thedrifter
02-12-06, 07:41 AM
February 12, 2006
The Wounded
Healing, With New Limbs and Fragile Dreams
By JULIET MACUR
It was a victory for Lance Cpl. Matthew Schilling to walk into the upper gallery of the House of Representatives on Jan. 31 for the State of the Union address. He wore his dress blues and a prosthetic leg. Five months earlier, he had been carried on a stretcher, wounded and bleeding, into a hospital in Iraq after a roadside bomb exploded 10 feet from him.
The blast tore through his right foot and calf and blew a hole through his left hand. But hearing President Bush speak confidently of victory in Iraq, Corporal Schilling, a smooth-faced Marine reservist and college student from Portersville, Pa., who grew up on a cattle farm, again felt that his sacrifice had been worth it.
"I felt really proud when all those people I met that night thanked me for my service," said Corporal Schilling, 21, who attended with his wife, Leigh Ann, as guests of their congresswoman, Representative Melissa A. Hart, a Republican.
Yet when the Schillings returned to the Mologne House, a hotel at Walter Reed Army Medical Center for wounded soldiers and their families, Corporal Schilling found that wearing his prosthesis that night had taken a toll. Blood blisters had formed on his stump, and he was soon back in a wheelchair facing more surgery.
The next day, a member of Corporal Schilling's Marine Corps unit and a victim of the same blast, Lance Cpl. Mark Beyers, wheeled up to him at the Walter Reed physical therapy clinic. Corporal Beyers's right arm and leg were amputated in Iraq. "We should go into surgery together," Corporal Beyers joked. "They can give us a two-for-one discount."
A boisterous 27-year-old construction worker from near Buffalo, nicknamed Big Buck, Corporal Beyers has had his own difficulties.
Since Aug. 26, when they were wounded, the two marines each have endured some 20 operations in three countries. Charting their care over the ensuing months, beginning just hours after the blast, has revealed a journey of medical setbacks and emotional turmoil.
Explosions have killed 1,123 American service members in Iraq and have wounded at least 10 times more, often with a devastating combination of injuries — ruptured organs and severed spines, obliterated limbs and burst eyeballs.
Among the more than 16,653 Americans wounded in Iraq are 387 amputees, including 62 who, like Corporal Beyers, have lost more than one limb, said Lt. Col. Paul Pasquina, chief of physical medicine and rehabilitation at Walter Reed. The amputations, traumatic though they are, are often accompanied by painful complications. "It's not as easy as putting on even the most high-tech prosthetic and just walking off," Colonel Pasquina said.
Most of the amputees returning from combat zones have an infection, because a bomb blast can embed bacteria, dirt or pieces of clothing deep into the wound, Colonel Pasquina said. A severe infection could require further amputation or possibly be fatal.
About 20 percent of the amputees have had potentially serious blood clots that formed as a result of the initial trauma. About half of them experience a condition in which bone grows at the site of amputation, called heterotopic ossification, he said. In the worst cases, the growth can prevent proper fitting of a prosthesis or pierce the skin.
Corporals Schilling and Beyers each have mild cases of abnormal bone growth. Fissures also have formed at the end of their stumps, where their wounds were closed, and the irritated, blistered skin could become infected.
Artificial limbs are increasingly sophisticated — legs with microprocessors that help provide stability and a normal gait, or arms with attachments shaped to catch baseballs or flip pancakes. But the psychological effects of losing a limb, particularly for young, active military members, can be deep and lasting, a constant reminder of the war.
A World of Hurt
For Corporals Beyers and Schilling and the other marines of India Company, makeshift bombs were so common, and the fear of losing limbs so real, that many of them devised personal survival plans. Staff Sgt. Michael Tracey said that because he is right-handed, he patrolled on the left side of streets. If a roadside bomb went off, he reasoned, he would rather lose his left limbs.
The bombs could be anywhere: in piles of garbage, potholes or dead dogs, molded to look like curbs, or covered with papier-mâché to look like rocks. They could be made from artillery shells, C4 plastic explosive or TNT. Insurgents sometimes add a mixture of diesel fuel and gel, their version of napalm.
The blast causes a violent change in air pressure that can rupture lungs and eardrums or burst blood vessels in the spinal cord and brain. It can fracture bones in the middle ear, causing permanent hearing loss. "The worst car crash is nothing in terms of what we see here," said Lt. Col. Brian Perry, an Air Force surgeon at an American military base in Balad, Iraq.
The Third Battalion, 25th Marine Regiment, the corporals' unit, lost 14 men in an explosion on Aug. 3, the deadliest roadside bomb attack on American troops in Iraq. By the end of its seven-month tour, 48 of the unit's reservists would be dead, including 28 killed by improvised bombs.
The explosion that wounded Corporals Schilling and Beyers occurred in the town of Hit. Seven marines on foot patrol were thrown to the ground after a blinding flash and an eardrum-piercing blast, they recalled. Five of them grabbed their weapons and fired into surrounding buildings.
Corporals Beyers and Schilling remained down. Marines carrying thick pads stopped their bleeding. One marine, trained as a combat lifesaver, placed tourniquets on their legs. A medic gave them shots of morphine. Then, to signal to caregivers that the men had been given the drug, he dipped his finger in their blood and wrote an M on each marine's forehead.
About an hour later, Corporals Schilling and Beyers were in surgery at the nearby Al Asad Military Base. It was the first of 13 operations they would endure in eight days, during stays at five hospitals in three countries. A doctor amputated Corporal Schilling's right leg below the knee. Corporal Beyers, with severe lung injuries, was in worse shape. Doctors amputated his right lower leg and his entire right arm, including the shoulder; shrapnel had destroyed his shoulder joint and just missed slicing his carotid artery, doctors said. For the next week he would be in an induced coma.
At the next stop, an Army hospital in Baghdad, doctors cleaned out their wounds to help prevent infection. Twenty-four hours after the blast, both marines were stable enough to be transferred to a hospital in Balad, where the wounded wait for the trip to Landstuhl Regional Medical Center in Germany.
In Balad, the whirling blades of the medevac helicopter shook the tent's canvas walls. Within moments, the doors to the trauma room swung open. Corporal Schilling arrived on a green mesh stretcher, his left hand and what remained of his right leg wrapped in bandages. Dried blood was caked on his nose and ears. The skin around his eyes was black and blue.
A doctor asked how he was doing. "I feel lucky to be alive, sir," he answered.
The Air Force Theater Hospital in Balad is a complex of 32 interconnected green tents housing the most advanced hospital in Iraq. Surgeons there operate more than 400 times a month, said Col. Elisha Powell, the hospital's chief for four months last year. "As surgeons, we've been waiting our whole lives for this, to save lives like this," said Colonel Powell, who added that they also treated Iraqi civilians and insurgents.
Corporal Beyers, whose shaved head was beginning to show blond stubble, arrived at Balad the evening after the blast. Doctors made sure he was stable, and a chaplain said a prayer, touching Corporal Beyers's muscular left arm, which is tattooed with a Marine bulldog. The next morning, he was flown to Germany.
Corporal Schilling would follow a day later. Despite his wounds, he was irrepressibly upbeat, still proud to have volunteered for Iraq. "I'm going to be fine, ma'am, because they make great prosthetics for legs," he told a nurse.
As the hours passed, he had trouble controlling his emotions. He said he felt guilty that Corporal Beyers had worse injuries and wondered how his friend would fare without his dominant arm. Was there a prosthesis for someone with no arm at all, he asked a nurse, his voice cracking.
That night, Corporal Schilling and two dozen others boarded a C-141 cargo plane for the five-hour flight to Germany. In silence, the crew tucked the men in with rough wool blankets.
Reality Creeps In
Corporal Schilling was rolled into an operating room the next morning. "Doc, please, I've got to keep my hand," he said before he was sedated.
The shrapnel that tore through the palm had severed bones and tendons. The tip of the middle finger was connected only by sinews. The tip of the ring finger was missing.
During the surgery, Dr. Paul Phillips, an Army reservist from Texas, inserted rods and pins to support the bones. "As bad as it looks, it's still fixable, and I'm not going to let him lose his fingers," he said.
Dr. Phillips amputated another inch and a half from Corporal Schilling's leg, so the wound could eventually be closed more neatly. He positioned a long wire with tiny teeth on it under the tibia, then the fibula, and sawed the bones. Fragments flew across the room and bounced with a ping on the tile floor.
In Landstuhl, a picturesque German town with green trees, rolling hills and beer gardens, the initial relief of surviving a blast or a firefight begins to fade for wounded soldiers. In a place that looks more like home, reality creeps in. Visitors told Corporal Schilling to stay positive. One of them was Maj. Gen. John J. McCarthy, deputy commander of the Marine forces in Europe.
But outside the hospital unit, the general looked grim. "There's not a kid in that unit who knew what they were getting into," he said. "When I asked them, are you ready to go?, they would say, 'Yes, sir.' But then I'd look at those 18-, 19-, 20-year-olds, two weeks out of boot camp, and thought, no, they are not ready for this struggle. I knew how scared they were, how reluctant they were."
He added, "Men like this one have shown more courage than we had the right to expect from them."
Corporal Schilling teetered between confidence and dread. The afternoon of the general's visit he took his first steps, balancing on a walker. He learned that his hearing would return; his eardrum had only been punctured. For the first time in a while, he grinned without forcing it.
But as the painkillers wore off, the horror of his injuries began to sink in. "Do you smell that?" he asked a reporter. "It's the blood from my stump. Can't you smell it? That's my own blood, right?"
Even so, he insisted on seeing Corporal Beyers. To prepare him, a nurse told him that tubes and wires were attached to nearly every part of Corporal Beyers's body. Doctors had cut open his abdomen to check for internal injuries. His lung had collapsed, his colon had ripped, he had lesions on his spleen, his liver was bruised.
When Corporal Schilling entered the room, he grabbed his friend's hand. The nurse heard him say: "I'm here now, Buck." Then, he cried. The next day, they flew home together.
Another Phase
Corporal Beyers regained consciousness at the National Naval Medical Center in Bethesda, Md., where he and Corporal Schilling began the next phase of their treatment. His blue eyes filled with tears. Pale and gaunt, he tried to talk to his fiancée, Lance Cpl. Denise Lauck, but he had a breathing tube in his throat.
"I was worried about his reaction to losing his arm and leg," Corporal Lauck said. "I really thought he would flip out."
But Corporal Beyers was calm when taken off the ventilator the next day. His first word was "Whammo!" which made his family laugh. Then he had questions: What does my face look like? Are my lips still there? Where is my other leg? Then he asked: How is Schilling?
The two shared a room for several days and exchanged fuzzy memories of the blast. They were separated when Corporal Beyers developed complications — pneumonia, infections in his wounds and pancreatitis, which made him weak and nauseated. He grew cranky, cursing at the medical staff. Corporal Lauck said he could not accept that his self-image as an invincible Marine was gone.
"I hate being here with all of these sick people," he said.
A few doors down, Corporal Schilling's mood was also declining. Marines from India Company who visited him said he seemed depressed. Leigh Ann Schilling, who described her husband as "the prettiest farm boy I ever saw," said he had become self-conscious about his injuries. "He even thought I wouldn't love him anymore because he had only one leg," she said.
He was also increasingly concerned about his hand. Doctors suggested amputating his third and fourth fingers and closing the gap in the hand, hastening his recovery. But he resisted.
"I already am missing a leg, so I was a little disappointed that they wanted to chop two fingers off, too," he said.
It will take at least eight operations over years to rebuild the bones in his hand and reconstruct the arteries and veins, said Lt. Col. Romney Andersen, an Army orthopedic traumatologist. "If this is what Matt thinks is best, this is what Matt will get," Dr. Andersen said. But he's taking a lot of risk." With each procedure, Corporal Schilling could lose function of his good fingers, he said.
While Corporal Schilling was dealing with his recovery, Corporal Beyers surged ahead. In early October, weighing 146 pounds, down from 195, he joined dozens of other amputees in rehabilitation at Walter Reed, one of two military amputee care centers. The second opened in January 2005 at Brooke Army Medical Center in San Antonio to meet the rising demand.
After 19 operations and 63 days in hospitals, Corporal Beyers went home in October for a visit. He attended a parade in his honor in his hometown, Alden, N.Y. He drank Labatt beer and played poker with friends. He jokingly called his right leg Stumpy.
Still, he missed the camaraderie of the military and said he felt relieved to attend India Company's annual ball in Buffalo, held in November.
Corporal Schilling had also talked about going to the ball with his wife. But after 16 operations, his emotions were tangled. He said he would feel uncomfortable going in a wheelchair and was self-conscious about his injuries. Doctors had grafted skin from his right thigh onto the top of his hand to cover the gaping hole. Skin taken from his lower abdomen closed the gap in his palm.
The palm looks fairly normal, but the top of his hand is a mass of flabby, hairy flesh, half the size of a softball. When a high school friend saw it, he ran into the hospital hallway and passed out, Corporal Schilling said. After that, Corporal Schilling said he began hiding his hand. "I didn't want to make anyone else sick," he said.
The first week of November, though, Corporal Schilling felt a rush of confidence when he was fitted with a prosthetic leg. Able to walk again, he agreed to go to another Marine Corps ball, this one held by his original unit in West Virginia. He put on his dress blues. His wife wore the same black halter dress she had worn to the ball the year before. At the ball, he saw pictures of four local marines who had been killed in Iraq.
He realized, again, how lucky he was to be alive.
Making Adjustments
By January, both Corporal Beyers and Corporal Schilling were in rehabilitation, back at Walter Reed. Corporal Beyers got his prosthetic leg on Jan. 4, but a few weeks later, the skin on his stump started to blister and bleed. He was back in his wheelchair.
"Some people think amputees just put on their leg and get up and run," he said. "But we don't. It's the worst feeling in the world."
A few weeks later, he was fitted with an electronic prosthetic arm that weighs about 12 pounds and attaches to his torso by a harness. By flexing muscles in his back and chest, he can open and close the hand and bend the elbow. But he said he was not likely to use it because it was too cumbersome.
He said he was looking forward to getting a nonfunctional, cosmetic arm. He wants it made to match his left arm, which is muscular again. He even plans to get a Marine Corps tattoo on the fake arm to complement the one on his real arm. He plans to marry Corporal Lauck on a Caribbean cruise in April. Eventually, he hopes to resume working with his family's construction company.
Although he and Corporal Schilling had been buddies in Iraq, they do not socialize much anymore.
"We're not just a bunch of guys living for the minute," Corporal Schilling said. "We have new lives now."
He still thinks about his time in Iraq. He had volunteered to replace a marine in his unit who had been killed, and he does not regret his decision to fight in the war. "It's just something we have to do to keep our own country safe," he said.
The Schillings are trying to look ahead. Corporal Schilling plans on finishing college to get a teaching degree. He and his wife were married in a rushed ceremony before he shipped out to Iraq, and during his tour they exchanged letters about their dream wedding. They have booked a church and reception hall for May 27.
But first, another surgery. Last week, doctors removed bone from Corporal Schilling's hip, inserting it into the hole in his hand and securing it with titanium rods. It will be another year before doctors can replace the tendons. Nerve transplants will follow. Right now, his middle and ring fingers are numb, as is part of his hand.
His leg also poses problems. After the State of the Union outing, when the blisters developed, Corporal Schilling saw Maj. Donald Gajewski, an orthopedic surgeon at Walter Reed, who told him the closure wound on his leg was not healing properly and that he needed an operation to correct it.
Hearing that, Corporal Schilling and Leigh Ann looked at each other and turned pale.
"Are you going to have to take any bone?" Leigh Ann asked.
Corporal Schilling interrupted: "My biggest concern is how long after the surgery will it take for me to be walking again?"
Three weeks, the doctor said.
"Sir, as long as I'm going to be ready to dance at the wedding," Corporal Schilling said, reaching for Leigh Ann's hand.
Ellie
The Wounded
Healing, With New Limbs and Fragile Dreams
By JULIET MACUR
It was a victory for Lance Cpl. Matthew Schilling to walk into the upper gallery of the House of Representatives on Jan. 31 for the State of the Union address. He wore his dress blues and a prosthetic leg. Five months earlier, he had been carried on a stretcher, wounded and bleeding, into a hospital in Iraq after a roadside bomb exploded 10 feet from him.
The blast tore through his right foot and calf and blew a hole through his left hand. But hearing President Bush speak confidently of victory in Iraq, Corporal Schilling, a smooth-faced Marine reservist and college student from Portersville, Pa., who grew up on a cattle farm, again felt that his sacrifice had been worth it.
"I felt really proud when all those people I met that night thanked me for my service," said Corporal Schilling, 21, who attended with his wife, Leigh Ann, as guests of their congresswoman, Representative Melissa A. Hart, a Republican.
Yet when the Schillings returned to the Mologne House, a hotel at Walter Reed Army Medical Center for wounded soldiers and their families, Corporal Schilling found that wearing his prosthesis that night had taken a toll. Blood blisters had formed on his stump, and he was soon back in a wheelchair facing more surgery.
The next day, a member of Corporal Schilling's Marine Corps unit and a victim of the same blast, Lance Cpl. Mark Beyers, wheeled up to him at the Walter Reed physical therapy clinic. Corporal Beyers's right arm and leg were amputated in Iraq. "We should go into surgery together," Corporal Beyers joked. "They can give us a two-for-one discount."
A boisterous 27-year-old construction worker from near Buffalo, nicknamed Big Buck, Corporal Beyers has had his own difficulties.
Since Aug. 26, when they were wounded, the two marines each have endured some 20 operations in three countries. Charting their care over the ensuing months, beginning just hours after the blast, has revealed a journey of medical setbacks and emotional turmoil.
Explosions have killed 1,123 American service members in Iraq and have wounded at least 10 times more, often with a devastating combination of injuries — ruptured organs and severed spines, obliterated limbs and burst eyeballs.
Among the more than 16,653 Americans wounded in Iraq are 387 amputees, including 62 who, like Corporal Beyers, have lost more than one limb, said Lt. Col. Paul Pasquina, chief of physical medicine and rehabilitation at Walter Reed. The amputations, traumatic though they are, are often accompanied by painful complications. "It's not as easy as putting on even the most high-tech prosthetic and just walking off," Colonel Pasquina said.
Most of the amputees returning from combat zones have an infection, because a bomb blast can embed bacteria, dirt or pieces of clothing deep into the wound, Colonel Pasquina said. A severe infection could require further amputation or possibly be fatal.
About 20 percent of the amputees have had potentially serious blood clots that formed as a result of the initial trauma. About half of them experience a condition in which bone grows at the site of amputation, called heterotopic ossification, he said. In the worst cases, the growth can prevent proper fitting of a prosthesis or pierce the skin.
Corporals Schilling and Beyers each have mild cases of abnormal bone growth. Fissures also have formed at the end of their stumps, where their wounds were closed, and the irritated, blistered skin could become infected.
Artificial limbs are increasingly sophisticated — legs with microprocessors that help provide stability and a normal gait, or arms with attachments shaped to catch baseballs or flip pancakes. But the psychological effects of losing a limb, particularly for young, active military members, can be deep and lasting, a constant reminder of the war.
A World of Hurt
For Corporals Beyers and Schilling and the other marines of India Company, makeshift bombs were so common, and the fear of losing limbs so real, that many of them devised personal survival plans. Staff Sgt. Michael Tracey said that because he is right-handed, he patrolled on the left side of streets. If a roadside bomb went off, he reasoned, he would rather lose his left limbs.
The bombs could be anywhere: in piles of garbage, potholes or dead dogs, molded to look like curbs, or covered with papier-mâché to look like rocks. They could be made from artillery shells, C4 plastic explosive or TNT. Insurgents sometimes add a mixture of diesel fuel and gel, their version of napalm.
The blast causes a violent change in air pressure that can rupture lungs and eardrums or burst blood vessels in the spinal cord and brain. It can fracture bones in the middle ear, causing permanent hearing loss. "The worst car crash is nothing in terms of what we see here," said Lt. Col. Brian Perry, an Air Force surgeon at an American military base in Balad, Iraq.
The Third Battalion, 25th Marine Regiment, the corporals' unit, lost 14 men in an explosion on Aug. 3, the deadliest roadside bomb attack on American troops in Iraq. By the end of its seven-month tour, 48 of the unit's reservists would be dead, including 28 killed by improvised bombs.
The explosion that wounded Corporals Schilling and Beyers occurred in the town of Hit. Seven marines on foot patrol were thrown to the ground after a blinding flash and an eardrum-piercing blast, they recalled. Five of them grabbed their weapons and fired into surrounding buildings.
Corporals Beyers and Schilling remained down. Marines carrying thick pads stopped their bleeding. One marine, trained as a combat lifesaver, placed tourniquets on their legs. A medic gave them shots of morphine. Then, to signal to caregivers that the men had been given the drug, he dipped his finger in their blood and wrote an M on each marine's forehead.
About an hour later, Corporals Schilling and Beyers were in surgery at the nearby Al Asad Military Base. It was the first of 13 operations they would endure in eight days, during stays at five hospitals in three countries. A doctor amputated Corporal Schilling's right leg below the knee. Corporal Beyers, with severe lung injuries, was in worse shape. Doctors amputated his right lower leg and his entire right arm, including the shoulder; shrapnel had destroyed his shoulder joint and just missed slicing his carotid artery, doctors said. For the next week he would be in an induced coma.
At the next stop, an Army hospital in Baghdad, doctors cleaned out their wounds to help prevent infection. Twenty-four hours after the blast, both marines were stable enough to be transferred to a hospital in Balad, where the wounded wait for the trip to Landstuhl Regional Medical Center in Germany.
In Balad, the whirling blades of the medevac helicopter shook the tent's canvas walls. Within moments, the doors to the trauma room swung open. Corporal Schilling arrived on a green mesh stretcher, his left hand and what remained of his right leg wrapped in bandages. Dried blood was caked on his nose and ears. The skin around his eyes was black and blue.
A doctor asked how he was doing. "I feel lucky to be alive, sir," he answered.
The Air Force Theater Hospital in Balad is a complex of 32 interconnected green tents housing the most advanced hospital in Iraq. Surgeons there operate more than 400 times a month, said Col. Elisha Powell, the hospital's chief for four months last year. "As surgeons, we've been waiting our whole lives for this, to save lives like this," said Colonel Powell, who added that they also treated Iraqi civilians and insurgents.
Corporal Beyers, whose shaved head was beginning to show blond stubble, arrived at Balad the evening after the blast. Doctors made sure he was stable, and a chaplain said a prayer, touching Corporal Beyers's muscular left arm, which is tattooed with a Marine bulldog. The next morning, he was flown to Germany.
Corporal Schilling would follow a day later. Despite his wounds, he was irrepressibly upbeat, still proud to have volunteered for Iraq. "I'm going to be fine, ma'am, because they make great prosthetics for legs," he told a nurse.
As the hours passed, he had trouble controlling his emotions. He said he felt guilty that Corporal Beyers had worse injuries and wondered how his friend would fare without his dominant arm. Was there a prosthesis for someone with no arm at all, he asked a nurse, his voice cracking.
That night, Corporal Schilling and two dozen others boarded a C-141 cargo plane for the five-hour flight to Germany. In silence, the crew tucked the men in with rough wool blankets.
Reality Creeps In
Corporal Schilling was rolled into an operating room the next morning. "Doc, please, I've got to keep my hand," he said before he was sedated.
The shrapnel that tore through the palm had severed bones and tendons. The tip of the middle finger was connected only by sinews. The tip of the ring finger was missing.
During the surgery, Dr. Paul Phillips, an Army reservist from Texas, inserted rods and pins to support the bones. "As bad as it looks, it's still fixable, and I'm not going to let him lose his fingers," he said.
Dr. Phillips amputated another inch and a half from Corporal Schilling's leg, so the wound could eventually be closed more neatly. He positioned a long wire with tiny teeth on it under the tibia, then the fibula, and sawed the bones. Fragments flew across the room and bounced with a ping on the tile floor.
In Landstuhl, a picturesque German town with green trees, rolling hills and beer gardens, the initial relief of surviving a blast or a firefight begins to fade for wounded soldiers. In a place that looks more like home, reality creeps in. Visitors told Corporal Schilling to stay positive. One of them was Maj. Gen. John J. McCarthy, deputy commander of the Marine forces in Europe.
But outside the hospital unit, the general looked grim. "There's not a kid in that unit who knew what they were getting into," he said. "When I asked them, are you ready to go?, they would say, 'Yes, sir.' But then I'd look at those 18-, 19-, 20-year-olds, two weeks out of boot camp, and thought, no, they are not ready for this struggle. I knew how scared they were, how reluctant they were."
He added, "Men like this one have shown more courage than we had the right to expect from them."
Corporal Schilling teetered between confidence and dread. The afternoon of the general's visit he took his first steps, balancing on a walker. He learned that his hearing would return; his eardrum had only been punctured. For the first time in a while, he grinned without forcing it.
But as the painkillers wore off, the horror of his injuries began to sink in. "Do you smell that?" he asked a reporter. "It's the blood from my stump. Can't you smell it? That's my own blood, right?"
Even so, he insisted on seeing Corporal Beyers. To prepare him, a nurse told him that tubes and wires were attached to nearly every part of Corporal Beyers's body. Doctors had cut open his abdomen to check for internal injuries. His lung had collapsed, his colon had ripped, he had lesions on his spleen, his liver was bruised.
When Corporal Schilling entered the room, he grabbed his friend's hand. The nurse heard him say: "I'm here now, Buck." Then, he cried. The next day, they flew home together.
Another Phase
Corporal Beyers regained consciousness at the National Naval Medical Center in Bethesda, Md., where he and Corporal Schilling began the next phase of their treatment. His blue eyes filled with tears. Pale and gaunt, he tried to talk to his fiancée, Lance Cpl. Denise Lauck, but he had a breathing tube in his throat.
"I was worried about his reaction to losing his arm and leg," Corporal Lauck said. "I really thought he would flip out."
But Corporal Beyers was calm when taken off the ventilator the next day. His first word was "Whammo!" which made his family laugh. Then he had questions: What does my face look like? Are my lips still there? Where is my other leg? Then he asked: How is Schilling?
The two shared a room for several days and exchanged fuzzy memories of the blast. They were separated when Corporal Beyers developed complications — pneumonia, infections in his wounds and pancreatitis, which made him weak and nauseated. He grew cranky, cursing at the medical staff. Corporal Lauck said he could not accept that his self-image as an invincible Marine was gone.
"I hate being here with all of these sick people," he said.
A few doors down, Corporal Schilling's mood was also declining. Marines from India Company who visited him said he seemed depressed. Leigh Ann Schilling, who described her husband as "the prettiest farm boy I ever saw," said he had become self-conscious about his injuries. "He even thought I wouldn't love him anymore because he had only one leg," she said.
He was also increasingly concerned about his hand. Doctors suggested amputating his third and fourth fingers and closing the gap in the hand, hastening his recovery. But he resisted.
"I already am missing a leg, so I was a little disappointed that they wanted to chop two fingers off, too," he said.
It will take at least eight operations over years to rebuild the bones in his hand and reconstruct the arteries and veins, said Lt. Col. Romney Andersen, an Army orthopedic traumatologist. "If this is what Matt thinks is best, this is what Matt will get," Dr. Andersen said. But he's taking a lot of risk." With each procedure, Corporal Schilling could lose function of his good fingers, he said.
While Corporal Schilling was dealing with his recovery, Corporal Beyers surged ahead. In early October, weighing 146 pounds, down from 195, he joined dozens of other amputees in rehabilitation at Walter Reed, one of two military amputee care centers. The second opened in January 2005 at Brooke Army Medical Center in San Antonio to meet the rising demand.
After 19 operations and 63 days in hospitals, Corporal Beyers went home in October for a visit. He attended a parade in his honor in his hometown, Alden, N.Y. He drank Labatt beer and played poker with friends. He jokingly called his right leg Stumpy.
Still, he missed the camaraderie of the military and said he felt relieved to attend India Company's annual ball in Buffalo, held in November.
Corporal Schilling had also talked about going to the ball with his wife. But after 16 operations, his emotions were tangled. He said he would feel uncomfortable going in a wheelchair and was self-conscious about his injuries. Doctors had grafted skin from his right thigh onto the top of his hand to cover the gaping hole. Skin taken from his lower abdomen closed the gap in his palm.
The palm looks fairly normal, but the top of his hand is a mass of flabby, hairy flesh, half the size of a softball. When a high school friend saw it, he ran into the hospital hallway and passed out, Corporal Schilling said. After that, Corporal Schilling said he began hiding his hand. "I didn't want to make anyone else sick," he said.
The first week of November, though, Corporal Schilling felt a rush of confidence when he was fitted with a prosthetic leg. Able to walk again, he agreed to go to another Marine Corps ball, this one held by his original unit in West Virginia. He put on his dress blues. His wife wore the same black halter dress she had worn to the ball the year before. At the ball, he saw pictures of four local marines who had been killed in Iraq.
He realized, again, how lucky he was to be alive.
Making Adjustments
By January, both Corporal Beyers and Corporal Schilling were in rehabilitation, back at Walter Reed. Corporal Beyers got his prosthetic leg on Jan. 4, but a few weeks later, the skin on his stump started to blister and bleed. He was back in his wheelchair.
"Some people think amputees just put on their leg and get up and run," he said. "But we don't. It's the worst feeling in the world."
A few weeks later, he was fitted with an electronic prosthetic arm that weighs about 12 pounds and attaches to his torso by a harness. By flexing muscles in his back and chest, he can open and close the hand and bend the elbow. But he said he was not likely to use it because it was too cumbersome.
He said he was looking forward to getting a nonfunctional, cosmetic arm. He wants it made to match his left arm, which is muscular again. He even plans to get a Marine Corps tattoo on the fake arm to complement the one on his real arm. He plans to marry Corporal Lauck on a Caribbean cruise in April. Eventually, he hopes to resume working with his family's construction company.
Although he and Corporal Schilling had been buddies in Iraq, they do not socialize much anymore.
"We're not just a bunch of guys living for the minute," Corporal Schilling said. "We have new lives now."
He still thinks about his time in Iraq. He had volunteered to replace a marine in his unit who had been killed, and he does not regret his decision to fight in the war. "It's just something we have to do to keep our own country safe," he said.
The Schillings are trying to look ahead. Corporal Schilling plans on finishing college to get a teaching degree. He and his wife were married in a rushed ceremony before he shipped out to Iraq, and during his tour they exchanged letters about their dream wedding. They have booked a church and reception hall for May 27.
But first, another surgery. Last week, doctors removed bone from Corporal Schilling's hip, inserting it into the hole in his hand and securing it with titanium rods. It will be another year before doctors can replace the tendons. Nerve transplants will follow. Right now, his middle and ring fingers are numb, as is part of his hand.
His leg also poses problems. After the State of the Union outing, when the blisters developed, Corporal Schilling saw Maj. Donald Gajewski, an orthopedic surgeon at Walter Reed, who told him the closure wound on his leg was not healing properly and that he needed an operation to correct it.
Hearing that, Corporal Schilling and Leigh Ann looked at each other and turned pale.
"Are you going to have to take any bone?" Leigh Ann asked.
Corporal Schilling interrupted: "My biggest concern is how long after the surgery will it take for me to be walking again?"
Three weeks, the doctor said.
"Sir, as long as I'm going to be ready to dance at the wedding," Corporal Schilling said, reaching for Leigh Ann's hand.
Ellie