"Trapped in between life and death"
Seattle Times staff reporter
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Sometimes brotherhood means much more than sharing parents. Sometimes it means sharing hands.
When a young Fort Lewis soldier returned from Iraq paralyzed from the upper chest down, it was his teenage brother who assumed the role of roommate and primary caretaker.
They've learned what it means to feel completely dependent and what it means to feel completely responsible.
Spc. Brandon Powell was scanning for snipers from the hatch of an armored troop carrier in Iraq when something hit him.
It must be the shock wave from a rocket-propelled grenade, Powell thought. His legs buckled and he slumped back into his seat, passing out for a few seconds. He awoke to someone shouting.
"Hey, Powell. Hey, Powell!" another soldier in his Army squad yelled. "Get a medic! Get a medic! Powell's hurt!"
A sniper's bullet had found the vulnerable flesh between Powell's helmet and Kevlar body armor. Like the other soldiers, Powell always left his constrictive neck armor at the barracks. What were the chances?
The bullet struck just below his Adam's apple, slicing downward and piercing his spine.
He was gasping, trying to breathe.
At home in Vancouver, Wash., Powell's younger brother, Blaine, got a phone call from their dad. Brandon's been badly hurt. Shot in the neck.
"He's dead," Blaine thought. No one can survive that.
No arteries were hit and Brandon spilled barely half a cup of blood. He was alive but paralyzed — a quadriplegic. He was 20 years old and just seven weeks into his tour in Iraq.
Brandon's injury ranks among the worst of the 17,000 U.S. military members wounded since the war started three years ago today. Another 2,300 have died.
That split second in the northern city of Mosul 16 months ago brought Brandon home to Vancouver and intertwined the brothers' lives in ways neither could have imagined.
Blaine, at just 19, became his brother's roommate and primary caregiver, tending to Brandon in the most intimate of ways. Brandon struggles with the idea of growing into adulthood while relying on others for virtually all his needs.
Together, they're finding the rhythm to a life that now includes catheters, hydraulic lifts and an uncertain future.
Coming to terms with paralysis
Brandon has no feeling or movement from his upper chest down. He can move his head and has some feeling in his shoulders. But his arms and legs are useless.
The paralysis affects his lungs, too. He can't breathe as deeply or speak as loudly as before. Unable to gesture with his hands, he shuts his eyes and sticks out his tongue to punctuate his speech.
He uses his chin to manipulate a joystick that controls a 300-pound, battery-powered wheelchair: reverse, turn, forward, faster and recline. The $6,000 chair, provided by the Department of Veterans Affairs, empowers him. When Brandon's in it, he and Blaine feel like equals.
But when Brandon's in bed and the chair sits empty, an eerie feeling sometimes washes over Blaine. His brother becomes dead weight, a disembodied voice asking for help.
In his wheelchair, pavement that Brandon once barely noticed presents an obstacle course of cracks and sudden dips. There are doorways that are too narrow, steps that are useless. People tower over him, and some assume he's mentally disabled.
Losing the use of his hands has been more devastating. He can't manipulate the controls on video games. He can't pick up a slice of pizza. He can't scratch his ear when it itches.
At night, in his dreams, he still walks and runs. Just finding the motivation to get out of bed each day can be daunting. He stays up late and sometimes sleeps into the afternoon.
"It's kind of like being trapped in between life and death. I'm alive and conscious, but God, I can't do nothing for myself," Brandon says. "There are days I just wish I was dead."
Growing up in separate households
Just 19 months separate the brothers, but sometimes it seems like years.
Blaine has the awkward signs of youth: braces, a gangly build, an infectious giggle. He gets wide-eyed over things he considers cool, like the nitrous-oxide canister that supercharged his Honda Civic until the engine burned out, or the replacement motor he stored for months in his apartment bedroom.
His boyish excitement is balanced with a traditional streak. He wears slacks and collared shirts, works hard and has been dating the same girl for more than two years.
Brandon is more reserved, more intense. Sometimes he seems world-weary. His absolute stillness gives him a Buddha-like quality among their kinetic young friends, and his voice carries a note of authority.
When it comes to appearance, Brandon is more edgy. He has a geeky-cool style. He rarely goes without his knit beanie and sometimes wears buttons on his T-shirts that say "slacker" or "dork."
Growing up, Brandon was the protector, speaking up for his younger brother.
Their parents divorced in the mid-1990s. The brothers remained close but saw less of each other. They frequently switched living arrangements, one staying with their dad, a truck driver, while the other lived with their mom, a barista.
Blaine began working nights at Safeway during his junior year in high school and moved away from home.
Brandon wanted to drive trucks, like his dad, but couldn't until he turned 21. So he enlisted in the Army three weeks out of high school, when he saw an ad on TV. It offered a way to kill time, move out of the house and learn more about himself.
"I found a window and I jumped through it," he says.
He quickly discovered a knack for computers and became the kind of tech-savvy soldier the Army wanted for its new Stryker units, based at Fort Lewis near Tacoma, which rely on technology as much as firepower.
Brandon and three other soldiers from the 1st Stryker Brigade, 25th Infantry Division were riding in the troop carrier Nov. 30, 2004, when the sniper shot him.
Back in the U.S. within a week
The bullet wound didn't hurt.
Collapsed inside the Stryker, Brandon lay still and waited, not knowing how badly he was injured. When the frantic soldiers in the Stryker had trouble finding their way to a field hospital, Brandon teased them by offering to drive.
The next few weeks were a blur.
He was evacuated to a military hospital in Germany, where doctors inserted metal plates and rods to stabilize his spine. Within a week he was at Walter Reed Army Medical Center in Washington, D.C.
Muddled by pain killers, Brandon imagined he was back in a medical helicopter and a procession of Middle Eastern women were offering him presents and apologies. Other times, he demanded that nurses show him his hands.
By mid-December he was lucid enough to understand what had happened: The bullet had shattered his spine at the sixth vertebra from the top. His spinal cord was damaged. There was a chance he might regain some movement over time — or it might never happen.
"It blew me away," he says.
As his unused muscles withered, he lost 90 pounds, his weight dipping to 140.
One day, Defense Secretary Donald Rumsfeld, who was touring the hospital, stopped by Brandon's bed. Rumsfeld offered his hand in greeting, leaving it extended awkwardly for a few moments before realizing his mistake.
The brothers make their plans
Brandon arrived at the Veterans Affairs medical center in Seattle just after Christmas, a month after the shooting.
He met with occupational therapists, psychologists and other injured soldiers in group sessions during his four-month stay. But the intense physical therapy that helped other soldiers regain their independence was of little use to him.
Soon, the brothers began making plans.
Brandon told Blaine he didn't want to live with their mom or dad.
"And so I said, 'You can come and live with me,' " Blaine recalls. "And he said 'OK' and made me caregiver."
Staff members at the VA hospital weren't thrilled.
"They didn't think it was a very good idea, because I was his brother, I was so young, and they didn't really trust my abilities or think I could do it," Blaine says. "I just took a mental note and I thought: I'll prove them wrong."
Sam Keagle, an occupational therapist at the VA, says she routinely advises patients to get an outside caregiver. Maintaining a close family relationship is hard enough after a spinal-cord injury without adding the demands of daily care.
"I think Blaine's fantastic. He's insightful, attentive to detail and very knowledgeable," Keagle says. "It's awesome for now. Do I hope it lasts? Not so much."
Skip Dreps, a Vietnam veteran who's partially paralyzed, worries that both brothers could miss out on careers and family life.
"It's like we've lost two in one family," says Dreps, who works for the Northwest chapter of the Paralyzed Veterans of America.
That's not how the brothers see it. Blaine says they maintain different interests and independent lives.
Brandon's discharge from the Army entitles him to lifelong VA disability benefits of about $6,500 a month — nearly half of which goes to Blaine for providing care. Another $500 goes to a friend who keeps an eye on Brandon while Blaine works three nights a week stocking shelves at Safeway.
"Our relationship is just the same as it was before, it's not changed at all," Blaine says, an edge of defiance in his voice. "And I work for myself, I'm my own boss. I don't have to count on anyone."
Blaine goes from buddy to nurse
Brandon turned 21 in May, five months after the shooting. A few streamers and balloons hang from their apartment ceiling and Blaine has bought a Fred Meyer carrot cake to hand-feed his brother.
Their friend, Tamra Nelson, comes over to visit.
She plucks at the stray hairs on Brandon's face and teases Blaine about his shaving skills.
Brandon notices the different hands of those looking after him. Blaine's are sticky and sweaty. Their friend Dustin Troupe's smell like Burger King.
Nelson's are soft and smell like peaches.
Blaine holds up his gift in front of Brandon: a triangular oak case to display his Purple Heart and Bronze Star. Nelson shows her gift, a glass case to hold the American flag the Army gave him when he was discharged.
Brandon keeps his own memento from the war: the crumpled bullet that passed through his neck and became tangled in the fabric of his back armor.
The ground-floor apartment near the Vancouver Mall is small and, as usual, the lights are low. Blaine found it a few weeks earlier, figuring the extra-wide shower and almost straight, smooth shot of pavement to the mall would be perfect.
Brandon's friends come over to play Magic: The Gathering, a fantasy card game he's skilled at playing. Blaine's friends drop by to talk about cars.
Blaine keeps the place fairly tidy, making a neat stack of the empty pizza and corn-dog boxes.
Both parents live within 10 miles of their sons. They visit, but neither is trained to provide Brandon's care. The parents each have their own worries, and the brothers prize their independence.
Before looking after his brother, the closest Blaine had come to being a caregiver was a dental-assistant course he took in high school. At first he was naively enthusiastic about his new role: He liked the red-carpet treatment they seemed to get at the movies and the mall.
When Blaine first stayed overnight with Brandon at the VA hospital, the staff gave him "a big old checklist of the stuff I had to do." It's an exhausting routine he's performed countless times since. Just getting Brandon ready for his wheelchair each morning took 2 ½ hours initially and still takes 75 minutes.
The ritual starts when Blaine snaps on a pair of surgical gloves. He's no longer a brother or a buddy.
He's a nurse helping a patient.
Blaine empties his brother's catheter and hoists him into a special bathing wheelchair using a hydraulic lift.
Then comes the bowel movement. Blaine uses his gloved hand to stimulate what his brother can no longer control. The process can take 30 minutes or more.
He scrubs his brother in an oversize shower, shaves him and brushes his teeth. He dresses him and hoists him into his motorized wheelchair. Sometimes he stretches Brandon's arms, which helps keep them from atrophying. But they don't do the exercises as often as they should — they can seem pointless.
Blaine feeds Brandon his breakfast one bite at a time, then gives him an assortment of pills: vitamins, anti-spasm medication and pain relievers.
He fills a water bottle mounted on Brandon's wheelchair that his brother can reach with a straw whenever he wants. Blaine drives him places. At night, he hoists him back into bed.
If they're sleeping away from home, Blaine wakes up every two hours to shift Brandon into a new position.
Medical complications loom
"Straighten my legs! Straighten my legs!"
Brandon's legs are twitching and cramping as Blaine hoists him from his wheelchair to his bed.
It's a cruel twist. Brandon can't move and his skin is numb. But he still feels pain, especially when his undisciplined muscles clench. A phantom fire burns in his left foot. His shoulders ache where tendons take the strain once held by his now-wasted muscles. His bladder hurts.
He takes drugs to quiet the spasms, to cut the pain. But they don't always work.
Blaine straightens Brandon's legs then unclips his catheter and washes it out in the bathroom. They talk about the low urine levels, which can indicate a build-up of calcium in the bladder, a common problem for quadriplegics.
Blaine then grabs Brandon's heel and bends his foot to slip on a medical bootie. The shoe keeps Brandon's toes from curling during the night and straining his tendons.
The bed hums as pockets of air in the special mattress inflate and deflate to keep Brandon moving during the night, reducing his chances of developing pressure sores — a big worry for people with paralysis.
Actor Christopher Reeve, who was paralyzed in a horse-riding accident in 1995, had excellent medical care. But he died in 2004 at age 52 after a pressure sore became infected.
Urinary infections, pneumonia and blood clots are among the other threats. Still, someone of Brandon's age and disability can expect to live another 40 years on average, about 20 years less than a healthy, active person.
Blaine tucks pillows under Brandon's arms and calves, washes his face with a pink cloth and moves Brandon's head until he says it feels right. Blaine then pulls the sheet over his brother's head like he's a corpse.
That's how he likes to sleep.
A new challenge in Minneapolis
They planned the summer trip for weeks, discussing strategies to launch a bowling ball down a ramp, how to juice-up Brandon's chair to make it go faster, when they'd fit in a side trip to the biggest mall in the country.
Although still sorting out their lives in Vancouver, here they are in Minneapolis, where Brandon's competing in the 25th National Veterans Wheelchair Games.
It's a chance to get away from home and meet some people who share Brandon's disability. And the trip is free. The Paralyzed Veterans of America, which organizes the games with the VA, picks up the tab for first-timers.
The trip, though, is a logistical ordeal. Airline workers transfer Brandon into a special wheelchair narrow enough to fit down an airplane aisle, while his massive battery-powered model is stowed below.
Once on board, Brandon finds the airplane seat confining, and his shoulders ache by journey's end.
At the hotel, the beds aren't designed to handle the hoist used to move Brandon in and out of bed. So Blaine does the lifting himself or, when he can, recruits some help.
The games themselves are a dizzying crush of 500 disabled veterans and their supporters from around the country.
Wheelchair convoys jam the Hilton lobby each night and spill onto the streets as the veterans laugh, drink and tell stories.
At first, Brandon and Blaine keep to themselves.
Brandon's injuries are more recent and more extensive than most. And the brothers stand out in the crowd dominated by much older Vietnam-era veterans.
But as the week unfolds, Brandon blossoms. He strikes up conversations with strangers and cements a friendship with a young Navy vet from Idaho, who popped a vertebra while clowning around on a trampoline at a Florida base.
On the third day, Brandon confronts a challenge he once mastered — target shooting.
He was known as a crack shot in the Army. But without the use of his arms, he must rely on someone else to position the gun.
Blaine holds the modified air gun so Brandon can see down the sight. Brandon instructs Blaine to move it up or down, right or left to find the target, then blows into a tube to trigger the round.
It's a frustrating process.
"I'm sucking at this event," he confides to another veteran during a break.
Northwest team coach Carrie Booker says it's hard to come to terms with lost skills.
"People either really go for something they did well before," she says, "or they drop it."
But Brandon's frustration evaporates the following day when he learns he's won gold medals in bowling and wheelchair-race events. He even gets a silver in target shooting.
At a small ceremony, actress Bo Derek, a games patron, drapes the medals over Brandon's head. He's never been recognized for much, and his medals — first those from the Army and now these from the games — mean a lot.
He beams with pride.
"Can't look past tomorrow"
Over winter, the brothers bought their own home. By January, contractors finished widening the doorways, laying linoleum to aid in maneuvering Brandon's lift, and pouring concrete wheelchair ramps.
The VA gave them $54,000 toward the house, about half of which paid for the modifications. To help with the mortgage, the brothers rent out a room in the house and a small apartment above the garage.
"It's funny, but going the way I was before, I never would have had my own place," Brandon says. "It's mine. And nobody can tell me what the hell to do around here."
His voice-activated computer allows him to send e-mail, surf the Internet and play games with other people online. He drifts for hours in this virtual world.
He sometimes feels guilty that his wants and needs take precedence over Blaine's, and he wonders if their life together can last. Blaine has his girlfriend and his own future to consider.
But Brandon enjoys how close he and Blaine have become.
For his part, Blaine says he's happy, although he dreams of a break. Maybe take time for himself on a beach. Some place like Cancun.
Brandon has regained a lot of the weight he lost after the shooting. He talks about getting an online job, or taking a business class at the local community college. Maybe one day he'll even meet the right woman.
But most of the time, he won't let himself think too far ahead. He's 21 and can't yet contemplate growing old as a quadriplegic. He hopes his paralysis will ebb, but that becomes less likely as the months go by.
"I just can't look past tomorrow," he says. "I try to be hopeful and think that I'm going to get better, that I'll get my arms back. That I'll wake up one day ... "
His voice trails off.
Nick Perry: 206-515-5639 or firstname.lastname@example.org
Alan Berner: 206-464-8133 or email@example.com
Copyright © 2006 The Seattle Times Company