Stryker Brigade News

We missed the OT/PT folks this morning as we all had a difficult time getting out of here (the Mologne House) when we wanted to. Scott was awake and looking much better than yesterday. The IV is gone, but not for lack of trying to re-establish it during the night. After several tries, it was decided to stop and try him on oral medications. He's taking Ciprofloxacin to finish off the bladder infection, time-release morphine and oxycodone for "breakthrough" pain. I'd say the new regimen has worked well today.

I had a discussion with Scott's doctor after I heard words like "permanent" and "board" and "benefits" during a discussion of how Scott was doing. He said he was working on Scott's profile and I asked to discuss this with him.

For those of you not familiar with what a profile is, it is a system used to evaluate a soldier's ability and limitations with a numberic value (1 to 4)for each of six areas. The best number is a 1 and the higher the number, the greater the limitation the soldier has. All 1's is called "the picket fence." The areas covered are physical capacity or stamina, upper extremities, lower extremities, hearing and ears, eyes and psychiatric and the letters P, U, L, H, E, S are used to represent these systems. I myself had temporary and permanent "profiles" during my time in the Army. A temporary profile usually reads something like "no prolonged running, jumping, crawling or breathing" and is designed to protect the soldier while an injury heals. A permanent profile indicates the soldier is unable to perform a task or should not perform a task. Often, a soldier will "break profile" and do something they should not do. I did this once when I participated in a retirement parade for an officer I respected very much. The difficulty arose when a senior NCO ordered me to break it again later on to get even for my being selected as acting First Sergeant over him (because he was a jerk and the vacationing First Sergeant didn't trust him not to screw up the company in his absence). You can't pick and chose when you will obey a profile. You need to do it all the time. Think of it as being sort of like a restraining order. The person who is protected needs to follow it as well as the person being restrained.

Now that you know what a profile is, we'll resume our story. The original idea was to give Scott a permanent profile with some bad numbers (3's and 4's) in some of those slots. While I have no objection to those numbers, per se, and I'm of the opinion they are accurate now, I do have a very strenuous objection to those limitations being considered permanent. I'm not Pollyanna, nor do I believe that this is the best of all possible worlds. I am hopeful, optimistic and even a bit confident, that with sufficient motivation and rehabilitation, Scott can continue to improve. We do not know when this will end, but it will not end before we begin. I also told the doctor (who shall remain anonymous for now) that the main motivation for Scott's recovery is the fact that he is still a soldier. More than that, he is a non-commissioned officer who has led men in combat and strongly desires to return to duty. Removing this from him now would seriously jeopardize his recovery. I told the doctor that Scott responds best when addressed by his first name--Sergeant. He sits straighter, talks better and works harder for persons who refer to him as Sergeant Thorne. If you treat him like he's five, he will take this as an insult or a demonstration of disrespect. Just for good measure, I quoted Army Regulation 40-501 which lists the Army's medical fitness standards and procedures for medical boards which requires a "reasonable period of rehabilitation" before a medical board could be held for persons with brain injuries. The doctor agreed to make the profile temporary and to check on the need for a medical board before being sent to the VA facility in Minneapolis. He came back a few minutes later with clarification that Scott would be assigned to a medical holding company at Walter Reed (which may be bad news for the First Minnesota Volunteer Infantry), would not be "boarded" as a condition of attending the VA brain rehabilitation program (think of it as contracting out that service to avoid duplication of effort) and would have his temporary profile re-evaluated every three months.

And thus, another "Gort event" was averted. (I've worn out the gorilla joke. Also, my brother-in-law asked me if Scott was in the same room as Klaatu from the movie The Day the Earth Stood Still, which he knows to be one of my favorites. Sorry, but he's not in Room 309, Rob. Gort was the robot who melted things that bothered him with a beam that came out of a visor in his helmet. I always thought he'd make a good Court bailiff. Every time a judge would say an attorney was pushing the limits, that visor would come up and the attorney would sit her butt back down and shut up.)

A visitor came by today. Colonel Reyes, Director of Defense Information Systems, with a care package and a nice card from his staff. Unfortunately, Scott was the only one present for the visit (the colonel came early and I was arranging for a barber to come up while Julie worked on her travel orders. Tiff and Aly were at an appointment.) so I couldn't talk to the colonel about how I abused his systems.

Another by-product of the doctor talk was the afternoon arrival of an Air Force Captain from the Traumatic Brain Injury team to begin his assessment. He had gotten the word about addressing Scott as Sergeant, so we were off on the right foot. Scott also shook his hand with his right (the morning brief was therefore effective--"yesterday you spoke to them all, today you will shake their hands, tomorrow you will continue to improve.") We gave the captain a briefing about where we've been and what's happened so far and then he began his work. While he was working, the speech pathologist and her graduate assistant came in. They turned around to leave, but we chased them down and got them back so they could hear Scott speaking to the Captain. The expressive and receptive problems Scott is still experiencing will make a neuropsychological evaluation difficult, but not impossible. Scott was not able to perform at his old level, of course, but he was speaking about as well as we've heard. The Captain did say something that got all our attention about his expressive aphasia: "That goes away." Cool.

The speech therapists consulted with the TBI rep about their own testing results from last week and then began their session. Their questions asked things like "Does a dog quack?" and "Can you point to the ceiling?" Scott's response to the latter question was "yes," but when told to point to the ceiling he did so with his right arm (he's showing off, but it's okay with everyone). The abstract is harder for him, in effect, while he following orders and directions immediately. Which is to be expected, of course, but the ability to understand the finer thoughts of life is going to make that profile thingy go away. He also refers to his right foot as "him" and uses "him" to describe other body parts (not that part!) whose names escape him. He knows the names of the objects, but just can't say the proper names, something the TBI rep understood as well. Scott can write the numbers for the months and when shown November, pointed out his birthday as "mine." He knows the day he enlisted and his date of rank (very hooah, that is). If we knew the date for getting the skull opening replaced, he'd yell that hourly.

Still can't get him to sing. He won't even try. Not even the scatological stuff he used to love. Oh well. I'll try again tomorrow.

Once the speech work was over, we had to roll Scott down the hall to optometry. We got him in a new t-shirt, courtesy of the American Red Cross, that was white with blue trim on the neck and sleeves. He put on his knitted cap (It holds in body heat and not everyone is ready for seeing him) and I rolled him down there with his mother. After some confusion about why he was there (a little communication goes a long way, guys), I brought him into an exam room. He was given a blinder (not sure of the exact name, sorry) and told to cover his left eye and read the smallest line he could on a hand-held chart. I waited a few seconds and then told the tester he couldn't speak very well right now. Hmm. Can't just read A-Z-E-F-P-G, huh? She left and returned with a second chart and asked him to point to the letters on the bigger chart that he saw on the small one (some colonel's idea, she said). I suggested having him write the letters for her on a piece of paper. She got a clipboard and Scott correctly wrote the letters he saw with his left hand while she held the chart with one hand and the blinder with the other. I held the clipboard. 20/20 vision at short range.

I asked Scott if he felt good enough to go see PFC Majors (the other soldier from the patrol still at Walter Reed) and he indicated he wanted to go. We got him down to the 4th floor, but had to wait while they finished x-raying Majors. We used the delay to "gown up" and wash up with the alcohol hand cleaner. We rolled Scott next to Majors and they tried to speak to each other while I explained to the two nurses the significance of the meeting. Scott told him he was getting better. Well, it was pretty hard on both of them to see the other (as much as they both wanted to). One of the RN's had to leave, that's how upset he was at the scene. Scott pulled off his knitted cap to show Majors his skull and that upset Majors and put the RN over his limit. He went next door and Julie went to talk to him. He told her he was in Iraq for three months and just couldn't get used to seeing these injuries. Julie told him that if it wasn't for people like him doing this work, Scott and Majors wouldn't have made it back alive. I knew it was time to end the visit and wheeled Scott out into the hallway where he began to cry very hard. I hugged him as best I could from behind and we got him back to his room. He complained about being cold on the way, which is no surprise since he's got no fat on him at all. He shivered a bit once he got back into bed, but the blanket/quilt combination did the trick. He announced he didn't want to talk about it and we certainly didn't press the subject.

Whoever paraphrased Sherman was right. War is Hell.

Julie spoke with Majors' mother this evening and with her permission, this is his condition as reported by her:

He's paralyzed from the neck down. He has some movement in his right arm and some movement coming back in his chest. The spinal cord was severely damaged. He can feel her touching his left leg (it hurts to do so). The doctor is not looking for the legs to come back, but won't say it's impossible. A bullet also went through the top of this foot and "pulled all the muscles and tendons through the bottom." He's going to the VA hospital in Augusta, GA when he leaves here. He also has pneumonia (which I suspected when I heard they were x-raying him).
Personal observation: He looks fine, but if he's got pneumonia, that's not good.

Alyson got her shots this morning and she did great until about 4 p.m. when it was clear she was unhappy. Mom and baby then left for the evening. Scott gobbled up his dinner which consisted of turkey, some stuffing, mystery veggies (where do they grow this stuff?) and some type of pie slice. As usual, the fruit disappeared first. Julie went downstairs to the dining facility to get turkey burgers to go while I waited for Jubal Early to show with the hair clippers. The ghost didn't appear and Scott eventually crashed after getting a dose of oxycodone for pain. He didn't believe he could have any pain meds and so I got the nurse. She came in with it and said he could have it every four hours if he needed it. Scott gave us a "well, what do you know?" _expression and took the pill.

I'm all packed, but not ready to go. We had a meeting, just the three of us in the hotel room, on what to look for in the way of tricky paperwork, profiles, etc. to ensure Scott doesn't get screwed or "helped" when he doesn't need it. Tiffany used to do some unit clerk stuff, Julie is an expert at bank fraud protection and spotting fiduciary abuse, and I'm just evil. It should work out okay, then.

ST