A New Kind of Care in a New Era of Casualties

By ERIK ECKHOLM, Published: January 31, 2006

TAMPA, Fla. — Specialist Boutin, 21, had arrived in Tampa just five weeks before, mute and hardly able to swallow, his right arm and leg almost useless. During a midnight patrol in a village near Samarra, an insurgent dropped a grenade into his Bradley fighting vehicle. Fragments sprayed into his face and the left side of his brain, leaving him with Broca's aphasia — able to comprehend but not to speak.

He weathered fungal infections, facial pain where nerves were damaged and the destruction of his pituitary gland and a maxillary sinus, the kind of internal wound that can torment a person for life.

But now, after hard hours each day in therapy, he can jog briefly and write messages with his right hand. As speech therapists coax the right side of his brain to take over lost functions from the left, he has begun to make one-word responses and spontaneously utter a few words at a time. Soon he will head home to Georgia for continued therapy.

"Yes," he uttered instantly when asked if he felt he was progressing. Determination gleamed from his remaining eye.