She looked at my face and arms and hands. My hands looked like someone had cut them with a knife. Her eyes gazed down to my feet.
“Is this your son?” the nurse asked her. How could a mother recognize her son? By his feet.
“Yes, that’s him,” she replied.
After a brief visit, they took my mom to the nearby guesthouse, a temporary-housing facility where she’d stay for the next two months.
My mom asked for a room where she could see the hospital from the window. Every so often in the middle of the night she’d go to that window and look up at the lights, wondering what was going on in my room. Sometimes she wouldn’t fall asleep until dawn, when it was time for her to get back up.
In the meantime, an extraordinary team of professionals cared for me. The burn center director, Dave Barillo, was attending me personally. Over the next months, Barillo’s stocky frame was a frequent presence in my room, and if he wasn’t looking at me, he was talking to my mom.
And Bonnie Jackson was the burn ICU’s charge nurse. An academic with a calm demeanor, Jackson had seen burns of all types, severely disfigured and depressed patients, and distraught families. The average age of her combat patients was between twenty and thirty-five. She treated all of them like they were her own children. In fact, all of the ICU staff was very protective and possessive of the patients, and sometimes patients became more dependent on their nurses than on their parents or spouses.
Back in Dalton, word of my injury spread fast. Susan Ward heard it from one of her middle school students, and she got on the phone with Coach McClurg. He didn’t know anything, but he began calling around and Susan began calling around, and between the two of them they learned that I’d been burned. Susan found BAMC on the Internet and called the facility.
“I need to know if you have this young man,” she told the burn unit receptionist.
“I’m sorry, ma’am,” he replied, “I can’t give out that information.”
Susan wasn’t having any of that. “You don’t understand,” she said. “My husband is on staff at the high school, and this kid is one of ours. I need to know.”
The receptionist turned her down again.
“Okay,” Susan persisted. “If I ask you questions, can you answer yes or no?”
The receptionist said he might be able to do that.
“Do you have a Hispanic male from Georgia?”
“We might,” he answered.
“Would his name be Jose Rene Martinez?” she asked.
“It might.” Then the man gave Susan the phone number to the guesthouse where the patient’s mother just might be staying.
Susan was the first of our friends who called to support us; many were people my mom had never met. When she’d get a call, she’d jot down the person’s name, how he or she was connected to me, and a phone number. She kept this list to show me.
And by the first weekend, we had visitors. Jacob and Jeris—the other two-thirds of the Multicultural Idiots—made the eight-hour drive with Jacob’s mother. When my mom worried aloud about how I might end up looking, Jacob’s mom made her laugh. “Don’t you worry about that,” she said. “He’ll be fine. Look what they did with Michael Jackson.” The next weekend my godmother, Alejandra, came from Louisiana. But the most important people—my grandmother and my sister, Consuelo—weren’t there.
My mom begged the social worker to try to bring them up from El Salvador. The social worker wrote to the consulate and even obtained approval for the plane tickets, but in the end, someone in the Salvadoran consulate denied the request. My mother was crushed.
But friends in Hope and Dalton continued to rain down encouragement. Acquaintances and even strangers sent their good wishes. Schoolkids sent get-well cards. Coach Stubber called my mom from Hope nearly every night. He probably spoke to her forty-five days in a row, every day. “Maria, this is Coach,” he’d say, and ask how I had done in the twenty-four hours since they’d last spoken. Stubber heard the determination in my mom’s voice, but he heard the fear as well.
In those first days, even my doctor, Dave Barillo, was afraid for me. Just about anything and everything can go wrong with burn patients. Serious burns represent the most severe injury a person can suffer and still survive. Once the proportion of burned area rises above 20 percent, every organ in the body begins to work overtime. The heart pumps at two and a half times the normal rate. The immune system breaks down, so the patient is at great risk of infection. Burn patients aren’t out of the woods until they go home. Barillo had seen patients survive for a year in the hospital and still die from some complication before going home.
And I wasn’t simply a burn patient—I was a blast injury/overpressure injury/abdominal trauma patient with a 34 percent burn. I wasn’t responding well to treatment and I became increasingly unstable as the days passed.
The inhalation injury, which is a chemical burn to the lungs and airways, was the biggest challenge to me in the first few weeks after the blast. In the fire I had inhaled air heated to 1,200 degrees as well as potentially more than three hundred toxins spewed from the burning vehicle, which made it difficult to get enough oxygen into the body. The smaller-particle toxins tend to end up in the lungs. The fix for that was to ventilate me and hope my lungs repaired themselves.
Finally, after two weeks, I began to turn around. In time I grew strong enough to breathe on my own. In another week, it would be time to wake me up.
One afternoon about ten days in, when I was still in my deep sleep, nurses asked me to respond if I could hear them. I moved a toe. My mom was ecstatic to hear the news. She rushed to my bedside and asked me to do it again. Nothing. Day after day, she tried again, and nothing.
By Sunday, April 14, my mom was feeling pretty dejected. She was just asking me for one little sign, and I wouldn’t deliver. Before visiting hours she went to the chapel and then on to my room. It was noon. She leaned over my face, absorbing all of me, staring at my closed eyes.
“Mijo,” she said, “I’m here.” She chatted as she always did, like she was talking to a doll. She talked and talked. Nothing.
“Mi amor, I’m your mommy. If you hear me, give me a signal. Move your little feet.”
My feet didn’t move.
“Son, move your little eyes if you can hear me.”
I squeezed my eyes.
Her prayers, and all the prayers of the people who had been rooting for me, had been answered.
“Mijo,” she whispered, “do you remember Coach Stubber?”
I squeezed my eyes.
“Do you remember Jacob’s mother?”
I squeezed again.
“Do you remember the Multicultural Idiots?”
Again.
“Do you remember Mucho?”
I answered with my eyes.
“Do you know that Mommy loves you very much?”
Squeeze.
“Do you love me?”
Nothing. I didn’t respond.
She repeated the question: “Do you love your mom?”
Still nothing.
“It’s okay,” she assured me. “I love you anyway.”
Those few minutes restored her faith, the faith that had been shattered sixteen years earlier by my sister’s death. She decided to ask God for just a bit more. She sank to her knees on the floor of my hospital room. “God,” she prayed, “if it’s true that you exist in the blue sky, just take a little look through this window and make this child wake up.”
Nothing.
Without another word, she got to her feet and left.
Back at the guesthouse she climbed into her bed, though it was only early afternoon, and considered what had just happened. Had God prompted her child to show her those signs? Yes, she decided, he had. She got out of bed and again went to her knees: She asked God to forgive her. “You know what you’re doing, but I don’t want to listen,” she prayed. “Thank you for letting me have J.R. I’m letting you have the child you’ve already taken. Thank you for letting me k
eep this one.”
CHAPTER NINE
Who Will Love Me Now?
For three weeks I had lain in that bed, hovering somewhere between complete darkness and the most vivid of dreams. And then, through the fog, I heard a man’s voice.
“Private Martinez,” he said. “Private Martinez, if you can hear me, open your eyes.”
I obeyed, but the bright lights hurt, and I slammed them shut again.
“It’s okay to take your time,” the voice said. “When you’re ready, open them.”
After a couple of seconds, I blinked again and focused slowly on the ceiling above me—white tiles with a swirly pattern.
“Private Martinez,” the voice insisted. It was a little irritating. “Private Martinez, we’re going to remove the tube. We need you to cough as much as possible, okay?”
I nodded. Something hard in my chest was dragged upward, through my throat and out my mouth. I gagged. They sat me up. I coughed and coughed, expelling all that stuff that had been sitting in my airway for weeks.
When I couldn’t cough anymore, I sat limply like a baby while someone wiped the drool from my chin. I raised my head and stared in front of me at the sea of masked, bonneted people in green.
“Private Martinez.” There he was again. “We have someone special here who’s been by your side the whole time.”
It was my mom, the person I loved most in the world. I allowed my head to roll to the right and was able to bring my gaze to meet hers. Her eyes were all that were visible. Like everyone else who came into my room, she was wearing PPE—a mask, surgical cap, gown, and gloves. But I could see her tears in her eyes. She touched my hand lightly.
“I love you, Mama,” I croaked out, surprised to hear my own voice. It was hoarse—my vocal cords raw from the breathing tube.
The voice spoke again from somewhere over my bed. “You’re in San Antonio, Texas,” he told me.
What was I doing in Texas? Last time I checked, I’d been in Iraq. “What the hell am I doing in San Antonio?” I said aloud.
I heard a round of appreciative laughter. Dr. Barillo introduced himself and explained that I’d been injured in Iraq and that I was being treated in the burn unit at Brooke Army Medical Center. He asked me if I remembered what had happened. I nodded, but he explained anyway—that I’d run over a mine and been burned. I listened politely but felt really tired.
Before I drifted back to sleep, I turned to my mom. “I told you I was going to come back home.”
Later, when I was fully awake, I told my mom about the vision I’d had of the teenage girl who said, “You’re going to be okay. Mom needs you.”
She and I murmured “Anabelita” almost at the same moment.
My mom reminded me that when I’d visited Anabel’s burial site in El Salvador, I’d sobbed and sobbed and didn’t want to leave the grave. That had broken her heart, and she’d wondered about this link between me and the sister I’d never met.
“She’s been watching over you,” my mom said now.
“You mean like my guardian angel?”
“Yes, mijo,” she answered.
That made perfect sense. I’d always felt that Anabel and I had a special connection. Now I had proof.
The next day Dr. Barillo was in my room again. He pulled over a chair and sat next to my bed so I could see him without moving my head.
“Right now you can’t do much for yourself because of your injuries,” he said, “so a nurse will be taking care of you.” He explained that my nurse would come in every morning at seven thirty or so and feed me. Then my nurse would put me on a shower bed—a rolling waterproof tray—and push me into the shower room to bathe me.
The doctor talked about all the other tasks that the nurse would do for me, but after a bit I tuned him out. I could hear his voice, but in my mind I began to create my own story line starring this nurse. I imagined this angel of mercy as a beautiful young girl, about twenty-two, just out of college. I’d never really had a “type,” but this girl would be a blonde with beautiful light eyes—green or blue—and a Coke-bottle figure. There would be instant attraction between the two of us, which she’d try to conceal. But I’d see it in her smile, the way her eyes would close when I’d make her laugh. We’d fall in love. We’d close the door to my room and make out. I’d be released from the hospital as good as new, and I’d marry this gorgeous woman and we’d have kids together. My mom would be so happy, and so would we.
And then I heard another voice say, “Hi, I’m Mike. I’m your nurse.”
Mike Shiels was a tall thirty-year-old Irishman whose nose crinkled when he smiled, although at the time I could only see his blue eyes. His long hair was collected under his bonnet and his goatee was hidden beneath his surgical mask.
“You’re not my nurse,” I sputtered. No way.
“What were you expecting?” he asked.
“A girl,” I said.
Mike laughed. “Don’t they all?”
I was crushed. I thought about how this Mike guy would be feeding me like a baby and bathing me, of all things. The idea of this guy touching me like that—well, that would be embarrassment on top of indignity. But he’d been a licensed vocational nurse, or LVN, for ten years. He liked to say that, as a medical professional, “You either love burns or you can’t handle them.” He definitely fell into the former camp. Caring for someone like me was personal for him. I was a soldier, and he’d been a soldier, so we understood each other.
And as a nurse, his job was to keep patients alive and get them out of BAMC. He never felt sorry for me, because he knew he was starting me on a long journey and that eventually he’d see me getting out of bed and living my life. His confidence flowed into me and made me feel, more often than not, that I wasn’t a victim.
But my pain was constant, despite the pain medication—often methadone—that Mike and the other nurses administered. Burn pain, I’ve since heard, is like no other. In addition to the agony caused by tissue destruction, burn injury invites further torment by stimulating inflammation and hyperalgesia, an extreme sensitivity to painful stimuli. Irritating substances aggravate the exposed nerve endings, packing an even bigger punch.
My weeks in the burn ICU became routine. Most mornings—when he was on duty—a cheerful, energetic Mike would wake me up. He gave me some time to rouse myself while he went back out to get my breakfast. As I awaited his return, I’d try to grab a few more minutes of sleep, like a middle school kid, before the day started.
When he returned, he clicked on the TV, usually ESPN, and we’d talk about sports—the Spurs, the NBA playoffs—while he fed me, holding the spoon to my mouth because my hands were “frozen” into closed claws.
After breakfast, Mike reviewed the plan of the day and discussed our goals and timeline. I’d state my concerns and Mike would answer my questions. I’d ask him why he did certain things, and he’d explain. He always spelled out everything he planned to do so I’d be mentally prepared for each move. But the morning shower was one element of daily care that defied preparation.
Mike and an assistant would load me onto a shower bed and wheel me down the hall, ceiling lights blinking past. The shower room, called the tank, was kept at a temperature of 100 degrees. Skin keeps us warm, so a burned person with compromised skin can’t maintain body temperature and isn’t able to insulate himself. The place smelled like pure hospital with a dollop of burned skin. Mike would direct the showerhead onto my body; in some places I could perceive the sensation of the water, in other areas I felt nothing. Then he would administer the treatment that all burn patients come to know and loathe: manual debridement. Sloughing off the dead tissue felt like alcohol being poured into a wound, like red-hot pokers being jabbed into you, like your brains are being torn out through your hide—all of this centered on the patch of skin being scraped.
The first time I experienced this, I practically went crazy. I erupted into tears. Then I screamed and writhed. “Why are you doing this to me?” I howled as Mike rubbed the
washcloth, called a fluff, back and forth across my wounds. “I’ve done nothing to you!” I reached up to his scrubs, clawed at them.
But debridement is the necessary evil of burn treatment. Dead tissue breeds infection, which is the most serious complication of a major burn injury. A burn wound is contaminated by bacteria, foreign tissue, and dead cells, and it’s a farm for bacterial growth. Infection is responsible for 50 percent to 60 percent of deaths in burn patients. It’s every caregiver’s nightmare, and Mike wasn’t having any of it.
“I’m sorry, buddy,” he said. “I have to do this, and it’ll benefit you down the road.”
The road? My future? I didn’t care. I wanted it to stop now. But it continued, every single morning. It was almost like being a child again and seeing my mom pull out the belt. I knew it was really for my own good, but that didn’t make me like it any better.
And I began to hold it against Mike. Every morning in the tank I’d plead with him, “Why are you doing this to me?”
Every day the answer was the same: “You’ll see. Someday you’ll see what a difference this makes.”
After my treatment, I was left alone to air-dry back in my room. No more pressure on my skin to cause more pain. I’d lie in the shower bed, the radio playing softly through the ceiling speakers. I’d listen to the words of each song—what else did I have to do?—and try to figure out if the singer was speaking to me. Christina Aguilera sang “You are beautiful,” which only made me cry. I cried for the young man I had been and the person I was now. Even though I hadn’t yet seen my burned face or body, I knew that I probably wasn’t beautiful anymore. And that hurt almost as much as the physical pain.
After the tank, Dr. Barillo would come in to evaluate my wounds before they were dressed again and my skin lubricated with an antimicrobial cream to help prevent infection. Then I’d get some time to catch my breath, maybe have a nap before morning rehab.
In the early stages of my recovery, ICU rehab might be as “simple” as sitting in the “pink Cadillac”—the chair the staff used to help patients sit up and learn to breathe properly. I don’t know why they call it a Cadillac, because it sure isn’t comfortable like a fancy car; it’s more like a torture contraption.
Full of Heart: My Story of Survival, Strength, and Spirit Page 10