TOPICS > Health

Wounds of War

April 26, 2005 at 12:00 AM EDT


JOSEPH BRISENO: Open, OK? Thank you. I love you Jay, I love you.

SUSAN DENTZER: This is how the day begins for Jay Briseno, with his father, Joe, lovingly brushing his grown son’s teeth.

JOSEPH BRISENO: OK, that is done. OK, can I wash your face now, you can go back to sleep?

SUSAN DENTZER: These daily care giving rituals have gone on for nearly two years, ever since Jay Briseno was wounded while serving in Iraq. An army reservist, he was working as a civil affairs specialist to help rebuild the country. Then came a fateful day in June 2003.

JOSEPH BRISENO: Jay was shot point blank by an Iraqi randomly, I mean, one of the bystanders that shot him because there were a lot of Iraqis in that area. And the bullet went into the back of his neck and exited here, his cheekbone.

SUSAN DENTZER: The shot severed Jay’s spinal cord and left him paralyzed from the chin down. Two subsequent cardiac arrests cut off oxygen to his brain, leaving him brain damaged.

JOSEPH BRISENO: And I want you to smile if you can feel my hand, my touch, OK? Why don’t you smile? Can you feel that? OK.

SUSAN DENTZER: Today, Jay Briseno is fully conscious, but unable to speak. He communicates by smiling or grimacing. Army officials say he’s the most seriously disabled soldier yet to have returned from the war in Iraq.

Although Jay Briseno’s is the worst case, there are also several hundred other very disabled soldiers and Marines. They’re among the nearly 11,600 wounded in Iraq or Afghanistan. With their numbers growing, the Army last year launched a special disabled soldier support system known as DS-3. It’s helping disabled soldiers like Jay Briseno get the services and benefits they’re entitled to and smoothing their transition back to an altered civilian life.

JOSEPH BRISENO: OK, I’ll be quick.

SUSAN DENTZER: As much as these seriously disabled veterans need assistance, so too do their families. Suzanne Mintz heads the National Association of Family Caregivers, which advocates on behalf of an estimated 50 million Americans caring for disabled family members.

SUZANNE MINTZ: When you are dealing with chronic illness or disability, your life is outside the norm and people who haven’t experienced things like that, families who are not living with people who need assistance on that level don’t have a clue. Most of it goes on in bedrooms and bathrooms and so the rest of the world doesn’t see. It is a total act of love. It is definitely a sacrifice. But I’m sure they can’t imagine doing it any other way.

SUSAN DENTZER: Caring for Jay now requires a 24/7 commitment from the Brisenos, Filipino immigrants who are naturalized U.S. citizens. Besides the long hours, there’s hard physical labor, and at best, sporadic sleep at night.

Dr. Steven Fish is a neurologist who is Jay’s primary physician at the Washington, DC, Veterans’ Administration Medical Center.

DR. STEVEN FISH: They are a very close family, and they insisted that he remain at home. They’ve created an intensive care unit in the basement of their home to care for him. The father has actually left his full-time job to be the full-time caregiver for Jay.

SUSAN DENTZER: In fact, Joe Briseno, who served in the U.S. Army himself for 16 years, quit his most recent job as a computer software quality inspector to coordinate Jay’s care.

JOSEPH BRISENO: You know, anyone’s family, you cut the income in half, it’s, you know, it’ll take a burden. Jay will never be an inconvenience for us and, regardless, we are ready for how long it would take to care for Jay because he’s our son. He’s our child.

SUSAN DENTZER: Jay’s mother, Eva Marie, has kept her day job to preserve some family income. Even so, most of her time and attention is focused on Jay.

EVA MARIE BRISENO: I love my son, since he was born; I let my husband talk about this because it’s too emotional.

SUSAN DENTZER: The Brisenos have received substantial help from the Department of Veterans’ Affairs, which pays all the bills for Jay’s medical care. After some initial foot dragging and the intervention of the Army’s DS-3 unit, the VA also provided Jay’s special bed and his other medical equipment.

A specially trained nurse paid for by the VA provides virtually round-the-clock nursing care. And every several months, Jay can spend two weeks at the local VA hospital so his family can get a break. Sandy Garfunkel, director of the Washington VA Medical Center, acknowledges that the bill for all this care is high.

SANDY GARFUNKEL: I would estimate that if we go through a whole year, considering everything that we do, it approaches a half a million dollars a year, and that, by the way, is probably what it would cost if Jay was in the medical center in our intensive care unit. The guidance we’ve received from people above us is that, that’s our mandate, to obviously provide care for all veterans, but certainly the veterans coming back from Iraq and Afghanistan receive some priority and the highest, the highest level of care that, that we can give.

SUSAN DENTZER: And the highest level of care is what Jay Briseno requires given the extent of his injuries and disability, says the VA’s Dr. Fish.

DR. STEVEN FISH: He is unable to breathe on his own. He is dependent on a ventilator for breathing. He requires suctioning through his tracheostomy tube. He requires frequent repositioning and turning. He…


DR. STEVEN FISH: Because, to prevent pressure sores, he requires feeding through his — the tube that goes into his stomach.

JOSEPH BRISENO: Jay eats four times a day, breakfast, lunch, and dinner and a little snack at night. This is what he eats.

SUSAN DENTZER: Once a day, Joe Briseno and the nurse use a special lift provided by the VA to hoist Jay out of bed.

JOSEPH BRISENO: There’s a lot of safety precaution. If the sling is not all the way up to his neck, it’s very, very dangerous.

SUSAN DENTZER: They help him into a special wheelchair and push him a few feet to the nearest window.

JOSEPH BRISENO: This is the most exciting part of the day for Jay. Yes, it looks cloudy, but looks good. Do you want to watch TV? Huh? We put on the Simpsons?

JOSEPH BRISENO: You going to be OK, you need my help?

EMT: I’m all right.

SUSAN DENTZER: The quiet times are interrupted every now and then by the occasional big emergency. That happened one day in mid-March, as we were scheduled to meet with the family.

Jay suddenly had difficulty breathing through the tracheostomy tube inserted in his throat. Emergency medical technicians and an ambulance were summoned. Jay and his parents were rushed to the VA Hospital in Washington so the tube could be replaced. Two more emergency trips to the hospital would take place over the next three days before the breathing tube problem was finally resolved.

Suzanne Mintz of the Caregivers’ Association says ongoing crises like these take a huge emotional toll on families.

SUZANNE MINTZ: Care giving families grieve and I call it perpetual grief, because unlike when somebody dies and you can come to some resolution, in care giving if the person continues to go down hill or even if stay the same but they’re passing milestones in life, there are losses. And so the grief goes on and on and just maybe when you feel like you’ve gotten over some of it, something else happens.

JOSEPH BRISENO: That is true. That is a true statement because, in the basement, every day, tears, laughter, smiles, pain, fear, hope, faith, you name it, everything, love, in the basement. And each moment that Jay can — can share with us we treasure because God can take him away any time.

SUSAN DENTZER: The Brisenos told us their abiding religious belief gets them through, as does support from their local Roman Catholic Church. Three times a week, Dick O’Connell, a church deacon, visits the Briseno home to bring communion to Jay.

DICK O’CONNELL: Hey there, how’s my buddy? Got a big smile for me, huh?

SUSAN DENTZER: O’Connell breaks up a small portion of a communion wafer and dissolves it in water. And then Joe Briseno injects it into his son’s feeding tube. Jay smiles.

DICK O’CONNELL: We thank you for the nourishment…

SUSAN DENTZER: Through their faith, the Brisenos draw hope that Jay will improve to the point that he might one day walk or speak again. We asked Jay’s neurologist, Dr. Fish, about those prospects.

DR. STEVEN FISH: I don’t think it’s likely that he’ll ever walk again with medical technology and science at the current level that we have now. However, you know, he did have a good deal of cognitive recovery, which was not really expected either, so I don’t tell the family that it is never going to happen because I know that they feel that they need to have hope.

SINGING: Happy birthday to you –

SUSAN DENTZER: And so hope filled the air at Jay’s recent 22nd birthday party, held in March at his former high school.

SUSAN DENTZER: Along with the friends and family present were VA and Army officials. Jay was awarded a Purple Heart. Later, his father told us how proud he was.

JOSEPH BRISENO: He’s my son, but he is also an American hero.

SUSAN DENTZER: But so are you.

JOSEPH BRISENO: Maybe. I’m just doing my best.