Globe and Mail


What happens to the wounded when they come home?

On the long road to recovery

EDMONTON -- While the country has stopped to mourn 27 young Canadian soldiers killed in Afghanistan, the sacrifices of dozens more quietly continue at home, as they slowly recover from their battle wounds.

Edmonton has emerged as a key hub for treating the returning wounded: The University of Alberta and Glenrose Rehabilitation hospitals are becoming this country's version of the Walter Reed Army Medical Center, the U.S. military hospital that treats hundreds of soldiers.

A small army of military and civilian medical staff in Edmonton have had to come to terms with this new reality very quickly due to the jump in battlefield casualties since Canada's combat duties increased earlier this year.

Doctors say those who return on stretchers are also coming back with devastating head injuries and damaged or lost limbs -- wounds more severe than military medical staff have seen in previous conflicts. Modern body armour is saving the lives of soldiers who would have died in battles of yesteryear.

Soldiers, too, are struggling to cope with this new reality.

Only a few months ago, Private Brent Ginther was a 20-year-old small-town Alberta boy dodging bullets on the hot, dusty battlefields of Afghanistan.

Today, he is surrounded by wheelchairs, seniors playing shuffleboard and long days of physiotherapy as he recovers at the Glenrose Rehabilitation Hospital.

His life was transformed forever on June 12, when those flying bullets finally caught up to the infantry soldier posted with the 1 Battalion, Princess Patricia's Canadian Light Infantry, Charlie Company.

He was shot in both thighs after his platoon tried to capture Taliban insurgents who were cornered behind a grape hut. He now uses a wheelchair.

"I couldn't really see them and I don't think they could see me. I guess they got lucky," the plain-spoken 6-foot-1 soldier said from his hospital bed.

Pte. Ginther's thin legs are strapped into braces. Dressed in blue-and-white striped pyjamas and a camouflage-coloured baseball hat, he is surrounded by books and movies, including Office Space, Anger Management and a thick tome about the history of heavy metal band AC/DC.

He doesn't recall being dragged into a waiting helicopter after he was shot. He barely remembers the emergency surgeries that Canadian medics performed at a field hospital in Kandahar for two days. It's all lost in a fog of painkillers.

His memories only start to flicker back to life after he was flown to a U.S. military hospital in Landstuhl, Germany, where he said doctors "cut a lot of muscle out because it died from not getting enough oxygen from the tourniquets being on too long."

After six days, he was flown to Edmonton to begin his long recovery and determined struggle to walk again.

That now familiar route -- Afghanistan to Germany to Canada -- has been taken by about 20 seriously wounded Canadian soldiers since January. Dozens more have made the trip since Canada's military was first dispatched to the war-torn country in 2002.

Not since Canada's involvement in the Korean War more than 50 years ago have so many of this country's soldiers been killed or maimed on the battlefield.

Because most of the more than 2,000 soldiers who were sent to Afghanistan earlier this year for a six-month tour were from the Edmonton army base, medical staff there were charged with fine-tuning the plan to treat the first large group of returning wounded.

Major William Patton, Edmonton's base surgeon and most senior medical officer, said his staff had been preparing for the possibility of increased casualties for a year, and is confident as outfits from other Canadian military bases begin to rotate through Afghanistan, they can learn from Edmonton's experience.

"These practices will be shared nationally," he said.

Major Patton, a 41-year-old former reservist who joined the military full-time more than a year ago, said he sat down with administrators at the U of A hospital and Glenrose to explain the impending situation.

He said the reaction by both facilities has been "overwhelmingly positive and supportive," with each supplying ample resources and staff when the call goes out that another soldier has been injured.

When the wounded first arrive in Edmonton, most are taken directly to the U of A hospital, where stays range between three days and several months. A pseudo-military wing on the hospital's third floor, referred to as 3F2, has emerged mainly because it has trauma nurses who have become familiar with dealing with serious combat injuries.

Major Patton said military doctors, surgeons and nurses are "embedded" in both hospitals to assist with the soldiers' recovery because "they bring a military perspective to their care."

Combat wounds are more complex to treat than injuries normally seen by a Canadian doctor, he added. The two most common suffered by returning soldiers are head wounds, and orthopedic injuries to arms and legs.

Major Robert Stiegelmar, one of two military orthopedic surgeons based in Edmonton, said most of the seriously wounded he has treated likely would have died if not for recent advancements in body armour that protects their vital organs, especially from bomb attacks.

"More people are surviving, and because of that we are seeing things we haven't, like a person coming in with two broken feet instead of just one," said the 41-year-old father of four who is being deployed to Kandahar on Monday.

He said these injuries use a lot of hospital resources because they require repetitive surgical procedures to repair the damaged skin, bone and even nerves. For example, soldiers who are hurt in a bomb blast often require up to 20 operations -- every two to three days -- on their damaged limbs. During a soldier's recovery, every member is assigned to what the military call an assisting officer upon their return to Canada. That person is essentially at the beck and call of the soldier until she or he no longer requires help, or leaves the military.

Petty Officer 1st Class Ron Roberts was assigned to Pte. Ginther when he flew back to Edmonton last June. "I'm at his disposal basically 24/7. My normal daily duties come second," he said. "Brent and his family are No. 1 over everything else."

PO1 Roberts said that Pte. Ginther's "overall outlook" has changed 100 per cent since they first met. "He's got a tough road ahead of him. But I think, overall, he has come to terms with the situation and is moving forward. He's a tough guy."

There are still a lot of unknowns for Pte. Ginther. He doesn't know when he will be able to walk again. He doesn't know what he wants to do with the rest of his life.

"I don't know," he sighs. "I've come up with a million different things. Never just one thing sticks in my head."

Pte. Ginther expects that he will apply for a medical release after he is rehabilitated and returns home to Coaldale (population 6,000).

"But I don't know what comes after that."