Kurt Santini was just an hour out of surgery Tuesday and already eager to get out of bed.
The Virginia resident and U.S. Army veteran has been in debilitating pain for 17 years. The discs in his neck and back were severely compressed following a 100-foot fall from a military helicopter, after both of his parachutes failed. The injury caused nerve damage that threw off his balance and impaired the use of his limbs.
Dr. Franco Vigna, an orthopedic surgeon affiliated with Catholic Health, performed a two-hour operation on Santini at Kenmore Mercy Hospital, removing three of his discs and replacing them with a “cage,” built using a steel plate and eight screws. Santini, 41 and the married father of two children, said the relief was immediate.
“I feel so great, I want to get up, I want to move,” he said from his hospital bed. “I didn’t ever think I was going to get this. The VA told me the damage was permanent and that I’d always be in pain.”
The $25,000 operation was done for free, thanks to Vigna’s partnership with Operation Backbone, the nonprofit that connected the doctor with the patient, and the surgery with Catholic Health.
“This took a team,” Vigna said. “We take care of the people who take care of us.”
Mike Sformo, a Corfu, N.Y, native and veteran of the U.S. Navy, founded Operation Backbone eight years ago, after injuring his neck during a workout. His own insurance covered the cost of much of his treatment, but for a $127 copay that he asked the federal Department of Veterans Affairs to reimburse.
Sformo said his request was unceremoniously denied, and his thoughts immediately went to the veterans who are critically injured or desperately ill, and dependent on what he described as “the outdated, backlogged” VA for their care – people like Santini. The idea for Operation Backbone was born.
“What do you do if you live in Iowa, you’re out of work and have no money, your wife has left you because you’re so sick and depressed, you’re stuck on the couch and three hours away from the nearest VA (Medical Center)?” Sformo said. “I decided to change the way health care works for the U.S. military. It all started with $127.”
Operation Backbone helps both current and retired servicemen and -women access private health care, provided pro bono by partner doctors and hospitals around the world. Sformo, who is now based in Maryland, said he gets “hundreds and hundreds” of calls for help every month.
And Sformo isn’t shy about his disdain for the Department of Veterans Affairs, particularly its health administration, which since World War II has exploded in size. The result, he said, is an oversized, overtaxed system tangled up in bureaucratic red tape; former service personnel are either underserved or largely ignored, he said, and so their physical conditions worsen, and their mental well-being deteriorates. A 2017 RAND Corp. study indicated that at the time, there were about 400,000 patients awaiting attention by the VA – and those were only the traumatic brain injury cases.
“The VA is antiquated, overrated and enormous,” Sformo said. “We [at Operation Backbone] have the treatment capability, the access to the technology and most importantly, we have the time to take a case and follow it all the way through.”
Santini’s story is sadly typical, Sformo said. After his 10-story fall nearly 20 years ago, Santini repeatedly has been denied corrective spinal surgery by the VA. His teeth were left broken, as well, and his chronic pain was merely masked with highly addictive opioid painkillers, which he said, “only make (him) feel worse.”
“I’ve never seen anyone get screwed over so bad, by the VA, by Congress, and by every presidential administration going back to Clinton,” Sformo said of Santini. “He’d been sentenced to a slow, agonizing death. And we’ve spent many hundreds of hours getting him to where he needs to be.”
In addition to the operation with Vigna, Operation Backbone also made it possible for Santini to have the overdue dental work, performed by Jack Bubba last week at University at Buffalo’s Oral & Maxillofacial Surgery. Sformo said that by his estimates, if Santini had received proper care at the time of his accident, the expense to taxpayers would have been about $14,000. Now, with the long-term disability and aftercare necessitated by years of neglect, the total cost could reach into the millions.
Operation Backbone can’t help everybody, though, and it focuses on the “top 1 or 2 percent” of cases; that is, the most complicated and time-consuming among them.
“We take those cases out of the Department of Defense or the VA, then we give the patients back, so they can return to serving their country or return to their daily routines with a higher quality of life,” Sformo said.
The process by which Operation Backbone decides to accept a patient is extensive. It gathers details about the origins of the injury or illness, and all related medical records. If no such documentation exists, Sformo said, the case is ineligible.
The organization, which is funded by donations and corporate sponsorships, then gets to work, matching patients with private doctors willing to provide free care. If the VA is for whatever reason reluctant or refusing to give the necessary referrals, Sformo leans on Congress, the Pentagon, even the White House. It is often a frustrating, dragged-out ordeal – and in most cases, there is little time to waste, he said.
“The progression for these men and women is: alcohol, opiates, suicide,” Sformo said. “They’re in pain, they’re angry and they’re agitated. Their will is gone. Kurt reached his wit’s end about seven years ago, and I’ve been telling him to just hang on. It’s like (veterans are) a commodity to be used and tossed aside.”
Sformo does acknowledge, there are men and women who’ve been successfully treated and healed at VA hospitals. Indeed, another RAND Corp. study conducted in 2004 concluded that the Veterans Health Administration was outperforming all other sectors of American health care in 294 measures of quality.
“I meet some who say the VA has been great,” he said. “And to them, I say, ‘Good, I hope it always works so well for you.’ The reality is, not every patient has that experience.”
And while Operation Backbone has done a lot of rewarding work for those patients in particular, Sformo said it’s the pushback he gets from government, and the soldiers who get no help – as well as those who, despite it, will never be the same – that really stick with him. So much of what ails them today was once avoidable, he said. He likens his frustration to that of a gambler who can’t place a bet, despite knowing the outcome of a future horse race.
“We see the coulda, shoulda, woulda,” he said. “We can repair some things, but the damage is done.”
Still, Sformo is determined to continue the mission of Operation Backbone by spreading word of its existence. He hopes to get more private physicians, hospitals and technical experts to partner with him, “to prove that we can do what we set out to do, and hopefully influence the VA to get on board and be more willing to sign what we need signed, when we need it.”
“Every success has been amazing,” he said, “and I want to do the same thing for every one of them.”