By Gloria Montgomery, Army MedicineNovember 29, 2011
FORT HOOD, Texas (Nov. 29, 2011) -- With the Civil War and its death toll weighing heavy on his soul, President Abraham Lincoln would often find solace visiting wounded Soldiers at Washington-area military hospitals. During one of these visits, Lincoln witnessed an amputation procedure on one of his Soldiers.
Shocked at the surgeons' enthusiasm with their knife skills and indifference to their patient, a troubled Lincoln asked them a poignant question: "But what about the Soldier?"
Ten years of non-stop war has revolutionized the way the Army is treating its wounded, ill or injured Soldiers. Gone are the days when the Army would tell Soldiers "good bye and good luck" after handing them their discharge papers.
Today, thanks to a sea change in cultural and organizational philosophy, the Army of the 21st century is going "New Age" in healing the mind, body and spirits of its hurting and ill. In a nutshell, Army leadership is telling the Soldier, "It's OK if you hurt. We're going to let you heal and take care of you and your family until you do."
To recognize the invaluable sacrifices of our wounded, ill and injured Soldiers and their families, the Army annually dedicates November as Warrior Care Month to celebrate their unlimited potential and to raise awareness and support for the many programs and initiatives designed to help them heal and transition.
For the Soldiers, cadre and civilians of the Fort Hood Warrior Transition Brigade, or WTB, warrior care is a year-round challenge, defined by its creed: Soldier's First; Soldiers Always.
"Soldier care is the center of our foundation," said Maj. Jason Good, commander of Company F, on the WTB's commitment to helping Soldiers heal and transition back to either Soldiering or as a civilian member of the community. An Army Reservist who was a military analyst for the Center for Army Lessons Learned in his civilian vocation, said warrior care to him is about relationship building as both a teacher and a mentor.
"To be good at what we do we have to be life coaches," he said. "All we're doing here is using a common sense approach in the overall care of the warrior. Our Soldiers are no different than 'line' warriors. They just have serious medical issues."
An abundance of outdoor activities such as exotic game hunts and fly-fishing trips are helping wounded warriors redirect their energies miles outside the Fort Hood gate to South Texas or Lake Texoma, courtesy of nonprofits like the Rocky Mountain Elk Foundation and Project Healing Waters, among several organizations with close ties to the WTB.
Adapative sports such as Ride 2 Recovery bike rides are challenging a Soldier's endurance level while the Department of Defense-sponsored Warrior Games are demonstrating athleticism is not about disability, but about ability. More importantly, for the Soldier who soon will be trading Army Combat Uniforms for a two-piece suit, Operation Warfighter's job internship program is arming Soldiers with the tools to walk confidentially down the path of success, and, more often than not, a job with a federal agency.
Doing what's right and makes sense, said Capt. Laveeta Springer, officer-in-charge of the brigade's medical team and former nurse case manager for WTB's Company B, wouldn't be possible without a great leadership team.
"It's always been about collaboration," Springer said about WTB leadership, most of who come to the WTB from line units. "We're not stifled. I've never heard, 'do it my way, or no way.'"
This professional autonomy, she said, not only boosts morale, but also provides her nursing team the freedom to think outside the box, take risks and try new things. The results, she adds, are incorporated into a Soldier's Comprehensive Transition Plan, or CTP, which combines the Soldier's physical pain, mental state and emotional attitude into a holistic approach to healing, not just the part that hurts, but the heart and soul as well.
Moreover, according to Peggy Thomas, Company B nurse case manager, these risks sometimes promote healing that can only be called a miracle.
"I had a Soldier who had severe TBI (traumatic brain injury), so we sent him to a specialized clinic," she said. "Four months later, I didn't even recognize him. He was standing up straight, didn't use a cane, didn't stutter. All I could say was, 'Oh my God, it's a miracle.'"
Innovative therapies such as massage and acupuncture to relieve stress and manage pain are also popular alternative therapies as are four-legged creatures, whether it's a horse in the Horses for Heroes program or mutts in Divine Canines, who are unknowingly helping soldiers "reconnect" with their softer side simply by touch.
For Sgt. Able Duran, the twice-monthly Comfort for America's Uniformed Services, or CAUSE-sponsored massage sessions, when synched with his acupuncture and chiropractic treatments, knock out his pain so much that his snoring will often wake him up from his treatments. Hesitant to try anything "different," Duran said, chronic pain was his catalyst to try anything the Army offered.
"I'm now a believer," he said.
There's a very profound benefit to touch, according to Viola Crowder-Moger, who coordinates the CAUSE-sponsored massage and Reiki sessions for warriors and their caregivers.
"The results can't be denied," the licensed massage therapist said, adding that she commends the military for opening itself up to try alternative therapies in their search to care for its Soldiers and families in absolutely the best way they can.
FACTORING IN THE FAMILY
But it's not just about healing the Soldier.
"You case manage the whole family," said Thomas. "Soldiers don't come here alone. They come with a family."
In addition, according to Springer, family involvement adds a second set of eyes to the healing equation, a critical link otherwise not available to the Soldier's triad of care: the squad leader, nurse case manager and physician.
"It's so important that we get to know the family because they help us paint a better picture of the Soldier because they'll tell us things the Soldier might not want to share with us," she said.
No one knows that better than Roberta Lathrop, whose husband was injured in Afghanistan and is now assigned to Company D. In the beginning, she was accompanying her husband to every medical appointment, which the WTB encourages spouses to do. Now, she said, he's confident enough to go it alone to his medical appointments.
"You have to let them know that all they need to worry about is healing," she said.
In fact, she is so grateful to the WTB for welcoming family involvement in the healing and transitioning process, she volunteers Tuesday through Saturday to pour ceramic molds for WTB Soldiers and family members to paint during the Soldier and Family Assistance Center's, or SFAC's, twice-weekly expressive arts classes.
Estimating that she has poured well over 1,000 molds this year, she said it has allowed her a way to give back to those who have helped in her husband's healing and transitioning, in addition to witnessing a Soldier's recovery process.
"I'll sit there and watch them use heavy colors in the beginning, and in time, see them begin to use brighter colors. It's very rewarding for me to see that," she said, emphasizing that projects like ceramics help Soldiers think about something besides their injuries, relax and meet other people. "If you sit there and worry all the time, you're not going to heal."
Visiting with family members also allows squad leaders and platoon sergeants like Sgt. 1st Class Thomas Cherry of Company F, to bond with family members, to see how they live and to see if the spouses need any help.
"We also educate them on the numerous SFAC services available to them as a spouse," he said, adding that WTB spouses are entitled to free child care, marriage counseling and stress-management classes, as well as one-on-one financial counseling sessions with SFAC's financial advisor to help improve or repair credit scores.
Over time, caring for a loved one can overwhelm a family, which is extremely detrimental to a Soldier's recovery.
"Family members get burned out," Thomas said, adding that sometimes it might be as simple as the spouse just needing someone to talk to while other times it might require respite care to provide short-term relief to the overstressed caregiver. "If a family member isn't doing well, it affects the Soldier."
For Heidi Fuller, whose husband is in Company B, the Wounded Warrior Project's sponsorship of the monthly WTB Spouses Day Out gives her permission to take a day off.
Besides enjoying the VIP treatment at local spas, sharing her thoughts and feelings with other spouses has provided her with an emotional release because it has validated some of the guilt she was feeling after her husband came home from war a different person.
"When your husband gets home, you think he's going to be normal, but it's not like that," she said. "Then you get angry at yourself and then start feeling guilty about being angry. By sharing your thoughts with the other spouses, you realize you're not the only one feeling that way."
THE CORNERSTONE OF CARE: THE COMPREHENSIVE TRANSITION PLAN
Key to a Soldier's recovery and subsequent transition is the Comprehensive Transition Plan, or CTP, which enables the team that manage a Soldier's care, to all be on the "same sheet of music" and know exactly what the Soldier is thinking and feeling and how he or she is progressing in the transitioning process. The CTP addresses every aspect of a Soldier's life: social, spiritual, physical, family, nutrition, financial, career and emotional domain, as well as tracks everything medically related such as appointments, medications and specialized care.
According to Janique Parnell, who supervises all the brigade's social workers, the CTP has been invaluable in improving behavior health care.
"Automated CTP has opened doors for us," she said, "because the Soldier is now speaking more freely, thanks to the self-evaluation portion of the CTP. It's a wonderful process because the Soldier owns it."
The tracking portion of the CTP also ensures Parnell and her social workers that the Soldier is getting the help he or she needs. Parnell said that at first, the CTP process can be overwhelming because of all the tasks that go with it.
"It takes a moment really to soak it all in because it's so different from anything Soldiers have ever done before," plus, she adds, they don't understand the process here. "'You mean you really care about my family?' Yes, we really do."
Parnell said that once the hurdles of acceptance and trust are broken, then the transitioning process goes well.
Thomas adds that some Soldiers may not like to talk because they don't like any kind of confrontation, good or bad, but being able to write down their feelings helps them because they avoid the face-to-face confrontation.
Soon to be medically retired, Staff Sgt. Eric Madden, Company B, said the CTP has helped him plan his future.
"It addresses issues you're having and guides you to the right resources to resolve them, however," he said, "you've got to be honest about your answers for it to work for you."
"If a Soldier does has an issue, but doesn't want to tell me personally about it, I'll get wind of it because he's put it on his CTP, and together, we'll try and resolve it," said Staff Sgt. Joseph Ruda, a squad leader with Company D.
"Every day is different," said Ruda about the 10 Soldiers whose care he manages. "Some Soldier issues are the same, but the majority of days they're different. And as a squad leader or platoon sergeant, it's imperative you know your Soldiers and their issues and take care of them."
Although the demands of 24-hour duty days, seven days a week can wear on you, Ruda said, being a WTB squad leader has been the most rewarding of his career.
"If they had cadre as a military occupational specialty, I'd request it," the 20-year career Soldier said. "I enjoy doing what I do. Yes, it gets annoying and frustrating, but it's worth it because in the long run, they're still Soldiers."
No one is more thankful for the dedication of the WTB's squad leaders and platoon sergeants than Sgt. 1st Class Roderick Johnson's mother, Janice Johnson, who also is a WTB civilian employee. Diagnosed in February with stage four liver cancer, her 40-year-old son was transferred to the WTB from the Fort Bragg, N.C. Warrior Transition Unit in April.
"I've seen the dedication of WTB's cadre firsthand," the social worker assistant said. "I can't say enough about the men and women of Company A because they are continually by his side, monitoring his care, taking him to doctor's appointments, making sure he's comfortable and making sure he has the meds he needs. They've been invaluable in their support of my son and have been such a comfort to me."
Moreover, she said, that when her son's squad leader visits her home-bound son, his bad day disappears.
"He can be really down, but when he sees those ACUs," she said, "his eyes light up and his demeanor changes. They really care about their Soldiers, and it's not because I work here and he's my son: He's first, and foremost, a Soldier."
LIFE BEYOND THE ARMY
Once WTB Soldiers heal and are ready to transition, they have two options: Soldiering on or moving on in civilian life.
"Of course we want our Soldiers to get back into the fight," Thomas said, "but we understand that some can't, so we want them to transition successfully as veterans."
To help Soldiers in that process is WTB's internship program, which program director Anthony Thomas said, often translates to full-time employment in a federal agency.
"It doesn't matter what skill set an agency is looking for because they're willing to teach those to Soldiers willing to learn them," he said, "because it's not about meeting certain criteria or what their MOS (military occupational specialty) was, it's about bringing different dynamics to the team, such as discipline, leadership and ethics."
In fact, Sgt. 1st Class Johnny Shull, who said getting out of the military after 22 years is pretty much like falling off a cliff, knew his fuel-handling experiences wouldn't land him a job, however, after attending WTB's November career fair, he found out his management, administration and bookkeeping skills would.
"Knowing that and learning how to tailor my resume has boosted my confidence in finding a job," he said, adding that he is hoping to start an internship soon with the Army Corps of Engineers.
Sgt. 1st Class Benjamin Paschall's internship with Fort Hood's Directorate for Emergency Services is his dream job, he said, and is grateful to the WTB for having the program because when he got out in 1988 after serving eight years active duty, all he got was a handshake.
"That was it. You're on your own," he said, who at the time was married and had two kids. "Today, they help find you a job. Everything is waiting for you. All you have to do is apply yourself."
Nothing is more rewarding for Thomas, he said, then seeing the fear disappear from the faces of his Soldiers when they land jobs.
"There's an enormous amount of worry and stress on both the Soldier and the family during the transitioning process because they're venturing into the unknown," he said. "That's why it's such a beautiful thing to witness the Soldier go from intern to direct hire."
Good praises WTB's work program because it provides Soldiers, especially his remote care Reservists and National Guardsmen, with opportunities to build resumes, explore employment interests, develop job skills and gain valuable work experience in the community where they live.
Surprisingly, Good said, a misconception about Reservists and Guardsmen is that they have a job to return to when their active-duty stint is over.
"We think just because they're 40 and older that they've a career," he said, "however, we've discovered more than half of them don't."
Because of that, Good said, pushing the transitioning process in their face is key to their success.
"I'm not telling them they might transition, but that they're going to transition, so let's just get it started now," the former military science professor said. "You're not going to be sitting at home. You're either going to be in school, working or at a medical appointment."
For remote care Reservist Spc. Huard Harral the work program has allowed him to segue from employee to intern with the same agency he had been working for before he was activated: the Fort Worth Independent School District's ROTC program. Previously a ROTC instructor, the 37-year-old Citadel graduate is now writing curriculum, developing PowerPoint lessons and creating teacher and student workbooks. Once he is healed, Harrell hopes to return to full-time employee with the FWISD.
"I'm in a truly unique situation because of who my civilian employer is," said Harral, who suffered severe injuries when he fell from a 35-foot obstacle course during training. "Being afforded this opportunity has been a huge boost to my morale because I wouldn't have this opportunity if not for the WTB."
Soon to hang up his ACU's, Staff Sgt. Madden said his time here as been valuable in helping him heal and develop skills to succeed in the civilian world. He's also thankful for the "fun" times here at the WTB like the hunts and the fishing trips, but more importantly, that the Army didn't forget about his family in the process.
Sgt. James Earl Jones, who is 54 years old, of Company C, is grateful to the WTB for giving him the gift of time: Time to heal, time to go to school and time to sort things out. A supply technician with the Texas National Guard, Jones credits WTB's policies and programs with keeping him "on point" so he could focus on healing.
"It's a blessing, really, that someone put this kind of plan in place because without a WTB, I probably would've have been medically discharged," he said.
And that's what Janique Parnell likes to hear.
"The idea is when you transition out of here, you can say for having been here and the services that we've provided, you have determined that you're a better person," Parnell said, "Outside of making sure you're safe, we've gotten you connected to the right person and the right places for care. The rest is up to you."