The Pentagon has just one burn center to treat the hundreds of servicemen and women who've been badly burned in the wars in Iraq and Afghanistan.
Sgt. Joe Fowler spent four months hospitalized at the Brooke Army Medical Center in San Antonio. He's an outpatient now, showing up daily at Brooke's burn unit for a two-hour course of physical therapy. But he and his wife, Leslie, know they still have a long road ahead of them.
"It's a minimum of two years ... just for the general healing process," says Leslie Fowler. "It will probably be more like five years, as far as continued surgeries and things like that. It's not something, unfortunately, that can be healed tomorrow, but he's doing wonderfully."
Joe Fowler was a dog handler with the 148th Military Police Detachment. He was assigned to the Army's 10th Mountain Division. On Dec. 11, 2005, he was in a convoy heading out to a warehouse to search trucks carrying ballots just before the Iraqi elections.
His Humvee hit an anti-tank mine. Fowler remembers everything: the initial explosion, flames of orange and red, and looking back from across the road, where he was thrown, to see the truck twisted into a big heap of metal.
One of the soldiers in the Humvee died. Fowler also lost his dog Dak, a Belgian Tervuren, who he says was like his best friend. Fowler says the loss of his dog is worse than dealing with his own injuries, which are extensive. He had burns on 54 percent of his body and multiple broken bones.
Fowler's face and arms are laced with red scars and a patchwork of skin grafts. He can't straighten his arms; his elbows stay bent. He's had three surgeries to replace his eyelids, so they can close and his eyes can be saved.
A Soldier's Motivation
Fowler's physical therapy is slow and painful as he learns to reuse his weakened and damaged hands. But Fowler and his wife remain upbeat.
"You gotta get back and heal up for the family, to make sure you're there for them," he says.
Leslie Fowler moved to San Antonio with their son Shane, who's now 10 months old, and has pretty much grown up in this hospital.
"Our logic is, it's just one day at a time," she says. "He'll get well, that's the important part, and he's here. My son gets to see his dad, and gets to have a dad."
And sometimes, what might seem like a small success can make all the difference, says Maj. Ian Black, chief of anesthesia at Brooke's burn center.
"These are incredibly stoic guys," Black says. "They just want to be functional. I mean, the difference between having all their fingers cut off or amputated, and having a little bit of a nubbin, so they can button their shirt and go to the bathroom -- that's what they're worried about. To be functional enough so that they can take care of themselves."
Charging Down the Mountains
Fowler does think about his life before his wounds -- like fishing and riding his mountain bike around his home in Colorado. He talked a lot about charging down hills on his bike, says Capt. Kerry Kingsley Smith, a registered nurse at Brooke.
And Kingsley Smith in turn mentioned Fowler to his own mother-in-law. She wrote to the bike company Trek, telling them about Fowler's condition. Trek responded by sending adaptive parts for his bike, to make it easier for him to ride.
So Fowler has set a goal: He wants to have enough grip strength in his hands to get on that bike by the end of the year.
Meanwhile, there's been another breakthrough. Last Sunday, he was able to brush his teeth by himself -- for the first time in seven months.
Produced by NPR's Andrea Hsu.
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