W Post: After 7 years at Walter Reed, Kyrgyz woman has no place to go



After 7 years at Walter Reed, Kyrgyz woman has no place to go

By Annys Shin
Washington Post
Sunday, March 28, 2010; A01

Lyudmila Sukhanov has spent the past seven years at Walter Reed Army
Medical Center as a patient and a prisoner of sorts.

The 26-year-old from Kyrgyzstan has no home, no family, no place to
go. Her medical prognosis is as uncertain as her legal status. Since
she was a teenager, she has lived amid the constant hum of fluorescent
lights and the ever-present odor of disinfectant.

"The longer I am here, the harder it is to take," she says. "I want to
live like everyone else. I want a place [I can] call home. Maybe have
a cat or dog, cook for myself, have a bed where I can sleep, and
there's no one laughing or screaming at nighttime."

After an appendectomy gone wrong and a series of botched operations,
Sukhanov was near death in her native land. An accident of
international politics saved her, as American diplomats and generals
eager to please an ally arranged for her to be brought to Walter Reed.

Sukhanov, who loves Popeyes fried chicken and dreams of meeting talk
show host Tyra Banks, is thankful to the many people who came to her
aid. But now she is 6,500 miles from home, and although she has
survived longer than anyone, herself included, expected, neither she
nor the U.S. military sees an escape from Room 621.

She tells time by talk shows. If Maury is on, it's 1 p.m. If Tyra is
on, it is 3. She's grateful to be alive, but this is no way to live.

In April 2002, Sukhanov had the good fortune to be dying in a hospital
in Bishkek, the capital of Kyrgyzstan, not long after the former
Soviet republic allowed the United States and its allies to build an
air base nearby. On the base, the South Korean army set up a hospital
where missionary doctors brought Sukhanov in a last-ditch effort to
save her life. By the time U.S. officials came across her, she weighed
70 pounds, her intestines were exposed, and she needed a plastic bag
to catch whatever oozed out.

After several months and many more operations, the base hospital ran
out of the medicine she needed. Her only hope was to get to a better-
equipped hospital outside of Kyrgyzstan. A Russian-speaking American
major lobbied his superiors for help; the U.S. ambassador and base
commander fought to have her airlifted to the States. Medical
evacuations are usually reserved for members of the U.S. military or
American citizens. Sukhanov was neither.

But with Kyrgyz cooperation vital to the United States, saving Lyuda,
as she came to be known, was not only humane but also strategic, a
goodwill gesture directed at a vital but skittish ally. The request to
medevac her received the blessing of the commander of U.S. forces in
the region, Gen. Tommy R. Franks, and then-Defense Secretary Donald H.
Rumsfeld.

In early 2003, a C-17 military transport plane braved dangerous
conditions to airlift Sukhanov first to Germany and then to
Washington.

When she arrived at Walter Reed, she had been through 18 major
operations in less than a year and was unfit for further surgery. The
only word of English she knew was "pain."

She languished in intensive care for a year. At one point, a priest
was called in to administer last rites. In 2005, doctors finally
deemed her healthy enough for an operation that stabilized her but
left her with only six inches of intestine -- too little to absorb
enough nutrients to keep her alive. She would have to be fed through a
process called total parenteral nutrition, or TPN, an intravenous
delivery of the salts, glucose, vitamins, amino acids and lipids she
needed to live.

At first, she was tethered to an IV 24 hours a day. Gradually, she was
able to eat more solid food and put on weight. Parishioners at St.
John the Baptist, a nearby Russian Orthodox church she attends,
sometimes brought her home-cooked food.

In time, Sukhanov gained enough strength to eat and go out on her own.
Starved for protein, she discovered fried chicken from Popeyes.
Because she can absorb so little when she eats, she is constantly
hungry. In her room, she keeps juice, crackers and a stash of
Progresso soup.

As long as she can maintain her weight at 110 pounds, she gets decent
stretches of time to leave the Walter Reed campus. She is still
painfully thin, but with her colostomy bag hidden beneath her clothes,
her blond hair brushed and her face made up, she can walk into a
restaurant without drawing attention.

These days, her treatments are down to three nights a week, 12 hours
per infusion, leaving her free to wander on the other days. She'll
pass a couple of hours sitting at Charlie's, a bar across Georgia
Avenue NW, watching people dance. She has even spent some weekends at
her boyfriend's house, cooking lentil soup and watching bad John
Travolta movies. For a few hours at least, she can feel normal.
No options

But on Sundays, Tuesdays and Thursdays, she must be back in Room 621
by 9 p.m. On those nights, a nurse takes the catheter that dangles
below her collarbone and hooks it up to an IV bag, and Sukhanov flips
on "The Suite Life of Zack & Cody" on the Disney Channel and tries to
sleep.

Some nurses resent Sukhanov for taking up a bed. Her care has cost
taxpayers millions of dollars. Yet there is no easy solution for her
predicament. She can administer her own infusion and change her
colostomy bag, which gives her confidence that she could live outside
the hospital. Given her history, doctors aren't so sure. To receive
nutrition or medication, she must have a catheter inserted into a
major vein, and she is running out of places to put it.

"She has had so many central lines, she's out of access options," says
Jeffrey Nelson, chief of colon and rectal surgery at Walter Reed.
"She's had a lot of infections of lines."

Returning to Kyrgyzstan is no option, hospital officials say. Sukhanov
would probably lose access to her IV nutrition and die. And she has no
family to return to. Her mother died when she was 17; her father died
a few years ago, leaving her four siblings on shaky financial footing.

Sukhanov was married when she got sick, but she says her husband left
her to die at the hospital in Bishkek, saying he could not afford to
keep making the trip from their home five hours away. Since she has
been in the United States, she has reached out to a brother and a
sister, but Sukhanov says they will have nothing to do with her.

"If I can mail her money, she would be talking to me," Sukhanov says.
"Nobody needs sick people."

So Walter Reed is home. She has tried to make her side of the room
less sterile by hanging stuffed frogs on her IV stand and putting up
posters of puppies, dolphins and flowers. She shares her bed with a
stuffed brown bear that sports a purple hospital band. Next to the bed
is a table with several boxes of fresh colostomy bags.

The few outfits in her closet are gifts from her church. The pastor's
wife gave her a cellphone.

Sometimes, her church gives her some spending money. On a recent
evening, she walked over to Charlie's wearing a tweed suit over a gray
turtleneck and some eye shadow. The bartender recognized her and
nodded. Sukhanov has come before to listen to the music and maybe
dance a little, but on this evening, she left after sipping half a Bud
Light.

When she is broke, she stays on the grounds, passing much of the day
indoors, reading Russian cookbooks, playing a portable Nintendo or
watching TV. She learned English mostly by watching Disney Channel
shows such as "That's So Raven."

When she's bored, she sometimes visits the Red Cross office at Walter
Reed to see whether they have new video games. Even if they do, she
says, the volunteers often turn her down because she is not a soldier.

Sleep is often elusive. People are always talking in the hallway.
Doctors, nurses and orderlies enter without knocking. She shares her
room with a constantly changing assortment of strangers, each with her
own set of disruptions.

"I can't stand it when they complain after two days, 'I can't take it
in here,' " Sukhanov says. "Look at me -- seven years!"

She has made some friends outside Walter Reed -- at church, for
instance. But most people, when confronted with the messy details of
her situation, don't want to get too close. For a while, a previous
boyfriend, an older Russian man, would drive church members to the
hospital to see her. They have broken up but remain friends.

The doctors and nurses come and go, too, and some are now reluctant to
get too involved with Sukhanov, especially after last fall, when two
nurses were suspended, one after taking her to the beach and another
after taking her to New York City. One was forced to resign and the
other quit in protest, according to the nurses and military documents.
Walter Reed spokesman Chuck Dasey said the hospital does not release
information on personnel matters.

Early last summer, an Army nurse, 1st Lt. Lionelle Trofort, arranged
to take Sukhanov for a weekend in New York, where she was delighted to
visit the heavily Russian enclave of Brighton Beach.

"I'm just dreaming to see it again," Sukhanov says. "It seemed like
I'm like everybody else."

A few weeks later, Tatiana Baker, a civilian nurse, took Sukhanov to
Breezy Point on the Chesapeake, her first view of the open sea. "She
was just in awe," Baker says. "She just sat there contemplating it
all."

For both trips, doctors wrote the necessary orders so Sukhanov could
take her meds with her.

After the New York trip, Trofort began to organize another visit,
posting a sign-up sheet so other nurses could come. But the trip never
happened. Instead, Trofort was threatened with court-martial. Charging
documents accused her of mishandling medication prescribed for the
earlier trip. Rather than face conviction, she resigned her post and
gave up her benefits, ending a 16-year career in the Army.

Baker, meanwhile, noticed that Sukhanov's health improved, physically
and psychologically, once she started leaving the hospital more. So
Baker started bringing Sukhanov to her house for a few hours at a time
and, later, for the weekend. Her doctors took no issue with her
adventures.

"It's sort of up to her, what her physical condition would allow,"
says Nelson, her surgeon. "We don't specifically limit her from doing
anything."

Baker said she was suspended for mishandling medications prescribed
for the beach trip. She protested her suspension and then quit. "I was
told it was inappropriate for me to befriend her as a nurse," Baker
says. "That's not why I became a nurse. I said to hell with that. You
can't keep her prisoner."
Uncertainty looms

Sukhanov wants to work. Last summer, Baker lined up a catering job for
Sukhanov, cooking meals once a week. The work tested her physically,
but she loved it, and the money let her go out to clubs, such as
Heaven and Hell in Adams Morgan.

"I like to be in club, in a crowded place, and look at healthy people
leading normal life," she says.

Sukhanov wants to stay in the United States permanently but faces
legal hurdles. She holds a special visa issued for medical
emergencies, and it protects her from deportation. But her time here
does not count toward residency or citizenship. She could get a green
card if she were to marry a U.S. citizen. Her boyfriend since last
summer, Hope Rochester, whom she met through the cooking job, says
they haven't discussed marriage.

Looming even larger than the legal obstacle is uncertainty over her
health. A few months ago, she started having pain again in her
abdomen. Doctors have been running tests but haven't figured out
what's wrong. She has stopped eating meat and is sticking with soft
foods and liquids.

On St. Patrick's Day, Rochester stopped by her room, as he does most
weekdays. When it was time for him to go, she walked him to the exit
gate, where she saw passersby on Georgia Avenue already sporting
sparkly green hats for their evening revels.

"Damn people," she says. "You don't know how happy you are."

Staff researcher Meg Smith contributed to this report.

http://www.washingtonpost.com/wp-dyn/content/article/2010/03/26/AR2010032601921.html
.