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Army sergeant and Paralympian: "I'm so grateful military nurses put up with me."

Retired Lt. Gen. Patricia Horoho (left) shares the spotlight with Sgt. Elizabeth Marks in March at the Rayburn House Office Building in Washington, D.C., after Marks was inducted into the U.S. Army Women’s Foundation Hall of Fame. (Courtesy photo) Retired Lt. Gen. Patricia Horoho (left) shares the spotlight with Sgt. Elizabeth Marks in March at the Rayburn House Office Building in Washington, D.C., after Marks was inducted into the U.S. Army Women’s Foundation Hall of Fame. (Courtesy photo)

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As a combat medic in Iraq, the work of Army Sgt. Elizabeth Marks included interactions with other medics but not with nurses. As a wounded warrior who worked relentlessly to be declared fit for duty, became an elite swimmer in the process and fought her way back after nearly dying from a lung ailment, her interactions with nurses have been plentiful.

“Maybe it’s because I’m in the medical field, but I don’t like to be a patient,” Marks said. “So I’m terrible. I’m an ornery, ornery patient. I’m so grateful military nurses put up with me.”

Marks suffered severe hip injuries during a deployment to Iraq in 2010. First hospitalized at Landstuhl Regional Medical Center, Germany, she was sent to the Warrior Transition Unit at Brooke Army Medical Center in Fort Sam Houston, San Antonio. Her case manager was Guillermo “Bill” Leal Jr., who became a nurse after retiring from the Army as a master sergeant in 1994.

“I know the Army, I know nursing, and I know people,” said Leal, who was a Special Forces medic when he was on active duty. “I don’t think there’s any other job better for me anywhere else than to be a nurse in the WTU.”

Marks underwent several painful surgeries and exhaustive rehab. She applied twice to the Physical Evaluation Board for a ruling of fit for duty, or FFD. Twice, she was denied.

Leal “was the first person who made me realize nursing is a field where you can really impact lives beyond hands-on patient care,” Marks said. “I was so scared I’d have to leave the Army, and he knew I didn’t want to. I talked to him every day. He believed in me when a lot of other people didn’t.”

Marks heard a lot of messages about the things she would no longer be able to do. But Leal sent a different message, namely that the wounded warrior wasn’t crazy for wanting to stay in the military.

Marks started swimming in January 2012 to regain strength. Within six months, she got cleared for duty – and also landed a spot in the U.S. Army World Class Athlete Program. Leal celebrated by giving her a flag with the initials FFD and WCAP.

Marks moved to Fort Carson, Colorado, in September 2012 to train. Two years later, she flew to the U.K. with plans to compete in the inaugural Invictus Games. By the time her plane landed, she inexplicably was having trouble breathing.

At Papworth Hospital in Cambridge, England, the medical staff suspected a respiratory infection and put her into a medically induced coma and onto the extracorporeal membrane oxygenation, or ECMO, life support machine. She was transported to Landstuhl and was in a coma for almost a month.  

At Landstuhl, “I was ready to be out of the ICU before I could even sit up on my own. I was ready to be out of the ICU before I could form full sentences,” Marks recalled. “So I would sit up in bed and try really hard to move, but I just didn’t have the strength.

The nurses saw how badly she wanted to make progress. They urged her along with little things like moving her into a chair. “Those little things were huge to me,” Marks said.

Amazingly, she was back in the pool by the end of 2014. Her winning streak continued, culminating in gold and a world record in the 100-meter breaststroke during the 2016 Paralympics in Rio de Janeiro, and bronze in the 4x100 medley relay. She also received the ESPN television network’s Pat Tillman Award for Service, the first active-duty soldier to receive the award.

Another nurse, retired Lt. Gen. Patricia Horoho, inspired Marks to mentor other wounded warriors. Horoho was the U.S. Army surgeon general and commanding general of the U.S. Army Medical Command from 2011 to 2016.

 “She has been extremely supportive and encouraging,” said Marks, who met Horoho in 2012 when competing in her first Warrior Games. “One of the reasons I stay in the military is because I want to be that support and encouragement for someone else.”

Marks called Horoho a true advocate for wounded warriors. “She believes there is still a purpose for us, that we have value,” Marks said. “She understands that just because we’re injured, or altered, doesn’t mean we’re out of the fight.”

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