By Michael E. Ruane
Washington Post Staff Writer
Thursday, November 11, 2010; 9:28 AM
The morning that Marine Cpl. Todd A. Nicely received his medal for valor, he and his wife, Crystal, paused in a restroom at Walter Reed Army Medical Center to pull the trousers of his uniform over his artificial legs.
Crystal maneuvered his pants past the carbon fiber feet. Then they fitted the prostheses onto the stumps of Todd's legs.
He put on his tan utility shirt, which she buttoned, attached his artificial left arm and slipped his metal pole crutch onto the stump of his right arm. When he donned his camouflage Marine Corps hat "low on the brow," he was ready.
It was the first time in six months that he had been back in his "cammies" - since the day in March when he had stepped on the explosive device in Afghanistan that tore off his hands and lower legs.
The blast broke his jaw, punctured his ear drums and left him, according to the latest statistics, one of only three men - a soldier and two Marines - from the wars in Iraq and Afghanistan to survive an attack as a quadruple amputee.
They now top a grim hierarchy of more than 1,100 military amputees from the two conflicts, which includes 21 people who have lost three limbs, 258 who have lost two and 832 who have lost one.
Nicely's wounds resulted from an explosive encountered on a foot patrol; his survival stemmed from good body armor and quick life-saving actions by comrades.
In the months since his injury, Nicely, 26, has endured numerous surgeries. He has cycled through three kinds of artificial legs and worked with three types of artificial arms.
He has had to strengthen his butt muscles to help operate his computerized legs and learn to use his shoulder muscles to help activate his artificial arms.
Nicely has spent weeks at Walter Reed learning to stand, walk, climb stairs, zip a zipper and unscrew a bottle cap. He still often needs someone to light his cigarettes for him as he motors around the hospital campus with an artificial arm sticking out of the back pouch of his wheelchair.
He is thin, thoughtful and bespectacled and is slightly taller on his mechanical legs than before - 5-foot-9 vs. 5-foot-8.
And he can be so matter of fact about his wounds that it's easy to forget that his limbs are metal and plastic, not flesh and bone.
"I'm just a regular guy who joined the military," he said.
As he sat outside in his wheelchair one day recently, with his artificial legs off and his right prosthetic arm in his lap, he smoked a cigarette, pushed up his glasses with his mechanical left hand and looked like a man waiting for a bus.
Yet he gets a distant gaze when he recounts his wounding. A squad leader, he stifled his screams for the sake of his men.
He does not dwell on his injuries. A younger Marine in his platoon was shot in the head and killed instantly four months before he was wounded.
"All you can do is be thankful you're alive," he said, "which I am."
When he was dressed that sunny morning of Sept. 17, he and his wife drove to Mologne House, an outpatient residence at Walter Reed.
In a courtyard out back, about 50 of his Marine buddies had gathered - many driving from Camp Lejeune, N.C., the night before - to see him get the Navy and Marine Corps Achievement Medal, with V device, for valor.
He was receiving the honor for his meritorious work in the weeks before the explosion.
At 11:30 a.m. he stood at attention - unsteadily for a moment - before his old company commander, Capt. Scott A. Cuomo, while the citation was read aloud.
After Cuomo pinned the green ribbon to Nicely's shirt, he gathered the Marines around him. Nicely, weary on his "C-legs," sat on a wall beside him.
"I just want to make sure that you understand how proud I am and we are for what you've done," the officer told him.
The courtyard was quiet except for the sound of a waterfall in a fountain. After Cuomo's talk, the Marines lined up in front of Nicely and took turns embracing him.'We equal each other out'
The afternoon of March 26, Nicely was leading his men back from a routine security patrol near the town of Lakari in southern Afghanistan.
They were walking in staggered formation on a road that ran along a canal. Ahead was a crude, single-file bamboo bridge over the canal.
Buried at the foot of the bridge was a bomb made of 40 pounds of homemade explosives.
Nicely had taken his men on scores of patrols like this before. They had found ammunition caches and explosives, waded through freezing cold water and come under enemy fire.
On this day, they were on a road they had often walked before. "I should have known better," he recalled.
Nicely had been in Afghanistan five months. He was in charge of 12 Marines in the 1st Squad, 1st Platoon, Company F, 2nd Battalion, 2nd Marines.
He had already served a tour with the Marines in Iraq in 2008. There, it had been relatively calm.
Around Lakari, it was not. The terrain was flat and interrupted by irrigation ditches and tree lines from which the Taliban regularly attacked.
"The first week that we actually owned the land, you couldn't go 400 meters outside of our base without getting shot at," he said.
Nicely, a native of Arnold, Mo., outside St. Louis, had found his calling in the Marines. He loved being responsible for younger Marines, loved being, at 26, "the old man." He had also found his wife, Crystal, 24.
Crystal, a native of Wathena, Kan., was a Marine, too, when they met on the Internet.
They were stationed at nearby bases in North Carolina. After dating for several months, they were married Feb. 20, 2009, in Jacksonville, N.C. "We did the courthouse thing," he said. She left the Marines the next June.
They made "quite a pair," she said recently.
He said, "We're actually kind of opposites."
"We are," she said. "I am the calm, collected [one] . . . and he is the wild, rambunctious, 'I have many stupid moments' man.
"We equal each other out," she said. "It's an adventure."
During his deployment, she had moved back to Kansas to be with her family.'Just keep breathing'
The day he was wounded, Nicely was walking in the lead.
"We always patrolled on foot," he said. "It was just a regular security patrol to make sure the Taliban was staying out of the area."
"I had decided to cross [the] bridge," he said. "Of course, I went first."
He stepped on a pressure plate rigged to the explosive and triggered the blast.
He does not recall any sound, just hitting the ground near the canal and water splashing on his face.
"Aw, God," he said he thought. "What happened?"
Lance Cpl. Felix Camarillo, 19, of Los Angeles was third in line, behind Nicely and the platoon's commander, Lt. Brian J. McGrath Jr., 27, of Glenside, Pa., who was along to interact with locals.
Camarillo saw Nicely engulfed in dust and debris. "Nice!" he yelled.
The explosion knocked down the whole patrol, Camarillo said.
McGrath tried to quickly sweep the area with a metal detector to make sure there were no other bombs. But there were so many fragments on the ground that he threw the detector aside and rushed to Nicely.
The blast had blown off Nicely's helmet and flak jacket.
He looked awful.
"I almost lost it," Camarillo said. "There were bones sticking out. . . . His right leg was just completely gone. His left hand was gone."
Much of his right arm was also gone and his left leg was barely attached, other Marines remembered.
He also had a wound that looked like shrapnel had gone through the bottom of his jaw and come out his left cheek and an abdominal wound with part of his bowel protruding, his friends said.
Camarillo and Lance Cpl. Sean Harrigan, 19, of Methuen, Mass., who were trained to treat combat trauma, put tourniquets on what remained of Nicely's limbs to stop the bleeding.
A strapping corpsman, Jerrod Francis, 21, of Louisville, sprinted over from another squad and went to work on the other wounds. He was amazed that Nicely's vital signs were decent.
Nicely recalled: "I remember . . . thinking to myself . . . 'Just keep breathing so you can get back to your wife.' "
"I remember screaming once or twice," he said. "You know, those curdling, bloody screams that they do on the movies, like: 'Waaaah! Waah!' I did that a couple times, and I remember thinking to myself: 'Don't do that again, because this is the last image that these boys are going to have of you in their heads. So stay strong.' After that, I just shut up."
He knew he gotten "blown up pretty good," he said. "I knew I was going to lose some. I wasn't quite aware that I had lost all four."
The Marines called for a helicopter, which arrived quickly. They put Nicely on a cot and carried him to the "bird," and he was flown away.
Camarillo did not think he would survive.
Later, after he had been evacuated, his buddies found one of his hands during a search of the area.'To me, it was still Todd'
Back in Kansas, Crystal Nicely was visiting one of her sisters when the Marines tracked her down.
"They put a sergeant major on the phone with me, and he asked me to sit down," she recalled. "He told me that my husband had been injured. I asked him if he was still alive. He said yes. He said, 'I don't know the extent of his injuries, but he is injured and he is missing some limbs.'
"All I kept telling them was: 'You've got to get me to him. . . . I need to see him.' "
She and his parents were flown on a commercial flight to the military hospital in Landstuhl, Germany, where Nicely had been taken.
He had lost his right leg at the knee, his left leg just above the knee, his left arm at the wrist and his right arm at the elbow.
"You always think it's going to be worse than what it actually is," Crystal Nicely said of the moment she saw him. "I mean, it wasn't good, but to me, it was still Todd. His [missing] limbs didn't really affect me. . . . I saw him breathe, and I was like: 'Okay, he's still alive. He's still with me.' "
Nicely was flown to the National Naval Medical Center in Bethesda, where his family began a vigil.
"We didn't know if he knew" the extent of his injuries, Crystal Nicely recalled. "And we didn't know how he would take it, if he would go down which path - the bad path, or if he would take some kind of hope."
Late one night, he woke up and told her: "I don't know what's wrong."
"What do you mean, 'You don't know what's wrong?' " she asked, sensing he meant his injuries.
"Do you want to know what's wrong?" she asked. He said he did.
"Well, baby, you know you're missing your legs?" she asked.
"Yeah," he said. "I know."
"Did you know you're missing both hands?" she asked, crying.
"No," he said.
He was quiet for a minute, then asked, "Did anybody else get hurt?"
She said no.
"Good," he said.
"And that was the end of it," she remembered.'I-hate-amputees tool'
One day in September, Nicely sat in his wheelchair at a table in Walter Reed's Military Advanced Training Center, where amputees get physical and occupational therapy.
His recovery was well advanced. Accompanied by his wife, he had attended daily therapy, worked hard and aimed to be finished at Walter Reed within a year of his injury.
Over the summer, he and Crystal moved to an apartment in Montgomery County with her dog, Reese. They commuted to Walter Reed in her Jeep. "This is the easy part," she said. "The hard part's over."
On this day, Nicely had on black shorts and a white T-shirt. He was not wearing his artificial legs.
He wore a battery-powered myoelectric prosthesis on his left arm and was using it to put a prosthesis on his right arm.
He looked like he was girding for battle - slipping the right arm's support strap over the back of his neck and looping it onto his left arm.
He flicked a tiny black switch on the right arm, set his right elbow at a 90-degree angle and said, "All right."
On the table before him was a checklist of tasks labeled "Activities of Daily Living."
It included such things as "open top of pill bottle," "take bill from wallet," "open pack of cigarettes." There was a four-part grading system beside each task, from zero (impossible) to 4 (smooth).
Nicely had become a good "crane operator," his therapists said, coordinating the mind and muscle skills required to move his arms and operate his hands. "It's pretty much like playing a claw machine" at an arcade, he said.
He had to practice buttoning a shirt, a brain-bending task that was done with a simulated shirt front and small wire hooking device he called an "I-hate-amputees tool."
There was the pill-bottle task, in which he spilled too many pills but expertly scooped them off the table and back into the bottle.
Then there was the open-a-bottle-of-Gatorade task.
"I'm going to spill stuff everywhere," he told occupational therapist Josef Butkus. The therapist replied, "Let me get you some towels."
Nicely wrestled with the bottle for several minutes, dropped it in his lap, started over and finally removed the cap.
With the 25-pound pinching power of the artificial hands, he partly crushed the paper cup Butkus gave him. But he managed to pour a drink, pick up the cup with his teeth and drink it.
Butkus then tossed the bottle cap back to him and said, "Your favorite part."
But Nicely easily replaced the cap, picked up the bottle and rotated it 360 degrees with a robotic hand.
It did not leak.'If it wasn't for you guys'
Nine days later, Nicely sat on the wall in his uniform before his fellow Marines in the courtyard behind Mologne House.
He had just heard his old battalion commander, Lt. Col. John McDonough, tell the gathering that he hoped his children might one day have the courage that Nicely has.
Now it was Nicely's turn to say something.
He pushed himself to his feet with his pole crutch.
"I just want to thank everybody," he said, gesturing with his artificial left arm. "I'd like to . . . thank my platoon for getting me back. If it wasn't for you guys, I don't think I'd be alive today.
"Other than that, I really don't have much more to say," he said.
He rubbed his nose with his flesh-colored left hand, shifted his weight on his legs and added, "I love you guys."