Sgt. Briggs's War

Bob Briggs got a head full of shrapnel in Iraq. Then he came home to more wars: to regain the use of his half-paralyzed body, and to get the U.S. government to pay for his medical care.

FROM THE TIME Bob Briggs was a kid, what always thrilled him most was the romance of operating heavy equipment—the big machines that made roads and dug holes and moved steel beams, that got jobs done and kept the world moving. The fascination never left him. It was part of the reason that the then-23-year-old Briggs enlisted in the National Guard in 1992, after the first Gulf War, as a combat engineer and equipment operator. And it was certainly the reason he chased after, and eventually won, what he calls his "dream job," as a road maintenance worker with the Iowa Department of Transportation.

These days, the heavy machine Briggs is learning to operate is his own body. Last April 16, at an encampment 70 miles west of Baghdad, an Iraqi insurgent's rocket-propelled grenade exploded about 10 feet from Briggs. The blast shredded the right side of Briggs's skull with shrapnel. His right eye was destroyed, along with most of the vision in his left eye. The resulting massive brain trauma effectively wiped out a lifetime's worth of vital neural connections that encompassed tasks as varied as walking, feeding himself, and making and storing memories. The left side of his body was almost completely paralyzed. Shrapnel littered his brain and right hip. After being evacuated from the field, he spent nearly a week on life support. "I got so much metal in me I probably won't be able to go through airport security ever again," he jokes now.

Since June 2, Briggs has spent countless hours in physical rehabilitation here at the Minneapolis Veterans Administration Medical Center, one of four newly designated "polytrauma" units created in April 2005 to deal with the complex and multiple injuries soldiers are sustaining in Iraq and Afghanistan. The staff at the new polytrauma units (the others are located in Tampa, Palo Alto, and Richmond, Virginia) have had to readjust and receive fresh training to deal with a set of life-changing injuries not seen in previous wars. "We're seeing a lot more brain injuries. That's definitely the most common injury," says Dr. Larisa Kusar, one of the lead physicians for the brain injury and polytrauma team. "But we're also seeing multiple orthopedic fractures, amputations, severed limbs, blindness—a lot of multiple traumatic injuries."

The physical therapy room where Briggs has spent countless hours since June is a drab, bare-walled beige. Today he's working to ascend a plywood riser built to simulate a curb. The diminutive physical therapist at his side is reminding him to lead with his right side, then to move the cane and drag the left side of his body onto the raised pallet. As a natural left-hander, Briggs is accustomed to leading with that side when he moves, and it doesn't work anymore. He has a hard time at first trusting his none-too-steady right side to carry the entire weight of his body, and the exertion wears him out quickly. He needs to stop and rest on a nearby chair for a few minutes. After a couple of more tries, Briggs executes the necessary movements more confidently. His rule of thumb in rehab: Don't stop trying until you get it right at least once.

Besides the curb-stepping exercise, Briggs's rehab regimen includes tasks such as climbing a set of stairs, rising from a chair, and getting up off the floor. The last is especially brutal given the essential uselessness of his left side: He compares the job of lifting his 200-pound frame into a standing position to "picking up a couch with one hand tied behind your back." Without the stabilizing tripod-base cane he uses in all his mobility exercises, it would be entirely impossible.

Briggs practices walking in the hallway outside the PT room, a 50-foot corridor finished in sedate institutional brown and beige. Before starting, he often touches the padded green helmet he wears, almost unconsciously. Portions of his skull had to be removed to accommodate the swelling of his brain, so the helmet is an absolutely vital part of his rehabilitation. Without it, falling down could be deadly.

The physical therapist tucks herself under Briggs's inert left arm and they set off. As they go, she uses her right foot to gently kick his near-paralyzed left leg out ahead of him, and a certain faltering rhythm is established by the clack of Briggs's cane and the little kicks the therapist is giving his bad leg. Together, they look a little like the equipment manager and the star linebacker, hobbling off the field.

As if the walking itself were not arduous enough, the therapist is peppering Briggs with questions as they go: "How are you feeling now?" and "How have you been sleeping lately?" and "How has this week been for you?" She encourages me to ask him questions, too. As they pass the waiting area where his wife, Michelle, is sitting, Briggs struggles to call up the answers while still pulling the weight of his body forward. The point of making him talk is to teach his brain how to do more than one thing at a time again. Briggs says the energy this requires is palpable, and that it's made his walks even more exhausting.

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