Chalk it up to innocence or early impairment, but what held Kevin Workman fast through his agony in Iraq was the hope that going home would heal him. The chain-saw headaches and shot-through fatigue, the thousand things he suddenly couldn't remember – they would all remit, he figured, to a solid week of sleep and some quality catch-up time with his young daughters. And if more was needed, well, the army would see him through. But his hopes for renewal were dashed in full when the plane touched down in New Jersey in September 2005. His marriage had cratered while he was off in Iraq, and he was greeted on the tarmac by a process server, not his wife and kids. Shattered, he decided to stay on at nearby Fort Dix while his brigade went home to South Carolina, and he was attached to a unit with the First I.D., training recruits for convoy security.
Barely holding it together with fistfuls of Motrin and assorted coping maneuvers (he called everyone "Bo," unable to remember names, and kept his hands behind his back so no one saw how much they shook), he caught his first break when he encountered Amy doing volunteer duty on base. "I was fresh off a breakup," she says in their kitchen, "and wasn't ready to date for a while. But we went out as friends with some people we knew from post, and he made me laugh like no one ever has."
She sensed something was off with him – "he couldn't remember things that really mattered to him, like the birthdays of his parents and kids" – but Workman hid behind his scabrous wit and said nothing of his constant pain. Finally, he confessed to her how sick and scared he was, and at Amy's insistence told his barracks commander, who sent him to the doctor on post. The snap diagnosis was PTSD, and sessions were arranged with a staff psychologist at the adjoining Air Force base. But his TBI symptoms, unidentified and untreated, continued to intensify by the month.
In the fall of 2007, too ill to keep working, he was admitted to the Warrior Transition Unit, a hastily conceived cluster of on-post sick bays for seriously injured soldiers. Under its former name, the Medical Holdover Unit, the system produced one of the war's great horrors: the neglect and abuse of wounded troops at Walter Reed. Out of that infamy came the WTU, a chain of installations at 35 bases whose mandate was to treat the thousands of soldiers needing six or more months of medical service. But, as with Walter Reed, many units were short on staff, overrun by cases too complex to manage, and hamstrung by slipshod leadership.
At the Fort Dix WTU, there was one primary doctor for the several hundred patients on base and a constant churn of caseworker types, many of them fresh out of school. Workman had four in his 15-month stay, and none seemed to know what TBI was or how to secure him help. "Me, I only knew it from this briefing they showed of a – a Humvee hit by a bomb," he says. "I went and asked Amy to look up TBI. Sure enough, it fit me to a T." He went back to his caseworker and insisted on being tested. Several days later, he got his exam: a 30-minute call from a clerk at Walter Reed, who asked him a series of questions over the phone. Shortly thereafter, a form arrived in the mail, telling him he'd tested negative for TBI. "I should've known," he grunts. "They couldn't even fix my goddamn molar after waiting 10 months for a crown."
Seething, he went to his doctor on base and restated his list of symptoms and blast exposures. The doctor concurred and wrote TBI in his chart but never sent Workman to an army neurologist or referred him for rehab treatment. Indeed, of the brain-injured men on post, only the most egregiously harmed got specialized care off base. One such soldier, who asked to be unnamed while his case trudges through the retirement process, was misdiagnosed for more than a year, despite symptoms so stark he couldn't complete a sentence or bathe and dress himself. It bears noting that, since finally getting robust treatment, he's come a long way, cognitively, in his 15 months of rehab. His speech has improved, he can perform some daily tasks, and, on good days, recall his prewar life in lucid and moving detail. "There's a spectrum of late recoveries acceptable to people, and if that's 20 percent better, that's still meaningful," says Harvard's Zafonte. "It might just be the difference between independent living and having to be cared for by your loved ones."
Workman would probably have profited, too, from a stint in an outpatient clinic. There, a neuropsychologist would have reduced his meds to only those essential to managing pain; speech pathologists would have led memory training and language improvement drills; an occupational therapist would have taught him strategies to knock off daily tasks; and group counseling would have improved his labile moods. There are such services in the army system, including four elite centers for intensive treatment and a dozen more clinics, regionally scattered, for ongoing drop-in care. But in order to get these benefits, you must know that they exist, and neither Workman's doctor nor his social workers ever thought to raise them as an option. What they told him instead was to bide his time: The VA would take care of him after he retired.
And so Workman, the good soldier, did as told and, after a year, put in papers for medical retirement. Unfit to reclaim his job as a state policeman, he had, in effect, lost two careers. What came next, however, was the final betrayal: a finding by the army's Physical Evaluation Board that he was just 30 percent disabled by his many injuries. "Offered me $600 a month for the rest of my life, and . . . said I could get a job at a diner. There was nothing about TBI – according to them, I don't have it – or how I'm gonna support Amy and my kids." The army's rating code, written in 1947, doesn't list TBI as a combat injury for which benefits may be paid. "I'm proud I served my country and would do it . . . all over again, but I never felt so ashamed to wear the uniform."
There it might have ended. But one day, while scrubbing latrines, Workman saw an ad on the wall offering pro bono aid to troops. The Military Legal Assistance Program, a pilot venture of the New Jersey Bar Association that is staffed by volunteer lawyers, has helped hundreds of soldiers process their claims with the retirement board. A senior lawyer with the program, who asked to be unnamed, filed a book-length appeal for Workman and joined him in Washington to plead his case.
Two months later, in the spring of '08, Workman was notified that he'd been bumped to 60 percent disability, though again there was no mention of TBI. "It wasn't great," he said of the proffered upgrade, "but I needed to go home . . . and start over. Get as far from Fort Dix as I could." The roughly $1,200 a month wasn't enough to live on, but next spring his state policeman pension will kick in, and between them, he guesses he'll get by. His lawyer, a self-described "former longhair," is glad to have been able to render aid, though with a crowded caseload (plus his paying work), he's fast approaching the point of saturation. "We rep 78 soldiers at this firm alone, and more keep coming through the door. Real-life heroes in a world of hurt, and the way the army's done them rips your heart."
He does, however, see cause for guarded hope. In 2007, Congress passed (and later strengthened) the Wounded Warrior Act, a law meant to ramp up treatment and assistance for soldiers with TBI. "In the last year or two, care has gotten better, though it's very inconsistent," says the lawyer. "Depending on where you live, you can get a month at Walter Reed, which has an intensive program for these guys." But what happens, he worries, "when they're retired and go to their rural VA to try to get help?"
For its part, the military has hired an impassioned leader to head up its TBI program. Since she took charge in September 2007, Brig. Gen. Loree Sutton has pressed to raise money, conduct outreach to soldiers, and reduce the stigma of seeking care. "Frankly, all of us wish we'd been involved years earlier, when the emphasis was on saving lives in theater," she says. "We're working furiously now to stand up programs and find troops who've fallen through the cracks. What keeps me awake at night is how to connect with soldiers who were hurt before we screened." To that end, the military has set up a 24-hour hotline (866-966-1020) for TBI victims or their loved ones to call.
But none of that effort has trickled down to Kevin Workman. He's been home in Genoa for almost a year and frequently drives an hour to the Syracuse VA to lobby for further care. What he's gotten for his pains is a 10-minute workup by the staff neurologist, who tapped him on the knees, asked a couple of rote questions, then handed him a stack of new prescriptions. "The drugs, they make me fat and lazy. I need the kind of help that they don't have here," says Workman. "But something's gotta give, 'cause I ain't done yet. I got plans for the time that I have left."
When told of Workman's plight, Sutton offered to intervene to see that he gets the care he needs. It's the first good turn in Workman's dealings with the army, and with any luck, not too late to matter. He yearns for the strength to tend to his parents, both of them in failing health, and beyond that, to build a lodge for wounded vets who want to come hunt these woods. Gutchess Lumber, a local logger, has lent him the use of a thousand acres, and other friends and merchants have pitched in too, building him a website (libertylodgeoutfitters.com) and forming an advisory board.
One day, Workman gives me a tour of the land, talking of adaptive turkey blinds for vets who are wheelchair-bound and tow-in paths for ATVs to carry amputees. It sounds a tad fanciful for a man so strapped he can't afford to fix his girlfriend's car and who, several days a week, is in the grip of such pain that he must lie down in a dark room. But out in the treeline, he seems reborn, the torpor and neuralgia falling away. As he walks, he ticks off the names of flowers and species of deep-growth pines. Suddenly he stops, eyes big as a setter's: There, in the clearing, stands a 12-point buck, sizing us up as he chews. For a glassine moment, nothing moves or breathes, the world in soft suspension – and then the deer huffs and glides off, raising a spray of leaves.