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Last Updated: Monday, 29 October 2007, 15:45 GMT
Legacy of care for US war-wounded
By Claire Bolderson
BBC News

Matthew and Lisa
Recovering has been a long process for Matthew and mother Lisa
At her home just outside Toledo, Ohio, Lisa flicks through the well-thumbed photographs of her son, Matthew.

She pauses at one particular shot of the handsome 21-year-old soldier taken just before he was sent to Iraq in 2004.

It is a favourite, she says, because of his broad smile and the twinkle in his eye.

It is also a reminder of how profoundly her son has changed. Matthew was a victim of the first suicide bomb attack on US forces in Iraq.

He was the only one in his vehicle to survive but his injuries were horrendous.

Lisa lists the blast damage - numerous broken limbs, burns, a depressed skull fracture.

"His scalp was peeled down like a banana," she says.

Grimly unique

Recovering from the brain injury has been a long, slow process and is not over yet.

What's important in my life is getting my son well. It eclipses everything else

Three years on, Matthew is back in a rehabilitation centre. He can walk and talk again but he has to learn to live from scratch.

In any previous war, Matthew would probably have been dead within hours of the attack. But the conflict in Iraq is grimly unique.

Battlefield medical care has become so good that soldiers with horrendous injuries are surviving against all the odds.

The types of injuries they are recovering from are also different to previous wars.

Sophisticated body armour means far fewer serious chest and abdominal wounds.

But it does not do much to protect the soldiers' heads and dealing with brain injury is now becoming a priority for the military.

Sometimes, the soldiers do not even know they have been hurt. That is the other unique factor in the Iraq conflict - the type of explosives being used.

Brain trauma experts say there could be thousands of US troops unaware that they are returning home with brain damage. Pain, depression and behavioural changes only emerge much later.

Community spirit

"Because it's new, there's a lot that needs to be learned about it," says Prof John Corrigan, a brain injury specialist at Ohio State University.

Matthew in hospital during his rehabilitation
Matthew has had to learn to live from scratch

"The military's started this past year much more aggressively trying to identify those soldiers who may have been exposed," he says.

The effect on the families of the wounded is profound. But whole communities also get involved when a seriously disabled soldier returns home.

In the case of brain-injured Matthew, local businesses and neighbours donated money and services to build a specially adapted extension to Lisa's house.

They kitted it right down to the washing machine and the hospital-style bed.

Lisa sees that generosity as one of the few positive results of what she has been through, that and the fact that she still has her son.

The political arguments over the rights and wrongs of the war are still raging across the nation.

With campaigning for the presidential election already under way, there is daily talk of whether to keep the troops in Iraq or pull out.

None of it is of any importance to Lisa. "I don't have time for that," she says. "What's important in my life is getting my son well. It eclipses everything else."

And long after the immediate drama of the conflict and its politics are forgotten, that will still be the case.

For families and communities across the US, caring for the wounded and disabled will be the true legacy of this war.

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