Raising Roberto (Again)

A devastating brain injury in Iraq leaves soldier Roberto Reyes with a support system of one—his mother

"Can you keep it down?" she asks while standing close to the nurses' station. "Robert can't take the noise." Soon, however, the prattle picks up again after Rivera has shut the door.

Rivera begins her daily routine: She turns on the two televisions with the volume down low and loads a DVD into Reyes's laptop.

"Papi, you want to watch your wrestling or Rocky?" she says, showing him the discs.

She has more than 30 of his DVDs, most of them bought cheaply on Baghdad's streets, but he watches the same two movies every day. He's lost his short-term memory.

He says nothing. She points to Rocky. Nothing. She points to the wrestling disc and he slightly bows his head. She puts the disc in the computer and gives him a magnifying glass so he can hold it up to the screen.

She checks the whiteboard at the foot of Reyes's bed to see if "Jimmy" is scrawled there. When Reyes first arrived at the hospital, he received regular physical therapy and was beginning to make progress, able to take short steps after several weeks. Then months went by without therapy; he has now regressed and can't even stand up. To make sure the new physical therapist, Jimmy, comes, Rivera asked him to sign the whiteboard after each session. She says he's still only showing up once a week instead of the required three times.


Asked about Rivera's complaints, James E. Connell, the director of community and government relations at the James J. Peters VA Medical Center, says that because of privacy regulations, the VA cannot speak about specific patients. But he did say that families dealing with a traumatic injury are often extremely sensitive, and because of their stressful circumstances are bound to find faults. He insists that resources and staffing are not an issue at the facility, and that each patient is regularly evaluated so that treatments are tailored to changing needs. Scheduled physical therapy sessions, he points out, could be canceled if a patient is experiencing muscle spasms, high pain levels, or increased anxiety. But Connell adds that it's common for family members to feel that progress, attention, and recuperation are not happening as fast as they'd like. "A family's response to a tragedy like this is visceral and it's real," Connell wrote in an e-mail, "but it is not necessarily based on the standards of medical practice."

At 5 p.m. it's time for one of Reyes's 22 medications. But Rivera says the nurses always seem to forget. About a half-hour later, Reyes begins to squirm from muscle spasms. Rivera reminds the nurses. She wonders about the other veterans on the floor who don't have mothers on hand to care for them. At 6 o'clock, an hour late, Reyes's pink painkiller is being pushed down his stomach tube. Each time Rivera watches Reyes load up on medications, it's hard for her not to recall his stubbornness as a child; he wouldn't even take a Flintstones vitamin.


Reyes often responds to a day of his mother's constant attention by wanting more, like a toddler would. He repeatedly asks her to help him put on his Nike shoes, although his feet are swollen and the shoes will only irritate them more. At other times, he throws hand signals and yells mumbled curses, seeming to react to something only he can see.

In moments of frustration, often in tears, Rivera takes her pack of Newports and rushes down the hall to the smoking room. A study released last year in a VA-sponsored forum suggests that such caregivers suffering from extreme stress age prematurely, and that stress can take 10 years off the life of someone like Rivera. From the time she enters the hospital to the time she leaves, around 10 p.m., Rivera smokes half a pack, but there's never enough time to get a fix before she hears her son screaming her name again.

She rushes back to be with him, but few are rushing to help Rivera herself.

Organizations like the National Military Family Association have paid attention to the concerns of parents like Rivera since the war began. They recognize that parents often feel compelled to provide full-time care and don't want to hand over their injured sons and daughters to institutions. "Parents don't want to put children in nursing homes," says Barbara Cohoon, deputy director for government relations for the NMFA. "But they are losing their jobs, feeling stressed out, and getting burnout caring for them."

The NMFA and the Wounded Warrior Project, another not-for-profit organization, have convinced Senator Hillary Clinton to promote legislation that would directly benefit the caregiver of a severely injured vet. In coming weeks, their proposal will be introduced as an amendment to the Heroes at Home Act, which was passed and funded last year. The new program is modeled after one used in the San Diego VA hospital for spinal cord injuries and would, through the VA, provide education about how to care for brain-injured patients, certify caregivers, and then pay them a salary. "This is vital," says Jeremy Chwat, the executive vice president of the Wounded Warrior Project. "They are providing the care anyway. It's better that they're properly trained and get paid."

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