The Broken Soldier

There have been a few bumps along the way, but altogether my experiences here at Knox have been better than I expected.  Some even good.  Few very good/excellent.  My primary care manager has truly been a blessing, and is truly about as good a doctor as I’ve seen - military or civilian.

Overworked, and overwhelmed I’m sure, he has done his best to manage my pain and attend to my other medical needs.  When a medical matter is beyond his ken, he refers me.  When I ask for something or to try a certain method, he listens, and 99/100 times assents.  He recognized very early on, to his credit, I am not your average junior enlisted soldier.

He’s done a great job annotating every symptom.  Every change - good or bad.  What works.  What hasn’t.  And he’s based his opinions re: prognosis, treatment plan, etc. on what’s known (rather than on ignorance as some here have done in the past).  When I have a question, he answers it, regardless of how long it takes.  He goes the extra mile for me.  He treats me with respect, and seems to admire and appreciate my level of understanding and involvement in my treatment plan.  A plan in which I am given choices regarding what will and what won’t be done.  I must assume he does the same for every soldier under his care.  We are fortunate to have him.

My Medical Evaluation Board was formally initiated this week.  I trust, because of my primary care manager’s efforts and proficiencies, the process will move with relative speed and its conclusion will be fair.  I see a neuropsychologist when I return from Thanksgiving pass.  My PCM and I have already arranged a meeting to go over the neuro’s narrative to make certain all is in order.

Once complete, I’ll do two physicals - Phase I and Phase II.  Then I enter the Physical Evaluation Board - a point in the process during which a disability rating is assigned based on impact of injuries and syndromes on my ability to perform my primary MOS.  I have no doubts that will run smoothly and fairly too ( a belief based almost entirely on Doc F’s care).  The Army needs more docs like him.

I’m writing in reverse chronology.  Cuz I’m fucking artistic and shit (that’s for you JR).

Okay, the smelly guy.  He’s my neighbor.  Italian.  Mexican.  It’s hard to tell.  We’ve not spoke more than two-three words to each other since I’ve been here.  My other neighbors claim the same.

Lately smelly guy has been smellier than usual.  There was talk of a forced shower: Comet and toilet brushes.  The “bucket over the door trick” but instead of water or whatever, this bucket’d be filled with Listerine.  Getting cadre involved.  All good ideas if we were middle school kids.  Smelly guy is smelly because he’s sick.  Seeing the inside of his room, with everything packed against the back wall, only further supported the ‘he’s sick’ theory.  Punishment - meted out by us or by CoC - is the last thing smelly guy needs, but probably the first thing he’ll get.  I shared my concerns for smelly guy with my case manager.  Hopefully she’ll be able to do something before ’soldier justice’ pushes this man over the edge.

Neurosurgeon.  Weird tics.  His eyes roll to the back of his head, and his eyebrows ebb and flow as with a turned seascape.  Each sentence punctuated with what was either a moue, lour, or strabismus.  JR wanted to punch him.

But he did have good info, in spite of his “Ouch!  I’m being raped by a Mountain Gorilla” expressions and gesticulations.  “Good” as in supported by current lit.  He saw no reason for open back surgery.  Instead he recommended an electrical implant.  The implant should help with the radicular symptoms, but the low back pain, probably not so much.

I may have to go to Walter Reed to have the implant done.  Holy Jesus, please keep me from that fucking place.  Look COLs and SGTs, I’m better.  No really.  See?  (Standing straight and walking with a “I’m being raped by a Mountain Gorilla” grimace of my own.)

I was pulling CQ last night.  Possibly the most boring duty a military member can perform.  Watch movies, drink soda, shoot the shit, and smoke with a few phone calls and leave sign ins between.  The only good thing about CQ, or so I thought until last night, is that one who’s pulled CQ gets the next day off.

Last night I met a Lieutenant Colonel.  She’s here at the WTU for reasons similar to mine.  An Army doctor fucked her.  Not proper fucked her, but in treating her destroyed her quality of life now and for the foreseeable future.  We talked for a good 20 minutes out in the cold.  I shared my tales of woe.  She shared hers.

She also gave me hope that change is coming.  She and I agreed that the way things are is not acceptable.   She assured me the kind of change that will better things - even for those too stupid to realize change is needed - is in the pipe.  She also reassured me that what I’m doing here, on this site, is right and to never be afraid to stand against what’s wrong.  As she left I said, “God bless you.”  She responded, “God bless you, and I got your back.”  Coming from a woman who started enlisted, has made it to LTC, worked at the Pentagon, etc., that meant a lot to me.  It gave me hope that the change I’ve been advocating here for the past year and half is possible.

J.R.’s in similar shape.  His entire back is worse than mine.  My lumbar is worse than his.  He’s former Army, MI.  Medically discharged.  Worked as a VA rater for many years before complete medical retirement (IU).  Now he spends a good portion of his time helping wounded/ill service members obtain the benefits they’re entitled by law.  He’s a very bright man, and I’m happy to have him aboard.

One can always count on Aurthur for a slice of depressing truth.  In reading my neurosurgeon’s notes from start to finish for first time, remember surgery was performed in early June, I got to boil and bubble some of my own sad stew, congealed and ready for slicing.  Things are worse than I previously thought.  But it’s not that that bothers me.

Included in my neurosurgeon’s notes was the report from my most recent MRI.  An MRI performed and evaluated here at Ireland Army Community Hospital.  It read as one would expect a report to read for a post op discectomy, laminectomy, foraminectomy patient.  The procedures I knew had been performed during my in-processing PCM screening.

However, I now know much more was wrong with the damaged area.  Much more, surgically, was done to the damaged area.  Of particular noteworthiness, a partial fusion of L5-S1 using a combination of superior and inferior facet joints (both of which were 90% degenerated and floating around my spinal cord) and some sort of bone promoting protein.  Something the radiologist failed to notice/mention in his report.

I don’t know this for certain, but I suspect he didn’t scour the films for abnormalities.  More than likely, he read the treatment history - which came from me, ignorant of all that had been done - and wrote a report consistent with what one usually finds and expects to find in patients with procedures of that sort.

That one misses the absence of two-three other levels degenerating and/or bulging, well, pathology vs. normal aging is something of a judgment call.  But missing missing facet joints and a partial fusion, well, that makes me, and those with medical backgrounds I shared this story with, wonder if he bothered looking at the films at all.  Perhaps that approach is common at his South American alma mater, but here in Los Estados Unidos, we take spine injuries and films that allow us to see them very seriously.  Community of Excellence indeed.

“Interesting story…although filled with exaggeration. Look around you. You live among heroes. They walk your streets and fill the halls of your Historic Kentucky Fort. These heros are the quiet sort. They live by the simple words…honor, selfless service, and integrity. They have seen the elephant and returned with honor and dignity. You have not served until you’ve walked a patrol with your brothers. Shame on you for exploiting our time honored profession. Many have served…and many have fallen. You are smearing the name of great men and women.  All we ask is…shut your mouth, soldier on, or move on. Your immaturity resonated in your words.  Grow Up.”

At least this comment is semi-well written.

Filled with exaggeration?  In what sense Ronnie?  In your next comment, which I will be more than happy to post, be specific regarding what portions of my posts are exaggerated.

These heroes, Ronnie, are not of the quiet sort.  They talk.  Quite a lot.  That they choose not to talk to you, or you choose not to listen in no way distinguishes ‘them’ from me.

You know not the character of my service.  That you speak to it anyway speaks volumes.  But let’s say, for sake of argument, that I was POG extraordinaire, in what way would that rejoin my criticisms of the Army medical bureaucracy and the difficulties navigating it?  Or bar me from speaking to the problem and its consequences?

Exploit - to make productive use of: utilize <exploiting your talents> <exploit your opponent’s weakness> 2 : to make use of meanly or unfairly for one’s own advantage.  In what sense have I done that?  And to what end?

Let’s recap.  I’ll write slowly and use small words.  Smaller even than those by which your idealized soldiers live - those residing somewhere in the Gumdrop River and Candy-cane Forrest district.  You know what?  Fuck that.  You’ve read the story, call it an exaggeration based on, I don’t know, nothing other than your opinion - based on your experiences not mine.  I don’t need to prove anything to you Ronnie.  But more importantly, I don’t care to prove anything to you.  It appears, Ronnie, this is an exercise for you.  An argument to be won or lost.  This is my life and the lives of many here.  You’ll have to forgive me if I’m not in the mood, nor ever will I be, to treat this as a game.

I don’t know you Ronnie, but I notice you live in the Louisville area.  I’d be more than happy to meet with you and work this out, bringing with me whatever information you feel you’d need to satisfy you.  I’m free on weekends.  However, I seriously doubt, based on past experience with those offering comments such as yours, that you can be satisfied.  And I am not in the business, as I don’t have the patience, the will, or the energy to convince the invincibly ignorant that a problem exists.  And that it is exposing this problem, systemic in nature, and its consequences that are the purpose of this site.  The invitation stands.

“Soldiering on” is difficult, Ronnie, when one can hardly walk.  With regard to ’shutting my mouth,’ quietly enduring poor treatment or injustice of any sort doesn’t make one a great soldier, it makes one a great idiot.

With regard to the immaturity resonating in my words, Ronnie, there are plenty of “heroes” here at the Knox WTU who’d disagree.  Cadre, wounded/ill, officer and enlisted alike, hold me in high regard.  And unlike many, Ronnie, the type of person I assume you are, that is, one who commands respect because of his rank or position (that is, if you ever had any), I naturally assume a leadership position regardless of the company I keep.  I doubt the heroes of whom you speak, but have demonstrated very little knowledge of in your comment, share your opinions.  In some sense, I write for them, sharing their stories along with my own, because they cannot.

Well Ronnie, I’ve wasted a good ten minutes on you.  I’ve paid you what you’re owed.  I’ll be in Prospect over the weekend, more than happy to sit down with you and discuss the ‘exaggerations’ on this site.

Addendumb: tailspin@yahoo.com isn’t a real email address according to Yahoo, and I can’t find any combination of Ronnie T Egland on Google.  I wrote to ‘Ronnie’ asking that he join me this weekend for a sit down.  During which time I’d share email conversations between Guard leadership and myself, medical records, fax receipts, etc. in honest effort to convince him/her the claims I make here are supported and supportable.  But I’m betting ‘Ronnie’ doesn’t exist.  If I were actually the things ‘Ronnie’ suggested I am, the next statement would be an example of tu quoque.  Good thing I’m not.  But one thing is certain, only a coward posts anonymously to a website devoted to this topic.  I don’t mind, ‘Ronnie’ that you’re wrong.  Wrong can be corrected.  But dishonesty and cowardliness have no antidotes.  Your comment is deleted.

I had a good night’s sleep.  Well, good for me - read to mean I only woke up 5 or 6 times.  Rested, I’m in a better mood and a better frame of mind.  I figured I’d use it, cuz I don’t know how long I’ll feel this way.

I set to reading recently obtained neurosurgeon’s notes.  As I read, a lot of my symptoms and behaviors finally made sense.  The EMG revealed much more than L5 radiculopathy - a designation that can be used to describe a wide range of symptoms.  The surgeon’s notes are precise.  Anterior Tibialis and Gluteus Medius are the major muscle groups affected by the ‘right side component’ at L5/S1.  AT acts in dorsiflexion and inversion of the foot at the ankle.  GM’s major action is to support the weight of the body on the same side limb.

For those who have seen me walk, I lean heavy on the cane to the right.  Doing so felt natural.  I really thought nothing of it.  Those in physical therapy disapprove of this gait.  Preferring instead that I walk with the cane in my left hand, leaning to the left which is, at best, awkward.  Leaning on the cane to the right provides support in depression or absence of GM action.

The affect of depressed or absent AT has been a semi-frequent topic discussed here: Foot drop gait.  As the spinal nerves carrying information from my central nervous system to my AT are ‘denervated’ (as revealed by EMG), the dorsum of my right foot, without proper orthotic, such an AFO, will drag when I walk.

I knew of these symptoms.  I mean shit, I live with them everyday.  I knew I had L5/S1 chronic radiculopathy.  But the actual muscles involved, and the nerve pathways that’ve been denervated, that I didn’t know.  Now I do, and so do you.

I give it to you with the same emphasis as if there were.

We had brunch at the Cheesecake Factory.  Eggs Benedict, baguettes, and Godiva Chocolate cheesecake: Honky soul food.  Too short of a visit with the wife and step.  Their crying made me cry.

I’m hoping to finally use one of my monthly four day passes to visit Sarah.  I always forget I have them.  With any luck, my wife will be back from San Fran by Turkey Day, or I’ll be able to fly out that way to celebrate together the Cali way.  Free range turkeys and pigs, tofurkey perhaps and whatever hippie bullshit passes as ham, and pastured Pepto to wash it all down.  Flesh or curd, I’ll be adding to the winter blubber.  If only relieving hunger were as simple as rubbing an empty stomach (yeah, that’s Diogenes’ quote assholes.  I’m a dirty scoundrel.  Hell, I live among people who brag about fucking midgets.  I’m saintly by comparison.).

Two appointments for the next week and a half.  Ain’t we got fun?  I’ll be catching up on all the movies I’ve watched 10,000 times, and on your tax dollars.  Yeah Lyle, suck on that.

Anyway, I’m medicated, both of my feet and my right calf are on fire, my back is killing me, I’m simultaneously exhausted and truculent, hungry and horny, and too high to play Pheidippides to the fridge or play Onan with my roommate’s sock drawer.  Fuck.  I guess I’ll go to sleep.  Hopefully I won’t dream of winged ponies - the creatures responsible, in the mind of that dip-shit nurse practitioner, for transmitting impulses from CNS to reflex points.  Community of Excellence.  Yeah.  There’s more excellence on a Tijuana hooker’s taint.

To my regular readers, good night, good night, parting is such sweet sorrow.  To the riffraff brigade, Lyle, Jay Starr, whomever other turds in your special education classes reading this blog, fuck you and the three-wheeled bike you rode in on.