By Justin Constantine | The Atlantic | TheAtlantic.com | September 6, 2011
I cry whenever I think of a memorial service I attended in Iraq. From the back of the hot, packed room next to the chaplain's office, I looked down the center aisle and saw six sets of boots, rifles, helmets, and dog tags. Six Americans had lost their lives defending their country. I had seen these Marines hug each other before heading out on patrol -- real hugs, as if they guessed they might not see each other again. They had been in Iraq for a while and knew how dangerous every mission was.
Blood and treasure are the costs of war. However, many news articles today only address the treasure -- the ballooning defense budget and high-priced weapons systems. The blood is simply an afterthought. Forgotten is the price paid by our wounded warriors. Forgotten are the families torn apart by lengthy and multiple deployments. Forgotten are the relatives of those who make the ultimate sacrifice in defense of our country. As we look back on 9/11, we should also remember all those who deployed to Iraq and Afghanistan. Fewer than 1 percent of Americans have fought in these wars, and it is important for the public to understand their effects on our fighters and those close to them.
The attacks of September 11, 2001, ushered in a new era of reservist involvement, and like many others, I volunteered to deploy to Iraq. As a Civil Affairs Team Leader, I was entrusted to help local Iraqi communities develop critical infrastructure projects. Our focus on foot patrols, combined with the intense heat and carrying 65 pounds of weapons and gear, made for long days. The enemy threat was omnipresent, and this was a chance to truly lead from the front. Being a part of this unit was the highlight of my military career, and in my short time there I learned a lot about leadership and troop welfare.
October 18, 2006, started out like any day over there, at least as much as I can remember of it. We had a newspaper reporter with us, and he rode next to me in the up-armored humvee. We stopped to inspect an Iraqi police station that had been shot up the night before, and then to check on a squad of Marines who guarded a notoriously dangerous area.
As we exited the vehicle at our next stop, I told the reporter about an enemy sniper in the area who had already killed several Marines, and warned him to move quickly. Based on this advice, he took a big step forward, and a bullet smashed into the wall next to us right where his head had been. The next bullet hit me behind my left ear and exited out my mouth, causing catastrophic damage along the way. Somehow, from hundreds of yards away, the sniper had managed to shoot me in the thin sliver of exposed skin between my helmet and neck guard. Miraculously the bullet did not hit my brain or my spinal cord. It did, however, tear apart my mouth and face. Although I initially did not lose consciousness, I do not remember anything from the sniper attack, nor anything else from the next two weeks.
The Marines closest to me thought that I had been killed instantly, but that did not deter Corpsman George Grant. With complete disregard for his own life, Corpsman Grant ran over to me, even though the sniper was still trying to pick off other targets. George saved my life that day. He performed rescue breathing and an emergency tracheotomy on me, even under these chaotic conditions. Ultimately, he was able to stabilize me long enough to get me to the closest medical facility. The Battalion Commander also stared down death to help provide emergency medical care to me.
Fortunately for me, these two warriors weren't the only ones willing to sacrifice their lives for mine. Lance Corporal (LCpl) Buhler, a young Marine whom I barely knew, then drove me to safety at 70 miles per hour, although we normally drove at a quarter of that speed due to the inordinate number of improvised explosive devices (IEDs) in the roads. Had we run over an IED driving that fast, our vehicle surely would have flipped over and killed both of us.
From Iraq, I flew to Landstuhl, Germany and then on to what is now the Walter Reed Bethesda Naval Hospital. By an odd quirk of fate, I would later run into LCpl Buhler at that hospital - he and his best friend in Iraq had approached a black BMW due to an intelligence tip, but the insurgents exploded it when they were just a few feet away. LCpl Buhler was lucky enough to only suffer from shrapnel wounds to his abdomen, but his best friend, as he said, was "vaporized" right in front of him. Although LCpl Buhler recovered from his stomach wounds relatively quickly, I am certain he will struggle with the mental image of his dying friend for the rest of his life.
The next four to six weeks were difficult for me, and at several different times the doctors were not sure if I would survive. At one point, my fever spiked to 105° and I had not slept in a week. I suffered from anxiety, fear, and depression, and had a severe allergic reaction to the medicine administered to me. As a result, extremely graphic and violent hallucinations filled my mind, to the point where although just lying in my bed, I was sweating profusely from the horrific images in my mind. In fact, my heart was beating so quickly that the doctors told my family that if they could not slow it down, I would have a heart attack and die.
After I woke from my medically induced coma, I could not talk for several weeks, but the doctors did not know if that was due to incredible swelling in my head and neck, or if Corpsman Grant had accidentally cut my vocal cord while performing the emergency tracheotomy. Initially, the only way I could communicate was to spell out words, one letter at a time, on the palm of my girlfriend's hand. Dahlia's patience was immeasurable, because it would take several minutes just to communicate one sentence. Although this was a step in the right direction, it was incredibly time-intensive and made it impossible to have a conversation. And it was only with Dahlia that I was able to communicate this way, probably because I felt so comfortable with her. That made visits with my family embarrassing and frustrating for me. Just like our wounded warriors who wake up in a hospital missing an arm or a leg, I did not fully understand what had happened but knew that something was severely wrong.
I can still remember being in the ICU, waking up and stating my last name (although almost unintelligible due to the damage to my mouth, teeth, and tongue), and seeing Dahlia's teary reaction as she realized I was "talking" again. As it turns out, even with the sniper still shooting at us, Corpsman Grant had performed such a perfect tracheotomy that my plastic surgeon later thought that another surgeon had done it.
I knew on one level that Dahlia loved me and just wanted to help, but always in the back of my mind I was inwardly embarrassed about needing so much care. And I struggled mightily with the knowledge that I was back in the States and my Marines were still in Iraq. Like every other wounded warrior in the hospital, I just wanted to hurry up and get back to my unit. It took a long time to move past that, as well as the extreme shame I felt following my injury.
I left the hospital six weeks after arriving there, but not before a number of complicated surgeries to rebuild my mouth, extract bone from my legs to reconstruct my jaws and to lay the foundation for many more surgeries over the next five years. Dahlia dropped everything in her life to take care of me. Although we are married now, Dahlia and I were not yet engaged when I deployed to Iraq, and she left for England to pursue her PhD at Cambridge University. She put her program on hold to be with me, which was one of many sacrifices she has had to make as my caregiver.
I am positive that every other wounded warrior's caregiver has had to make personal sacrifices to take care of those who need them most. The situation of an Army Specialist (E-4), who lost a leg in Afghanistan, serves as a good example. His recovery at Walter Reed was expected to take 18 months, so his young wife moved from Idaho with their baby. That meant forfeiting her job, her health care, and any in-person contact with family. The wife and baby lived in a small room with the bare necessities for six months until the Specialist was no longer an in-patient. The three of them moved to a (somewhat) bigger facility for 18 months while he was an out-patient. After feeling out of control and disrespected by the staff many times over, she could not take her family home soon enough. As another caregiver put it to me, she was her husband's chauffeur, cook, case manager, therapist, personal shopper, nurse, legal aide, job coach -- and on really good days, his wife.
As an outpatient, I was attached to a feeding tube for several months, and required 24/7 nursing. I spent eight months on convalescent leave, following a general cycle of surgery, pain medication and recovery period, over and over. Because virtually all of my teeth had been knocked out of my mouth, I had to carry a towel with me to wipe away the constant flow of saliva out of my mouth (I still drool when I turn my head to the side or bend over). And due to my difficulties with eating, we did not go out to eat for approximately one year; even to this day it is always an embarrassing experience to eat in public. Although I now have lower dentures, I am still waiting on the upper set, and also am missing the end of my tongue, which makes tidy eating impossible. As an adult, a military officer and a professional in the civilian world, the drooling which I simply cannot control is nothing short of humiliating, and I know it makes others feel awkward.
Like many returning from Iraq and Afghanistan, I continue to have issues with post traumatic stress disorder (PTSD). These episodes can range from nightmares to mental reenactments of my injury to inexplicable waves of emotion. Although PTSD is perfectly normal after going to war, in this country and within the Department of Defense there still exists a certain stigma associated with it. I truly believe that a sign of real strength is not to "tough it out" and pretend that the condition does not exist, but to be up front about it and get the help I need.
That being said, attending PTSD counseling can be easier said than done, as the Vet Center's 8 to 4:30 hours conflict with many veterans' work schedules. I recently contacted the Veterans Administration about this conflict, and was simply told that I should seek counseling from a nonprofit organization. That response was as insensitive and insulting as it was disheartening. And what about all of the service members struggling with PTSD who work two jobs to make ends meet, or who are single parents without flexible schedules? This is, unfortunately, a tragic circumstance faced by far too many of our young veterans.
Although I can play golf and exercise and have successfully adapted to my "new normal," the personal costs are significant and long-lasting. It has been five years since I was shot, and I cannot see out of my left eye, cannot always speak clearly, have difficulty running due to the missing bones in my legs, and periodically struggle with behavioral health issues, including not only PTSD but mild traumatic brain injury (TBI).
But I am only one wounded warrior, and there are almost 44,000 just like me from the wars in Iraq and Afghanistan alone. That means 44,000 families uprooted with lives turned upside down and 44,000 warriors who will spend years reintegrating into society and adapting to their new normal. These are the obviously wounded -- they are missing limbs, are blind, have newly deformed heads, or are now committed to a life in a wheelchair. Hundreds of thousands of other service members suffer from invisible wounds as they continue to fight the enemies that rage inside their minds. Not all of us will survive, succumbing either to the injuries themselves or to suicide, a desperate and horrible outcome that has continued to plague our community.
However, my distress cannot compare to the grief experienced by more than 6,000 families who have had to bury a loved one killed in Iraq or Afghanistan over the past 10 years. These are mothers, fathers, sons, daughters, husbands, and wives who will suffer every day due to their indescribable loss. I will not pretend to understand the depths of that sorrow, and I hope all Americans appreciate these terrible sacrifices that have been made.
As September 11, 2011, approaches, take a few minutes to think of wounded warriors and our families. We are in your community, sprinkled throughout small towns and big cities. Do not let our sacrifices go unknown or forgotten. Think about helping that soldier's caregiver with everyday chores, because he or she now has two full-time jobs instead of one. And don't forget that Marine who has to put on a prosthetic leg first thing every morning. Remind yourself that far too many service members have not made it back from Iraq and Afghanistan.
As painful as it is for me, I periodically remind myself of the Marines who did not make it back. I remember meeting some of them and reflecting on their Spartan lifestyles at their forward operating base. Every day brought a very real danger of stepping on or driving over an IED, engaging in deadly firefights with a determined enemy, or not making it into a bunker before incoming rockets and mortars exploded. I also remember their excitement when I gave them a bunch of ketchup and mustard packets I had grabbed for them at our chow hall. Their food -- heavily processed, dry, and tasteless -- left a lot to be desired.
Our unit had lost a lot of Marines, and I asked the Battalion Commander how he dealt with the memorial services for guys barely out of high school. He sighed, looked down, and softly said that it never gets any easier. To this day, it doesn't get any easier for me to think about it, but at the same time I don't want to forget about those young Marines and their memorial service. I gave them ketchup and mustard, and they gave me everything.
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