By Jared Chausow
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The sergeant who found Reyes crawling on all fours with his skull hanging open saw Reyes's helmet nearby. A shimmering liquid in it caught his attention; as he poured it out, he realized what it was: part of Reyes's brain.
Within 20 minutes, medics were stemming the flow of blood from Reyes's wounds. Despite losing about 40 percent of his brain on the battlefield, Roberto Reyes was kept alive by technology and techniques unimagined in earlier conflicts.
In previous wars, Reyes likely would have been just another casualty. During the first World War, eight out of every 100 soldiers wounded in battle died. In Vietnam, that number had improved to seven out of every 100. But in Iraq, only one in 100 injured soldiers have lost their lives.
Advancements in military medicine make the miraculous routine. New fast-clot bandages and coagulation powders can be poured directly into a wound. Small platoons of medics stay close by and reach wounded troops within 15 to 20 minutes, a significant improvement over the 30-minute average in Vietnam. Those medics can begin surgery immediately; helicopters are equipped as flying emergency rooms so that procedures can continue while soldiers are shuttled to larger aircraft to take them to the largest military hospital outside the U.S. at Landstuhl, Germany. Less than 48 hours after an injury, a soldier can be back in the United States while continuously hooked to life-support machines.
Four years since the war began, the military's polytrauma medical centers that handle brain-injured soldiers have treated 1,882 individuals, 30 percent of whom exhibit moderate to severe brain damage. The Defense and Veterans Brain Injury Center has estimated that between 10 percent and 20 percent of all returning soldiers have suffered some sort of brain injury.
Most don't suffer as extreme an event as the mine explosion that cracked Reyes's skull open. But brain injuries can arise without external evidencethey can result simply from the reverberations of a nearby bomb, the repetitive recoiling from shooting a gun, or riding a Humvee through rocky terrain for hours on end. "It's like putting a raw egg in a cup and shaking it," says Jane Higham, a project coordinator at the Brain Injury Association of New York State. "Imagine all the brain cells being torn apart and shredded."
Body armor can stop bullets, but it does little to guard from blasts or shaking. And unlike irreparably injured limbs that can be amputated, says Dale C. Smith, chairman of the medical history department at the Uniformed Services University of the Health Sciences, "You can't cut off a head. So we end up with all these bad head wounds."
At the same time Reyes, in a coma, was being airlifted to Walter Reed Army Medical Center, his mother, Aida Rivera, was busy at work in lower Manhattan as a security guard, surveying Wall Streeters entering a building. In her station, where she checked ID cards, her phone couldn't get a signal, so she didn't get incoming calls during her eight-hour shift.
Red Dog Reyes in Iraq, before a mine blew apart his Humvee
photo: Mara Altman
As she headed home, Rivera received a call from her sister, Maria Mendez, who said she'd come by with a meal. If that seemed unusual, Rivera pushed the thought to the back of her mind as she wondered what to spend her latest paycheck on: some extra socks to send to her son in Iraq, maybe a night on the town. When she arrived home, she found 11 members of her family waiting fo her at the door. Their eyes were puffy and red; tears ran down their cheeks. As her sister opened her mouth to say "Robert," Rivera hurried to her room and slammed the door. She didn't want to hear moreprolonging the minutes before her son, barely hanging on to life, would so deeply change her world.
It had been Reyes's choice to join the military, but now it was his mother's lot, with little resources to deal with the repercussions. It wasn't the job she saw for herself in 2002 when her son joined the Army and she went off to pursue, at the age of 41, her own goals: working as a security guard, dating again, and continuing school. "I had expectations for myself," she says. "I was going to go back and study."
Instead, she says, she had no choice but to become her son's full-time caregiver. And it is Roberto who needs schooling now.
He's learning his ABC's.
Over and over, Reyes screams "Mom!" at the top of his lungs. He asks for milk, and he wears a diaper. He plays with plastic figurines of such characters as Donatello from the Teenage Mutant Ninja Turtles and the Undertaker from WWE. He's 25 years old and needs his mother now as much as he did as a young boy growing up on the Bronx streets, maybe more. She's begun to call him "Baby Bamm Bamm"two years ago, his comrades called him Red Dog.