Treating Wounded Soldiers: Beyond PTSD

Image Gallery Navy Senior Chief Jim Pitts, a non-clinical case manager for wounded warriors, talks with Veterans Affairs social work supervisor Scott Skiles and Army Sgt. 1st Class Lee Smith, a wounded warrior military liaison. image by DoD / Fred W. Baker III

View photos from the Polytrauma Rehabilitation Center at utne.com/Polytrauma. 

Corporal Jason Poole was 17 when he joined the U.S. Marine Corps in 2000. On his third tour of duty in Iraq in 2004, Poole was in a group patrolling near the Syrian border when an improvised explosive device detonated, killing two Marines and an interpreter, and ripping off the top left part of Poole’s head.

He had surgery to repair and seal his skull and remained in a coma for almost two months. When he finally awoke to see the excited face of his twin sister, he was frightened and disoriented—although he laughs at the memory of reaching immediately for his head. “I thought I’d have some big Afro after two months,” Poole says, “but my head was shaved.”

Five years after that horrific blast, he sits in a visitors’ lounge at the Veterans Affairs Palo Alto Health Care System. He is blind in his left eye, deaf in his left ear. His right side is weak and his right arm heavily scarred. His hands and arms still contain scores of faint, freckle-sized black specks of shrapnel. But many subsequent surgeries have given Poole back a friendly and good-looking face whose scars do not overshadow his easy, bright smile. That in itself is something of a miracle. Not to mention the fact that he has relearned how to speak, how to eat, how to read, how to walk.

There is no official definition for polytrauma in most dictionaries, although it’s easy enough to figure out. Trauma is bodily shock or emotional injury. Poly is from the ancient Greek for many.

But at the VA Palo Alto’s Ward 7D, the Polytrauma Rehabilitation Center (PRC), the idea of “many” shocks and injuries barely does justice to reality. Palo Alto is one of four PRCs—along with those in Minneapolis, in Tampa, Florida, and in Richmond, Virginia—chartered in 2005 to address what the U.S. military acknowledges is a signature injury of its operations in Afghanistan and Iraq: traumatic brain injury (TBI) in combination with other combat wounds. Service members patrolling debris-strewn streets and crowded areas are vulnerable to booby-trapped roadside bombs that not only hurl shrapnel into and through body tissue at tremendous force and create burns, but also produce a shock wave that can severely damage the brain without any visible sign of injury.