GUY RAZ, HOST:
For the troops injured in Iraq and Afghanistan, the deepest physical pain often comes much later - weeks or even months after the incident. That was the case for Sam Brown, who was badly burned in Afghanistan. But before we get there, some background. Sam graduated from West Point in 2006. And in the late summer heat of 2008...
SAM BROWN: Goodness. Yeah, we don't know hot like that.
RAZ: ...he was deployed to southern Afghanistan to lead a platoon.
BROWN: Deployment is sort of the pinnacle of service. In particular, combat is somewhat glamorized by Hollywood and just, it's, you know, it's considered a patriotic activity, you know, something to be a part of. And I learned very quickly that it's not what it seems to be.
RAZ: Much of what Sam's unit did was hearts and minds stuff, checking in on locals in Kandahar to see if they had adequate water, whether they were safe. It was hot, often mind-numbingly dull and dusty.
BROWN: We called it moon dust. It was just this kind of powdery dust that stuck to everything. No access to showers for a couple of weeks, you know, at a time, and there were days where it peaked out at close to 130 degrees.
RAZ: Now, before he deployed, Sam ran through a series of scenarios in his mind, scenarios of what might happen to him in Afghanistan.
BROWN: Interestingly enough, the one drill I didn't run on myself was burning. And that just, for whatever reason, did not cross my mind as a potential type of casualty.
RAZ: Sam's story is featured in the latest issue of GQ magazine.
BROWN: I remember everything about the day I was injured.
RAZ: That September day in 2008, Sam Brown's unit was called in to back up another platoon that came under attack. They were just approaching the site in Kandahar.
BROWN: And we hit an IED, right as we got to their location, and that was the beginning of a new life for me.
JAY KIRK: He's not knocked unconscious immediately.
RAZ: That's journalist Jay Kirk, who wrote the article about Sam and reconstructed what happened that day.
KIRK: He's on fire. He's down on his knees with his arms just flaming. His face is on fire. He's trying to put himself out, you know? He's rolling around as much as he can, you know, drop and roll, but he has a tactical vest on so that's preventing him from putting himself out.
RAZ: Five days later, Sam Brown was in the intensive care unit at the Brooke Army Medical Center in San Antonio. And almost immediately, to prevent skin infection, he was taken to a shower room where his skin was scrubbed by nurses. This is a regular, often daily part of burn care.
BROWN: And it was as close to the same pain of being burned as I expect you could get, and it was a nightmare. And I thought, well, you know, when it was done, I thought, at least that's done. And the next morning, they woke me up and said they were going to do it again. And I wasn't prepared for that mentally.
RAZ: He was put on a wide variety of drugs, including morphine, but nothing could dull the pain.
KIRK: I mean, this is a drug that was invented in 1804, but there haven't really been a lot of advances in it since then. And there's a lot of really negative side effects to opioids. So, you know, there's nausea and constipation. It doesn't necessarily work on everyone, and then there's the tolerance levels. So, you know, the more pain you're in, the more you need, the more you take, the greater the tolerance is, the less it works, and it's very dangerous.
RAZ: 2,200 hundred miles away from San Antonio, two researchers at the University of Washington's Medical Center in Seattle were working with burn patients who, like Sam, weren't responding to pain medication. One of those researchers is David Patterson.
DAVID PATTERSON: It takes a certain amount of attention to process pain. And if you are able to put that attention elsewhere, there's less attention to process pain, and consequently, people will feel less pain.
RAZ: Patterson and his colleague Hunter Hoffman were experimenting with virtual reality. Hoffman had been using a computer program with arachnophobes, a program where by wearing special goggles, they become immersed in a world of friendly spiders. Patterson and Hoffman wondered whether a similar approach could work with burn patients. Here's Hunter Hoffman.
HUNTER HOFFMAN: We created a world that was the antithesis of fire, the opposite of fire, a cool place, snowmen, pleasant images, just to try to do everything to keep them from thinking about fire.
RAZ: They called it SnowWorld, and the Army was interested in trying it out with troops burned in battle, including Sam Brown.
BROWN: I was quite skeptical, but I was also at a place where I was willing to try anything that might help.
RAZ: That's because on a scale from one to 10, Sam's daily pain level often spiked at eight. So he put on the goggles and entered SnowWorld.
BROWN: It was like watching a B-rated Pixar film.
(SOUNDBITE OF MUSIC)
RAZ: Instantly, the world around him was populated with penguins and snowmen and wooly mammoths.
(SOUNDBITE OF WOOLY MAMMOTH)
BROWN: Everything about it was just cold and cool and cartoony.
RAZ: And miraculously, being inside SnowWorld dramatically reduced the pain of his physical therapy.
BROWN: Actually, they were able to move my arm and stretch it further than I had ever before to that point, and the pain was lower. So it was a very successful event.
RAZ: Sam Brown spent more than a year undergoing surgery, and in physical therapy. His face was reconstructed using harvested skin from his back. And during that time, he also fell in love. His dietitian, Amy, also an Army officer, is now his wife. And last September, almost three years to the day of his injury, they had a baby boy. His name is Roman.
BROWN: I still, in my own mind, pictured myself for a long time as I was prior to the burn. But I'm at a place now where I picture myself as is, and the scars are really just a great reminder of who I am and the opportunity I've been given in life. It's sort of an external tribute or reminder to a new life.
RAZ: Sam Brown's story is told by reporter Jay Kirk in the latest issue of GQ magazine.
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