Staying Power: New Regiment Lets Marines Take Care of Marines

By Fred W. Baker III
American Forces Press Service

Nov. 19, 2008 - In January 2006, as Marine Lt. Ray Baronie was lying in a hospital bed recovering from wounds he suffered in Iraq, a Marine lieutenant colonel in his dress uniform, sporting a question mark-shaped scar on the side of his head, paid him a visit.
Remarkably, he was there to offer Baronie a job. The wounded warrior thought maybe his medication was messing with his head.

The officer was Lt. Col. Tim Maxwell, himself a seriously wounded Marine, who had an idea to form a company to take care of other wounded Marines. He was recruiting help from within the wounded ranks.

Two years later, Baronie is back on his feet, albeit with a prosthetic leg and crutches, commanding Company A, Wounded Warrior Battalion East here. The company is the realization of both Maxwell's initial ideas and the Marine Corps' historic push to accommodate the influx of seriously wounded Marines since the start of the wars in Iraq and Afghanistan.

The Corps' Wounded Warrior Regiment has its roots in the Marine for Life program, created in 2002. With its headquarters on Marine Corps Base Quantico, Va., and a battalion on each coast, the regiment has incorporated into its ranks all Marines and some sailors seriously wounded in Iraq and Afghanistan, both past and present -- about 9,000 total, said the regiment's commander, Marine Col. Gregory A.D. Boyle.

A veteran combat commander, Boyle launched the regiment in March 2007 under the guidance of Marine Corps Commandant Gen. James T. Conway. In a rare position for a colonel of any military service, Boyle answers directly to a three-star general, Lt. Gen. Ronald. S. Coleman, the Corps' deputy commandant for manpower and reserve affairs.

"There are no filters between me and him," Boyle said. "I don't have to go through one-stars, two-stars. Nobody has to take the meat out of my brief and make it so it can't be understood. It's unfiltered. I go right to the top, which is nice."

In fact, according to Coleman, Boyle often reports directly to the commandant, testifying to the historic precedence the service has placed on care for its wounded Marines. Besides supporting the war, warrior care is the Corps' No. 1 job, according its commandant.

"I get all the money I need. I get all the people I need. I get all the priority I need," Boyle said. It "is pretty rare in the Marine Corps to have all those things. All I've got to do is pick up the phone and I can get whatever it is I need to take care of wounded warriors."

Besides those injured in the war, the regiment also assumes oversight of other seriously ill or injured Marines who need to focus their efforts on healing, and who may be a burden on traditional units that are steeped in a cycle of training and readying for deployment. The regiment also takes care of some sailors who were injured while attached to Marine units, such as those in ordnance and medical specialties.

The emphasis of the new regiment focuses on leadership, and Marines taking care of Marines, Boyle said.

"It's the Marine knowing that somebody cares about him. We're going to go talk to him every day. We're going to talk to his family every day. We're going to know who he is," Boyle said. "That's where we want our strength to be. I've got the money. I've got the people. But that doesn't make the program better.

"What the Marine is going to respond to is people walking into his room every day and asking how he's doing ... and carrying on a conversation with him and showing that they care about him."

There are about 1,200 seriously injured active-duty Marines recovering in bases, hospitals and homes across the United States, and reaching out to them is no easy task. But, the regiment has managed to connect active-duty, reserve, Veterans Affairs and other resources into a giant network spread across the United States.

Boyle launched the regiment with a small, hand-picked command staff and slowly built it to a size of about 230. It likely will grow to about 400 before Boyle is finished.

A New System of Care

The regiment's headquarters is at Marine Corps Base Quantico, Va., just a short drive from the Pentagon, and major military healthcare centers such as the NNMC in Bethesda, Md., and Walter Reed Army Medical Center, in Washington, D.C. Some of the staff are wounded Marines who working through their own recoveries.

While the headquarters is in temporary billets now, it is slated for a new headquarters building with construction starting this year. Before the staff moves in, they will have already outgrown it, said Boyle.

The regiment consists of a battalion here, another at Camp Pendleton, Calif., and a company in Hawaii. Each provides coverage for Marines receiving care in their areas. The east and west battalions divide their coverage of the United States by the Mississippi River, while the Hawaii company covers down on those recovering in the Pacific.

The battalion here has the command structure for two companies, but only one is in place. There are about 100 Marines in the company now, but it has oversight for more than 300. A new $27 million barracks complex is under construction that will move the Marines closer to the hospital and other treatment facilities on base.

The West Coast battalion has oversight of about 200 Marines and has a similar barracks construction project planned.

In the units, Marines spend their days concentrating on healing and transitioning to the next phase of their lives, whether that means recovering and staying on active-duty or leaving the service.

For those not reporting directly to the units, Marine patient affairs teams reach out to all major medical facilities. And, Marines are based in each of the Veterans Administration polytrauma centers in California, Florida, Minnesota and Virginia.

Also, the Marines have based 30 "super case managers" across the country in support cells to manage some of its most difficult cases. The case managers are based in communities where there is a large demographic of Marines recovering from their wounds. They work out of their homes, or out of borrowed office space. But their primary job is to be out meeting with Marines face-to-face to establish personal relationships, Boyle said.

To further extend its reach into the communities where former and current Marines are recovering close to home, the Corps enlisted active-duty representatives stationed at its 186 reserve sites across the country. These Marines are responsible for the training and readiness of the reserve units to which they are assigned, but they also are tasked with checking on recovering Marines at in hospitals and at home, including being on-call for help. Such calls sometimes come from family and friends when a Marine begins having difficulties coping with stress or a brain injury whose symptoms crop up months after their release from service.

Topping it off, the Marines have more than 100 "hometown links," or reservists, who spend their part-time duty helping former Marines find jobs, talking to civic groups, working with the media and other community relations work. They also can make house-calls, Boyle said.

"Within in a couple of hours, we can have a Marine standing on a Marine's doorstep, helping with his problem," Boyle said. "This really does allow us the ability to reach out and touch. It is nice to be able to not just sit here and talk to a Marine on the phone. Sometimes he may respond or may not respond, but if somebody shows up at his door, sits down in his living room -- that makes a huge difference."

The cross-country network is tied together by a massive computer tracking system launched this year. The Web-based system allows leaders to track a Marine as he moves through his recovery process. This is backed by a full-time operations center, also based at Quantico. Designed much like a combat operations center, it monitors every case within the regiment.

Most unique to the Marine Corps' program is its 24-hour per day, seven-day-per-week call center on Quantico. The other services have call centers, but the Marine's center on Quantico made a commitment last summer to begin calling some 8,000 former Marines who were injured since the beginning of the wars in Iraq and Afghanistan but have since left the service.

In the past, "We'd meet them at the door, we'd shake their hand and hand them a (record of their service) and say 'Have a good life,'" Boyle said. "We don't do that any more. It's Marine for life. We take care of them when they leave the service. For as long as they are out there, we are going to be here to help them and address their needs."

Of the center's 20 employees, 18 are retired Marines. The other two are Marine spouses. They started calling the most seriously injured first and, so far, have reached more than 5,000 of the Marines.

Many of the contact numbers on file are old and no longer valid so it takes some research and effort for the team. The team likes to talk to family members as they track down the Marine.

"We like to talk to moms and dads and wives, because Marines don't always tell us what's really going on. But moms and dads and wives do. We've fixed a lot of problems out there," Boyle said.

Call centers will be added to each of the wounded warrior battalions, and plans are to staff them with medical personnel for assessments and referrals.

The center also receives calls from Vietnam veterans and helps when they can, Boyle said.

Looking Forward

Taking care of wounded Marines now is no longer "business as usual," said Boyle.

As senior leaders work through the bureaucracy of changing a decades-old system, Boyle and his staff are on the front line of policy change for wounded warrior care. There has been some "push back" Boyle said, but, for the most part, his opinion is "everything is waiverable."

"It's not law. It's policy. They will waive policy, they will rewrite policy," Boyle said.

And, to date, many changes have been made to the policies that were most obviously in contradiction to the service's commitment to caring for Marines, he said.

But lasting, permanent change is needed within many systems to mold a single system that has the care of the Marine at its core, Boyle said.

"We've got to make sure that the wounded warriors are the priority. This is our one chance to fix it and fix it right," Boyle said. "If we do that now, we'll be much better off in the next conflict down the road."

As it is, Boyle said, the service is proving itself "100 times better" than it was a year ago at taking care of its Marines.

(Editor's note: This the latest in a series of AFPS articles about seriously wounded warriors who are returning to active duty).