These parent caregivers, many of them boomers and some older, face a 21st-century challenge: their children are coming home in unprecedented numbers with injuries that would have been fatal during earlier conflicts. “This is a war of disability, not a war of deaths,” says former Army physician Ronald Glasser, M.D., author of Wounded: Vietnam to Iraq (George Braziller, 2006). “Its legacy is the orthopedics and neurology wards, not the cemetery.” Not only have better helmets and body armor saved lives, but battlefield medicine now borders on miraculous. Someone arriving at the Air Force Theater Hospital in Balad, Iraq, has a 96 percent chance of survival. He or she can sometimes be stateside within 36 hours of the injury. As a result, there are just 6 deaths for every 100 injuries in Iraq and Afghanistan, compared with 28 deaths per 100 in Vietnam, and 38 in World War II, according to Linda Bilmes, a researcher at Harvard University’s Kennedy School of Government.
If this survival rate is heartening, the flip side is that many of these injuries are fearsome and require extended and complicated care. Part of the reason is that the nature of warfare has changed: today’s troops face a constant threat of IEDs. When these makeshift bombs detonate, they throw off pressure waves so intense that bystanders’ brains literally bang around in their skulls. “These are enormous explosions,” says Glasser. “The physics are astonishing—they will turn over a 70-ton tank. Anyone caught in the blast wave is going to be in trouble.” Sometimes injured brain tissue swells so dramatically that part of the skull must be removed to let the brain expand.
As of April 29 the Pentagon counted 31,848 wounded service members in the current conflicts. Independent experts say that is a conservative figure. They estimate the number of brain injuries alone might total 320,000, or 20 percent of the 1.64 million who have served so far—a number that S. Ward Casscells, the assistant secretary of defense for health affairs, calls “plausible.” In addition to the physical injuries, there are thousands of cases of depression and post-traumatic stress disorder (PTSD). Last year military screeners detected psychological symptoms in 31 percent of Marines, 38 percent of soldiers, and 49 percent of National Guardsmen returning from war.
For many of the newly injured, most in their late teens and 20s, the logical direction to turn for care is toward Mom and Dad. Many of the wounded are still single. Others are married to partners who can’t or don’t want to care for gravely injured spouses. As a result, across the nation, parents end up scrubbing burn wounds, suctioning tracheostomy tubes, and bathing their adult children. They assist with physical and occupational therapy. They fight for benefits. They deal with mental health crises and help children who have brain injuries to relearn skills. They drive back and forth to Veterans Affairs (VA) hospitals for outpatient appointments. In short, they put their own lives on hold.
Patty and Bob Harvey, both 58, for example, were looking forward to retiring early and moving from the Los Angeles area to northern California’s Humboldt County. But their son, Private First Class Nick Harvey, returned from Iraq in April 2005 with a mental illness that requires him to live at home, under his parents’ constant supervision. With 27-year-old Nick’s health their top priority, relocating is now not an option. “We can’t take him away from his comfort zone,” Patty says. “We don’t know what might cause a psychotic break.”