ICU

It took me five days to make it from a dusty, uncomfortable blast crater in Afghanistan to a sterile, uncomfortable hospital bed in the ICU at National Naval Medical Center, in Bethesda, MD. Luckily for me, I was much too high on Dilaudid to notice the bed, or the trip. My amputations had started out below the knee, but somewhere during the three hospital stops along the way the need arose for the remaining portions below my knees to be taken off. A lot of the time this is due to infections that are picked up from the dirt in Afghanistan. Or maybe there wasn’t much that existed below the knees to make keeping them viable. On the bright side, however, the stumps that were remaining were of a significant length for an above knee amputation. I was left with the entire femur on my left leg, and only a few inches shy on my right leg. I found it funny that throughout my entire hospital stay, the remainders of my legs were always referred to as stumps by the medical staff. I had expected a more elegant term, considering the fact that this was a hospital. At the same time, however, I enjoyed the casual nature of the word stump, and even considered naming them at one point. Later, when perusing my medical records, I found the elegant term I had been looking for: residual limb.

Along with the major injuries that I sustained, I also had a few minor injuries. I use the term minor loosely here, seeing as how these minor injuries would be considered major if they weren’t sustained in tandem with the severing of one’s lower legs. Starting from the lower portions first, I had lost a portion of the muscles making up the inner part of my right thigh. In order to close that wound, I would require a skin graft taken from the skin of my left thigh. My buttocks sustained several large wounds from shrapnel, some close to the sphincter, but mostly in the more meaty parts. That was okay, though, I have always had extra butt muscle to go around. The close proximity of these wounds to the working parts of the digestive system resulted in the doctors diverting my intestines to a colostomy that came through my abdominal area. The reason for doing this wasn’t because of any damage to the intestines, but because the doctors wanted to make sure that the large wounds on my butt didn’t get infected. The colostomy looked just like a fleshy bubble coming out of the left side of my abs. If you can imagine taking a tube sock and flipping the open part over, that is essentially what they did with the end of my large intestine. In order to make this work as a viable means of disposal, one must fasten a bag to one’s stomach. In order to do this, I was provided with sticky square “wafers” that I would cut a hole in the center of to fit my intestine bubble through. This wafer would sit around the bubble, and the bag would be clipped to the wafer. I can honestly say that I do not miss having that colostomy one bit, however at the time, I am very thankful that I had it. It certainly made things a lot easier when I wasn’t very mobile.

As for upper body injuries, I had some minor burns to my hands, and two totally perforated eardrums. The hands would heal, and my eardrums would be replaced with cartilage in two separate procedures called tympanoplasties. I consider myself extremely lucky that I still have all ten fingers in perfect working condition, my eyes, and most significantly, a brain that made it through the blast with only a grade three concussion, and no residual traumatic brain injuries (and thank goodness it didn’t get any stupider, I can’t afford that. While we are on a side note, I would also like to point out that I am glad that I’m not any uglier either). I have the utmost sympathy for men who have to live with an injury of the brain. These guys have to deal with constant headaches, recurring migraines, and losses of some faculties of the mind, such as their memory. While I may face many hardships and have some sort of discomfort constantly throughout the day as a result of wearing prosthetics, at least it doesn’t hurt. I don’t have constant pain. Constant pain is a much more harrowing plight than mine, and I can’t imagine how hard it is to withstand.

I spent my first week at NNMC in the Intensive Care Unit. I had a tube down my throat, one tube going into my arm, a breathing tube in my nose, a catheter, pads monitoring my heart rate, an epidural in my lower spine, and a wire for my pain button. Both my hands were wrapped in gauze for my burns. My legs were also wrapped in gauze, along with having woundvac machines attached to them to suck out the excess fluids leaking from my wounds. My rear end had a pad of gauze for the wounds there. The incision down the center of my abs used for my colostomy had been stapled back together, and the bottom parts of my stumps where the skin was reconnected were stitched together. To top it all off, I had my pirate hat on my head. I was practically being held together by duct tape like an old, dilapidated chair that you are trying to get one more good year out of.

When severely wounded patients arrive at Walter Reed National Military Medical Center, they are trucked in on an ambulance the size of an 18-wheeler, usually several at a time. They are dropped off at the front entrance of the hospital, where their family and friends are waiting. Waiting for me were my mom, dad, stepfather, stepmother, and my little brother. I vaguely remember being wheeled down the ramp and being greeted by their blurry, out of focus faces telling me that they were there. The next time I remember seeing them, I was in the intensive care unit of the hospital. Much like the last time I was ever in a hospital, the day of my birth, my family was in the room with me.

The ICU was a haze of Dilaudid induced hallucinations. I was being operated on every other day in order to keep my wounds clean. In the beginning, I hated going to surgery. Not because I was afraid of waking up during the procedure, or not waking up at all, but because the hallucinations I would experience from the anesthesia were nothing short of horrifying. I vividly remember two such hallucinations. The first was me in a bunker, lying on my back in my mother’s arms. I looked down, and saw that both of my legs were splattered. I could see an inordinate amount of blood covering the walls of the bunker. The pain was unbearable. The second, I was heading out on patrol with Marines from my first deployment. Right before we left the FOB, a sniper shot me in the neck. As I lay there, nobody came to help me, but continued to go out on the patrol. Instead of being concerned that I had been shot, my biggest issue was that I wouldn’t be going with my friends. After each hallucination, I would be woken up by either a doctor or a nurse, unsure of where I was, and feeling nearly hypothermic. I would shake violently from the cold, and be covered with heated towels until I warmed back up, then be wheeled back to my room. Eventually these episodes would stop occurring, and surgeries would become commonplace, but the first few were hell.

Along with the anesthesia induced hallucinations, the Dilaudid kept me seeing things for what seemed like 24 hours a day. I don’t remember getting a wink of sleep in that first week, because every time my eyes closed, it would be as if I was watching a movie and the screen was the inside of my eyelids. I would be flying across the ground, watching the Earth glide beneath me, and then I would dive into a cave and fly on forever until I opened my eyes. Other times I would see dancing aliens. I could swear that I would see ants crawling on me from time to time. On one occasion during a visit from my friends Bill Urrego and Jon Faff, I saw them melt into the ground.

“Bill…Faff…you guys are sinking into the ground. Bye..good luck with that.”

Throughout that first week, and during the entirety of my stay, I had visitors every day. I should say that both me and Daniel had visitors every day. Our visitors would keep the waiting room stuffed all day. Since we were in intensive care, the sheer number of people we had in our rooms were judged to be unsafe by the nurses. They had to rotate our visitors through two at a time. To this day, thinking about all of the support I received from people who took the time to come and see me, leaves me beyond humbled. I couldn’t believe that I had so many people who cared so much about me. They cared enough to come to a hospital and sit in a waiting room for hours just to see me for a few minutes.

When I first got to the ICU, I was on a clear liquid only diet, so when my friend John Saunders snuck me in a Mountain Dew, it was quite a treat. After much pleading with the nurse, it was decided that I could have a few sips. Doing the Dew over the years has become a trademark for me. It started in California prior to my first deployment when I realized that Saunders was a Mountain Dew fan as well. I would sneak two cans in my pack when we went out in the field for training, and wait until the conditions were at their worst. I would then sneak over to where Saunders was sleeping with the cans, and we would do the Dew in the crisp night air, underneath a canopy of stars that you can only see in the middle of nowhere. It is little things like that that keep you going when you are sick and tired of being dirty, eating MREs, and busting your hump all day. I would do similar things with my friend Ronnie, except with Butterfingers. One of us would discretely buy a Butterfinger, bring it out to the field, and we would secretly eat it during the worst parts of our training evolutions. Another method I came up with to keep morale high was to assign a celebrity impression to each member of my squad that they would have to perform on request. So when we were caught in the rain, or bouncing in the back of a dust filled 7-ton truck, or waiting for transportation for hours at a time, I would have them do their impressions, and it never failed to crack everyone up. My favorite impression was Martin Garcia doing Sean Connery. Primarily because he is about as far from Sean Connery as an individual can be. I can’t pinpoint an exact method to make it through difficult periods in life, but I am a firm believer that finding a way to laugh with your friends is essential. A scientist may say this is because of chemicals your body releases during laughter, but I think it is more psychological. It is about feeding off of the strength of a group. Knowing that all of you are in the shit together, and will come out of the shit together, even if one of you may need to sacrifice more than others. I know that personally I am at my best when other people are depending on me, and I think that holds true for most people, especially Marines. One of the best ways that I could contribute during these times was by improving morale via laughter, so I never let an opportunity to crack people up get by. I’ve done it so much over the past several years that now it comes naturally to me.

So here my friends and family were, by my side, letting me feed off of their strength, and feeding off of my strength. Just like in training at Twentynine Palms, just like in Iraq, just like in Afghanistan. And we were still thinking of ways to sneak in Mountain Dews, or crack each other up, because that’s how you do it when the hand you’re dealt isn’t worth betting. Their responsibility was to keep me going, and my responsibility was to keep them going.

Much like the last time I was in a hospital, being in the ICU was a lot like being a baby again. I just kind of laid there mumbling and drooling, with people coming in to look at me. I wasn’t doing much on my own; in fact my mother even brushed my teeth once or twice. My biggest challenges in the ICU were to keep my temperature down, and my oxygen uptake up. I hated having the breathing mask on, or the breathing tube in my nostrils, so I would take them out. The next time the nurse came in to take my vitals, however, my oxygen uptake would be below what they were looking for, so I would have to put them back in. At the same time, I had a recurring fever. When my temperature would go upwards of 100 degrees Fahrenheit, we would stuff icepacks in my armpits and on my chest and neck until it went back down to normal. My recovery was off to a slow start; I was still merely surviving. Once I got my senses back, it was game on.