Archie Staley sat on a silver stool in a small office in the depths of Walter Reed Army Medical Center and stared straight into the eyes of Vince A. Przybyla Jr.
Staley is 20 years old, a U.S. Army tank driver with a quick wit and an accent lush with the tones of the mountains of western North Carolina, where he grew up. Staley was nearly killed when a mortar round exploded and blew him 15 feet into the air on a roadside north of Baghdad on Easter Sunday. He lost his left eye and his face was crushed, burned and scarred by shrapnel, which also pierced his neck, cutting his carotid artery.
Every war has its toll, measured in stark numbers representing those who are killed and wounded. But the numbers don't show the emotional toll of war, the impact each death has on families and the life changes forced on those who suddenly find themselves without a leg to walk on, a hand to button a shirt or lace a shoe, or a lung to catch a breath. Depression is common among recovering soldiers, and it often turns to frustration as they face the task of figuring out what they are going to do with the rest of their lives because plans changed in the time it took for a mortar round to explode.
Families of the 750 U.S. soldiers who have died in action in Iraq and Afghanistan have buried their loved ones and then faced life without them. But for the 6,113 soldiers wounded in the war on terrorism, the issues are even more fundamental. For many of them, Washington and its military hospitals are the first stop in the journey to the rest of their lives -- a place to heal their wounds, replace lost limbs and plan their futures.
Losing his eye is what brought Staley to Przybyla.
Przybyla, a 48-year-old Detroit native, is an ocularist; he makes artificial eyes. He had recently fitted Staley with a new eye, and after a few days of testing it, Staley was back in his office for a follow-up visit before heading home to Millers Creek, N.C.
"I think it's fine," Staley said of his artificial eye, "but my mom thinks it looks a little high."
Przybyla leaned on his workbench, which is loaded with plastic containers of paint that he uses to get the color of the artificial eyes just right.
"I don't want you kicking my butt, but your mom might be right," the doctor said. "It needs to come down a hair. Not much. . . . Bring your head here, we're going to take it out."
Staley stayed put.
"Oh, I forgot," Przybyla said. "I know you want to take it out yourself."
Staley bowed his head and manipulated the artificial eye out of the socket. He lifted a mirror from the workbench and held it in front of his face, staring hard with his one good eye at the wound he brought back from Iraq.
"I can't say for sure that anybody ever wants to go to Iraq," he said. "Once you get there and come back, it's family, and you want to go back. If they told me I could go back to my unit tomorrow, I would."
Staley, a specialist with the 2nd Battalion, 63rd Armored Regiment, will forever carry the scars of war. But he has maintained a positive attitude and said that his brush with death has taught him to be a little more goal-oriented than he was before he joined the Army. For now, his goal is simple: to get used to his new eye, get healthy and then get out of the Army and into college.
Many soldiers are treated at Walter Reed Army Medical Center in Northwest, where doctors have seen 3,358 soldiers from the war in Iraq, including 741 battle casualties. The rest have suffered from noncombat conditions, including heat-related problems and injuries suffered in vehicle accidents.
The cost of treating America's wounded is difficult to measure because much of the medical infrastructure is permanently in place. A spokesman for Walter Reed said the hospital spent $42.3 million in fiscal 2003 treating soldiers wounded in Iraq and Afghanistan. So far in fiscal 2004, the cost has been $37.1 million.
Up and Running Again
The war cost Sgt. Mike Cain a leg.
Cain, 23, grew up in Berlin, Wis., and was on his high school basketball, track and cross-country teams. He loved running best of all. He joined the Army after high school, was posted to Italy and then to Fort Hood, Tex., where he met his wife, Leslie. She grew up in Gladstone, N.D., a town with a population of 233 on the edge of the Badlands, and that is where they will live and raise a family.
Cain went through periods of depression during his rehabilitation. With the help of family and the support of the hospital, he came out of it, and now he hopes to get his retirement papers by Sept. 1. He wants to get home to Gladstone in time for the birth of his first child. After spending time at home with his wife and new baby, he intends to find a college nearby and study physical therapy so that he can work with amputees.
A few months ago, Cain began running again. It was a huge deal, not only because he accomplished a goal he set for himself with his new life, but also because he was able to do something that he loved doing before a mine blew off his leg.
On Aug. 1, Cain ran in his first road race as an amputee, a five-miler in New York City sponsored by the Achilles Track Club. The race began in the rain about 8 a.m., and Cain was almost as excited about running with pro wrestler Nick Foley as he was about being in the race.
He finished in 1 hour, 45 minutes. "The first couple of miles I was feeling good," he said. "I was hurting at three miles, and at four miles I was hurting really bad. At five miles, I finished the race, walking at the end."
It was his first trip to Manhattan and he took in the usual tourist spots, Times Square and Central Park. He said that his artificial leg did not bother him, but that his left ankle, which was broken when he was wounded, was killing him, and that is what slowed him down in the race.
While Cain receives treatment at Walter Reed, he is living in Malone House, a hotel for soldiers on the hospital campus.
On a recent sizzling summer morning, Cain and other soldiers boarded a bus for a few hours of fishing and then lunch at a waterfront restaurant. It is one of many trips organized for wounded veterans -- ranging from an Orioles game to a weekly Friday night steak dinner at Fran O'Brien's Stadium Steakhouse in Northwest. The trips, many organized by the Disabled American Veterans, are designed to relieve the boredom of rehab, but there is another important element to getting the soldiers out in public. It gets them used to being in the real world again, where people will ask about their wounds or glance at their artificial limbs. It also gives the public an opportunity to thank them for their sacrifices, which happens quite often, and each time is gratifying for soldiers.
Cain stood up, rested a fishing pole against an iron railing, baited his hook and then drew the pole over his right shoulder and made a humpback cast into a stiff breeze.
He was standing on the edge of the Washington Channel at the end of Water Street, just past the Harbor Patrol police station. Cain is 6-foot-3, solidly built with wide shoulders. He was dressed in an Achilles Track Club T-shirt, shorts and sneakers. A temporary prosthetic he received at Walter Reed was visible, beginning below his right knee and disappearing into a sock and sneaker.
Cain felt a bite on his line and gave the pole a yank. "I definitely felt something," he said.
"I love doing this stuff," he added. "I'm always willing to go out and do anything like this. It's better than sitting around the hospital and doing nothing."
On Aug. 10, 2003, Cain, a member of Delta Company of the 4th Forward Support Battalion, 1st Brigade, 4th Infantry Division, was a passenger in an Army flatbed truck in Tikrit when a land mine exploded, severely wounding both legs and breaking his jaw. Cain spoke in a flat voice when he recalled his last moments in Iraq. "Nothing, really," he answered quietly when asked what he remembers. "Just waking up and seeing the blood all over the place. . . . It's the worst pain you can ever feel in your life."
He wasn't awake for long. He lapsed into a coma and woke up about a week later at Landstuhl Regional Medical Center in Germany. His mother, father and two sisters, flown in from Wisconsin, were there when he came to.
"I remember when I looked up and I saw them," he said, giving the fishing pole a slight jerk to try to get a fish interested. "I was happy as hell. [The doctors] just told me that I was in an accident, an explosion. And I was, like, 'Yeah, no [expletive].' And then they told me I lost my leg."
As he baited his hook and cast once again, he was asked whether he felt appreciated for the sacrifice he had made in the war. "I do," he said. "I feel it by the way the community reacts to you. You know, it is all about the soldiers now."
Ready to Move On
Mike Cuscianna, 25, an Army specialist from Braintree, Mass., was about 50 yards downstream from Cain, working what he told everyone was his lucky spot. Suddenly, he let out a whoop as his pole bent nearly in half.
"This sucker is big," Cuscianna said, his words carrying the accent of his Massachusetts childhood. "Get a net!" he yelled. "We're going to need a net for this one."
Cuscianna was wearing a sleeveless T-shirt, and as he reeled in the fish, a scar that ran like a zipper from his breastbone to his backbone was visible. His right bicep was scarred and not as muscular as his left because he had lost some bone and muscle, the result of a bullet ripping through his arm.
Cuscianna, the son of a dentist, joined the Army with plans to spend eight years in the service and then get out to become a police officer in his hometown. Assigned to the 1st Battalion, 77th Armored Regiment of the 1st Infantry Division, he was riding in a Humvee on patrol in Balad in the Sunni Triangle on April 19 when his unit came under attack. He was shot three times, once through the arm and twice in the upper body. Despite his wounds, he said he kept firing until his sergeant noticed blood coming out of his mouth and decided to get him out of there.
He's had five rounds of surgery since and has lost two-thirds of his right lung. He's ready to get out of the Army, and has started looking for a job.
"Well," he said, "if I didn't appeal my disability rating, I'd probably be out by now. They didn't give me a very good disability rating. They consider not having one of your lungs not a disability. It kind of pisses me off a little bit, to do all of this and then have them not recognize what you've done." He said the Army ruled that his injuries left him 10 percent disabled, while he thought losing most of his lung left him nearly fully disabled.
Cuscianna pulled in his catch with the help of a buddy, who snagged the fat catfish in a net that almost couldn't hold it. "Hey," he screamed so all the soldiers could hear him, "I told you I was going to catch the biggest fish today."
Cuscianna commutes to Boston each weekend to see his family and his girlfriend. Last week, he went for an interview at the Plymouth County Sheriff's Department, where he has applied for two positions -- prison guard and sheriff's officer. His life is in limbo while he waits for his release from the Army and his return to civilian life.
'Taking Way Too Long'
On Feb. 25, Victor Thibeault left Walter Reed and went on a field trip to Congress. Testifying before the House Armed Services subcommittee on total force, Thibeault talked about fighting off depression and feeling alone when he had to come to grips with the fact that the career he had planned in the military was no longer an option because of wounds he suffered fighting the Taliban.
"This was going to be my career in life," he told the committee. "But now it has changed. So I have to make a change in my life. It's a rapid change. So it's hard for me to make certain decisions. And I don't know about getting out of the military and going on to college or doing whatever."
Thibeault, 22, of Riverside, Calif., spent about seven months at Walter Reed after his left hand was blown off by a grenade that was tossed into the Humvee he was driving through a crowded marketplace in Kandahar, Afghanistan, on Dec. 3, 2003. Thibeault, an Army specialist with the 110th Military Intelligence Battalion of the 10th Mountain Division out of Fort Drum, N.Y., grabbed the grenade and tossed it under his seat. He said the grenade had a seven-second fuse, and just about the time he got it under the seat, it exploded, ripping off most of his hand and cutting up his legs with a shower of shrapnel.
His reaction was purely logical. "My buddy didn't see it, and so that's why I grabbed it. My thought process was, if it crossed over my body as I threw it out the window, it might have killed me and my buddy. If I threw it out into a crowd on the side of the road, it would have killed innocent women and children, and we would have all kinds of bad propaganda." So he ditched it under his seat, and when he pulled up his arm, his hand was pretty much gone except for his little finger. He kept driving with the hand he had left, getting himself and his buddy to safety and treatment.
Thibeault is now back at Fort Drum, reporting for duty every day and then doing nothing. He submitted his retirement papers in April and was told that it would take a few weeks for his retirement to be finalized. He accepted a job with the Disabled American Veterans office in Philadelphia and recently rented an apartment near the Temple University campus.
But the Army told him that his retirement papers might not come through for another three months or longer because of paperwork.
Thibeault said he worked through the rehab just fine, though he found it difficult to deal with the depression when he first landed in the hospital.
"The depression is too great," he testified in February, "and you don't have anyone there supporting you to help you get through that depression unless you go find someone yourself."
Now the depression is gone. But it has been replaced by deep frustration. He is paying rent on an apartment in Philadelphia and has a job waiting for him, and he's more than ready to start his new life.
"I stand around and I wait," he said recently. "I wait until they give me a final answer. I have to report for duty every day, and I can't even tie my own boots and I can't button the buttons of my shirt unless I button it first and then slip it over my head. . . . There are a lot of wounded soldiers who are taking way too long to get out of the military, and I think it should be a quick process."
Thibeault wears a glove on his left hand. He said surgeons offered to remove one of his big toes and attach it to his hand like a thumb, but he declined, saying he didn't want to lose any other body parts.
Archie Staley joined the Army on his 18th birthday with plans to serve out his time and then use his GI benefits to go to college and study psychology. If it were not for his body armor, he would have died on the battlefield. He faces another year of treatment at Fort Sam Houston in Texas, where doctors will try to erase the scars that run from his hand to his shoulder like highways on a map. The young man from the mountains was nearly blown apart, and now Army doctors and Przybyla are slowly putting him back together.
Przybyla is part artist and part mechanical engineer. He is the only ocularist in the Department of Defense and one of only about 100 in the United States.
He met Staley on June 14, when he came to his office. It took seven more visits to get the eye finished. It had taken Przybyla 15 hours of solitary work to make the eye.
He gets great satisfaction from helping to heal soldiers and make them whole again.
After shaving the edge of the eye, he came out of the back room and handed it to Staley.
"Vince," Staley said, laughing, "what did you do to this? You got it all slick now. I can't get it in. Oh, you got it slick, man."
"That's that WD-40," Przybyla joked.
Staley was dressed in a white T-shirt and blue jeans. He is beanpole thin. Doctors had to reconstruct his crushed jaw and then wire it shut for six weeks, during which time he said he ate every kind of creamed soup imaginable. He lost 30 pounds and has put only a pound or two back on, despite eating all the time.
Staley joined the Army to become a tanker. Growing up, he loved any kind of vehicle. He enlisted on Jan. 16, 2002, trained at Fort Knox, Ky., and was based in Vilseck, Germany, with the 263rd, whose motto is "Seek, Strike, Destroy."
He said his Army recruiter was a tanker and he caught the bug. "How could you not like it?" Staley said. "It is a 72-ton vehicle with a 1,500-horsepower turbo engine and a 120mm cannon."
He was deployed to Iraq on Feb. 14, 2004. On the day he was wounded, he was riding in a Humvee, out on patrol to engage enemy troops just north of Baghdad.
"They started lobbing mortar rounds," he recalled, "so we spread the vehicles out to minimize the damage and casualties. After we spread the vehicles out, I got out of the back passenger-side door to go around to the rear, for rear security. And as soon as I got out, a mortar or artillery round went off. I was told that I was 45 feet from the round when it went off."
He was wearing his body armor, a neck protector and protective glasses, as well as his helmet. He remembers nothing after getting out of the Humvee.
Once his treatment is finished in about a year, he will leave the Army and go to college. For now, he is getting used to life with one eye. He has had therapy on his left hand, trying to get it to close completely. He's left-handed, and his mother said that his penmanship was chicken scratch before he was wounded, and that it's about the same now.
He's been told that he'll be picking shrapnel out of his hand for the rest of his life, but other than that, he considers himself perfectly healthy. "I see perfect," he said. "I see just like I got two eyes. I drive the same that I always have. There is no difference -- you just have to turn your head to the left a little, that's all."
He was sitting on the silver stool, coaxing his new eye back into the socket. Once he got it in, Przybyla took a good look at him and said that the adjustment had worked. His eyes were now even.
"Can I go now?" Staley asked.
"Archie," Przybyla answered, "you're good to go, but we are going to want to do a follow-up with you in a couple months."
Staley stood and the two men embraced. Then Staley walked out of the office with his grandfather by his side, taking it step by step down the corridor with his new eye, heading toward his new life.