thedrifter
11-11-08, 07:32 AM
Medical tech challenges families of wounded
By Gregg Zoroya - USA Today
Posted : Tuesday Nov 11, 2008 7:12:44 EST
Harold and Mary Mowl were shocked by what they saw when they first visited their son, Kevin, in the intensive care unit at National Naval Medical Center in Bethesda, Md.
A 150-pound bomb had exploded under Kevin’s vehicle in Baghdad on Aug. 2, 2007. The blast broke his left arm and leg, his back, ankles and feet. His face was swollen; his eye sockets, nose and jaw were shattered. Doctors later removed some of his skull to allow his brain to swell.
“We didn’t know where to touch him,” Harold Mowl said.
Clearly, the 21-year-old son he had brought up in Upstate New York had been largely erased by the roadside blast that killed three other soldiers and wounded 11, the father said. The massive brain damage had taken so much away.
”If he recovered, he would be someone else,” Harold said. “We said to each other right away: ‘We will take care of him no matter what.’ ”
Kevin Mowl and critically wounded troops like him are symbols of a new type of war casualty on this sixth Veterans Day since the United States invaded Iraq. They are wounded troops who probably would have died on the battlefield in conflicts of previous generations, but thanks to advances in emergency medical care by the military, they come home alive. More than a dozen have lingered for months or even years before dying, usually of infection.
It’s a situation that puts families, doctors and military officials in the difficult position of balancing slim hopes of a partial recovery with the desire not to see their loved one, patient and servicemember suffer any more.
”These families have had their hearts wrenched out of them,” Marine Lt. Col. Grant Olbrich says of the relatives of the most severely wounded troops. Until recently, Olbrich was an advocate for families of severely burned patients as part of the Marine Corps Wounded Warrior Regiment.
Families are “looking at the choices and saying, ‘What should I pray for?’ ” Olbrich says. “ ‘Should I pray that my child dies quickly and doesn’t suffer anymore? Or should I pray that they survive and have as normal a life as possible?’ ”
Kevin Mowl’s case was typical — months of desperate treatment, brief hope for his family, and then death in February.
”This is not your father’s war. The families now are involved almost literally from the point of injury,” says Philip Perdue, trauma surgeon and chief of general surgery at Bethesda Naval Hospital and the doctor who treated Kevin Mowl.
“They see their loved ones in the ICU with the breathing tubes, as sick as can be. ... They’re at the bedside all day long. Sometimes, the patients don’t get better. And they see the person across the way get better. And they see someone else come and go. And it’s very wearing.”
The Army and Marine Corps have created programs aimed at helping relatives of severely wounded servicemembers. Patient advocates from each service’s wounded warrior program work with non-profit groups to pay for family transportation and find lodging for extended family and friends.
”When something happens (to a servicemember), it’s like a member of the family getting hurt, especially the critically injured. Because you see them suffer and you see them fight,” says Marine Col. Gregory Boyle, commander of the Wounded Warrior Regiment.
Despite such programs, family members of severely wounded servicemembers “don’t know what they’re stepping into,” Olbrich says.
For the Mowls, doctors at the Naval Hospital encouraged them to give their son a chance to get better, Harold Mowl says.
The doctors said the brain remains a mysterious organ with untapped capacity for some recovery.
”We wanted Kevin to have every opportunity to succeed,” Harold says, adding that his son’s doctors never talked about a major setback until the very end, when Kevin began to fail quickly after seven months of treatment.
“That last day,” the father says, ”we agreed to just let him go.”
Helping families cope
Harold Mowl, 61, is superintendent of the Rochester (N.Y.) School for the Deaf and the third generation of his family born without hearing. He and his wife were interviewed for this story through a sign-language interpreter.
Mary Mowl, 57, also is deaf, and is a volunteer executive director of a group that advocates for abused deaf people.
Their children, Carlene and Kevin, were born with normal hearing and learned sign language before they could speak, first signaling words such as “milk,” “water” and ”sleep.”
After Kevin was wounded, Bethesda Naval Hospital hired interpreters to help the Mowls every day at an overall cost of $60,000.
Jeannie Jones-Flanagan, a family advocate from the Army Wounded Warrior Program, tapped military and charitable resources to pay for the Mowls’ lodging, travel, meals, laundry, medications and myriad other expenses as Mary moved onto the hospital campus to be with her son and Harold traveled there every weekend.
“I’m helping them take care of their business, get through the day, work through situations, make small decisions, sometimes make big decisions,” Jones-Flanagan says. ”It’s a lot of networking, knowing people in certain departments so that you can cut through the red tape and get things done.”
She and other advocates are backed by staffs of soldiers, social workers, chaplains and mental health caregivers.
They work with charitable groups to cover mortgage payments, utility bills, lost income and family medical needs.
The government covers daily expenses and lodging for up to three family members attending in-patient relatives.
Advocates must arrange charitable support for extended family and friends.
“What is new for the (advocates) is that they’ve been in place long enough now to get the system down and be more effective case managers and advocates,” says Liza Biggers, whose brother, Ethan, lived for a year after he was shot in the head by a sniper in 2006. She is an appointee to a Department of Veterans Affairs committee examining the treatment of wounded.
”Being in the military medical system is incredibly complicated,” Biggers says.
“It’s absolutely essential to have someone help navigate the veterans and their families through it.”
A message from the Army
Spc. Kevin Mowl was about six weeks into an extension on a year of duty in Iraq when insurgents detonated 150 pounds of explosives inside a storm drain under the Stryker vehicle in which he was riding Aug. 2, 2007. The Stryker was ripped apart and overturned.
The next day, Harold and Mary Mowl returned from her first trip to Europe when they found a torn slip of paper in the door of their home in Pittsford, N.Y., outside Rochester. Scribbled words said to call the Army.
Using a video interpreter service provided by the phone company, Harold Mowl used sign language to speak with an operator who made the call. He learned that his son was ”seriously hurt” and heading home.
He called his daughter, Carlene, 25, in Manhattan. The operator passed along the news to Carlene. Harold Mowl watched the operator sign back, drawing imaginary lines down her cheeks. She was saying his daughter was weeping into the phone.
The Army flew Harold, Mary and Carlene to Washington, put them up in the Navy Lodge, a hotel on the hospital campus and provided each $64 in expense money for every day they were there.
Harold Mowl commuted to Bethesda every weekend or whenever his son was in surgery. His son underwent 12 major operations and countless lesser procedures, Perdue says.
Carlene arrived every other weekend. Two charities, Operation Hero Miles and Air Compassion for Veterans, used donated frequent-flyer miles to buy the Mowls’ airline tickets.
The non-profit Armed Forces Foundation covered lodging for Kevin Mowl’s grandmother, Jane “Betty” Mowl, and extended family and friends who visited.
Navy doctors worked for weeks mending Kevin Mowl’s many fractures and defeating multiple infections in his body.
Like other severely wounded servicemembers, Kevin Mowl could not speak because of a tracheotomy that helped him breathe. But he could sign.
Doctors watched with amazement as he communicated, confusingly at first, but then in periods of lucidness, with his hands.
It was rare insight into a brain-damaged patient’s progress, doctors told Harold Mowl.
In a blog they began to discuss Kevin’s situation, family members seized on such reasons for hope.
An entry from Sept. 1, 2007, says, ”Today was a most exciting day for us ... he flashed an ‘I love you’ to Carlene.”
’He is very quiet’
Kevin was in ICU for five months before he was moved to a ward, to the frustration and exhaustion of his family.
“Kevin continues to be a mixed bag psychosocially,” his father blogged last January. ”He is very quiet, and he does not respond consistently.”
“We often asked the doctor what would be his quality of life,” Mary Mowl recalls. ”They couldn’t give the answer, but they were optimistic.”
She remained with her son every day, preparing her own meals in the kitchenette in her hotel room or lunching at the hospital’s restaurant.
In January, she moved to a hotel in Richmond, Va., paid for by the Army, when Kevin entered a rehabilitation program at a VA clinic there.
The end was very fast: infection.
Kevin Mowl had been returned to Bethesda for brain surgery. A week later, he was wracked by fever and growing weaker. It was sepsis.
Doctors told the family that recovery was nearly impossible. Kevin had previously signed a do-not-resuscitate order. His father directed that life support be removed.
Kevin died Feb. 25.
“We got to see him a little bit longer,” Harold says of the anxiety the family endured during Kevin’s treatment.
”I wanted to see the doctors taking care of him. I wanted to see him taking every chance to succeed. It was not successful. OK. I think, for me, that was better than getting a call saying that he died.”
His wife nods in agreement.
“It’s hard,” says Carlene Mowl, ”because you’re in between” a combat death and survival.
“In one sense, it’s nice to have the time to say goodbye on your own terms,” she says.
”But it’s also hard to watch somebody try so hard to get better and then just not make it.”
Ellie
By Gregg Zoroya - USA Today
Posted : Tuesday Nov 11, 2008 7:12:44 EST
Harold and Mary Mowl were shocked by what they saw when they first visited their son, Kevin, in the intensive care unit at National Naval Medical Center in Bethesda, Md.
A 150-pound bomb had exploded under Kevin’s vehicle in Baghdad on Aug. 2, 2007. The blast broke his left arm and leg, his back, ankles and feet. His face was swollen; his eye sockets, nose and jaw were shattered. Doctors later removed some of his skull to allow his brain to swell.
“We didn’t know where to touch him,” Harold Mowl said.
Clearly, the 21-year-old son he had brought up in Upstate New York had been largely erased by the roadside blast that killed three other soldiers and wounded 11, the father said. The massive brain damage had taken so much away.
”If he recovered, he would be someone else,” Harold said. “We said to each other right away: ‘We will take care of him no matter what.’ ”
Kevin Mowl and critically wounded troops like him are symbols of a new type of war casualty on this sixth Veterans Day since the United States invaded Iraq. They are wounded troops who probably would have died on the battlefield in conflicts of previous generations, but thanks to advances in emergency medical care by the military, they come home alive. More than a dozen have lingered for months or even years before dying, usually of infection.
It’s a situation that puts families, doctors and military officials in the difficult position of balancing slim hopes of a partial recovery with the desire not to see their loved one, patient and servicemember suffer any more.
”These families have had their hearts wrenched out of them,” Marine Lt. Col. Grant Olbrich says of the relatives of the most severely wounded troops. Until recently, Olbrich was an advocate for families of severely burned patients as part of the Marine Corps Wounded Warrior Regiment.
Families are “looking at the choices and saying, ‘What should I pray for?’ ” Olbrich says. “ ‘Should I pray that my child dies quickly and doesn’t suffer anymore? Or should I pray that they survive and have as normal a life as possible?’ ”
Kevin Mowl’s case was typical — months of desperate treatment, brief hope for his family, and then death in February.
”This is not your father’s war. The families now are involved almost literally from the point of injury,” says Philip Perdue, trauma surgeon and chief of general surgery at Bethesda Naval Hospital and the doctor who treated Kevin Mowl.
“They see their loved ones in the ICU with the breathing tubes, as sick as can be. ... They’re at the bedside all day long. Sometimes, the patients don’t get better. And they see the person across the way get better. And they see someone else come and go. And it’s very wearing.”
The Army and Marine Corps have created programs aimed at helping relatives of severely wounded servicemembers. Patient advocates from each service’s wounded warrior program work with non-profit groups to pay for family transportation and find lodging for extended family and friends.
”When something happens (to a servicemember), it’s like a member of the family getting hurt, especially the critically injured. Because you see them suffer and you see them fight,” says Marine Col. Gregory Boyle, commander of the Wounded Warrior Regiment.
Despite such programs, family members of severely wounded servicemembers “don’t know what they’re stepping into,” Olbrich says.
For the Mowls, doctors at the Naval Hospital encouraged them to give their son a chance to get better, Harold Mowl says.
The doctors said the brain remains a mysterious organ with untapped capacity for some recovery.
”We wanted Kevin to have every opportunity to succeed,” Harold says, adding that his son’s doctors never talked about a major setback until the very end, when Kevin began to fail quickly after seven months of treatment.
“That last day,” the father says, ”we agreed to just let him go.”
Helping families cope
Harold Mowl, 61, is superintendent of the Rochester (N.Y.) School for the Deaf and the third generation of his family born without hearing. He and his wife were interviewed for this story through a sign-language interpreter.
Mary Mowl, 57, also is deaf, and is a volunteer executive director of a group that advocates for abused deaf people.
Their children, Carlene and Kevin, were born with normal hearing and learned sign language before they could speak, first signaling words such as “milk,” “water” and ”sleep.”
After Kevin was wounded, Bethesda Naval Hospital hired interpreters to help the Mowls every day at an overall cost of $60,000.
Jeannie Jones-Flanagan, a family advocate from the Army Wounded Warrior Program, tapped military and charitable resources to pay for the Mowls’ lodging, travel, meals, laundry, medications and myriad other expenses as Mary moved onto the hospital campus to be with her son and Harold traveled there every weekend.
“I’m helping them take care of their business, get through the day, work through situations, make small decisions, sometimes make big decisions,” Jones-Flanagan says. ”It’s a lot of networking, knowing people in certain departments so that you can cut through the red tape and get things done.”
She and other advocates are backed by staffs of soldiers, social workers, chaplains and mental health caregivers.
They work with charitable groups to cover mortgage payments, utility bills, lost income and family medical needs.
The government covers daily expenses and lodging for up to three family members attending in-patient relatives.
Advocates must arrange charitable support for extended family and friends.
“What is new for the (advocates) is that they’ve been in place long enough now to get the system down and be more effective case managers and advocates,” says Liza Biggers, whose brother, Ethan, lived for a year after he was shot in the head by a sniper in 2006. She is an appointee to a Department of Veterans Affairs committee examining the treatment of wounded.
”Being in the military medical system is incredibly complicated,” Biggers says.
“It’s absolutely essential to have someone help navigate the veterans and their families through it.”
A message from the Army
Spc. Kevin Mowl was about six weeks into an extension on a year of duty in Iraq when insurgents detonated 150 pounds of explosives inside a storm drain under the Stryker vehicle in which he was riding Aug. 2, 2007. The Stryker was ripped apart and overturned.
The next day, Harold and Mary Mowl returned from her first trip to Europe when they found a torn slip of paper in the door of their home in Pittsford, N.Y., outside Rochester. Scribbled words said to call the Army.
Using a video interpreter service provided by the phone company, Harold Mowl used sign language to speak with an operator who made the call. He learned that his son was ”seriously hurt” and heading home.
He called his daughter, Carlene, 25, in Manhattan. The operator passed along the news to Carlene. Harold Mowl watched the operator sign back, drawing imaginary lines down her cheeks. She was saying his daughter was weeping into the phone.
The Army flew Harold, Mary and Carlene to Washington, put them up in the Navy Lodge, a hotel on the hospital campus and provided each $64 in expense money for every day they were there.
Harold Mowl commuted to Bethesda every weekend or whenever his son was in surgery. His son underwent 12 major operations and countless lesser procedures, Perdue says.
Carlene arrived every other weekend. Two charities, Operation Hero Miles and Air Compassion for Veterans, used donated frequent-flyer miles to buy the Mowls’ airline tickets.
The non-profit Armed Forces Foundation covered lodging for Kevin Mowl’s grandmother, Jane “Betty” Mowl, and extended family and friends who visited.
Navy doctors worked for weeks mending Kevin Mowl’s many fractures and defeating multiple infections in his body.
Like other severely wounded servicemembers, Kevin Mowl could not speak because of a tracheotomy that helped him breathe. But he could sign.
Doctors watched with amazement as he communicated, confusingly at first, but then in periods of lucidness, with his hands.
It was rare insight into a brain-damaged patient’s progress, doctors told Harold Mowl.
In a blog they began to discuss Kevin’s situation, family members seized on such reasons for hope.
An entry from Sept. 1, 2007, says, ”Today was a most exciting day for us ... he flashed an ‘I love you’ to Carlene.”
’He is very quiet’
Kevin was in ICU for five months before he was moved to a ward, to the frustration and exhaustion of his family.
“Kevin continues to be a mixed bag psychosocially,” his father blogged last January. ”He is very quiet, and he does not respond consistently.”
“We often asked the doctor what would be his quality of life,” Mary Mowl recalls. ”They couldn’t give the answer, but they were optimistic.”
She remained with her son every day, preparing her own meals in the kitchenette in her hotel room or lunching at the hospital’s restaurant.
In January, she moved to a hotel in Richmond, Va., paid for by the Army, when Kevin entered a rehabilitation program at a VA clinic there.
The end was very fast: infection.
Kevin Mowl had been returned to Bethesda for brain surgery. A week later, he was wracked by fever and growing weaker. It was sepsis.
Doctors told the family that recovery was nearly impossible. Kevin had previously signed a do-not-resuscitate order. His father directed that life support be removed.
Kevin died Feb. 25.
“We got to see him a little bit longer,” Harold says of the anxiety the family endured during Kevin’s treatment.
”I wanted to see the doctors taking care of him. I wanted to see him taking every chance to succeed. It was not successful. OK. I think, for me, that was better than getting a call saying that he died.”
His wife nods in agreement.
“It’s hard,” says Carlene Mowl, ”because you’re in between” a combat death and survival.
“In one sense, it’s nice to have the time to say goodbye on your own terms,” she says.
”But it’s also hard to watch somebody try so hard to get better and then just not make it.”
Ellie