It's the weekly Tuesday meeting in the amputee center at Brooke Army Medical Center (BAMC) at Fort Sam Houston, Texas, and servicemen and -women barely out of their teens stream in, many on prosthetic legs, some in wheelchairs. Daniel Blasini, RN case manager, leans against a pool table in the middle of the crowded room and announces the latest Veterans Affairs news and upcoming activities.
The older "amps" tease and heckle Blasini until he erupts in laughter. The newly wounded ones are quiet, their faces pale and anxious, and Blasini spends a few minutes with each of them after the loose, lively meeting.
Blasini, a fireplug of a man with a soothing voice, helps those who've survived combat wounds to succeed in the rest of their lives. He relies on humor and an easygoing, personal approach as much as high-tech prosthetics and medical care. "They're my patients, but I also look at nurturing, guiding, and mentoring them," Blasini says. "Their foundation has been wiped out. We plan their care around whatever their goal is, whether it's getting married or going back to school."
The need for his position at BAMC was created by the war in Iraq and its legacy of damage wrought by improvised explosive devices that blow off limbs and broil skin. The job is tailor made for him because he served in the army, and his nursing experience includes rehabilitation, orthopedics, wound care, and psychiatric disciplines.
"I was working under Global War on Terrorism funds, hired as a contractor as case manager for soldiers, marines, and sailors who were injured," says Blasini, age 38. "Then Brooke had an influx of amputees and wanted me to do just amputee care. It's unique all around - not a lot of people know much about amputees, their medications, pain meds, psych meds, infections, weight gain and loss."
BAMC opened an amputee center last January and will become the military's premier facility for amputees next year when a new state-of-the-art out-patient center opens.
Blasini is usually found in the amputee center's rehab room, where rock music plays in the background and the young patients come and go, high-fiving each other on their way to the weightlifting machines or occupational therapy. They're all wearing shorts and T-shirts, their prosthetic arms and "c-legs" (computerized legs) exposed, although some have U.S. flags or tropical prints covering their stumps.
He says humor helps to get the maimed young men and women through some of the stages of loss and grieving.
"When they start to have their humor back, that's when I know they're getting better," he says.
The patients he sees rarely have just one injury. If they are not double amputees, they are missing a limb, hand, or foot and have either nerve damage to other parts of the body or severe burn wounds. They arrive at BAMC usually within a week of being wounded and after having received excellent care in the "golden hour." The battlefield survival rate has increased from 76% in the Vietnam War to 91% in the Iraq War, according to army medical officials.
"Even if they're in the ICU, I'll go there and start working on their future," Blasini says. "Where they want to be in 30 days, six months, a year and a half. If they can talk, I ask what their goals are."
He finds out what he calls "the missed dream"-what they thought about while they were in Iraq and wanted to do most when they got home.
"When we find out what that is, we bring the whole team on-doctors, wound specialists, orthopedic specialists, prosthetists, psychiatrists, and counselors-and that dream is at the core of care. It is the great motivator," he says.
Born and raised in Cleveland, Blasini attended Columbus State College for a year before joining the Ohio National Guard. He served eight years of active duty in the army at Fort Hood, Texas; Fort Devens, Massachusetts; in Turkey; at the National Security Agency in Fort Meade, Maryland; and at the Pentagon.
"I wanted to get into something where I'd never be bored," Blasini says. "Medicine is always changing, evolving. Now, I'm tired but never bored."
He received an associate's degree from San Antonio College and his bachelor's degree from the University of the Incarnate Word in San Antonio. Blasini and his wife, Sandra, have two children, 9-year-old Isabella and 5-year-old Dominick. After his workday at BAMC, he runs a pizza parlor in San Antonio. His cappuccino addiction helps him manage the long hours. He often goes out with some of the patients for dinner or a beer. Sometimes they go to his restaurant and he dons a chef's hat and apron and cooks up lasagna.
The Center for the Intrepid, a privately funded $40 million outpatient rehab center, will open at BAMC this year to handle all military amputee patients.
"We have to have it because of the need, that's the bitter part," Blasini says. "The good thing is it brings a lot of people together. It motivates people and brings out a higher level of personal care for the patient."
But seeing his young patients thrive outside the hospital is what drives him most.
Last summer Blasini accompanied some amputees on Soldier Ride, a cross-country bicycle trip to raise funds for the Wounded Warrior Project-devoted to raising public awareness about severely wounded soldiers-when the ride passed through his hometown of Cleveland. And he is planning a deep-sea fishing trip for his patients.
"I want to get them out on the ocean to work on their balance and strength, and give them an experience they may have never had," he says. "It's about showing them they can do anything."