Monday, September 30, 2013

Shutdown

If the government shutdown lasts more than two weeks, the VA will not be making benefit payments.

If November 1, we do not receive our VA checks, we cannot pay our mortgage. We will be able to buy food and pay our utilities, just barely, with savings and with Karl's SSDI payment (Social Security Disability Insurance). We do not have much in savings right now because we fixed up this house when we bought it, depleting our savings. If on December 1, we do not receive our VA benefits, we will not be able to pay our mortgage. We will be able to pay our utilities, but I'm not sure if we will be able to afford to feed our children. We will not have any money for Christmas.

Sometimes people ask Karl what his long term plan is. They imply he needs a plan besides collecting the disability income he earned by getting injured in combat. Karl and I laugh about this. He won't be getting better. What is his plan supposed to be? Whenever we talk about this, I say, "if the government has failed to the point it isn't taking care of its veterans, we have bigger things to worry about."

blast waves

Last night Karl and I watched Red Dawn, the 2012 version. During one of the explosions in the movie, Karl said, "Yeah, that sucks. I've been in a lot of blasts like that."

"What? A lot?"

"Yeah, remember how I've told you about when there's a blast and you can watch the dust rising up off the surfaces around you?"

Oh, yes, I do remember this. I somehow did not connect my husband talking about clouds of dust lifting off tables to his head receiving the force of a blast wind. I did not think about how many times his body has absorbed blast winds. Some studies indicate that a single blast wind could cause the degenerative brain condition CTE (Chronic Traumatic Encephalopathy)*. I prefer the term "blast wave," but the article I'm linking distinguishes between "shock wave" and "blast wind." I don't know the difference.

What I do know is that it is misleading of me to refer to Karl's TBI as coming from that time he drove a Stryker over a pressure plate bomb, even if it is the easiest explanation. It would be more accurate for me to say he has an unidentified degenerative brain condition due to multiple exposures to blasts over a two and a half year span in combat. I'll stick with the misleading, simple version. It is shorter and more attention-grabbing. It makes a better story.

And yes, he still has all his limbs, which is what people really want to know.





*http://medicalxpress.com/news/2012-05-brain-injury-soldiers-exposure-explosion.html

sounds like a jerk to me

My eyelids are swollen. They have been swollen for several days and finally it looks like the swelling is going down. I've spent the past 3 days in a dark room, sleeping excessively and resting my eyes. On Friday, Karl went to a later section of his class so he could pick up a prescription for me. On Saturday, Karl managed the kids all day so I could lay in bed keeping my eyes closed. On Sunday, Karl and the kids went to church and he missed singing in choir so that I could stay home and rest my eyes. Karl has also been getting me food, water and medicine. In short, he has been being a model husband.

I mention this because often when I am trying to explain what Karl's issues are, if my audience includes married women, they say, "sounds like a man to me," then laugh. I have so many problems with this statement, as a feminist and as someone married to a man with brain damage. It is a disservice to men to think they all act like they have brain damage and it is a disservice to my husband with brain damage to dismiss his issues by attributing them to his penis. What I want to tell women who say this is "maybe you're just married to a jerk."

When I read studies about how women still do more housework than men, I pause and take inventory. Karl does dishes. This was part of our marriage agreement, that he would do dishes. Karl usually does the laundry - washes, dries, folds, puts ours away. I get the kids to put theirs away. I typically unclutter because clutter drives me crazy. I grocery shop. I pay the bills. We don't sweep or mop with any regularity, so it's hard to say who does which more. The kids pack their own lunches and clean their own rooms. We have probably mowed an equal number of times. I cook more often for us and we probably cook equally for the kids. Karl feeds the dogs, with help from the kids. Karl feeds the chickens and puts them to bed more often but I spend more time socializing with them. In short, our housework is probably pretty evenly split. I do spend a significant amount of time reminding Karl to do the dishes, but he does them.

Even though I spend a lot of time refereeing between Karl and the kids, he is generally willing to be the "on" parent. If I have lost my patience and just need to run away, I can tell Karl and the kids "bye," and head out with no explanation. Sometimes I just go drive around for half an hour not having to do anything for anyone. This is usually at dinner or bedtime, which follows the same routine every night, so it is the perfect time for me to bail. Routines are much easier for Karl (and the kids) to follow than instructions.

Last night before we went to sleep, Karl said, "I'm sorry I'm a disappointment to you."

"You're not."

He isn't. Primarily because he isn't a jerk. He is an honorable, loving, giving man who happens to have brain damage. He does not use his injuries as an excuse not to parent or partner. In fact, I am the one who steps in to tell the kids not to climb on him because they're going to hurt his leg or his back. I am the one who tells him he can't carry both kids at once because I know he will be limping later if he does.

Karl works very hard at finding ways to minimize the effect his cognitive defects have on our lives. He uses his smart phone for its maps and calendar. He gives himself extra time to get around. He explains to his instructors that he has TBI and how it impacts him. He even occasionally listens to me when I explain things to him. He has problems parenting. He yells at the kids for being kids. He is not consistent with them. He forgets what he is supposed to be doing. Sometimes he takes his frustration about not knowing what he's saying or doing or where he's going out on us. Sometimes he acts like a jerk, but not because of his TBI. Sometimes he acts like a jerk because he's a person, much the same way all people act like jerks sometimes.

Most of the time, he does not act like a jerk. He acts like a fair and hard-working person who has cognitive defects. If you are married to someone who has no cognitive defects and often claims to "forget" things, you might just be married to a jerk.

Tuesday, September 24, 2013

Our Starbucks Anniversary

Sunday was the six year anniversary of the day my husband and I got married in Starbucks. People laugh when I tell them I got married at Starbucks and I have to stop them to tell them the funny part, which is not that we got married at Starbucks but that we were the second couple that week to get married at that Starbucks.

It is very common in the military to get married without a wedding. There are many benefits to being married in the military, such as higher pay. Once a service member decides to get married, it makes practical sense to do it as soon as possible. I agreed with this, but I didn't want to miss out on a wedding. I knew how easy it was to put off the planning until your ten year anniversary was looming with no wedding in sight. I wanted a dress and I wanted everyone to look at me and talk about how pretty I was. So I told Karl that I would not marry him unless it was less than three months before a wedding we were actively planning. So, by the time we got married at Starbucks, our Save the Date cards had gone out and I was addressing our invitations. Our cake had been ordered and I had bought the first two of my four wedding dresses.

My first wedding dress was a $30 tea length dress from Ross. It was white with lace around the mid-section. It was perfect for the summer wedding I thought we would be having. Then Karl's tour got extended three more months and my wedding became a winter wedding. So I bought another dress. It was $12 on clearance at J.C. Penney. It was floor length and ivory, with a black twist of ribbon.

The day Karl and I got married at Starbucks, I wore a black t-shirt, jeans and a wide black and white striped headband. Karl and I ordered coffee and breakfast sandwiches and bought our minister's coffee. Then we sat at the back table. He asked us if we were related (no) and if we wanted to be married (yes) and we signed our marriage certificate. I took a selfie with my cell phone of us kissing. We joked about how I had trapped him or he had trapped me, saying things like "got ya now!" Our minister didn't seem very amused..

After we finished our coffee, we went home to take a nap. We had been up late the night before at a bar with the guys who had come home on the last flight. In the privacy of our room, we exchanged vows with each other, silly things like Karl promising to do the dishes (which he does, because he promised - I have done the dishes maybe 12 times in the past six years) and us both promising to love each other. That afternoon we went to the fair.

By the time our wedding date arrived, I was pregnant with our daughter. It shouldn't have been a surprise - we were trying, but I started gaining weight immediately and a week before our wedding, I realized my dress didn't fit. I was only about 6 weeks along. I started shopping for another dress and bought one for $100. It was pretty. I wasn't in love with it but I was overwrought and feeling desperate. A few days before our wedding my mom and I went to Goodwill and I saw a gorgeous Alfred Angelo halter dress with intricate beading and a train. It was $85 and my mom encouraged me to try it on. When I did, her eyes filled with tears. I, of course, bought it and wore it. I spent less than $250 on my four wedding dresses combined.

Our ceremony is on a VHS tape. It lasted less than eight minutes and ended with me leaving my husband at the altar to head for the food, which is sort of embarrassing. Luckily, he was already stuck with me. It was a small, casual wedding at my mom's house. People stood for our ceremony. Our food came from Costco, as did our flowers. I forgot our sparkling cider until after everyone had left so we had no toasts. We had no dance. We just hung out and I wore my wedding dress all day. Some of my favorite photos of the day are of me giving my dog (who has since died) her medicine in all my bridal glory and my eldest asleep in my arms as I sit on the floor in my gorgeous gown. We have official wedding photos too, of Karl and I gazing adoringly at each other and kissing.

One of my favorite photos of Karl and I at our wedding shows me rolling my eyes at him with my hand to my forehead in exasperation. I have an almost identical photo we took in a photo booth the day we were married. I am glad we had a wedding. It was fun. I am also glad we got married at Starbucks first. I get two very distinct anniversaries. Every September we go to Starbucks and tell the bored, unimpressed baristas that we got married there. They have never, to my amusement, given us a free coffee. Every December we go on a real date for our wedding anniversary and sometimes give each other gifts. Our marriage and our wedding represent the best of Karl and I: our ease with each other and our ability to laugh at ourselves.

Sunday, September 22, 2013

What is a veteran?

Last week there was a shooting at a Navy Yard. A friend of mine posted a link* on facebook about how the shooter was collecting VA benefits. She commented "...so what? why is this relevant?"

While the link leads to USA Today, I would not call the handful of sentences an article. They mention what he was receiving benefits for: tinnitus and "an orthopedic problem," and make note that he was never deployed to Iraq or Afghanistan. I have no idea whether or not any of this is relevant. The tone of the "article" seems to imply that collecting VA payments is bad and that being deployed is the only thing that could legitimize collecting those payments.

I saw an essay titled "Don't call Navy Yard Gunman Aaron Alexis a Veteran," which also highlights that Alexis was never deployed. While the essay goes on to say that Alexis' status as a veteran isn't necessarily the cause of the shooting and cautions against the stereotypes of veterans as time bombs, I take offense to the title. Alexis is a veteran. His veteran status does not excuse or explain his actions. His disability rating also neither explains nor excuses his actions.

I find it disturbing that the response to Alexis being labeled a ticking time bomb veteran is to disavow his veteran status at all. Veterans are people. Some veterans are assholes and some veterans are noble. Some veterans are ignorant and racist and sexist. Some veterans are intelligent and compassionate. What "veteran" means to me is that a man or woman wrote a blank check to our government. That is a noble thing to do, regardless of the motives. It is noble to volunteer for service, even if it is the only noble action in a lifetime of terrible deeds.

I know a veteran who has some guilt because she collects VA disability because of an injury she suffered in boot camp. She never made it past boot camp. I knew her before she joined the Army. Her plan was to serve her country. She was blind-sided by an injury and a misdiagnosis, followed by mistreatment and lifelong leg pain. She is a veteran and she deserves to be compensated for her injury. She is not a ticking time bomb.

I know veterans who judge other veterans based on their branch of service or their MOS (Military Occupation Code). Whenever I hear an infantry vet complaining that a group of air force veterans won't understand what they're going through, I tell the story of my husband meeting a Air Force dental technician. She told him she had PTSD, and he mentally scoffed, but he asked what her job had been. After she told him she was a dental technician, he scoffed a bit more, but said something non-committal. She then opened up a bit, explaining that her primary job had been to identify dead soldiers by their dental records. It was an eye-opening moment for him and me, reaffirming that you never know what someone else has been through.

I know another veteran who has several issues. He was never deployed. He has PTSD from watching men die in training, TBI from a head injury on a ship and back pain from a fall in training. He feels guilty about collecting disability payments because he never went to war. I know vets who went to war who feel bad they didn't die in combat.

It is not easy being a veteran, not least of all because people stereotype them. Veterans are not ticking time bombs. They are not all burly men either. They are people. Some people are assholes and some people are noble. Some people are ignorant and racist and sexist. Some people are intelligent and compassionate.



*http://www.usatoday.com/story/nation/2013/09/18/navy-yard-shootings-aaron-alexis/2834103/ **http://www.thedailybeast.com/articles/2013/09/18/don-t-call-navy-yard-gunman-aaron-alexis-a-veteran.html

Tuesday, September 17, 2013

midnight panic

I woke up and immediately rolled over to check for Karl. I do this every time I wake up, regardless of the hour. His side of the bed was empty. I reached for my phone to check the time: 2 a.m. As I sat up, I tried to remember the last moments before I fell asleep. We were watching Futurama and he promised to shut down the iPad when he was done. He put my wrist guards on my wrists for me, as I was nearly asleep by the time I remembered that I need to sleep in them every night or I wake up with my hands painfully asleep.

As I walked to the living room, I tried to sort out whether or not Karl had fallen asleep with me. Sometimes, once I am asleep, he gets up and heads to the living room to spend the night watching war movies. The living room was empty, the tv off. I listened for signs that Karl was in the bathroom as I headed down the hallway opening doors to the library and our children's rooms. I located him in our daughter's bunk bed, snuggled in to the top bunk with our daughter. Our daughter has been having problems sleeping lately, waking us up in the middle of the night and falling fitfully back asleep in our room. Last night she even poked me until I woke up just to tell me she loved me. I don't know if our daughter came to our room and woke Karl up or if she found Karl on the couch before he made it to our room. It doesn't matter. What matters is I now know where Karl is and he is safe.

It is probably about once a week that I wake up alone and slightly panicked about where Karl is. Sometimes I find him awake, engulfed in some movie about the war he fought or one he didn't or maybe just Star Trek. Sometimes I find him asleep on the couch, lights on, tv on, clothes on. Sometimes, like tonight, I find him in one of our children's beds. Sometimes he comes back to bed with me and sometimes he stays up all night or stays where he is, peacefully asleep, as I take his glasses off and turn the lights off.

What am I afraid of in the middle of the night when Karl is gone? I am afraid he has disappeared. I am afraid I will not find him in the living room or our son's bed. I am afraid I will not be able to find him at all. I have heard wives talk about waking up in the middle of the night to find their husbands sleeping in the driveway or the car. I am not the only one searching for my husband at 2 a.m. As I look for him, I often think, maybe Karl wandered off out of some misguided notion that we are better off without him, which I know he sometimes thinks. Maybe he just gave up on society and has finally left to go live in the woods, like he so desperately wants to. Maybe he stepped outside to investigate a noise and wandered off, unable to remember where he is.

Over the years, as I have gotten used to finding Karl, my panic at waking in bed alone has lessened. I wonder how long until my panic increases as the possibility of him wandering off in the middle of the night increases. This is the strangest thing about brain degeneration: we have no idea when it is going to get worse or how bad it is going to get. I have no idea if Karl waking up and wandering off one night is a real possibility or just something my brain made up to panic me, but at least tonight, I know where he is.

Monday, September 16, 2013

This is not about my sex life

I promise I will never write about my sex life. I believe sex is a perfectly normal act. I also want what I write to be accessible to my family and my husband's family and the people we go to church with and the exes I'm friends with. Therefore, you will never read about my sex life. However, I will write about sex. I will write about sex because oftentimes when I am in a group of women who are married to veterans, someone sheepishly brings it up.

"Is he on Gabapentin?" another wife will ask.

"Is that what it is?" the sheepish wife asks.

"It's probably the narcotics, yeah." Everyone around the table nods.

Gone are the days of her airman laughingly bragging about his weekend conquests with his friends. He is 28 and his sex life has evaporated, replaced with narcotics for his leg pain, which causes him to limp self-consciously. Another wife says her husband just doesn't feel sexy anymore. It isn't surprising. He went into the service a young, fit, virile man, but he was medically discharged overweight and aching.

It is hard enough to convince these young men who feel old that they are useful and valuable assets when they can no longer serve or even work. It is nearly impossible to convince them that they are still desirable when they are covered in burn marks or filled with shrapnel. Not only are they embarrassed by their limps, their scars, their bodies and minds failing them, but they have to contend with their masculinity fading. How can a man who used to be so confident admit he just doesn't feel sexy? What if he feels sexy and his body just won't cooperate because of his daily cocktail of pain relief meds? What if he feels sexy, his body is working, but there is too much pain to find a way to comfortably have sex? Who is he supposed to talk to about this?

No one. So his wife comes to a support meeting and sheepishly brings it up. She wants to know how to get their connection back. She wants to know if it is her fault. She wants to know how to show him she wants him, how to combat the morphine, what position will cause the least strain on his tender body. So we talk. We talk about positions and pain. We talk about medication cocktails and side effects. We talk about calling him hot or smacking his butt playfully. Everyone at the table laughs too. We laugh in recognition and, maybe, sometimes, embarrassment. We laugh because we are in a safe space where we can joke about our virile men, aged before their time. One woman I know even demonstrated a particular position on a chair once. Then we really laughed. I don't know if the other women tell their husband about our mirth or our suggestions. Sometimes our suggestions work and sometimes they don't.

Sometimes I feel a bit sad for the men who were told how manly they looked in a uniform, only to come home and take it off, revealing their vulnerability.

Sunday, September 15, 2013

the gift of memory

"I'm tired. Not physically tired. I'm just tired of this," said Karl.

I know. I know he is tired.

He is tired of his legs aching when our son sits on his foot to be carried around the house. He is tired of his back hurting when he carries our daughter. He is tired of his body cracking and popping when he gets out of bed. He is tired of feeling like an old man. He is tired of having an old man's mind too.

I am hyper-vigilant about suicidal depression, so when Karl says he is tired, I immediately ask if he is thinking of killing himself.

"No," he says and laughs, "And I'm not going to say I'm a survivor either!"

I stare at him blankly, not getting the reference.

"Like that guy in that movie," Karl reminds me, "he said he was a survivor and you said 'he's going to kill himself.'"

Oh, yeah. I knew it. He was a supporting character in Music Within and a veteran with PTSD. As soon as he said "I'm a survivor," in his I'll-be-fine speech, I knew it and I was right, but why does Karl remember that enough to make an off-hand reference? If questioned, I doubt he would remember the name of the movie, but he could probably give a pretty good plot summary. Maybe it is because Karl identified with the characters who couldn't find their way back to civilian life. Maybe it is because war was a central theme to the movie. Karl often remembers random facts involving war, guns, knives, swords and defenses. I'm not sure where he stores these, but it is not the same place his brain tosses practical information.

I wonder if when Karl forgets where we live, he will remember how a trigger system works. Maybe one day, I will put a card in his wallet with our address and a picture of our house. One of the reasons we chose this house is that it is within walking distance to the library and our children's elementary school, not to mention a variety of stores and restaurants. Not only are they within a one mile radius, but they are on the same street. To get to the library, you walk out our door and turn right. To get to the school, you turn left. You walk until you get there and to get home, you turn around. It is unlikely Karl will have a problem finding the grocery store, the gas station, the medical marijuana dispensary or the library any time soon.

One day he may have a problem navigating our straight road, but not yet. Yesterday he walked a mile with the kids to take them to their school playground so they could spend an hour on the monkey bars. This is a gift. It is a gift that Karl is able to spend so much time with our children while they are young. It is a gift that they will have memories of him, even if he may not retain memories of them.

Friday, September 13, 2013

grasping at straws

I recently saw a gif of a girl who lost 88 pounds in a year. I am not really into body shaming or diets, so I'm not sure how I ended up reading an article about her, but it mentioned she had gone on a ketogenic diet. I had never heard of that, so I googled. I found a lot of conflicting information about the effects of high fat diets on the body and a lot of conclusive studies about the effects of high fat diets on the brain.* Ketogenic diets are prescribed by some doctors for children with epilepsy, some percentage of whom are later able to go off their anti-convulsants.

After I saw the phrase "neuro-protective," I started typing in the search terms "ketogenic diet TBI." If there is one thing I look for, as someone who loves someone with TBI, it is the phrase neuro-protective. I have exhaustively searched "marijuana neuro-protective," as we live in a state where medical marijuana is legal. I have repeatedly searched for "neuro-protective vitamins," before putting my husband on a vitamin regimen. Nothing piques my interest more than the phrase "neuro-protective" because I am witnessing my husband's brain fail and I would do anything to slow the process. Needless to say, my husband and I are now on a ketogenic diet. If I want my husband to stick to a diet that could help his brain, I must follow it too. I can't just assign him a diet because he can't even always rely on himself to follow a gluten-free diet, which he must be on because he has celiac disease.

As I read studies about TBI and ketogenic diets, I wondered why no one had mentioned ketogenic diets to me. I wonder why no one ever mentioned studies about the neuro-protective properties of marijuana to me. I wonder why no one has ever mentioned brain boosting vitamins to me. I wonder why I am the only one trying to save my husband's brain. I am the one who asks questions about the use of Alzheimer's medications in TBI patients. I am the one who asks for MRIs and referrals. I am the only one fighting for my husband. That is not to say I don't have allies. There are other women who have been fighting this battle since before I was born and women who have been fighting as long as I have. There are men fighting this battle for their women.

When we had my husband's intake appointment at the VA here, to establish patient care, his new primary care physician looked shocked when Karl mentioned he has TBI. Then our appointment was over. Hopefully the nurse we spoke with got a referral in for more neuro-psych testing, which she mentioned. Apparently the VA here does not communicate enough with the VA in Texas to use his testing from there. I am not opposed to him having another round of neuro-psych testing. In fact, it might be helpful to have some new benchmarks. If no one from the VA arranges an appointment for him, I will be going back in with him, to ask for referrals. Next week my husband will see a psychologist - a therapist with the VA who is a woman with no military experience - and hopefully get set up with a psychiatrist.

I don't expect any of these people to help. I don't actually expect anything to help. Every few weeks, Karl and I have another tearful conversation about him getting worse. Sometimes I feel like I am standing helplessly by, watching a freight train heading towards the end of the line. I am the only one trying to place tracks in front of it. I have no idea how to lay tracks. I don't know if I'm using the right pieces. I have no idea if the train is going to derail regardless of what I do, but I have to try to stop it.







*http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321471/ for further reading

Sunday, September 1, 2013

football's more dangerous cousin, war

I'm a nerdy girl. I'm not a full on nerd. There are only a few comic books I like (Terry Moore's Strangers in Paradise; Neil Gaiman's Sandman and Endless series). I never got into Buffy the Vampire Slayer (the tv series; the movie was 1990s movie gold) or Doctor Who. However, I did get a letter jacket in high school for Mock Trial, which is pretty nerdy. I read a lot. When I was told my daughter probably should not play sports because she was born with a solitary kidney, I wasn't too concerned. My husband, who owns way more comic books than me, lettered in marching band in high school. It is unlikely the two of us would somehow produce an athlete.

Our daughter was born in 2008. All I knew about football then was that it involved throwing a ball and tackling people, weird dances when your ball went were it was supposed to and eating lots of queso every January or February. In 2008 I knew even less about brain injuries than football, despite my husband having driven over a bomb the year before. I had no idea that my husband had a life-changing TBI (Traumatic Brain Injury) or that his injury was relatively common in football players.

I now know more about TBI than at least one neurologist I've encountered in the VA (Veterans Affairs) health care system. I still don't know anything about football except that football season just started and that brain damage is very common in football players. This year when I watched the Super Bowl I was the life of the party. Whenever big burly men would slam into or pile on top of each other I would exclaim, "ooooo that's a TBI!" My knowledge of TBI and its sneakier, scarier cousin CTE (Chronic Traumatic Encephalopathy) have led me to care about football players, if not the sport itself.

I have read several articles about whether or not watching football is a moral issue and I have asked others that myself. What concerns me though isn't the moral character of football fans. What concerns me is the visibility of football players with CTE. When I see a Sports Illustrated cover with a football wife proudly standing next to her husband, I feel compelled to read about her fears that one day he will not know who she is. I share her fears, but no one cares about me or my husband. He is not as marketable a story as a football hero. After all, he was only a soldier. He never earned millions chasing a ball down a field. He instead spent his time chasing men who were trying to kill him. He did not earn a single champion ring. Instead, he earned a CIB (Combat Infantry Badge). We don't have the money to see the best doctors money can buy. Instead we see whomever the VA gives us or whoever will take Medicare.

Sometimes those doctors listen to us. More often, they pass the buck, asking us why speech pathology or a neurologist hasn't taken care of us yet. A speech pathologist at the VA said my husband was lucky he was smart enough to make accommodations for himself. He also gave Karl a list of websites with games that may help improve his memory and processing time if he plays them often enough. In Karl's only appointment at that clinic, they told him they were so busy with men who were worse off than him that it was unlikely they would see him again and they haven't. Another time, a psychiatrist ordered my husband a battery of neuro-psych testing. The results of his testing showed delayed processing and short term memory loss, but no one had followed up with us. When we went back to the psychiatrist a year later, I sat in her office and cried. She sent us to a neurologist who denied my husband could have any long-term effects from driving over a bomb.

"He's just depressed," the man told me as I looked at him with a befuddled expression on my face.

In the past decade, there has been significant research proving that even a single blast-wave can cause permanent, life-altering damage to a brain.

Unfortunately, we are at the mercy of the system. When there is only one neurologist in your area at the VA, you will see that neurologist, whether or not he understands the constantly evolving field of brain research. When the VA's speech pathology clinic in your area is inundated with other veterans who also have TBI, you will not get another appointment unless you are a severe case. We have had slightly better luck with doctors whose offices accept Medicare, but they have extraordinarily long waiting lists. Consequently, when people ask if my husband will get better, I have no answer.

Clinically speaking, each TBI is different. There is no way to predict whether or not a brain will find ways to reroute its information. Furthermore, CTE is only detectable post-mortem. This means, in the simplest terms possible, that if a football player or a mere mortal starts exhibiting signs of dementia or memory loss following a head trauma, no one knows what exactly is going on or what is going to happen next. Some neurologists are now saying that even TBI is degenerative.

I hope the football players are getting better care and more answers than we are. I hope they do not let the NFL or anyone else pay them off and sweep them under the rug. My husband is at the mercy of an overwhelmed system, but men with money, power and a public face are not. They can use their notoriety to call attention to brain injuries. As we learn more about their brains, we are learning more about the brains of men and women who suffer head trauma in war.

I still do not understand football. I know only that it involves a ball, some dancing, a Bowl, some queso and there are over a thousand professional football players every year at risk for brain injuries. Men whose names are known, men who are considered heroes, men who are visibly and vocally suffering through the "signature wound" of the wars our country has been fighting for over a decade now. These men have the ability to help further brain research for another kind of hero.

war consumes me

"Were you there?" I ask, leaning forward, "would you write me a letter for his purple heart?"

My husband does not have a Purple Heart. He never applied for one. His incident was in the midst of several other more devastating incidents and wasn't recorded well. When no one gave him a Purple Heart, he didn't ask for one. In the years since, we have talked about applying for a Purple Heart, especially as the military has expanded their requirements for Purple Hearts to include TBI. Karl will not ask his friends for letters corroborating the incident, but I will.

"Yeah," Dozer tells me, "I was there when he drove over that pressure plate."

"Or whatever it was... I never looked," Karl says.

"No, man, it was a pressure plate."

"You saw it?"

"Yeah, man, there was a square shaped hole. I remember we came around the corner and no one was hurt. The wheel blew off, right? No one was hurt and then I saw you."

For six years, I have referred to the incident as my husband driving over an IED or a bomb. Now I have a new phrase to add to my lexicon. My husband drove over a pressure plate. It sounds innocuous to me. A pressure plate. I have seen pressure plate explosions on tv shows. When I google "pressure plate," video game references come up. Pressure plates are completely outside my reality.... except they aren't. Pressure plates exist in my world. When I google "pressure plate IED," I find pictures, videos and references to Afghanistan. Apparently a pressure plate IED is a home-made bomb activated when enough weight (pressure) presses onto it. It is also a "victim-activated" device, which means it is set off by the person it hurts. The good thing about victim-activated devices is that they are less likely to be followed by an ambush than devices that require someone else to wait for the victim to be on top of the IED. Victim-activated devices don't need their creator to babysit them. They may not even have an intended target. They are just there for whomever is in the wrong place at the wrong time.

I wonder occasionally about who created the bomb that changed my life. Was it a man or a child? Did he have children? Was he nice? That sounds like a silly question, but I mean it. Would he help a neighbor in trouble? Did he create a bomb to protect or to attack? Is he still alive? Does he have PTSD? Does he ever wonder if his bomb went off? How long was it there before my husband drove over it?

I could listen to the retelling of his war all day every day. More details eek out every time he tells me about Okada's foot being destroyed or Elliot being hit by friendly fire or flames engulfing him when he drove over the IED. I could write every word he says and rework the stories every time he retells them. There are paintings and drawings in our garage of men with their heads blown off or laying bloody on the ground after their car was decimated by Karl's Stryker. I never remember the details when I show these amazing pieces to our friends. I cannot absorb the full weight of Karl's 27 months in the desert.

I will never know the answers to my questions. If it is ever safe to travel to Iraq, I would like to go. I would like to walk the dusty streets my husband still wanders sometimes. I would like to go with other men he served with and listen to their stories. I want to know everything. I am selfish in this when we hang out with the guys. I want to consume their war as it has consumed them.