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thedrifter 07-21-2003 05:55 AM

The Soldiers of Ward 57
 
The Soldiers of Ward 57
The War After the War
Soldiers' Battle Shifts From Desert Sands to Hospital Linoleum

By Anne Hull and Tamara Jones
Washington Post Staff Writers
Sunday, July 20, 2003; Page A01


First of two articles

The taxicab pulls up to the curb of Walter Reed Army Medical Center, and Pfc. Garth Stewart slides into the back seat. A nurse stows his duffel bag in the trunk, offering her last advice. "Move your leg around on the flight," she says.

The American flag hangs slack on the flagpole. Garth lays his crutches across his lap. The lanky 20-year-old soldier from Minnesota rubs the place where his leg was amputated. The throbbing alternates with jolts that feel like electrical shocks. Two Percocets are in his pocket for the plane ride home.

As the cab cuts through Rock Creek Park, Garth rolls down the window to smell the forest. After weeks of hospital food and disinfectant, he breathes deeply. He rips the plastic hospital ID bracelet from his wrist and crumples it in a ball.

The bed that Garth left behind on Ward 57 will be filled by day's end. Even though major combat operations in Iraq are over, the wounded keep arriving. Twice a week, transport planes land at Andrews Air Force Base, bringing fresh casualties. Accidents, ambushes, pockets of resistance. Nearly 650 soldiers have passed through Walter Reed during Operation Iraqi Freedom, more than half of them since the conflict was officially declared over.

On TV, the war was a rout, with infrared tanks rolling toward Baghdad on a desert soundstage. But the permanent realities unfold more quietly on Georgia Avenue NW, behind the black iron gates of the nation's largest military hospital.

Here, the battle shifts from hot sand to polished hallways, and the broad ambitions of global security are replaced by the singular mission of saving a leg. Ward 57, the hospital's orthopedics wing, is the busiest. High-tech body armor spared lives but not necessarily limbs.

The night President Bush declared the end of major combat, the soldiers on Ward 57 slept, unaware of victory.

Garth Stewart was curled in a miserable ball of blue pajamas.

First Lt. John Fernandez, the West Point graduate, was beginning married life from a wheelchair.

Pfc. Danny Roberts was wishing for Faulkner instead of a glossy guide about adapting to limb loss.

Their war was not yet over.

Walter Reed has been treating wounded soldiers since the beginning of the century, expanding and contracting with the rhythms of war. During World War I, the number of patient beds grew from 80 to 2,500 in a matter of months. Three generations later, the soldiers from Operation Iraqi Freedom arrive, some so fresh from the battlefield they still have dirt and blood beneath their fingernails.

Each morning, across the sprawling grounds of the 147-acre compound, reveille is sounded at 6. But up on the hospital's fifth floor on Ward 57, the fluorescent dawn is indistinguishable from the fluorescent night. Two long halls flank the nurse's desk, the command center of the ward. Doctors begin their morning rounds at dawn.

In Room 5714, Garth Stewart is sleeping when three doctors arrive. One of them reaches for a light switch, and before Garth can shield his eyes, his room is flash-blasted in white.

"Can we take a look at the leg?"

Garth flips back the bedsheet. His desert tan has gone sallow. His GI buzz cut is a woolly disgrace. Even in this condition, he wishes for a decent soldier's haircut. The drugs have made his stomach cramp so much that he stays curled on his side. Now, with the doctors hovering, he tries to straighten out his 6-foot-4 frame. His amputated leg won't lie down. It trembles in midair.

A doctor works quickly, unwrapping the bandage and then the white gauze. Garth watches as they probe the black caterpillar of sutures on his bulbous stump. He moans. The stump begins to shake violently. "I'm gonna get sick," he says.

"You want your bucket?"

Garth reaches for the container. "I can't do this much longer," he says, holding his hand over his eyes.

"We're almost finished," the doctor tells him.

"No," Garth says, "not that, everything. I can't take it any more."

They leave him in darkness, with his bucket. Only four weeks earlier, Garth was a mortar man with the 1st Battalion of the 3rd Brigade, 3rd Infantry Division. "You get out of high school and you join the Army, or you get out of high school and live in your parents' basement," he says. He chose Fort Benning over Stillwater, Minn.

For someone who signed up for four years of regimen and order, Garth was unusually iconoclastic. Tattooed on his chest was a line from the novel "Fahrenheit 451" by Ray Bradbury: "If they give you ruled paper, write the other way." And yet he loved the discipline of Army life. At Fort Benning, he competed on the martial arts team. Because he was a Minnesotan who called sodas "sweet fizzies," some of the guys nicknamed him "Sweet Fizzies, King of Fighters."

Garth was so eager for the fight in Iraq that he bought a high-powered custom scope for his rifle. He used it only once, to shoot out some factory windows. But Iraq turned out to be messier than he thought. He saw charred bodies, and a grotesque assemblage of dead Iraqi soldiers who had barreled their car into an American tank.

On April 5, his unit was on the Karbala highway when some of the guys stopped to pose for a picture in front of a sign that said "BAGHDAD." Garth and a buddy decided to inspect a nearby bunker. The explosion blew both of them down. Garth's left boot was a wreck, and a chunk was missing from his lower leg. His other leg had a softball-size hole in the calf. A medic told him he'd probably lose a big toe.

He had surgeries in Kuwait and Germany, each time losing more of his foot. At Walter Reed, the orthopedic team decided that his leg needed to be amputated at mid-shin so he could fit into the highest functioning prosthesis.

Now, Dilaudid drips through his intravenous line, along with so many other drugs that he is too sick to eat anything but crackers.

Scenes from the war drift through his head. When he was in Iraq, an Army general came up to his company and said, "Man, we gotta stop Saddam. He boils little girls in acid." The statement struck Garth as "hilarious propaganda."

But lying in bed, he can't stop remembering all the Iraqi people who came out of their houses to shake the hands of the American troops.

Garth tries to make sense of things. "Any beautiful and scornful poem you read about war, it's about the horrible randomality of war," he says. The same Special Forces medic who treated Garth and his buddy after they stepped on the land mine was shot by a sniper two days later south of Baghdad. Now that same medic is on Ward 57, minus his right leg.

Ironies of War


Even with the war officially over, Ward 57 is filled to capacity. Officers are forced to share rooms with enlisted soldiers. "I've got a full-bird colonel in with a private," the charge nurse says one morning, scanning the room assignments with frustration. "Out of respect, he should have his own room."

"Oh, cry me a river," another nurse says.

The famous POW, Pfc. Jessica Lynch, is in a private room at the end of a hallway on 57, with a military police officer seated outside her door. In the rest of the ward, doors are open, visitors flowing in and out. All day long, soldiers buzz the intercom at the nurse's station.

Yeah, when you get a chance, I just spilled something over me.

Yes, ma'am, I need a Percocet.

Uh, can I have a blanket, please?

Yes, ma'am, I was using the urinal and . . . I need a new pair of pants.

In his room, Danny Roberts squints through eyeglasses that survived Iraq without a scratch. The aspiring English teacher in him has to appreciate such irony, same with the half-finished copy of William Faulkner's "As I Lay Dying" he had in his truck the day his feet got blown to pieces. Reading helps break the boredom now. Danny props himself against the pillows and jots reminders in a green spiral notebook: Call bank to replace the ATM card blown up in Iraq with his wallet; order tickets for the Red Hot Chili Peppers concert; get checked for anemia.

He's always been pale and skinny, not the brawny soldier pictured on recruiting posters. Still, he loved the Army so much he had a replica of his dog tags tattooed around his neck after leaving active duty and going to the reserves. Civilian life was a tough adjustment. Danny managed a band for a while, then moved to Hollywood, then New Orleans, partied too hard, went home to Wisconsin and started tending bar and going to college part time. Then his reserve unit was activated, and 26-year-old Danny was en route to Iraq.

He was part of a supply convoy, hauling food and water. He went through his brief war listening to New Age music on his headphones to tune out the ugliness around him. There were wild dogs, that searing white heat, enraged Iraqi boys who would mob the slow-moving convoy, hurling bricks at the hated American faces. Danny never so much as chambered a round in his own weapon. And then one afternoon, he stepped on a land mine.

At Walter Reed, surgeons operated four times just to clean out the wounds. Danny's right heel had been torn off and was replaced with a metal plate. Two toes were missing on his left foot, and the others had to be amputated. As he was healing from that surgery, doctors delivered more bad news: The explosive had destroyed tendons, too, causing the left foot to flop uselessly. He would never be able to walk on it, and it would lose circulation and eventually have to come off anyway. A prosthesis would give him far more mobility. It was up to him whether to amputate now or wait it out. Go ahead, Danny told them, then wept alone in his room that night.

Danny is now the model patient, always chipper and polite. Thank you so much, he tells the nurse bringing pain medication. "Awesome work," he congratulates his surgeon. He urges the bleary-eyed residents to get some sleep.

One morning, an intern unwraps his bandages, causing Danny to grip the bed rails in pain. "Oh, Danny Boy," she begins to sing, trying to distract him. He manages an appreciative smile even as he winces.

The Honeymooners


By the time he reached Walter Reed, John Fernandez had made a vow. "I'm not going to feel sorry for myself," he swore. Not when three men around him, including the gunner he tried to save, came home in body bags. "I'm here and I'm alive and I'm going to walk out of this place."

His hospital room is the first home he and his 22-year-old wife, Kristi, have shared as husband and wife. Kristi has moved a cot into his room. They hold court bedside, John recounting his story to visiting dignitaries, buddies and hospital staff. "I don't have any problems talking about it," he reassures the curious. His 13th Field Artillery unit was pushing toward Baghdad when an explosion blew John from his cot as he slept by his Humvee the night of April 3, less than 20 miles from the Iraqi capital.

"I woke up. My legs were numb," he recalls. "I took off the sleeping bag and I screamed." His feet were bloody pulp. The Humvee was in flames, spewing fuel. Patches of fire burned around the wounded soldiers. "I crawled away, calling for my gunner. He called back. His legs were bad, pretty much blown off. So I threw my flak vest down on him, put my M-16 on his chest and started dragging him." Help arrived, and the gunner was carried off. Two more soldiers -- just kids, John thought -- appeared through the smoke. The Humvee exploded, throwing all of them to the ground again. His rescuers began to panic.

"Calm down, it's okay," John remembers telling them. "Just grab my legs, not my feet." At the mobile Army hospital, one of the senior sergeants burst into tears. "Don't worry about it," John heard himself saying. "I'm okay."

Arriving at Walter Reed, feet swathed in thick bandages, he figured he was in for some serious reconstructive surgery.

But the wounds were grievous, and infection set in.

Twelve surgeries later, John Fernandez is a double amputee.

Surgeons sawed off one leg just below the knee, the other a couple of inches above the ankle. His wife of three months insists that nothing has changed between them, and talks about dancing together at the big wedding postponed by war. The surgeons agree: Anything is possible. People climb mountains, ski, run marathons on state-of-the-art artificial legs. John had always been an avid athlete -- lacrosse, basketball, soccer, hunting, fishing, you name it.

Kristi had been waiting at the curb when they unloaded John's stretcher at Walter Reed. She remembers seeing his smile first, running to kiss him, to say "I love you" over and over through happy tears.

The honeymooners in Room 5711 quickly became the darlings of Ward 57. Encamped in the small room, they crack jokes in their Long Island accents and beg visitors from back home to bring fresh bagels. They draw a cartoon of John on the nurse's dryboard, with the proclamation: "I am the Spanish Thunder." That was his nickname as captain of the Army lacrosse team. John used to have legs like tree trunks.

The swelling is going down on his two stumps, and doctors hope to start fitting him for artificial limbs soon. The rehabilitation specialist, Jeffrey Gambel, says that John should eventually be able to bear weight on the longer stump, which will mean he won't have to put on both prostheses to get to the bathroom in the middle of the night. "It will be very hard to walk on," Gambel cautions, "like a cone."

"Like a pirate," John suggests. He and Kristi burst into laughter, sharing the same ludicrous thought:

"Halloween!" they hoot almost simultaneously. No need to worry about a costume this year.

Celebrity City


America is sending cookies and Hickory Farms baskets to Ward 57. Orioles tickets and NASCAR passes arrive. Sheryl Crow brings her guitar and sings for each soldier. Michael Jordan is as fast on hospital linoleum as he is on the basketball court: Here's an autographed cap and whoosh, he's gone. Kelsey Grammer pulls up a chair bedside. They are too young to remember Bo Derek; ("What's '10'?" a soldier asks after being introduced to the movie star.) But they thoroughly appreciate Jennifer Love Hewitt.

The staff on 57 worries about the attention being showered on the soldiers. What happens when they are no longer in the spotlight? Gambel watches as country singer Chely Wright and her entourage give each soldier a yellow rosebud. "They are told they're heroes, and they get home and they don't feel like heroes," Gambel says. "They feel like some dumb guy who stepped on a land mine."

So many celebrities and politicians arrive that a 28-year-old Special Forces medic whose left leg was amputated hangs a NO VISITORS sign on his door. The phrase "Thank you for your sacrifice" has lost its meaning, he says. "It's like someone saying 'Happy Birthday' or 'Merry Christmas.' "

One Sunday afternoon, the nurse's station on 57 gets word that Secretary of Defense Donald H. Rumsfeld is coming for a visit. Counters are scrubbed, a hot rod magazine on the front desk gets stashed and nurses patrol the halls, making sure patients and rooms are presentable. An hour later, Rumsfeld cancels. He has a cold.

Salvation


Of all the specialists who puzzle over Garth Stewart, of all the expensive drugs dripping into his veins, nothing brings relief. The stomach cramps and constipation persist. Instead of getting better, he's getting worse. And then his magic bullet arrives.

The remedy comes from an unlikely deliverer known as the Milkshake Man. Jim Mayer is a veteran who lost both legs in Vietnam. Several times a week, he brings McDonald's milkshakes to the amputees on Ward 57. The visits are just an excuse to talk and counsel. Mayer arrives this Saturday afternoon but Garth refuses the shake. Too rich. Any chance of a Mountain Dew, he asks. Mayer heads downstairs to the commissary.

The super-caffeinated soda does it. Caffeine! The next day, Garth is sitting up in bed. His blinds are open. "Mountain Dew saved my ******* life," he says, his voice deep and robust. Suddenly, he is ravenous. "Domino's keeps showing this commercial for Cinna Stix," he says. "You dip them in icing. Man, I want some."

When six Washington Redskinettes push through the double doors of Ward 57, wearing maroon sparkle bras and hot pants, Garth is waiting. "You guys are so cute," he practically shouts. One of the cheerleaders touches his stump. Garth says, "So many people look at this as you are less of a man. You should see the dignity of the guys who come in here to visit me. They roll up pants, and they are standing on plaster."

A day after the Redskinettes visit, Walter Reed's highest commanders come to bestow military honors. After the VIPs leave, Garth sits in bed, a gold medal pinned to his pajama top and an empty delivery box on the sheet beside him.

"Quite a day, man," he says. "Pizza and a Purple Heart."

The next morning, he's wide awake when the doctors arrive for rounds. Freshly barbered, he looks like a soldier again, which is what he wants to be as soon as he can escape the captivity of Walter Reed. He has one question: "When can I get out?"

"I think a week is certainly feasible," a physician, Ken Taylor, says, checking for signs that the skin flap is healing.

Garth says how badly he wants to rejoin his unit in Iraq. "This is something I'm really serious about, doc."

Taylor stays focused on Garth's stitches. "An amputation is not a death sentence as far as the Army's concerned," he says. "We've got two four-star generals with amputations. It's hard for me to say if you'd be a ground-pounder again, an infantryman, but I don't rule it out."

Garth continues to press. "I mean, if someone came and got me, could the Army stop me from leaving?"

Taylor pauses, holding the gauze in his hand. The 37-year-old Army major is unshaven. He has worked all night, and his long day in the operating room starts in 45 minutes. But he remains calmly intent on Garth. "You're itching to get out of here, and I'm itching to launch you," he says. "The fact that you're even saying that is fantastic. You were this guy curled up in a ball two days ago who didn't want the light turned on."

"You're on the fence right now," he says gently. "I can't pop your hood and look inside and tell you what's going on today to know what I have to do to get you out of here. The human condition is not like that. We're on your side. You buyin' what I'm sayin'?"

Garth folds his hands behind his head. "Yeah."

When Taylor leaves, Garth comes up with the idea to buy his own plane ticket back to Iraq. He can't stand the idea of the 3rd Infantry Division over there without him.

Trip to the Mall


Danny's little green notebook is full of his scrawled reminders now. There's a lot to think about, plans to make. He and his girlfriend, Mindy, will need a new apartment, ground floor. And transportation -- he sold his beater of a pickup truck before going off to war. Will a wheelchair fit in Mindy's Kia? He fantasizes about buying a bass guitar once he gets home to Green Bay, too.

In the haze of painkillers and too many different people trying to brief him on Army policy, the economics of being a disabled reservist confuse Danny. There are forms to complete, boards to convene, hearings to go through before the Army decides what his status will be and what kind of compensation he will get. The process can takes months. His head hurts. He thinks it must be the meds.

"I'm not one to gouge the system," he says, "but everyone's told me I already paid a big price and deserve what I can get."

His mother, Nancy, arrives from Green Bay with Mindy, a blur of hugs and held-back tears. Nancy brings her son's favorite chocolate chip cookies, homemade.

Mindy Bosse, a 20-year-old juggling two waitressing jobs and college, has final exams back home and can only stay the weekend. She'll start hunting for a new place for them to live, but Danny needs to get money for the security deposit out of his Wisconsin bank account, and the bank doesn't seem to understand that his ATM card and identification are now confetti in the Iraqi desert.

Danny remembers what happened to him April 9 with the kind of vivid detail so common among wounded soldiers that doctors have a term for it: flashbulb memory.

His convoy was exploring an abandoned Iraqi air base. Danny kept finding souvenirs: an Iraqi beret emblazoned with an eagle, a gas mask, the blouse from an Iraqi uniform. Best of all, there was a hardcover book with an autographed photo of Saddam Hussein inside.

Wow, he thought, this is my lucky day.

Two hours later, he was having a cigarette with a few buddies. He kept bouncing the heel of one combat boot off the toe of his other boot, an old habit. He figures now that this mindless motion set off the land mine beneath him. Three others were hurt, none as badly as Danny. He can still see the speckles of blood on a buddy's shirt. "It was my fault," he would later sob to doctors, who noted the crying jags in his chart as they transferred him from Kuwait to Germany to Walter Reed.

Now he is getting a fresh cast on his shattered heel.

"Ankle up, ankle up, ankle up," the technician says.

"I'm trying," Danny apologizes. The procedure causes pain not only in the heel but also in the severed nerves that have gone haywire on the opposite stump, where his left foot was amputated just above the ankle. He squeezes his eyes tight and grimaces, but doesn't complain.

He massages his stump.

"Your body gets used to pain," the cast tech offers.

"I've definitely gotten used to pain."

He scores a day pass, and he and his mother head to the nearest mall, in Wheaton. But that first excursion outside the cocoon of Walter Reed leaves Danny depleted physically and emotionally. The wheelchair they have given him was clearly intended for a large and husky man; Danny is neither. Maneuvering through crowds of shoppers, and up and down inclines, is a lot trickier than a hospital's wide, level halls. And then there are the stares. The adults quickly avert their eyes, but the kids ask straight-out what happened to his foot. Accustomed to living in a ward full of amputees, Danny didn't think to cover up the raw red stump when he ventured out.

He returns to Walter Reed bone tired. Nothing to write in the green notebook today. In a small voice, he asks everyone -- his mom, the social worker, the nurses -- to leave him alone for a while.

It's too hard to concentrate, and these headaches won't go away. Worried doctors schedule him for a battery of tests.

Discharge


Across the ward, John Fernandez is packing up. His orthopedist, Donald Gajewski, is so pleased with the way John's wounds are healing, and how well John has managed on his day passes outside the hospital with Kristi, that he offers a deal: Discharge to Fisher House, a small inn on the hospital grounds for patients' families. But they need to return for daily dressing changes and physical therapy. The prosthetics lab will be able to start casting John for artificial limbs once his swelling has gone down.

"Take it easy," Gajewski cautions, "you're still healing."

The nurses cluster around as they leave, offering a round of applause.

At Fisher House, they are in the dining room eating lunch when John's grandparents arrive from Long Island.

"Gramps!"

"Johnny, Johnny." Frank Fernandez, 81, is a veteran himself, a Navy man who survived the bombing of Pearl Harbor and then had two torpedoed ships sink beneath him. He spent 33 hours in the water and won't go swimming to this day.

Mary Fernandez, 74, bustles through the door.

"I brought cookies from New York!" She kisses John. "How you feel? You're still pale."

"No, I'm great. I'm fine."

"Your eyes. You always have lively eyes. Your eyes are pale."

Frank agrees.

"You need more color," he concludes. "Color, color, color. That's the name of the game. Color! Before you know it, you'll be shootin' baskets. You know, why not?"

John smiles.

"Right now it still hurts," he tells them.

"It has to hurt," his grandmother clucks.

"Let it heal, John," his grandfather says softly. "Let it heal."

John and Kristi excuse themselves for a nap, and only after they leave the room does his grandmother's smile begin to tremble. Tears slip down her face.

New Arrivals


Nighttime on Ward 57. The rooms are quiet except for the beep of morphine pumps and the sound of a lone TV.

Downstairs, the triage room is bracing for an influx of new casualties. An hour ago, another medevac plane landed at Andrews Air Force Base.

A gallery of photographs from Walter Reed Army Medical Center by Washington Post staff photographer Michael Lutzky and a video report on Marines recovering from their injuries at the National Naval Medical Center in Bethesda can be viewed at www.washingtonpost.com/nation.



? 2003 The Washington Post Company

http://www.washingtonpost.com/wp-dyn...l?nav=hptop_tb


Sempers,

Roger

thedrifter 07-22-2003 05:42 AM

The Soldiers of Ward 57
Moving Forward, One Step at a Time
After Iraq, Wounded Soldiers Try Out New Limbs, New Lives

By Tamara Jones and Anne Hull
Washington Post Staff Writers
Monday, July 21, 2003; Page A01


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:

"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 . . . "

"I am in the Army," Garth snapped.

And yet he has earned her admiration. One of the tools she uses is a full-length mirror. It helps the soldiers see how their bodies are leaning as they get used to having only one leg or one arm. Some of the new amputees refuse to look.

When Cooks led Garth to the mirror, he stared, as if trying to burn the image into his mind.

Today, Cooks wants Garth to practice walking. Sweat has gathered on his forehead from doing a set of leg-lifts and push-ups. Cooks hands Garth a pair of crutches. He blows a puff of air from his cheeks and stands. Cooks buckles a harness around his waist so she can pull him upright if he loses his balance.

Taking a step, Garth extends his stump as if he still had a leg and foot. "Good, Garth," Cooks says, walking alongside. Garth travels 30 feet and then proceeds out the front door of the PT room. A man sitting in the lobby averts his gaze into a magazine, not lifting his eyes until Garth passes.

Garth makes it back to the table and lies down, winded. Cooks touches his bandaged stump. Garth gasps. "Ow, ow, ow, what are you doing?" he asks, desperately. He exhales and stares at the ceiling. He can feel someone watching him. A girl with auburn hair has paused beside his table. She is struggling on her own crutches. Garth reaches out, placing his large hand on her small one.

A Visit From Hulk


A blast injury is like no other wound, a war unto itself. The tremendous force of a land mine shears soft tissue from bone, then reverberates through the skeleton with an energy that has nowhere to go but up. The brain bears the final insult, whiplashing inside the skull. Hitting the ground hard can also cause a blast victim's brain to swell, bleed or tear without any outward sign of a head wound. When a land mine or grenade or mortar detonates, the sound waves alone can cause concussion.

Danny Roberts, 26, is wheeling himself to the Traumatic Brain Injury unit, one gleaming hall down from his room on Ward 57. "There's nothing wrong with me," he fumes. The slight reservist from Green Bay, Wis., had just been getting his life on track, tending bar part-time and settling on a major -- education -- when his Army reserve unit, the 890th Transportation Division out of Hobart, Ind., was deployed. He went to war with paperback classics in his duffel bag, never fired his weapon, then was blown sky-high by a land mine while just standing around talking to his buddies one afternoon. His left foot is gone.

Now a neurologist will flip through a tablet of drawings: What's this, and this, and this? he asks. A bench, a tripod, a seahorse. Danny is usually so good-natured that nurses on Ward 57 drop by his room even on their breaks to chat. But today he's exasperated, his lips pressed tightly together. He is sure his nagging headaches are a side effect of his meds, that's all.

Deborah Warden and her associates patiently explain to Danny that concussions can be mild; he may not even realize he has any symptoms. They cover his eyes and ask him to identify smells: coffee, oranges. They break a cotton swab in half and tap his palm with the cotton, then the stick. Which is soft, Danny? Which is sharp?

A technician attaches electrodes to Danny's scalp. An electroencephalogram will chart any abnormal brain waves. Verbal and written tests will chart concentration and memory. Once that's done, doctors have promised discharge. Goodbye, Walter Reed, after 24 days.

When the examiners take a break, Danny goes AWOL. He rolls back to his room. Hulk Hogan is coming to visit! "I'll be there for that," he says.

Minutes later, Hulk barrels into Danny's room, all cartoon swagger.

"We just wanna thank you guys for going over and protecting us," the wrestler booms. "We love you, brother."

He glances at Danny's stump. "They'll fix that flat tire and get you runnin' again," he says.

"Put me in a headlock," Danny begs. His mother has a camera ready.

Hogan declines, but poses with his arm around him instead.

Word comes that a medevac plane departing Andrews Air Force Base the next morning can ferry Danny and his mom to Wisconsin. The brain team will call him with their findings, and he can get an artificial foot at the Veterans Administration hospital in Milwaukee.

When Taylor comes to say goodbye at dawn, the orthopedist finds his cheeriest patient in a tearful fury. The charge nurse is insisting that he cannot go because he needs valid military ID to board the plane. Danny's was shredded by the blast.

"You have any other ID? Driver's license?" Taylor asks.

Danny shakes his head. "They're saying it's my fault, that I should've taken the initiative! I can't walk up there." He jerks his head toward the nurses' station. " It's their job."

"You're absolutely right," Taylor soothes.

He confronts the stubborn charge nurse: This is ridiculous, he says. Danny didn't need ID to be flown here and shouldn't need it to leave. Just send him to Andrews, they'll let him on. "I doubt it," the nurse says. But she hands Danny a lunch sack filled with narcotics and his blue plastic hospital card. "Maybe that will work," she suggests. Nancy Roberts points out that her son has his dog tags tattooed on his chest -- what more ID could anyone want?

Taylor and Danny exchange goodbyes, and Taylor studies him for a moment.

"You're the most down you've been since you came here," he ventures.

"I know. Just frustrated."

"It's the system. All right, my friend . . . "

Downstairs, they load Danny onto a litter and a couple of uniformed soldiers carry him through the lobby to the white shuttle bus idling outside. At Andrews, no one demands proof that Danny Roberts is a soldier.

World Without Sleep


Walter Reed, named after the Army major who proved that yellow fever was transmitted by mosquitoes, launched into operational tempo the day the war in Iraq started. The pace didn't slow when the war ended.

Some soldiers have been patients of 57 for so long that they are treating the nurses' station like a concierge desk. They request Chinese take-out menus and the number for pizza delivery. "They think this is a hotel," one nurse says. "I keep tellin' them it's a hospital."

Which no one really can forget. A team of Army psychiatrists visits the soldiers daily. They ask: Are you sleeping? Are you eating? Are you dreaming?

Most of the soldiers swear the war left no psychological imprints, such as the lieutenant who is such a charming cut-up that he invites his doctors home to Houston for margaritas. "Every day above ground for that guy is a celebration," comments a hospital staff member.

Then why can't the soldier sleep at night? A psychiatrist teaches him hypnosis. Imagine you are on a beach, the doctor says. Breathe.

Sleep is just as elusive for the nurses in the crush of overtime hours. They talk about sleep constantly. "I close the Venetian blinds, put on the siesta mask and earplugs; then the silence drives me crazy," one nurse tells another during dinner break.

Taylor's pager goes off so frequently that his 4-year-old son knows what the sound means. "Are the soldiers hurt?" the boy asks. "Do they need you?"

"Yeah, buddy, they do," Taylor answers before returning to Walter Reed for another numbing stretch.

He considers the soldiers his brothers and sisters, "not just a payment on my boat."

That sense of brotherhood overrides all sense of exhaustion on Ward 57. Jim Mayer, a Vietnam veteran and double amputee, is known as Milkshake Man because he brings McDonald's milkshakes to the soldiers several times a week. Garth Stewart has become a buddy. He loves hearing about Vietnam.

But one night, when Mayer walks into Garth's room, it's empty and smells of cleaning solvents. Garth has been discharged.

Mayer feels his eyes welling up. Then he reminds himself: This is a good day.

Holding Tight


Gajewski unwraps the bandage from John's worrisome left stump. Kristi hovers protectively. The surgeon takes a cotton-tipped swab and pokes beneath the black sutures. A thin red line of blood wells to the surface. Gajewski smiles.

"That's what we wanna see. We want to see that skin edge healing. Dead, unhealthy tissue doesn't bleed. We just had a little skin-edge necrosis is all. I can't get the applicator in deep there, and that's a good sign."

"You already had us in tears last night!" Kristi blurts out, relieved.

"I was in tears!" the doctor counters.

The Fernandezes head for the hospital cafeteria. Standing in line for omelets, Kristi rubs the burred back of her husband's head, and he leans in to nuzzle her. She stoops to wheelchair-level, and they kiss. This isn't how they were supposed to start their life together. They had a five-year plan: She would finish school, get into public health administration. He would finish his Army tour in 2006, then put his degree in systems engineering to work in the civilian sector. They'd start a family.

War fast-forwarded their lives. John decided to apply for medical retirement; he'll look for work as an engineer. Kristi will have to plunge into the job market. Where they live will be a matter of accessibility; even the little choices, like who drives, are dictated by injury. They have to compromise their very closeness: John's relentless pain makes sharing a bed impossible for now.

Yet they insist that they're coping just fine. Kristi hasn't fallen apart, not once. "I'm still waiting for it." No looking back is their attitude. "If this had to happen to anyone," Kristi says, "I'm glad it's us." Because they can handle it, she is sure.

"All I see when I look at him is John."

For his part, John speaks of what happened to him with an engineer's cool regard. He is a mathematical problem -- man, minus legs -- with a mechanical solution. Even though the explosion that killed three men beside him remains under investigation as a possible friendly-fire accident, John is unwavering in his support of the war. "It could happen in any war," he says. "It's war. It's not a pretty thing."

The hospital staff marvels at the resilience of John and Kristi Fernandez, at the tight net beneath their trapeze act. But among themselves, the doctors and nurses who have treated traumatic injuries for decades question whether the young lovers can bear the stress over the long term. "Is their relationship going to survive this?" Taylor wonders aloud.

On the most important day of his new life so far, John nearly misses the appointment to get his first artificial limb when a fellow amputee -- a sixtyish stranger -- blocks his wheelchair in the hall and begins spouting advice. John and Kristi listen with polite impatience. The man is diabetic. Once he's out of earshot, they hurry to Miller's lab. "Nothing he said applied," John observes. "I know!" Kristi nearly shouts. "It wasn't vascular, it was a bomb!"

Joe Miller greets them with the foot he ordered for John from a catalogue.

"What exact type of foot is this?" John wants to know. "Is it flexible? How does it work? What about lateral distribution weight?"

"This is a dynamic response foot," Miller says. "A special keel gives you ankle motion without having a true joint."

John has brought a new sneaker for the new foot. Kristi pulls it out of her ever-expanding tote bag, which also contains sterile gauze, John's pills and lip gloss.

A thick silicone stocking slips over John's stump. A brass pin on the bottom will screw into the plastic socket Miller has crafted, which in turn fastens onto the artificial foot. "Does it hurt?" Kristi wonders.

"No, I'm all right," John assures her.

"I forgot what you look like with legs!" she says happily.

Miller leads the way to a practice walkway flanked by parallel railings. He warns John to take it easy, that he may feel dizzy.

For the first time since he was wounded, John Fernandez stands.

"I'm going to be a lot taller!" he discovers, laughing. The prosthesis has added two inches to his 5-foot-8 frame.

"Oh, I like it when you stand up," Kristi says flirtatiously.

The parallel bars shake from the force of John's grip, and Miller asks if he's okay, can he manage. And John answers the way he always does.

"Yeah, I'm all right."

Memories of War


When Garth Stewart was in Iraq, he would lie under camouflage netting and listen to the plastic leaves rattling in the wind. He'd close his eyes and imagine he was at home in the woods in Minnesota.

But back in Stillwater, all Garth can think about is Iraq. His mom works in the bakery at a grocery store, so he has the apartment to himself most of the day. Fitted with a new prosthesis, he practices walking with his cane. He plays video games and reads Marcus Aurelius.

His friends throw a party in his honor. Garth holds everyone spellbound with his stories from Iraq. He removes his prosthesis to let people see. A guy drinks beer from the hollow socket.

Garth keeps in touch with the Milkshake Man. Jim Mayer encourages Garth to visit Ward 57 someday to speak to new amputees. At first, Garth recoils. That hospital represents nothing but pain. But the idea starts to grow on him.

Stillwater is green and hot, cut in two by the majestic St. Croix River where Garth swam as a kid. One afternoon, a friend picks him up and she drives him to the river. Garth limps as he makes his way toward the water. "It's not much farther," his friend says, looking back to make sure Garth is okay.

The two of them lie on a rock in the sun, Garth's silver prosthetic ankle glinting in the sun. Canoeists paddle by and birds fly overhead. "I came back here and people think the Iraqis just surrendered," Garth says. "The TV didn't show anything. I saw bodies. Melted bodies. Skulls. Bodies with the skin falling off. We got to Karbala and we started fighting the Republican Guard. Those guys don't want to take no for an answer."

His feelings about the war remain mixed. But there is no doubt surrounding his desire to be a soldier again.

Finally he gets the news he's been waiting for. Garth is told to report back to Fort Benning, Ga., home of the 3rd Infantry Division.

A Future in Flux


Danny Roberts is home alone in his new ground-floor rental outside Green Bay when the three boxes arrive from Iraq, emissaries from a distant dreamscape. Danny tears into them, dirt and sand spilling everywhere. My stuff ! All his Army gear, plus his CD player, the last disc he listened to still inside.

In Wisconsin, Danny is unsettled, scattered. Waiting for a new foot, still unable to put weight on his other leg with its mangled heel, he can't reach the cupboards so his girlfriend has to put dishes out for him each day before going to work.

For now, he spends hours watching TV or reading or playing video games. Doctors told him it would improve his concentration.

Tests revealed mild brain trauma, after all. Which bums Danny out, despite assurances it will heal on its own within a few months. Sometimes he forgets where he put things, or who called or visited him that day.

He joins a chapter of Purple Heart veterans, and they push his wheelchair in the Memorial Day parade.

The Veterans Administration is trying to determine what kind of vocational training would suit him, but Danny is convinced they screwed up the test results. "You have no reading comprehension," he remembers the VA lady telling him. He is still incredulous. "All I know how to do is read!" Does this mean they won't pay for him to get the English degree he wants? He sweet-talks the VA lady into retesting him, and plans to re-enroll in college this fall. He's applying for a discharge from the Army.

Maybe he won't teach, after all. Maybe he'll buy land in the Colorado Rockies. He knows a tiny town called Alma where they're always desperate to fill the lone policeman's job. He imagines himself the peacekeeper in that cool, quiet place.

Jennifer Love Hewitt keeps calling. The actress kissed Danny's forehead when she visited Ward 57. Now she wants him to participate in an MTV documentary. Sure, he tells her.

Danny is still trying to sort out what he thinks about this war. "I want the world to be a better place," he muses. "We gotta focus on homelessness, on education. We spend more money on guns and tobacco than we do on education."

He records a new message on his answering machine. Danny's voice sounds rushed, like he's worried that time will run out. Well before the beep, he offers a hurried signoff.

"Peace" is what he says.

Reporting for Duty


Fort Benning is just like Garth remembered: scrubby little sand hills and Georgia pines, with hot asphalt roads slashing the landscape of flat buildings. One thing is different: No one is here. Garth passes his barracks. The parking lot is empty. All 4,500 soldiers in the 3rd Brigade are still deployed.

He knows it's up to the Army to decide his assignment, but Garth wants to convince the medical review board he can be a ground-pounder again.

A cab drops him off and he walks into battalion headquarters. Behind a desk, the weekend duty sergeant is playing video games. Garth introduces himself. "I was wounded in Iraq," he says. "I need a place to stay tonight."

The sergeant dials someone on the phone. "Hey, we got a WIA here," he says.

"Hey," Garth says, pleased at the heroic-sounding acronym. "I guess I am a Wounded In Action."

Three hours later, another sergeant arrives to welcome him back and announce that a room in the barracks awaits him. Instead of the fourth floor where he used to live, he's getting a spot on the first floor where the noncommissioned officers are housed.

Garth's jaw drops. "No stairs!" he says.

He arrives in his new barracks and sits down on the bed. After 16 hours of wearing his prosthesis, his leg is throbbing. He lays his cane aside and looks around. There are fresh sheets on his bunk and the room has been stocked with toilet paper, bottled water and a few candy bars.

"Outstanding," he says.

Graduation Day


John Fernandez returns to West Point at the invitation of Vice President Cheney. It is graduation day, and he is a guest of honor. Only 48 hours earlier, he was at Walter Reed getting his second foot attached.

For the first time since the war, John is back in uniform, crisp in his Army dress blues, spit-shined shoes on plastic feet. He gazes from his wheelchair at the perfect rows of proud cadets; only two years have gone by since he was one, too. John begins steeling himself, a soldier with a mission. As the opening bars of "The Star-Spangled Banner" fill the stadium, John rises from his wheelchair, up through the blinding pain. With Kristi holding him tight, he stands tall for just a few shaky minutes, and salutes his flag.

The first part of this series, a gallery of photographs from Walter Reed by staff photographer Michael Lutzky and a video report on Marines recovering from their injuries at the National Naval Medical Center in Bethesda can be found at www.washingtonpost.com/nation.

http://www.washingtonpost.com/wp-dyn...l?nav=hptop_tb
? 2003 The Washington Post Company


Sempers,

Roger


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