As an occupational therapist, I certainly know about “the after.” But I did not have an in-depth perspective of “the before,” until the Joint Civilian Orientation Conference (JCOC) gave me the full picture.
Occupational therapists have historically worked on community reintegration of wounded warriors. To meet this societal need, our profession grew exponentially during World War I and World War II. I think of the conversion of the Ahwahnee Hotel in Yosemite during World War II into a naval hospital for returning soldiers who had what was then called “psychiatric issues” -- what today is known as post-traumatic stress disorder (PTSD). Surrounded by the majestic Sierra Nevada mountains, nestled in a green meadow among aspen and pine trees, and canopied by the brilliant blue sky illuminated with sunlight, occupational therapy – art, crafts, work programs, etc. -- was provided in most areas of the hotel.
Prior to my participation in JCOC, I had never conceptualized what our wounded warriors were like before they incurred their injuries. The military culture produces muscular men and women who are strong, courageous and disciplined. Imagine the mettle of someone who is willing to walk on an Afghanistan road looking for hidden landmines knowing there’s a possibility of being blown up at any minute. When they experience a blast, they survive because of their armor – but they can lose limbs, ears or other body parts, incur a traumatic brain injury (TBI), and/or endure a moment that will trigger life-long PTSD.
As we returned to Washington, D.C., on the last evening of our tour, another C-17 transport aircraft had landed at Andrews Air Force Base. We witnessed wounded warriors on stretchers being transported from plane to ambulance to be taken to Walter Reed National Military Medical Center. These soldiers were rescued from combat by medics, young non-commissioned troops who provide emergency medical care, and taken to a theater hospital near the combat zone for further procedures. Once able to endure air travel, they were transported on a C-17 to Germany for acute care. After this acute phase, they were transported to Walter Reed. The sight of them was sobering. The comment that sticks in my mind was voiced by one of the commanders at Walter Reed: “When someone arrives at Walter Reed, the guys say they have a “paper cut” if only one limb has been amputated.”
Walter Reed National Medical Center is a state-of-the-art facility that includes an impressive amputee department and the National Intrepid Center for Excellence, where soldiers with TBI are treated. I was fascinated by the National Intrepid Center, which seemed to me to be like a modern version of the Ahwahnee Hotel in its days as a naval hospital. First, the facility is so quiet you can hear a pin drop. Second, its programs provide a sense of healing through physical, behavioral, social and spiritual care. Third, its design allows for connectivity with trees, the sky and natural light. In the art therapy room, I will never forget the masks painted by soldiers – a design with a split face depicting conflicted feelings, another with a vise squeezing a skull with the words TBI and PTSD written across the forehead, and a third with blood stains on stars and stripes.
The highlight for me was when occupational therapist W.M. Carey of the Warrior Transition Brigade introduced us to the animal therapy program. In this program, a wounded warrior has the opportunity to train an energetic puppy to become a service dog. Through meaningful, productive work (and bonding) with a dog, a severely wounded warrior can experience reduced anxiety and stress, decreased use of pain medication, reduced isolation and a sense of accomplishment. To be honest, it is hard to convey just how great this program is. I saw soldiers who had lost several limbs display pride in their achievements. I saw spirited puppies exuding love to them as only a devoted canine can do. And once again, I witnessed the power of occupation.
What worries me at this point is what happens when these wounded warriors leave Walter Reed and join civilian society? Is America ready to embrace them? And what can each of us do through our occupational therapy professional skills to enable them to live life to its fullest? This is the very minimum they deserve for having put their lives on the line for all of us.
Photos by Glen Fawcett, official Department of Defense photographer
I've been following your reports regarding wounded warriors and challenges in transitioning back to civilian life,and have found them quite illuminating. There are so many challenges these soldiers face -- coping with the wounds of war,getting back to normal society, employment instead of deployment. Thank you so much for your articles; they've helped to make me more aware of of just how important a role we all need to play in helping these men and women to heal.