National Military Appreciation Month: Home Base Program’s commitment to Veterans & their Families

By Major (ret) Arturo R. Murguia

Mosul, Iraq January, 2006.  Iraq is in the midst of some of the worst sectarian violence in Middle East modern history.  Coalition forces are battling an unforgiving insurgency.  Two Army occupational therapists in Northern Iraq continue to rehab wounded US and Iraqi troops and Iraqi citizens.  In the fog of war, US forces open fire on what turns out to be a family vehicle, killing two of its occupants and catastrophically wounding another, a young Iraqi boy.  Across the pond, a major sports team’s ownership, its team physician, and the local hospital are openly asking how they can support service members, veterans and their families.

What may have appeared as mutually exclusive and sometimes maddening events gave birth to the Boston Red Sox Foundation and Massachusetts General Hospital’s Home Base Program.  Today, the Home Base Program is one of the most successful private-public medical partnerships because of a little Iraqi boy and a chance meeting between three medical providers and the people of Boston.

From the Ashes…

Rakan Hassan was riding in his family’s vehicle when US forces unwittingly and tragically fired on his family’s vehicle killing his parents and leaving him paralyzed from the waist down.  Rakan would never walk again and his siblings, all of whom witnessed the tragedy, would be forever changed.  After hearing of Rakan’s story from a constituent, the late Senator Edward Kennedy pushed past bureaucratic entanglements to bring Rakan to the US to get him the best possible care.   And he would turn to the only physician he knew who could assist in turning this little boy’s life around for the better.

Rakan Hassan (wheelchair) & Dr. Larry Ronan (far right). Boston Globe story “A Long Rehab Begins.” Courtesy of Boston Globe Story Boston Globe Staff Photo/Michele McDonald

Larry Ronan, M.D., is the Red Sox team physician and also an internist at Massachusetts General Hospital (MGH).  Army Lt. Col. Matthew St Laurent and Maj Sarah Mitsch are Army occupational therapists who were deployed to Mosul.  St Laurent and Mitsch are both New Englanders and huge Red Sox fans.  Dr. Ronan had been charged with Rakan’s care by Sen. Kennedy.  The three of them crossed paths at the 47th Combat Support Hospital (CSH) when Dr. Ronan brought Rakan back to Iraq.  Because of Dr. Ronan, MGH and Spaulding Rehabilitation Hospital’s commitment to world class care, young Rakan was now able to walk with the assistance of crutches.  This is something that would have been unfathomable in post-invasion Iraq. 

According to St Laurent, Sen. Kennedy’s office facilitated Rakan’s transfer and care to Dr. Ronan, “With the assistance of the late Sen. Kennedy, the military, and many others Dr. Ronan, Mass General and Spaulding Rehab Staff were able to save (Rakan).”  He continued, “Once Rakan was stabilized and rehabilitated, he was brought back to Mosul, essentially in the arms of Dr. Ronan.”  St Laurent continued, “Those ‘others’ include the unnamed American people who, without financial support to humanity, the above events and successes would never have happened.”

Seeing the extraordinary work that Dr. Ronan, and later, St Laurent and Mitsch were performing on Rakan, the family decided to bring Rakan’s cousin to the CSH for care.  St Laurent stated that Rakan’s six year old cousin, Haneen, appeared to have a 3 months old blast injury to her left arm, “Her left, radial forearm bone was shattered and had been partially debrided by Iraqi medical personnel.  There was nothing we could do except provide adaptive splints to help her fingers and wrist function.  She needed reconstructive surgeries under the supervision of Dr. Ronan and his medical team to prevent her from having a permanently disabled left arm.”

What happened next was nothing short of astounding.  St Laurent emailed Dr. Ronan Haneen’s x-rays from Mosul.  Dr. Ronan emailed back St Laurent on March 7th, 2006, “I’ve secured funding,” which, St Laurent interpreted as, “send her to Boston.” St Laurent went on to say, “Maj Mitsch and I worked our butts off to get  (Haneen) out of country to Dr. Ronan and his team of medical professional ‘angels’ and the Boston community to treat and care for her and her dad at Mass General.”  St Laurent continued, “A few months later, after her surgeries and rehab were complete, she was returned to Iraq with a fully functioning left arm.”

I wish I could tell you this is the happy ending to this chapter.  It isn’t.  Sadly, Rakan was killed when insurgents detonated a bomb near his home.  There are myriad reasons given as chronicled in Kevin Cullen’s Boston Globe article, “The end of Rakan’s war.”  At the end of the day, Rakan is still gone.  His death leaves a gaping hole in the hearts of all who cared for him.  However, if not for this young boy, the development of a relationship that would go on to change hundreds, if not thousands, of lives may have never taken root.

Just a meet and greet… 

Not to take anything away from the 2004 World Series Champion Red Sox and its achievements, but something more defining occurred with the Red Sox’s 2007 World Series Team.  Some will tell you the 2007 season was more memorable and significant because the second World Series title validated the 2004 team’s improbable comeback, especially after injury plagued seasons, none worse than the 2006 season.  But if you ask Boston Red Sox owners John W. Henry, Principal Owner, Tom Werner, Chairman and Larry Lucchino, President and CEO, they might tell you their post season took on greater significance after the team paid a visit to the former Walter Reed Army Medical Center.

LTC Matthew St Laurent (right), at the former Walter Reed Medical Center, with Iraqi physical therapists (L to R) Lt. Weaam Mousa, Lt. Tamer Gebur and Lt. Ali Nasaif, and their translator, Nihad Asker, a dentist. Photo Credit: Joshua L. Wick, WRAMC Public Affairs

Prior to the Red Sox’s White House Visit in 2008, Dr. Ronan contacted his friend from Mosul, Lt. Col. St Laurent and Maj Mitsch, and said the Red Sox ownership wanted to know if the team could stop by the former Walter Reed.  Nothing special, just a two hour meet and greet for wounded warriors.  The ownership and team were so moved by what they witnessed, they delayed their chartered flight and stayed for 4 hours.  Home Base Program Director, John A. Parrish, M.D. stated, the Red Sox ownership immediately and collectively asked, “What can we do?”  This visit solidified the Red Sox ownership’s resolve to do more for our wounded warriors.  They charged Dr. Ronan with putting together a proposal for a more committed relationship with wounded warriors and their families.

In March 2008, the Red Sox were finishing their spring training exhibition games in Japan.  Just days removed from their visit to Walter Reed, the Red Sox ownership reiterated their desire to see a program proposal.  After observing the first hand affects of the invisible wounds of war, they recognized this was now a sacred obligation they needed to keep with the wounded warriors and families they visited.

Building Home Base

Creating this multi-faceted program was no easy task.  It was decided the best course of action would be to construct a full-spectrum care model for PTSD and TBI patients that incorporated family care and community education and research.  Michael D. Allard, Chief Operating Officer for the Home Base Program stated, “This program is focused on three principle areas: direct clinical care to veterans and family members;  education of the community and clinicians about the “invisible wounds of war” and the challenges faced by military families and groundbreaking research to find better treatments for TBI and PTSD.  We do this in collaboration with the Department of Veterans Affairs and the Military Health Care system.”

It isn’t just these focus areas that make the Home Base Program uniquely qualified to offer this level of care to service members, veterans and their families.  Dr. Parrish stated, “According to the US News and World Report, Massachusetts General has the number one rated psychiatry department and the number five rated rehabilitation department at Spaulding Hospital.”

The Boston Red Sox Foundation and Massachusetts General Hospital put together a team to build the Home Base Program that was stacked with political heavy weights.  Dr. Ronan reached back to his patient, and a former Army Private, the late Sen. Edward Kennedy.  According to Dr. Ronan, Sen. Kennedy was true to his nickname, the “Lion of the Senate,” as he was “instrumental in promoting the program, gathering partners, and cutting through bureaucratic red tape.  Sen. Kennedy did this while in the middle of his own terminal illness and he still took time to visit wounded warriors.”  The Foundation then enlisted the aid of then Veterans Affairs Secretary, Lt. Gen. (Ret) James Peake, MD.  Secretary Peake’s involvement was critical in steering the initial concept of the program towards a more holistic and familial approach.

Rakan’s Legacy

Today, the Red Sox Foundation and Massachusetts General Hospital’s Home Base Program has partnerships with New England area National Guard units, the Veterans Affairs Healthcare System, the Center for the Integration of Medicine and Innovative Technologies and other academic institutions.

There are those who will give a multitude of reasons why the care of veterans and their families is not their responsibility, that it is an inherently government function and responsibility.  And when you think about Rakan and Haneen, everyone could have said, “It’s not our responsibility”.  Lt. Col. St Laurent and Maj Mitsch could have said they were too busy with their combat duties.  Dr. Ronan could have said he was too busy with his own patients.  Sen. Kennedy could have said he was too busy with his own medical care.  Mr. Henry, Mr. Werner, Mr. Lucchino could have said they were too busy running a major league franchise.  But that’s what is so remarkable when you consider how these providers and the Boston community rallied around these youngsters and then the Home Base Program.  Everyone around them knew it wasn’t their responsibility, but they undertook these causes just the same.  They will probably go one further and tell you it is a shared responsibility and it is sacred obligation to care for those who have given so much in defense of our Nation.  Nothing will ever wipe away the pain that so many feel because of Rakan Hassan’s death.  However, his banner is carried on today by the people of Boston who continue to care for those who bear the scars of war.

Major (ret) Arturo R. Murguia is a medically retired Army Officer who served a total of 24 months in Operation Iraqi Freedom, most recently with the 101st Airborne Division in 2006.