How can you help heal our broken heroes in the Mail's Christmas appeal

Saturday, December 5th, 2009

By Max Hastings

Last updated at 10:05 PM on 04th December 2009

A young man in shorts stands in a ward chatting to a nurse, idly practising a golf swing with a reversed walking stick. Where his left leg should be, there is instead a densely engineered substitute of steel and hydraulics.

On damp Tarmac outside the building, half-a-dozen smokers puff away under a shelter, clustered in their wheelchairs. In a basement workshop, RAF technicians bend over high-tech lathes and cutters, fashioning moulds and thigh sockets.

I showed surprise at seeing airmen doing this work.

The human cost: For men like Fusilier Thomas James, the fight is far from over

An officer said: ‘If you think about it, they are simply using the skills they learn on aircraft for a different sort of application.’

This is Headley Court defence medical rehabilitation centre in Surrey, the place where the human cost of Britain’s war in Afghanistan is displayed in its starkest guise.

This is where very young men who have suffered appalling injuries on the battlefield come to learn to remake their lives. It would defy any visitor not to be profoundly moved by what they see here.

There are teenage private soldiers whose legs vanished in roadside explosions in Helmand, officers whose flesh and sinews were mashed to pulp by high-velocity bullets, drivers whose vehicles and bodies were devastated by blasts which impacted with a force that mocked armour plate.

Even as recently as the Falklands War, many men died from such injuries.

Today, however, with the extraordinary advance of battlefield medicine and fast helicopter evacuation, they survive.

Once their lives have been saved, the challenge for Headley Court is to show them a future. The graph of patient numbers has climbed steeply and tragically since 2006.

In addition to hundreds of non-battle cases, the centre is now treating around 200 severely disabled combat casualties, 120 in wards and another 80 who have graduated to single accommodation.

‘Nowhere else in Britain is doing what we are doing here,’ says Colonel Jerry Tuck, the Army doctor who is its commanding officer.

‘All the time we’re asking ourselves: “Can we do this better? Can we do this better?” ‘

A soldier badly wounded in Helmand is flown first to Selly Oak hospital in Birmingham.

Probably about six weeks later (although this can stretch to 14 weeks or more) he arrives for the first time at Headley Court.

Within hours, plaster casts are made of an amputee’s stumps. Within a day, he is fitted with the socket for his first prosthetic limb, individually moulded to his arm or leg. Within five days, the limb itself is fitted.

Then the long, long process begins, of teaching a man to use it – or, in the case of multiple amputees, them – and managing diet, treatment and medication.

Patients spend three or four-week stints at the centre, travelling home at weekends, and between treatments receiving physiotherapy at regional rehabilitation units.

The Forces charity SSAFA has funded two houses at Headley Court and Selly Oak, to provide accommodation for families who go there to be with their wounded sons or husbands.

Many patients still cherish the distant battalion as their home. Beside one bedside stands an artificial leg. The pillow is coloured in the Parachute Regiment’s maroon red, surmounted with its winged canopy badge. A teddy bear sits on another pillow.

Legs, legs, legs – prosthetic limbs – lie around everywhere in the wards and treatment rooms, unforgettable images.

Lieutenant Colonel David Richmond, 42-year-old commanding officer of the Argyll & Sutherland Highlanders, was hit near Musa Qala in June last year by a single AK-47 round that shattered his thigh bone.

Today, 17 months later, his right leg is still held together by a cage of steel and wires, and he returns regularly to Headley Court for more and ever more treatment.

‘They told me at the beginning that it would take a long time,’ he says, adding wryly: ‘But at the beginning my idea of long wasn’t quite as long as it has turned out.’ His leg has been society. It’s very hard to know what medical care each one will need in ten years, or in 25.’

There are widespread variations about the manner in which men come to terms with their disabilities.

Many work fiercely at exercise, practising with their new limbs until – in a phrase much used at Headley Court – they ‘plateau’. That means, in Colonel Tuck’s words, ‘they have recovered as much functionality as they are ever going to have’.

Some of those who seem bravest may, in reality, be in psychological denial about the reality of their new life and its limitations. A few are defiant. One said bitterly one day: ‘I’m no longer fit to be a soldier, so why should I obey an order to get up in the morning?’

Others have flaunted their frustrated aggression among civilians. It is not always patients’ most severe injuries which can cause them most grief. Some, for instance, recoil from the sight of their own body scars while more readily acknowledging the loss of limbs.

Most of the alienated young men are eventually reconciled. But who can be surprised at their anger? Some come from the least privileged section of society. Plenty are from broken homes, or lack education.

Parents and girlfriends find it as hard to cope with the experience of a son or lover deprived of limbs as the young men themselves. I recently met one of them with his mother.

More pain was etched into her face than into that of her son. Headley Court is full of black comedy, created by its patients.

Many, suddenly flush with money from compensation cheques, buy new cars, some of them absurdly fast and expensive. There is a fashion for personalised number plates, for example NO LEGS.

This is one of their ways of coming to terms with a predicament that would be unbearable if they did not laugh. So that is the story. That is a glimpse of the pain. Headley Court has become, for the British people, a symbol of our complex guilts about a controversial war.

The big question is: what more can we do to help these young men, who have sacrificed so much in our name?

There is almost unanimous praise for the medical care every casualty receives, from the moment he is wounded to the day he leaves Headley Court. saved, though it will always be shorter than the other. He will be able to continue an Army career if he chooses.

For others, who have lost limbs, decisions about the future are much more difficult. The Army does its utmost to offer them the option of continued employment, but few are capable of returning to active duty.

‘How many storemen are there jobs for?’ one amputee shrugged, when I discussed this issue with him at his home.

‘I think most men would be much better off being helped to start civilian careers.’

This view is widely shared in the Army. Yet for many graduates of Headley Court, it is tough to form new lives in the outside world, which finds it hard to understand, and their treatment by some people is occasionally despicably callous.

Some stories of civilians complaining about amputees in the local swimming pool, of yobs mocking disabled soldiers, have been wretchedly true.

‘The nation has got to think hard about what it is going to do for these people,’ says Colonel Tuck.

‘It is not just about not shunning them. It is not just about meeting their medical needs. It is about enabling them to live full lives in society. It’s very hard to know what medical care each one will need in ten years, or in 25.’

There are widespread variations about the manner in which men come to terms with their disabilities. Many work fiercely at exercise, practising with their new limbs until — in a phrase much used at Headley Court — they ‘plateau’.

That means, in Colonel Tuck’s words, ‘they have recovered as much functionality as they are ever going to have’.

Some of those who seem bravest may, in reality, be in psychological denial about the reality of their new life and its limitations. A few are defiant.

One said bitterly one day: ‘I’m no longer fit to be a soldier, so why should I obey an order to get up in the morning?’

Others have flaunted their frustrated aggression among civilians.

It is not always patients’ most severe injuries which can cause them most grief. Some, for instance, recoil from the sight of their own body scars while more readily acknowledging the loss of limbs.

Most of the alienated young men are eventually reconciled. But who can be surprised at their anger?

Some come from the least privileged section of society. Plenty are from broken homes, or lack education.

Parents and girlfriends find it as hard to cope with the experience of a son or lover deprived of limbs as the young men themselves. I recently met one of them with his mother.

More pain was etched into her face than into that of her son. Headley Court is full of black comedy, created by its patients.

Many, suddenly flush with money from compensation cheques, buy new cars, some of them absurdly fast and expensive.

There is a fashion for personalised number plates, for example. This is one of their ways of coming to terms with a predicament that would be unbearable if they did not laugh.
So that is the story. That is a glimpse of the pain.

Headley Court has become, for the British people, a symbol of our complex guilts about a controversial war. The big question is: what more can we do to help these young men, who have sacrificed so much in our name?

There is almost unanimous praise for the medical care every casualty receives, from the moment he is wounded to the day he leaves Headley Court. The staff are superbly dedicated. The facilities are the best money can buy.

The gym and exercise machines are state-of-the-art. A huge swimming pool is approaching completion, built with £8 million raised by that marvellous charity Help For Heroes, and another £3 million from the taxpayer.

At last, and after shameful prevarication by the Ministry of Defence, wounded soldiers are receiving compensation payments approaching those paid to civilians for severe injuries.

Most of the big problems are psychological, and none of the answers are easy. The only criticism I would make of Headley Court is that the common living spaces are cramped, dull and drab. The Junior Ranks’ Club is a cheerless bar.

Desperately bored, frustrated young men can find little to amuse them in evenings at the centre or in nearby Leatherhead or Dorking.

A private benefactor is currently funding a study for a possible big new Rehabilitation Centre on a Midlands greenfield site.

This would be available to NHS civilian patients as well as soldiers, and make life much easier for families who today must travel to Surrey from Scotland or the North to visit loved ones.

But in the nature of things, building such a facility will take time.

For several years ahead, the rambling old buildings at Headley Court must accommodate and care for hundreds of young men with the space it has got.

There is an inescapable tension between the demands of a treatment centre and those of living quarters where patients must spend months of their lives.

There seems a good case for a short term blitz — spending some money quickly to brighten the place up, even if it goes to waste eventually, when a new centre is established.

As for the future lives of its patients, a limited number can continue careers in  the Army.

Major Peter Norton, the bomb disposal expert awarded the George Cross for his work in Iraq, where he lost an arm and a leg, is now lecturing at the Shrivenham Defence Academy.

Others with relatively limited disabilities, or specialist skills, can return to their regiments.

Patients with severe permanent handicaps face the hardest choices. I have never forgotten an encounter long after the 1982 Falklands War with a young man whom I met on the battlefield, where he lost a limb.

Sport and the Army had been everything to him. When these were gone,he found himself bereft.

For me, the Falklands was a marvellous adventure, long in the past by the time we met again. For him, however, as we talked I came to realise that the war had been a disastrous, life-changing experience.

He has never psychologically recovered, because he finds it hard to exist in a civilian world with little understanding of his predicament.

This is where the young men of Afghanistan need our help — and where SSAFA makes a vital contribution, providing support. The last thing they want is pity, but the most important contribution is respect.

An officer at Headley Court describes a scheme to recruit disabled soldiers for the police, who want ex-service personnel for support tasks. If this works, it sounds promising.

For many soldiers, the regiment has been their family, their sheet anchor. If they must lose this along with their limbs, in its place they need more than jobs, incomes, homes.

They want something to belong to, an organisation which understands them and which is worthy of their loyalty. They must not be left alone, to contend with their disabilities and memories. They need help to manage money.

Suddenly, they find themselves in possession of more cash than they have dreamed of — but which must fund them through a lifetime. Many need the support and understanding of a girl, which is asking a great deal, but can make all the difference in the world.

I am wary about using the word ‘hero’, so often devalued. The soldiers who come home from Afghanistan to find themselves at Headley Court did not choose such an outcome.

Nobody who goes into battle thinks it will be their own fate to lose arms or legs — that is what might happen to somebody else. But most become heroes through the courage with which they face this destiny when it befalls them.

It is our job to show ourselves worthy of them, by helping them to help themselves to make a future; by showing our gratitude, admiration and support wherever we may encounter men of Helmand and Headley Court.

They have given so much. Now it is our turn: to see that right is done by them.
Read more: http://www.dailymail.co.uk/news/article-1233336/How-help-heal-broken-heroes-Mails-Christmas-appeal.html#ixzz0YlMccqGU

(Thanks to Steve McNeice for sending this message)

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