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Veterans Health Administration

Expanding the Goals of Rehabilitation

man sitting in a chair, talking

OIF Veteran Vincent Short has worked with the polytrauma rehabilitation team at the Washington DC VA Medical Center for five years.

After coming home from his deployment in Iraq, Vincent Short faced a lot of uncertainties and second-guessing — from himself. He would write a check on auto pilot, then, just as automatically, doubt his work. Time and therapy taught him to be sure of one thing, however.

“As the person who got hurt, you just kind of want to get up and get back in the game — but you’re not the same,” Short said. “One of the hardest parts was acknowledging that I was never going to be Vincent Short, pre-incident. Recognizing that I need help and accepting help.”

For a man who worked his first job at the tender age of eight, his diminished level of independence was no small thing to overcome. Short called it a “big, tear-jerking reality.”

He started with speech therapy and then physical therapy at the Washington DC VA Medical Center to deal with the physical and mental disabilities he suffered after serving in Operation Iraqi Freedom. The polytrauma therapy team coordinated a rehab program to cater to Short’s individual disabilities and progress.

“One of the hardest parts was acknowledging that I was never going to be Vincent Short, pre-incident. Recognizing that I need help and accepting help.”

— Vincent Short, OIF Veteran

Short had to lower his shield and learn who he could trust — and who not to trust. He was gaining the tools to operate outside of therapy.

“I prefer to be the 400-pound teddy bear in the room instead of the 400-pound gorilla,” Short said.

Five years later he still has appointments with the Washington DC VA Medical Center polytrauma therapy team, but Short’s goals have grown over the years.

Going back to school

“[Vincent] came with the goal of simply being able to function in the community,” said Heather Malecki, Washington DC VA Medical Center Polytrauma Coordinator. “Now, he has the goal of going to school and we’ll help him with that.”

Academic reintegration is an option that many Veterans are considering, thanks to the G.I. Bill. However, an undergrad degree, as well as the graduate programs Short is considering, can create a potentially stressful and unsuccessful scenario for some therapy patients. Veterans taking online courses, attracted by the privacy and flexibility, have an especially low success rate.

Social interaction is only one part of the challenge. Malecki explained that it is primarily the speech and occupational therapists who lead the team in designing a rehabilitation program for aspiring students.

“They simulate a classroom setting and work with the patient on focusing attention, problem solving and sequencing; all things they would encounter in a classroom setting.”

Some of these exercises can also be carried out in the medical center’s new Independence Way program, composed of a series of model environments where patients can practice daily tasks. Scavenger hunts in the imitation mini-mart and problem-solving exercises at the mock-Metrorail station prepare would-be students for academia.

“Once you get to these higher-level skills, the therapists have to be very creative,” Malecki added. Once they get to school, Veterans’ cognitive disabilities can oftentimes be accommodated with extra time during tests and other support.

Going to graduate school is an important goal for Short personally, as well as professionally. He credits the polytrauma therapy program for helping him figure out who he wants to be.

“Folks are very friendly, but — more importantly — they are very firm,” Short said. “I’ve done so well in the program; I never want the program to stop.

“Every week I take a step, a small step, but a step.”