The Broken Soldier

Before I write anything else, I have to thank BabyJesusHorse for agreeing to participate.  His knowledge and experience are invaluable to those of us who’ll seek compensation for service-connected injuries and illnesses.  He’s a good writer, a very kind man, and he cares about his uniformed brothers and sisters.  His participation also ups the intelligence quotient quite a lot.

Drug problems.  I’m not referring to my depency on narcotics.  Though I’m sure I’ve referred to my depency sometime earlier, and will no doubt again sometime later.  No, this post is about problems obtaining medications prescribed to WTU soldiers.

The problem is simple to describe: We’re given two week supplies of narcotics (usually prescribed for accute or chronic pain and or insomnia), but often cannot, due to limited staffing and man-hours, get follow up appointments, procedurally necessary for refills, before our drugs run out.  Meaning some, myself included, have gone without pain medication for days.  Some go through withdrawal.  When I asked them why they endure this suffering quietly, I’m given an indoctrinated/enculcated response.

I’m not given to taking that route.  The first time it happened I complained to my case manager.  My meds were refilled by phone (which apparently isn’t supposed to happen).  The next time it happened, I took the prescribed amount from the leftover smaller doses I had lying around (for example, instead of one 40 mg Oxycontin, I took one 20 mg and two 10 mg), and brought the problem to the attention of my platoon leader.  He assured me this problem is going to be addressed.  I believe him.

I’ll keep you all abreast.

Bad pain day.  Debilitating pain day.  Slow, hobbling movements.  A lot of “Are you going to be okay brother?” as I entered the Patton Museum auditorium for our monthly town hall meeting.  I’m going to spare my readers a full report of the meeting, as much of it is irrelevant to this post.

The Chaplain spoke.  A brilliant, yet humble man.  A man whose life and all its energies are devoted to God and to us.  His words were moving and uplifting.

Next the Warrior Transition Battalion Commander spoke.  He is awesome!  His intelligence, his experience, his appearance and the way he comports himself, they all command respect.  The kind of officer one thinks of, if one served before the new millennium, when one thinks of officer.  A different breed of person.  A natural leader, differentiated from the enlisted under his command by more than a bachelors degree and completion of a 14 week course.

Yet, in spite of my admiration for him, I found myself disappointed with him today.  He spoke of certain problems and how they have been, they’re being, or they will be resolved.  But as he spoke he revealed something of his metaphysical commitments.  For those of my readership, especially my critics who don’t understand what they consider ‘big words’ and get angry at those who use them, one’s metaphysical commitments refer to what one believes is.  In this case the commander spoke to the nature of Army bureaucracy.

Army bureaucracy is huge, cumbersome, but will, eventually, plod towards the general direction of what’s right, wanted, needed, etc.  Most shook their heads and or made some utterance signifying agreement.  Some seemed to even find it humorously tolerable in a “Gee, isn’t is funny when Uncle Youngea drinks up the still fruit, impregnates all the pigs, and drives the riding mower into the lake?” sort of way.  Ha ha, that’s our Army. [Wink wink.  Nudge nudge.]

There’s nothing in the definition of ‘bureaucracy,’ which the Army certainly is, suggesting inefficiency, and even if there were, that wouldn’t justify the harm done.  There’s nothing funny about the state of Army medical care.  There’s little to suggest Army medicine, as a general rule or as a whole, is plodding in the right direction.  There’s nothing tolerable, humorously or otherwise, about this bureaucracy’s failings.

Real people are hurt by this type of thinking.  Real people die because most of my brothers and sisters accept that this is just the way things are.  Real families lose their sons, daughters, husbands, wives, fathers, mothers, etc., and I suspect they don’t find anything funny about it.  And real people will continue to be hurt and killed, and families will be harmed until we recognize that there’s a mighty big difference between what is and what ought to be.

It’s clear there are those who get it.  That change is needed.  That a resigned laugh at how things are isn’t going to cut it anymore.  But those are few in number, and we tend to face a lot of hostility from the rest our fraternity.

Turn on the news and you’re bound to find some demagogue treating this war in a demagogic manner.  “If not for this war, we could fund free donuts and coffee drinks of ones choosing for all.”  Etc.  Etc.  Wonderfully acted out anger regarding the costs of the current conflicts.  Costs, that if redundant programs were reduced, could at least partially be recouped.  And as politicians and pundits argue in circles, rote from their side’s talking points, something important is lost.

Yesterday my best buddy here at the Fort Knox Warrior Transition Unit was admitted for suicidal ideations.  I don’t know for certain, but if I had to guess, it’s because he feels worthless given his injuries and the limitations they impose.  No analysis or opinion in today’s post.  Just think about him for a moment today.  Think about the many like him throughout the armed forces at the front and here at home.  Pray for them.  And remember, for everything we do there’s always a cost.

I went to the Murphy Pain Clinic last week to discuss spinal cord stimulator implantation.  I’m on plenty of soporific drugs - Oxycontin, Percocet, Flexeril, Clonopin, etc.  I may have blacked out or simply ‘lost’ that block of time.  Sometime between walking in, laughing at the nurses’ strange preoccupation with my urine, and giving the doc a parting handshake, I agreed to four more steroid injections.

Two transforaminal injections and two facet injections.  The former and the latter require fluoroscopic X-ray and contrast dye guidance, and bath the inflamed spinal nerve roots in an anesthetic/steroid solution.  While invasive, the risks associated with this procedure are minimal.  Many find their symptoms abate, if only temporarily, upon completing the series.  For those who don’t respond, this is the road to electrical relief.

I have a problem with this because a) I’ve had several failed epidural steroid injections, and b) the approach assumes inflammation is the cause of pain, and c) I have no facet joints near the offending nerve roots - though it’s likely the areas once occupied by facet joints are pseudo-arthritic.  I sense this approach is an insurance company mandate.  I also sense, given past experience, this approach will fail.  But if this is what’s required to get the stimulator, this is what I’ll do.

Most of this will happen after Christmas Exodus.  Be sure I’ll keep you all abreast of every development.

Bad pain day.  Rolled out of bed around a 5/10.  Three appointments spaced three hours apart.  A lot of sitting and walking.

The foci of my treatments - mental/emotional and physical - have shifted a bit.  No longer do we harbor hopes of betterment.  Managing a lost cause seems the focus now.  Recognition creates its own pain.

I’ve accepted that this is my life.  I will never bench 400 pounds again.  I will never dunk a basketball again.  I will never walk the “Arb” with my wife again.

I know this.  I’m not at peace with it.  Finding it will be the greatest challenge of my life.  Where and how does one find peace in pain?