Soldier’s story underscores importance of orthopaedic research

Nine months after captivating the attendees at the Extremity War Injuries IV symposium (See “EWI-IV highlights advances in combat care,” AAOS Now, March 2009), Capt. Ray O’Donnell returned to Washington, D.C., to share his story with members of Congress.

Capt. O’Donnell and his wife Kelly flew in from their home in Mililani Town, Hawaii, to help make the case for increased funding and support of orthopaedic research and care in meetings with Rep. C.A. “Dutch” Ruppersberger (D-Md.) and Sens. Daniel Inouye (D-Hawaii), and Daniel Akaka (D-Hawaii). As the AAOS manager of research advocacy and the chair of the AAOS Extremity War Injury and Disaster Preparedness Project Team, we were proud to accompany them.

A routine patrol ends badly
The recipient of a Bronze Star Medal with Oak Leaf Cluster, Capt. O’Donnell was injured during a routine combat patrol in August 2007 in Afghanistan. A roadside bomb threw Capt. O’Donnell approximately 80 feet from his vehicle.

Capt. O’Donnell sustained several severe injuries, including a left hip dislocation that also fractured his pelvis and hip joint, a fracture and dislocation of his right wrist, a bladder rupture, several facial bone fractures, and a collapsed lung. Tragically, two close friends were killed when his vehicle was destroyed.

Capt. O’Donnell had already experienced the deep cost that U.S. soldiers paid in recent conflicts. In 2005, his best friend 1st Lt. Nainoa K. Hoe was killed in Mosul, Iraq, and Capt. O’Donnell escorted the body home for burial.

“Nainoa’s men were the most important thing to him,” said Capt. O’Donnell in a 2005 interview with the Honolulu Advertiser. “He never asked his men to do something he wouldn’t do himself.”

For his own injuries, Capt. O’Donnell was initially treated in Bagrum, Afghanistan, and, after initial resuscitation, was rapidly transferred to Landstuhl Regional Medical Center in Germany. He next flew to Walter Reed Army Medical Center for further stabilization and care and finally to Brooke Army Medical Center in San Antonio for definitive treatment of his injuries. He ultimately recuperated at the Polytrauma Rehabilitation Center at the James A. Haley Veterans’ Hospital in Tampa, Fla.

Capt. O’Donnell discussed the frustration he experienced during his recuperation. Although he did not sustain the loss of any limbs, his left leg was completely paralyzed from the knee down, leaving him unable to walk on his own. Meanwhile, he watched fellow patients who had lost limbs begin to run and jump with the help of prosthetics. So disheartening was the experience that Capt. O’Donnell asked to have his leg amputated so he too could enjoy the mobility that amputee patients were experiencing.

Ultimately, as Capt. O’Donnell explained, he accepted the counsel of his physicians, and opted to rehabilitate his injured leg. After returning to Tripler Army Medical Center in Honolulu, he was fitted for a custom orthotic device that now allows him to walk without assistance, despite significant paralysis of his left leg below his knee. Now, after training and rehabilitation, he walks with only a slight limp, runs regularly, and recently completed a biathlon.

Orthopaedic research made it possible
In sharing his story, Capt. O’Donnell highlighted two important points: first, that without the groundbreaking research of the orthopaedic community, he would not be walking on his own right now, let alone running, and second, that all members of the Armed Forces deserve treatment as good as his.

Further research is clearly needed to improve the care that military physicians are able to deliver to wounded soldiers. Effective treatments such as those that enabled Capt. O’Donnell to return to high levels of physical activity are still lacking for many wounded soldiers who sustain high-energy open extremity injuries.

“I can’t ask my men to charge through that door, if I don’t know that they’re going to get the best possible medical care if they get hurt,” a passionate Capt. O’Donnell said.

Kelly O’Donnell provided the unique perspective of a young military wife dealing with a severely injured husband. They had been dating when Capt. O’Donnell was hurt, and he proposed while in the hospital. When the hospital’s chaplain refused to officiate, Capt. O’Donnell’s father, himself a veteran, performed the ceremony. Today, Mrs. O’Donnell is an outspoken advocate for providing soldiers with the kind of medical care they deserve and performing the necessary orthopaedic research to make that care possible.

“We need to provide all of our soldiers with the care that they need,” said Mrs. O’Donnell, after her husband told Rep. Ruppersberger that, although he was confident that, as a captain, he would get the orthopaedic care that he needed, he was less confident that lower-ranked troops would receive similar care.

Meeting with the home team
We then joined the O’Donnells in visiting Sens. Inouye and Akaka. The meeting with Sen. Inouye was particularly poignant, because Capt. O’Donnell served in the same battalion that Sen. Inouye served in during World War II.

A service-disabled war hero, Sen. Inouye won the Medal of Honor after being critically injured as the Allies fought in Italy. Prior to the war, he had been a premedical student at the University of Hawaii, with hopes of becoming an orthopaedic surgeon. After losing his right arm in combat, Sen. Inouye changed his career plans but continued to be active, learning to play the piano with one hand and entering politics.

“While I was in the hospital, you were my inspiration,” Capt. O’Donnell told him.

“You are too kind,” replied Sen. Inouye.

After meeting with Sen. Inouye, Capt. O’Donnell met Sen. Akaka, with whom he shares a familial connection. He again praised the military orthopaedists who helped him to walk again.

“They’re now a part of our ohana,” said Capt. O’Donnell, using the Hawaiian term for extended family.

For more information on AAOS efforts to increase federal funding for orthopaedic research, visit the AAOS office of government relations Web site at www.aaos.org/dc

For more information on the Extremity War Injuries symposia, visit www.aaos.org/ewi

Jamie A. Gregorian is the manager of research advocacy in the AAOS office of government relations; he can be reached at gregorian@aaos.org

Andrew N. Pollak, MD, chairs the AAOS Extremity War Injury and Disaster Preparedness Project Team; he can be reached at apollak@umoa.umm.edu