WASHINGTON — For months, Spc. Rory Dunn lay in Bed 32, Ward 58, on the fifth floor of Walter Reed Army Medical Center, recovering after a roadside bomb in Iraq exploded and crushed his forehead from ear to ear.
As he lay in the neuroscience unit struggling to recover from one of the worst traumatic brain injuries doctors had seen, he vowed that he'd never come back to Walter Reed.
Last week, he did.
Dunn wanted to thank the doctors, surgeons, nurses, therapists and others who'd helped him survive after most thought he'd surely die.
"This guy here is a miracle," said Solomon Montgomery, a former professional football player turned physical therapist, as he enveloped Dunn in a hug.
"Dude, you look good," said Dr. Stephen Rouse, who restored Dunn's skull using a plastic insert designed by a 3-D computer program.
Since he left the hospital in 2005, Dunn has rebuilt his life. He's living with his dog, Duke, in a condo he bought in Renton, Wash.
His wounds have healed, but scars remain. He wears an eye patch to cover the socket that was left empty when one of his eyes was blown out. He has a hearing aid in one ear and is profoundly deaf in the other. He has no sense of smell. He still has pieces of shrapnel in his brain. Every night, he checks to make sure that the windows and doors in his condo are locked. His mom said he still felt as if he had a bull's-eye on his back.
At times he seems restless, easily frustrated, quick-tempered. But underneath is a 25-year-old who's overcome a terrible ordeal with his sense of humor and gentleness intact.
"I'm trying to lead a normal life," he said.
As he does, some of the bitterness lingers from the nearly yearlong battle that he and his mother, Cynthia Lefever, fought with the Army, which sought to discharge him before he'd received "optimum treatment," the Army's definition of what it must do before a wounded soldier can be discharged.
McClatchy chronicled Dunn's struggles in a July 2005 article.
Despite the Army's promises that it would take better care of its wounded warriors, Dunn remains unconvinced.
"I have a hard time believing things have changed too much," said Dunn, who talked with other wounded soldiers in the corridors of Walter Reed and attended veterans meetings with his mother.
Standing outside Ward 58 and walking the halls of Walter Reed, Dunn carried a scrapbook of his life, from growing up in a Seattle suburb to his days in Iraq to his recovery.
"Rory, Rory Dunn. Oh, baby," Linda Starks, a nurse's assistant who was his favorite as he lay in Bed 32, said as she hugged him with a huge smile and misting eyes.
Rouse still has the mold of Dunn's skull that he used to design the cranial implant. Instead of plastic inserts, surgeons now are experimenting with titanium mesh, he said.
Montgomery, the physical therapist, invited Dunn to his wedding next year in Las Vegas.
Wounded soldiers were wheeled by, some with wounds as severe as Dunn's.
"Some of them feel ashamed. They think they are different," Dunn said. "I hate that. It's a shame. They should be proud."
After two highly critical reports on the Army's medical system, changes have been made. Medical hold units, where soldiers often languished as their futures were determined, have been disbanded. They've been replaced with "warrior transition" units, which provide more assistance to the wounded and their families. The Army also is working more closely with the Department of Veterans Affairs to ease the transition from one medical system to another.
When it comes to traumatic brain injuries, the Army is doing more screening especially to detect mild cases.
"We are making continual improvements," said Col. Robert Labutta, a traumatic brain-injury consultant in the office of the Army's surgeon general. "Any system or process can be improved, but I think we have made a lot of progress."
The Army estimates that 10 percent to 20 percent of the soldiers returning from Iraq and Afghanistan have at least a mild form of traumatic brain injury, though other estimates vary considerably. Traumatic brain injury is a physical injury to the brain — not a mental condition — due to blasts from exploding rocket-propelled grenades, land mines or improvised explosive devices.
It's become the signature wound of the conflicts in Iraq and Afghanistan. In mild cases it's like a concussion. Symptoms can include memory loss, trouble sleeping, depression, irritability, blurred vision and lack of concentration. In severe cases, the symptoms are like Dunn's.
"There is a much better awareness of TBI throughout the Army," said Labutta, and soldiers now are being evaluated and treated in the battle zone.
Dunn's mother, who's become an advocate for wounded veterans, said it was hard to tell whether things had improved.
"We can't say for sure what changes have been made," she said. "But in talking with soldiers we are hearing the same stories."
Lefever said that she and her son had met a young woman at Walter Reed whose husband was wounded in Iraq just before Christmas and was now a triple amputee.
"She was there with her baby," Lefever said. "She was numb. She didn't know what to do."
"You only have four limbs," Dunn said. "Can you imagine waking up and having only one? These soldiers and their families should be treated with the utmost respect."
Dunn remembers a bright flash and his Humvee shaking as a bomb hanging from a tree alongside a road near Fallujah detonated in May 2004. Five weeks later he awoke from a coma in Ward 58. Then began 10 months of often-agonizing recovery from his wounds.
Along the way, Dunn and his mother grew close to Washington Sen. Patty Murray, a senior Democrat on the Senate Veterans Affairs Committee. Murray has been a leading critic of the care that wounded veterans have received.
Murray cleared a busy schedule last week to meet with Dunn and Lefever for nearly 45 minutes. She later said that Dunn had been her inspiration as she pressed the Pentagon and Veterans Affairs to do more for the wounded.
Dunn and his mom told Murray that the Army and the VA need to start supplying wounded vets with medical alert tags. Because of the shrapnel in his head, Dunn can't have an MRI, for example. It would kill him.
Police, medical emergency personnel and other first responders also need to be better trained so they don't mistake a person who has a traumatic brain injury or post-traumatic stress disorder for an unsteady drunk or a violent criminal, they said.