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The Wounded Warrior and the Art of Independence

The Wounded Warrior and the Art of Independence
Erik Johnson, MS, OT
March 21, 2016

The Wounded Warrior

I want to take you through the journey of the wounded warrior and show you what it looks like from the beginning to the end. It begins in the actual battlefield. Their journey begins the first time that they are compromised, or that first actual moment that they are hit. We are going to talk about behavioral health a little bit here in a minute. When somebody is injured, the behavioral health component begins right away.

I wanted to show you a quick clip of one of our wounded warriors named Travis Mills. He was injured in Afghanistan in 2008. This is a documentary, A Soldier's Story, that recently came out about him. 

A Soldier's Story


I encourage you to seek out this documentary and watch. It is very powerful, there is a lot of occupational therapy treatment shown. 

Next, I wanted to show you an actual medevac that took place. When Travis was hit, our medevac team responded within seven minutes of notification.



We always fly in pairs to make sure that if anybody does take fire, there is somebody there to report or help. We never fly so low. As the "birds" come in, we have a medevac team waiting to take the injured soldier through a triage process, and then forward to a surgical team that will work with them from there. 

Behavioral Health

As you know OT started back in World War I as reconstruction aides (Figure 1). We have a big team of army occupational therapists at the hospital here in San Antonio. Behavioral health is probably the number one thing that is going to help any of our soldiers make it through the devastating injuries that they have received.


Figure 1. OT origins.

I do not succeed in my job if I do not think about their family life, their sexual intimacy, their ADLs, their long-term leisure interests, and things like that from the very beginning. If I am not thinking about that from day one, then I have already missed the boat on being an effective provider for them.


Polytrauma is like a snowflake. Each and every patient is different. They have different injuries, they have different family lives, they have different scenarios that they have gone through. Your treatment plan should be individualized.

Upper Limb Amputee Protocol

We are going to go now into upper limb amputee protocol (Figure 2) developed during the wars in Iraq and Afghanistan. It was developed as a guide for treating patients. Lieutenant Colonel Yancosek, a mentor of mine, has been a fantastic advocate for the wounded warrior and army occupational therapy. She currently serves as the Director of the Center for the Intrepid, which is our big amputee center down here in San Antonio. She, amongst a bunch of other people, helped developed this program. It would not be where it is at today if it were not for them.


erik johnson

Erik Johnson, MS, OT

Erik Johnson previously served at the San Antonio Military Medical Center where he was the chief of OT in the Department of Defense Burn Center. He also previously served as Chief of Amputee Services at Walter Reed Hospital. He has worked with soldiers who have suffered devastating injuries during combat operations. He specializes in occupation based upper extremity orthopedics, complex polytrauma, and cognitive dysfunction.

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