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For Many Wounded Warriors, Not All Damage is Visible or Combat-Related

Image of A picture of Alex and Allison Pate. Alex and Allison Pate are pictured shortly after Alex’s cancer diagnosis in 2017 (Photo courtesy of Alex and Allison Pate).

Alex and Allison Pate have known each other since they were teenagers. Alex joined the Air Force after high school and the couple married shortly thereafter. Alex is now a retired staff sergeant, and the Pates currently live on a farm in the same rural southwestern Missouri town of Forsyth where they both grew up.

What makes them unique is that their journey back to home, while it may feel like a lifetime of experiences for the young couple, has actually only taken a little less than five years.

Alex is a 'wounded warrior,' but he never saw combat in his military career. His battle was against cancer and the toll that the subsequent treatment took on his body. He is a stark reminder that not all wounded warriors suffered their injuries in combat operations.

"About two years into his service, he was diagnosed with cancer," said Allison, who now serves as her husband's 'informal' caregiver. "He was having problems when he was doing PT and getting really fatigued and finally went and got things checked out."

At the time, she was 19 and he was 22.

Alex learned that his testicular cancer had already spread to his chest and abdomen, and required immediate intervention.

"They went ahead and, within the week, removed one of his testicles and had a port [for the administration of medication and fluids] put in. They also did some scans and realized they needed to start chemotherapy the following week," Allison said.

"His chemo schedule was very intense. He had five days of eight-hour sessions the first week and every week it would start over again."

The physical effects of Alex's treatment were almost immediate. The emotional effects would come later.

"We basically lived in the hospital and, within the first two months, he had lost 60 to 80 pounds. He couldn't keep a drink of water down, let alone food. It was very scary," Allison recalled.

After about six weeks of recovery following his final chemotherapy treatment, Alex returned to active duty.

"When he got back to work, they gave him light duties to get started, but the anxiety and depression due to being in a small room with no more than two or three people throughout chemo was taking over him," said Allison. "He just wasn't himself anymore. We were young and we wanted to act like it, to be excited. I had never seen him like this and we kind of shut down."

They were told that what he was going through was "normal" for a cancer patient and that the anxiety and depression would slowly go away.

"We were told that he would be the old Alex. He'll be athletic. He'll want to be outside. He hunts, he fishes, he'll be a 'man's man' - he loves to work," she said. "That wasn't Alex anymore. He would come home from work and sleep for 15 or 16 hours. He didn't have any drive and he didn't want to do anything anymore."

The chemotherapy had taken its toll, especially on his knees and back.

"He had no muscle carrying him when he lost all of that weight."

Air Force Wounded Warrior volleyball practice session Alex Pate serves a volleyball during an Air Force Wounded Warrior practice session at Scott Air Force Base, Illinois, in August of 2019 (Photo by Senior Airman Greg Erwin, 375th Air Mobility Wing Public Affairs).

"The old Alex" wasn't returning and, as a vehicle operator, he was expected to use heavy equipment, including operating tow trucks and rigs, as well as performing maintenance.

"His body was the main thing he used for his job, and he wasn't able to do those things anymore," Allison said.

Alex faced skepticism within his command. After fighting off cancer, they expected him to return to being "young and healthy" again, physically and mentally. This was not the case.

"He was treated like: 'You got through it - move on.'"

Two years of physical therapy couldn't fix the degenerated and bulging disks in his back. She recounts a medical visit to Louisiana State University's Surgery Center: "They walked in and opened his file and said, "Oh, this has to be the 80-year-old man next door. We're sorry. We must have mixed your X-rays up,""

But that was his X-ray at age 23, she said.

Even though his wounds aren't immediately visible, Allison says she and her husband are still able to identify with wounded warriors who have suffered injuries both inside and outside of combat.

"We don't ever compare our story to other people, who may have been injured in combat, because there's no two people who are going to be alike. But we can find common denominators and connect with people and be there for each other in the ways that we know how to."

Allison said she and Alex really found their support network when he became a part of the Air Force Wounded Warrior Program, or AFW2.

"That's where he found people that fully believed him and fully listened to what was going on. We still consider some of the people we've met through AFW2 as family," she said. "I have a notebook full of people that I can call at any time, when I might be doubting myself."

Looking back, Allison credits an unnamed Air Force psychiatrist at Barksdale Air Force Base in Louisiana - the Pates' one and only duty station - as being one of Alex's biggest advocates on the road that would eventually lead to him being medically retired.

"He is the main reason Alex was able to get out the way he did. A lot of people couldn't connect the dots - why his anxiety wasn't getting better; why his depression wasn't getting better; why his body was still so deteriorated," she said.

"That psychiatrist believed him from day one. That single person made him feel seen, heard and appreciated."

The telehealth technology that has expanded since the COVID-19 pandemic also helped lessen Alex's previous anxiety about attending in-person appointments.

"Alex will do things privately as much as he can," said Allison. "Being able to go online and book a doctor's appointment on the computer, doing therapy appointments at home - stuff like that has helped with his anxiety more than anything."

Testicular cancer is most common among males between the ages 15 and 34. It can be detected early through screenings both at home and by a doctor; recovery rates are very high among those who identify it early.

Alex has remained cancer-free since he left the Air Force. The Pates now have two children, ages one and two. Alex now works part-time as a tow truck driver, while Allison is a stay-at-home mom and caregiver.

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