He stayed on the roof firing his machine gun for one mortar round too long. That's how Dustin Bowen thinks of it.

The 22-year-old Marine lance corporal was under heavy attack in Ramadi, Iraq, in 2006, at a time when the city was ground zero for some of the fiercest combat in the second Iraq war. He remembers the blast. A fellow Marine told him he was blown off the roof and sat on the ground like he didn't know how to get up. 

He was pulled to cover and kept fighting until the unit could be reinforced, kept fighting despite some pain in his leg and his shoulder and the screaming agony in his hand.

For the next 10 years the agony in the hand wouldn't ever go away.

They did field surgery on the hand, braced and wrapped it, knew it wasn't fixed. Command "persuaded" him, he said wryly, not to evacuate. He took a thumb tack, snipped off the pin with a wire clipper. He embedded the pin in his numb shooting finger and lightly wrapped it before each sortie. It was the only way he could tell whether he was pulling the trigger.

"I learned how much pressure it took to engage the weapon by how much pain I'd feel shooting up my arm," Bowen said recently in his Beaufort home.

When he returned to the United States, he found out he had shattered the bones in his hand. While he underwent a series of surgeries, he worked through a former commander in Iraq to train other Marines before they shipped out.

He showed them the finer points of how to do combat in-country, tricks like putting your cradle arm on top of the rifle with the forefinger pointing up the barrel.

That way, you didn't have to take that half second to aim. You just pointed and fired.

Bowen underwent more surgeries — it would eventually total more than 15. Medical staff would tell him after that while he was under general anesthesia they sometimes struggled to hold him down as he thrashed and yelled, "incoming."

But by 2013 he had failed the third and last chance at a medical evaluation required to stay in the Marines. He sneaked into a surprised lieutenant commander's office to plead his case. He had joined the Marines because he wanted combat. Now he didn't want to back off.

"I wanted to do my 20 years. I lost a lot of friends while I was deployed in Iraq. I've lost more since," he said. The commander sized him up and told him evenly, "Son, it's time to go home."

Coming home would become its own sort of hellish fight. His useless hand became a surgery study case of "limb salvage" — could any function be saved?

He learned to live with pain so excruciating that when he insisted a wisdom tooth be removed with local anesthetics only — because of the thrashing — it wasn't so bad.

Finally last year, he told his surgeon he'd had enough. He just wanted to amputate.

"Now I have an arm again," Bowen said.

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Reach Bo Petersen at @bopete on Twitter or 843-937-5744.

Science and environment reporter. Author of Washing Our Hands in the Clouds.

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