Finding the Beauty

in a New Normalby Kara McDermott

Finding the Beauty

in a New Normalby Kara McDermott To Army Staff Sgt. Daniel Miller, a four-story, 65,000-square-foot rehabilitation center is one of the most beautiful places youll ever see.

track, firearms training simulator, sixlane swimming pool, 21-foot climbing tower, a prosthetic center and a wave pool called a Flowrider all places that engage Miller and others like him It is not a description you would expect to improve their strength, balance for a rehabilitation center. In this case, and confidence. beautiful is in the eye of a beholder whose future hinges on what goes on The center is not a spa. Rehabilitation inside. This place is beautiful because requires fortitude and hard work. In it offers hope for troops like Miller, just one month since suffering his whose dreams include completing injuries in Iraq, Miller labored through everyday activities with ease and two-hour rehabilitation sessions, twice learning to walk again. a day, from Monday through Friday. In February 2009 Miller woke up in a hospital in Germany after a roadside bomb in Iraq blew through the bottom of his vehicle and left him a bilateral amputee. While in Germany, Miller repeatedly heard people say you need to get to San Antonio. And so he went, eventually moving from his home in Kansas to that place he thinks is so beautiful: the Center for the Intrepid. The Center for the Intrepida multimillion-dollar facility located on the campus of Brooke Army Medical Center at Fort Sam Houston, Texas is one of the most modern outpatient rehabilitation centers in the world. Its mission is to advance the science and art of prosthetic rehabilitation and burn care one patient at a time. Equipped with the latest technology, the center is ideal for wounded warriors like Miller. It includes an indoor running The physical therapist is your best friend when you need it and your worst enemy when you need it, says Miller. When you dont feel like you can go any further they are there to push you. Millers sentiment is echoed by other patients at the center, including Spc. Ricardo Samudio. Everyone, from the nurses at Brooke Army Medical Center to the physical therapists at the Center for the Intrepid, is like an extension of my family, Samudio says. If I ever need anything outside of the workout, I can call my physical therapist or doctors on their personal phones. I love it here. For Col. Jennifer Menetrez, the director of the Center for the Intrepid, the beauty of innovation sparks deep pride and satisfaction. There are things here that dont exist anywhere else in the world, she

Above: A servicememberamputee demonstrates his surfing ability at Center for the Intrepid and the Fisher Houses in San Antonio, Texas. The Center for the Intrepid is a state-of-the-art medical treatment facility for wounded servicemembers and their families. DoD photo by Cherie A. Thurlby. (Released)

MHS Profiles

Finding the Beauty in the New Normal

I expected the best and thats exactly what Ive gotten.says. For example, most gait labs which are designed to analyze the movement and forward progression of the human body have only eight cameras and one or two force plates. The Center for the Intrepid gait lab is fitted with eight force plates and 26 cameras that are mounted on an automated truss and use infrared light to analyze and calculate human motion and joint angles. There is a treadmill that has force plates embedded in it, and two additional walking paths use river rocks and sponges underneath the ground to simulate varied terrain.

The lab uses parallel bars that elevate to an incline so service members can practice walking up a hill and analyze their bodies. Force plates in the floor, parallel bars and treadmills measure ground reaction forces in three directions. Using these factors, the therapist can determine the torque that muscles or prosthetic components are producing. We dont always just walk on flat surfaces, so trying to analyze whats happening on different

Finsing the Beauty in the New Normal

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It is really rewarding to me when a spouse says, Thanks, he is a totally different person than he was last monthterrain paths is very important, says Menetrez. The Computer Assisted Rehabilitation Environment is another thing of beauty at the center. CAREN is a 21-foot simulated dome with a 300-degree screen that immerses patients using sensors and highspeed infrared cameras and a moving platform that reacts to the patients movements. The unit is one of nine in the world. CARENs comprehensive analysis of patients movement is important to improving rehabilitative care and techniques and is central to the research mission of the center. The staff at the Center for the Intrepid use new and innovative approaches to help patients relearn how to function on a day-to-day basis. In the realm of occupational

therapy treatment, activities are designed so that patients can successfully perform occupational tasks and activities of daily living such as bathing, dressing, shopping, cooking, writing and doing household chores. There is even an activities of daily living apartment, where patients practice these skills in a real-world environment. The apartment has a fully equipped kitchen, bathroom and living room, and its computer workstation is outfitted with state-ofthe-art voice recognition software, compact keyboards and a heightadjustable desktop. Occupational therapists also use a driving simulator to help patients readjust to driving in environments that are not dotted with potential bombs or snipers and

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Finding the Beauty in the New Normal

to practice using adaptive driving equipment if needed. Although there is no denying the benefits of such a technically advanced facility, there is much more at the Center for the Intrepid that makes it beneficial to service members. The center also offers patients the ability to access all of the providers they may need throughout the process of their rehabilitation. Its a one-stopshop in which patients are treated holistically. I have never seen a team of interdisciplinary providers work this well together. It is absolutely incredible, says Wendy Foster, a vocational rehabilitation counselor with the Department of Veterans Affairs at the Center for the Intrepid. There is no distinction between active-duty providers, VA providers or civilian providers, because we all have the same goal. We just all have our piece of the puzzle to plug together to get the patient well again. The caregivers at the Center for the Intrepid do not work only on a patients most obvious injuries, such as an amputated leg or a severe burn. A dedicated team focuses on training the patients to thrive, not just survive. Patients have access to a military performance lab, occupational therapy, physical therapy, prosthetics, physical medicine, orthopedics, nutrition, case management, vocational rehabilitation counseling, behavioral medicine, veterans benefits counseling, a wheelchair orthotist, veterans health care administration counseling and chaplains. The overarching goal at the center is to treat the person, not just the injury.

For patients at the center, learning to thrive means addressing and healing the mental and emotional injuries as well. Some people dont look like they are wounded very badly, but theyve got a pretty bad traumatic brain injury, along with some serious post-traumatic stress disorder, says Miller. Those guys are wounded just like the rest of us. Those wounds run just as deep as a missing leg. The center uses several therapies, techniques and counseling methods to treat the psychological wounds that many service members experience. These include supportive therapy, prolonged exposure therapy, cognitive assessment and behavior therapy, alpha stimulator, biofeedback, medication management and family support group meetings. Sometimes results take time. According to Jorge Torres, a clinical nurse specialist in adult psychiatry at the center, when it comes to psychological health and traumatic brain injury, progress isnt evident overnight. But for the patients and their families, and for him, the efforts can have a profound impact. It is really rewarding to me when a spouse comes to me and sits in my office and says Thanks, he is a totally different person than he was last month, says Torres. According to Torres, the stigma of treating mental health issues is real, but it is not as evident at the Center for the Intrepid as it might be elsewhere. This is due in large part to how Torres interacts with his patients. He is able to gain their trust by participating in everyday activities like cycling. He

Left: Army Staff Sgt. DanielMiller on a rowing machine. Photo by Maria Gallegos.

Above: SPC RicardoSamudio is a patient at the Center. He is pictured here on an exercise bike. Photo by Maria Gallegos.

Finsing the Beauty in the New Normal

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Left: The symbol of a broken ring,cracked but still intact, marks the entrance to the new Center for the Intrepid. Photo by Daren Reehl

of a supportive band of brothers and sisters who work together and encourage each other every day to push a little harder, go a little further. When I got to the Center for the Intrepid there were people from all different backgrounds and lifestyles, but theyve been through the same experiences Ive been through, says Samudio. That really helped me feel better and go through the treatment faster, because whenever I felt down or negative there has always been someone to talk to. The Center for the Intrepid is dedicated to those severely wounded warriors whose selfless sacrifices for our nation entitle them to the best rehabilitative care. For many patients, like Miller and Samudio, the dedication of supporters, staff and providers has paid off. Every bit of my expectations has been met, and I expected the best, says Miller. Thats exactly what Ive gotten. The equipment is the best, the people are the best, everything Im getting is amazing. If you need it, they got it or theyll get it. For the service members at the Center for the Intrepid, it is all about finding a new sense of normal, a new sense of self in a life that has been turned upside down. Learning to walk again, making friends who understand the challenges that lie ahead, finding success at a new job or skill, wrapping both arms around a child even if one arm is prosthetic those are beautiful things.

joined the centers cycling club, which meets every Wednesday. The amount of contact I get with the patient here far surpasses any other setting, says Torres. If a patient was seeing me in an outpatient clinic, they would see me maybe once a week, twice a week, or every month. Here, whether the patient has an appointment or not, they probably see me almost every day because when Im not in my office, Im walking around chit-chatting with the folks.

It takes courage and determination to adjust to and bounce back from the serious injuries experienced by the patients at the Center for the Intrepid. For many, the road to rehabilitation meant moving across the country to face the long, uphill and often painful battle to get better. But beyond the impressive facility and innovative therapy, the center features another ingredient for successful recovery the resolve that is brought by the patients themselves. That determination and camaraderie results in the formation

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Finding the Beauty in the New Normal

Senior Airman Jessica Tarver, 1984-2009She was my inspiration, [the] first person to come talk to me at the hospital that wasnt a doctor or family. She didnt have to do that. She just did because we were both bilateral amputees. Even when she wasnt feeling good she would always give you a smile. Army Staff Sgt. Daniel Miller

This issue of MHS Profiles is dedicated to

In early 2009, Tarver shared her story for a video project about the Center for the Intrepid. View the video below and experience for yourself the inspiration that Tarver gave to many.

Finsing the Beauty in the New Normal

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