"Beyond The Battlefield" is a 10-part series exploring the challenges that severely wounded veterans of Iraq and Afghanistan face after they return home, as well as what those struggles mean for those close to them. Other stories in the series can be found here. Listen to reporter David Wood discuss "Beyond The Battlefield" with NPR's Terry Gross here.
Last January, on a dusty parade ground in Mosul, Iraq, Army Sgt. Robert Fierro was shot in the head.
An Iraqi soldier, part of a battalion being trained by American troops, had broken ranks and opened fire. As Fierro and others scrambled, a bullet struck him just beneath his helmet, crushing the right side of his skull. The tall, muscular 33-year-old collapsed to the ground, limp and almost lifeless.
At the same time in central Texas, it was a cool Saturday morning. Inside a snug house at Fort Hood, Lisa Fierro and her two kids had blankets and pillows scattered on the floor and "Band of Brothers" in their DVD player. Lisa, an experienced Army wife, had allowed her 8-year-old son, Diego, and his 6-year-old brother, Rodrigo, to watch the miniseries as a treat, helping them pass the time until their father came home from the battlefield.
A call from one of Lisa's girlfriends, also an Army wife, interrupted them: Go turn on the news, she said, something's happened. Off went "Band of Brothers." Lisa flipped impatiently through the channels. Nothing. Switched on the computer to Yahoo News, typed in Mosul and up popped the story: "Two Americans were killed in Mosul and one injured when an Iraqi soldier …"
Lisa called her dad, her stomach churning. "It's our guys," she said.
After she hung up, the phone rang again, this time a liaison officer from Robert's unit, Apache Troop, 1st Squadron of the 9th Cavalry. He called often while Robert was away: Lisa was a volunteer leader with the Family Readiness Group, a team of spouses organized to support military families by relaying important messages from the Army’s leadership through phone-trees. But this call wasn’t about helping other spouses.
"I need to come talk to you," the officer said. "Hurry up," she told him.
She gathered the boys. "Something's happened to your dad," she said, trying to stay calm, "and they are coming to tell us what. Please pick up the pillows." She told Diego to watch by the window and "tell me what kind of car they come in and what they're wearing." An official military sedan, carrying officers and a chaplain in dress uniforms, meant they were going to tell her that Robert was dead.
"It's a white truck," Diego shouted, "and they're wearing ACUs [fatigues]!" Before the doorbell rang, Lisa knelt and took the boys in her arms. "Daddy's alive!" she cried, tears brimming in her eyes. "Daddy's alive!"
A FAMILY AFFAIR
Families have always suffered in wartime, from stress and anxiety and from anger that a loved one is away. For many, that suffering is also mixed with pride in their shared service. And the dread of not knowing how a loved one is faring on the battlefield can be displaced by a more seismic reality: that a loved one has become a casualty. The wars in Iraq and Afghanistan are no different, with more than 52,600 casualties in the past decade, a list that includes almost 5,000 soldiers killed in action.
But for those whose son or sister or husband has been badly wounded and survived, the past decade of war has seen something new. Families, once cold-shouldered by the military, are now considered an essential part of the healing process.
The military immediately flies families to the bedsides of wounded soldiers and puts them up in local housing, courtesy of the Defense Department, for as long as needed. Child care is provided and counseling is available. A network of volunteer nonprofits covers food, clothing, transportation expenses and more.
Family members, for instance, can fly home for a few days rest or to see the children, and fly back to Walter Reed courtesy of Hero Miles, an organization that uses donated airline frequent-flyer miles to purchase plane tickets. Organizations such as the Fisher House Foundation and Operation Homefront provide long-term housing.
More than 500 combat-wounded warriors were treated last year at what is now the Walter Reed National Military Medical Center in Bethesda, Md., each accompanied by an average of three family members.
Involving families in the recovery of the severely wounded is not pure compassion on the part of the Pentagon. It "has been an enormous benefit," says Dr. Paul Pasquina, chief of orthopedics and rehabilitation at Walter Reed. "They are here to greet them, and they're housed right here and able to participate in each medical and surgical decision. In rehab you often see spouses and children there going through it with the patient -- that's been very, very powerful, especially in building self-reliance."
For someone with severe combat wounds, he explains, one of the greatest hurdles involves relying on a wife or father to tie shoes, feed meals, or help in the bathroom. So family members work alongside professional therapists, and learn to encourage soldiers to fend for themselves.
None of this is easy, of course, and the military has teams of psychiatrists, social workers and therapists on hand to work with families tasked with helping and accommodating severely wounded loved ones.
"Once a member of a family is traumatized, the whole family is traumatized," says Dr. Steven Davis, a psychiatrist on the Walter Reed staff. "Some families are strong, some are less strong. Most of what we do is trying to stabilize the family because the family will become the permanent caregiver."
A LONG RECOVERY
After the military contacted her, Lisa Fierro knew only that Robert had been shot in the head and was on a ventilator at the U.S. military hospital in Balad, Iraq, about to be flown to Walter Reed, and that she had to race to meet him there.
When the liaison officer left her house, she took an uneasy breath. Hold on, she told herself. I am prepared for this. She pulled out a notebook she'd assembled before Robert deployed four months earlier, so that in the midst of a possible crisis when it was difficult to think straight she’d have a list that would tell her exactly what to do.
Wills, powers of attorney, marriage certificate, the boys' birth certificates and key contacts: someone to pay the rent, someone to look after the dog, a list of what bills to pay and when. A second power of attorney in case a neighbor or friend had to take the kids to the doctor.
"I pulled all this out and it saved my life," she later recalled.
She wasn’t sure if a hospital of the severely wounded was a good place to be for her young sons. Sensing her hesitation, Diego offered to stay at home with his little brother, whom the family had nicknamed “Yoyo.”
"I said no,” Lisa recalls. “You are still a little boy, this is our family, it is happening to all of us. We will go and see your dad, and if you don't want to see him that's okay."
She also cautioned the boys: "I will not lie to you. We don't know how daddy's going to come out of this."
Robert had been shot Jan. 15, 2011. He arrived at Bethesda Jan. 17, and the family, aided by Army family assistance officers all along the way, got there at 2 a.m. the next morning. Lisa rushed in to see her husband, whose face and head were so swollen from his injury that she almost couldn’t recognize him. He'd had a craniotomy to relieve the pressure of the swelling, and tubes and wires protruded from his bandages.
"I talked immediately with the doctor," Lisa recalled. "I said, 'Lay it on me,' and she did. She said it's bad but there's hope, but he had a long recovery ahead of him."
The next day Lisa brought the boys in. Robert was still sedated. At the doorway, Diego peeked in. "Can he hear us?" he whispered. "Of course he can!" his mother said.
They set up house in the Navy Lodge on the Bethesda campus. Lisa looked into local schools, which were eager to take the kids, but she decided otherwise. Her father, a retired Army sergeant, volunteered to teach. He flew up from Texas and held class in their hotel room, wearing a coat and tie to make the instruction seem more formal.
Before long, word got out that the Fierro family was at Bethesda, where Robert was recuperating from a terrible head wound, and offers of help poured in from old friends and former neighbors, as well as soldiers and wives who had moved from Fort Hood and Robert's unit, 1/9 Cav, to Washington.
After school hours, Diego and Yoyo were whisked off on excursions to ballgames, museums, even the White House, which arranged a special tour that went on for so long that Yoyo began to feel hunger gnawing at him. His eyes lit up when they were ushered through the State Dining Room, which was set for a formal dinner. An aide finally noticed his discomfort and disappeared. He returned a few minutes later with a bag of M&Ms -- autographed by the president.
Far from being depressed, the kids were having a ball. "They were like, 'Can we do this every year?'" Lisa recalls, laughing.
But it was hard, working with Robert and his therapists every day, hours on end. His physical recovery went quickly: Within days, he was up and out of bed and walking on the treadmill. "The doctors had said I would never use my left arm again, so I worked hard on that," he says. He pushed himself relentlessly in the gym.
Diego and Yoyo came to see their father daily in what Lisa said was an essential part of his rapid recovery. "Seeing them there every day I think helped push himself to work harder, he had something to work for, to get back to being a father again," she says.
The boys stayed a month before returning to Fort Hood, but they visited regularly until Robert was released from Walter Reed in April to spend several weeks at the VA Polytrauma Center in Richmond, Va.
The center specializes in focused physical and mental rehabilitation, and it worked with Robert and other patients to help them fully recover speech, reasoning, memory and other cognitive functions that the severely wounded often lose. It was these mental faculties that gave Robert the most trouble.
"I was tired and frustrated," Robert said of the mental difficulties. "I knew I needed help and more rehab time." Therapists at the polytrauma center worked with him patiently. While he exercised on the treadmill, they'd give him multiplication problems and have him shout out the names of football teams to match their hometowns -- "New York … Jets! Philadelphia … Eagles!"
"It was difficult and frustrating, doing some things I thought were childish, like playing Connect Four and finding the difference between drawings of stick figures," he says. "I knew something was wrong, but it was hard to ask for help."
Lisa pushed him. "They'd give him a task to do and sometimes he couldn't do it, and he'd get on himself," she says. "I'd tell him, you can do this, yes you can! I'd tell him he was doing really great when he was down, I'd tell him, it's not what you can't do, it's what you can do!"
"I could fight for him when he couldn't fight for himself."
Visibly improved, Robert returned to Walter Reed in July for additional rehab work, and will have a titanium plate implanted in his skull later this year. He's worked hard to regain his physical strength, and said his mental functions are returning.
"I feel I've worked hard enough to be able to stay on active duty," he says. He's a combat soldier and wants to stay that way. "It's something I enjoy."
VA doctors at the polytrauma center in Richmond said his progress has been remarkable -- in some measure due to the persistent presence of Lisa and the boys. Keeping the family together through the crisis, she said, turned out to be a good decision for all of them.
"I was determined for the kids that this not be the kind of thing where they'd look back and say, 'Well, we had a great childhood until my dad got shot,"' Lisa told me. "I wanted it to be, 'We had a great childhood and my dad got shot and we got to go to D.C. for a month and we had a great time!'"
Other veterans agree with Lisa’s view that having family nearby speeds a recovery.
"After I got blown up in Vietnam, I was with 40 guys in an amputee ward in San Antonio for a year, and in all that time I only saw two family members come in, and that was because they lived in San Antonio," says Jim Meyer, a double amputee who works with the Wounded Warrior Project , a private nonprofit that helps wounded soldiers returning home.
"The idea was families got in the way. Now, look at this!" he says, sweeping his arm around the amputee center at Walter Reed, where wounded soldiers and Marines were busy working out in a gym crammed with spouses, kids, baby carriages and teenagers.
Even with state-of-the-art, family-centered rehab therapy, complete or even satisfactory recovery from devastating wounds may not come for years, if at all. Many of the wounded and their families already have spent years in hospital wards and nights in dreary, neon-lit waiting rooms outside operating rooms and intensive care units.
Asked if it was difficult to get through the bad days, Lisa replies, "How can you not?"
For her family, at least, the future definitely looks brighter than it did on that awful day last January when their world turned upside down, and then shrank to an intensive-care hospital bed in Bethesda.
During those dark days, she says, she would pray "for just one more day, just one more … and now I pretty much have my husband back, and the boys have met some wonderful people here. I'm glad they are getting to see how much people sacrifice for what they love.
"Everything," Lisa says, "has turned out for the best."
NEXT: What happens when families are stretched too thin, or the military isn't so generous? Meet caregivers who have an even tougher time getting their loved ones the treatment they need.