The large number of U.S. troops who need care for multiple combat wounds, including head injuries, has led the U.S. Department of Veterans Affairs to take a larger role in treating active-duty service members.
Traditionally, the military's medical system — at places such as Madigan Army Medical Center — is responsible for wounded active-duty soldiers, as well as Reserve and National Guard members hurt while mobilized.
The VA treats service members when they leave the military and part-time soldiers when they complete mobilization.
The VA also has specialized in those with spinal cord injuries, said Jay Uomoto, who directs the Center for Polytrauma Care for the VA's Puget Sound health care system.
"Aside from that, you wouldn't see a lot of active-duty members in the VA," he said.
But the role of the Seattle and other VA hospitals changed in 2005 because of the many service members who have suffered multiple injuries from enemy explosives in Iraq and Afghanistan, and who need specialists to meet their long-term rehabilitative needs.
The change was the result of a partnership between the VA and the Defense Department. The thrust is a national network of polytrauma centers, where the wounded get intensive inpatient and outpatient care and rehabilitation.
The VA has expanded the mission of its four polytrauma centers in recent years. A fifth center has been announced for San Antonio.
Once a soldier is stabilized, or in cases of less severe injuries, the patient comes to one of 17 "polytrauma network sites," including one at the VA in Seattle. There, a team of specialists can continue care and ensure that soldiers are "plugged into" other services they might need, Uomoto said.
The Seattle facility coordinates care for wounded service members in Alaska, Idaho, Oregon and Washington. It has looked after almost 200 patients since April, including more than 50 now. About 40 percent are active-duty, largely sent from Madigan, Uomoto said. The rest are veterans.
Bill Campbell, a 46-year-old Shelton resident and former sergeant in the Washington Army National Guard, is one of the patients. He volunteered to serve in Iraq with the 81st Brigade Combat Team.
During deployment in 2004-05, he guarded a base near Baghdad, which was a frequent target of insurgents using car bombs.
Campbell suffered two concussions and endured multiple blasts.
He returned home suffering memory loss, chronic depression and headaches. The memory problems were so severe that he could no longer do his job as a biologist for the state Department of Fish and Wildlife, where he had worked for 19 years. The VA classified him as 100 percent disabled.
Campbell generally praised the care he's received from the VA. He transferred to the Seattle polytrauma center last year as an outpatient and meets with a therapist once every two or three weeks to help with his memory and organizational skills. Things are different now than when he arrived because of the growing number of service members the specialists are treating. "I tend to get less time when I go," he said.
Uomoto said the Seattle center has seen a higher number of wounded service members and expects another influx, in part because of the recent return of the 3rd Brigade, 2nd Infantry Division, the Fort Lewis Stryker soldiers who fought insurgents for 15 months. Kenneth Jarrett, the Seattle VA's vocational rehabilitation counselor, said Madigan and the rest of the military medical system provide comprehensive care, but polytrauma cases require highly specialized and complex treatments. These patients also involve long-term rehabilitation, which was never the role of military hospitals to provide, he said.
"We're confident we'll be able to address the needs," Jarrett said. "The whole system is ready to support us."
The team of specialists based at the Seattle hospital makes trips to the VA hospital at American Lake. Uomoto said plans call for a second team of specialists to be established at the Pierce County site sometime in the future.
The VA also has case managers stationed at Madigan to ease the transition for injured service members who bide their time in the warrior transition battalion.
Soldiers in that unit work toward recovery and a return to duty, or await a medical board and separation from the service.