VIdeo: Delayed Casualty Part II: Lakeville soldier’s family copes with loss
By all accounts, life after Iraq for Army Specialist James Bowlby seemed normal — at first.
After returning in March 2004 from a year-long tour of duty in Iraq, Bowlby, 24, appeared healthy. He worked 16-hour days delivering furniture, and he and his fiancee moved into an apartment in Taunton.
But about a year later, Bowlby began experiencing heavy edema, or swelling throughout his body, his family said recently.
“He would say he didn’t feel well, but he’d push himself,” his mother, Donna Bowlby, said. “He got a job. But at least once a day, it was, ‘I don’t feel well. I just don’t feel right.’”
For Bowlby, it was the start of a grueling battle with Goodpasture’s syndrome, a rare autoimmune disease that attacks the lungs and kidneys.
After more than two years of dialysis treatments and emergency hospital visits, Bowlby died on July 17. Fifteen minutes before his death, Bowlby and his longtime fiancee, Jennifer, were married in his hospital room.
Bowlby is among what some call the “delayed” casualties of war, soldiers who fought in Iraq and Afghanistan, came home alive and apparently healthy — then developed medical problems that in some cases have claimed their lives.
Their deaths have left families like the Bowlbys with questions about how these veterans contracted their illnesses and how the Department of Veterans Affairs handled their medical care.
More than two years before his diagnosis, Bowlby had begun a stream of trips to the Veterans Affairs Medical Center in Brockton, his family said.
His blood pressure was “out of control,” he had severe pain in his lower back, and he was constantly throwing up and having headaches, his widow, Jennifer Bowlby, said.
It took two years for Bowlby to be seen by a general physician, she said. When he was seen by a doctor, Bowlby told the doctor about his body swelling and then asked questions, she said.
“Every time I brought him in, they said it was strep throat, he had high blood pressure, that it was all in his head,” Jennifer Bowlby, 22, said.
After making several visits to the Brockton VA, and weakened by his condition, Bowlby’s frustration grew, she said.
“A lot of times we were left waiting for so long that we would end up leaving,” she said.
One day in March 2006, during a 5 a.m. emergency visit, medical staff at the Brockton VA center drew Bowlby’s blood. The couple was about to leave, when a nurse and doctor tracked them down in a hallway.
The blood test had found that Bowlby had less than 5 percent of his kidneys functioning, Jennifer Bowlby said. “They started an emergency IV and transferred him to the West Roxbury VA,” she said.
There, surgeons placed a femoral catheter into Bowlby’s thigh for emergency dialysis. Later, they would place a catheter into his chest.
The greatest battle of this soldier’s life had begun.
Facing down illness
When asked recently about Bowlby, VA spokeswoman Diane Keefe said she could not comment on a patient’s medical care or treatment.
“It would be part of his care at the hospital and we don’t comment on a patient’s care or treatment,” Keefe said.
According to his family, doctors diagnosed Bowlby with post-traumatic stress disorder, depression, and with Goodpasture’s syndrome, a rare autoimmune disease that causes the immune system to make antibodies that attack specific parts of the lungs and kidneys.
Initially, Bowlby didn’t respond well to his dialysis treatment. Within the first year of hemodialysis, he suffered two strokes, his widow said.
“He was constantly throwing up,” she said. “His blood pressure was through the roof. He was just so weak, he could barely get out of bed.”
In the summer of 2007, doctors placed a catheter into Bowlby’s abdomen. He underwent peritoneal dialysis at his home 14 hours each day, she said.
He fared better. “He had his good days and his bad days,” Jennifer said.
The good days included time spent with their 2-year-old daughter, Jaymi. “It was very hard to separate the two of them. They were always together,” Jennifer said.
Special time with Dad
On a recent day on the family’s deck, blond-haired, blue-eyed Jaymi Bowlby giggled as she wrapped her arms around “Tigey,” a life-sized stuffed tiger that her father gave to her before he died.
The toddler has asked if “Daddy” is lost in Lakeville, and wonders when he is coming home, her family said.
Bowlby would often put his daughter to sleep for a nap.
“He could just run his hand right down her face, and she’d be out cold,” she said. “Now, I can’t get her to go to sleep.”
Bowlby went on kidney dialysis for more than two years. He was placed on a list of patients seeking kidney donors. No donors came up, his family said.
On July 3, Bowlby came home from a stay at Signature Healthcare Brockton Hospital, where surgeons had changed the location of his catheter from his abdomen to his chest for dialysis.
The next day, Bowlby had a four-hour dialysis session at the Taunton Kidney Center. But at bedtime, Jennifer Bowlby saw her fiance couldn’t breathe and complained of chest pains.
“He was gasping for air and I had to give him rescue breaths,” she said.
An ambulance took Bowlby to Morton Hospital in Taunton. While in the ambulance, an emergency medical technician asked if Jennifer was Bowlby’s wife.
“I said, ‘Well, not legally yet, but at heart we’ve been married for four years,’” she said.
James Bowlby — the combat soldier she had first met in an Army recruiting office in Taunton when he was 20 and she was 18 — began crying.
“He said, ‘I’m so sorry we didn’t get married yet. I want to marry you,’” Jennifer Bowlby said. “That was the last thing I heard from him.”
‘It’s just hard’
At Morton Hospital, Bowlby’s heart stopped. Emergency crews “shocked it for him to come back,” she said. The family was placed in a waiting room. “We were told he’s not going to survive the night,” she said.
Within hours, Bowlby was transferred to Massachusetts General Hospital in Boston. There, Bowlby remained unconscious.
On July 14, his family decided to take Bowlby, who had serious brain damage, off life support.
“We all felt that it was best for him because he would never be the same,” Jennifer Bowlby said. “He wasn’t going to be able to feed himself or have any quality of life.”
But Bowlby hung on, until his wedding ceremony.
The plan had been to get married when Bowlby was well enough to stand on his own two feet, when he could walk down the aisle. That never happened — they wed in the hospital room before clergy and loved ones as he lay unconscious in his bed. He died 15 minutes later.
But Jennifer Bowlby has no regrets.
“We didn’t really get to exchange our rings, or a kiss, but it was nice to get married,” she said, tears streaming down her cheeks. “It’s just hard.”
Maria Papadopoulos can be reached at firstname.lastname@example.org.