Monday, April 02, 2007

By Edward Lee Pitts
Washington Bureau

WASHINGTON -- At 27, Sue Downes, of Tazewell, Tenn., is a mother of two, a combat veteran and a double amputee.

Having lost both her legs in the aftermath of a roadside bomb along a snowy mountain pass in Afghanistan last year, Army Spc. Downes now lives at the Walter Reed Army Medical Center in the outskirts of the nation's capital. She has endured 10 surgeries and can count 20 scars on her body. Her full-time job is learning to walk with prosthetic legs during therapy four hours a day at the hospital's amputee clinic.

Spc. Downes moves now with crutches, as long as someone is there to assist her. She recently walked for the first time outside and hopes one day to go on the hospital-sponsored skiing or kayaking trips. But most of all, she wants to be there again for her two children.

"I haven't been a mommy in almost three years. That is my motivation," she said of her children, Austin, 6, and Alexis, 8. "I want to be able to get up and be normal as much as I can and do things with them like walking with them and riding bikes."

More than 25,000 U.S. soldiers have been wounded in combat in Afghanistan or Iraq since the military began operations in 2001 and 2003, respectively. More than 11,000 of those did not return to duty, according to Defense Department records.

The survival rate for the wars has risen to 90 percent of those injured, compared to the 75 percent injury survival rate of the Vietnam War, according to a panel of military surgeons at a recent conference of orthopedic surgeons.

"People in previous wars who would have died are now getting home to their families," said Dr. Christian T. Hanley, an Air Force major stationed at Andrews Air Force base in Maryland just outside Washington, D.C. "They are not coming home in body bags. They are coming home to be taken care of."

Better body armor and mobile teams of critical care doctors and nurses who respond quickly on the battlefield have led to more combat survivors, Dr. Hanley said.

Injured troops often are at a field hospital within an hour of their injury, he said. Many find themselves back in the United States 65 to 72 hours after being hurt.

The troops first come to Andrews where three flights arrive each week carrying an average of 20 to 40 patients. The most critically injured are transferred to Walter Reed or the National Naval Medical Center in Bethesda, Md.

Using U.S. Department of Veterans Affairs numbers, Harvard University public policy professor Linda Bilmes studied survival rates in U.S. wars. In her report, she wrote that as of Sept. 30, 2006, more than 50,500 U.S. soldiers had suffered nonmortal wounds in Iraq, Afghanistan and nearby staging locations -- a ratio of 16 wounded for every fatality.

In its daily casualty reports, however, the Pentagon defines the injured as only those hurt by bullets, shrapnel and other direct combat-related wounds, she wrote. Using this more narrow definition, the Iraq conflict still has a ratio of eight wounded per fatality -- still much higher than any previous war in U.S. history, Ms. Bilmes wrote.

Success in saving the lives of injured troops has resulted in an increase in traumatic brain injuries and post traumatic stress disorder, according to Mike Krause, the Tennessee coordinator for the Iraq and Afghanistan Veterans of America, which has more than 100,00 members, including 482 from the Volunteer State.

Mr. Krause, deployed once to Afghanistan and twice to Iraq with the 101st Airborne Division, said some injured soldiers are coming home with memory loss, personality changes and a loss of some motor functions that may not be noticeable until months after leaving the military.

Mission cut short
Spc. Downes' experience on the front lines of the U.S. military came to an abrupt end on Nov. 28, nine months after she was deployed to Afghanistan with a military police company. With fresh snow on the ground and mountain roads so narrow the military humvees hugged the edges, Spc. Downes' convoy headed for a humanitarian relief mission to a remote village.

A blast from two pressure-plated anti-tank mines buried under the road, with mortar and rocket propelled grenade rounds wired to them for added power, threw Spc. Downes from the humvee where she was the turret gunner. The explosion killed two other U.S. soldiers.

"They were aiming to do some damage," Spc. Downes said.

The attack occurred just three days after she returned to Afghanistan from leave. Since medical helicopters could not reach her because of the snow and mountainous terrain, Spc. Downes suffered a six-hour convoy along bomb-riddled roads before reaching a U.S. base. Along the way, as Spc. Downes lay on the humvee's back seats, the convoy stopped at Greek and French military hospitals where doctors removed her lower legs.

It was the sixth and last combat experience Spc. Downes would face. On Dec. 3, six days after the attack, Spc. Downes found herself back in America, this time in a hospital.

The list of wounds is long for the slight-framed, soft-spoken Spc. Downes. She endured a fractured femur, two shattered kneecaps, a cut in one eye from shrapnel, a lacerated liver and large intestine, nerve damage and a collapsed lung. Doctors told her they were amazed she survived.

"They were just taking beans and rice to a village," said Gabe Downes, her husband. "She's alive. That's all that matters. She's alive."

Spc. Downes wears a bracelet that holds pictures of the two men who died in the attack. She says she will be forever bonded to them.

She joined a military police unit after turning down an offer to become a cook because she said that would have been too boring.

With two children under 10 and a husband injured in tank training exercises during his military stint, Spc. Downes could have received a deferment from her unit's deployment. But she said she trained too hard not to go and did not want to let fellow soldiers down.

"I wanted to go. I wanted the experience," she said. "I knew it is a war zone, but it was more traveling, you get to see the world."

Spc. Downs said that, despite her injuries, she has no regrets about joining the military 2 1/2 years ago.

"I'd go back now if they'd let me do my old job," she said recently. "I'm going to miss it so much when I go back home."

complex injuries
Spc. Downes is an example of a polytrauma patient, the term used by VA officials to classify injuries typically found in blast victims, such as amputations, severe burns, hearing and vision problems and psychological trauma. The VA operates four major polytrauma centers -- in Minneapolis; Tampa, Fla.; Richmond, Va.; and Palo Alto, Calif. -- and 17 regionally based polytrauma facilities.

"One of the harshest realities of the wars in Iraq and Afghanistan is the number of service members who have sustained complex and multiple injuries in combat," said Sen. Daniel K. Akaka, D-Hawaii, the chairman of the Senate Veterans Affairs Committee. "These men and women are coming home with extraordinarily complex health care needs. We do not know the full magnitude of this need, as many returning service members have yet to seek care from VA."

Mr. Krause said the high rate of wounded troops, many of them in their late teens to mid-20s, should force Veterans Affairs to readjust its treatment regimens.

"You can't treat an Iraq vet the same way you treat a Vietnam vet," he said. "The Iraq vets have their whole lives ahead of them. They need to be able to function normally for the next 60 or 70 years."

Spc. Downes said now her home is at Walter Reed because no hospital close to her rural Tennessee town can offer the same treatment. Speaking in calm, carefully collected words, she referred to her "new life," one that her son says has given her "robot legs."

"Losing my legs, I've never really let it bother me," she said, adding that life is not done with her yet. A religious person, she says God has a plan for her future.

"I just have to find out what that is," she said. "I'm not going to go home and sit there the rest of my life. You can be surprised at what you can do when you are faced with something like this. I'm not going home before I can walk and run."

Staff Writer Mary Fortune contributed to this story.

Read the original article on the the Chattanooga Times Free Press website.