Inside the Painstaking Recovery Process of a Medal of Honor Marine
Six
years ago this month Lance Corporal Kyle Carpenter suffered grievous
wounds after shielding another Marine from a grenade blast in
Afghanistan. Somehow, he survived. This is the story of his remarkable
recovery.
I. The Damage
The
thick steel body of the grenade flexed and swelled before exploding and
tearing flesh and bone from Lance Corporal Kyle Carpenter’s face. The
date was November 21, 2010. The place was Marjah, Afghanistan. For seven
days, the extent of Carpenter’s wounds remained a mystery to his
family. Despite e-mails, voicemails, and calls with Marine Corps
representatives, his mother and father knew only that their son was
being evacuated from Afghanistan in critical condition. The military
told them that Kyle had been badly wounded and that his chances of
survival were unknown. On November 25, Thanksgiving Day, Robin and Jim
Carpenter drove 12 hours, slowed by the holiday traffic, from Gilbert,
South Carolina, to Walter Reed National Military Medical Center, in
Bethesda, Maryland, to await their son’s arrival. His flight was delayed
because of blood clots in his legs. A flight at high altitude could
have killed him.
Carpenter
arrived at Walter Reed on Sunday, November 28. Robin held his hand all
the way from the ambulance to the elevator taking him to the
intensive-care unit. Carpenter’s head appeared roughly double its normal
size—it was wrapped in gauze and pressure dressings to deal with the
effects of the explosion and the aftermath of emergency brain surgery.
The doctors in Afghanistan had to remove shrapnel before Carpenter could
be flown to Landstuhl, in Germany, and then to Walter Reed. Tubes
protruded from his neck, head, chest, abdomen, and each of his limbs.
The Carpenters had not seen their son in four months. His mother
remembers thinking that Kyle looked worse than anything she had seen
while working as a radiology technician in a trauma hospital. She knew
it was Kyle only because the hospital staff told her it was.
Throughout
Kyle’s deployment, Robin had worried that harm would come to her son.
“For the four months Kyle was in Afghanistan, I felt like every time I
came home a car would be sitting in my driveway. I did what I was
supposed to do—the care packages, the letters—but I still feel like I
didn’t have enough faith. My gut told me that he would come home
wounded, or worse.”
VIDEO: Kyle Carpenter’s Recovery
Kyle
Carpenter had been wounded when a hand grenade landed beside him and a
fellow Marine in their lookout post. Without hesitation, Kyle lunged
toward the explosive to shield his friend from the blast. He was wearing
body armor, which offered some protection for his torso, but the
exploding grenade left entry and exit wounds in his skull, shredded his
face, severed major arteries, splintered his right arm, collapsed a
lung, and left him hemorrhaging beneath a plume of grey smoke. For his
action in Marjah, Carpenter would be awarded the Medal of Honor.
Repairing the damage to his body would take years, and in some ways it
is not over. This is the story of Carpenter’s recovery.
II. Patrol Base Dakota
The
squad of Marines had spent the night of November 20 patrolling open
fields and deep canals. Doing so was safer than using the roads. The men
were four months into a seven-month deployment, and Private First Class
Jared Lilly had already seen two of his friends killed by explosives.
Others had been wounded by gunfire. Lilly and his 1,000-man unit were
spread across fortified bases inside Taliban territory. That relative
comfort and safety was now at an end. Lilly and the rest of his 14-man
squad had just moved to an even more remote and dangerous location.
In
a village, the Marines took over a compound—a collection of buildings
behind 10-foot-high mud walls—to use as its patrol base, which they
called Dakota. The compound had been commandeered from a local family,
which was evicted. Before sunrise, more than 250 sandbags had been
hand-filled and stacked into makeshift guard posts. A request for heavy
equipment to fortify the new patrol base had been denied hours before
the mission began. Instead, the Marines chiseled at the ground with
collapsible shovels.
There
were walls at Patrol Base Dakota, but the enemy could maneuver within
30 yards of the Marines unseen. A canal ran alongside the compound,
lined thickly with tall reeds. On the first day the Marines spent at
Dakota, Taliban fighters heaved grenades over the walls. One Marine took
shrapnel to his abdomen. Another had his scrotum peppered with shards
of metal. Later that night, the owner of the compound came for some of
his belongings. He brought a message from the Taliban: Tomorrow the
Marines would be attacked worse than they just had been.
Sunrise
brought machine-gun and sniper fire. A barrage of grenades began
exploding throughout the courtyard. Marines who were sleeping scrambled
to put on their gear. There was a second barrage of grenades, then
screaming in Pashtu: an Afghan soldier had been wounded. Two more
grenades exploded in the courtyard. Then another grenade. Then another.
The last of the explosions came from the rooftop of one of the
buildings. Two Marines were known to be there.
Lilly
sprinted to the building and up the rungs of a wooden ladder, charging
into the dust and smoke. Lance Corporal Nick Eufrazio was lying on his
back. He had been hit by shrapnel and appeared to be unconscious. In a
corner, Kyle Carpenter lay face down in a widening pool of blood. Lilly
reached for his arm. It squished limply in his hand. Carpenter’s face
was torn into four separate flaps of flesh. Lilly placed tourniquets on
each of Kyle’s arms. One of them was so badly mangled that Lilly worried
he would cinch down too tight and “pop his arm right off.” Carpenter
gasped for breath, his chest heaving.
The
squad’s Navy medical corpsman, Christopher Frend, had treated many
casualties before, but had never seen anything like Carpenter. His arm
was so shattered that Frend felt as though he was splinting a wet rag.
Carpenter’s right eye had nearly fallen from its socket. The corpsman
inserted a tube through a nostril hoping it would help Carpenter breath.
It didn’t. When Frend removed the tubing, Carpenter sprayed teeth,
flesh, blood, and mucus from his nose. He was trying to speak. His
tongue seemed to be searching for the rest of his jaw. He was asking,
“Am I going to die?” The Marines on the triage team began reminding Kyle
of stories he had told them about life at home. The more they talked
about his family, the more stable he became.
III. Aboard the C-17
The
rotors of the medical evacuation helicopter thumped in the distance as
it flew toward Patrol Base Dakota. Lilly and four others carried the
wounded to the landing zone on nylon sheets. Lilly thought he’d never
see Carpenter alive again. He heaved his helmet across the patrol base
and sat with his back against the wall. Tears dripped onto his
cigarette. Other Marines began cleaning off the blood on his skin and
uniform with baby wipes.
Aboard
the helicopter, the medics triaged Carpenter’s wounds. When his heart
stopped, the team worked to revive him: chest compression, fluids,
drugs. There was a heartbeat—and then it was gone. Once more he was
revived, and for the moment stabilized. Upon arrival at Camp Bastion,
Carpenter’s admission code was given as “P.E.A.,” the military acronym
for Patient Expired Upon Arrival. But he wasn’t P.E.A. at all.
Neurosurgeons
removed shrapnel from his brain. Vascular surgeons repaired his veins
and arteries. Torn flesh was stretched and sutured; nothing
cosmetic—that could wait. Stopping blood loss and preserving tissue was
more important. Carpenter was wrapped in pressure dressings and
stiffened with splints. The medical team’s goal was to get him stable
enough to fly to Germany and then to the United States. The medical
staff at Walter Reed could rebuild him. He just needed to stay alive
until he got there.
On
Thanksgiving, Carpenter was cleared to fly to Germany. Only after he
arrived at Landstuhl was his mother able to speak to her son. Carpenter
was in a medically induced coma, and his state of awareness is unknown.
But a nurse held a phone to his ear when Robin and her family called.
They remember the nurse telling her that Kyle’s heart raced on the
monitor every time she spoke.
After
two days in Germany, allowing blood clots to dissolve, Carpenter was
wheeled aboard a U.S. Air Force C-17 transport airplane. The airplane
was fitted with two intensive-care bays: the second one was for an Army
sergeant named Ryan Craig. More than 150 other service members were on
the plane, the majority of them ambulatory patients—“walking wounded.”
For
nearly a week, Ryan Craig’s mother, Jennifer Miller, had been in
Germany with her son. Next of kin are normally flown to Landstuhl only
if a patient is terminal. “I got a call at 5:22 a.m. from somebody in
Afghanistan who said Ryan was hurt,” Miller recalled. “They didn’t give
me many details . . . . that my son’s injuries were not
life-threatening. At 8 a.m. they told us about a gunshot to the helmet.
By 11:30 a.m., . . . they told us the bullet hit his head, but didn’t
penetrate. . . . . At 2:30 p.m., they told me they’d removed part of his
skull. By 5 p.m., I was going to Germany.”
Like
Carpenter’s mother, Miller had decades of experience working in a
trauma hospital. She assumed her trip was to give approval for doctors
to remove her son from life support. But no: he was still hanging on,
and stable enough to be transported. Jennifer was harnessed into a seat
among the doctors and nurses. Once the plane reached cruising altitude,
Jennifer alternated between talking to her own son and to Robin’s. She
said to Carpenter, though he remained unconscious: “I’m not your mom,
but I am a mom. We’re going back to the United States. You’re going
home.”
The flight from
Germany took more than 12 hours. At one point Craig went into cardiac
arrest. Doctors re-started his heart as the aircraft descended by 10,000
feet to help increase cabin pressure. Craig and Carpenter survived the
flight, and after landing at Dover Air Force Base, in Delaware, they
were loaded into ambulances. Miller stared out the back window of the
one carrying Ryan, blue and red lights flashing in the darkness—mother
and son speeding toward a recovery that is still ongoing today. She
could see Carpenter’s ambulance behind theirs, the white and yellow
lines of the highway trailing behind. Police blockades closed off
intersections as the ambulances sped toward Walter Reed.
IV. “We’re Going to Save It”
Carpenter’s
parents were inside the main lobby. So was Tiffany Aguiar, a friend of
Nick Eufrazio’s, the man Carpenter had tried to shield. Eufrazio had
suffered severe head injuries and was already at Walter Reed. As the
ambulance pulled up, Robin and Jim rushed outside. Aguiar stood
motion-less when she saw Carpenter. Very little of his face was visible,
but the parts that were exposed were “scarred and indistinguishable,”
she recalled. Robin’s face left an impression just as deep. “I could
never, ever imagine my parents being in that situation,” Aguiar said.
“The image of a mother seeing her son come back from war like that is
something that doesn’t leave you.”
Walter
Reed’s chief of trauma surgery is Dr. Debra Malone. She prepared to
evaluate Kyle. When a patient arrives, Malone explained, treatment
starts over. The medical team ordered a full body CAT scan. An angiogram
was administered to gauge whether the blood flow to the injured parts
of his body was sufficient. Because Kyle had been revived twice during
his medical evacuation, and because he had been given 12 pints of blood,
the team wondered how much more his immune system could withstand.
Dozens of x-rays were taken before his treatment strategy was presented
to orthopedic, vascular, reconstructive, and trauma surgeons.
“There’s
no recipe book for combat trauma or medicine,” Malone said. “Someone
can be stable and their wounds can look clean, and a few seconds,
minutes, hours, or days later, things can look very different. It’s a
difficult thing to explain to patients and their families. It’s not a
journey on a flat paved asphalt road; it’s a journey through a
treacherous mountainous path.” And then? And then, she said, if
everything goes well, “eventually you make it to a beautiful meadow.
That’s the rest of your life.”
Carpenter
had a long way to go. Because his right arm was shattered—a total of 34
fractures, the bones broken into shards—his mother was worried that the
doctors would need to amputate. “We’re not taking his arm,” Malone’s
team told her. “We’re going to save it.”
During
the weeks and months ahead, Robin made her home in the waiting room.
Jim had gone back to South Carolina—to his job as a poultry salesman and
to the couple’s two other sons, Price and Peyton, both teenagers. A
woman named Janine Canty introduced herself to Robin upon Kyle’s arrival
and grew close to Kyle and his family. She wasn’t a doctor, nor was she
part of the staff at Walter Reed. She was a case manager with the
Semper Fi Fund, a nonprofit assistance organization that helps wounded,
ill, and injured Marines and sailors. Her husband was a Marine with 27
years of service.
By
the time she met Robin, Canty had been with the Semper Fi Fund for just
over four years. In the beginning, Janine didn’t know where to look or
what to say when she walked into a patient’s room. With time, she became
more comfortable asking patients about their injuries—above or below
the knee or elbow, closed or penetrating brain injury. She also became
more comfortable asking families if they needed financial help. Being
around pain, injury, and suffering had somehow become normal for her,
Canty said, but the moments of success and hope made all of it
worthwhile. Families worry about finances when a service member is
wounded. Support allows a family to focus on recovery.
For
Robin and Jim, the assistance helped them to travel back and forth
between home and Washington—one of them always with Kyle, the other with
the rest of the family. “I can’t imagine there being another choice—to
be apart—because there were two boys at home and somebody had to raise
them,” Canty said.
V: One Step at a Time
Carpenter
was in surgery almost weekly. Orthopedic surgeons repaired his bones.
Malone repaired his soft tissue. Other surgeons applied and repaired
skin grafts. Carpenter was treated with leeches to control blood pooling
under the skin. Because his head had borne the brunt of the blast, dirt
and debris were embedded in Carpenter’s face. Malone referred to the
damage as “mud tattoos.” It would take months of reconstructive surgery
and laser treatment to remove it all. The medical team focused on small
successes as a way of boosting morale. Carpenter himself lived in “a
haze of drugs,” as Malone described it.
When
he was finally allowed out of that haze, in the spring of 2011, there
were psychological issues to contend with. Malone remembered visiting
with him. “I think it was the first time since his injury that he was
talking to me with a clear mind,” she said. “Other Marines would always
come in to visit him and he didn’t like them seeing him how he looked.
It wasn’t that Kyle seemed self-conscious. He knew they were deploying
to Afghanistan soon, and he didn’t want them to worry more about being
injured like he had been.” Carpenter needed to be medicated simply in
order for the staff to change his bandages. Malone’s medical notes quote
Kyle talking about these procedures: “It is the worst pain I have ever
felt.”
Malone stood by
Carpenter when he took his first steps in the hospital. “When a wounded
warrior is about to get out of bed for the first time,” she said,
“everybody knows it is going to happen. We line the hallway and when
they step out of their room we ring a bell and cheer.” Carpenter was in
pain, but he kept walking. Yellow foam cubes encased his right arm,
which itself was held together with hundreds of screws and dozens of
plates. Carpenter circled the nurse’s station with nearly the entire
wing in tow. Chimes echoed throughout the hall.
Carpenter
would remain at Walter Reed for another year. Robin rarely left. She
missed the birthdays of her husband and of her other two boys. She
missed sports championships, first dates, family dinners. Throughout
Carpenter’s recovery, Robin and Jim would on occasion meet in Dunn,
North Carolina, roughly halfway between their home and Walter Reed.
Dinner, a kiss, and then off on their separate ways. Sometimes it was
Jim who went north to be with Kyle, Robin heading south for a spell at
home.
What Jim
Carpenter cannot forget is the staff at Walter Reed. “When I first saw
Kyle, I didn’t think he would have any quality of life—living bound to a
bed or a wheelchair,” he said. “He kept progressing and I kept getting
my son back. There’s so much weight put on the hospital staff to repair
wounded people—people just torn apart—and they do it day in and day out.
It seems impossible and thankless. It’s Groundhog Day for them.”
The
drive from Camp Lejeune, North Carolina, to Walter Reed, in Maryland,
takes around six hours. Jared Lilly, the Marine who triaged Kyle on the
rooftop in Afghanistan, made the trip in February 2011. He was excited
but nervous about seeing Kyle for the first time since the explosion.
“Kyle was like the lovable little brother,” Lilly said. “He was the guy
that everybody wanted to be friends with and he was really nice to
everyone, but he was also someone who really enjoyed being by himself.
Most of our platoon ran 20-minute three-mile runs. He could do it in 15
to 16. He was a serious athlete. But I had no idea what to expect. The
last thing I had in my head was him with his jaw blown off. I expected
him to still be a mess.”
When
Lilly parked his car, Kyle and Robin were walking together out of the
entrance to the hospital. “I ran over to him. There was no walking,”
Lilly recalled. “I did not expect him to be walking and when you see
that, wow. . . . . But as you got closer, all the real stuff hit you.
His arm was still in a sling. He was tiny and skinny at this point. You
could see where he had been sewn up—they hadn’t done any plastic surgery
to make him pretty. It was just to save the tissue.” Lilly remembered
looking him over, in awe that the medical team had “put him back
together.” Carpenter’s mind seemed sharp. Lilly wanted to hug and
squeeze his friend, but “didn’t want to break him.”
VI. The First Salute
Many
years before Carpenter was wounded, Erik Johnson had himself been a
patient one infection away from death. It was 1997 and he was about to
deploy to Bosnia as an Army private. He had been driving a military
vehicle with other soldiers when one of the tires ruptured and sent the
truck flipping end over end. The truck came to a stop when it struck a
street sign and burst into flames. Johnson and another soldier were
trapped inside. His arms and half of his face suffered third-degree
burns. The other soldier died. Johnson endured months of recovery that
included debridement of his burns, a sterile process that involves
scrubbing his flesh with a sponge resembling a Brillo Pad.
Fifteen
years later, his own hospitalization was part of what helped him form a
friendship with Carpenter. Kyle had been at Walter Reed for more than a
year when he first met Johnson, who would work with him as his
occupational therapist. Before meeting Carpenter, knowing only what he
could guess from the chart, Johnson anticipated someone frail and with
poor mobility, and perhaps lacking in motivation. To his surprise,
Carpenter walked into his clinic wearing gym shorts, ready to get to
work.
“I asked to look
at his grafts and understand his injuries,” Johnson recalled. “And he
wanted to see mine. He was really interested in how things would look
when things matured. We talked about follow-up procedures and how I had
an upcoming surgery with his same surgeon. He reminded me a lot of
myself.”
Carpenter and
Johnson were both from South Carolina. Both were Gamecocks fans. There
was plenty to talk about. One of the subjects was pain. Johnson
explained to Carpenter that a position of comfort is a position of
contracture, and that it prevents functional independence. He needed
Carpenter to know that pain is a necessary part of recovery. The two
spoke a lot about Carpenter’s prosthetic eye. For his first one,
Carpenter asked if an image of a Purple Heart could be placed where the
pupil would ordinarily be. The prosthesis team initially told him that
this was impossible—and then found a way to do it, giving him the eye as
a surprise.
Dr.
Richard Auth was in charge of Kyle’s facial reconstruction. Because of
the array of injuries to Kyle’s face, the team relied on a variety of
imaging technologies, including magnetic resonance and 3D spiral
multi-slice. The scarring and missing tissue and bone meant that the
skin on Kyle’s face had to be stretched before acrylic teeth could be
implanted into his mouth. Each time Auth met with Carpenter’s mother,
she expressed the hope that she hadn’t lost her son’s smile forever.
Mold after mold was made and refined. In the operating room, Auth kept a
picture of Carpenter before his injuries. He and his team were
determined to give him back his smile.
During
years two and three of his recovery, Carpenter was able to spend some
time at home. He undertook occupational therapy with Julie Durnford, a
therapist in Lexington, South Carolina. Carpenter was the first
combat-wounded service member she had ever treated. “His injuries were
challenging and I had been a therapist for 20 years,” Durnford said. “He
couldn’t function normally by any means. He always told me he wanted
his arms to get better so he could stay in the military. He always
looked exhausted by how hard he worked to recover. When he took any
breaks during therapy he would try to motivate the old ladies with
broken wrists or hips. And he always, always made time to speak with any
World War II, Korea, or Vietnam veterans who came into the clinic.
Always.”
Carpenter
began calling her Dr. Julie. She helped him regain some use of his right
hand. It was all about the small successes for Carpenter, she said. Her
favorite moment was when he scratched his own nose for the first time.
His smile was beautiful, she remembered, even with missing teeth.
As
Carpenter dedicated himself to his recovery, Nick Eufrazio’s friend
Tiffany Aguiar finished college and earned a commission in the Marine
Corps. In August 2012, she graduated from officer candidate school as a
second lieutenant. The first salute is a tradition among Marine
officers: they render the honors to a service member or veteran whom
they respect and admire. Tiffany had hoped Eufrazio would be her first
salute, but owing to his injuries and ongoing therapy he remained
incapacitated. So Carpenter stepped in. He had by now regained much of
the use of his right arm. Standing in front of the Iwo Jima Memorial,
just beyond Arlington National Cemetery, Carpenter and Aguiar faced one
another. Both were wearing their dress blues. Carpenter’s Purple Heart
was pinned to his breast. In his left arm he held a photograph of Nick
Eufrazio. He raised his right hand to the brim.
VII. A Fresh Eye
Robin
Carpenter circled the granite island at the center of her kitchen. Then
she looked out a window, stared at her phone, and wondered where Kyle
was. She had been told that the President of the United States was about
to call. Kyle wasn’t answering. At last he walked in. “Does anyone have
an iPhone charger?” his mother remembered him saying.
On
June 19, 2014, William “Kyle” Carpenter was awarded the Medal of Honor.
During the ceremony, Carpenter’s occupational therapist at Walter Reed,
Erik Johnson, noticed something different about his appearance. He was
wearing an ordinary prosthetic eye, not the one with the Purple Heart
pupil. To Johnson, the switch seemed symbolic: Carpenter was no longer
defining himself in terms of his wounds. At the White House, Carpenter
stood among those he had fought alongside—both in the hospital and on
the battlefield. When the Medal of Honor was clasped around his neck by
President Obama, Carpenter was with his family, his friends, his squad,
and nearly all of his medical team.
Since
being injured, Kyle has skydived and run marathons. He is a full-time
student at the University of South Carolina. He is a sought-after public
speaker on the issues veterans face as they reintegrate into the
civilian world. “The Marine Corps wasn’t part of my plan for Kyle,”
Robin Carpenter said, looking back. “I still remember what he said to me
when I tried to talk him out of it. ‘If I don’t do this, it will be
someone else’s son.’”
Thomas J. Brennan is the founder of The War Horse,
which is a nonprofit newsroom dedicated to investigating the
Departments of Defense and Veterans Affairs, and which collaborated with Vanity Fair on this article.
No comments:
Post a Comment