San Antonio Express-News (Sunday)
Center eases the darkness of war
By helping them recover from catastrophic injuries, facility ‘respects and honors’ warriors
The word “intrepid” mesmerizes with images of bravery and strength in the face of immense obstacles.
Explorers scaling mountains, battling seas, traversing glaciers or traveling to space. Entrepreneurs disrupting industries. Athletes beating the odds. Teachers helping kids. First responders rushing to trouble. Military members serving the nation.
All sorts of heroes are worthy of this adjective, which is the perfect name for the one-of-a-kind rehabilitation and research facility at Brooke Army Medical Center, or BAMC — home to long journeys of a different type.
The Center for the Intrepid, or CFI, is a 65,000-squarefoot, circular building (to promote 360-degree healing) where doctors, therapists, technicians and specialists help military people and civilians recover from amputations and other catastrophic injuries.
Arnold Fisher, a philanthropist and New York real estate firm leader, led
600,000 donors in funding the $55 million center that opened Jan. 29, 2007. It was a special event punctuated by the tragic reality that the wars in Iraq and Afghanistan were not only grinding in the background, creating thousands of dead and wounded — they were expanding.
Just three weeks before the grand opening, President George W. Bush announced the “surge” that sent an additional 20,000 troops to Iraq. And as the wars grew, so did the numbers of U.S. wounded and dead.
“Presidential hopefuls, high-powered generals, celebrities and millionaire philanthropists rubbed shoulders with enlistees and everyday people to mark the opening of the Intrepid Center,” Sig Christenson, Express-News military reporter, wrote of the grand opening that drew 3,000 people.
15 years of service
Since then, the outpatient center has helped more than 3,000 service members with its holistic approach to physical, occupational and recreational therapy.
Various tools, such as virtual reality, motion analysis, a firearms training simulator and a therapeutic aquatics program that includes a surfing wave machine, help the CFI accomplish its mission.
Beyond that, the CFI aids patients with case management, behavioral health, pain and internal medicine, and in-house prosthetic fitting and fabrication.
The CFI endeavors to not only help people regain their quality of life and thrive, but it also maximizes the potential for some to return to active-duty service.
Between 2001 and 2015,
1,645 U.S. military people suffered limb amputations in combat. But that number doesn’t account for those whose combat injuries resulted in amputations later in life, nor does it include the
many more who lose limbs to noncombat accidents, injury and disease.
As combat in Iraq and Afghanistan wound down, so did the numbers of combatrelated amputations, but the center didn’t become less busy or important to military readiness.
“We still have the obligation, and we love the obligation, of taking care of our catastrophically injured service members,” Dr. Jeffrey Tiede, a pain-management physician and the center’s director, told me during a visit April 26. “And when we look at the history of the CFI, we actually had more unique amputations from service members this last year than any point in the last six years.”
The causes, he said, are motor vehicle accidents (primarily motorcycles), training mishaps and cancer.
Rehabilitation and treatment for amputations is a slow and iterative process, lasting months or years.
Without active wars, Tiede worries the community will lose sight of the sacrifices military people and their families make.
“People are still injured. Families are still impacted, whether it be in combat or not in combat — and combat operations are still happening,” he said.
Sometimes the CFI treats civilians whose injuries mimic wartime injuries. They’re selected on a case-by-case basis and approved by the secretary of the Army or defense. Civilians receive specialized care, and the CFI maintains readiness.
Beyond physical therapy
Retired Army 1st Lt. Christopher Parks spoke about his journey, which began eight years ago when he woke up in San Antonio’s Audie L. Murphy VA Medical Center with his right leg missing above his knee.
The Army combat medicturned-physician
assistant had survived an Iraq deployment intact, but a flesh-eating bacterial infection nearly killed him.
“I went to bed February 28, and I woke up April 15 (2014)” said the 49-year-old who was stationed at Fort Hood at the time.
During his six-week coma, he endured nine surgeries to battle the deadly bacteria. Two months later, he transferred to the Center for the Intrepid.
After six months, he returned to Fort Hood, but the level of care didn’t compare to the CFI.
“Dollar General (versus) Rodeo Drive,” he said. “I was the first amputee the physical therapist had seen in five years” at Fort Hood.
He lives in Kempner but was back at the center after a surgery to remove excess skin and tissue from his residual limb that required him to get a new prosthetic leg.
During his recovery, he made the Army team for the Warrior Games, the United States’ annual adaptive sports competition for wounded, injured or ill military people. Then he competed in the Invictus Games, the international competition, earning a gold medal in 2018 for wheelchair basketball.
Parks’ positivity is contagious.
“I’m happy. I should be dead, bro. I’m good. I am so good. ” he said. “Life is what you make it.”
When asked about how the center has helped him, he highlighted the physical therapy and camaraderie.
“At Fort Hood, I’m one of one. I mean, there’s very few amputees, but down here, you can’t throw a stick without hitting two — they’re everywhere, so there’s a camaraderie that exists,” he said.
Air Force Master Sgt. Justin James echoed Parks’ sentiments. The 45-year-old combat controller currently assigned
to the Air Force’s Special Warfare headquartered at Joint Base San AntonioLackland severely injured his left ankle and leg in a 2013 parachuting accident but continued to train and deploy.
On April 29, 2021, doctors amputated his leg below the knee, and he’s had 15 prosthetics so far. With time, the residual limb changes size and shape, which requires prosthetic adjustments.
“Camaraderie is a huge part in a patient’s recovery process,” he said. “Knowing that you’re not alone with your injuries helps improve your psyche and rehabilitation.”
And like Parks, he’s gotten involved in the Warrior Games, making the Air Force’s team for archery, upright cycle, air rifle shooting, discus, shot put and several swimming events.
An enduring commitment
In a hallway, I met John Fergason, CFI’s lead prosthetist, who’s been at BAMC since 2004. He held a carbonfiber prosthetic leg as he conversed with a physical therapist about some needed adjustments. It’s an example of the real-time prosthetic modifications that occur daily at the center.
His business is different now that the wars in Iraq and Afghanistan are over.
“We’re not at war, that’s the bottom line, but you have to remember that for my clientele — they don’t necessarily just pass through,” he said.
He’s still seeing patients he first saw in 2005, and on this day, he had just helped a patient who’d driven from Houston because his prosthesis needed a quick repair before an international business trip.
“He was a very complicated case for years,” Fergason said. “He was a special operator, and this is where he feels taken care of, so we keep taking care of him.”
With fewer combat injuries, the center can focus more on readiness and research.
Dr. Alison Wiesenthal, the first female and youngestever chair of BAMC’s Department of Rehabilitation Medicine, is especially proud of the CFI’s lasting promise to its patients.
“This building is a representation of the community’s respect and honoring of our soldiers. And the Department of Defense has continued that commitment,” she said. “So that commitment is enduring.”
And in Military City, USA, the bond with the community is strong. The CFI has brought people to the area who likely wouldn’t have been here otherwise.
Not only is the CFI important to its patients and San Antonio, it’s also helping improve care for everyone with its research.
Experts are part of various studies, including one with Johns Hopkins University to genetically re-engineer stronger skin and another that is eyeing adaptive sockets for residual limbs. There also are studies on prosthetics, limb health, chronic pain, PTSD and exoskeletons.
In 2009, a CFI therapist and prosthetist developed the Intrepid Dynamic Exoskeletal Orthosis, or IDEO, that helps patients regain lower extremity mobility without amputations.
Tiede said the device can help people with catastrophic lower leg injuries. The CFI has fitted more than 1,200 service members with the devices and return to duty rates are “very high.”
“We’re able to salvage not only limbs but careers,” he said. “We have operators, Green Berets and pilots across the spectrum that use these across the world.”
So many intrepid people have passed through the center or are recovering there now.
Beyond those it’s directly helped, the CFI has also dampened the trauma of war that echoes through generations. That is a light in a dark world.