Specalist Joe Paulks NY Times Video
Joey Paulk, center, was badly burned when his Humvee struck a buried mine that ignited the fuel tank.
Specialist Joey Paulk awoke from a coma in a Texas hospital three weeks after he was burned nearly to death in Afghanistan Wrapped in bandages from head almost to toe, he immediately saw his girlfriend and mother, and felt comforted. Then he glanced at his hands, two balls of white gauze, and realized that he had no fingers.
So it began: the shock of recognition. Next came what burn doctors call “the mirror test.” As he was shuffling through a hallway at Brooke Army Medical Center in San Antonio, he passed a large mirror that he had turned away from before. This time he steeled himself and looked.
His swollen lower lip hung below his gums. His left lower eyelid drooped hound dog-like, revealing a scarlet crescent of raw tissue. His nostrils were squeezed shut, his chin had virtually disappeared and the top half of one ear was gone. Skin grafts crisscrossed his face like lines on a map, and silver medicine coated his scars, making him look like something out of a Terminator film.
“This is who I am now,” he told himself.
After nearly 30 operations, Joey Paulk began to resign himself to his appearance, but surgery through a program at U.C.L.A. Medical Center helped restore a measure of self-confidence. Here, he is being examined after a chin implant.
Mr. Paulk, though, has come close. After leaving Texas, and the Army, in 2009, his mouth and eye still deformed, he returned home to California and became something of a recluse, hiding beneath hooded sweatshirts, baseball caps and dark glasses when he went out, if he went out at all.
But he found his way to a program at U.C.L.A. Medical Center called Operation Mend that provides cosmetic surgery for severely burned veterans at no cost — and the operations fundamentally realigned his face, restoring not just the semblance of his former visage, but also a healthy chunk of his self-confidence.
He is venturing out again, to bars, beaches and ball games. On Veterans Day last year, Mr. Paulk, 26, rode in the lead car of the New York City parade, his head bared for tens of thousands to see.
“The burns on a soldier’s face are huge: It’s your military uniform and you can’t take it off,” he said. “The surgery changed so much on my face that it completely changed my whole outlook on life.”
Getting help from his roommate, Devon Hodgen, before a wedding.
But it was not to be. By the time he awoke in San Antonio from a medically induced coma, he had already undergone numerous operations and skin grafts to patch his charred face, arms and legs. With his mother’s permission, a surgeon had removed all his fingers, which had been burned black and to the bone and were all but certain to become infected. He had lost 50 pounds in barely four weeks.
Over many months, his body accepted the vast majority of his skin grafts and he regained strength. But the one attempt by a surgeon to replace scar tissue on his face had failed, Mr. Paulk felt. After nearly 30 operations in 18 months, he began to resign himself to his appearance, and prepared to return to Vista, suffering from what his doctors called “surgery fatigue.”
The program had its origins in late 2006 when a wealthy philanthropist, Ronald A. Katz, was watching a Lou Dobbs interview with a badly burned Marine named Aaron Mankin. Charmed by the Marine but appalled at the extent of his wounds, Mr. Katz’s late wife, Maddie, poked him in the ribs and practically issued an order: “You have to do something!”
The military already had a state-of-the-art burn center at Brooke. But while the center offered reconstructive surgery, its focus was on saving lives and getting the wounded back on their feet. The Department of Veterans Affairs did not provide reconstructive surgery unless it was deemed medically necessary to restore, promote or preserve health — criteria that did not seem to include making someone look better.
Mr. Paulk remained a tough sell. But the smaller indignities of his injuries made him relent when an Operation Mend representative called again. He could not open his mouth wide enough to eat a hamburger. Could Dr. Miller fix that? And what about his misshapen lips, which made it impossible for him to pronounce his own name? Dr. Miller pledged to have Mr. Paulk whistling and eating double cheeseburgers again.
With the first surgery, Dr. Miller removed scar tissue, raising the eye lid and lower lip. With second and third operations, he improved the alignment of Mr. Paulk’s eyes and lips by replacing scars with healthy tissue. A fourth surgery implanted silicone to add definition to his chin.
At a recent checkup in Dr. Miller’s office, Mr. Paulk admired his new profile in the mirror. “From a distance, you can’t tell I was injured,” he said.
There are still uncomfortable moments. Some drunks taunted him about his looks at a baseball game, nearly starting a brawl. And Mr. Paulk admits to moments of self-consciousness about his hands. When, for instance, a little girl gawked at him at U.C.L.A. recently, he reflexively tucked his palms under his armpits.
But he has also learned how to function: to put on socks, pull up zippers and tie shoes. He can send texts and drive. He can’t play his beloved baseball, and video games remain a challenge, but he manages to catch a football and spike a volleyball with his palms.
“Sometimes I’ll hold my cup against my body so I can talk with my hands, and I’ll maneuver and pick it up and everyone thinks it’s so intriguing,” he said. “But I’m just doing what I’m doing to survive.”
NY Times
