RALEIGH, N.C. — Ever since his truck got hit by a pair of bombs in Iraq a couple of years ago, Josh Cruce forgets a lot. But he still remembers the man he used to be.
It's one of the cruel tricks modern combat injuries play on soldiers. Healed from their visible wounds, they look like their strong, confident, active former selves. They just can't figure out how to be those people anymore.
Cruce thinks he has finally found the old Josh — the one before the brain injury, the crushed vertebrae and the paralyzing depression — in a swimming pool in East Raleigh, where he shows up most Thursday nights for kayaking class. It's one of dozens of civilian-run alternative therapies combat veterans are using to reclaim their physical and emotional strength after suffering brain injuries and post-traumatic stress disorder.
Most of the programs rely on volunteers, are free to veterans and their families, and combine what science knows about combat stress with intuitive notions about how to relieve it.
"It's liberating," says Cruce, 23, who got into the kayaking class soon after it started last May. He had tried physical therapy, antidepressants, epidural injections and counseling, with limited success.
"I never left my house, except to walk the dog. I felt threatened everywhere. I slept all the time. I was getting fat," Cruce says.
He believes kayaking gave him his life back. He's now a full-time arts student at Wake Technical Community College with plans to pursue business degrees at East Carolina University. He's rebuilding his four-year-old marriage.
"I've never been in rehabilitation that's been this beneficial to me," Cruce says. "It eases my back pain. It releases my mind, and it challenges me in a way that's not frustrating.
"It's extremely uplifting. It's brought an enjoyment in my life that I haven't had since I got hurt."
There are sculpting, painting and writing classes, and programs that give wounded warriors a guitar and teach them to play. But most of the therapies acknowledge service members' inclination toward sports, and their need for physical activity they can do on their own. Different programs offer nearly every sport: surfing, biking, skiing, snowboarding, climbing, golf, fly-fishing and more.
"These men and women, they're very aggressive and very goal-oriented. They really like to push themselves. They're risk takers. That's why they're in the military," says Kirk Bauer, executive director of Disabled Sports USA, based in Rockville, Md. The organization helps fund programs for veterans around the country, including the Raleigh chapter of Team River Runner, which runs the kayaking class.
Disabled Sports USA was started in 1967 to help injured Vietnam vets get back into sports. Bauer, who lost his leg to a grenade in that war, was an early participant.
"In a way, becoming disabled is a much bigger blow to the soldier than to a person who has never been active. Suddenly they are missing being able to run a marathon, ski down a slope or bike 100 miles. That brings them a lot of depression. They lose their entire self-image and really go into a negative spiral.
"The main thing is to get them out of that as soon as possible. Telling them they can go back to school and get a degree means almost nothing. They have to do something, and it has to give them a concrete example of what's possible."
Sports can do that, Bauer says, and quickly; the basics of most sports can be learned in a day.
In the early years of the wars in Afghanistan and Iraq, the military was criticized for being unprepared for the debilitating injuries that were sending service members home or emerging after they had returned.
Military and Veterans Affairs doctors were overwhelmed. Facilities were lacking. Veterans waited weeks for appointments and had to fight to have their symptoms recognized as deployment-related.
The government has spent heavily on improvements at facilities such as Walter Reed Army Medical Center in Washington and at wounded warrior battalions in each branch of service. Last year, the Army's battalion at Fort Bragg got a new fitness center and spent $6.9 million upgrading its barracks.
Many of the programs civilian volunteers now offer are modeled on those pioneered by the military's wounded warrior services and still used by active-duty soldiers recovering from injuries.
Neither the military nor the VA, both of which refer patients to civilian-run programs, contribute to their cost.
"A lot of injured vets have cognitive impairments or are at risk for depression or isolation," says Abena Jones-Boone, a recreational therapist at the Durham VA who came recently to watch the kayaking class.
"This is a way to reintroduce them to the community, with people who have been through the same thing. And they say it's fun."
While less costly than a lengthy hospital stay, getting an injured vet back into sports is not cheap; volunteers are constantly trying to raise money for gear — regular and handicap-adaptive — as well as travel and other expenses.
The one thing most programs seem to have plenty of is volunteers, who act as instructors, spotters and cheerleaders.
"Personally, for me, this is just giving back to veterans for all of the efforts they have made for us," says Dharma Richards, who went through Yoga Warriors training and is certified to teach combat veterans with post-traumatic stress disorder and other issues. She runs an Apex studio, Yoga Garden, with her husband, a former Marine.
Ann-Marie Kennedy, a fine arts instructor at Wake Tech, hosted a nationally touring workshop last fall called Combat Paper Project.
The workshop guided veterans through a four-day process of turning old military uniforms into paper, which they used to create works of art. About 20 people participated.
Kennedy, who was drawn to the project because of her interest in paper-making, found it created more than artwork.
"There was a sense of community that came out of it," she says.
"I have a lot of veterans in my classes. They're so young, and they have already been through multiple deployments. You might be surprised to learn that this person who is 22 has been in combat and has been through all sorts of stuff but doesn't really talk about it in class.
"A community college is not necessarily a great place to connect with other people. A lot of people commute in, they have busy schedules, they're managing family and jobs and full-time school.
"A lot of times people don't have a way of just connecting with other people who have similar experiences.
"The workshop allowed for that."
Kennedy hopes to arrange a follow-up event such as an exhibit of veterans' artwork, or a time when vets could use the school's studios.
Dana Lapple didn't know much about veterans' issues when she decided to launch a local chapter of Team River Runner last year. The University of North Carolina-Chapel Hill grad student and lab tech is an avid kayaker. When she heard injured veterans elsewhere were getting into kayaking, she knew it could be done in North Carolina, which has deep military roots and plenty of fast water.
She has four or five students, who heard about the program through the Durham VA. They learn the fundamentals in the warm pool at Gypsy Divers, after the facility has closed at night. Lapple has about 20 volunteers who can coach novices on how to maneuver into and out of their kayaks, proper safety techniques and the nuances of paddling and rolling.
With discounts from national retailers, Team River Runner can fully outfit a paddler with a kayak, safety vest and other gear for about $700. The group needs more money to take on additional students and pay for river-running trips to the mountains of North Carolina and beyond.
Tony Gonzalez can't wait for warm weather, so he can try his new kayaking skills on a river.
Gonzalez is a former supply specialist for the 82nd Airborne who spent six months in Afghanistan in 2003 at a base that was under nearly constant rocket barrage. He wasn't physically injured, but three years after he got out of the Army, his family was still telling him he had changed.
"I was very explosive, when I used to be the peacemaker, and now it seems like I'm always looking for an excuse" to get in a fight, he said. It had gotten so he was afraid to leave the house.
"I don't want to get in trouble," he says. "I don't want to be out there screaming at people."
He started kayaking in September. "Doing this," he says, "I'm calm."
Gonzalez thinks kayaking helps because it combines solo and team elements, and because it provides an adrenaline rush in a relatively safe setting. The veterans talk with one another, and they learn to trust the volunteers, most of whom have never been in the military.
"I don't think I'll ever put it behind me," Gonzalez says of his combat experience. "But maybe I can turn it into a lesson."