done. You couldn't let it preoccupy you. It just became part of the environment. Like loud noise."

It wasn't surprising, then, that when Gadson got hit, he was on his way back to base after attending a memorial service for two soldiers killed by a makeshift bomb.

The first few months at Walter Reed, he didn't care that he had survived; he couldn't live like this, not without his legs. He'd lost both because of the blast and suddenly weighed 150 pounds instead of 210.

There had been huge advancements in prosthetic technology since the start of the war, and eventually he would be outfitted with the latest bionic, battery-powered legs that had sensors that help correct missteps. But at first, the depression was devastating. At his lowest point, he said, he cried for what seemed like 24 hours straight. He assured his family members that he wasn't suicidal, but he also told them that he had given up, that they should move on without him: "You guys just live. Just leave me in the corner in my wheelchair, and I'll manage."

Slowly, his wounds healed, and so did his psyche. There was no epiphany, no single event that turned him around. Just a vague notion that maybe today wouldn't be as bad as yesterday.

By August, three months after the explosion, he started to venture out of the hospital.

Among the first places he went to were his son's Pop Warner football games and his daughter's field hockey sessions. He didn't go into the stands like the other parents but cheered from his wheelchair on the sidelines, as close to the action as he could get.

* * *

February 2010, Walter Reed: In Germany, the doctors had told Guyton, the redhead from Burke, that they were sorry but that there was nothing they could do. They had to take his left leg as well, leaving him with two stumps.

Drugs had replaced his adrenaline, and still he didn't feel any pain. But his battlefield instincts were still switched on.

Don't look down, he told himself again. Don't think about it.

At Walter Reed, though, there was nothing to do but think about it. Reality sank in slowly. At first, he told himself he would master his new legs. Soon he would be walking. Then he would run. "And life will be normal again," he said.

But there's nothing normal about realizing that your wheelchair doesn't fit through the bathroom doorway at your parents' house. So you have to scoot through on your hands and then hoist yourself on top of the toilet bowl -- a gymnastic feat that takes strength and leverage and is precarious even with practice.

There's nothing normal about watching the muscles on your stump atrophy away, or the stares from other diners when he fell last year at 2 Amys pizzeria in Cleveland Park. And there's nothing normal about what he called "the sick jealousies" at Walter Reed, where he looks at other patients and thinks, "If I only had one leg."

"You see people out walking around, and it seems easy enough," he said. "But what you don't see is them at home using a wheelchair or scooting around. Try being at that level for a while. It's degrading. It's like being a child again. And you know this isn't a temporary situation. It's going to be like this for the rest of your life."

Chandler, one of the first amputees, felt the same way in the early weeks of his recovery. He was now officially handicapped, and people treated him as such.

"There's a huge stigma about what you can and can't do," he said.

Eventually, he met some older Navy SEALs who had lost limbs in motorcycle accidents and helped show him the way. He was told that he could no longer be a Marine, but with help from fellow Marines, he persuaded the Corps to keep him. Then he served three more tours, all in Iraq. He was told that he couldn't parachute out of airplanes, but he completed airborne school. He was told that he couldn't run a marathon, but in 2007 he did that, too.

Now Chandler works with other amputees at a San Diego military sports program affiliated with the U.S. Paralympic team. His experience as an amputee makes him something of a sage. Anger and frustration are normal, he tells them. So are nightmares, and although they might become more infrequent, they don't entirely go away. At least they haven't for him.

But just because life is forever changed, he tells the athletes, doesn't mean it's over. There is an after.

At times, that has been hard for Guyton to imagine. He's still getting used to his wife pushing him around in his chair. He's still adjusting to his new legs, which he says are "like walking on stilts."

But through the guys who came before, Guyton, now 29, has caught glimpses of his future -- and who he might become. After so much time stuck in the past, reliving that day, he has started to look forward.

He has got eight more months or so at Walter Reed, a long way to go before he's fully in the after. But he has started to think about what he'll do next. Maybe law school.

In December, Guyton bought a prep book for the entrance exams, but he hasn't opened it yet. He will, he says. Any day now.

Staff researcher Meg Smith contributed to this report.

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