Sgt. John Peck, a former Marine who served in Afghanistan in 2010, still vividly recalls the day he became a quadruple amputee.
Peck, who was a muscular six-footer, was leading a sweep into a compound in the town of Sangin, located in the Helmand Province. After inspecting bedrooms and small crawl spaces, the team moved outdoors and Peck remembers suddenly flying through the air. There was dirt and he could see colors and shapes and thought to himself.
"I don’t want to die here," Peck remembers thinking.
"I woke up two months later, and basically found out that I don't have arms or legs no more," he said.
His injuries were extensive, and have so far required 29 surgeries. To be sure, in any other war in history, he would be dead. But like many other veterans, Peck, now 27, is preparing for a life as an injured veteran.
He and so many others are overcoming what has become one of the signature wounds facing American warriors since 9/11 – from IED or roadside bomb blasts that have led to amputations and traumatic brain injuries. The severity of these injuries has forced the medical field and its technology to evolve.
"People see me and think, 'He needs help 24 hours a day,'" he said. "Every day I brush my teeth, take care of what I need to do."
He said he can make his own meals and "can adapt for everything." He has already been skydiving and scuba diving and now has his sights set on cliff jumping.
But the physical injuries were not all that Peck had to overcome. Shortly after he was injured, his young wife left him. He called the divorce the darkest period of his life, a time he spent secluded in his hospital room. His wife could not "hang" with his injuries, Peck said. But the once vibrant and athletic Marine had no choice, and fortunately, he had support.
For two months, his mother Lisa sat beside him at Walter Reed Army Medical Center in Bethesda, Md. She placed her hand on his chest—to show that she was there—and sang him a few country songs. As her son lingered on the edge of consciousness, she found herself talking to him as though he could understand her, trying to convince him to pull through. She would tell him that he is still a young man and urged him to hang in there. But she also remembered telling him that she understands "if you need to go."
Lisa does not remember much from the day she found out about her son's injuries.
"I've been told that I pulled into the driveway and didn't even put my car in park," she said. "I jumped out of the car and asked, 'What did they do to my baby?'"
Technological advances have helped these veterans gain some semblance of a normal life. Peck, who has the distinction of being among five other veterans who have lost all their limbs at war, relishes off-road driving in his Track Chair—or a wheelchair designed to function as an all-terrain vehicle.
The Track Chair sells for $15,000 and the money was raised by a non-profit called the Independence Fund and a New York firefighter who impersonates Elvis. The Veterans Administration cannot afford to provide these off-road vehicles to all amputees.
Prosthetic limbs once designed out of plastic have improved substantially over the past few years. They are now, by and large, made from titanium, which is considered to be more resistant to infection.
Soldiers have outposts at the forefront of battles where life-saving treatment, once reserved for large-city hospitals, can be done on the fly.
Col. Rocco Armonda has performed 600 brain surgeries in the past 12 years. He provided neurological care from an Army field tent south of Fallujah in Iraq. He has become an authoritative voice on decompressive craniotomy and offered advice to doctors who operated on Rep. Gabby Giffords, the former Arizona congresswoman shot by a madman in 2011.
One element that has changed when treating brain injuries is removing half the skull for four to six months. This is longer than usual, due to concerns over delayed swelling and infection.
"The biggest thing that we're doing now is not trying to remove every single fragment of bone or every single piece of metal that penetrates into the cranial vault," he said. "We're doing much larger incisions."
Lt. Col. Eric Holt is on a medical fellowship at Walter Reed studying ways to cope with chronic pain. One of his studies includes ways to prevent brain trauma and PTSD by localizing anesthesia on a battlefield rather than using morphine.
Holt is notable because he is one of Armona's former patients. His skull was smashed in Afghanistan back in January 2009, when an anti-tank mine exploded.
He likened his injury to swimming while dressed in a formal suit. Everything is slower.
"There is a significant amount of frustration because you know what you can do but you just don't quite know how to get there," he said.
For Peck, however, "stuff can always be worse," and has made a life for himself in Fredricksburg, Va. He lives with his mother and maintains an upbeat disposition. He is contemplating starting a landscaping business, but admits he might just prefer to relax on a beach somewhere.