Brendan Morrocco received a double arm transplant yesterday.
Message from his mom this morning is, "he is exuberated and alert-the arms are beautiful."
Miracles do still happen.
Merry Christmas, Brendan, and to your family.
You are such an inspiration.
Below is a post from this blog in 2010 detailing his story.
A Man of Independence
Read the article below from today's edition of
The New York Times.
You will then understand how amazing it is that I was able to chat with Brendan last night via Facebook.
Godspeed Brendan.
And Godspeed to your unsung hero Michael.
Spirit Intact, a Soldier Reclaims His LifeBy LIZETTE ALVAREZ
WASHINGTON
BRENDAN
Marrocco and his brother, Michael, were constructing a summer bucket
list, to get them out and about, trying new things. A Washington
Nationals game versus their beloved Yankees — sure, since they were
stuck here rather than home on Staten Island. Perhaps a ride on the
Metro, with its reliable elevators. Pizza: definitely.
How about going to an amusement park? Michael suggested optimistically.
“Would that really be safe?” asked Brendan, a smirk crossing his lips.
The
beach? “I don’t do beach anymore,” Brendan replied. Then what about the
National Zoo, the one with the pandas? “They got pandas?” Brendan said,
razzing his brother again. “Why didn’t you mention that?”
Clutching
a pen firmly in his oversize rubber hand, Brendan Marrocco completed
the lineup. A trip to Annapolis, Md. A ride on a boat. And, his personal
favorite, firing guns. He drew a miniature picture of a handgun next to
that one.
Each would be a major accomplishment for Brendan
Marrocco, who a year before had come so close to death that doctors
still marvel over how he dodged it. At 22, he was a spry, charming
infantryman in the United States Army with a slicing wit and a stubborn
streak. Then, on Easter Sunday 2009, a roadside bomb exploded under his
vehicle, and he became the first veteran of the wars in Iraq and
Afghanistan to lose all four limbs in combat and survive.
In the
nearly 15 months since, Specialist Marrocco has pushed past pain and
exhaustion to learn to use his four prosthetics, though he can walk for
only 15 minutes at a time. He has met sports stars like Jorge Posada and
Tiger Woods — and become something of a star himself here at Walter
Reed Army Medical Center, where his moxie and humor are an inspiration
to hundreds of other wounded service members. He has also met, fallen in
love with and proposed marriage to a young woman who sees what is there
rather than what is missing, though Specialist Marrocco has lately been
questioning the relationship.
Now he is preparing for a rare and
risky double arm transplant at the University of Pittsburgh Medical
Center that could profoundly improve his independence. One of the first
things he will ask of his new arms is to drive a stick shift (the one
time he got behind the wheel, in an empty parking lot, his rubber hand
became unscrewed and was left dangling).
There have now been 988
service members who have lost limbs in combat since the first of the
wars began in 2001, but Specialist Marrocco’s many wounds raised so many
questions. Would he crumble mentally? Was his brain intact? How would
he ever cope with daily needs like eating, bathing, even simply getting
out of bed and putting on clothes?
“I would close my eyes and see
a head and a torso,” his mother, Michelle Marrocco, 50, said of the
early days. “How much worse could it be?”
But Specialist
Marrocco, who was promoted from private in November, “has exceeded the
expectations of everyone but himself,” said Maj. Benjamin Kyle Potter,
35, the orthopedic surgeon who has treated him since he arrived at
Walter Reed last year, in April.
He can already write legibly (if
left-handed), use a computer (but not play video games), work on a
model car (with some help) and text furiously (a generational
requirement).
He has not done it alone. His brother, Michael, 26,
gave up a good-paying job at Citigroup to move into Walter Reed and, as
he put it, “hang” with Brendan, shedding his tentative nature along the
way. Their long-estranged parents, an engineer and a nurse, learned to
communicate again as they kept vigil by Brendan’s bedside in the early
months. And his indefatigable physical and occupational therapists take
him out for Chinese food or watch ballgames with him on television long
after their shifts end.
A contrarian by nature, Specialist
Marrocco has become a bit of a homebody, preferring the haven of Walter
Reed — where he is a role model — to the awkwardness of the larger
world. And despite 14 operations, he refuses to let a dentist’s needle
near his mouth to replace the eight teeth he lost in the blast.
One
sweltering day this spring, a Marine sat in a wheelchair outside while
Specialist Marrocco practiced walking nearby. The Marine had arrived at
Walter Reed in May and was waiting for a shuttle bus. He lost both his
arms and legs in Afghanistan, and is the wars’ second quadruple amputee.
The
Marine watched Specialist Marrocco amble up an incline, determined to
tame his prosthetics. “I’m hoping to be just like you soon, man,” he
shouted.
NOT quite six months into his combat tour, Private First
Class Marrocco sat behind the wheel of an armored vehicle as it made
its way back to Forward Operating Base Summerall in Baiji, a town in
northern Iraq. His was the last truck in a four-vehicle convoy on a
routine mission escorting a group of soldiers from one base to another. A
machine gunner, Private Marrocco had become a driver a few days before.
“It was one of my first driving missions,” he remembered. “I wasn’t driving the truck I was supposed to drive.”
He
had arrived in Iraq on Halloween 2008, eager to fight. But by then,
there was little fight left in Iraq. Violence had diminished; American
forces were dropping in number. His days were spent mostly on patrol,
conducting occasional raids and lifting weights at the base’s makeshift
gym.
Growing up in the Huguenot section of Staten Island, Brendan
had been smart and outgoing, but preferred racing cars to taking tests.
His parents enrolled him at Staten Island Academy, hoping the
prep-school atmosphere would knock sense into him. It did not.
“He is a very headstrong individual,” explained his mother. “He has taken it to an art form at this point.”
College
did not stick, either, so he enlisted in the Army. When he got to Fort
Benning, Ga., in January 2008 for basic training, he felt grounded for
the first time in his life. Here was a career he could love.
“You kept the danger in the back of your mind,” he said. “You didn’t want it to happen, but you had to train for it.”
It
is difficult, though, to train for hidden bombs, which is what makes
the wars in Iraq and Afghanistan so insidious. All he can recall of that
Easter Sunday drive back to his base is the flash of light against the
black of the early morning. “I hit a pressure wire,” he said. “It was
across the road.”
The bomb, a particularly lethal one known as an
explosively formed penetrator, shredded his armored vehicle. His best
Army buddy, Specialist Michael J. Anaya, was killed. Another soldier was
wounded; the fourth man in the truck walked away unharmed. Roadside
bombs do that — choose the soldier on the right but not the left, the
one from Florida but not Georgia.
Maj. Jayson Aydelotte, 38, the
trauma surgeon on duty at nearby Camp Speicher, got the call before
dawn. Incoming wounded. He shook the sleep from his eyes and got into
his scrubs.
Private Marrocco was rushed in. Within eight minutes,
his clothes were off and he was connected to a giant bag of intravenous
fluid. Both arms and a leg had been sheared off. The other leg, the
left, “was hanging literally by a thread,” Major Aydelotte recalled.
Doctors
quickly began pumping blood into Private Marrocco’s body, but it
sprayed straight onto the ceiling and walls. Aghast, Major Aydelotte
looked more closely. One of the two carotid arteries, which carry blood
from the heart to the brain, was severed, an injury so lethal it can
kill within minutes. “When fragments fly, they make tons of holes in
you,” the doctor explained. “He had a hole in his neck. But we didn’t
suspect it to be a carotid injury because it wasn’t bleeding.”
It
was not bleeding because there was so little blood left in his body —
80 percent of it had spilled out in the field. “Any one of his injuries
was life-threatening,” Major Aydelotte said. “It’s incredible.”
The
medical team cleaned out each amputation wound, took a vein from his
groin to reconstruct the carotid, and sewed him up top to bottom. The
same day, he was transferred 85 miles to a larger base in Balad, and
then on to Germany. He had survived the initial trauma and surgery. But
other serious threats loomed: Infection. Pneumonia. Brain injury.
One
day a couple of months ago, Major Aydelotte happened to run into
Specialist Marrocco at Walter Reed. “I didn’t tell him who I was,” said
Major Aydelotte, who had quietly kept tabs on his patient’s progress. “I
didn’t want any kind of accolades from him. His life was saved, but I
didn’t do it. He was meant to be saved.”
BRENDAN’S father let the
phone ring again and again. Nobody important ever called his home
number. Plus, it was Easter Sunday. The ringing was so maddeningly
persistent, though, he finally picked up.
“Mr. Alex Marrocco?”
the official-sounding voice said. Mr. Marrocco hung up, assuming it was a
telemarketer. Then the ringing started again. A houseguest answered.
“It’s a major such-and-such from Hawaii,” she reported.
Mr.
Marrocco blanched, his mind reeling back to what he had learned at basic
training graduation back at Fort Benning: If you get a knock at the
door, the soldier is dead. If you get a phone call, the soldier is
wounded.
The official-sounding voice, hoping to cushion the blow,
asked when he had last spoken to Brendan. The day before. They had
talked about a motorcycle that the father was eyeing. The son, a motor
head, was urging him to buy it; one day, they could ride side by side.
Not
wishing to delay the inevitable, Mr. Marrocco demanded, “Tell me what
happened and where it happened.” The voice paused, then said, “I’m sorry
to have to tell you this, but Brendan was involved in an explosion and
he lost both his legs and both his arms.”
Mr. Marrocco’s knees buckled. He fell on the kitchen floor.
His
ex-wife was in her car that morning after church and checked the voice
mail on her cellphone. There was an urgent message from the Army:
“Brendan has been involved in an accident.”
The hours that
followed were a blur. To stay focused, Mrs. Marrocco tucked her despair
under her nurse’s cap and digested the facts from the doctors at
Landstuhl Regional Medical Center in Germany. Her son’s legs were both
amputated above the knee. His right arm was amputated above the elbow.
The left arm retained its elbow; thank God for small favors, she
thought.
His cheekbone had collapsed, and the retina in his left
eye was badly damaged. The beefed-up body armor and helmet had fulfilled
their missions. Private Marrocco’s torso — his internal organs — and
his head were mostly intact. Then she heard about the carotid.
“How did he live?” Mrs. Marrocco asked.
“We don’t know how he lived,” the doctor said.
The
parents, who separated seven years ago, flew together to Germany, where
their son was in a medically induced coma. He was swollen and burnt and
stitched, with a patch over one eye. His hair was the texture of a
Brillo pad. His lips were puffed out of proportion.
“Had I not
been told it was my son, I would not have recognized him,” Mr. Marrocco
said. Mrs. Marrocco struggled to see beyond the wounds, the respirator
and the missing arms and legs. Her son, who was small to begin with, had
all but disappeared. “I could not accept it,” she said last month. “And
I haven’t accepted it.”
By Wednesday night, about 90 hours after
the blast, Private Marrocco was in Washington in Walter Reed’s
intensive care unit. He drifted in and out of consciousness. In time, he
began to realize something was wrong with his arms, though he could not
see them well at first, in part because one eye was swollen shut.
“He
looked up at me and lifted his arms up,” his father recalled. “He kind
of looked at them and realized they were bandaged and they were
different sizes. He couldn’t talk. He had a tube down his throat. But he
mouthed the words, ‘I have no hands.’ I nodded to him. And that was it.
He put his arms down. ‘O.K.’ ”
Mr. Marrocco did not have the
heart to tell his son about his legs. “During that first week, Brendan
kept pleading, ‘Dad, Dad, take my boots off. My feet are burning. My
feet are burning.’ I would say, ‘Brendan, your boots are off.’ ”
SITTING
by her son’s bedside the next week, shortly after he emerged from an
operation, Mrs. Marrocco noticed that his left residual leg looked
particularly bloody. The nurse on duty said a doctor would come by soon
to take a look. Mrs. Marrocco demanded one immediately. Then her son’s
blood pressure began to drop precipitously.
“That was one of the
worst experiences of my life without a doubt,” she said. “I went back to
my room and called one of my best friends, whose son is a youth
minister, to get the children to pray. God hears children’s prayers
better. I said, ‘Get the prayer chain going. I’m losing him. I’m losing
him.’
“If I hadn’t been there,” she added, “I feel I would have lost him.”
In
those early weeks, the worst of the pain often seized Private Marrocco
in the middle of the night. On good nights, he slept 20 minutes and then
wrestled with pain for three or four hours. He tossed and turned. He
bobbed up and down. And his father sat watching, unable to do anything
to alleviate the agony. It was, Mr. Marrocco said, “the hardest thing
for me to bear.”
The family wondered about Brendan’s brain. Bomb
blasts are notorious for shaking up the head so severely they leave
tracks of destruction, despite the Kevlar helmets. Soldiers who return
home with even moderate brain injuries can have trouble holding jobs or
remembering to pick up a child at day care.
“You can’t rehab a
brain-dead individual,” Mrs. Marrocco said. “How would you show him to
do a situp if he doesn’t understand that?”
After Private
Marrocco’s brain passed a battery of tests, his family then fretted
about his mental health. Could he avoid the powerful punch of depression
and post-traumatic stress, a one-two so harrowing it can cripple a
soldier as easily as a bullet? Not long after Private Marrocco regained
consciousness, Sgt. Justin Minisall, who had been wounded in the
bombing, ducked in for a visit. Private Marrocco asked how Specialist
Anaya, the gunner in the truck that day, was doing.
“The sergeant
looked at me with wide eyes, and I looked at him,” the private’s father
said. “The sergeant told him, ‘He didn’t survive.’ Brendan just laid
there and, kind of like everything else, took it in and didn’t really
say much.”
A week or two later, Brendan told his father, “I am
really sorry that Mike died, but I am glad to be alive.” Mr. Marrocco,
knowing how close the two were, saw that as a good omen for his mental
health. Survivor guilt can sometimes cut too deeply. “That moment made
me think, ‘He will be O.K.’ ”
As the weeks passed, the Marroccos
were forced to look further down the road. The parents each considered
quitting work, but each had a mortgage to pay. And the son, while
grateful for his divorced parents’ dedication, was afraid they might
suffocate him. He was a grown man. He had fought in a war.
Then
his brother did something nobody expected: he volunteered to leave his
friends, his social life and his job in information technology at
Citigroup, and move to Washington.
The brothers were close, but
they were opposites: Brendan the brash, outgoing, rule-defying joker;
Michael, reserved and shy, the kind of guy who prefers melting into the
background. Mrs. Marrocco worried that Michael, not a caregiver by
nature, was not up to the painstaking job.
“It needed to be done,
and I was best prepared to do it,” Michael explained in retrospect.
“Instead of making a company a million dollars, I can see where my
efforts are going.”
Since May 2009, the brothers have lived on
the Walter Reed campus in connecting dormitory-style rooms, with a
kitchen and maid service. The Army does not charge Michael rent and it
gives him $64 a day for living expenses. The military also underwrites
all of Brendan’s expenses, including the hand transplants, and pays him a
$2,400 monthly salary.
“This tragedy has made Michael a better
person,” Mrs. Marrocco said. “He is more talkative, more interactive
than he’s ever been, more forthcoming, and he makes plans for himself
and for the future, which is different from where Michael was.”
THE
two brothers spend most waking hours together; Michael takes time for
himself while Brendan has his daily nap. They watch television in the
evenings, or at least argue about watching television. Michael wants
“South Park.” Brendan wants “Law & Order” or “NCIS.” The older
brother wakes the younger each morning, gives him his pills and a glass
of water, and “that’s about it,” Michael said. Brendan has come a long
way from when he struggled to put on his own T-shirt and brush his
teeth. The two leave at 9 a.m. for physical therapy, a short wheelchair
ride away.
Michael also keeps track of his brother’s many
mechanical parts. “So many things to remember,” Specialist Marrocco
joked. “Arms. Legs. We’ll get out the door and down the block and I’ll
say, ‘Mike, you got my arm?’ ”
His left arm is a rubber
myoelectric model, complete with a hand, that responds to muscle
impulses; he wears it most of the time. The right is a primitive
body-pressure hook that he puts on mainly for therapy sessions. He has
the high-tech C-Leg X2, which has a knee joint sensor and is not yet
available to the general public.
He mastered standing in his
prostheses within two months, and walking a few steps shortly after
that. But walking long stretches is infinitely more difficult, a bit
like balancing on stilts, only without the benefit of knees or real arms
for balance. He spends a lot of time doing situps and side body lifts
to build up core strength, then transfers to the parallel bars to walk
with support if he needs it. Unlike other soldiers, he does not listen
to an iPod while exercising, so he can fully concentrate on the
instructions of his therapist, Luis Garcia, a former medic in the Army
Reserve.
Of all the leg amputees Mr. Garcia has worked with over
five years at Walter Reed, Specialist Marrocco has been the quickest to
adjust to his legs. “He has incredible balance, incredible drive,” Mr.
Garcia said.
Before and after lunch in the cafeteria he has
occupational therapy: writing, picking up small items like popcorn,
positioning a pin on a beret, baking a cake, opening a can. In his
wheelchair, a BlackBerry balanced on his thigh, Specialist Marrocco
pecks furiously at the keys with his rubber hand or with his “fluffy
finger,” an upside-down pencil contraption created just for this task.
Unlike
using the prosthetic legs, using mechanical arms does not hurt
physically. But the tasks are mentally taxing, and Specialist Marrocco
occasionally nods off at the table.
“I want Brendan to be able to eat cereal,” his brother told Maj. Sarah Mitsch, the occupational therapist, one spring afternoon.
“We’ll have to get a swivel spoon,” Major Mitsch replied.
Around
Walter Reed, Specialist Marrocco is a celebrity. Tour groups stop by to
wish him well. Invitations pour in for sporting events. At the Military
Advanced Training Center, where the wounded learn anew how to walk,
run, box and climb, he inspires with his toughness and wit.
“It’s
funny the complaining that goes on when Brendan’s not there,” Mr.
Garcia said. “And then when he’s there, everybody shuts up. It puts
things in perspective for them. It puts things in perspective for me,
too.
“I never catch him feeling sorry for himself. I’ve never heard him say, ‘I wish this had never happened.’ ”
There
are times, though, when Specialist Marrocco’s optimism and confidence
are no match for his discomfort and fatigue. He rarely sleeps more than
four hours a night and still suffers phantom pain in his right arm. He
can be cranky and not keen on visitors; one of his pet peeves is people
who talk too much. He jokingly calls his comrades with below-the-knee
amputations “the paper cuts.”
But he does not blame the military
or curse the war. If he had his way, he said, he would be back in Iraq,
behind a machine gun. “I have no idea why I’m so happy,” he said.
It
did not take long after the bombing for his wry, dark humor to break
through. “Look at all the legroom I got!” he announced after boarding a
first-class flight to Hawaii in November 2009, to reunite with his unit
as it returned from Iraq. And, he explained, being able to feel your
arms and legs when they are not actually there — which happens after
traumatized nerves go awry — has its advantages. “I can move my hand
around and give someone the finger,” he said. “I can do these things,
and no one can see.”
Once, when he asked for a glass of water, a
startled woman responded, “but you don’t have any arms or legs!” His
tart retort: “I have a mouth!”
But Specialist Marrocco does admit to “down days,” and acknowledged, “This does suck.”
“You
know, Mama,” Mrs. Marrocco recalled him saying quietly one day, “it
would have been really nice if they left me even one hand.”
KATE
BARTO, a beautiful, grounded 23-year-old from Johnstown, Pa., who was an
intern with a nonprofit group at Walter Reed last summer, could not
help but notice Specialist Marrocco in his wheelchair. But it was his
charming wisecracks that really got her attention.
“He had a
great spirit about him,” said Ms. Barto, who now works for Hope for the
Warriors, another organization that supports wounded service members.
“And we became friends.”
The two talked on the phone constantly.
“I would fall asleep on the phone with him,” she said. Her only
hesitation in getting more involved was that she had just come out of a
three-year relationship. The rest, she said, she could handle.
Her
family and friends worried. They feared empathy was overriding common
sense. But Ms. Barto has a gift: She can see clearly and comfortably
past Specialist Marrocco’s disfigurement and disabilities.
“One
of my mom’s concerns was that I was feeling sorry for him,” Ms. Barto
said. “ ‘Do you really love him? Do you pity him?’ There is no reason to
pity him. He had a horrible thing happen to him. But he is no less of a
person.
“Our lives will be as difficult as we make them,” she
added. “As long as he believes I am going to be around and I love him,
we’re going to be O.K.”
On Thanksgiving, Ms. Barto and Specialist
Marrocco were playing the question game in his room. She would ask a
question and he would answer, then vice versa. “He suddenly asked, ‘Will
you marry me?’ ” Ms. Barto recalled. “I said, ‘Is this for real?’ Yes,
he replied, ‘Will you marry me?’ ” She said yes.
A couple of
weeks later, he slipped the ring, with three diamonds, into his
wheelchair pocket for her to find. “It completely blew me away,” she
said.
But theirs is not a fairy tale. In April, Ms. Barto said,
Specialist Marrocco grew increasingly stressed as the calendar ticked
toward his “alive day” — the anniversary of the explosion that nearly
killed him — and he broke off their relationship. They reconciled, but
then last week decided to take another break.
“We still talk,”
Ms. Barto said on Friday, her voice cracking with emotion. “We’re
backing off, giving the relationship a rest, giving him the space I
think he needs.” She still has the ring.
Despite his remarkable
progress, Specialist Marrocco is still struggling to find his place in
the wider world. His family tries to coax him out of his Walter Reed
fortress for more trips to shopping malls, restaurants and sporting
events. But he finds such outings draining and awkward. People stare, or
look away. They ramble, not knowing what to say. “I just tell them I
got blown up,” he shrugged. “I don’t like it, but I can’t do anything
about it. I just pretend they are not looking.”
His mother was more direct: “He hates it. He absolutely hates it.”
He is, however, eagerly anticipating leaving Walter Reed to get a new pair of arms.
THE
donor has to be a man. The blood and tissue types have to match, of
course. But so do the skin tone and size. The call could come at any
time, and the Marrocco brothers will jump into Michael’s black Monte
Carlo and high-tail it 237 miles to the University of Pittsburgh to
prepare for surgery. They have 10 hours to get there to give the doctors
enough time to do their work.
Dr. W. P. Andrew Lee, the
hospital’s chief of plastic surgery, will lead four teams of more than
20 surgeons to give Specialist Marrocco, as he put it, the chance to
live “a normal life” (a fifth team will handle the donor). His legs
would still be missing. But new, human arms would mean he could put on
the prosthetics himself. And: hug tightly, drive, twist open pill
containers, catch himself when he falls, fix an engine, play Modern
Warfare 2 and greatly increase his chances of getting a job.
“It’s going to give me so much more independence to do more stuff on my own,” Specialist Marrocco noted.
Nine
people in the United States and about 34 others around the world have
received hand or arm transplants since the first successful one in
France in 1998. Dr. Lee has performed three in the past 14 months; in
May 2009, his team did the first double hand transplant in the United
States, and in February, the nation’s first double transplant that
extended above the elbow, like Specialist Marrocco’s.
The
transplant is mind-boggling in its complexity. The doctors must attach
nerves, blood vessels, muscles, tendons and elbow joints, all within
about 11 hours. A new antirejection protocol that Dr. Lee formulated
should reduce the risk of infection, organ damage and diabetes.
Specialist
Marrocco’s nerves would begin regenerating one inch a month — it could
be a year or two before he gains feeling in the fingertips. It will
never be like before the blast, Dr. Lee said, but the new arms can be
almost as good in terms of touch and motor skills.
Unlike a heart
or liver transplant, “a hand transplant does not save lives,” Dr. Lee
noted. “It improves the quality of life.” He added, “We have to be very
careful to balance benefits versus the risk.”
Specialist Marrocco
wonders whether he will be able to get tattoo artists to make house
calls to decorate the new specimens; he wants something to memorialize
Specialist Anaya.
“You’ve got to give them a reason to come,” said Mr. Garcia, the physical therapist.
How about, “I have no arms and no legs and I’m in a wheelchair,” Specialist Marrocco answered.
He
expects to spend six months rehabilitating in Pittsburgh (his brother
will move there with him). The time there may set back his leg progress,
so he will likely return to Walter Reed for further therapy.
Back
home in Staten Island, several charities — the Stephen Siller
Children’s Foundation, Building Homes for Heroes and a fund dedicated to
Specialist Marrocco — have been raising money to build him a
wheelchair-accessible house. In August, the actor Gary Sinise, who
played a combative double amputee Vietnam veteran in “Forrest Gump,” is
scheduled, with his Lt. Dan Band, to support the effort.
Ms.
Barto is still hoping to move to New York with him, after a wedding at
the National World War II Memorial on the Mall here in Washington. She
said they had talked about having children, and that Specialist Marrocco
wanted a girl, if only so he could answer the door when a date arrived
and say the words, “You should see what happened to the other guy.”
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