Mended Hero

THERE’S A PHOTO OF DOUGLAS HAYENGA that ran in newspapers nationwide when the United States first invaded Iraq. It shows the Marine Corps lance corporal kneeling on the ground in the desert with his head bent forward, trying to wash his hair using a bottle of water.

“We had just pushed into Iraq,” recalls Hayenga, gazing at the picture. “I was 19.” He joined the Marines at 18, right out of high school. And although the photo of him in Iraq is only four years old, in many ways it was taken a lifetime ago.

Today Hayenga, a 23-year-old sergeant, has endured more pain and suffering than most of us ever will. In March 2004, he was in Fallujah, defending a building on the outskirts of the city, when a mortar round exploded 10 feet away. He was in what Marines call the kill zone; his best friend died in the attack. Hayenga was critically wounded, with a shattered tibia and extensive nerve damage to his leg and arm.

When San Diego Magazine interviewed him in July 2005, he was in a wheelchair after surgery; clear plastic tubes curved out of his veins, and his face looked pale and tired. A year later, Hayenga is robust, smiling and able to walk with one crutch. In June, he graduated from college; several months before that, he and his Navy wife bought a house in Chula Vista.

Hayenga, wearing a perfectly creased and spotless green uniform, could be a poster boy for recovering veterans—a man with too much at stake to ever consider failing. He was barely 21 when he was injured, with the prime of his life ahead.

“He has been a model patient, a patient of courage,” says Captain Amy Wandel, staff plastic surgeon at Naval Medical Center San Diego. She has performed multiple reconstructive surgeries on Hayenga.

The young Marine had planned on a career as an officer; in fact, when we first interviewed Hayenga, he wanted to get his bachelor’s degree and return to Iraq. But his leg was so badly injured—it was within medical guidelines to amputate, he says—that he can no longer run the distance it takes to be a Marine and is being medically retired.

 Hayenga says at first that was difficult to accept, but he is extremely focused and pragmatic. “After I was injured, I knew there would be two paths my life could take,” he says. “Best-case scenario would be for me to recover, finish school, become an officer. But if that couldn’t happen, I knew I was going to have to leave the Marine Corps and find another career. I didn’t want to get out of the hospital and think, ‘Well, what do I do now?’ ”

Once he made up his mind, Hayenga didn’t waste any time. While sitting in a hospital bed recovering from more than 20 surgeries, he finished his associate’s degree through Vincennes University—one of many schools that offer degree programs at the Naval Hospital. Then he started working on his bachelor’s degree through Southern Illinois University. He was one of the youngest students in his classes, composed largely of senior officers preparing for post-retirement careers.

“We’d go around the class and introduce ourselves. They would say they were retiring, and I’d say, ‘Yeah, well, I’m retiring too,’ ” says Hayenga.

While he studied—often writing his assignments and papers in bed—he also went through rehab, what he describes as a long, slow and painful process. Surgeries performed on Hayenga’s leg and arm were extensive, and the healing process lengthy.

When he first returned from Iraq, doctors at Camp Pendleton operated to save his leg, but an infection developed, and he was sent to the Naval Medical Center. Captain Wandel says Hayenga had a large hole in his leg from the gunshot and was missing skin, fat, muscle and bone in the area. Reconstructing his leg required microvascular surgery, bone grafts, skin grafts and other surgical procedures. Muscle from Hayenga’s stomach was used to cover the hole made by the blast injury; he often jokes now about the “six pack” in his calf.

After spending more than a year in a wheelchair, Hayenga could use crutches but was still unable to walk on his own. “It was really frustrating,” he says. “I never thought of myself as being handicapped. I even felt bad about parking in handicapped spots, especially when I was on crutches. I had been using them for so long I could probably walk a couple of miles on them.”

His biggest physical problems now are centered on pain management. Hayenga says he went from feeling nothing in his arm and leg to hypersensitivity, where the slightest touch or temperature change caused excruciating pain. He explains, “I’m using physical therapy and working on my own to get the nerves back to normal, especially in my arm. I manage the pain with medication, and I’m desensitizing it little by little.”

Hayenga began putting pressure on his injured leg gradually. “I was used to running and being healthy, so I thought, ‘Okay, give it a month or two and I’ll be back to normal.’ But it’s not that way at all; it’s a slow process,” he says. “I went from putting hardly any pressure on my leg to 30 pounds and then moving gradually up to 80 and so on.”

He says he didn’t allow himself to think negatively. “I never thought once that I was going to lose my leg or not be able to run. And even with all the nerve damage in my arm— I couldn’t feel a thing—I believed it would come back. I had a lot of support and encouragement from the people around me—my wife and my friends.”

Many of the friends were other Marines recovering at the medical center. “Some of these people are now my best friends,” he says, “like the friends I made in my Marine Corps unit.”

That support buoyed Hayenga, giving him the confidence he needed to push himself. In August 2004, he participated in the Hope & Possibilities Run in New York City, using a hand-cranked bike. Last October, he did the same in the Marine Corps Marathon in Washington, D.C. Because he had a college exam the day before, Hayenga didn’t arrive in Washington from San Diego until the morning of the race, and he competed after just two hours of sleep. Along with other injured military personnel, he ran as part of a Freedom Team. Hayenga finished in three hours and 31 minutes.

“It gave me a good sense of accomplishment. And seeing these other guys doing it, I thought, ‘They are missing a leg, and you still have both of yours; you can do this,’” says Hayenga. The 2005 marathon had the largest turnout in the race’s history, with a significantly higher number of competitors using traditional wheelchairs and hand-cranked bikes. According to the Washington Post, that increase was attributed, in part, to the large number of military personnel injured in Iraq and Afghanistan.

Dr. Wandel says Hayenga’s severe injuries are fairly typical of what she sees in those returning from Iraq. The sergeant’s psychological wounds have proved a bit tougher to tackle, although he is making progress. Hayenga has posttraumatic stress disorder (PTSD), which took a while to surface.

“When I was in the hospital and with my family, I felt safe. But when I was on my own, after my wife went back to work and I was alone, I didn’t,” he says. Within a month of leaving the hospital he was experiencing intense anxiety, overreacting to noises and having nightmares. “I’m still really jumpy,” he says. Seeing a counselor has helped, as has EMDR—eye movement desensitization and reprocessing—a method of dealing with PTSD that works well for Hayenga. During EMDR, patients reimagine their painful experiences while a therapist directs them to move their eyes; that movement is similar to what occurs naturally during REM sleep.

 After two years of hospitalization, Hayenga finds himself thinking about a career in medicine, one of several career options. If he chooses to pursue medicine, or something in the health care arena, he says he would love to work with the military. “I could really relate to people coming back from war,” he says. “I try to talk to injured Marines or [Navy] corpsmen now on the ward, to be a kind of mentor, because I’ve been through a lot of it.”

While undergoing physical therapy and waiting for a bone graft, Hayenga asked to work in the hospital’s wound clinic, so he could learn to perform basic care. Drawing from his personal experience, classroom work and involvement in the clinic, he developed a program to teach family members how to care for wounds. He says it’s the sort of information he could have used when he was discharged from the medical center.

“Sure, my wife and I saw the doctors, nurses and corpsmen doing it [changing bandages] in the hospital, but we didn’t have the hands-on experience until we got home. It was a lot tougher than we thought.” He has also been a consultant to the Clinical Quality Team that’s helping in the development of the medical center’s new Comprehensive Combat Casuality Care Center for severely injured service members.

Considering what he’s been through, the intensity of Hayenga’s drive and his positive outlook are noteworthy, if not remarkable. But the experience and the injuries changed his life, he says, opening doors that might otherwise have stayed closed.

“I had the time to think about my life,” he says. His indefatigable Marine spirit helped. “Marines have a can-do attitude, and that’s my attitude. It is something that will always stay with me, and because of that, I feel real hopeful,” Hayenga says, smiling. “I mean, if I can make it through this, I know I can have a successful future.

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