Healing The Most Deeply Scarred

Tomorrow is Memorial Day, the day we honor all the servicemen and women who have lost their lives in the service of their country. Thanks to modern medicine, and the skill of dedicated surgeons, American warriors have a greater chance than ever of surviving the most horrible of battle wounds. Even the most deeply scarred are on the mend, as David Martin reports in our Cover Story:

At age 23, Joey Paulk is still recovering from wounds suffered nearly two years ago in Afghanistan. He was in a Humvee hit by a triple-stacked anti-tank mine.

"It hit our fuel tank," Paulk told Martin.

"So, you burst into flame?"

"Yeah."

His face has been through hell.

Dr. Timothy Miller, the head of reconstructive surgery at UCLA, is inspecting the results of his first attempt to repair Joey's face.

"Well, for our first shot I think we did pretty good," he said.

Dr. Miller expressed delight that Paulk could close his mouth when asked: "That's amazing!"

Until now Joey's features had been so distorted by fire he couldn't close his mouth or his eyes.

Now one of this country's top plastic surgeons, Miller first saw the wounds of war as a young doctor in a MASH unit in Vietnam. The wounds he sees from roadside bombs in Iraq and Afghanistan, he says, are worse.

"Do they produce a particular kind of disfigurement?" Martin asked.

"Absolutely," Dr. Miller said. "The roadside bomb is an incredibly destructive. It's got a blast. It's got unbelievable heat. So the depth of the burn is usually very, very significant."

So significant that Joey spent 17 months at Brooke Army Medical Center in San Antonio, considered the best burn unit in the world. But it was philanthropist Ronald Katz who came up with the idea and the money to get disfigured soldiers into the expert hands of Dr. Miller.

"A bad burn is about as severe an injury and as painful an experience over a long period of time that you can imagine," Dr. Miller said.

How much Miller can do to give Joey back his looks depends a lot on how much unburned skin he can find to repair the scarring. This is not nip-and-tuck plastic surgery; Dr. Miller's inspiration comes from an inscription he found on a 16th century Italian cathedral: it is the divine right of man to appear human.

Paulk "feels great," he told Martin. "Yeah, I'm less, less embarrassed walking around. I used to always wear my sunglasses, even at night, to try to cover my eyes."

"You didn't like all the stares you were getting?"

"Yeah, it kind of bugged me."

The UCLA program is called Operation Mend, but that little word doesn't begin to capture what's happening here - and the real work isn't limited to the face.

"You got your hands messed up real bad, too. I guess there's not much they can do for that?" Martin asked.

"I can do basically everything I can when I had fingers," Paulk replied.

He lives pretty much like any other twenty-something, and he doesn't need his finger to cream his father in ping pong.

At Joey's house he lives with his girl friend, Sarah, who was his high school sweetheart and has stuck with him.

"You find out who the real you is when the external you gets messed up," Martin said.

"Oh, definitely, yeah. Definitely," Paulk said.

"And I guess you find out if your girlfriend really likes you."

"Oh yeah, definitely!" he laughed.

So far Operation Mend has spent $1.2 million treating 24 patients, and according to UCLA, federal health care only covers about a third of the cost for the state-of-the-art surgery these burns require.

"There must be hundreds of young men and women who have been burned and disfigured by roadside bombs," Martin said.

"We're trying to get the word out," Dr. Miller said.

Octavio Sanchez is one of more than 800 service men and women who have been through the burn center at Brooke, and one of the lucky two dozen to end up at UCLA. Today he can walk done the street with his wife Vanette, holding his youngest son, and just be one of the neighbors.

His Humvee was hit by a string of three roadside bombs in Iraq.

"When I came out of the vehicle, I was engulfed in flames," Sanchez told Martin. "They ran up and put me out with a fire extinguisher."

In the space of a few brief moments, he went from handsome to disfigured. He had third-degree burns over 70 percent of his body.

Sanchez said his wife was distraught. His children could barely recognize him.

"When I went out to Iraq I was a good 206 pounds, you know, a healthy man," he told Martin. "And when my children saw me, I was just about a buck thirty-five, I looked totally different. My oldest son said, 'The only reason I recognize you, Dad, was because of your tattoo.' And my other boy, he, he couldn't believe it. He said that it wasn't his dad."

His children - Jacob, Octavio, Jaslyn and Ryan (who wasn't born yet when his father was wounded) - all seem totally oblivious to their father's wounds now. But there was a time when it hurt to be seen with him in public.

"My oldest boy Jacob, he would get upset, you know, and that's when it started getting me upset, when he would get upset," Sanchez said. "One day we were at the mall and when we were walking out he brought it up to my attention. He was in tears, he was angry. He said he wanted to beat them up, you know? That's when I knew I was gonna be later on down the road looking for somebody to reconstruct my nose."

After meeting Dr. Miller, Sanchez underwent surgery to recreate his nose. "My forehead was one of the areas that didn't get burned, and it just so happened that it, it ended up harvesting my nose," Sanchez said.

Dr. Miller took some cartilage from Sanchez's rib, which he describes as "not fun at all."

"That's not the nose that God gave you?" Martin said.

"It's not. It's not the nose that God gave me. It's the second nose God gave me."

"What did Vanette think as this new nose was growing?"

"She said it was kind of big, you know?" Sanchez laughed. "But it started kinda forming, you know, and started getting a little bit smaller."

"It goes with your face," Martin said.

"Yeah."

"It doesn't look like somebody else's nose."

"Right."

Sanchez lost his right hand but kept his left even though it is barely functional, just so he could feel his children's faces. He still attracts the occasional stare, but Dr. Miller has given him back his divine right to appear human.

If you were to stare at the Sanchez family today, you'd wouldn't say, "Ooh, what happened to him?" You'd say, "My, what a beautiful family."
"I'm just blessed, you know, to be here, you know, to be alive, and watch my kids grow, spend time with my wife, family."

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