emma_goldman
25th October 2006, 05:34
The New Wartime Body
http://www.wiretapm ag.org/stories/ 41191
By Izzy "Socket" Klatzker September 6, 2006
When amputee vets return from Iraq, they may get the
latest technology available for replacement limbs, but
they rarely get the job training or physical and
emotional support they need to rejoin civilian life.
What happens when one's body becomes the war zone, the
setting for patriotic pride, and the argument for
technological advances that alter scientific and
economic landscapes? It often means returning with a
different sense of self and relationship to one's body
for U.S. soldiers back from Iraq. Re-entry varies from
the conceptual to the physical, and amputee veterans
are returning from the Iraq war faced with
transitioning back to civilian life without
straightforward support to navigate the military health
care system or job opportunities.
The Homecoming
Jody Casey, formerly a 19 Delta Cavalry Scout sniper
now organizing with Iraq Vets Against the War (IVAW),
set the tone of our conversation, "I wasn't ready for
re-entry. I wasn't briefed about anything regarding re-
entry. So, on top of dealing with the anger and
isolation of being back, I also had to be my own
advocate." Casey advocated for work, securing mental
and physical health care in a society that does not
understand the realities of war. Counseling programs
"were pushing all these pills my way without even
hearing what I was going through, then they set me up
with a counselor who has never known combat."
He faced similar frustrations when looking for
employment. "The job on the top of the list was to be a
teller at Wal-Mart. No offense to anyone who works
there, it's just that I felt unseen, insulted, and
under-valued. .. They trained us only to re-enlist or
work for Black Water Security or KBR." [Kellogg, Brown
and Root is a former subsidiary of Halliburton] Both
are mercenary war-profiteer subcontractor companies
currently patrolling, fighting, and "providing
security" at a much higher pay rate than U.S. soldiers
receive in Iraq. Casey stressed the enormous need for
worker retraining programs and a modified GI bill that
includes part-time and vocational students. "I only got
trained to kill and be a solider."
Casey matter-of-factly shared some ideas about how a
worker re-training program could look. He suggested
vocational training, something akin to "helmets to
hardhats," utilizing an apprenticeship model, but
provided by the Army. "Such a program could help you
retrain from war on many levels because right now they
are unleashing unstable people back into society."
The Body
Sources from Walter Reed Army Medical Center in
Washington, D.C., estimate that since the onset of the
Iraq invasion and occupation upwards of 400 U.S.
soldiers have come back needing amputations and
prosthetics (30 percent have multiple amputations) .
According to icasualties. org, since April 2003, between
18,000 and 20,000 U.S. soldiers' injuries include
second- and third-degree burns, bone breaks, shrapnel
wounds, brain injuries, paralysis, and eye damage. In
addition, 9,744 U.S soldiers wounded in action returned
to duty between 2003 and 2004, while 8,239 soldiers did
not return to war.
"The rocket went through my leg like a knife through
butter. It was a terrible scene ... there was just
blood and muscle everywhere," Tristan Wyatt, 21,
reported in a November 9, 2003, L.A. Times article
entitled "Hospital Front." A rocket had cut off his leg
and those of the two other soldiers with him four
months earlier in Fallujah, a type of injury treated
frequently at Walter Reed. Doctors Dennis Clarke and
Jim Kaiser both reported (upper extremity) amputations
from the elbow down, (lower extremity) above the knee
or through the hip resulting from roadside bombs,
bullets, and IEDs (Improvised Explosive Devices).
Kaiser concluded that "explosion injuries are vicious;
they affect multiple body parts; for example, if one
gets hit on the right side, part of the right leg, arm,
and oftentimes their face gets exploded and pocked-up."
"We were always working with a base of 100 patients at
any point in time," began Dennis Clarke, a visiting
Orthoist-Prosthetis t who specializes with lower
extremity amputees. "On any given day, Walter Reed's
orthopedic wing has about 50 inpatients and another 180
outpatients, " says Jim Kaiser, who spent one week as a
guest prosthetist at Walter Reed's Occupational Therapy
Department in 2004. Working consistently, with hardly a
break for lunch, they made fittings for new prosthetics
and adjustments on old ones, and cleanings of
amputation sites were constant.
"There was always something to do and someone to see
to. We were very, very busy," Kaiser continued. "Some
prosthetics we made were arms; most were leg/lower
extremity from explosions and many of the same people
had multiple amputations. " Two factors -- the war's
urban setting and quick response time -- have vastly
increased the survival rate for the wounded compared to
Vietnam. However, since Vietnam, the number of those
wounded in action has risen from 3 percent to 6
percent, according to Wendy Y. Lawton in the George
Street Journal, December 10, 2004. Dennis Clarke
continues, "When one third of your patients have more
than one limb missing, the work and stress and
attention is different and accelerated. "
The Technology
"Vets are provided with a training leg with the most
high-tech components (mechanical parts) and myoelectric
hands and elbows. Civilians do not get offered such
things. These vets motivate research for new technology
... being tested on vets by such companies as Ossur and
Otto Bock," remarked Chicago orthoist-prosthetis t John
Angelico of Scheck and Siress.
In the field of orthotics and prosthetics (O and P), an
orthoist specializes in planning, making, and fitting
orthopedic braces, and a prosthetist makes artificial
body parts (limbs and joints) called prosthetics,
prosthetic devices, or singularly, a prosthesis. Hip
disarticulation is an amputation through the hip joint
removing the entire lower extremity. What was once a
rare surgery has become more commonplace in the field
since the Iraq war. Myoelectrics utilizes the
electrical properties of muscle tissue from which
impulses may be amplified, a technology that adapts and
compensates for the wearer's natural gait and any
irregular terrain, slopes, or steps. The most commonly
used device on vets coming from Iraq is the C-Leg, a
myoelectric leg developed by the companies Ossur and
Otto Bock.
"I was surprised the veterans were receiving
[myoelectric technology]. We had to struggle with the
VA (Veterans Administration) to authorize knee
technology. It took a year to get authorization. And
then years later Walter Reed was giving that away to
anyone." Jim Kaiser shared his insights on how the army
has improved treatment of amputee vets. "Then, a vet
could get one knee prosthesis, a carbon flex foot
mechanism and a spare prosthesis. Their goal was to
make sure a vet has a prosthesis to wear and one
spare." While the standards apply today, the technology
and care are so vastly different that it seems that the
army is more willing to support vets from Iraq than
their predecessors from Vietnam. Greater research and
development of upper extremity technology has triggered
a $4 million grant from the federal government for Dr.
Kuiken at the Rehabilitation Institute of Chicago.
According to Kaiser, "It was the most money spent on
prosthetics since Vietnam."
Dennis Clarke explained that the Department of Defense
has created a "dream team" of experts brought in on a
contractual basis since early on in the war. The volume
and complexity of these injuries make it essential to
bring in outside specialists. "Now there are three
people permanently on staff at Walter Reed in the
Prosthetics Department as well as the additional
civilian folks brought in."
When wounded on the battlefield, soldiers are flown to
the Landstuhl airbase in Germany. Marines are sent to
Bethesda while the Army is sent to Walter Reed, with
all surgical procedures performed stateside.
Innovations in sanitation, swelling control, and the
use of digital cameras and scanners complement the
plaster molds taken for every patient needing a
prosthesis.
They send the records to Iowa for the Socket Interface,
creating a personalized socket or suction system and
joining it to the actual prosthetic device. The Socket
Interface is done entirely on CADCAM -- computer
designed, computer manufactured technology -- in
approximately 48 hours with minor adjustments and
alignments in person, but largely done on the computer.
The success rate is high.
According to Clarke, the rehabilitative process is
comprehensive, "Daily therapy of walking on parallel
bars, transferring from one position to the next, and
ultimately using crutches, to using one crutch, to
using a cane. This process can take from 2 weeks to 2
months. Some patients were there eight weeks total,
some were there 18 months."
The future may hold a very different series of events,
technologically speaking, for U.S. vets needing
prosthetic devices. According to Lawton's George Street
Journal article, "$7.2 million from the Department of
Veterans Affairs was earmarked in 2005 for a team of
researchers working to restore natural movement to
amputees -- particularly Iraq veterans. Within five
years, scientists based at Brown [University] and the
Massachusetts Institute of Technology hope to have
created 'bio-hybrid' limbs that will use regenerated
tissue, lengthened bone, titanium prosthetics and
implantable sensors that allow an amputee to use nerves
and brain signals to move an arm or leg. Work through
the Providence VA Medical Center falls into six
research programs."
"The prosthetic industry is moving forward because of
war," Dennis Clarke observed. "War is the single driver
of technology in our profession. The net effect of
these young and vibrant amputees is that they are
pressing forward and doing well; that makes us look
good. Technology does not lead change. Need leads
change, and war is good for business because it
necessitates need. One could argue that as earnest an
anti-war statement could be made regarding the same
issues." When people talk about war being good for
business and good for technology, it's important to
recognize who ultimately benefits and who pays with
their lives. Recruiters are enticing people into war
with promises of making money, but soldiers are not
coming back wealthy. Soldiers are coming back in body
bags or with serious injuries. With their lives and
bodies changed, vets come back owing more money in the
face of increased medical expenses and often in worse
situations than they were in upon leaving.
The Figures
According to Corey Flintoff on the NPR program Day to
Day, the cost of the invasion of Iraq could top $2
trillion -- much greater than any Bush administration
estimate -- when estimates include long-term costs such
as replacing worn out or destroyed military equipment,
debt incurred to finance the war, and providing
lifetime care for disabled veterans.
The most commonly needed device by Iraq vets is the
myoelectric arm that ranges in price from $25,000 to
$35,000 (according to Dr. Kaiser). The C-Leg
microprocessor knee costs $50,000 with additional costs
of components. Expensive technologies, yet these
figures fail to consider vets' other healthcare costs
such as surgeries, medications, doctor's appointments,
and physical therapy.
Insurance programs sponsored by the Veterans
Administration include the Service-members Group Life
Insurance (SGLI), with the supplements of the Traumatic
Service-members Group Life Insurance (TSGLI), Veterans
Group Life Insurance (VGLI), Family Service-members
Group Life Insurance (FSGLI), and Service Disabled
Veterans Insurance (S-DVI). Each consists of its own
rules and regulations, claims processes, fiscal
calendars, and terms of eligibility. The TSGLI took
effect on December 1, 2005, as a new program for
service members who suffer from severe trauma: total or
partial blindness, total or partial deafness, hand or
foot amputation, thumb and index finger amputation,
quadriplegia, paraplegia, hemoplegia, third degree or
worse burns, traumatic brain injury, and coma. Yet, the
myriad regulations dictate that beneficiaries had to
file claims with the SGLI prior to December 1 in order
to apply for TSGLI.
The Department of Veterans Affairs (VA) benefits
booklet is a confusing description of programs,
muddling the options available to vets. Examples of the
poor wording include terms like "severely disabled" or
"otherwise in good health" as requisites for coverage.
This represents a bureaucratic nightmare considering
that a soldier may need multiple insurances to meet
their medical and life expenses. Yet, who judges good
health and on what basis? Such are the obstacles
encountering returning veterans who frequently are
incapacitated, possibly not conscious, and focused
elsewhere upon arrival from combat. The booklet makes
no mention that vets can get a liaison or advocate to
help mediate their medical needs. Taking initiative is
vital to accessing any of these benefits.
The rate of injury is steady with no end in sight.
Private individuals are pooling resources for research
projects and individual vet support projects alike
(with others listed at www.fallenheroesfun d.org). The
Intrepid Project has contributed over $14 million to
military families, yet many more families will need
help so long as operations in Iraq and Afghanistan
continue. Elizabeth Bernstein wrote in "The Gift
Shift," a November 25, 2005, Wall Street Journal
article, describing that "the president of the Intrepid
Fallen Heroes Fund had collected well over half of the
$35 million the fund needed to realize its big goal to
build a center in Texas where U.S. troops can recover
from war wounds and be a research facility for
prosthetic protocol technologies. "
The high caliber technology provided to Iraq amputee
vets has had a side effect on the access to care for
non-vet amputees. Jim Kaiser states that "The climate
in the sector of health insurance is that of
[suppressing] technological costs." According to
Kaiser, "Blue Cross considers a C-Leg experimental; the
technology has been available in the U.S. for five
years and in Europe for nine. The insurance companies
use terms like 'situational, experimental and lack of
medical necessity' in order to deny people access to
technology that is becoming the norm in its field.
Myoelectric arm technology is 30-years [old], which
insurance companies continue to dismiss as
experimental. If one does not have bills covered by the
VA, how does one pay to keep up with the expanding
field? One possibility is that non-vets just don't get
to participate in this new technological landscape
unless independently wealthy or have very committed and
convincing doctors on their side. Perhaps non-vets may
just have to wait for the insurance companies to catch
up."
Dennis Clarke elaborated that one hope for The Fallen
Heroes Fund facility is to collect enough data to lobby
mainstream non-military insurance companies. "It's a
fact that the industry has not proven its case yet. We
need to prove to the insurance companies what the real
benefit of these technologies are, how much better are
these than the old ways. Our next step is to change the
standard practice of insurance companies." How many
more soldiers must demonstrate such necessity in order
to raise the bar for all amputees?
The Adjustment
The IVAW website quotes Douglas Barber, later found
dead by his own hand, "All is not okay or right for
those of us who return home alive and supposedly well.
What looks like normalcy and readjustment is only an
illusion to be revealed by time and torment. Some
soldiers come home missing limbs and other parts of
their bodies. Still others will live with permanent
scars from horrific events that no one other than those
who served will ever understand."
Soldiers face a range of realities upon return. Some
re-enter with a broad support network, adequate medical
coverage, and stellar care. Others return feeling like
absolutely nothing is intact and any possible resources
are inaccessible and inadequate. Jim Kaiser stresses,
"It is essential to provide constant quality follow-up
care [to the veteran] once [he or she is] released from
the VA system." However, he worries that what is
offered post-release pales and is lacking compared to
what is offered immediately post-injury. In his
practice of 120 people, 16 percent are disabled. "It is
important to hire disabled people in the business of
improving prosthetic care and not to shut people out."
These needs for support, recognition, and employment
may seem obvious to some, but they do not go without
saying.
Returning to active duty may seem like the lone option
to some vets. Jody Casey had few prospects upon arrival
home from Iraq. After being part of the U.S. military
industrial complex, staying in can be easier than
extricating oneself. "A significant percentage (10-20
percent) of amputee soldiers remains in active duty,"
Dennis Clarke explains. "With prosthetic technology,
one can do more than ever after sustaining these types
of injuries and recover faster ... these soldiers are
specialists in their field, and it is better to bring
back experienced solders with good training and combat
experience."
Throughout the VA literature and my conversation with
Dennis Clarke, much emphasis was put on remaining in
active duty. The push -- after being injured, healing,
receiving state of the art medical care -- is to get
back in the game. Those soldiers on active duty are
rewarded with medical care coverage and accolades.
Soldiers who choose not to return have far fewer
options. The war practically creates a "super-soldier"
archetype with bionic limbs and a taste for combat with
vengeance running through them. The focus on active
duty inhibits considering alternatives, divesting money
and lives from this war. The creation of the invincible
wounded warrior serves as propaganda for the war
machine.
Jody Casey addressed the concept of support. "They
don't want you to know what your rights are ... I had
no idea where my local VA was or what my medical
coverage was." He discovered that his coverage was "two
years of full medical and six months of dental." The
IVAW and a veterans' support group are his community
now and have become integral to his life. Having served
in Iraq, working with IVAW and Vets for Vets has
provided Casey with a different viewpoint of what the
Iraq war is about -- war profiteering happening at
every level. "This is not about liberation" he
concludes, "it's about a few people making a lot of
money on the back of the poor and now people like me
have to pay for it with their whole selves."
*** *** *** ***
Izzy "Socket" Klatzker lives in the hills of Tennessee,
tends goats and chickens, enjoys loving, organizing,
learning, writing, critiquing, imagining and creating.
http://www.wiretapm ag.org/stories/ 41191
By Izzy "Socket" Klatzker September 6, 2006
When amputee vets return from Iraq, they may get the
latest technology available for replacement limbs, but
they rarely get the job training or physical and
emotional support they need to rejoin civilian life.
What happens when one's body becomes the war zone, the
setting for patriotic pride, and the argument for
technological advances that alter scientific and
economic landscapes? It often means returning with a
different sense of self and relationship to one's body
for U.S. soldiers back from Iraq. Re-entry varies from
the conceptual to the physical, and amputee veterans
are returning from the Iraq war faced with
transitioning back to civilian life without
straightforward support to navigate the military health
care system or job opportunities.
The Homecoming
Jody Casey, formerly a 19 Delta Cavalry Scout sniper
now organizing with Iraq Vets Against the War (IVAW),
set the tone of our conversation, "I wasn't ready for
re-entry. I wasn't briefed about anything regarding re-
entry. So, on top of dealing with the anger and
isolation of being back, I also had to be my own
advocate." Casey advocated for work, securing mental
and physical health care in a society that does not
understand the realities of war. Counseling programs
"were pushing all these pills my way without even
hearing what I was going through, then they set me up
with a counselor who has never known combat."
He faced similar frustrations when looking for
employment. "The job on the top of the list was to be a
teller at Wal-Mart. No offense to anyone who works
there, it's just that I felt unseen, insulted, and
under-valued. .. They trained us only to re-enlist or
work for Black Water Security or KBR." [Kellogg, Brown
and Root is a former subsidiary of Halliburton] Both
are mercenary war-profiteer subcontractor companies
currently patrolling, fighting, and "providing
security" at a much higher pay rate than U.S. soldiers
receive in Iraq. Casey stressed the enormous need for
worker retraining programs and a modified GI bill that
includes part-time and vocational students. "I only got
trained to kill and be a solider."
Casey matter-of-factly shared some ideas about how a
worker re-training program could look. He suggested
vocational training, something akin to "helmets to
hardhats," utilizing an apprenticeship model, but
provided by the Army. "Such a program could help you
retrain from war on many levels because right now they
are unleashing unstable people back into society."
The Body
Sources from Walter Reed Army Medical Center in
Washington, D.C., estimate that since the onset of the
Iraq invasion and occupation upwards of 400 U.S.
soldiers have come back needing amputations and
prosthetics (30 percent have multiple amputations) .
According to icasualties. org, since April 2003, between
18,000 and 20,000 U.S. soldiers' injuries include
second- and third-degree burns, bone breaks, shrapnel
wounds, brain injuries, paralysis, and eye damage. In
addition, 9,744 U.S soldiers wounded in action returned
to duty between 2003 and 2004, while 8,239 soldiers did
not return to war.
"The rocket went through my leg like a knife through
butter. It was a terrible scene ... there was just
blood and muscle everywhere," Tristan Wyatt, 21,
reported in a November 9, 2003, L.A. Times article
entitled "Hospital Front." A rocket had cut off his leg
and those of the two other soldiers with him four
months earlier in Fallujah, a type of injury treated
frequently at Walter Reed. Doctors Dennis Clarke and
Jim Kaiser both reported (upper extremity) amputations
from the elbow down, (lower extremity) above the knee
or through the hip resulting from roadside bombs,
bullets, and IEDs (Improvised Explosive Devices).
Kaiser concluded that "explosion injuries are vicious;
they affect multiple body parts; for example, if one
gets hit on the right side, part of the right leg, arm,
and oftentimes their face gets exploded and pocked-up."
"We were always working with a base of 100 patients at
any point in time," began Dennis Clarke, a visiting
Orthoist-Prosthetis t who specializes with lower
extremity amputees. "On any given day, Walter Reed's
orthopedic wing has about 50 inpatients and another 180
outpatients, " says Jim Kaiser, who spent one week as a
guest prosthetist at Walter Reed's Occupational Therapy
Department in 2004. Working consistently, with hardly a
break for lunch, they made fittings for new prosthetics
and adjustments on old ones, and cleanings of
amputation sites were constant.
"There was always something to do and someone to see
to. We were very, very busy," Kaiser continued. "Some
prosthetics we made were arms; most were leg/lower
extremity from explosions and many of the same people
had multiple amputations. " Two factors -- the war's
urban setting and quick response time -- have vastly
increased the survival rate for the wounded compared to
Vietnam. However, since Vietnam, the number of those
wounded in action has risen from 3 percent to 6
percent, according to Wendy Y. Lawton in the George
Street Journal, December 10, 2004. Dennis Clarke
continues, "When one third of your patients have more
than one limb missing, the work and stress and
attention is different and accelerated. "
The Technology
"Vets are provided with a training leg with the most
high-tech components (mechanical parts) and myoelectric
hands and elbows. Civilians do not get offered such
things. These vets motivate research for new technology
... being tested on vets by such companies as Ossur and
Otto Bock," remarked Chicago orthoist-prosthetis t John
Angelico of Scheck and Siress.
In the field of orthotics and prosthetics (O and P), an
orthoist specializes in planning, making, and fitting
orthopedic braces, and a prosthetist makes artificial
body parts (limbs and joints) called prosthetics,
prosthetic devices, or singularly, a prosthesis. Hip
disarticulation is an amputation through the hip joint
removing the entire lower extremity. What was once a
rare surgery has become more commonplace in the field
since the Iraq war. Myoelectrics utilizes the
electrical properties of muscle tissue from which
impulses may be amplified, a technology that adapts and
compensates for the wearer's natural gait and any
irregular terrain, slopes, or steps. The most commonly
used device on vets coming from Iraq is the C-Leg, a
myoelectric leg developed by the companies Ossur and
Otto Bock.
"I was surprised the veterans were receiving
[myoelectric technology]. We had to struggle with the
VA (Veterans Administration) to authorize knee
technology. It took a year to get authorization. And
then years later Walter Reed was giving that away to
anyone." Jim Kaiser shared his insights on how the army
has improved treatment of amputee vets. "Then, a vet
could get one knee prosthesis, a carbon flex foot
mechanism and a spare prosthesis. Their goal was to
make sure a vet has a prosthesis to wear and one
spare." While the standards apply today, the technology
and care are so vastly different that it seems that the
army is more willing to support vets from Iraq than
their predecessors from Vietnam. Greater research and
development of upper extremity technology has triggered
a $4 million grant from the federal government for Dr.
Kuiken at the Rehabilitation Institute of Chicago.
According to Kaiser, "It was the most money spent on
prosthetics since Vietnam."
Dennis Clarke explained that the Department of Defense
has created a "dream team" of experts brought in on a
contractual basis since early on in the war. The volume
and complexity of these injuries make it essential to
bring in outside specialists. "Now there are three
people permanently on staff at Walter Reed in the
Prosthetics Department as well as the additional
civilian folks brought in."
When wounded on the battlefield, soldiers are flown to
the Landstuhl airbase in Germany. Marines are sent to
Bethesda while the Army is sent to Walter Reed, with
all surgical procedures performed stateside.
Innovations in sanitation, swelling control, and the
use of digital cameras and scanners complement the
plaster molds taken for every patient needing a
prosthesis.
They send the records to Iowa for the Socket Interface,
creating a personalized socket or suction system and
joining it to the actual prosthetic device. The Socket
Interface is done entirely on CADCAM -- computer
designed, computer manufactured technology -- in
approximately 48 hours with minor adjustments and
alignments in person, but largely done on the computer.
The success rate is high.
According to Clarke, the rehabilitative process is
comprehensive, "Daily therapy of walking on parallel
bars, transferring from one position to the next, and
ultimately using crutches, to using one crutch, to
using a cane. This process can take from 2 weeks to 2
months. Some patients were there eight weeks total,
some were there 18 months."
The future may hold a very different series of events,
technologically speaking, for U.S. vets needing
prosthetic devices. According to Lawton's George Street
Journal article, "$7.2 million from the Department of
Veterans Affairs was earmarked in 2005 for a team of
researchers working to restore natural movement to
amputees -- particularly Iraq veterans. Within five
years, scientists based at Brown [University] and the
Massachusetts Institute of Technology hope to have
created 'bio-hybrid' limbs that will use regenerated
tissue, lengthened bone, titanium prosthetics and
implantable sensors that allow an amputee to use nerves
and brain signals to move an arm or leg. Work through
the Providence VA Medical Center falls into six
research programs."
"The prosthetic industry is moving forward because of
war," Dennis Clarke observed. "War is the single driver
of technology in our profession. The net effect of
these young and vibrant amputees is that they are
pressing forward and doing well; that makes us look
good. Technology does not lead change. Need leads
change, and war is good for business because it
necessitates need. One could argue that as earnest an
anti-war statement could be made regarding the same
issues." When people talk about war being good for
business and good for technology, it's important to
recognize who ultimately benefits and who pays with
their lives. Recruiters are enticing people into war
with promises of making money, but soldiers are not
coming back wealthy. Soldiers are coming back in body
bags or with serious injuries. With their lives and
bodies changed, vets come back owing more money in the
face of increased medical expenses and often in worse
situations than they were in upon leaving.
The Figures
According to Corey Flintoff on the NPR program Day to
Day, the cost of the invasion of Iraq could top $2
trillion -- much greater than any Bush administration
estimate -- when estimates include long-term costs such
as replacing worn out or destroyed military equipment,
debt incurred to finance the war, and providing
lifetime care for disabled veterans.
The most commonly needed device by Iraq vets is the
myoelectric arm that ranges in price from $25,000 to
$35,000 (according to Dr. Kaiser). The C-Leg
microprocessor knee costs $50,000 with additional costs
of components. Expensive technologies, yet these
figures fail to consider vets' other healthcare costs
such as surgeries, medications, doctor's appointments,
and physical therapy.
Insurance programs sponsored by the Veterans
Administration include the Service-members Group Life
Insurance (SGLI), with the supplements of the Traumatic
Service-members Group Life Insurance (TSGLI), Veterans
Group Life Insurance (VGLI), Family Service-members
Group Life Insurance (FSGLI), and Service Disabled
Veterans Insurance (S-DVI). Each consists of its own
rules and regulations, claims processes, fiscal
calendars, and terms of eligibility. The TSGLI took
effect on December 1, 2005, as a new program for
service members who suffer from severe trauma: total or
partial blindness, total or partial deafness, hand or
foot amputation, thumb and index finger amputation,
quadriplegia, paraplegia, hemoplegia, third degree or
worse burns, traumatic brain injury, and coma. Yet, the
myriad regulations dictate that beneficiaries had to
file claims with the SGLI prior to December 1 in order
to apply for TSGLI.
The Department of Veterans Affairs (VA) benefits
booklet is a confusing description of programs,
muddling the options available to vets. Examples of the
poor wording include terms like "severely disabled" or
"otherwise in good health" as requisites for coverage.
This represents a bureaucratic nightmare considering
that a soldier may need multiple insurances to meet
their medical and life expenses. Yet, who judges good
health and on what basis? Such are the obstacles
encountering returning veterans who frequently are
incapacitated, possibly not conscious, and focused
elsewhere upon arrival from combat. The booklet makes
no mention that vets can get a liaison or advocate to
help mediate their medical needs. Taking initiative is
vital to accessing any of these benefits.
The rate of injury is steady with no end in sight.
Private individuals are pooling resources for research
projects and individual vet support projects alike
(with others listed at www.fallenheroesfun d.org). The
Intrepid Project has contributed over $14 million to
military families, yet many more families will need
help so long as operations in Iraq and Afghanistan
continue. Elizabeth Bernstein wrote in "The Gift
Shift," a November 25, 2005, Wall Street Journal
article, describing that "the president of the Intrepid
Fallen Heroes Fund had collected well over half of the
$35 million the fund needed to realize its big goal to
build a center in Texas where U.S. troops can recover
from war wounds and be a research facility for
prosthetic protocol technologies. "
The high caliber technology provided to Iraq amputee
vets has had a side effect on the access to care for
non-vet amputees. Jim Kaiser states that "The climate
in the sector of health insurance is that of
[suppressing] technological costs." According to
Kaiser, "Blue Cross considers a C-Leg experimental; the
technology has been available in the U.S. for five
years and in Europe for nine. The insurance companies
use terms like 'situational, experimental and lack of
medical necessity' in order to deny people access to
technology that is becoming the norm in its field.
Myoelectric arm technology is 30-years [old], which
insurance companies continue to dismiss as
experimental. If one does not have bills covered by the
VA, how does one pay to keep up with the expanding
field? One possibility is that non-vets just don't get
to participate in this new technological landscape
unless independently wealthy or have very committed and
convincing doctors on their side. Perhaps non-vets may
just have to wait for the insurance companies to catch
up."
Dennis Clarke elaborated that one hope for The Fallen
Heroes Fund facility is to collect enough data to lobby
mainstream non-military insurance companies. "It's a
fact that the industry has not proven its case yet. We
need to prove to the insurance companies what the real
benefit of these technologies are, how much better are
these than the old ways. Our next step is to change the
standard practice of insurance companies." How many
more soldiers must demonstrate such necessity in order
to raise the bar for all amputees?
The Adjustment
The IVAW website quotes Douglas Barber, later found
dead by his own hand, "All is not okay or right for
those of us who return home alive and supposedly well.
What looks like normalcy and readjustment is only an
illusion to be revealed by time and torment. Some
soldiers come home missing limbs and other parts of
their bodies. Still others will live with permanent
scars from horrific events that no one other than those
who served will ever understand."
Soldiers face a range of realities upon return. Some
re-enter with a broad support network, adequate medical
coverage, and stellar care. Others return feeling like
absolutely nothing is intact and any possible resources
are inaccessible and inadequate. Jim Kaiser stresses,
"It is essential to provide constant quality follow-up
care [to the veteran] once [he or she is] released from
the VA system." However, he worries that what is
offered post-release pales and is lacking compared to
what is offered immediately post-injury. In his
practice of 120 people, 16 percent are disabled. "It is
important to hire disabled people in the business of
improving prosthetic care and not to shut people out."
These needs for support, recognition, and employment
may seem obvious to some, but they do not go without
saying.
Returning to active duty may seem like the lone option
to some vets. Jody Casey had few prospects upon arrival
home from Iraq. After being part of the U.S. military
industrial complex, staying in can be easier than
extricating oneself. "A significant percentage (10-20
percent) of amputee soldiers remains in active duty,"
Dennis Clarke explains. "With prosthetic technology,
one can do more than ever after sustaining these types
of injuries and recover faster ... these soldiers are
specialists in their field, and it is better to bring
back experienced solders with good training and combat
experience."
Throughout the VA literature and my conversation with
Dennis Clarke, much emphasis was put on remaining in
active duty. The push -- after being injured, healing,
receiving state of the art medical care -- is to get
back in the game. Those soldiers on active duty are
rewarded with medical care coverage and accolades.
Soldiers who choose not to return have far fewer
options. The war practically creates a "super-soldier"
archetype with bionic limbs and a taste for combat with
vengeance running through them. The focus on active
duty inhibits considering alternatives, divesting money
and lives from this war. The creation of the invincible
wounded warrior serves as propaganda for the war
machine.
Jody Casey addressed the concept of support. "They
don't want you to know what your rights are ... I had
no idea where my local VA was or what my medical
coverage was." He discovered that his coverage was "two
years of full medical and six months of dental." The
IVAW and a veterans' support group are his community
now and have become integral to his life. Having served
in Iraq, working with IVAW and Vets for Vets has
provided Casey with a different viewpoint of what the
Iraq war is about -- war profiteering happening at
every level. "This is not about liberation" he
concludes, "it's about a few people making a lot of
money on the back of the poor and now people like me
have to pay for it with their whole selves."
*** *** *** ***
Izzy "Socket" Klatzker lives in the hills of Tennessee,
tends goats and chickens, enjoys loving, organizing,
learning, writing, critiquing, imagining and creating.