"Despite your injuries, you're still a Marine... "

Palo Alto — Marine Lance Cpl. Jorge Ortiz, 19, of Fresno, who was critically injured in an explosion in Afghanistan, rests at the Polytrauma Rehabilitation Center at the Department of Veterans Affairs hospital in Palo Alto, where physicians and therapists take a team approach to care for those who have suffered catastrophic injuries. Photo: Mark Boster / Los Angeles Times.

"Despite your injuries, you're still a Marine and the Commandant has ordered you to cooperate with the doctors and therapists and get back in the fight."

- Marine Staff Sgt. Jeffery Jimerson, an Iraq veteran assigned to the hospital.

Tony Perry of the LA Times has done some terrific reporting about the 3/5 Marines, and this is his latest from the Polytrauma Rehabilitation Center at the Department of Veterans Affairs hospital in Palo Alto.

Palo Alto has the only VA polytrauma unit on the West Coast. Others are at VA hospitals in Tampa, Fla.; Minneapolis; and Richmond, Va. — all care for both active-duty and medically retired personnel.

The Palo Alto unit has a staff of medical specialists and an agreement with nearby Stanford University School of Medicine. There are specialists in amputation, auditory impairments, blindness, spinal cord injuries, and post-traumatic stress disorder and other mental health conditions.

Here, mending bodies is only one piece of the puzzle.

Recently, the 19-year-old [Marine Lance Cpl. Jorge] Ortiz suffered a complication common to new amputees: leg bone growth protruding through one of his stumps.

Ortiz, who grew up in Los Angeles before his family moved to Fresno, underwent surgery to remove the growth so he could resume the long, difficult ordeal of being fitted with prosthetic legs and learning to walk.

But the surgery has left Ortiz in enormous pain.

His doctors have given him a variety of medications that leave him foggy and could slow down his recovery from another of his wounds: traumatic brain injury.

Although he lacks a visible head wound, Ortiz has the slowed responses and memory difficulties common to troops damaged by the blast of roadside bombs that are the Taliban's weapon of choice.

"Can my pain medications go up?" Ortiz asked one of his doctors during a bedside visit.

"No," Dr. Ted Scott, the attending physician at the polytrauma unit, answered softly. "We want to start getting you off that."

"But what if the pain gets worse?" Ortiz said.

"You're basically on everything known to medicine," Scott replied. "It's one of the things that make me sad to be a doctor: We can't fix everything."

It's a dilemma for doctors and patients: medication can dull, although not eliminate, pain but they also can delay recovery from traumatic brain injury and other wounds.

Still, Ortiz has some advantages. He is known among the medical personnel for his determination.

Palo Alto — Ortiz gazes into a mirror in the physical therapy room at the Veterans Affairs hospital in Palo Alto, one of four such specialized trauma centers nationwide. A combat photographer, he was taking pictures of a captured weapons cache in Sangin, Afghanistan, on Jan. 15 when he stepped on a buried explosive device. Photo: Mark Boster / Los Angeles Times.

Read more about LCpl. Ortiz's fight and that of one of his fellow patients, Cpl. Farrell Gilliam.