FACT

A REPORTER AT LARGE

THE CASUALTY

by DAN BAUM

       An American soldier comes home from Iraq.
 

A bomb injures in many ways. The shock wave can loosen organs and leave a victim to bleed to death internally, or rake him with shrapnel. Long after the initial wounds are treated, the effects of the bomb continue to plague the victim. In Cain's case, the blast pulverized dirt, truck metal, engine fluids, and his own clothing, and drove microscopic debris deep into his muscles, macerating the tissue. Each tiny fleck had to be dug out, the pulped flesh cut away, and the wounds cleaned and re-cleaned--a process that took twelve surgeries, over three months. (Had there been any people between him and the mine, their flesh might have been atomized and driven into his, which can cause particularly dangerous infections.)

Starting the day after he regained consciousness, Cain was in the care of Lieutenant Justin LaFerrier, an Army physical therapist whose bulging muscles, under a tight white coat, make him a walking advertisement for the active life. LaFerrier is in charge of many of the Iraq-war amputees at Walter Reed. While Cain was still undergoing surgeries to clean his wounds, LaFerrier had him wheeled most days to the physical-therapy room on the third floor. It's the size of a gymnasium, filled with bars, racks, and machines that look like torture instruments from the Middle Ages. An amputee, particularly one who has lost a leg, has to reëstablish his body's balance, and LaFerrier put Cain through hours of exercises to build up the muscles he'd need to operate crutches and a prosthesis. "Your core is your stable basis of support," LaFerrier, a Rhode Island native, explained to me. "When you take a step, you don't think about it. When an amputee does that, he has to first stabilize the residual limb in the socket. You have to train those muscles to do that." We watched a sweaty, gasping soldier who had lost both legs and one arm inch along the parallel bars in shiny, high-tech prosthetics. "I like to push them to the limit," LaFerrier said. "They're young. They're strong. I want to cause muscle soreness, but not the 'Ooh, I shouldn't have done that' pain. I take them as far as they can tolerate." The amputees call LaFerrier their "physical terrorist."

Although Charlene took all her sick days and vacation days and her co-workers donated a hundred hours of theirs, she and Kenneth eventually had to return to Wisconsin. After they left, Cain's warrior spirit drained away. One day, he refused to go to physical therapy, and when he was wheeled there against his will he was sullen and uncooperative. Frequent phone calls from his men in Tikrit--another amenity unknown to casualties of earlier wars--would cheer him up for a few minutes, but then he'd start to miss them, and sink lower in spirits. Captain Blain sent his father and wife, both of whom live in the Washington area, to visit. Celebrities passed through, too--Cain met the actor Gary Sinise, who played a Vietnam War amputee in "Forrest Gump," and the country singer Shania Twain. One day, President Bush sat on the edge of his bed and asked him if he wanted anything. Cain told the President that his men needed water. When Cain spoke to them by phone two days later, they told him that they suddenly had more water than they could possibly use.

Still, Cain couldn't shake the feeling that he'd be stuck in a chair and useless the rest of his life. He was withdrawn, and continued to refuse physical therapy. The hospital finally asked Charlene to come back, figuring she could make him work for LaFerrier the way she'd once made him practice the sousaphone. She somehow found a way to take time off. Mothers are often asked to assist in the recovery process at Walter Reed, LaFerrier told me.
 

I met Cain in December at Mologne House, a hotel on the Walter Reed campus for visiting families and for soldiers undergoing outpatient treatment, including physical therapy. The Federal style of the two-story lobby, with a gigantic chandelier and a grand staircase, belies the building's age; Mologne House opened in 1997. It is adamantly a hotel, not a medical facility. Its rooms are indistinguishable from, say, rooms at a Hilton, except that the bathroom cabinets frequently resemble pharmacy shelves, with doxycycline, Ambien, and Percocet nestling among Old Spice and Mega-Men dietary supplements. The Mologne House staff are upbeat and pleasant amid a high percentage of guests who are adjusting to blindness, facial scars, and missing limbs. They differ from the staff of an ordinary hotel only in their mandatory daily inspections of every room, a practice instituted in July as a suicide-prevention measure.

Cain was sitting on the edge of his unmade bed wearing shorts and a Packers jersey and cap, his naked stump jutting out. Saddam Hussein had been captured the night before and President Bush happened to be speaking on television, but Cain was absorbed by a hockey simulation on his PlayStation 2. He looked terrible--sallow and sunken-eyed, with a two-day stubble. He'd dyed his hair a garish chrome yellow. He kept shifting uncomfortably on his hollowed buttock. Every surface in the room was covered with CDs, model airplanes, hockey magazines, Packers memorabilia, boxes of Frosted Mini-Wheats, and bags of Funyuns. Dirty laundry and candy wrappers were strewn on the floor. Cain's prosthesis, a white-and-magenta running shoe with a complicated steel-and-plastic ankle joint, rose like a tower from the rubble, a pattern of American flags decorating the calf-size plastic socket that fits his stump. He told me that he had no regrets, and that he would do it again if he could. Would he let his son join the Army? "Fuck no," he said. "I'd tell him, 'I'll beat the shit out of you if you try it.'"

Cain's girlfriend, Leslie Lantz, a muscular, dark-eyed beauty, who had arrived from Texas the week before, was flipping through "Portraits of War," a book of Iraq-war drawings published by Detroit Free Press. Charlene was making a halfhearted attempt to straighten the room. She had been there for three weeks, sleeping in the bed next to the one Cain shared with Leslie. "I knew Mom would come," Cain said sheepishly. "I quit doing everything, so they had to call her." I asked how it felt to have his mom in the bed next to his and Leslie's. He didn't answer directly. "It's nice having Mom here," he said. "But she cries a lot." He swivelled his gaze back to his hockey game.

"I'm on antidepressants," Charlene said. "After this happened with Michael, I couldn't deal."

At Walter Reed, an informal network of gruff Vietnam and Gulf War veterans minister to the blind and the bandaged with great tenderness. Jim Mayer, for example, fought with the "5th Infantry Division in Vietnam. Today, at fifty-eight, he runs an executive-training program in the Department of Veterans Affairs, but to the soldiers lying in Ward 57 he's the Milkshake Man. He arrives three days a week after work with a box of McDonald's milkshakes, which he offers from bed to bed. I had been at the hospital three days before I realized that his legs are carbon, graphite, and plastic below the knee; he had stepped on a mine near the Cambodian border. One afternoon, he cried "Watch this!" and went skipping down the hall. The amputees couldn't take their eyes off him.

"We want to make sure no veteran is ever again treated the way we were when we came home," Mayer told me. The vets help organize trips to the Smithsonian and the White House and arrange free tickets for the young men to see the Wizards play basketball and the Capitals play hockey. Wounded soldiers who can make the trip are also invited every Friday night to Fran O'Brien's, a fancy steak house in downtown Washington, where they can load up on thirty-dollar steaks and all the beer they can drink, free of charge. Hal Koster, one of the restaurant's two owners, served three tours as a gunship crew chief in Vietnam. "It's an honor," he told me one Friday before Christmas as he watched more than two dozen young men consume a few thousand dollars' worth of beef, crab cakes, and tiramisu. "Nobody did this for us."

The amputees I met were all eager to talk about their wounds, and welcomed the chance to tell the story. War stories, like Holocaust stories, are all both alike and different, and all improbable; each turns on moments of horror, serendipity, and unimaginable bravery. Sitting next to me at Fran O'Brien's was Steve Reighard, of Bloomington, Indiana, who was hacking one-handed with a combination knife-fork at a steak the size of a dictionary. "They ambushed us," he said. "I'm standing there trying to realize what happened and my arm is laying there. I picked it up and fell in the dirt." Across the table, Robert Acosta, of Santa Ana, California, manipulated a steak knife with his stainless-steel hook. "They threw a hand grenade in my truck," he said. "I picked it up and, damn, dropped it down between my legs. When I grabbed it again, it blew up in my hand." At Walter Reed, Phil Bauer, a strapping cavalry scout from upstate New York, had described being on a Chinook helicopter that was shot down on November 2nd, killing fifteen soldiers on their way to a short leave. When he came to, he said, he was pinned atop the open-eyed corpse of a woman soldier to whom he'd just given a piece of gum. His leg was jammed beneath the burning roof of the Chinook, and he had to lie there, without morphine, for two hours while a "jaws of life" apparatus was flown in from Tikrit. "It was like cooking a steak with the cover down," he said. He lost his right leg below the knee. At the dinner, a soldier named Ed Platt, from Harrisburg, Pennsylvania, told me that the signature moment of his calamity was when the medics used the ribbons of his leg--shattered by a rocket-propelled grenade--as its own tourniquet. "They just folded it up," he said. "I looked down and I'm looking at the sole of my boot." He shuddered. "O.K., cool, whatever, dude," he muttered to himself as he finished his story. Doctors amputated just below Platt's right hip.

Platt sat across from Michael Cain, who was playing keep-away with another soldier's cap. "He's a 'baloney,'" Platt said of Cain. The word was a play on "below knee" but perfectly evoked the unnatural pink cylinder that Cain's lower leg had become. Though the Purple Heart club is a band of brothers, there is a hierarchy of wounds. A whole leg trumps a half. A right hand trumps a left. And everybody was down on one soldier who was physically unmarked but said he had been mentally wounded by the war.

It was possible to forget how young some of the soldiers were as they told their stories of wounds and weapons, of campaigns and tactics, and of the time one of them, under orders to do nothing, watched a crowd of Iraqi men drop a woman who was said to be an adulteress from a high bridge ("We were, like, 'Fuck!'"). But then they started talking about their favorite movies. All of them liked "Elf," while their hands-down favorite was "Finding Nemo."

The conversation turned, as it often does among Iraq-war amputees, to the mysterious workings of the Med Board. Officially called the Physical Evaluation Board, it determines whether a wounded soldier may continue in his or her Army job, is fit for some other Army job, or should be medically retired. It also quantifies a soldier's disability, which determines what percentage of a soldier's base pay will be awarded in benefits. Soldiers talk about the Med Board the way people in the Old Testament talk about God--as an inscrutable, mercurial, sometimes vengeful force. None of them understand how the board works, and all fear they will get "Burger-Kinged out," meaning medically retired with a meagre benefit. A missing arm has to be worth thirty per cent, right? they asked each other. And a missing leg forty?

Whatever their retirement prospects, all the amputees said they had no regrets. Robert Acosta spoke of the need to fight terrorism and the choice a soldier makes to face death. "Shit happens," he said. Steve Reighard said, "I believed in what we were doing." If we hadn't gone to war, he said, "eventually we'd see chemical arms and those kind of munitions on our streets." The other soldiers nodded. At one point, Reighard leaned over and said quietly, "You know, we kind of have to think that." He gestured at his missing arm. "Otherwise, this is in vain."

Michael Cain was pale and his voice raspy as he hobbled toward the door on his cane and prosthesis, which, being new, was painful to wear. But he kept up the hard, edgy banter that amputees use among themselves. "Hey, Acosta, give me a hand!" he yelled to the one who'd fumbled the grenade. "Platt, shake a leg." I walked two blocks for my car and pulled into the restaurant's semicircular driveway. Cain got in front and, with the door still open, pulled off his prosthesis for relief. A line of well-dressed diners, standing on the curb waiting for valets to bring their cars, stared at him, aghast. When Cain noticed, he waved his prosthesis and yelled in a falsetto singsong, "Look! My leg comes off! Look!" The onlookers turned away. Cain was still laughing cruelly as we drove off.
 

Shortly after the holidays, I flew to Milwaukee and drove two hours northwest to Berlin. (The name is pronounced with the accent on the first syllable.) Downtown Berlin has a lot of quaint brick buildings, but, with the Wal-Mart on its outskirts and the chains in nearby Oshkosh, there are not many people on the streets.

Michael was home, though not yet out of the Army; he was waiting for the Med Board to rule on his case. Following a final medical evaluation, it generally takes two to four months to get a decision. I found him in his parents' living room, watching the pro-wrestling show "Monday Night Raw" at top volume on a television screen the size of a bedsheet. Michael reached up to shake my hand without taking his eyes from the screen. His prosthesis sat amid a pile of wrestling magazines and empty bottles of Mountain Dew Code Red, and he rubbed his elevated stump as though it ached. Leslie was still around; she sat across the room, flipping through a magazine. One of Michael's younger sisters, Stephanie, sat at a computer in the corner of the living room, searching online for nursing-aide jobs, and his father was in the kitchen, cooking himself a late supper of fried ham and eggs on toast spread with peanut butter. He is a fatalist, and, when asked how he felt about Michael's decision to enlist or what he thinks of the Army's policies on disability payments, he falls back constantly on the phrase "There's nothing you can do." Besides taking care of his llamas, he often feeds his neighbors' animals as well. He is the family cook, and always has dinner on the table when Charlene gets home from work.

Charlene, who arises around four-thirty in the morning to go to her job, is the family rock. She absorbs blow after blow without appearing to crack. Michael's injury is her project. She's in charge. On the phone to a friend, she uses phrases like "I brought him home on December 16th," "I want to catch that before it becomes a full-blown infection," and "I need to get him to Milwaukee because he has a torn medial meniscus and PCL." At the kitchen table, she is often immersed in the maze of forms required for every treatment, trying to insure that care will be adequate and costs will be covered--complexities that sometimes take her hours a day to manage.

Until last year, Charlene and Kenneth had raised their granddaughter Felicia, who is now six, because Michael's older sister, Yolanda, was unable to care for her. When Charlene was at Walter Reed with Michael, she got a call that Yolanda, who was seven months pregnant with her second child, was going into labor, and that the baby had hydroencephaly. The baby was born on September 29th, and has brain damage of indeterminate severity. "His brain is not developed totally," Charlene said. "We won't know for a while how damaged he is. So I'm dealing with all this stuff. Then I get a call to go back to Michael's room, because he needs me. Then my phone rings, and it's my youngest saying, 'Yolanda's back in the hospital with a kidney infection.'"

When I asked Charlene how she felt about the war, she said, "I don't like the fact that these young kids are joining up. I realize somebody has to do it. I still have my doubts about Saddam. I can't say I supported the war. Thinking about it now, maybe, I'm just kind of neutral about it. I'm angry Michael got hurt. I don't know who at. I'm just angry."

At Walter Reed, Michael's spirits had been buoyed by routine, Army discipline, and the loving ministrations of the Vietnam vets, as well as of his mother. In Berlin, he was no longer Sergeant Cain, or a war hero in the nation's entertainment- and star-filled capital, but a one-legged guy in a Barcalounger with little to fill his days beyond PlayStation 2 and thrice-weekly physical-therapy appointments. Gone was the gung-ho warrior counting on a twenty-year career. Michael was even thinner and paler than he'd been a month earlier, and he was so withdrawn he spoke only in monosyllables. Charlene said that he hadn't been sleeping well. Michael wasn't working, though he told me he was thinking of taking an assistant manager's job at the local McDonald's. In the fall, he said, he was going to the University of Wisconsin at Madison "to study computers, computer programming, something like that." I asked if he'd applied and he said no. "But they've got to take me."

After the wrestling match, Leslie drove us to a dingy roadhouse called the Country Inn; the two of them hardly spoke, and seemed more like an old married couple than like sweethearts. Michael spent most of the evening at a video slot machine, his thin frame lost in a voluminous green-and-gold Packers coat, downing one Coors Light after another, dribbling away his money. Our destination the next day was the Fox River Mall, an hour away, in Appleton. Michael is still drawing nineteen hundred dollars a month in base pay; he spent a hundred and fifty on a pile of Green Bay Packers memorabilia--jersey, helmet, stickers, and flags for the car--to add to his already extensive collection. Leslie did the driving again, and again they hardly spoke. Every few minutes, he'd raise her fingertips to his lips and kiss them, and she'd smile.

On January 21st, Michael returned to Berlin High School to speak to an assembly. He limped to the podium wearing a Washington Capitals jersey, which the star right wing Jaromir Jagr had given him in the team's locker room during Michael's celebrity-wounded phase. After admitting he'd come unprepared, Michael bashfully delivered some uplifting bumper-sticker slogans about keeping a positive outlook on life (a phrase he used three times). He made no appeal to patriotism, though he told the students he had no regrets.

During questions, someone asked if they could see Michael's "new leg." He rolled up his pant leg to show the prosthesis; the auditorium fell silent. Then he pulled it off, and a few kids squealed "Eeew!" The room exploded in applause. When he was asked about compensation, Michael seemed to get carried away by the attention he was receiving, saying that he would get "thousands of dollars" and "a hundred-per-cent disability," that the Army had promised him a hundred thousand dollars for college. "And if I have children their college will be paid for," he said. "Their birthing process will be paid for. . . . I pretty much have everything paid for."

The truth is that Michael will need several more surgeries; the ankle of the left leg is fractured and may need to be reset; he suffers from hammertoe, a downward contraction of the toes; and many nerves are damaged. The Army and the Veterans Administration will pay for the surgical procedures, but disability compensation is still a mystery to him and to most other soldiers. It is based on a complex formula that includes an estimate of lost-earnings potential. Now that most jobs don't involve much physical movement, the amputees are afraid they'll receive little.
 

At the end of February, Michael was back at Walter Reed because his prosthesis was still painful. He has "heterotopic ossification," or calcium deposits that caused the bone to protrude. He was being fitted for a new liner and socket. I found him and Leslie, now his fiancée, in their room at Mologne House, and though I expected him to be depressed by being in the hospital, his spirits seemed enormously lifted. He looked more filled out, with better color in his face, and he was back to making endless jokes. We took a taxi to a nearby Mexican restaurant. Michael went outside for a cigarette, and stood at the window pantomiming being a homeless old drunk. Leslie put her face in her hands. Then he came inside, draped a paper napkin over his arm, and, in a Pepé Le Pew accent, pretended to be a fancy waiter until Leslie pulled him into his seat.

Because he seemed so much happier being back in the military milieu, I asked him why he didn't consider trying to stay in the Army and get a job suitable for a one-legged soldier. A career working with computers, after all, doesn't require two whole legs. He waved away the suggestion, saying only, "Nah. I don't want it." A little later, he said that sitting at a computer all day "isn't really being a soldier." I asked if he had applied to Madison yet. "No, we're putting that on hold because we have the baby coming," he said. Leslie grew very still, staring at her plate. Michael put his arm around her proudly, and she glanced up quickly through her falling brown hair. The baby is due in August.

continued from part one