Life After the Triage

The Army Combat Lifesaver course is a medical course that teaches emergency lifesaving measures while in a combat environment. During this course, you learn to prioritize the most life-threatening injuries while waiting for medical personnel to arrive.  I completed the combat lifesaver course before my first deployment, and thankfully had no opportunity to use these skills. It wasn't until 3 days before my ETS date that I would be forced to use the triage skills I had learned, albeit in a different manner than was intended.

That day started off rather uneventful. It was Easter Sunday, my husband was on his 4th deployment, and I had been on terminal leave for a few weeks in preparation for ending my time in service with the Army. I was 4 months pregnant with my third child, and I had just found out two days prior that I was having a baby girl, which is pretty exciting when you already have two boys. The plan was to have a quiet Easter celebration at home with just me and my boys, which was off to a great start with my 3-year-old cuddling with me on the couch and my 7-year-old right there next to us. My pregnant belly was making it harder and harder to fit a 3-year-old on my lap, but I would not give up those cuddles for anything in the world. After all, there was a time when my youngest child could not be in the same room with me. There was a time when I had to leave him at just 8 months old to serve my country in Iraq. Only to come home to a son who didn't know who I was, and who couldn't be in the same room with this stranger that was his mother. No, I was not giving up those cuddles for anything. Then my cell phone rang…

It was a number I did not recognize, which made me reluctant to answer. I wish I had known before I answered that call that our lives would never be the same after. I often think of myself as two different people: the woman before that phone call and the woman after. I answered the call with my 3-year-old on my lap. It was my husband's rear detachment commander, someone we knew fairly well. I could hear the hesitancy in his voice; he knew he was giving me life-changing news. He said, "I don't know how to tell you this, so I'm just going to read the white line message."

He then went on to describe my husband's injuries, which were actually quite uncertain at this time. What was certain was that my husband had lost both of his legs, sustained a traumatic brain injury, and was in surgery. I was filled with so much uncertainty when that call ended. I didn't know what to think or how to feel. I didn't cry. I just felt numb. I had so many questions, but the hardest question of them all was how do I tell my sons? Should I tell my sons? How much would a 3 and 7-year-old really understand about war? What if I told them about their father's injuries and reassured them that he would be okay, and he dies during one of the many surgeries that he would have? What kind of damage would that do to two young boys?

Once my sons and I went to see my husband at Walter Reed, that's when triage mode kicked in. Our mission was clear; my husband needed to learn how to walk again. During our two years at Walter Reed, we primarily focused on my husband's physical injuries, which were easy to do because they were so severe. The unfortunate thing about being hyper-focused on my husband's physical injuries is that we failed to treat his nonphysical injuries, his traumatic brain injury. We wouldn't fully feel the effects of this neglect until 3 years after my husband's injuries.

It was a hot summer day in northern California, and my husband and I were driving home from an event in separate cars. He decided to take the kids in his car because I had a stop to make. I had arrived home about 10 minutes after my husband did, and I noticed that the house was unusually quiet for a house with 3 kids. I saw my sons playing in their room and asked where their sister was. They said confidently that she was playing outside on her playground. I began doing dishes, not really thinking much about it. Then I decided to check the playground for my daughter, and to my surprise, she was not there. I asked my sons again where she was, and they assured me that she was outside somewhere playing. When I asked my husband where our daughter was, he insisted she was inside. A panic quickly filled me as I realized nobody knew where my daughter was. I frantically began searching for her all over the house and in our yard to no avail. Then I glanced over at my husband's truck and was able to make out the faint image of my daughter through the darkly tinted windows.

I ran to the car and opened the door to find my daughter crying frantically, her chest rising and falling dramatically with each breath. He had forgotten her in the car. She had been in the car for at least ten minutes, and her body temperature had risen to over 100 degrees in that time. I could see the fear, pain, and confusion in my husband's eyes. This moment was a product of our triage. We focused primarily on his physical wounds while he was a patient at the greatest hospital with the greatest doctors, but we failed to get the help we needed to manage his TBI.  We overlooked this massive invisible wound, and we were dealing with the consequences of it.

After that day, I began picking up more on my husband's TBI symptoms. There are the textbook symptoms such as memory loss that cause my husband to forget conversations that we had only days priors, and attention problems that cause my husband to almost burn down our house by leaving the stove on. But I also began to pick up on other symptoms such as visual-spatial issues that make it difficult for my husband to judge distance, especially when driving.

This is what life after the triage looks like. Teaching your 3-year-old how to unbuckle her car seat in case daddy forgets her in the car. Checking to make sure he turned off the burner on the stove after using it. Recognizing that having 3 kids in the backseat of a car on a long road trip is just too much stimulation for him. And trying to understand that hurtful words may be related more to his inability to cope with things around him rather than a reflection on how he feels about me. This is life after triage.

Written by a Veteran Caregiver

Glass Castle

"I've spent my whole life watching people, dancing on the inside, while I'm looking in. Hands pressed up against the glass window, wishing they would invite me, to come in" ~ Justina Lyn

Being raised on a religious hippie commune in Northern California, you can imagine that I did not exactly fit in with other children. I had to wear long-sleeved homemade dresses over pants and wasn't allowed to socialize with children outside of our religion. My family was dysfunctional to the extreme. They were the embodiment of sex, drugs, and alcohol mixed with end-time paranoia prepping. I never felt comfortable around people because I knew my family wasn't typical. We were gossiped about behind our backs and, even worse, on occasion, ended up in the newspaper and not in a good way. I lived outside of a large glass castle representing normality, wishing that someone would invite me to become a part of their ordinary happy world.

For most of my teen and adult life, I have wanted to be a part of something more. I thought I had found it in music and women's ministry, but that turned out to be false. Being a part of a church is like having a club membership that expires once you move away. The same can be said of neighbors who you thought were friends or even family members whose lives differ from your own. It wasn't until I joined the military community as a caregiver that I felt I had become a part of something bigger than myself, something real, and gained a sense of belonging.

For many, being a caregiver isn't just a job; it is an identity. My mom recently told me that even as a little girl, I was her little caregiver. How many caregivers out there can relate? My veteran said to me that he had always wanted to be a soldier. As a young boy, he dreamt of serving his country and being a hero like Rambo. During my childhood, I was busy rescuing baby birds or bottle-feeding kittens whose mommies had died. It is no surprise that we both ended up in professions representing the core of who we were and still are.

There is a misconception that being a caregiver ends if your loved one passes on or if the relationship ends in divorce. I tell my divorced caregiver friends that they are still caregiving for their veterans because they are. Most of them still have to do all of the scheduling of visitation, time management with reminders, and act as a mediator between children and other family members. We encourage each other by starting support groups like The Coalition's Veteran Caregiver Alliance (VCA) for those in the trenches of everyday caregiving. The VCA was founded by caregivers to encourage and support other caregivers on their journey.

Being inside the glass castle of caregiving means that people can look in just as we can look outside. There will always be those who misunderstand our lives, judge or pity us for staying, or lack the comprehension of how exhausting the job of caregiving can be. I have learned to accept a certain level of isolation beyond that of my caregiver family. My value and worth are not determined by what the outside world thinks of me because I know I am needed by my veteran. The caregiver community is strong, and we are growing stronger every day. We love and support each other because we live it, and no one can understand our lives like another caregiver. Military caregivers have been given the added responsibility of caring for our nation's heroes. Without their caregivers, many veterans would end up homeless or in a VA care facility. We, as caregivers, are the veteran's last line of defense, their advocate for better care and resources. I am no longer on the outside with hands pressed up against the glass window, wishing someone would invite me. I have found my home, my life, and my community as a military caregiver.

Written by: Justina Lyn, HTH Representative & Veteran Caregiver