U.S. Army Sgt. Joey Bozik remembers coming out of a coma at Walter Reed Army Medical Center not fully understanding why he was there.

"I knew something had happened to me, I just didn't know what," Bozik said.

He first inquired about his family, then about himself.

"I had an above-the-knee amputation of my right leg and a below-the-knee amputation on my left leg. I had a below-the-elbow amputation on my right arm. And on my left hand, my thumb and pinkie were fractured and the metacarpals in my hand were fractured and I fractured my wrist," Bozik said.

The human toll for the U.S. military in the Iraq war is not limited to the nearly 2,000 troops deaths since the March 2003 invasion. More than 15,220 also have been wounded in combat, including more than 7,100 injured too badly to return to duty, the Pentagon said. Thousands more have been hurt in incidents unrelated to combat.

Bozik, a 27-year-old from Wilmington, North Carolina, recounted what happened to him, as he used his left hand and a prosthetic right hand to pedal a stationary hand bike in the physical therapy room at Walter Reed. His 25-year-old wife, Jayme, stood watchfully behind.

On October 27, 2004, Bozik was in the front passenger seat in a vehicle on patrol south of Baghdad, checking for insurgent roadside bombs, known as improvised explosive devices (IEDs). Coming down a highway overpass, his driver steered the truck more widely than the two vehicles in front.

It rolled over an anti-tank mine with two mortar rounds attached. The explosion blew two other soldiers free of the vehicle. But Bozik was trapped inside.

Military doctors say U.S. troops are surviving wounds in Iraq that would have been fatal in previous wars due to advances in medical care and body armor.

Military statistics showed that while 23 percent of U.S. troops wounded in combat in World War Two died and 17 percent in the Vietnam War, 9 percent of those wounded in Iraq and Afghanistan died. Without the advances since Vietnam, the U.S. death toll in Iraq would be nearly double the current total.

But military doctors said some troops who may have died in previous wars are surviving, but with grievous injuries such as multiple limb amputations. More than 300 troops have undergone at least one limb amputation. By far the single biggest cause of combat wounds are blasts from IEDs.

'A MIRACLE'

"We look at patients oftentimes and feel like it's a miracle that they're alive," said Lt. Col. Paul Pasquina, chief of physical medicine and rehabilitation at Walter Reed, which has treated more than 4,400 troops hurt in Iraq.

"Someone who loses one limb is a challenge to get back to a meaningful, functional lifestyle," Pasquina said. "But somebody who loses three limbs, on top of other types of soft tissue wounds, fractures, head injury, spinal-cord injury, paralysis...?"

Pasquina and Lt. Col. Warren Dorlac, chief of trauma surgery and critical care at Landstuhl Regional Medical Center in Germany cited several factors for why a larger percentage of wounded U.S. troops were surviving:

• advances in body armor, with torso armor better protecting the chest and abdomen, heart and lungs and helmets better protecting the brain;
• better trained and prepared battlefield medics;
• improved in-country surgical capabilities allowing patients to be stabilized so they can be quickly flown out of Iraq.

Moving patients to U.S. hospitals usually took 45 days during the Vietnam War, but has been reduced to as little as 36 hours now. Most troops flown out of Iraq are then treated at Landstuhl before being sent along to facilities in the United States including Brooke Army Medical Center in Texas or Walter Reed in Washington.

For the first anniversary of the blast that wounded him, Bozik and his wife are planning a celebration with friends.

"We'll call it my 'life-day,"' Bozik said, wearing red shorts and a white T-shirt with an athletic gear manufacturer's slogan, "Just Do It."

"He's always got that positive attitude," his wife said.

"The way I look at it is I've been given a second chance on life," Bozik said. "Everybody always wants to know what the meaning of life is. I'm not saying I have the answer. But I can tell you one thing, I have a better understanding of what life's about."

© Copyright 2005 Reuters Ltd

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