The Refectory Manager

The refectory . . . A place to nourish the soul. A place to share the savory comestibles, the sweet confections, the salty condiments of the things that matter. A place to ruminate the cud of politics. A place to rant on the railings of religion. A place to arrange the flowers of sanguine beauty. A place to pause in the repose of shelter. Welcome, my friend. The Refectory Manager

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Location: College Place, Washington, United States

Friday, March 31, 2006

There are no bionics that can fix a break like that.

The last two days were spent at a professional conference. The Maryland state Dietetic Association annual meeting.

Somehow, I found myself yesterday in an intense conversation with an individual who is both and Registered Dietitian and a Registered Nurse. As it turns out, she is a “contractor” working in the Neurology Clinic at Walter Reed Army Medical Center.

Now I have spent my days in that facility. Some six years back in the late 60s and early 70s, and another 6 years in the 80’s. I saw the Viet Nam war from the perspective of those ambulance busses rolling into the West-Ambulance Entrance at WRAMC in the middle of the night from Andrew’s Air Force base, their cargo of maimed GI’s just off of air-evacuation flights from Southeast Asia.

I met a lot soldiers (and sailors and airmen as well) who suffered terrible wounds. I will never forget the duo that were inseparable in that hospital. They were there for months. I often wonder if they are still together today. For you see -- one had no arms and was wheel-chair bound. The other had no eyes. Between the two of them, they could go anywhere and handle anything.

There was one ward in that old Walter Reed Hospital that held about 30 Stryker frames. The “vegetable ward.” Most of the men were paralyzed from the neck down. And far too many were paralyzed in the their mental faculties as well. When I think of the homemade tube feedings that were used in those days . . . made from milk, baby food, raw eggs . . . and blenderized in blenders that got cleaned only a few times during the day, and the ambient temperature in the kitchen near 100 degrees . . . and I think of the HACCP (Hazard Analysis Critical Control Points) protocols rigorously controlling the time/temperature parameters that we religiously follow in today’s commercial kitchens, I wonder how and why we didn’t kill them with food poisoning! I do know that diarrhea was a horrible problem for them.

And I often wonder how many of the homeless today are those very same men from then. Somehow, there is this mighty mystic of the shock and awe of the initial battle, and the subsequent abandonment of the blood-letters in the aftermath. It reminds me of an old poem I heard somewhere:

On the brink of danger,
But not before.
God and the doctor you adore.

But when danger is past,
And all is righted,
God is forgotten and the doctor is slighted.

And the sorry history of experience bears out the slight to the maimed soldier as well.

But in my conversation yesterday with this RN/RD from Walter Reed, I realized that some things have changed and some things have not.

The injuries are simply horrific. The IED’s (improvised explosive devices) just blow limbs to infinity. The parts of the torso that are protected by armor survive relatively unscathed. But the concussion injuries to the face, skull, and brain are devastating.

She told me of a recent incident.

A newly admitted soldier was in her clinic. He had no limbs. His neurological trauma was still being assessed. And while in the clinic, his wife came in. Her first visit. She was obviously pregnant, and obviously by some other man. She looked at her soldier-husband. Pointed at him. Pointed at him! “I don’t want a thing to do with that!” Turned. Walked out. Her last visit.

She didn’t use the words “with him.” It was “with that!”

Technology today can do miracles with bionic prosthetic devices. And the military and Veterans Administration will (hopefully) be funded appropriately to provide these restorative devices and procedures for the next 70 years that the twenty-year-olds might otherwise expect to live.

But at that sentinel moment, in the mayhem of a clinic bulging with casualties, deep within the Army’s flagship hospital now totally overrun with trauma, an injury that cannot be healed was inflicted. That soldier’s heart was now broken. There are no bionics that can fix a break like that.

One can only wonder how or even if, an avalanche that buries one’s spiritual journey can ever be cleared.

One can only wonder why the slogan “Support Our Troops” has such a hollow thud of hypocrisy.

One can only wonder at the motivation of a government that has so wantonly destroyed its blood and treasure and reputation. For what. Why.

One can only wonder of the uncounted broken hearts with stories that will forever remain untold.

Why must it always be the soldier’s heart that must break when it is the politician that has failed.

The Refectory Manager,
LTC, US Army, Retired

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