By Jeremy Borden

When he arrived at National Naval Medical Center in Bethesda, Maryland, Navy SEAL Lieutenant “J”* could hardly move. His jaw was wired shut. During a September 2007 operation in Iraq, J had been shot multiple times in the left arm and face. A tracheotomy was performed so that he could breathe. But every time he moved, the tubes would scrape against the inside of his throat, producing coughing fits and blinding pain. The “trache,” as he called it, would be in place for seven-and-a-half-months.

Still fresh off the battlefield, J penned a “welcome” sign to those visiting his room that would come to represent the tenacity of those wounded in defense of our nation. Although in pain, he was able to write, and his mind was steady and strong. A family member came to visit and talked to the others in the room, but not to J. Speaking about him, but not to him, made J feel as though he no longer existed or was in a coma. He held up a note to his wife to bring a big piece of paper - he had something to say.

“I would have gone with a billboard if somebody would have dragged it up there,” he said of the letter recently. The note, written on a bright sheet of orange paper and prominently displayed on the door of his hospital room, would inspire his fellow wounded warriors, as well as gain the attention of the Secretary of Defense and the President of the United States. J’s words to his fellow wounded warriors were fight harder - a display of character that is innate to U.S. Special Operations Forces (SOF).

Today, J has limited mobility in his left arm and continues to receive reconstructive surgery to his face. With his 26th surgery coming up, J was told that his recovery is nothing short of remarkable. Doctors were able to “unfuse” his elbow after the injury, so J can now extend it about 45 degrees, more than doctors ever believed he would be able to do again. The bullet in his face passed millimeters from his brain and eye, leaving his face badly scarred, but did not inflict more serious injury. This summer, J returned to his SEAL team in a support role. He’s happy to be alive, but he wants more than anything to go back to combat.

While his recovery is a testament to both his positive attitude and his doctors’ unwavering care, he and other SOF wounded warriors cite the constant presence of the Care Coalition as the other major player in their recovery. The Care Coalition is dedicated to supporting a SOF wounded warrior and his or her family during rehabilitation, recovery, and beyond.

Based in Tampa, Florida, the Care Coalition is a part of the U.S. Special Operations Command. The Coalition assigns patient liaisons and advocates to each of the critically wounded within the SOF community. J credits the organization for doing everything from keeping his family up to speed on his status before his arrival at Bethesda to making sure his doctors coordinated with each other so “they understood the whole puzzle,” as he put it, “not just their piece.”

For J and the others under the Care Coalition’s watchful eye, the liaison/advocate structure is a model that works, and one that the other services hope to emulate.

A night mission in Karbala, Iraq, would leave Maj. Kent Solheim with four bullet wounds–two to his right leg. Despite being injured, Solheim continued to fight and for his valor received the Silver Star. Solheim hopes to compete in an Ironman and return to combat.“

The Care Coalition has 36 employees including 12 in-hospital patient liaisons worldwide. They track all current and former wounded Special Operators, and are on call to handle any need 24 hours a day - for the rest of their lives, if necessary.

Jim Lorraine, the Care Coalition’s director, says the program’s success with a small staff relies on thinking "outside the box” and doing whatever it takes to solve problems - a tactic similar to the operational training employed by SOF.

In addition to handling the needs from anyone of their wounded around the country, Lorraine and his team also highlight the inspiring stories of recovery within the SOF wounded warrior community. The Care Coalition interfaces with military leaders and nonprofit organizations to educate them on the issues the warriors and their families face. As a government organization, the Care Coalition cannot solicit funding or goods. But it can form relationships with a wide range of people and organizations to make sure that the changing needs of SOF’s wounded warriors are known as they transition from wounded warrior to service member or civilian again.

The Care Coalition’s patient liaisons, located at all the major medical treatment facilities, are insiders, with a firm grasp on how the system works and what hurdles each patient faces, both physically and mentally. Almost all of the liaisons have been through the harrowing experience of being wounded themselves, and navigating not only complex medical issues but bureaucracy, all the while worrying about their families. The mountain of issues - from filling out paperwork correctly to making sure their families have a place to stay while visiting the hospital - is a huge burden, one that the Care Coalition aims to relieve.

“That’s such a critical time … when your life has been totally flipped upside down,” said Major Kent Solheim, who was wounded in Iraq on July 27, 2007 - his “Alive Day.” “You don’t have a clue how this stuff works. But the Care Coalition does this all the time, so you don’t have to worry.”

Sgt. John Walding likes to tell people that with a nickname like “John Wayne” and a birthday on the 4th of July, he was born to be a Green Beret. Walding was injured during an operation in Afghanistan in April 2008. Nearly every one of his Special Forces team that night would be wounded. Walding and nine of his teammates would each be awarded the Silver Star–the most awarded for a single battle. Walding would like to return to combat one day.

On April 6, 2008, a group of Green Berets dropped into a steep valley with a near-frozen stream running through it and jagged rock all around. The terrain was so uneven there was no place for the helicopter to land. The Special Forces team, comprised of American and Afghan fighters, was forced to jump from their helicopter with 60 pounds of gear onto the icy terrain below.

Their mission was formidable: scale a steep cliff and take out high- level insurgent targets at the top of the mountain. Sgt. John Walding and the team expected a small insurgent force of 20. The group was met by close to 200, and a fierce six-and-a-half hour gun battle ensued.

“It was the worst terror I’d ever been in,” Walding said. He can still recall in painstaking detail every moment of that night and the battle, despite the wounds he received. “I remember everything,” Walding said, “up until I died.”

Walding, whose right leg was hit by sniper fire during the battle, managed to stem the bleeding, and slide down the steep mountainside with the rest of the team, fighting the whole way. He was put on a makeshift gurney and carried across the icy river, half submerged, and then back again, before the rescue helicopter found a safe landing zone to evacuate the badly wounded Green Beret.

Before the ordeal was over, and Walding was en route back to the U.S., he would flat-line and be resuscitated twice on the operating table. Nearly every soldier that night had been injured, but every American survived. Ten of them - including Walding - received Silver Stars for their valor.

A year later, Walding’s role in the military is still in flux. He wants to return to the same kind of covert counterinsurgency missions he carried out before, but he knows that may not be possible. He spends his days rehabbing and working out, doing Arnold Schwarzenegger impressions as he heads to the weight room, and cracking jokes with Solheim, a friend and fellow amputee. He and Solheim find different ways to push themselves by competing. The two recently completed the Boston Marathon on hand bikes and finished in just over 1 hour and 50 minutes. Walding runs a seven-and-a-half minute mile on his prosthetic leg. One day, he and Solheim want to compete in an lronman competition.

He and Solheim credit MSgt. Christian “Mack” MacKenzie and SFC Marty Thompson, the Care Coalition patient liaisons at Walter Reed Army Medical Center, for helping them through their rehabilitation and recovery. Thompson and MacKenzie find themselves worrying about “their guys” -being both a friend and care coordinator so that the warrior can put all of their energy toward what is important: getting better.

As for getting back into the fight? “It’s who we are,” Walding said. If Solheim and Walding are physically able and can play their part, they’ll return to the frontlines.

Air Force MSgt. Christian “Mack” MacKenzie has found his second calling after flying helicopters. MacKenzie’s chopper was hit by a rocket-propelled grenade over Fallujah, Iraq, in April 2004. While MacKenzie would lose most of his sight in his left eye, he would see his dream to fly again as early as 2005 on non-combat missions. Today, he works for the Care Coalition, advocating for wounded Special Operators.

On a recent day at Walter Reed, the gregarious MacKenzie walked the brightly lit halls of the hospital, greeting doctors and nurses with a smile and a question for each, impulsively checking his BlackBerry along the way. He’s there every day, making face-to-face contact with doctors and administrators, checking in on those from Special Operations units who have been injured and recovering at Walter Reed. It’s building those personal relationships that make him an effective advocate, he says.

Thompson and MacKenzie have 22 wounded Special Operators under their wings at the moment. The duo is constantly monitoring reports to make sure they know who is where and what their status is.

By 1 P.M., MacKenzie has e-mailed back and forth five times with a contact in Landstuhl, Germany - the transfer point for critically wounded service members from the battlefield to the United States. MacKenzie, once a critically injured patient himself, draws on his personal experience every day in his job.

“There has never once been a SOF guy to come through on a MedEvac and one of us isn’t there,” MacKenzie said. “It hasn’t happened. My schedule revolves around my guys.”

MacKenzie is there for the families too, something Solheim and Walding said was a huge relief. The soldiers worry about the strain on their spouse juggling the complexities of a husband who has been seriously wounded, the endless paperwork, their children, and making complicated medical decisions.

Stopping at a platform that overlooks the main triage hall at Walter Reed, MacKenzie described what often happens to a family member who has been called there. With sometimes dozens of soldiers transferred in - all seriously wounded - a family member is not allowed onto the floor to see their relative as doctors work to save lives. Below, the huge, automatic sliding doors open revealing hospital cots. Family members look over the railing, hoping to steal a glimpse of a loved one.

It’s during that confusion that MacKenzie makes sure the family members know he is there, that he’s working for them, and will keep them updated. But when the relief of getting through that first hard surgery subsides, the question of “what next?” begins to creep up on the service member and their family.

“A lot of it is mental,” Thompson said, as he described a wounded warrior’s first weeks of recovery. They think, “‘How will society accept me? Will I be able to stay in the military if I choose? Will (fellow soldiers) accept me and will I be one of the normal guys like I was, like I am?”

MacKenzie, a former flight engineer in Air Forces Special Operations Command, knows that moment well.

In 2004, a rocket-propelled grenade hit the helicopter MacKenzie was flying in. He remembers the flash of the windshield blowing up, sending him, blinded, to the floor of the chopper. The pilot pulled back into a steep vertical climb. Miraculously, the crew landed safely outside Fallujah.

After MacKenzie had undergone emergency surgery in Iraq, he was transferred to Landstuhl. It was on that flight that his emotions took over. He thought of his wife, and an overwhelming feeling of loneliness consumed him. “People don’t realize… you’ve been ripped away from the guys you’ve been working with for months. In an instant it’s all gone,” MacKenzie said.

That’s why he was relieved when a friendly voice met him at Landstuhl. A fellow member of his unit had come to meet him-without orders - jumping on a flight to be there to support his buddy. As the days in Germany wore on, and MacKenzie struggled to regain his sight, his friend bought a book to read to him to help ease the boredom.

MacKenzie says those days at Landstuhl became his inspiration for working for the Care Coalition. In his role as a Care Coalition liaison, he handles everything from the mundane to the critically important. From looking for doctors to provide a second opinion to buying presents for a child’s birthday to FedEx'ing a package for a patient, no need is too small, no task too large.

“This is the most honorable thing I’ve been a part of,” MacKenzie says. “The look on a family member’s face, the look on a soldier’s face, it just changes everything. We’re not clinical. These are our brothers.”

Sgt. John “Mikey” Fairfax hardly remembers waking up in Landstuhl, Germany, a few days after an IED exploded under the wheel of his vehicle in Afghanistan leaving him badly wounded in August 2005. He has since become the first amputee to pass the Army’s Jumpmaster School. He continues to push the limits as he becomes more comfortable with his prosthetic leg. Fairfax would like to return to combat.

Wounded warriors are pushing boundaries more than ever before, especially within the SOF community. For Special Forces Sgt. John “Mikey” Fairfax, it’s been a long road since July 30, 2005, when an improvised explosive device put Fairfax within inches of his life and would eventually take his right leg. He’s been through four years of rehabilitation, but now Fairfax sees the light at the end of the tunnel. He is starting anew as a soldier, getting into a routine of training, and is coming to grips with his new “normal.”

“Hey, life didn’t stop because I’m missing an appendage,” Fairfax said. “I look at it like, 'I used to do this, now I have to figure out how to do this in a different way.’”

Fairfax was driving on an early morning patrol in Afghanistan’s Uruzgan province when the lED exploded under the wheel. He remembers noise, smoke, panic. And then pain.

“I remember thinking, 'Man, I hope my leg is still there, I hope my leg is still there.’”

Fairfax has had close to 30 operations since the accident - he’s not sure of the exact number at this point-almost all to try to save his right leg. But several MRSA infections later (“every time somebody cuts on me I get an infection,” he said) and years of severe, chronic pain finally made Fairfax face the gut-wrenching decision to have the leg amputated.

It’s a decision he says he rarely regrets. Earlier this year, Fairfax became the first amputee to pass the Army’s Jumpmaster School. The course is physically grueling, though it doesn’t require an actual jump. To pass the course, among other things, the Jumpmaster must quickly and efficiently inspect a fellow jumper’s equipment. Most need to go into a deep squat to do so, but because Fairfax doesn’t have a knee, he has had to make do by dropping down on his prosthetic or other knee. Fairfax also received level-one combat certification recently - the mastering of a series of hand-to-hand combat moves.

Throughout the journey to recovery, Fairfax also credits the Care Coalition’s constant support in clearing the path for him, helping him focus on his rehab and his future. “There were a few eyebrows, like 'Hey, I don’t think he’ll be able to do that’ just because it’s never been done,” Fairfax said. “I proved it could be done. In our community, people are like, 'Hell, yeah.’ I just want to be back supporting the guys in any way I can and guys understand that in our community.”

Within the SOF wounded warrior community returning to the frontlines is a shared goal. They know the path will be hard, and maybe not even possible, but it is that hope that drives them to push harder. Each sign of progress - a lunge, an arm motion - tells them that maybe getting back in the fight is within their grasp.

“After all the work it took to become a Green Beret, I need to be able to do it again,” Walding stated. “It’s who I am. Besides, for someone with the nickname 'John Wayne’ … who was born on the Fourth of July …from Texas…” he added with emphasis, “if I was ever born to do anything … it was to be a Green Beret.

"But you are going to reach limitations,” Walding continued. “You’ve got to put blinders on, lean forward, and give it hell.”

Now, for the most part, the day-to-day of these men -LT J, Fairfax, Solheim, Walding, and MacKenzie - is a restrained optimism. It is a conversation sometimes rife with “gallows humor” - casual, biting, dark jokes about their injuries-and a relentless drive to succeed supported by the ongoing efforts of the Care Coalition. “Special Operations always finds a way,” as Fairfax said. “We say, 'I’m going to make this happen: We don’t say, ”'I can’t do it.’“

Getting dropped into the world’s most dangerous places and carrying out inconceivably perilous missions is usually the stuff of fiction. But for a Special Operator that is reality - one which also comes with a sense of purpose and camaraderie that cannot be rivaled.

"I wear these scars with pride,” J said, “because I know that my friends and family and hopefully other Americans will never have to wear them. Why wouldn’t you want to go back and do that?”

To protect the privacy of the men featured in this article, some names have been altered.