One soldier’s survival story

One soldier’s survival story
By John Boyle

The roadside bomb ripped through the Humvee and the soldiers riding inside, tearing flesh from the bone and pelting them with hundreds of bits of shrapnel.

Jonathan Pruden, a lieutenant at the time and a former emergency medical technician, saw one of his feet dangling by a flap of skin. He knew he’d been hit bad and called for a tourniquet immediately.

Today, nearly 18 months after that attack in Baghdad, Pruden knows just how lucky he is – despite 16 surgeries, constant pain and injuries that still leave him unable to walk.

“I would’ve died even 20 years ago,” said Pruden, a graduate of Reynolds High School and Appalachian State University who joined the U.S. Army Reserves at age 17 and was commissioned in 2001. “I took 15 units of blood in the first 48 hours after the attack.”

Pruden, 27 now and a captain in the Army’s 3rd Division, is stationed at Fort Stewart in southeastern Georgia. He is also one of the 10,369 American soldiers wounded in Afghanistan and Iraq (as of mid-November). Of those injured, 1,004 died – a survival rate of roughly 90 percent.

It’s the highest survival rate of any war in U.S. history. For instance, in the Vietnam War, one in four wounded soldiers died, nearly all of them before they could reach mobile surgical hospitals.

Despite the high survival rate, the injuries are not less severe, according to a recent report in the New England Journal of Medicine. In fact, many young soldiers have had faces, arms and legs blown off and are now returning home badly maimed. They have survived because of Kevlar vests and quick treatment in the field.

“This is unprecedented. People who lose not just one but two or three extremities are people who just have not survived in the past,” said Dr. Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston who researched military medicine and wrote about it in the Dec. 9 New England Journal of Medicine.

The journal notes that although “firepower has increased, lethality has decreased.”

“The critical core, your chest and your abdomen, are protected,” Dr. George Peoples, a Walter Reed Army Medical Center surgeon who served in Iraq and Afghanistan, said, referring to Kevlar vests. Parodixically, what we’ve seen is devastating extremity injuries because people are surviving wounds they otherwise wouldn’t have.”

One soldier’s recovery

In Pruden’s case, his personal physician recommended amputation on several occasions, mostly because his injuries were so severe and amputation would allow him to become more functional sooner. But he’s opted for reconstruction.

“My thinking is we could always do more later if it didn’t work out, but we couldn’t put it back,” Pruden said.

As it stands now, he has no feeling in his lower left leg and is missing his left pinky toe. He has gross deformities to both feet, and his right leg is about two and a half inches shorter than his left. His right ankle is fused, and he can’t bend it.

He also has limited range of motion in his left arm from “a baseball-sized hole” in his shoulder blade.

“That piece of shrapnel lodged against my spine, and the doctors left it there because it was safer,” Pruden said. “I’ve still got about 150 pieces of shrapnel left in my body.”

In constant pain, Pruden relies on OxyContin for relief and realizes he’s become addicted to it even though he’s steadily weaned himself to smaller doses. Right now, his main job is to diligently perform his physical therapy and try to regain use of his legs, he says.

He’s been in five different hospitals, from Kuwait to Walter Reed to Brooke Army Medical Center in Texas. He has seen progress from all the surgery, albeit it’s been slower than he wanted.

“I think I’ve made great gains as far as the reconstruction of my limbs,” he said. “I’ve gotten up on crutches and walked on crutches, but right now with the tendons sticking out, I have a lot of swelling and bleeding. Until I can get in and have that operated on, I’ll be off my feet and in a wheelchair.”

Despite the difficult recovery, Pruden has a positive attitude about his recovery. He’s working on his master’s degree in public affairs at the University of Florida in Gainesville, and he plans to get a civilian job in that area when he’s discharged from the Army.

He’s quick to say that he’s leaned on his wife, Amy, physically and emotionally.

“Mostly I’ve gotten through it by talking about it with other wounded service members,” Pruden said. “And my wife has been my emotional support. She was there every day in the hospital, and that kept me going.”

Such an outlet is vital to psychological recovery, experts say. Injured could flood hospitals

America’s 158 Veterans Administration hospitals are readying themselves for heavy usage from Iraq veterans. Among the 45,880 veterans of Operation Enduring Freedom in Afghanistan who have left active duty, 5,113 have sought health care from the VA.

That 11 percent rate of utilization is lower than the 16 percent rate among the 168,528 Iraqi Freedom veterans who have left active duty, according to statistics from the Department of Veterans Affairs. That indicates that more soldiers are being wounded in Iraq and will require care.

Locally, the VA hospital in Oteen has not been deluged with returning veterans.

“We’ve only had about six people come through for any medical care,” said hospital spokesman Jim Williams. “Most of those are for musculo-skeletal issues. Most of those (injured veterans) have already been treated at Walter Reed and then they’re relocated back to base.”

With a high number of mountain-area reservists serving in Iraq, though, the demand for services could rise. Four units have been deployed to Iraq or Afghanistan already.

Dealing with concrete shrapnel

Staff Sgt. Mike Himsey, 48, says he’s got “nothing but high marks” for the local VA. for them. Himsey, a Murphy resident and member of the 210th, was injured July 8, 2003, when the Humvee he was riding in got hit by a roadside bomb.

“My ear was hit with shrapnel, and I did have some loss of hearing,” Himsey said. “I was in the turret, and we had body armor up to your neck. The space in between the body armor and the helmet was where I got all my injuries. It threw quite a bit of concrete in the back of my ear, and all around the back of my neck.”

Himsey needed 38 stitches to close up the wounds and required surgery at Walter Reed. After going through physical therapy, Himsey went back to Iraq on Feb. 7 of this year and served out his tour, returning in June.

“For me, my wife and I had talked about it, and it was really a mind recovery for me to go back,” Himsey said. “I really needed to go back to be with my men. If I hadn’t gone back, I would’ve felt like I was letting them down.”

Although he’s back working as a toolmaker for MGM Brakes in Murphy, Himsey still has some discomfort and lacks full range of motion in his neck. He frequently stretches out his neck as he’s walking around the plant, but he’s recovered about as fully as he’s going to.

Not that he’s complaining.

“Compared to other soldiers it wasn’t too awful bad,” he said.

Pruden, too, is remarkably humble about his injuries. He’s more interested in advocating for other soldiers and trying to see that they can work their way through the massive bureaucracy that awaits injured vets.

And he wants the American public to be aware of the sacrifice soldiers are making in Iraq and take it upon themselves to make sure veterans have decent housing and medical care.

“I think some people don’t grasp the numbers and severity of the wounded soldiers that are coming back,” he said.