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Traumatic brain injury.
The way I could describe it is just, you're afraid.
You're afraid, am I going to start forgetting things?
Do I want to talk?
When I came here,
I couldn't move.
You know, I had the ex-fixator around my right leg.
I had a splint and a cast on my left leg,
And I had a cast on my right arm.
And plus, anytime I had to raise out of the bed,
I had this shell
That was strapped to my chest
To keep my spine from moving and getting damaged.
The night of the 12th of November, I saw these guys
Digging in the road, putting an IED in.
We had to wait.
The situation had us wait until the next morning.
I was driving the M-RAT
My teammate was gunning.
And I had another Army soldier in the back.
Had a civilian contractor in the passenger's side.
And I had my interpreter in the back as well.
When we got there,
It was gone.
I mean, within hours, they moved it on us.
We saddled back up on the road,
See if we can clear it,
See if we can find it again.
Within about 5, 10 minutes
Of starting our crawl there,
We hit the IED.
It blew me through the steel-locked door.
It blew my gunner out the top like a cork.
And the other individuals inside
Did not survive.
Pull.
Pull it.
Oh.
Wow.
You know, as a Marine,
We know what we're going to be taking care of.
[Background Conversation]
Being in this hospital,
You see a lot of people worse off than what you are,
And so I'm like, okay,
I'm all right.
Pull, pull, pull.
Traumatic brain injury, my injury,
Is scary.
These feelings.
Nightmares, terrors,
Not being able to sleep.
And when you talk there's, like, this yawning sound
In the back of your head when you're talking,
When you have serious conversations.
I don't want to be injured.
Nobody wants to have something that's going
To stick with them for the rest of their life.
And, you know, you fear and you fight through it
And you try to make it work the best you can.
We'll work on that.
We'll get there.
This VA hospital is top-notch.
They have doctors here that are on the dime.
They'll talk to you, specialize in getting your
Problems solved, and take the time.
And they're there.
They're there every second of every minute
That you need them, and they're very,
They're very persistent about it.
They're making sure that you're okay.
They take care of what's wrong with you.
I found that most of my words and most of my feelings,
And most of my emotions are fought with through therapy.
And there's this therapist, Joe,
And he's relentless.
Ready?
A little bit more?
Okay.
Good.
Ugh.
Just don't break it.
Okay.
Haven't broken anything all day, Ben.
I know.
Try to relax.
But my biggest thing that I contribute to him
Is, I couldn't lift my legs.
I'm lying in bed, and I had no power in my legs.
And slowly, after weeks and weeks of him
Just lifting my leg up and me holding it ...
And he's like,
"You're doing good, you're doing good."
And then I'm like, this guy's crazy,
Because I can't feel nothing.
And I just remember this one day,
When he's holding my leg up,
And I'm about to tell him "Not today,"
And by the time I get out "Not today,"
He's holding my foot up, and he's exercising with me,
And I'm holding it up for, like, five seconds,
You know?
And I'm like, "Hey, Dad!"
Dad's sitting there.
I'm like, "Look at this!
Look!"
And I'm holding my leg up for 10 seconds.
You know, and you're like, why not?
Let's keep going.
He's been my confidante, when I've had my hardest days,
My hardest times.
You know, you need that person to talk to.
I mean, it's been him.
A lot of people in my job wonder
How their family's going to take things.
You're a father,
You're a husband.
That's tough.
This wasn't my first combat deployment,
And every time before you leave, you tell your wife
In a sense, you tell her goodbye,
But you tell her what you want to happen
If something goes wrong.
And so, when she showed up here at the hospitals
And was traveling with me, she had everything taken care of
To where she was in charge.
And she was the deciding factor
On a lot of things for me in recovery.
My wife didn't leave my side.
She was there.
I mean, if I had an itch to scratch,
Or I had to shave,
Or had to move,
Or anything.
And the nurses, they just, you know,
They made a spot for her,
And they made sure that
She knew how to dress my wounds,
She knew how to give me medicine.
She knew how to care for me.
You know, my family and my sisters,
They would all come down and visit and be part of it.
Family's important.
Family's what's going to heal you.
Family's what's going to take care of you.
Is Dad around?
Watch this, Mom.
Watch.
Watch me fall on my tail end.
[Nurse] No, you won't.
Watch this, babe.
[Wife] Oh my God!
[Laughs].
[Wife] Oh my God.
I know.
[Wife] Good job, baby!
You're a patient here for so long
And you go back to your family.
And you have to make your injuries in your life.
You have to continue with your life to make it work.
When someone's laying in bed with their hospital gown on,
And we see them come in here for their first time,
They've been reduced.
Their roles have been taken away from them.
They can't hold their children.
They don't necessarily
Have the same relationship with their spouse.
Their parents have a tendency at times, wonderfully,
To step in
In support,
And then they've got a tremendous medical team
Around them.
But their roles have kind of melted away,
And they've become this kind of one singular being,
Which is not who they are.
So, what we try to do is hopefully
Listen
To what they have to say,
Listen to the problems
That they're having in their own voice,
And listen before you speak.
And address the problems that they have,
So you can gain their trust
And their faith
And to really kind of get to the heart of things.
And then we begin to slowly rebuild their roles.
The VA is always transforming.
It's a generational-based health care system.
It's a World War II cohort that comes through,
And a Korean War cohort,
And then a Vietnam cohort,
And now the OEF/OIF cohort that comes through.
So, the VA, about every 15 years,
Has to re-gear itself for a new patient population,
With their own specific needs,
And to help support them as they move through.
As a result of the Iraq and Afghan wars,
And the just volume of injuries
That have occurred from that ...
And again, predominantly,
It's been in the area of traumatic brain injury,
Although there have been a number of burns,
Amputations,
Spinal cord injuries,
A whole lot of musculoskeletal pain issues.
With a specific focus as brain injury as the lead,
Because that's the one that's the most challenging,
The VA has really taken the lead on developing
What we call the polytrauma system of care,
Which is a closely integrated care system
Across the United States, based on the concept
That we're going to concentrate specialized services
For folks that have had the severest of injuries.
And, then we're going to disseminate additional resources
In other geographic locations
In the U.S., to care for those that have had less
Severe injuries, but still require a lot of services.
And those are centers that provide any kind
Of inpatient or outpatient, or even home care
That is needed for veterans.
Everybody in our program has a brain injury.
We definitely have individuals who are combat injured,
And then those that were injured stateside.
And that could be from a variety of reasons.
Motor vehicle accidents
Are one of the most common.
In Afghanistan and Iraq, we have people
With very severe typically head injuries, or polytrauma,
Multiple kind of damage, very severe damage,
Who are admitted as inpatients,
Typically in our polytrauma units.
Good job.
And, pain is almost universally part of their problem.
The other group are those people
Who are not wounded as severely, or may actually lack evidence
Of a tissue wound,
But come back from deployment
With evidence of a mild TBI,
And may have a number of other complaints,
Most typically headaches.
I've never seen a treatment
Or a prosthetic device denied,
If the member would benefit medically from it.
And I think he's young.
He had a kind of injury
That you continue to recover from over long periods of time.
And, you know, I would never say
That there's a definite cutoff.
[Spanish translator]
[Major Kevin Farrell] You have, family members
Who are in denial, they're really having a tough time
Accepting the new reality
Of the condition of theirLoved one in most cases.
Most of our guys are young,
And they're often accompanied by their mothers,
Or the fathers.
And I can't tell you how many times ...
You know, I can see the sigh of relief
When they get off the plane at the airport,
And you see the look of relief on the family member's face
When they see that uniformed Marine officer
Standing there to greet them.
We meet them at the airplane.
We put them on the ambulance.
Oftentimes, we'll bring the family members
In our government vehicle back here to the hospital.
And we're with them from the time they land
Until the service member's in the hospital,
In their bed, in their room.
It's a roller coaster ride.
Families are one of our key elements
In our rehabilitation comprehensive program,
Because it's kind of like,
Family is the base of the emotional, social, psych
Aspect of our therapeutic approach.
So, we want to integrate the families
In any way possible,
And families are usually
Part of everything that we do here.
[Background Conversation]
When somebody is injured significantly,
it's not only they that are injured.
Their loved ones and caregivers and whole
Family supports are injured as well.
We're blessed that, when people come down
To our facility, that we're able to not just accommodate
Family members, caregivers and loved ones,
But we're really able to integrate them into what we do.
They can stay on campus here with us.
They're encouraged to participate in the therapies.
They're really encouraged to be part of the team.
My life has not gradually changed.
It has changed instantaneously,
And permanently.
David was a crew chief and maintainer
At Spangdahlem Air Force Base in Spangdahlem, Germany.
David was in a car accident in which there
Was a light rain on the road,
And it had bubbled up some oil from the surface,
And he lost control,
And an oncoming car broadsided the car.
My husband came to me and said
That he had received a phone call from Dave's commander
That he had a head injury and that we were leaving for Germany
Very quickly.
We'd be in ICU talking to the doctors,
Going through the translator.
Because it was all German.
And, asking about the other injuries.
Because we could see he was in pain from those,
And they said, "Don't even worry about those.
Everything that we're doing really is to deal
With the brain right now, and to save the brain,
And try and protect him from any further damage."
They weren't very hopeful at the time
That he would survive at all, and then secondarily,
That he would ever come off life support.
They really didn't think that that was going to happen.
And I just wanted to bundle him up in my arms
And hold him, and I didn't know how to do that,
And where to touch him or anything like that.
It was very hard.
After four and a half months in the hospital
In Germany, we went on a video conference with the VA,
And Dr. McNamee was involved in that,
And a number of the staff
That's at Polytrauma right now.
And, it was kind of nice for me to be able to see
This is the first time I saw faces of the people
That he was going to be treated by,
Before we got there.
They were the first team that kind of said to me,
It's up to Dave and his response to the therapies
That we provide for him.
We don't know what he's going to do
Or not going to do.
Let's just do what we do and see what happens.
And it was very, very good for me,
In particular, having been there for five months now,
Bedside, to have a team that I knew wasn't setting any limits.
Our decision to move here
Had to do with David's care.
We wanted to continue it in a staff with a VA
That was, you know, fully equipped for his severity
of brain injury.
David will be coming home permanently.
But, he comes home on the weekends.
He stays for the day, and then we take him back
In the evening.
We love David, and of course we know
We're dealing with a situation here, and as his parents,
We're going to do the right thing for David
And all that.
But, the thing I think, honey,
That you and I.. are always trying to figure out
And balance out and stuff like that.
This isn't all about David.
No.
We are the parents of six children.
Erica and David are adults,
and our school-age children, whom we've adopted,
Are Andrew, Erin, Zoe and Victoria.
They can be involved in helping to care for David,
Or to play games with David, or whatever
We're going to be doing.
And really encourage their desires to love
Their brother in a practical way,
And not stop them, because I think that they might drop
A little food in his lap.
And they've been growing as people, also.
One of the concepts that we try to get people to understand
Is that things are going to be
Normal again someday.
But it's going to be a new normal.
Slowly.
Little drinks.
Whatever has happened to them, and the current
Struggles that they're having,
Are not going to define their lives.
They're going to be people again.
They're going to walk, they're going to talk.
They're going to move.
There's going to be joy.
There's going to be pain in their lives.
But, if we can kind of help reawaken
The person inside of them,
I think we've done a tremendous job.
One time, Dr. McNamee said to me, we needed to
Get David's story out there, because I believe
That there is a lot of David's out there,
That are not getting the treatment that they can have
To help them emerge and come fully conscious,
And have productive lives even if they aren't
The same lives that they had before.
And I've always said to them, you know,
I can see that
What we're doing here at the Polytrauma unit
Is to move from survivability to thrive-ability.
And that's exactly what they're doing.
And I love it.
David was asking me, you know, where am I?
Where am I in my life now, is basically what he was asking.
And the recreation therapist says,
"What did he do?"
You know, and I say, "Well, he was a rock climber."
"Well, then let's see if we can get that done."
My reaction was, they're going to do what?
They were going to let David go rock climbing.
I'm thinking, like, this isn't safe.
He might get hurt.
But part of the healing was, let the kid go on a rope
And hang from it.
That's what he loves to do.
When he was emerging and he was asking
What happened,
I said, you are still an active duty airman,
And you are still serving your country,
Through your cooperation
And your hard work through therapy.
Because the men and women who are coming off the desert
With TBIs will benefit from what they
Learn from you.
And he gave me a thumbs up.
[Applause; Cheering]
He could have given up.
He could have just stopped.
He could have gotten angry.
And he didn't.
And, the day that I went to the gym and saw him do that,
And he's grinning, you know, from ear to ear,
And just having a blast at it.
You know,
This is good.
This is not a shot, and medicine and drugs and stuff.
This is therapy through the mind, straight to the heart,
And the will of the body and everything.
And that's what we do in rehabilitation,
Is give people lots of motivation.
We're really good cheerleaders.
But we also give them the tools, the skill sets,
The knowledge, the equipment, the resources, the access,
Whatever they need, to open those doors
And to get through them.
Hey, Jen
Jen.
Talk with me here, okay?
What are we doing, blinks, these days?
Blinks.
Hard blink for yes.
No blink for no.
Yeah.
A pretty firm blink.
Give me a yes.
So, as individuals get admitted to our polytrauma unit
Is your pain here?
We develop the treatment relationship
And the treatment plan.
We always try to communicate with people
Early on that
This is individualized,
That the recovery plan and the rehabilitation,
And the medical issues and the things that we're going
To address are really individualized
To every specific person.
I always like to say, this isn't conveyer belt therapy.
To be able to use that relationship
And set that relationship, of one of trust,
And to really
Help gently lead people through these issues.
You always hear about how modern health care
Is so rushed and is such a challenge.
Well, in rehabilitation medicine,
Your job is to actually get to know this person,
And as many aspects of them as you can,
As well as their family,
And their support teams, and their employer,
And their co-workers and all that,
And to really understand what makes this person tick,
So that you can put them back together.
Because it isn't just a single pill,
Or an exercise, or an injection, or an X-ray,
That's getting these people back together.
It never works like that.
What you need is someone who can really facilitate
All these things coming together, and to do that,
You've got to get to know the person.
And that's what I just totally love.
This is going to feel funny, okay?
It's going to feel like your brain is buzzing.
That's too bad.
Nothing dangerous.
The guys with their craniotomies,
With a piece of skull missing from their brain,
They get very nervous about going to a barber.
Barber's get nervous because the skull isn't there.
So, it gives you an opportunity to actually
Sit and talk to them.
[Background Conversation]
And when you talk, you don't always talk about medicine.
And you don't always talk about their issues
Or their symptoms.
You talk to them as people.
Where do you want the fade to start?
Fade usually is like two fingers above the ear.
So, the approach that we take is
Relationship-based medicine.
It's not, medical care team
That is outside of patients' lives and only see them
Briefly during periods of the day.
But it's about getting to know them,
Knowing what their strengths are,
Knowing what their current struggles are,
Knowing what their goals in life are
And what motivates them.
I don't really believe in miracles.
I think they kind of happen one day at a time.
But I could see why people
Would call some of these things miracles.
Just from the Point A to Point B
Has been unbelievable.
The steps in between are the ones people don't see,
But I can understand why they'd say that,
Because it truly is miraculous to see the recovery
That some of these folks have been making.
Every time I see someone
Who has got a significant disability,
You know, to me, just seeing the little things
That you and I often take for granted,
You know, is, to me, the biggest thing
That our patients have to do all the time.
It's food for the soul, to see these guys
Recover and accept the reality
That is their new life and not give up, you know?
They never say die.
There's not enough words that can describe
How great it feels just to be Dad again.
Not the Marine, not the husband.
Just to be Dad.
And that's all they know, and that's all they see.
So, it's fabulous to be back home.
♪
I couldn't wait to take them fishing,
Go swimming, seeing how well they can swim.
When I was a child, I had memories with my father.
Coming up to the lake,
And doing all the little things he taught me.
You know, fishing and swimming and walking
And trees,
And the animals, and just all the little things
That you see and notice around and learn about.
And so, with them here, you know,
I wanted to make our own memories,
So that they can go, Yeah. Hey, I remember that.
Or, you remember when ... ?
I love hearing stories about that.
You know, my dad's got several acres of land.
And, what he did was, you know,
We cut out about an acre.
It's nothing but woods.
And, picked up a couple books from the hardware store,
And literally cut out our driveway to our house.
And now, you know,
We're going to be putting a house up,
And what we pictured it to be is what it's turning out to be.
It's going to be my first house.
I mean, that's ... anybody that ever had a house,
They can understand what it's like to have
Their own house that they call their own,
And to be next door to my dad?
That's the greatest thing in the world,
To be his neighbor.
I love it.
I can't wait.
I think everybody at the VA had a place,
And everybody at the VA had a job.
And for some reason, maybe it was fate,
They are all in the right place at the right time.
They all knew their job,
And they all knew what they had to do.
And they always seemed to do a little bit more
Than what they had to.
They were the ones who kept me going,
Especially when I begged them to quit
And they wouldn't let me.
For some reason, a piece inside of me said,
You know, when you go home, it's back to normal.
So when I make plans to do something around here,
I have to think about everything
I'm going to do,
Every step I've got to take.
That was unexpected.
I didn't think it was going to be like that.
The VA's been wonderful.
They're such a big part of me
That I will never forget.
They'll always be in my heart, with me.
And everything they've taught me how to do
To fend for myself
And recover,
I have to use that.
I use it every day.
Dr. Mac promised I'd walk out.
Holy cow!
I know, huh?
I thought that man was crazy.
And I later found out that he told the nurses,
I want that man to walk out of here when he's done.
And he took a picture,
Me leaving that door,
Pushing a button to get out, walking on my own.
Next year, I'll be running.
Physically running.
And I believe it.
Because I did what he said.
I walked out.
♪