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SAN ANTONIO, Texas (Reuters) - Since Marine Staff Sergeant Benjamin Ricard hit an improvised explosive device in 2009 that blasted him out of an armored vehicle in Afghanistan, he's been on a mission to recover from a traumatic brain injury he says would have killed him if not for today's military medicine.
"My injury is scary," Ricard told Reuters. "Nightmares, terrors, not being able to sleep. And when you talk, there is this yawning sound in the back of my head. You fear, and you fight through it the best you can."
A new rehabilitation hospital opening in San Antonio this month -- similar to the one treating Ricard in Richmond, Virginia -- will focus on addressing the severe physical and emotional wounds common to soldiers returning from Iraq and Afghanistan.
From special flooring suited to wheelchairs to unique stairwells designed to prevent suicide, the three-story, 85,000-foot Texas facility seeks to meet needs of war veterans who have suffered the types of catastrophic wounds that would have left them dead on the battlefield 20 years ago.
"They were healthy young men before, and we are committed to making sure they will be healthy young men again," Dr. Jim Wells, Chief Medical Officer for the Veterans Administration's $67 million San Antonio Polytrauma Rehabilitation Center, told Reuters.
The facility's mission is to provide acute rehabilitation to those who have suffered major wounds to more than one body system, with an emphasis on brain injuries, Wells said. It is next door to the bustling Audie Murphy VA Hospital and across town from the San Antonio Military Medical Center, the largest U.S. military hospital in the world.
It's one of five polytrauma units the Veterans Administration has been opening around the country in the past two years in response to the drastic drop in the number of wounded soldiers who die from their injuries.
In the Vietnam War, about 25 percent of the wounded died from their wounds, according to Pentagon figures. In the Iraq and Afghanistan Wars, that rate is 7.3 percent. Patients who have suffered what would once have been deadly wounds are surviving and requiring new kinds of treatment.
Improved military medic training, evacuation speed and the availability of drugs that prevent blood clotting have contributed to the change, said Tom Yackevicz, a former Army medic, now the program manager for the polytrauma facility.
"We now have surgical units integrated into the battlefield," he said.
The other polytrauma centers are in Tampa, Florida; Palo Alto, California and Minneapolis.
San Antonio's center is designed to look more like a hotel than a hospital. The lobby has a Starbucks. All medical equipment is hidden inside cabinets.
When the Texas facility opens, it will treat no more than 12 inpatients at a time. Some will have had three or four limbs amputated. Others will have massive burns or severe head wounds.
The small number of patients will help the nurses and rehabilitation specialists tailor treatment to help each veteran relearn what he or she loves to do, Wells said.
"We have lower-limb amputees who have joined us in our golf tournaments," he said. "They are playing on softball teams. They can focus these types of rehabilitative therapies around the patient's own goals, what he wants to do.
"The technology is out there, to get the patients as close as possible to doing the things they love."
Much of that technology is being developed at polytrauma hospitals, including what Wells called the "eye gaze" system, which involves computers that allow disabled veterans to turn on and off appliances and adjust electronic controls in their homes simply by their eye movements.
At the new San Antonio facility, beds are 10 inches off the ground so brain injury patients, who have a tendency to lose control of muscles, won't fall far if they tumble out of bed.
The exercise rooms contain weight machines built for people in wheelchairs and treadmills for patients trying out artificial legs. There are places in the parking lot designed to help veterans learn how to get in and out of cars. In a courtyard, surfaces ranging from rugged fields to sand will help patients relearn walking on all types of terrain.
Much of the center is geared toward helping the parents or the spouse of the wounded soldier transition into their new and unexpected role as caregiver.
"When they are no longer in need of our care here at the Polytrauma Center, the one constant that patient has in their life is the family member," Wells said.
"Preparing to deal with what they will need from early on through the advanced stages is very important."
In addition to special sleeping quarters for families, and classes on wound care and medications, there is a fully furnished apartment in the center for families to live in before patients are discharged, to try out life on their own.
"When questions come up, the nurses are right outside; help is just a call away," Yackevicz said. "Our staff can immediately come in and answer their questions, so they can deal with these issues before they come up after the soldier is back at home."
Cyndee Harmon knows how key family services are. Her son, Army Specialist Christopher Harmon, receives outpatient services at the VA Hospital in San Antonio. He suffered a catastrophic brain injury in a collision with a drunk driver.
"When we come here, every day we learn something new," Cyndee Harmon told Reuters. "We learn when to back off, when to push him, how to react in situations."
At the new facility, the goal is to fully return men and women not just to useful and productive lives, but to the useful and productive lives they love.
"Our job is not completed until they are where they want to be," Yackevicz said. "These are the overachievers, these are the very best of their generation. We cannot afford to lose them."
Editing by Corrie MacLaggan and Jerry Norton