En español | Every November we celebrate those who have worn the uniform, including the less than 1 percent of our population who voluntarily serve in the military today. And while we often place the attention and accolades on the veteran, especially the injured or wounded, the family and caregivers deserve our equal attention and gratitude.
The three caregivers profiled below see their roles not as a job but as a part of their life. Their words and devotion contain wisdom for all of us.
Husband as caregiver
Brian Vines, 58, and his wife, Natalie, 49, met in the military while both were assigned to Fort Bragg, North Carolina, home of the airborne and special operations forces.
"We had so much in common,” says Brian, a Texas native. “We speak the same language and understand why we act the way we do. We both have a strong faith in God, which has helped us through some trying times."
In 2005, while stationed in Iraq, Natalie suffered a blast injury and an undiagnosed traumatic brain injury (TBI) that manifested in severe migraines. Like so many service members who simply wanted to continue their service, Natalie did her best to hide the symptoms. But in 2009 she received another TBI that resulted in a seizure disorder, cognitive disorder and severe PTSD. Those injuries led to her medical retirement and to what Brian describes as “rock bottom,” from Natalie's frustration around word-finding issues to suicidal ideation.
"Not to stereotype, but as a guy, I wasn't necessarily wired to be a caregiver,” he admits. “But as a result of her injuries, I had to learn what she needed from an emotional and physical standpoint. At the time, I didn't see myself as a caregiver, I just thought this is what a loving husband does."
Through connection to organizations like the Elizabeth Dole Foundation and the Wounded Warrior Project, Brian learned to identify as a male caregiver. More important, he learned that he wasn't alone. He found other male caregivers with whom he could speak about the unique challenges of assuming and identifying with this role, as well as advocate for others.
"Many people view disabilities as being the worst possible thing that could happen, but in many ways the experience and sharing our story has brought us closer than we ever would have been otherwise,” says Brian, who deals with his own diagnosed PTSD from two tours in Iraq.
An initial challenge — asking for help — was a pride issue. “At first I felt as if I needed to be in charge and control, to not ask for assistance because somehow that made me feel as if I was failing,” he says. “But that's a stigma I'm now actively working to diminish. I decided when Natalie came home that if I was going to be a caregiver, I would be the best I could be.”
Brian assists Natalie on a range of tasks including medication management, aiding in balance and mobility, and helping her understand conversation and written instruction, among other day-to-day activities. He cautions all caregivers that “compassion fatigue” is a real thing: “If we don't make time for ourselves during the day, even for a limited amount of time, then we become less capable. When we constantly put other people's needs ahead of our own, we don't deal with our own issues.”
The Vineses have a new sense of purpose and a mission to informally host wounded warriors and their caregivers in a house they are building in Alabama. The dream is for multiple families to visit, share stories, form connections and community, and learn how to wake surf.
"People need to remember you are not alone,” Brian says. “Your story doesn't have to be a tragedy where your injuries push you apart. It can be a love story where your experiences bring you closer together.”
Caregiver to husband and daughter
Rocio Alvarado, 42, of Long Beach, California, met her Marine husband, Brian, 39, while he was on active duty. In 2008, while back from two tours in Iraq, he was diagnosed with head and neck cancer, which was treated and was pronounced in remission. The next year, odd symptoms began appearing — rashes on his face, overall soreness in his body, swelling around his eyes in the morning. His weight began to drop dramatically, and Rocio pushed the doctors for answers.
A frustrating yearlong medical journey brought a diagnosis of dermatomyositis, an autoimmune disease that affects the muscles and skin. Brian couldn't lift his arms, bathe alone or put on his shoes. “I had to help him with so many basic tasks,” Rocio says. And yet she doesn't use the word “caregiver” to describe herself.
"For me, what I do is simply part of the vows I took,” she says. “This is what we promised to each other, and that's the way it should be. You don't walk out the minute things get hard."
Rocio and Brian's 13-year-old daughter, Rhiana, has only known her father in and out of hospitals. And she has had her own challenges: Bullied by other kids for learning issues at school, Rhiana was first diagnosed with ADHD and then as autistic and with borderline intellectual functioning. Rocio made the decision to homeschool their daughter in addition to taking care of her husband.
"It was hard to access the right services for our daughter, but now she is starting physical therapy and counseling,” Rocio says. “She is finally getting in touch with her feelings and able to voice what is helpful to her. That helps me, too."
Rocio is aware that many people might look at her family and wonder what makes their relationship work.
"My husband and I have always tried to laugh,” she says. “Life is already full of daily stresses, so learning to laugh at yourself and with each other helps so much."
One of Rocio's coping strategies to make time for herself is a long, hot bath.
"I can be in the tub for two hours, listening to music, reading, scrolling through my phone as the water gets cold. It's my idea of bliss,” she says. Projects, especially during the pandemic, have helped keep her sane. She started painting her daughter's room and ended up including the living room and dining room.
Brian's disease is an ever-changing condition. There is no cure, only treatment that can stabilize and prolong his life. “We are good right now,” Rocio says. “When it feels tough, I have my moments alone to talk to God and pray. This is the life I am able to carry … and we are here, 15 years later. We learn to take the good with the bad and the bad with the good."
The unexpected caregiver
It was love at first sight when Precious Goodson, now 50, from Newnan, Georgia, met her husband Leonard Goodson, 54, in a laundromat. Lenny proposed to her two weeks later, although she made him wait two years before getting married. He had already served in the military as a medic when they met. A few years later he signed up for National Guard duty, a commitment of one weekend a month and a way to honor the bonds he felt to the military.
But in 2008, he called to tell her he was receiving a promotion to sergeant and would be deployed to Afghanistan. Precious was upset that she hadn't been part of the decision and was unfamiliar with military culture and life.
At the time, she was teaching elementary school and had just finished a few advanced degrees as a teacher. Sending her husband off to war was something she had not imagined when she took her vows.
On Leonard's first R&R from Afghanistan, he was withdrawn, barely talking at all for the first three days. “We were not communicating, and I was confused and worried,” she remembers. “We finally got away for the weekend and I expected that would make things better, but it was still so different, and he was very distant. He just wasn't there. It was in his eyes."
Leonard was evaluated as having had injuries stemming back to an incident in Afghanistan. During a fall, he had almost been paralyzed, which led to a cervical fusion of his neck. Back injuries that were overlooked at the time have led to ongoing physical therapy and pain management issues. Precious recalls the battery of tests and doctor's visits at Fort Stewart in Georgia, which was three hours from their home.
Suddenly she had to make decisions about finishing the school year or going to be with her injured husband. “The servant heart that led me to be a teacher now carried me to a new place as a caregiver,” she reflects.
And so began an intense period of advocating for her husband and his medical conditions. “It took a lot of pushback on my part to make sure he got what he needed,” she remembers.
In 2010, when they returned home, Precious began to notice that her husband's mental health was deteriorating.
"It got so bad and I started searching for answers. He took all the locks off the doors and I couldn't get in and out of my house,” she recalls. “He would explode at the smallest things and I had no one to talk to. He knew something was wrong and he checked himself into a mental hospital."
Ultimately, Lenny was diagnosed with PTSD, which finally gave her a name for the behavior she was seeing at home.
"I didn't feel any relief for a long while,” Precious says. “I was still scared, and I was with him every day. He was unpredictable, and on top of that our finances were in tough shape. He needed me home, but I needed to make an income. I felt such a great sense of fear and hopelessness. I didn't know what to do."
"Today I'm at a stage where I have a better hold on what's happening, and I have more support. This has not been a progressive journey, however. He has been hospitalized five times for suicidal ideation. We moved to Florida and then back to Georgia, where I realized how important it is to be near those who provide understanding and support.”
Precious identifies with the term “caregiver.”
"Having that definition has helped me define who I am,” she says. “Not only has it given me an identity, but it has allowed me to give back and help other military caregivers on this same path. It was gratifying to know that my inner strength and drive to help and serve others is not just thriving, but a fundamental part of who I am.”
As we move through this Veterans Day month, it's also critical to remember that there are caregivers serving in silence who have physical and emotional needs as well. Especially during this pandemic, they are at greater risk due to isolation.
Brian Vines put it this way: “What concerns me after this series of wars since Sept. 11 is that America has become callous. Service members are still at risk, still out there fighting. If we aren't paying attention to our active-duty military, how are we paying any attention to the caregivers who deal with the aftermath when they come home?"
That part is up to us.