By all odds, Jose Pequeno's family should have buried him 11 months ago.
The 32-year-old military police officer from Sugar Hill, N.H., was manning an Iraqi checkpoint on March 1 when someone tossed a hand grenade into his Humvee. The blast blew Pequeno through the door.
Today, he sits in a wheelchair, his eyes moving when he hears a familiar voice. He utters sounds that convey frustration, or anger.
There is a crater where the left half of his brain used to be.
Pequeno's doctors have some small hope he will improve when his skull is rebuilt and his brain is given a chance to expand.
"I look at him sometimes and wonder what he's thinking, if he can think," says his mother, Nelida Bagley.
That Pequeno made it this far is due to the quality of battlefield medicine, the speed with which he was evacuated to Germany, and the care he got at military hospitals in Washington.
How far he progresses now depends on the staff of the Polytrauma Rehabilitation Center at the James A. Haley Veterans Hospital here. He has access to as many as 12 specialists in medicine and pain management and 10 people specializing in occupational, physical, vocational and speech therapy.
The center is one of four mandated by Congress in 2004 to deal with the horrific multiple injuries of modern warfare, particularly those caused by blasts that hurl shrapnel, shatter bone and shred limbs. This is where the most grievously injured in Iraq and Afghanistan start their long journey home.
Twelve patients are in the unit now, all changed for life. Most are linked by a stunning resilience and determination to prove they haven't been defeated.
'Why not me?'
They call Pete Herrick the "Poster Child."
It's all about attitude.
Herrick sits in a mechanized wheelchair, his left leg gone above the knee. But that hardly matters since Herrick is a quadriplegic with only limited movement of his head.
In May 2004, a mortar round exploded in a group of 43 men, including Herrick, who were on patrol in Ramadi. Thirty-three were injured, and five died.
"My best friend was killed," Herrick said. "He was standing right next to me."
A piece of shrapnel pierced Herrick's neck and lodged in his spine. Three years later he is still in rehab, learning to deal with a future in a wheelchair after a career as a custom woodworker for an upscale home builder in Gainesville.
Herrick, 39, has learned how to move the chair by blowing into a tube, how to manipulate parts of the chair to change position, how to use lifts and deal with a world filled with obstacles.
He can operate a computer by using an infrared dot stuck to his nose. And he has Diana, his wife of 22 years.
"He's the same person he was before," Diana says. "We still laugh every day. He's still my best friend. The changes are all physical. He's still the same old Pete."
There seems to be no bitterness.
"Why not me?" Herrick says. "I've never had the outlook that this isn't fair. It just happened. Somebody got off a lucky shot. Some people win the lottery; some people wind up in wheelchairs. The odds are about the same."
'We can't back out'
Thomas Deierlein thought he had moved beyond the military.
Deierlein graduated from West Point in 1989 and became an Airborne Ranger. He left active duty in 1993 to become chief operating officer of an advertising research company in New York.
He was called back from reserve status 12 years later, in 2005. A few days before he reported, he was told it was a mistake, that his military obligation was over. He went anyway.
"I volunteered for Desert Storm, but I didn't go," Deierlein said. "Maybe if I had already seen combat I would have felt differently."
The Army made him a civil affairs officer and sent him to Sadr City, the most impoverished and dangerous slum in Baghdad.
Deierlein worked with local officials to provide essential services: water, sewer, trash pickup.
On Sept. 9, he got a call that a sniper was shooting at one of his contractors. He went to the scene, and the sniper got him. The bullet entered his left hip, shattering his pelvis and the base of his spine.
Deierlein, 39, lost so much blood he nearly died on the spot. For three months he lay immobile. The man who had weighed 185, who had eaten up marathons in six-minute miles, who could do 86 situps in two minutes, disappeared.
Deierlein lost 25 pounds, 80 percent of his leg strength and 70 percent of his upper body strength. His buttock muscles shrank, so while he can stand or lie down, sitting causes excruciating pain. Only now is he learning to walk again.
What he didn't lose is his "nearly dysfunctional competitiveness." In the gym, it leads to a recurring contest with another patient and a therapist to see who can be the first to name the artists on old rock music piped into the gym.
"Journey!" Deierlein shouts after just two chords of one cut, and the fiery look in his eyes says it really isn't a game with him.
"You're right," he says. "There is nothing even remotely like a quiet game of Pictionary or Monopoly at my house. ... Eurythmics! Yeah! Two for me. And that would be none for you."
Deierlein created a foundation last year to collect money to buy vitamins, school supplies and clothes for Sadr City children. In November, he sent $22,000.
"I can't get angry over this," he says, nodding toward his legs. "You can't second-guess the choices you've made because you can't make them again. I knew the situation. I was out there in wartime in a dangerous place doing very dangerous things.
"But I do get upset at suggestions that we back out and let them fight it out. The kids are suffering so much. It would just get worse for them."
A song ends and another begins. Deierlein's head snaps toward the sound:
Bringing them back
Nearly 3,500 U.S. service personnel have died and 25,000 have been wounded in Iraq and Afghanistan. Nearly two-thirds of wounded suffered blast injuries from mortars, rockets, artillery, grenades and roadside bombs. Nearly half of all blast injuries include brain trauma. They also include spinal cord injuries, open wounds, torn nerves, crushed joints and shattered bone.
Bringing people back as far as possible is the mission of the VA's four polytrauma units in Tampa, Richmond, Va., Minneapolis and Palo Alto, Calif.
"The severity of the injuries in this war is much greater, but there have been so many improvements in battlefield medicine that many are being kept alive who otherwise wouldn't have made it back," said Dr. Steven Scott, chief of physical medicine and rehabilitation at Haley and director of the polytrauma unit. "It makes rehab far more difficult and complex and much longer."
The wounded are not the only victims.
"One of the things that's hardest for a family is understanding that the patient might not be the same person he was before," Scott said. "Each disability has unique characteristics that might change behavior, change the way the patient thinks, even change who he is. In some respects, it's easier for the patient because he doesn't realize what's happening."
Scott knows better than to expect miracles.
"I tell each patient to close his eyes and tell me what his dream is," he said. "For you or me it might be to be rich, or famous or successful. The patients dream smaller: controlling the bladder, moving a hand. My job is to make those dreams come true."
'I want my son back'
Nelida Bagley, Jose Pequeno's mom, remembers it as the longest six hours of her life.
"I had just gotten home from work when the call came from Iraq," she recalls of March 1. "They told me my son was in surgery, that he had been injured. Part of me died right there, and it will never come back."
Nelida, 55, didn't hear for six more hours that her son survived. She would learn later that he lost nearly half his brain to a hand grenade thrown into his Humvee, that the man sitting next to him had died.
Eleven months later, Pequeno cannot speak or walk. No one is sure how much he understands of what goes on around him.
His wife and two children are at home in Sugar Hill, where Pequeno was police chief before he went to Iraq. Nelida won't talk about her daughter-in-law or her grandchildren.
"Everyone deals with things in their own way," she says.
She has given up her job and her home in North Woodstock, N.H., to be at her son's side. She has gone through her savings. And Pequeno's sister, Elizabeth, has abandoned her life for him.
"He is my big brother, my father figure, my protector," said Elizabeth, 22, as she rubbed Jose's chest playfully. "He took care of me my whole life. Now I figure it's time for me to take care of him."
Before Iraq, Pequeno ran five miles a day. He hunted, fished and loved motorcycles and snowmobiles. Sugar Hill officials have named an acting police chief but say they won't replace Pequeno as long as he lives. They continue to pay part of his salary.
Nelida doubts she could have survived this ordeal without Haley's polytrauma unit. A nearby Clarion Hotel has a section called Haley House, which the VA pays for and where family members of polytrauma patients can stay for free.
Mostly, Nelida and Elizabeth stay in Jose's hospital room, sleeping in recliners. They have decorated a wall with photos of Jose's life. And Nelida regularly attends a support group established by the hospital specifically for the families of wounded.
"People tell me they know what I'm going through," Nelida said. "But they don't know. They have no idea. I can't go to my daughter. I'm hurting, but I can't lay all that on her. I need somebody to talk to, somebody else who's going through this, too. The group gives me that."
Haley officials pushed Nelida to become a volunteer, and she puts out a newsletter for families like hers. They gave Elizabeth a paying job as an assistant in the nursing recruitment office.
"It's personal here," Nelida said. "Not a hospital. More like home."
She begins to sob softly. She has become practiced in crying without letting it interrupt the flow of her thoughts.
"I want my son back," she says. "I know he will never be the way he was before. But I want to help him back as far as I can. I brought him into this world, and I'm not going to give him up without a fight."
A newsman's story
Thirteen months ago, ABC News co-anchor Bob Woodruff and producer Doug Vogt were seriously injured by a bomb that exploded under their vehicle in Taji, Iraq.
Woodruff suffered head and body injuries and lost part of the left side of his skull. It has since been replaced with an acrylic implant.
He will tell his story in an ABC special report called To Iraq and Back, scheduled to air Tuesday at 10 p.m.