On April 27, 2003, Col. Robert Frame, MD and a five member public health team were traveling through central Baghdad on their way to a meeting at the Ministry of Health. The meeting with the minister of health, who was coming out of hiding for the first time, was a way to show that the legitimized Iraqi government was becoming relevant. Frame, public health chief for the 352nd Civil Affairs Command in Iraq for Operation Iraqi Freedom (OIF) and public health team, had been working alongside ministry employees and department heads for several weeks, consulting and strategizing how to re-establish and run a credible health operation in a country that had all but ignored its health care system under Saddam Hussein.
“More good things happened than bad”
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Frame’s team never made it to the meeting. Insurgents fired upon and ambushed his Humvee in downtown Baghdad. The firefight lasted 20 grueling minutes. Frame, the first to be shot, still remembers when he was hit. He still remembers the sounds of gunfire, the noises and the feeling of hot blood running down his body. He remembers knowing that he was on the verge of dying.
Frame was shot in the left arm. A teammate, Col. Anderson rushed to wrap a tourniquet around his shoulder to stop the bleeding, one of the numerous heroic acts of the day. The team members covered their sector and kept control of the events. All were shot. His arm was dangling from the tricep and he was still losing a significant amount of blood. Frame slipped on his own blood and fell to the ground. His team had rallied together and stopped the insurgency, but the second Humvee, carrying Frame’s team, was driving away.
“Two of the Iraqis in the crowd came out and waved the Humvee down and lifted me up,” Frame explained. “My partner realized I was not in either Humvee and pulled me into the backseat.”
The Humvee drove to the pickup point where Frame was placed in an ambulance and received medical assistance. Frame believes his life was saved by the tourniquet administered by his partner. When it was over, all 4 team members and an interpreter were injured. Three were medevacked out, including Frame. But all had survived. The team had fought heroically and helped save each other’s lives.
“You know all things considered, it was a great day,” Frame said. “More good things happened than bad and no team members were lost.”
Survival
Following the ambush, as two teammates were carrying him to the ambulance, Frame slipped into unconsciousness from the loss of blood. He does recall bits and pieces of information from the ordeal. The little he remembered revealed some surprising and devastating realizations.
“I do not recall pain at any point,” Frame said. “I remember hearing conversations in the background and I remember knowing that I was very close to dying. I remember hearing the comment, ‘We have to get the colonel out of the country before he dies.’ I hear it in my dreams, sometimes even now.”
According to Frame, shortly after being wounded, a Forward Surgical Team restored circulation in his arm with a plastic shunt. Frame was then medevacked to the Combat Support Hospital where the medical emergency surgical response team had an external stabilizer placed to steady the bone fracture and performed a vein graft from his left thigh placed to replace the shunt. While Frame was suffering from numerous injuries including wounds to his left leg, the arm was the first priority. He and 2 other team members were then medevacked to a Navy Combat Fleet Hospital in Rota, Spain and then transported to Walter Reed Army Medical Center (WRAMC). After his stay at WRAMC, Frame rehabilitated in Delaware and stayed with a cousin. He lost the use of his left arm and hand. He also lost his bicep and does not have a complete deltoid or pectoralis muscle. His vascular system in the upper left extremity has significant atrophy. If you were to run your hand down Frame’s shoulder, you would feel only bone. According to Frame, there were discussions regarding amputation of the thumb and index finger. Although not functional, he decided to keep them.
More protection
Following numerous surgeries, Frame acquired a small amount of function in his elbow and the last two fingers on his hand. However, Frame donned a device from the U.S. Department of Veteran’s Affairs (VA) that tied together with an elbow hinge, but that limited his function and made it more difficult to manipulate. Frame’s injuries required custom-made equipment, rather than off-the-shelf support.
His arm was uncontrolled and hit the doorway as he walked through. There was a tendency to fall due to the weakness in his leg and when he fell, he fell on the damaged and sensitive shoulder. His brace was tearing up his clothes and protecting his elbow, yet inhibiting the area of his arm with the most function. The injuries began to mount and something had to be done.
“I went back to the VA and they could not really do anything for me aesthetically,” he said. “But then they referred me out to Kevin.”
Instant connection
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Kevin Matthews, CO, LO, of Advanced Orthopedic Designs, sat down with Frame in 2007. The connection was instantaneous. Both men were veterans. Frame, a maxillofacial prosthodontist in his civilian life, was fascinated with Matthews’s ability to think creatively despite the many physical restrictions he faced.
“We shared some professional commonalities before I lost the use of my arm and my hand,” Frame said. “I created prostheses for head and neck patients. We connected on many levels. Although I had lost my profession of 25 years due to the injury and that is still something I have to sort through, it was exciting as a patient to be supported by a compassionate clinician.”
The passion for the job seeped through Matthews’ eyes, as did his admiration for working with wounded warriors.
“The more intricate patients they send directly to me,” Matthews explained to O&P Business News. “I listened to his story and I knew I was dealing with a real hero.”
Frame brought in all the contraptions and apparatuses that he used over the years. Matthews noticed right away that tying the brace together was not going to work. Matthews created a custom-made hemoral fracture brace that protected his shoulder and another custom-made brace that protects Frame’s hand. The brace goes over the shoulder and down the elbow.
While it did not produce additional functionality, according to Frame it filled needs of more personal importance. The aesthetics and comfort were important for Frame, who tends to shy away from attention. A giant permanent brace on his left arm, did not suit Frame’s demeanor.
“My biggest goal was … to not break anything, because that was getting old,” Frame joked. “The other goal was being able to conceal all the braces a little more so it was not in your face all the time. I believe we have achieved those goals.”
Matthews created a brace with a desert camouflage, red white and blue design, as well as a black brace for more formal occasions. The brace can be worn and concealed underneath a coat and a large shirt.
Transition
After a discharge from Walter Reed Army Center, he returned to his position as the assistant under secretary of health for dentistry for the VA. During that time he connected with the chief officer for readjusting counseling services, Vet Centers, and was able to join the readjustment counseling and outreach section in the hopes of helping his fellow veterans.
“It was a wonderful opportunity to continue with the VA and to help my fellow warriors. In our civil affairs community we used to see ourselves as the quiet professionals. I have the privilege to continue serving the warriors and do so in a quiet way.”
Matthews is also grateful for the sacrifice Frame made and for being a small part in a hero’s life. They have made a lifelong connection.
“I think I have had an impact on his life,” Matthews explained. “But if you look at what I made for him, it is really not that much. I think what I really did was sit down and listen to him and go over what his activities are and what he needs the orthosis to do.”
Today, Frame works with soldiers and their families in facilitating opportunities and connections upon their return home from war by inviting them to be part of the Vet Center and VA community.
“I am simply able to work with men and women quietly and provide for them some opportunities so they can return to their normal lives and it has been quite a privilege and humbling to work with these men and women who are unbelievably resilient,” Frame said. — Anthony Calabro
