For Americans, Veterans’ Day is an occasion to honor and celebrate all military veterans who have served in the United States Armed Forces. In November 1919, “Armistice Day” was created to honor the veterans of World War I, and in 1954, President Dwight D. Eisenhower re-named the holiday as “Veterans’ Day” for widespread observance of all veterans.
Each of these service members have made sacrifices for our nation, and adjusting to life back in the United States is difficult. Many return home with debilitating injuries. A portion of these injuries are traumatic brain injuries (TBI) acquired while serving in the military. A TBI is any disruption in normal brain function that can be caused from activities such as playing sports, hitting your head, or being involved in a motor vehicle accident. Military service members most commonly experience a TBI from explosions during combat. According to the Centers for Disease Control and Prevention (CDC), over 430,000 veterans have been diagnosed with a TBI in the past 20 years.
While working with my professor, retired Commander David Crumbley, I had the opportunity to learn more about TBI and his experience while serving at the Walter Reed National Military Medical Center (WRNMMC). He introduced me to retired Army Captain Patrick “Pat” Horan and his wife, Patty Horan, whom he cared for 14 years ago when Capt. Pat Horan was initially injured. They remain friends today. I had the opportunity to interview the Horan family about their incredible story of rehabilitation and recovery throughout the past 14 years.
On July 7, 2007, Capt. Horan was on a patrol in Iraq when a sniper’s bullet struck him between his helmet and the left side of his head, exploding when it hit his skull. Most of his left temporal lobe in his brain was destroyed. Doctors removed half of his skull and put him in a medically induced coma to reduce brain swelling. Bullet fragments are still in his head today.
Due to the extensive brain damage, doctors told Mrs. Horan that they were unsure if her husband would survive. If he did survive, they were unsure how much function he would regain or if he would ever talk or understand words again. In his honor, Mrs. Horan was given the Purple Heart, his boots, and his tags.
Six weeks later, however, Capt. Horan woke up for the first time. A year into his recovery, he was able to stay awake and alert for a full day. Over the next 13 years, Pat underwent numerous brain surgeries and daily extensive rehabilitation programs. These therapies helped Pat re-learn how to walk, talk, and complete daily tasks.
His rehabilitation journey was accompanied by complications of epilepsy, or seizures, commonly seen in patients with a TBI. To help with the epilepsy, the Horans were given a therapy dog named Wilson. Wilson was trained to identify early signs of a seizure and alert someone before Pat’s seizure occurred. Wilson retired this year but still lives with Pat and Patty. They have a new therapy dog named Rocco. Pat also had trouble in moving the right side of his body, apraxia (difficulty performing movements) and global aphasia. Both apraxia and global aphasia are commonly associated with left temporal lobe brain damage. The left temporal lobe of the brain is located behind the left ear and controls the processing of languages and emotions as well as visual perception. Global aphasia occurs because of a damaged Wernicke’s area in the left temporal lobe and Broca’s area in the left hemisphere of the frontal lobe. Together, these areas of the brain help to understand language, produce words, and use grammar.
Due to this extensive brain damage, Pat was unable to read and write, or to carry on a conversation for more than two years. Pat still works extensively each day to continue strengthening these skills and says that this has been one of the most difficult parts of his recovery. Amazingly, Pat was able to train another part of his brain to take over the function of the left temporal lobe. Another part of his brain now controls language understanding and speech production, a difficult and an uncommon occurrence in TBI. Everyone, including his neurologists, were amazed by this ability.
Today, Pat continues daily speech, occupational, and physical therapies to revive and strengthen his skills. He stays busy spending time with his family, playing pickleball, and volunteering with various organizations such as CURE: Epilepsy, Semper Fi & America’s Fund, America’s VetDogs, and the Stroke Comeback Center. He has spoken at several universities, including Auburn University, where nursing students were given the opportunity to visit WRNMMC for a week. He has a mentor through Wounded Warriors as well. Despite having aphasia and still having some difficulty finding certain words while communicating, Pat remains a social butterfly and has never been ashamed of his speech. Mrs. Horan says that he never lost his sense of humor.
At the conclusion of my interview, I asked the Horans if there was any advice they wished to share with me as a future nurse and with others. Pat said that nurses were the ones to give him hope throughout his recovery process. They were there every step of the way throughout a patient’s recovery and hold a unique perspective when caring for patients. For fellow Americans, they desire a greater awareness to TBI and aphasia and a larger effort to honor veterans. They believe it is important for people to be more understanding and to make more of an effort to reach out to those affected by TBI. They suggest volunteering for various organizations, reaching out to someone they know, or doing research on these topics to gain a better understanding.
Today, researchers continue to develop more effective solutions to prevent major TBIs from occurring among military service members. Better technologies continue to be created to provide the best possible outcomes for veterans. In many cases, especially mild TBIs, partial to full recovery is possible and does happen. There is still so much to learn about TBI recovery and rehabilitation.
Veterans should not only be honored and celebrated on Veterans Day, but also be honored and celebrated daily. Thank you, Pat, for your service to our country, and thank you to all veterans who served and continue to serve our nation.
