LESSONS FROM THE MAIMED -- A NEW WAR HEIGHTENS INTEREST

IN THE TRAVAILS OF VIETNAM AMPUTEES

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Lessons from the maimed

A new war heightens interest in the travails of Vietnam amputees

Sunday, March 19, 2006
Rita Price
THE COLUMBUS DISPATCH


When Tom Morrow left the Marine Corps in 1970, he was handed two things: discharge papers and a leg.

No one promised to call and see how he was doing, he said. No one told him when, or whether, he should go to a hospital for checkups. Good luck, he heard people say.

Morrow was 19 years old. He had lost so much of his body to a "Bouncing Betty" land mine that he weighed just 89 pounds.

"They actually nicknamed me Baby-san," he said. "I looked young, and I was shy."

The shy part hasn’t changed. But Morrow is 54 now and stocky. In the years since Vietnam, the West Side resident has married twice, divorced once and suffered a heart attack.

He has tamed his anger, curbed his drinking and given up on finding a prosthetic limb that fits without pain.

The military doesn’t know any of this. Researchers say it hasn’t asked many questions about the fates and fortunes of an estimated 6,000 troops who lost arms, legs, hands and feet in America’s longest war.

"They know they’re out there," said Stephen Wilson, an associate professor at Ohio State University. "They really do not know what their life situation has been like."

Redoubled importance

If Vietnam veterans were the last to be maimed by war, their journeys might seem less timely. Three years ago, for example, one of the biggest issues facing Department of Veterans Affairs prosthetics officials was a wave of middle-aged men losing limbs to vascular disease.

Iraq and Afghanistan quickly created a new amputee profile.

Meeting the complex needs of the newly injured could become easier, Wilson said, if researchers could better understand those who fought and suffered before. The underanalyzed combat amputees of Vietnam make up the nation’s largest surviving group with a lifetime of amputee experience.

"We want to gather information about their health — operations, prosthetics, all that," Wilson said. "We’re trying to get into the psychosocial piece as well."

To fund the effort, the Department of Defense has approved $2 million for a partnership between Indiana University and OSU. University researchers are using it to establish the Indiana-Ohio Center for Traumatic Amputee Rehabilitation Research, a project unique in its focus on combat amputees.

"The goal is to register Vietnam amputees, identify them and build a databank," said Wilson, an associate professor emeritus in the School of Allied Medical Professions. "They can’t all be alive now, but there are probably thousands."

New medical-privacy regulations and aging, fragmented records kept by both the VA and the Defense Department have thwarted attempts to gather a master list.

Wilson said OSU and Indiana likely will reach out via newspaper ads, the Internet and national veterans organizations.

Morrow wishes the project well. He said he doesn’t want to complain about his injury or his life. Unless, maybe, it could do someone else some good.

Far different treatment

At least initially, the experiences of today’s amputees differ vastly from those of their predecessors.

In Vietnam, severely injured troops first went to mobile hospitals, then to Japan and on to scattered U.S. facilities.

Today, Walter Reed Army Medical Center in Washington is the giant, famous funnel for almost all amputees. "Some of these kids are here so fast they still have sand in their hair," said John Farley, who lost a leg in Vietnam. "And after we get ’em, we keep ’em. They’re in a womb."

Farley is a member of the Amputee Coalition of America and serves on the advisory board for the new Indiana-Ohio center. A retired federal judge, he spends part of every day as a peer visitor on Ward 57 at Walter Reed.

"As of yesterday, there were 395 amputees from Operation Iraqi Freedom and Operation Enduring Freedom," Farley said in an interview earlier this month. "We know them. We’ll continue to know them. We’re gonna keep track, because that’s how you learn."

Farley remains gracious when he talks about a lack of data on Vietnam amputees. "Different times, different places, different cultures," he said. "The country was totally confused then. It made the mistake of associating the troops with the policies."

The attention paid to this new wave of amputees is, by comparison, intense.

Politicians, military brass and movie stars visit Walter Reed regularly; journalists put their names on six-week waiting lists for the chance to speak with and photograph someone whose arms or legs were blown off by a roadside bomb.

"They’re rock stars," said John Loosen, a Vietnam amputee who now works as an eastern-region prosthetics chief for the VA.

Top-notch treatment is expected and given. Instead of one limb, new amputees might receive multiple state-ofthe-art models: an everyday leg, a leg for running, a leg for showering.

"Our intentions were to be able to walk," Loosen said. "For the new generation, walking is a gimme. Their goals are to maintain the lifestyle they had."

Assistance abounds, and that’s great, Farley said.

But eventually patients leave the hospital and graduate from rehabilitation programs. Knowing more about the postwar life of the Vietnam amputee, Farley said, should make it easier to advise and monitor forty- and fiftysomething Iraq amputees.

"Just like every war, this one’s going to go away someday," said David Gorman, a Vietnam amputee and the executive director of Disabled American Veterans.

"What happens then? I’m 57 now. What’s going to happen when these kids are 57? Will the VA be around? How do we make sure we’re preserving what they’ll need?"

Lingering effects

Early portraits of surviving Vietnam amputees have emerged from previous, smaller studies of patients treated at the same hospital.

Initial medical care appears to have been adequate, said Wilson’s partner at Indiana, Mark Sothmann. Quality-oflife issues are another matter.

"We know we’re going to have to delve into that more," said Sothmann, dean of the School of Health and Rehabilitation Sciences.

According to the VA, the studies showed that future success and satisfaction depended less on the severity of injury than on the amputee’s coping skills, family support and access to vocational rehabilitation.

Still, one 1982 report on Vietnam amputees showed that they were twice as likely to be unemployed as were uninjured Vietnam veterans. Amputees also earned less money, held more blue-collar jobs and obtained fewer college degrees, the VA said.

They appear to suffer high rates of heart and vascular disease, skin irritation, persistent pain and problems with their prosthetic sockets.

"The amputee is an individual changed," said Joe Andry, who lost a leg in Vietnam.

Andry works as a veterans policy analyst and liasion for the Ohio Department of Job and Family Services. He mastered the labyrinthine VA system early. Not everyone does.

"There are services out there, but you might not know about them," he said.

To obtain the help or care he needs, an amputee might need to move among programs run by the VA, Defense Deparment, Department of Labor or veterans organizations, Andry said. "I think it’s going a lot better, but it’s still a matter of connecting folks," he said.

For today’s amputees, the first such bridge to be crossed is the move from an all-inclusive military hospital such as Walter Reed to the sprawling, clinicbased VA health system.

"There is something of a feeling of abandonment when you leave that military environment," said Loosen, the VA prosthetics chief. "But we’re really trying hard to keep track of them, to understand the needs of the younger serviceman."

Steve Miller, a former veterans affairs liasion for the city of Columbus, said he hopes Iraq amputees receive more outreach services.

"If a new arm were to come out that would benefit me, I’d love for someone to call and say: ‘Hey, Steve. How about this?’ "

That never happened for Miller or for his friend Tom Morrow.

"Guys get tired of dealing with a prosthesis that doesn’t feel right, so they toss it in a closet," Miller said.

He thinks the VA and other care providers should try to appear less rigid. "If it’s going to improve an amputee’s life, get it for him," said Miller, who is blind, missing much of one arm and once persuaded the VA to give him the equipment he needed to make an adaptive fishing pole. "If it’s going to help him be independent, approve it."

Miller has suffered additional insults because his injury didn’t come at the hands of the enemy. While out on an ambush, the 18-year-old paratrooper had to move an anti-personnel mine.

It went off. "I’m not sure what hurt me worse," Miller said. "The mine or the 40 feet of jungle it tore me through."

Weeks later, a general pinned a Purple Heart on his pajamas. The Army notified him that he was ineligible and told him to give it back.

"I’ve got it, and you can’t have it," he responded.

Miller was then instructed not to wear it.

"I’ll wear it wherever the hell I want to wear it," he said.

But he doesn’t. Miller put the unofficial Purple Heart in a case with his other medals. After 38 years, he’s no longer interested in arguing.

Morrow said he isn’t mad anymore, either.

"I didn’t realize this until about 10 years ago, but I was angry because they didn’t give me any options," he said.

No one said he could stay in the Marines at a desk, or find a way to work abroad and "see the world," as he’d dreamed.

After multiple surgeries to close his abdomen, repair deep burns and remove the full length of one leg, Morrow was told that the only thing left to determine was his disability.

"That hearing lasted 20 minutes," he said. "I was done. Like a piece of meat."

Morrow joined veterans organizations and became an American Legion post commander but never settled into a career.

He worked as a tow-truck dispatcher and a shipping clerk and put in eight years at a General Motors plant before retiring.

Some of today’s amputees remain in the service, even jump out of planes again, Morrow hears. Still, "I feel so bad for them. I think about this war," he said. "It totally upsets me."

A few days ago, Farley sat at Walter Reed with "a really beautiful young girl who’s been mangled."

In three months, six months, a year or so from now, he hopes that she and others like her are receiving the phone calls and invitations that Vietnam amputees did not.

"Bring these kids back in," Farley said. "Ask how they’re doing."

rprice@dispatch.com 

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Larry Scott

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