I am posting this as it discusses many of the issues involved with Vac.
Many things haven't changed in three years since this was first written.
HEALTH & LIFESTYLE
The Quiet Fight: Master Corporal Paul Franklin
November 6, 2007, by Natalie Salat
ILLUSTRATION: SHARIF TARABAY
Master Corporal Paul Franklin.
“I get rock star parking.”
As Master Corporal Paul Franklin pulls into the parking lot of Earls Restaurant in downtown Edmonton on a humid July day, he brings his Mini Cooper to a stop in one of the spots reserved for disabled parking.
Looking into this nifty little car, driven by a broad-shouldered guy wearing military fatigues, you might wonder why he’s parking there–especially if you happened to have missed all the media coverage.
But the thing is, Franklin can only drive with his hands. His legs are gone.
On Jan. 15, 2006, the medic with One Field Ambulance of the Edmonton Garrison was driving an armoured Mercedes jeep in a convoy on Kandahar Road in Afghanistan when a suicide bomber succeeded in blowing up the vehicle, killing diplomat Glyn Berry and delivering devastating injuries to Franklin, Private William Salikin and Corporal Jeff Bailey. Franklin lost both of his legs, besides sustaining third-degree burns and wounds all over his body. He would have lost his life, too, had his buddy Corporal Jake Petten not tied around his leg the very same tourniquet–a “high-tech” American-issue model–that the medic had taught him to use.
It’s now a year and a half later, and in a week’s time, Franklin is planning to drive through his beloved mountains to get to Vancouver. He has set up a meeting with fellow double-above-the-knee amputee Warren MacDonald, who climbed Mount Kilimanjaro with prosthetics that look like articulated feet. “He does all sorts of neat stuff,” enthuses Franklin. “So I’m going to see him and kind of compare…and see what kinds of products he uses.”
Over lunch on the patio, he takes me through a striking collection of photos–many from Afghanistan–carefully arranged in a leather-bound album. One of them shows his feet, dangling over the edge of an Afghani mountain. The medic had taken the picture after he had climbed to the top of the mountain, only days before the suicide bomber attack. After both of his legs were amputated, doctors said he may not walk again. Last March, he defied expectations by walking his son, Simon, to school on prosthetic legs. That was tough–”like getting hit over the head with a sledgehammer”–but one day he hopes to climb again.
In the meantime, there are plenty of figurative mountains to conquer–improving his range of physical functioning, managing a level of pain beyond what most people will ever experience, building a new life with his wife, Audra, and eight-year-old Simon, and establishing his charity to help improve the care and quality of life of amputees in Canada.
Through it all–and despite the fact that he doesn’t sleep too well these days–he’s managed to maintain a positive outlook. “This time is just dessert, because I died last year. Everything else is just fluff. Just enjoy it.”
But his optimism has been tested. One of the most severely injured of the Canadian Forces members to survive the war in Afghanistan, he has come across a bewildering array of situations–from red tape to petty jealousies–in obtaining necessities such as home adaptations and in trying to maintain a career within the CF. “I want to say I got good care,” says Franklin, “because I did.” He got top-notch treatment at the Glenrose Rehabilitation Hospital in Edmonton, where he learned to walk again, and, thanks to the $250,000 cheque he got immediately from the Service Income Security Insurance Plan, he was able to buy his car and relocate with his family to a house more suited to his needs.
Still, despite becoming well-known in the media and gaining the ear of powerful people like the Chief of the Defence Staff General Rick Hillier, he’s had his share of struggles with the system–and with perceptions. “People tell me all the time–oh, you had it easy. And yet, I’ve had to fight for everything.”
Fortunately, his trials–and triumphs–are helping to bring about changes in the way the military, the Department of National Defence and Veterans Affairs Canada are looking after injured CF members.
* * *
The master corporal is no longer in a formal rehabilitation program. “I’m just living my life. But that, in a sense, is the rehab,” says Franklin.
He works half days in casualty support at Canadian Forces Base Edmonton. “The next half a day should be rest, and then hanging out with your family. But in reality what I do…is I work on the charity (the Northern Alberta Amputee Program). I work on promoting the book (The Long Walk Home by Liane Faulder). I also do a speaker’s bureau, so I work on speeches and lectures and stuff that I do outside the military, and then of course (there is) the family piece.”
Franklin has organized, attended and spoken at all manner of events in the past year, from a Northern Alberta Amputee Program fundraiser featuring comedian Rick Mercer to The Royal Canadian Legion’s Youth Track and Field Championships.
A former marathon runner, Franklin also keeps active. Now 40, he says he is in the best shape of his life. He has to be. “It’s so difficult to walk (with the prosthetics) that, if you let yourself go, there’s a big downslide very, very quickly.” And he watches what he eats and drinks, “cause if my legs swell, then my (prosthetic) legs don’t fit. And so therefore I can’t walk, and therefore my legs will get bigger, because I’m not walking.”
The Forces provide him with a limited number of prosthetic limbs, and they aren’t cheap. C-Legs, which Franklin uses, can cost up to $60,000 each. “What DND has done with me is that I have two (sets of) legs–a computerized leg and a running leg,” he explains. Franklin adds that he has the option of getting a mechanical pair of prosthetic limbs on top of the ones he already has. First, though, he wants to see how his rehab goes; he doesn’t want to wind up with a cornucopia of prosthetics. “I never want to be that guy that’s the exception, right?”
But he does want to help other amputees–whether soldiers or civilians.
In April, Franklin and two fellow military amputees joined civilian and military health-care providers from DND and VAC on a visit to the Walter Reed Army Medical Centre in Washington, D.C. They spent nearly five days checking out the centre’s amputee program–a model of care that not only assists veterans in returning to a high level of physical functioning, but that also provides crucial mental health support.
One of the aims of Franklin’s charity is to establish a similar “centre of excellence” in Canada. “I mean, there is a group of veterans that go from Korea till now, and they need help, and Veterans Affairs is not the best place (to get it),” he comments. While he does believe the department is trying, he adds that VAC has a ways to go in updating its policies and practices. “When someone from Veterans Affairs says, ‘You get a new leg every three years,’ well, that’s nice, but do you even know what a prosthetic leg looks like? Do you know what the costs of them (are)? Do I need a new one every few years, or do I need a software upgrade? The guy (from VAC) is, like, ‘I don’t know.’”
Darragh Mogan, executive director for Veterans Affairs’ service and program modernization task force–which led the development of the New Veterans Charter (Testing The New Charter, page 22)–says the department is working together with DND on “continuity of care” issues, including prosthetics. “There’s…a National Defence standard of service that we want to be able to replicate, so if a person leaves the military they all of a sudden don’t have a different, presumably lesser benefit. And that is a top priority.”
Dominion Command Service Bureau Director Pierre Allard, observes, “It’s difficult to judge (the progress) right now, other than (VAC) telling us they put things in motion to provide quality prosthetics. The proof in the pudding will be when these guys go out the door, and they haven’t gone out the door yet.”
At the time of writing, none of the Canadian military amputees from the war in Afghanistan had left the military. Like all other CF members with disabilities–and there are more than 330 from the mission in Afghanistan alone–they have three years in which to establish that they are able to continue in the military–or be medically released.
As long as Franklin continues to wear the uniform, the responsibility for his care falls mainly to the Canadian Forces; however, he also receives a monthly disability pension from VAC (he remains under the Pension Act, as his injuries occurred before the new charter came into force). Certain other benefits and services, such as home adaptations, come under the VAC umbrella as well.
While the master corporal says he is satisfied with his pension, there have been frustrating glitches in his care–even with an assisting officer in the CF and a local case manager from VAC helping him out. He offers a few examples. “I was in physio and the salesman from the wheelchair company came in and took my wheelchair away because the bill wasn’t paid. So I had to phone my assisting officer, and then they phoned the brigade sergeant.” Eventually, he got his chair back, he notes, but it was a good thing he had developed a game plan for that possibility–just in case.
Then there was the saga of the stair lift. Initially, says Franklin, VAC told him it would pay $4,900 for changes to his house–not nearly enough to get a good-quality stair lift. “This is one of the fights that I had to have.” When VAC subsequently asked for three estimates, observes Franklin, he and his wife “knew that if we gave them three, they would pick the cheapest one.” So they went ahead and put a deposit on the $15,000 stair lift. “It’s expensive, but it will last forever,” explains the medic. “We got in trouble for putting the deposit down and then purchasing it.” The lift was installed in March 2006; VAC reimbursed Franklin last November.
Lieutenant-Colonel Gerry Blais is the director of the joint DND/VAC Centre for the Support of Injured and Retired Members and Their Families, which has the mandate of providing information and assistance to current and former CF members and their families. Based in Ottawa, the centre was established by the two departments in 1999 after several inquiries highlighted that CF members and veterans were not getting the support they needed. Among the staff are several employees from VAC to help members with their entitlements to benefits and services.
Another of the centre’s responsibilities is keeping track of casualties.
Blais says everyone involved in CF members’ care–whether DND or VAC–is trying to improve the co-ordination of that care. The last few years have been a learning process, he adds, owing to the increased operational tempo in Afghanistan and unfortunate rise in the number of casualties coming back. “We hadn’t seen these kind of traumatic injuries in (these) numbers…since the Korean conflict, basically. All the procedures and the knowledge and everything were not necessarily as great as they could or should have been.”
But, he adds, in the months since the summit, a number of improvements have been in the pipeline. “We’ve developed something called the mobility project, whereby all of (the wounded CF member’s) needs are going to be analyzed by an occupational therapist, and then they’re going to be sent here to the centre and we will have payment and approval authority. These things now will be done in the snap of a finger.” The project was to receive final approval in the fall.
In addition, notes Blais, the recent addition of two-person detachments of centre staff at 10 bases across Canada will help with the co-ordination of CF members’ care–particularly for reserve units. “Right now, everyone on the bases is trying to do the right thing, and in certain areas we’ve found that sometimes there’s just a little bit of a co-ordination problem,” he explains.
The centre staff at each site will be responsible for informing CF members of the assistance available, bringing together all of those medical and administrative resources, and, where required, helping individuals. “I would like to see a seamless transition from the Canadian Forces to Veterans Affairs,” asserts Blais. “We’re working very closely (with VAC), where we don’t want there to be a line in the sand saying, ‘OK, you’re a CF member today and you’re a veteran tomorrow,’ and the one side or the other forgets about you in between.”
Mogan echoes this sentiment. “We have a task force with National Defence–the continuity of care task force–to make sure that the one person who doesn’t have to worry about who does what and when is the person who needs (help).”
And things have changed considerably over the last decade, he emphasizes. “We have a ways to go, but we have come an awful long way.” Whereas DND and VAC used to be “two solitudes,” there are now regular discussions between the two departments at all levels, whether between base commanders and VAC’s district directors or higher up. “We have mapped every process that there is between the two organizations, found the flaws, and now we’re trying to fix them…. It is making a difference–(in) everything from getting medical records for people applying for disability awards to early notification if someone’s on medical release.”
The Legion’s service bureau director agrees that things are much improved, particularly with respect to timeliness on the part of VAC. Putting things in perspective, says Allard, in 1995 the department had around 6,000 applications a year and a turnaround time of 18 months. “They received, last year, probably more than 30,000 claims with a turnaround time of four months. I don’t think there’s a problem of timeliness, and I’m not even sure timeliness is a good measure, because timeliness might be the enemy of quality decisions.”
With regards to Franklin’s case, he observes, “At the end of the day, you deal with people who have to apply certain regulations. If the regulation says, provide three estimates. I need three estimates, you know? So maybe we change the regulations, but then the taxpayers who…demand accountability may not like the solution. Nothing is simple. If it was, we’d all be rich.”
* * *
On top of sorting out the logistics of daily living, Franklin is trying to establish whether he can maintain a career within the Canadian Forces–one that relates to his passion for teaching tactical medicine and improving the care of soldiers on the battlefield.
That hasn’t been smooth sailing.
“I went back to work in September (2006) with the idea that I’d go in training and teach tactical medicine and work my half days,” explains Franklin. “That was the idea. What happened was, I get there and this young corporal shows up and says, ‘I’ve got duties for someone on half days’–obviously me–and she’s like, ‘The first thing on the list is shred paper in the library.’ I f–kin’ lose my legs to shred paper in the back room!
“I was mad. So, I ended up not doing the stuff they wanted, and doing speeches, and touring the country talking about what happened to me, and all the media stuff that I’ve done.” That hasn’t sat well with everyone at DND, he adds. “There’s been a lot of people in middle management, specifically, that don’t like me being in the Forces. They’ll walk up to me and say they’re jealous of what I’m doing, they’re jealous of the position I’m in, (that) I shouldn’t be going on as many trips.”
Fortunately, he adds, he has had the support of upper management–especially Hillier. In fact, the CDS has stated that anyone who has been injured in the theatre of operations would not be released from the military unless he personally signs off on it. Unfortunately, this might not be enough to enable Franklin to stay in the CF. “I feel that I’ve got two years left in the military because I’m unpromotable,” he says, voice softening.
CF members who are ill or injured have three years in which to meet minimum operational standards under the Forces’ universality of service standard, which includes “the requirement to be physically fit, employable and deployable for general operational duties.”
On the bright side, Franklin notes there has been progress, albeit slow, with getting a formal peer support program in place for CF members with severe physical injuries. He has informally been talking to and visiting other injured soldiers, but says there needs to be something more structured in place, analogous to the centre’s Operational Stress Injury Social Support network. “Peer visits are so effective, because it’s one on one, it’s quick, you just chat about stuff.” He has been involved in helping the CF organize a network where people with similar injuries can talk to one another.
According to Blais, that network should be up and running “by the end of the calendar year.”
Things can’t move quickly enough for Franklin, who is keen to bring about as much positive change as he can. “I can’t really solve any of the big problems, but I can solve the amputee problem, I can solve some of the tactical medical issues…. I can help wounded soldiers come back with a bit more dignity, especially in the western area. And I can help it so that the next medic doesn’t have to go through what I did.
“I’ve got little goals.”
* * *
Just as our lunch is coming to an end, a dapper man in his forties approaches our table. “Excuse me. Hi. Were you injured in Afghanistan?”
“Yeah,” replies Franklin.
“I’d just like to acknowledge you and thank you,” says the man, shaking his hand.
Franklin may not be a rock star, but he may be the closest thing the Canadian Forces have got.
Paul Franklin
MCpl (ret)
Just a note to add I never did get to see Warren Macdonald but have followed his very cool website.
Please take a look and read his great motivational messages.
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