March-April 2013

The Re-education of Dr. Holt

He was a Harvard-trained anesthesiologist who'd been a championship swimmer at West Point. But after his Humvee hit a bomb, the Bethesda man faced his toughest challenge-relearning how to walk, talk and do his job.

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“It’s still a daily struggle for both of us,” says Nashwa Holt, pictured with her husband, Eric. “It’s not the same as it was; he’s not the same. …It’s added a new dimension of difficulty to our lives.” Photo by Michael Ventura.


Holt’s Humvee as it appeared after hitting the IED. Army file photo.

Eric Holt felt weightless and weirdly peaceful as his body flew 100 feet through the quiet, pitch-black night in rural Afghanistan. The only sound came from beneath him—the crunch of metal as the Humvee, lifted off the ground by a buried bomb, went tumbling end over end down the one-lane road.

Then Holt slammed into a stone wall. His night-vision goggles crushed into his face, his M-4 assault rifle into his chest. A vertebra in his neck burst into shards of bone. His brain rattled inside his skull.

Still conscious, he looked down to check that his hands and genitals were intact. He managed to crawl away, looking for his medical bag in the darkness as someone screamed in pain.

An Air Force lieutenant colonel and Harvard-trained anesthesiologist, Holt had been living for several months at a forward operating base (FOB) in Afghanistan. Attached to a special operations team, he and the other medical personnel would go out on missions with enough equipment to set up an operating room within five minutes. The day they hit the improvised explosive device, they had completed a mission hours away and were returning to the FOB, traveling at high speed with the headlights off. Taliban were known to operate in the area; turning on even a flashlight was dangerous.

It was 1 a.m. and freezing cold. Holt couldn’t feel his injured face or chest, but it felt like someone was hitting him across his neck with a baseball bat. He could see the shadowy outline of the Humvee driver, his legs mashed, hanging half out of the smoking vehicle. He also could see the man who was screaming, trapped under the turret of a .50-caliber gun, his pelvis crushed. Holt stumbled toward that turret. He tried to talk, but his jaw was askew and his words made no sense.

Two men from the convoy put a C-collar around Holt’s neck while others rushed to set up a defense perimeter. The men carried Holt to its edge and laid him down.

“If you hear voices or see anything coming this way,” they told him, “this is your field of fire.”

At Holt’s home in Florida, the phone rang in the middle of the night on Jan. 24, 2009. When Dr. Nashwa Holt, an anesthesiologist like her husband, answered, she was confused by the formality of the longtime friend on the other end. “Dr. Holt, this is Maj. Friedlander,” he said.

“Ryan? What’s up?” she asked.

Then came the knock at the door. Four men in flight suits and a woman with a clipboard stood outside. Eric’s dead, Nashwa thought.

In fact, she was told, he was critically injured, with extensive facial fractures and paralysis. He would be flown to Landstuhl Regional Medical Center in Germany, and eventually to Walter Reed Army Medical Center in the District (now part of the Walter Reed National Military Medical Center in Bethesda).

As the largest U.S. military hospital outside the United States, Landstuhl has been the first stop for many of the more than 56,000 American casualties in Afghanistan and Iraq, including more than 6,600 who have died. Holt would turn out to be one of the survivors.

Over the course of the next year, he would have to relearn how to walk, talk and care for himself. Eventually he’d retrain as an anesthesiologist and buy a home in Bethesda. But on that January night, as Nashwa listened to the list of her husband’s injuries, she couldn’t have known that any of that was in his future—or even that he had a future.


Holt, at work in a makeshift operating room in Afghanistan. Army file photo.


Nashwa and Holt met when the two were doing residencies at Harvard. After their marriage in 2005, she followed him from her home in Boston, where her Egyptian-born parents were prominent doctors, to his posting at Eglin Air Force Base near Fort Walton Beach, Fla.

Their young marriage had been strained by Holt’s three, four-month deployments to the Philippines, and then a fourth deployment to Afghanistan—all in less than three years. Nashwa wasn’t about to wait for his return this time. She booked the next commercial flight to Ramstein, Germany. In retrospect, her packing made no sense: She threw into a bag two sweaters, a pair of jeans and a bathing suit. For the trip, she wore Jimmy Choo boots with 4-inch heels.

A family friend at Landstuhl arranged for someone to meet her at the Ramstein airport, but no one showed. She was hysterical when she approached a man with a military backpack. An Army colonel, he began calling people at the base, yelling for someone to pick her up.

When she arrived at the base hospital near Ramstein, nurses warned her not to be shocked. Still covered in dried blood, Holt was nearly unrecognizable. Doctors were now certain his spine was fractured; permanent paralysis appeared likely.