Cover Story
REHAB: Andrew exercises during morning physical therapy at Walter Reed.
Photo by Luke Sharrett
REHAB: Andrew exercises during morning physical therapy at Walter Reed.

Walking wounded

Military | The Iraq and Afghanistan wars have produced more amputees than in recent U.S. combat history, but one young warrior and his wife discover life is fragile, and love is bigger

Andrew Smith has a vision. In January his brother is getting married. Smith imagines being able to walk up the church steps and down the sanctuary’s center aisle. After all, he is the best man.

This activity would be an after-thought for most 25-year-old men. But Smith is learning to walk all over again.

Last March while on patrol in Afghanistan, Smith stepped on a pressure plate, triggering an estimated 10-pound homemade bomb. The explosion hurled Smith into the air, took out his left leg below the knee and his right leg above the knee, and sent his life and that of his newlywed bride onto a path far from their original plans.

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Now Smith just wants to walk a hundred feet down a church aisle in such a way that no one attending the wedding will realize that underneath his dress pants are two prosthetic legs. He doesn’t want to use a cane. “I don’t want to take any attention away from my brother,” he said.

This past summer Smith seemed a long way from reaching his goal. Recuperating at a military hospital outside of Washington, D.C., Smith couldn’t stand on his prosthetics for more than a few moments. “The longer I’m in them the more it hurts,” he winced.

Prosthetists worked to mold the artificial limbs into a better fit for what was left of Smith’s leg bones. While he waited on a comfortable adjustment, Smith depended on a wheelchair. He sometimes moved its wheels with his arms. At other times his wife, Tori, pushed him along.

Around him Smith sees plenty of evidence that his injuries do not condemn him to a life of confinement. Today a double amputee can do more than just stand.

One recent morning a pair of 20-something soldiers wearing black shorts and gray T-shirts with the word Army printed in black jogged beside a busy street near the entrance to the Walter Reed National Military Medical Center. As they ran past the line of cars and headed toward the military gate, the four prosthetic legs they wore matched each other stride for stride.

Since the start of the wars in Afghanistan and Iraq, over 17,000 Americans have been catastrophically wounded. As the United States honors war heroes on Veterans Day and readies for the end of war in Afghanistan, the saga for America’s wounded military personnel—particularly its amputees—will stretch not only over withdrawal timetables and political cycles but over their lifetimes. 

The military has treated 1,559 amputee soldiers (of those, 272 lost an arm or hand). Such large numbers are due to advancements elsewhere. With modern body armor, better-protected vehicles, improved medic training and rapid evacuations, U.S. soldiers survive battlefield wounds nearly 90 percent of the time. Smith would have died if his injuries had occurred in Vietnam. 

By 2010, a military study reported the highest amputee-per-wounded soldier and amputee-per-killed soldier rates in the nation’s history. In other words, more soldiers who would’ve been killed in the past are now wounded amputees. 

That’s why portions of the 243-acre Walter Reed campus in Bethesda, Md., look like a village with two residency requirements: You must be well under the age of 30 and you must be missing one or more limbs. In addition to Walter Reed, the military has hospitals specializing in amputee care in San Antonio and San Diego. All three have opened within the last seven years.

With the rest of the amputees in this community, Smith attends physical therapy two hours each weekday. 

The rubber-floored rehabilitation room contains items you would expect to see in an average gym: a rack of hand weights, multi-colored exercise balls, elastic resistance bands, and exercise machines. But there are also items you don’t see in a gym: cycles powered by hands instead of feet, an indoor track with an overhead support harness, and, in one corner, several dozen prosthetic legs stacked up like backstage props. Dominating the room’s center are rows of beds with white sheets and pillows. It’s as if a Gold’s Gym has merged with a hospital ward.

Most of the patients are double amputees. A few have lost three limbs. A couple of soldiers are missing just one leg. “We call a single below the knee a paper cut around here,” Smith says.

A soldier lost multiple limbs about once in every four combat amputations in 2009. Last year the ratio increased to almost one in two. Amputations hit an average high of 22.1 per month in 2011, according to a recent report by the Armed Forces Health Surveillance Center.


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