An Iraq war veteran's extreme road back

Brett Miller competes in the Sea Otter Classic in Monterey, California, this past April.<br>    <strong>Courtesy of Sea Otter Classic and Brightroom</strong>

Brett Miller leaned over his mountain bike's handlebars and took in the breathtaking view as the wind whipped across the grassy ridgeline. Beneath him was an adrenaline junkie's dream: a narrow dirt trail with steep descents, hairpin turns and unexpected bumps. The extreme sport of downhill mountain biking is not for the faint of heart. And common sense says it shouldn't be for Miller.

He suffered a traumatic brain injury nearly two years ago in Iraq when a roadside bomb exploded next to his Humvee. The blast cost him the sight in his right eye, hearing in his right ear and half the strength on his left side, and it left Miller with a memory so poor that he could not recall much of this serpentine course even though he had made several practice runs.

"I have a constant battle with equilibrium, depth perception and balance--basically all the things you need for this sport," Miller said while adjusting his racing helmet. "But it doesn't matter how I finish. What matters is that I'm trying."

Moments later it was his turn in the starting chute of the Corral Hollow Downhill, held in the rugged backcountry between Livermore and Tracy, California, and he launched himself down a rocky path that looked more like a rainwater gully.

It was in this exhilarating sport that Miller began to find purpose in a life inexorably changed by war. And he discovered something else: healing. Miller has been treated at Bay Area Veterans Affairs medical centers since October, and he won the grudging approval of the staff to try mountain biking after it concluded the risks were outweighed by the therapeutic benefits.

The journey of recovery is different for every wounded man and woman who returns home searching to reclaim, or adjust to, what was lost. The path for Miller, who received a Purple Heart medal, has become a winding race course.

Heading into danger

Sgt. Brett Miller of the Oregon National Guard is 32. His salt-and-pepper hair is cropped short, military-style. He plays the guitar and is handy with tools. He has an easygoing personality accented with self-deprecating humor. He jokes that he's so slow on his bike that "I should get a bell for my handlebars. You know, 'ring, ring.' Or maybe I could put on a basket."

His personable manner also makes it difficult to discern, in casual conversation, that he suffered a devastating brain injury. But Miller said he feels lost without gadgets such as his SUV's navigational system or the handheld computer he carries to keep track of his schedule and phone numbers.

"I've been told that I hide my problems well," Miller said recently at the Veterans Affairs hospital in Palo Alto, California, during a break between group counseling sessions. "But it sucks that I'm dependent on devices."

A native of the Sacramento-Lake Tahoe area, Miller had always been independent. "He was as sharp as a tack," Miller's father, Mitch, said. "He was really super-bright and could remember minute details. He's one of those people who could have done anything that he chose to in life and excelled at it."

With a master's degree in wildland fire science, Miller taught college courses in firefighting during the winter and battled blazes for the U.S. Forest Service in the summer. He led an elite 20-person "Hot Shot" crew into often-perilous situations. Miller, who joined the National Guard in 1998, found more danger in Northern Iraq.

On Aug. 11, 2005, he was in the passenger seat of the lead Humvee providing security for a convoy. A buried homemade bomb consisting of three artillery shells detonated six feet from his door. Miller remembers a sharp pain in his right ear and nothing else. Only after he was transported to Landstuhl Regional Medical Center in Germany did he begin to comprehend that he had been seriously wounded.

Some injuries were obvious: his lost sight and hearing deficit, a badly injured knee, a broken nose and nine fractured teeth. But other problems were harder to diagnose.

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The hidden stuff

Traumatic brain injury, or TBI, has become the signature wound of the fighting in Iraq and Afghanistan because of the blast force of improvised explosive devices, the insurgents' weapon of choice. As of March, the Defense and Veterans Brain Injury Center estimated, 2,130 U.S. military personnel had suffered TBIs, with 30 percent of them deemed moderate to severe.

But officials at Palo Alto's polytrauma center, one of four VA facilities that treat TBI patients, believe the number of undiagnosed cases is much greater. For a year after his injury, Miller was in that category.

His health improved only marginally in military hospitals. Miller recalls being at Walter Reed Army Medical Center, in Washington D.C., for a month and never getting into a room; he was kept in a hallway. Later transferred to Madigan Army Medical Center in Tacoma, Wash., Miller believed his doctors were missing something.

"There are so many people in the military hospitals that they really just try to push you through," Miller said. "You feel like cattle. I was one of those soldiers who fell through the cracks. The military is quick to treat the physical injuries. But they need to brush up on the hidden stuff."

It was only when he persuaded his case manager to have him tested for neurological problems last September that the extent of his brain injury was revealed. When he arrived at the Palo Alto VA, he needed canes to walk, his speech was impaired, his cognitive processing was slow and he had lost about 35 pounds. But Miller said the difference between his VA treatment and what he received in military hospitals was like "night and day." The polytrauma center's program has teams of therapists who work with brain-injured patients for hours each day.

"At Thanksgiving, he came home for a visit and he still was a mess," said Mitch Miller, who lives in the Sierra town of Pollock Pines. "His knee was so banged up that he could hardly walk. He couldn't see well. His hearing was poor. But the VA has given him new life. The difference in Brett is just incredible."

As Miller regained use of his body and mind, he also pondered what would be next for him now that his careers were over. "I was in a hospital bed for a year trying to figure out what I could do that would make me as happy or fulfilled," he said. "I didn't have a goal."

Then he decided on a simple one. He wanted to ride a bike.

VA staff's quandary

The first time he "rode," Miller essentially walked his bike because he couldn't get on the seat. He worked up to making slow turns in a parking lot and then riding on flat trails.

"I had the feeling of the wind is blowing in my face," he said. "That might seem small, but when you can't do something for so long, it gives you a sense of freedom."

He went searching for a bigger challenge. Miller struck up a friendship with Javier Bustamante, a Sacramento County deputy sheriff who was advertising one of his downhill mountain bikes. Bustamante agreed to sell it to Miller, but he had a logical question: Do your doctors know about this? For the hospital staff, Miller's determination posed a quandary. VA doctors and therapists prefer to motivate patients to do more, not tell them what they cannot do. And many of the young military personnel they treat are risk-takers by nature.

Yet if Miller fell and hit his head, more serious brain damage was possible.

"What Brett does is kind of scary," said Dr. Elaine Date, head of the Palo Alto's polytrauma center. "But when you're in the rehabilitation field, you always have to balance medical safeness with what the patient has a passion for. He just lit up when he realized what he could do on a mountain bike. It would have burst his balloon if I told him that he couldn't do this."

Mountain biking was becoming an extension of Miller's rehabilitation, providing the motivation to get stronger. It also gave him the sense that his life was going to be OK. So his therapists decided to give Miller their blessing to race if he could demonstrate his ability. Miller went riding with recreational therapist Kayla Forster and Sgt. Lee Smith, a VA military liaison. Miller did fine even though his knee injury makes it difficult for him to pedal. Smith, though, fell and broke his collarbone.

"When we first went out, I was reminding myself to stay open-minded," Forster said. "But I kept thinking, What am I going to tell the rest of the team? 'Yeah, he could fall and die, but...' Yet he's smart and safe. He's aware of his deficits and he compromises for them. I can't think of a better thing for him to do that would help his progress."

When Miller, wearing a helmet and pads, competed in Monterey's Sea Otter Classic in April, staff and friends from the VA cheered him on wearing "Team Miller" T-shirts. He did well enough in his age division to qualify for a national race this summer.

A new outlook

Mountain biking, Miller said, is an escape from the painstakingly slow rehab process. It also reminds him of what he still has and helps him avoid dwelling on what is gone. He is a divorced father of an 8-year-old daughter whom he rarely gets to see. An engagement to another woman ended after he was wounded. Miller knows he will never fully recover his memory. One day, at a VA session teaching memorization techniques, group members were asked to remember 16 words. Miller got just five on his first attempt.

"I'd rather not tell people what's going on with me, but that creates problems," said Miller, who is now in a residential treatment program at the National Center for Post Traumatic Stress Disorder in Menlo Park, California. "People become impatient with me. They look at me like, 'What's wrong with you?' because I need to have things repeated to me or have things written down. That stuff bothers me."

And yet Miller says he has a much more positive, less-stressed outlook. His newfound passion for sports is part of the reason. He did well enough at a Colorado skiing clinic for disabled veterans in April that he was approached about racing competitively. And there's mountain biking.

"Out here I'm just another guy riding," Miller said that spring day at the Corral Hollow Downhill. "Most people don't know somebody who was wounded in Iraq. And I guess they don't expect someone hurt in Iraq to be racing mountain bikes."

But he does. Like the other competitors, he went down the hill alone, racing the clock. Unlike one rider who left in an ambulance with his arm in a sling, Miller stayed on his bike. His top speed reached 31mph, and he finished sixth out of eight riders in his age group. But like he said, it didn't matter.

Just before going down the hill, Miller added one thing that he often tells people now.

"I like my second life better than my first life."


Contact Mark Emmons at memmons@mercurynews.com. For more of the San Jose Mercury News go to www.mercurynews.com. Copyright 2007, San Jose Mercury News, California. Distributed by McClatchy-Tribune Information Services.

Photo courtesy of Sea Otter Classic and Brightroom.


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