Battle Field Angels (35 page)

Eleven days later, a bright fall sun warmed the shoulders of mourners at St. Mary’s Cemetery in Missoula, Montana. Andrew Bedard’s flag draped casket had been carried to his grave, not far from his rifle, which had been planted bayonet down in the grass, his helmet balanced on the rifle butt with his combat boots nearby. A Celtic bagpipe group played “Amazing Grace,” followed by Taps.

Corpsman Leoncio and gunner Seeley underwent months of emergency and reconstructive surgery, complications, and agonizing physical rehabilitation. Both were flown to the National Naval Medical Center in Bethesda, Maryland, where they were joined by Matt Hendricks. Leoncio was transferred from Bethesda to the Brooke Army Medical Center in San Antonio, Texas, for intense postoperative care and physical therapy. He underwent an abdomen reconstruction. Shawn Seeley was transferred from Bethesda to St. Joseph Medical Center in Tacoma, Washington, following a series of surgeries, fears of a hole in his gall bladder, crippling pain, and casts for both legs and both arms. Only Lima Company executive officer Brad Watson had escaped hospitalization. Within an hour of reaching the military hospital in Ar Ramadi with Leoncio, he had written a medal nomination for the corpsman.

Neil Frustaglio endured a nightmare of his own. On December 7, 2005, two months after the IED that had shattered Seeley, Leoncio, and Hendricks, an IED destroyed Frustaglio’s Humvee. Corporal Joseph Bier was killed instantly. The three other Marines in the Humvee, including Frustaglio, each lost both legs. After emergency care in Germany, Frustaglio began rehabilitation, which led to a reunion with his wounded buddies.

On March 31, 2006, the Marines completed their six-month deployment and returned to the Marine Corps Air Ground Combat Center at Twentynine Palms, a live-fire training complex less than one hundred miles from Palm Springs. Leoncio, Seeley, and Frustaglio were there to greet them. The grins, hugs, and tears were a welcome relief.

A week after the reunion, Captain Rory Quinn paused as he looked down from the podium at corpsman Leoncio and his family. Some of Doc Leo’s relatives had flown from the Philippines for the April 6 ceremony at Naval Hospital Camp Pendleton, the Marines’ sprawling training base in California. On either side of Quinn, forty-five corpsmen in their dress whites stood in formation. Others in the nearby hospital leaned out of second-story windows.

Quinn’s throat thickened with emotion as he took nearly fifteen minutes to describe the initial moments after the blast. For many of Leoncio’s relatives, it was the first time they had heard the specifics of what happened.

“He won’t brag on himself, so I have to do it for him,” said Quinn:

Leoncio made his way to the podium to receive his Bronze Star and Purple Heart.

Tears welled up in Quinn’s eyes as he hugged his corpsman. Neither heard the applause.

“When you look at this brave warrior standing beside me, evil is in for a rough ride,” said Lieutenant General John Sattler as he pinned the awards on Leoncio.

On May 30, 2006, Lance Corporal Shawn Seeley walked across sodden grass at the Tahoma National Cemetery in Kent, Washington, to attend a Memorial Day Ceremony. Missing a thumb and with a face webbed with scars, the nineteen-year-old was eager to rejoin the Marines.

After the hole in his thigh had healed, Matt Hendricks became a teacher in Virginia. Lima Company’s executive officer, Brad Watson, escaped the blast with minor injuries and left the Marines, destined for Chicago. Meanwhile, Neil Frustaglio rebuilt an uncertain life in Wisconsin.

Within a year of his amputation, Leoncio joined the Paralympics training program. He ran-walked the Army Ten-Miler a year after losing his leg. In early 2007, he snowboarded on Mammoth Mountain in California’s Sierras on a specialized prosthetic leg outfitted with a mountain bike shock absorber. Six months later, he was surfing.

In some ways, Leoncio was typical of soldiers wounded in a war marked by increased survivability and disability. In Vietnam, one in four wounded soldiers died. In the first three years of the war in Iraq, one in ten wounded soldiers died. By the fourth year, the wounded-to-killed ratio improved to 16 to 1.

Many factors contributed to increased survivability. Corpsman and medic training became more sophisticated. All Army combat medics took the National Registry of Emergency Technicians course, which included life-support and prehospital trauma care training. They had to validate their critical-care skills every six months.

Well-equipped mobile military hospitals usually were situated less than one hour from the battlefield. Advances in medical transport by air enabled a soldier gravely injured in Iraq to receive state-of-the-art treatment en route and arrive in the United States within four days. In Vietnam it had taken the seriously wounded an average of forty-five days to reach a U.S. military hospital.

Improved body armor also contributed to survivability. Guerilla warfare in Iraq was one of detonation rather than gunfire. Nearly 70 percent of soldier injuries in the first three years of Operation Iraqi Freedom were the result of explosions, while only 16 percent were from gunshot wounds. Body armor protected soldiers’ chests and abdomens but left arms and legs exposed. As a result, the ratio of killed to wounded in Operation Iraqi Freedom was 1:7, compared to World War II when almost as many soldiers were killed as wounded (1:1.7).

Increased survivability has produced greater disability with postbattle medical care sometimes failing to keep pace. Only about half of the veterans who lost an arm or hand used prosthetics because they were heavy, difficult to manipulate, and broke easily. They differed little from the prosthetics that were available to World War II veterans. In 2005, the Department of Defense unveiled a $35 million research program to improve arm and hand prosthetics.

Improved body armor, more rapid treatment, and increased use of explosives by the enemy have resulted in traumatic brain injury becoming the most common injury on the battlefield. Various military reports estimate more than 130,000 American soldiers have returned home from Iraq and Afghanistan with traumatic brain injuries. Research has shown TBI is related to but not the same as post-traumatic stress disorder, resulting in an unprecedented generation of postbattle casualties that place a premium on mental health care.

The prevalence of disabled Iraq veterans has threatened to overwhelm the Veterans Administration. By 2007, the VA estimated that the Iraq war had produced 300,000 psychiatric injuries whose lifetime cost of care of $600 billion exceeded the cost of the Iraq war to that point. That same year, the Government Accountability Office reported that the VA was taking an average of 150 days to process a disability claim and that appeals were averaging 657 days. The claims backlog totaled 600,000, and the GAO predicted 638,000 new claims by 2012 at a cost of $70 billion to $150 billion.

On September 30, 2008, the VA received increased federal funding to hire two thousand additional claims processors and $1.6 billion to provide veterans with prosthetics that employed new biomedical technology.

Although advances in military medicine made war more survivable than at any time in history, they produced a generation of warriors whose wounds and disabilities have created new demands on military medicine off the battlefield.

Afghanistan and Iraq

O
n April 25, 2007, as the setting sun neared the horizon, the Army patrol entered a dry riverbed in the Paktika province of eastern Afghanistan. The soldiers had been in the field for several days, looking for weapons in the small villages that dotted the region’s rocky plain. It was similar to many missions that had lasted two or three days in the field. Soldiers returned to their outpost for a day or two to resupply and rest, then headed out again. The patrol also typified changes that were taking place in military medicine. The medic on the mission was a woman.

Monica Brown’s patrol convoy consisted of four Humvees and one Afghan National Army pickup truck. As the convoy entered the riverbed, the last vehicle in the column disappeared in a deafening explosion. It had triggered an IED that detonated directly underneath the soldiers inside. At almost the same instant, the enemy opened fire on the convoy. The ambush threatened to pin down the soldiers, with little hope of rescuing anyone who might have survived the explosion.

Brown jumped out of her Humvee as enemy rifle and machine-gun fire ricocheted off the vehicle. It was her first firefight. She and platoon sergeant Jose Santos sprinted more than one hundred yards back to the burning Humvee, out of which four wounded soldiers had managed to climb. Some were rolling in the dirt, smothering their burning uniforms. Sergeant Zachary Tellier had pulled a fifth soldier, specialist Larry Spray, clear of the wreckage. Spray and another soldier, Stanson Smith, were seriously burned.

Gunfire intensified as Brown and two soldiers with relatively minor injuries moved the critically wounded into a depression a few yards away. When the enemy began launching mortars at the exposed patrol, the medic shielded Spray with her body. The situation became even more dire when mortar rounds, grenades, and fifty-caliber ammunition began exploding inside the burning Humvee. Shrapnel as large as softballs ripped through the air near Brown and the men she was treating.

Brown stabilized Spray and Smith, but she didn’t have enough supplies to treat all their burns. Under enemy fire, other members of the patrol positioned another vehicle so the two men could be loaded into the back and evacuated to a safer location about five hundred yards away. Again Brown protected the wounded, positioning herself between them and the enemy. She monitored their condition and gave instructions so accompanying soldiers could assist her. Nearly two hours after the attack began, Spray and Smith were evacuated by helicopter. The enemy disengaged, and the battered patrol returned to its outpost.

Two years earlier, Brown had accompanied her brother to a Texas gulf coast Army recruiting office. Raised by a grandmother, she had attended nine different schools because her grandmother’s work forced the fractured family to move frequently. Brown didn’t meet her father, who was serving a prison sentence for drug use and distribution, until she was thirteen years old. Her mother was estranged from the family. At seventeen years of age, Brown enlisted in the Army. She thought about being an X-ray technician, but decided to serve as a combat medic instead.

Her four months of training as a medic were difficult: she nearly vomited the first time she watched a surgical procedure on a patient’s throat. But by 2007, she was assigned to the 782nd Brigade Support Battalion of the 82nd Airborne Division and was stationed at a large American military base in Khost, Afghanistan. A few months after she arrived, Brown was sent to a remote Army outpost in Paktika. It was a small collection of tents that included a forty-square-foot aid station.

Brown was one of thousands of women serving in Afghanistan and Iraq.

The military became an all-volunteer force in 1973 when the draft was abolished. That led to new opportunities for women in uniform. Although women have served as nurses and in other noncombat positions since the Civil War, their roles expanded following the Vietnam War. In 1994, women served aboard U.S. Navy battleships. Four years later, women flew combat missions over Iraq.

The war in Afghanistan began on October 7, 2001, when the United States launched Operation Enduring Freedom to support a new national government against the Taliban, which had ruled the country since 1996; capture the terrorist Osama bin Laden; and destroy his organization, Al-Qaeda, which was responsible for the September 11 attacks on the United States. Less than two years later, on March 20, 2003, the United States invaded Iraq. Operation Iraqi Freedom was intended to eliminate suspected weapons of mass destruction, overthrow Saddam Hussein, and establish a democratic government. By the end of 2008, women accounted for approximately 11 percent of the 1.6 million Americans who had been deployed to Afghanistan and Iraq.

Female corpsmen and medics not only treated wounded soldiers, they attended to civilians and refugees. They had some advantages over their male counterparts. Only female medics could provide care to women in homes and clinics in Afghanistan, where traditional culture prohibited treatment by a male medic or doctor without a male family member being present. In this deeply patriarchal society, female medics sometimes gathered tactical intelligence from women who otherwise would not speak to male soldiers or medical personnel.

They also operated with and treated Afghan National Army soldiers on joint missions. They slept on the ground, ate Afghan food, and gradually overcame initial Afghan male resistance to their presence on the battlefield. They faced the same risk of death, combat stress, and multiple tours of duty in war zones as their male counterparts.