Iraq: Our Responsibility Back Home

The mainstream media places so much emphasis on the death toll in the continuing Iraq War, it sometimes seems too little attention is paid to those who endure life-altering wounds.

In a powerful New York Times article earlier this year, Denise Grady looked at a unique phenomenon of the war by spotlighting a 23-year-old Marine corporal, Jason Poole.

"Men and women like Corporal Poole, with multiple devastating injuries, are the new face of the wounded, a singular legacy of the war in Iraq. Many suffered wounds that would have been fatal in earlier wars but were saved by helmets, body armor, advances in battlefield medicine and swift evacuation to hospitals. As a result, the survival rate among Americans hurt in Iraq is higher than in any previous war - seven to eight survivors for every death, compared with just two per death in World War II.

"But that triumph is also an enduring hardship of the war. Survivors are coming home with grave injuries, often from roadside bombs, that will transform their lives: combinations of damaged brains and spinal cords, vision and hearing loss, disfigured faces, burns, amputations, mangled limbs, and psychological ills like depression and post-traumatic stress."

As for Jason Poole, he returned from Iraq with severe brain damage after getting caught by a bomb. Subsequently, he has had to relearn how to talk and walk. Some injuries he can do nothing about -- blind in one eye and deaf in one ear, and with a new face largely rebuilt through skin and bone grafts held together with titanium screws and plates.

Poole is hardly alone, as the Times points out:

"So many who survive explosions -- more than half -- sustain head injuries that doctors say anyone exposed to a blast should be checked for neurological problems. Brain damage, sometimes caused by skull-penetrating fragments, sometimes by shock waves or blows to the head, is a recurring theme.

"More than 1,700 of those wounded in Iraq are known to have brain injuries, half of which are severe enough that they may permanently impair thinking, memory, mood, behavior and the ability to work.

"Medical treatment for brain injuries from the Iraq war will cost the government at least $14 billion over the next 20 years, according to a recent study by researchers at Harvard and Columbia."

The Times' Denise Grady paints a strikingly vivid picture of Jason Poole's personal odyssey, which began when he was hit by a bomb during foot patrol:

"Shrapnel tore into the left side of Corporal Poole's face and flew out from under his right eye. Metal fragments and the force of the blast fractured his skull in multiple places and injured his brain, one of its major arteries, and his left eye and ear. Every bone in his face was broken. Some, including his nose and portions of his eye sockets, were shattered. Part of his jawbone was pulverized.

[...]

"An array of therapists -- speech, physical, occupational and others - began working with him for hours every day. He needed an ankle brace and a walker just to stand at first. His balance was way off and, because of the brain injury, he could not tell where his right foot was unless he could see it. He often would just drag it behind him. His right arm would fall from the walker and hang by his side, and he would not even notice. ..."

His greatest concern was getting used to his new face:

"'Dr. H. Peter Lorenz, a plastic surgeon at Stanford University Medical Center, planned several operations to repair the damage after studying pictures of Corporal Poole before he was injured. 'You could say every bone in his face was fractured,' Dr. Lorenz said.

[...]

"Operations in March and July repaired his broken and dislocated jaw, his nose and damaged eyelids and tear ducts. He could not see for a week after one of the operations because his right eye had been sewn shut, and he spent several weeks unable to eat because his jaws had been wired together.

"Dr. Lorenz also repaired Corporal Poole's caved-in left cheek and forehead by implanting a protein made from human skin that would act as a scaffolding and be filled in by Corporal Poole's own cells.

"Later, he was fitted with a false eye to fill out the socket where his left eye had shriveled.

"Some facial scars remain, the false eye sometimes looks slightly larger than the real one, and because of a damaged tear duct, Corporal Poole's right eye is often watery. But his smile is still brilliant.

"In a recent conversation, he acknowledged that the results of the surgery were a big improvement. When asked how he felt about his appearance, he shrugged and said, 'I'm not good-looking but I'm still Jason Poole, so let's go.'"

Although experts say escalating numbers of brain injuries and amputations in modern-day warfare have eclipsed that of previous wars, even in Vietnam, it is only part of the story.

Also of concern are the rising incidents of post traumatic stress disorder.

The mental toll of the war cannot be stressed enough. As Boise Weekly recently noted, a Department of Veterans Affairs study found that 28 percent of combat veterans returning from Iraq and Afghanistan (about 24,000 troops) have been diagnosed with mental disorders, "a number on par with the number diseases of the musculosketal/connective system (36.9), digestive system (28.3) and diseases of the sense organs and nervous system (25.1)."

All told, according to a recent study by Nobel Prize-winning economist Joseph E. Stiglitz, the final price tag for the Iraq War might exceed $2 trillion.

Whatever the ultimate cost, a sizable chunk will be providing lifetime health care for veterans. Salon's Mark Benjamin explains the Stiglitz study:

"The study considers a number of hidden costs, including the price tag of caring for the 20 percent of wounded soldiers returning from Iraq with 'major head or spinal injury,' plus amputees and soldiers with 'blindness, deafness, partial vision and hearing impairment, nerve damage and burns.' The study figures that 3,213 soldiers who have suffered head or brain injuries in Iraq, for example, will need lifetime care that could total from $600,000 to $5 million per soldier.

"The study also includes scenarios where some veterans will need care for 20 or 40 years. It also estimates, based on trends from the Persian Gulf War, that additional veterans will later need disability checks from the Department of Veterans Affairs to compensate them for a wide range of service-related health problems, at a price tag of at least $2.3 billion per year, for decades."

Meanwhile, the Bush Administration continues to consider the Department of Veterans Affairs something of a budgetary afterthought. In April 2005, Congress infused the agency with an emergency $1.5 billion because VA needs had been drastically underestimated. Even with the additional funds, veterans groups indicate that VAs throughout the nation are weathering staffing shortages and overwhelmed resources.

And in a vile bit of cost-cutting, the Administration is currently reviewing the benefits of some 72,000 veterans who have been deemed totally disabled and unemployable as a result of PTSD.

To some extent, the debate over the Iraq War is now largely sophistry. Even though plenty of people on both sides of the issue (including your humble blogger) like to make nasty little digs at the other side, the argument over Iraq is pretty much moot, folks. Right or wrong, we're there, and there really isn't much of an option to leave that devastated country until we can do so with a modicum of moral responsibility. In other words, preserving life needs to be priority No. 1.

As an opponent of the war (although I have to admit, much to my chagrin, that I had begun supportive of it), I will concede that I have spoken with several families whose loved ones died in Iraq, and who were grateful for private meetings with the president. In those sessions, they told me, Bush was tearful and genuine -- and it meant a lot to those who were enduring such loss.

Consoling words are nice, but they do not repair lives. It is absolutely critical that the Bush Administration -- and successive administrations, for that matter -- meet their obligation to our nation's veterans.