Bryant Jacobs stands with his cane
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The

Last Leg

A life with new limits

Bryant Jacobs expects to soar.

A year after arriving at Walter Reed Army Medical Center, he's still fighting pain and immobility. His legs don't work as they once did and never will.

But he's also come so far. At first he wasn't expected to live; later there were doubts that he'd walk. Now nothing seems impossible.

So, in February 2006, as the Winter Olympic torch is being lighted in Torino, Italy, Jacobs signs on for one of many adventures aimed at helping wounded warriors live fuller lives — a New York snowboarding trip.

He envisions himself cutting back and forth across the slopes, as he did so effortlessly in the canyons near his Utah home.

But that's not how it goes.

When Jacobs falls, he can't even lift himself off the snow.

"I had to have my instructor help me up — and then I'd fall again," he says. "I had been snowboarding for seven or eight years. I was used to being able to go to the top of the mountain, and now I could barely even get off the lift."

When he painfully hyperextends a foot, his instructor gives him a choice: Get down on your own or have ski patrol come get you. Jacobs can't stand, but he can't bear the idea of having to be carried off the mountain. Embarrassed, angry and disappointed, he scoots the rest of the way down on his board like a sled.

The trip is one of many reality checks that will mark the rest of his time at Walter Reed and beyond.

He has graduated from a wheelchair, and then from a walker — but he might always need a cane. The nerve damage in his legs has resulted in a condition called "drop foot," so he'll likely always walk with a limp and a slight dragging of his feet, too.

The damaged nerves around and below his right knee, hypersensitive since the blast, sometimes respond with excruciating jolts to the gentlest of touches. Even pulling on a sock can send shock waves coursing through his leg.

But at least he has his leg.

Three times a week, the medical evacuation flights from Iraq and Afghanistan arrive at nearby Andrews Air Force Base. In each plane, on average, is one person who has already lost an arm or leg or is about to.

"Be grateful," Jacobs tells himself. "It could have been so much worse."

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His family and doctors made the choice while he was still living under a haze of heavy sedation: His right leg would be rehabilitated, rather than removed — a process doctors call "salvage."

In the nearly two years that follow, no one has spoken to Jacobs about amputation — until he is about to be discharged from Walter Reed and relieved of his service to the United States Army.

"Why don't you just cut it off?" a therapist casually asks.

It's a question that, once a limb had been saved, would rarely have been asked in the past.

For hundreds of years, doctors viewed amputation as a desperate last resort. Today, with advances in battlefield medicine — and, in particular, the ability to get soldiers to combat hospitals quickly after injury — many limbs that would have been removed in past wars are being saved.

But that triumph has come at the same time as a revolution in medicine and public perception about amputees.

"The fastest man on no legs," South African sprinter Oscar Pistorius is vying to compete in the 2008 Summer Olympics in Beijing, prompting some to ask if his carbon fiber running blades give him an advantage over able-bodied athletes.

Army Capt. David Rozelle, who lost his right foot in a mine explosion in Iraq in the summer of 2003, has become the first amputee in modern history to return to combat. In the years to come, more than 60 others will follow in his footsteps.

"It used to be that society often looked at amputees with pity," says Joseph Webster, the director of the Veterans Affairs Amputation System of Care. "That's shifted, certainly to a large extent, to admiration."

And sometimes a bit of envy. Increasingly, Jacobs' appreciation for his legs is tempered by his desire to be as active as many of the people he sees on prosthetics.

But 22 months of Walter Reed's frustrating mix of medicine and military regulation have taken their toll. His discharge date has already been pushed back several times. It literally takes an act of Congress — an infuriated intervention by Rep. Jim Matheson — for Jacobs to be released to attend his sister's wedding.

"I just want to get home," Jacobs tells the therapist. 'But I'll think about it."


Photo above: Bryant Jacobs skis with an instructor at the Vail Veteran's Program during a trip at the end of January in 2010. Jacobs had been an avid snowboarder before being injured in an IED explosion while serving in Iraq. He hopes that having his more severely injured leg amputated will give him the opportunity to snowboard again. Courtesy of Bryant Jacobs.

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Jacobs returns to the Salt Lake Valley in the fall of 2006 and enrolls at the University of Utah the next year. Between classes, he parties.

He dates; he drinks; he gambles in Las Vegas and Nevada's smaller and closer border casino towns.

A veteran's disability check is no fortune, but as a single guy with no kids and no debt, Jacobs has no trouble affording his lifestyle.

Fully disabled veterans receive about what a starting teacher might expect to make. The money is tax-free, and Jacobs pays no tuition for college. His medical care is covered by the government.

"I feel like I'm making up for lost time," he says. "Everybody else was spending their early 20s partying, and I was spending mine in the hospital."

At Walter Reed, he was visited by Adam Sandler, Shaquille O'Neal, Dan Marino, the cast of "The Sopranos," a parade of politicians and two groups of NFL cheerleaders — the latter visits ranking among his favorites. He learned to golf from a wheelchair. He was flown to Chicago for a White Sox game.

There are fewer such experiences in Utah. But in a nation still struggling with how it cared for veterans of past wars — perceived mistakes some have vowed to right — there are still plenty of invitations.

He goes elk hunting and deep-sea fishing. He's a guest of honor at the Army-Navy football game. And, in the spring of 2007, he resolves again to master a mountain — on skis and adaptive poles mounted with ski blades — at the National Disabled Veterans Winter Sports Clinic in Colorado.

And this time it's more like he hopes.

"The outriggers just take some of the weight off my leg, so I can keep stable," he says after returning to Utah. "My preference would still be to be on a snowboard. But for now this is OK."

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They sit together, as new dates do, joking, laughing and moving closer as the night goes on.

Introduced through friends, Michele Clark Rogers at first thought Jacobs was a cocky party boy, arrogant and rude. The divorced mother of two young daughters didn't need someone like that.

But then she saw his dedication to his family and theirs to him. She saw his loyalty to his friends. She learned his story.

She reaches down and playfully squeezes his thigh.

"No!" Jacobs screams, jumping from his chair, backing away. "You can't do that! Don't you know you can't do that?"

For a moment it seems as though the entire restaurant stops.

He'll forget this ever happened. For her it will become a crystal-clear memory — one of the moments when she had to decide whether to take on the physical and emotional challenges of being his partner.

Yes, she decides, he's worth trying for.

Slowly she begins to trust him. Slowly, she starts to love him. When he asks her to marry him, she will say yes.


Photo above: Bryant Jacobs' wife Michele reflects on a long day as Jacobs sits on his couch and recovers after an exhausting horseshoe tournament at Scott Generazo's home in Herriman.

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New homes in The Cove, an upscale hillside subdivision in the southwest Salt Lake suburb of Herriman, are going for $350,000.

Jacobs won't pay a dime. Early in 2009, a national nonprofit, Homes for Our Troops, gives him and another wounded Utah veteran, Travis Wood, the keys to new homes designed to accommodate their disabilities.

The two veterans become instant friends, marveling at their fortune and confiding in one another about the tension they feel, having received so much when others didn't come home at all.

More than 4,000 U.S. service members have died in the ongoing wars.

Newly elected President Barack Obama has ordered the withdrawal of troops from Iraq — and has made clear his intention to draw down forces in Afghanistan. Critics say the move will leave those countries less stable; they question whether the lives lost and wounds suffered will be in vain.

Like Jacobs, Wood was wounded in a roadside bomb explosion. And like Jacobs, he fought at first to salvage his injured leg. But a year after being evacuated from Afghanistan, Wood asked his doctors to take his right foot.

In doing so, he joined a small but growing number of delayed amputees — those whose limbs are removed, usually by choice, more than three months after their injuries.

Military officials say about a fifth of all amputations are considered delayed. Like Wood, the vast majority make the decision within a year or two of their injuries.

It doesn't take long for Wood to decide that life is better on a prosthetic foot. He can move more easily and feels less pain. "If I could do anything differently at all," he says, "it would just be not to wait as long as I did." VA researchers doing clinical follow-ups for a study of 22 delayed amputees have found that's not an unusual perspective. Every single one would do it again.

Maj. Benjamin Potter, one of the authors of the study, expected he'd see high rates of satisfaction, but didn't think it would be unanimous.

Still, "amputation is not a panacea," Potter says. "It's a lot easier to take a limb off than to put one back on, so I want to make sure that patients understand that things might not work out as well as they'd like."

Jacobs is intrigued by Wood's experience.

"We talked about it quite a bit," Wood says. "I told him how it was for me — and you could see it was something he was processing."

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It's early in the winter of 2010. The snow at Solitude Mountain Resort is still a little light for most locals, but Jacobs can't wait.

He straps on his boots, snaps into his skis and glides up to an empty lift line in one of his favorite places in the world, the same canyon where he fell in love with snowboarding as a teenager.

Now 30, he'll start the day with what he expects to be an easy run using his adaptive poles, up the Moonbeam Express lift and down the Little Dollie run.

It's a beginner's route, but halfway down he has to stop to rest and readjust his boots. It's 40 degrees outside and the sun hasn't touched all of the slopes yet, but when he arrives at the base of the mountain, nearly a half-hour later, his face is dripping with sweat.

Slumping onto a bench, he loosens the buckles on his boots with a groan for each.

"What I don't understand is that I was doing this before — it was fine before," he says, remembering how the specialized poles helped him tackle much harder runs in Colorado. "Now there's just so much pain."

He bows forward and curses.

"I feel," he says, his voice almost a whisper, "like maybe I'm never going to get up there again."


Photo above: Another veteran talks with Bryant Jacobs during an elevator ride as Jacobs visits the VA to get a physical therapy assessment, Wednesday, March 26, 2014.

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It doesn't happen in a moment, or even a series of moments. The conviction just grows over time.

His mobility has plateaued — and at times it appears to be getting worse. The pills aren't controlling his pain.

He doesn't feel whole.

At an appointment with a doctor at the Veterans Affairs hospital in Salt Lake City, Jacobs asks about amputation.

The doctor laughs; there are so many other therapies to try, he says.

"The thing is," Jacobs says, "I've got all of these friends who are amputees. They're out running and hiking. They're doing all these things I can't do."

It's true that prosthetic technology is advancing, but so are medical interventions that can provide more function and less pain. Give it some more time, the doctor says.

Jacobs concedes for the day.

But he's made up his mind. He'll finish school and then he'll ask again.

Faced with resistance from VA doctors, he'll keep asking.


Photo above: Bryant and Michele Jacobs and friends attend Armed Forces Day at the Gallivan Center where Bryant gave the keynote address, Saturday, May 17, 2014.


Next: In days before surgery, veteran's resolve grows
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