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'I'm not out of Iraq'

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Luis Fabregas can be reached via e-mail or at 412-320-7998.

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WASHINGTON - The soldier groans on his hospital bed as pain fires down his right leg.

He thinks about lifting the sheet and peeking.

He doesn't.

"Do I still have my leg?" he asks a nurse.

"No."

U.S. Army Spc. James Stuck buries his face in his hands and cries.

Half his leg is gone, the nurse tells him. What remains is a bloody stub that mushrooms just below the knee.

The soldier asks her to take a picture. He'll look at it later.

That was more than eight weeks ago, at the Army's Landstuhl Regional Medical Center in Germany.

Stuck doesn't know what happened. He only knows he was a soldier in Iraq, and now he is missing a leg.

Now in the U.S., his recovery will not be easy. It will test his body, his patience and his soul.

"People don't know how I'm alive," says Stuck, 22, of New Kensington, Westmoreland County, assigned to the 101st Airborne Division in Kirkuk. "If I don't tell my story, nobody's going to know."

Here at Walter Reed Army Medical Center, the country's premier medical facility for the military, officials say Stuck is among perhaps the largest population of amputees in the U.S. - nearly 400 soldiers who lost legs or arms since the start of Operation Iraqi Freedom.

Like his fellow soldiers, Stuck will get much more here than a fancy new limb with an internal computer.

He will learn how to walk, how to tie his tennis shoes and how to look at himself in the mirror.

And he will learn how to begin a new life without the leg that helped him become a soccer athlete at Valley High School.

He will endure weeks of agony and frustration.

"I turned 22 here - happy birthday," he says.

His leg swells overnight, and itches. Cruelly, it feels sometimes as if it's still there, as if nothing happened.

Doctors at Walter Reed say Stuck's recovery will take at least five months. That's far shorter than the average soldier amputee, who can spend up to a year confined to a hospital.

"I put him in the highly motivated category," said Dr. Brian Belnap, chief of inpatient amputee service at Walter Reed, who oversees Stuck's care. "I think he'll be out of here before June or July."

In his mind, Stuck remains with his buddies in Iraq. He hopes to see his squad leader, who will return later this month to give Stuck his Purple Heart.

"I may have come back, but my whole platoon is in Iraq," Stuck said. "I may have come back, but I'm not out of Iraq."

A memory lost

Nobody understands how James Stuck lost his right leg instead of his left.

Five days before Christmas, he was a relative newbie in Iraq, driving an up-armored Humvee down a road filled with craters, when an improvised explosive device detonated to his left.

"When you drive, you drive with your right foot forward and your left usually sits back - so, boom," Stuck says as he sips a Johnny Walker Red-and-Coke at the Mologne House, a hotel for soldiers undergoing outpatient treatment. "That's what mangled it up, and that's why they had to chop it off."

Stuck remembers nothing.

But he has seen pictures: the destroyed Humvee, with only a tiny piece of the front right axle seemingly intact; the burned bumper lying one-tenth of a mile away; the radio mount blown into the back seat.

As he recounts his ordeal - pieced together from reports by fellow soldiers - Stuck is talkative and blunt.

"You can call it a stump or nub," he says of what remains of his leg.

He pauses often and smiles easily, seemingly aware of his poster-boy appeal - broad shoulders, blue eyes and a gap-toothed grin resulting from a failed acrobatic stunt at his grandmother's house when he was 10.

Stuck knows he could have died. But today's military is far more medically advanced than during any previous war.

Soldiers with life-threatening wounds are treated on the spot by combat medics trained as emergency medical technicians, with the ability to handle far more serious injuries.

The wounded are rushed to mobile surgical units minutes away from the combat zones, where doctors immediately perform lifesaving surgeries and can care for patients for up to 72 hours, said Jaime Cavazos, a public affairs supervisor at Army Medical Command in Texas.

Other than his care, Stuck credits his survival to the protection afforded by the M-1114 Humvee, a 9,800-pound monster with steel-plated doors and layers of ballistic-resistant glass.

His doctors say Stuck arrived at Walter Reed in stable condition. His records aren't specific about when they removed his leg.

Stuck says the sorrow over losing his leg lasted only 30 minutes.

"All right," he recalls saying to his nurse, "what do I need to do to heal it?"

That level of motivation is rare, experts say.

Often, a soldier's emotional wounds are as deep as the physical ones. They become irritable and hypervigilant, can't sleep and feel guilty about surviving.

"They start asking questions like, 'Why did I make it home and my friend didn't?', 'Do I deserve to be here?' " said Dr. Jeffrey Peters, a psychiatrist and vice president of behavioral health at VA Pittsburgh Healthcare system. "You see people with an unnecessary burden of guilt."

During his inpatient stay, Stuck met daily with a psychiatric team. They taught him to look ahead, not back.

That was evident during an early March ski trip to Vail, Colo. Though he never before skied, he quickly mastered the slopes and spent three days perfecting his moves.

His motivation did not surprise Ruth Demuth, a Vail ski instructor.

"Someone with a disability, they want it so bad, they don't make excuses; they really listen," she said. "They know that if they can do this, they can do anything."

'I am not a quitter'

After high school, Stuck attended LaRoche College for two months and decided he wasn't cut out for academics.

In class one morning, he suddenly realized he'd slept through the entire lecture - and the one before it.

"I couldn't juggle soccer, partying and school," he says.

Having worked odd jobs at several restaurants, Stuck enlisted in the Army Reserves. He trained first at Fort Benning, Ga., and then at Fort Campbell, Ky.

"I didn't quit college," he said. "I just left. I am not a quitter."

His family supported his decision to join the military.

Stuck's father, Doug, 56, who retired from a job in heavy construction, offered a few words of caution. "Ten fingers, 10 toes - come back whole," Doug Stuck told his son days before he left.

Doug Stuck felt devastated when he received a call from his younger son, Jonathan, to tell him about James' injury.

"My knees started shaking. I thought I was going down. I lost it. I couldn't talk to anyone; I was mentally deranged."

He drove to Washington, D.C., from New Kensington on Jan. 13. When he got there, he didn't ask his son what happened.

"I let him do all the talking," he said. "I didn't want to ask questions and be inquisitive. It was awkward."

Doug Stuck has witnessed every step of his son's care: When James learned to use a device that delivered pain-killing morphine to his veins; when James complained of phantom pain in his amputated leg; and when James received a slick new leg made of carbon fiber.

"It's his strength that has pulled me through this," the father says.

Working it out

Stuck's rehabilitation workouts resemble a day at a high school gym.

One early morning, dozens of soldiers are performing varying types of exercise routines.

Stuck finds a spot on a wide, blue mat and takes off his prosthetic leg with the ease of someone removing a winter coat.

He rests on the mat, his back propped up on a pillow.

"My leg feels great," he says as he takes off an elastic sock he wears to control swelling.

His tattoos jump out from beneath his shorts and T-shirt. One spirals around his left arm - images of bees, mushrooms, hamburgers and McDonald's french fries.

Another tattoo, which he got just before leaving for Iraq, is at the base of his stump. When his leg was amputated, the little girl on the tattoo lost both legs. Stuck is happy that doctors saved part of her.

He stretches what remains of his right leg and lifts it as high as he can. One, two, one, two.

Next to him, a soldier who lost two legs watches in silence, his eyes almost glazed.

"Every time I see you in here, I'm doing some crazy stretches," Stuck tells him, as he pushes his body on an oversized gray ball and grunts.

The other soldier says nothing, but smiles.

Stuck dreads that his brother Jonathan will have to see this.

"I don't want him here," he says. "I don't know how it will hit him. He just turned 19. I can understand where it'd be awkward even for me to see somebody. If this hadn't happened to me, it'd be awkward for me to walk into that. I would just stare and not blink ... just stare at one person."

Only the beginning

A team of doctors and physical and occupational therapists measure James Stuck's moves.

This will be his life for the next four months.

They will conduct excruciatingly long tests to measure the force of his foot as it stumps on the floor, even the length of the steps he takes.

"I feel like a freaking robot," Stuck mutters in the gait-and-motion laboratory as an engineer places quarter-sized markers across his thighs, back and chest.

In a matter of minutes, cameras placed around the room will pick up the markers and measure how Stuck's knee joints bend.

The 90-minute gait evaluation is one of the newest, most advanced ways to measure how people walk. The objective: to gather data that ultimately could help build an ideal prosthetic leg.

Physical therapist Barri Miller coaches Stuck through a series of walking exercises, while engineer Brian Baum builds a stick figure on a desktop a few feet away.

The stick figure will match Stuck's limbs, comparing his right leg to his left in real-time. It will show if his foot is stable and if he's using too much force to walk.

Miller instructs Stuck to take 12 steps fast, hoping to see if his leg bends or twists when it's moving.

Stuck strides across the room, his eyes fixed on a wall.

"That was beautiful," Miller said.

Stuck is visibly tired. As Miller explains the test results, Stuck obviously is ready to stop; he's hungry and frustrated.

"You've lost me," he tells Miller. "You're pounding me with stuff to remember."

The therapist gives Stuck her take-home message. He'll need to strengthen his knee. It is slightly bent upon landing, a common problem people have with below-the-knee amputations. He also will need to point his foot downward a little more when he takes a step.

Stuck appears relieved when the session is over. But he knows this is only the beginning of a long road.

Later that night, he talks about learning to walk again.

"That's the hard part," he says. "You've learned everything once, and now I have to learn it again."

And he talks about seeing his shattered leg for the first time, in the pictures taken by the nurse in Germany.

"You could see the bones, the muscle," he says, his voice trailing off. "I'm glad I didn't look at it back then. I would have been devastated."