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August 08, 2011
Inspired by young wounded veterans, federally funded labs are creating artificial limbs that may soon blur the distinction between disabled and able-bodied athletes
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August 08, 2011

Prosthetics: Between Man And Machine

Inspired by young wounded veterans, federally funded labs are creating artificial limbs that may soon blur the distinction between disabled and able-bodied athletes

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Examine what military tacticians call the tip of the spear—the leading force in combat—and you're liable to find 1st Lieut. Melissa Stockwell, U.S. Army (ret.). It's a role she has embraced since April 2004, when a roadside bomb in Baghdad blasted off all but six inches of her left leg and made her the first female American amputee of the Iraq war. Four years later, as a swimmer, she became the first veteran of that conflict to qualify for the Paralympic Games. Now, having just passed her board exams to become a certified prosthetist, she figures to be a very busy woman, spearheading yet another movement.

Stockwell leads a generation of disabled veterans of the Afghanistan and Iraq wars who are becoming elite athletes. The combined number of vets on the U.S. teams at the 2008 Summer and '10 Winter Paralympics jumped to 21 from a total of seven at the previous Games, in Athens and Turin. At next year's London Paralympics, U.S. officials estimate that 20% of Team USA will be composed of veterans. That infusion has helped the U.S. creep up in the medal count, from fifth to fourth to third, over the last three Summer Paralympics.

Stockwell's cohort stands poised to deliver more than medals, however. It's the vanguard of a revolution in attitudes toward people with disabilities. "My prosthetic is definitely a badge of honor," says Stockwell. "I'll walk around in shorts and flip-flops." At the same time, tens of millions of dollars from the departments of Defense and Veterans Affairs are funding advances in prosthetic technology so profound that they raise essential questions about what it means to be human.

To meet the growing demand from wounded warriors, the U.S. Olympic Committee is disbursing $7.5 million donated by the VA to help not only veterans but also active-duty soldiers. Since 2004 U.S. Paralympics has been hosting military sports camps to enhance the rehabilitation of veterans and active service members with disabilities. Meanwhile the USOC and the DOD are ramping up events such as the Warrior Games, which were staged for the second time, in May, in Colorado Springs, with 200 physically impaired vets and soldiers competing in seven sports.

People who work with them agree that soldiers are athletes to begin with, and injured ones are like any jock aching to get off the DL. "It's amazing how many say to me, 'I'm going to be your best patient,'" says Peter Harsch, director of prosthetics at the San Diego Naval Medical Center. "Their driving force is, Number 1, to get back to their division or squad. But then, this is a military where everyone had a choice whether to go into it." (As many as 18% of amputees return to active duty, most of them to noncombat jobs.)

When Stockwell arrived at Walter Reed Army Medical Center in Washington, D.C., her very survival still hung in the balance. After 15 operations, 20 blood transfusions and a series of infections, she was turned over to Walter Reed's therapists. "I looked around and saw people missing two, three and four limbs, people with traumatic brain injury and lost eyesight," says Stockwell, who had been a rower and diver at Colorado. "It motivates and inspires." After one year at Walter Reed and two more dedicated to swimming, she was still a long shot at the 2008 U.S. Paralympic trials, yet she lopped a staggering 17 seconds off her previous best in the 400-meter freestyle to make the team. (She did not medal in Beijing but carried the U.S. flag at the closing ceremonies.) Now a paratriathlete, Stockwell won gold in the severe leg impairment category last September at the world championships in Budapest. "I've done more with one leg," she says, "than I ever would have done with two."

That's a tribute not only to Stockwell's grit but also to Walter Reed. There, 30 physical and occupational therapists at the Military Advanced Training Center (MATC) use state-of-the-art equipment such as the Computer Assisted Rehabilitation Environment (CAREN)—a virtual-reality room that simulates real-world conditions and that Harvey Naranjo, coordinator of the MATC's adaptive sports program, likens to "a Wii on crack"—and a diagnostic studio in which 35 cameras and six force-measuring plates feed data to computers that instantly detect when a prosthesis needs the slightest adjustment. More than anything else, the MATC, which is scheduled to move this month to Bethesda, Md., is a hothouse where wounded warriors challenge one another to reclaim as much as possible from the lives they once knew.

As soon as patients build up enough strength and coordination, the therapists introduce competitive sports. "With this type of population you can only do cones and weights for so long," says Naranjo. "The discipline to get up in the morning and work out is already embedded. Prior to their injuries they were all physically fit, so they'll recover quickly if you get them going fast."

Naranjo's unit prides itself on sending athletes to iconic marathons for the able-bodied such as the New York City Marathon and New Mexico's Bataan Memorial Death March. In May 2010 a Walter Reed team, Missing Parts in Action, competed in Washington State's Ski to Sea, a 100-mile relay race comprising seven sports: cross-country skiing, downhill skiing or snowboarding, running, road biking, canoeing, mountain biking and sea kayaking.

In February, only two weeks after Walter Reed sent a group of adaptive snowboarders to try para--snowboard cross at Utah Olympic Park in Park City, one of them—former Army Capt. Nathan Wayne Waldon, an above-the-knee amputee—placed 18th at the World Snowboard Federation World Cup, which stages a special competition for para-athletes. Adaptive snowboarding might be a medal sport at the 2014 Paralympic Winter Games, and Waldon hopes his busy nonathletic life (he works in program management for General Dynamics and takes graduate business courses at night at Georgetown) will permit him to participate. "All they want to do is get better, to go out and kick some butt, and we give them the tools to do it," Naranjo says. "In previous wars, it was, Here's your prosthesis, have a good life. These guys have pushed the technology. Things I thought were incredible 10 years ago are nothing compared to what I'm seeing now."

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