One thing different about the Iraq conflict is that soldiers are now surviving wounds that would have surely killed them in the past. Helping these men and women recover will cost billions over the next 20 years.

An excerpt from the Jan. 22 NYT story:

PALO ALTO, Calif. - It has taken hundreds of hours of therapy, but Jason Poole, a 23-year old Marine corporal, has learned all over again to speak and to walk. At times, though, words still elude him. He can read barely 16 words a minute. His memory can be fickle, his thinking delayed. Injured by a roadside bomb in Iraq, he is blind in his left eye, deaf in his left ear, weak on his right side and still getting used to his new face, which was rebuilt with skin and bone grafts and 75 to 100 titanium screws and plates.

Even so, those who know Corporal Poole say his personality - gregarious, kind and funny - has remained intact. Wounded on patrol near the Syrian border on June 30, 2004, he considers himself lucky to be alive. So do his doctors. "Basically I want to get my life back," he said. "I'm really trying."

But he knows the life ahead of him is unlikely to match the one he had planned, in which he was going to attend college and become a teacher, get married and have children. Now, he hopes to volunteer in a school. His girlfriend from before he went to war is now just a friend. Before he left, they had agreed they might talk about getting married when he got back.

"But I didn't come back," he said.

Men and women like Corporal Poole, with multiple devastating injuries, are the new face of the wounded, a singular legacy of the war in Iraq. Many suffered wounds that would have been fatal in earlier wars but were saved by helmets, body armor, advances in battlefield medicine and swift evacuation to hospitals. As a result, the survival rate among Americans hurt in Iraq is higher than in any previous war - seven to eight survivors for every death, compared with just two per death in World War II.

But that triumph is also an enduring hardship of the war. Survivors are coming home with grave injuries, often from roadside bombs, that will transform their lives: combinations of damaged brains and spinal cords, vision and hearing loss, disfigured faces, burns, amputations, mangled limbs, and psychological ills like depression and post-traumatic stress.

Dr. Alexander Stojadinovic, the vice chairman of surgery at Walter Reed Army Medical Center, said, "The wounding patterns we see are similar to, say, what Israel will see with terrorist bombings - multiple complex woundings, not just a single body site."

[American deaths in Iraq numbered 2,225 as of Jan. 20. Of 16,472 wounded, 7,625 were listed as unable to return to duty within 72 hours. As of Jan. 14, the Defense Department reported, 11,852 members of the military had been wounded in explosions - from so-called improvised explosive devices, or I.E.D.'s, mortars, bombs and grenades.]

So many who survive explosions - more than half - sustain head injuries that doctors say anyone exposed to a blast should be checked for neurological problems. Brain damage, sometimes caused by skull-penetrating fragments, sometimes by shock waves or blows to the head, is a recurring theme.

More than 1,700 of those wounded in Iraq are known to have brain injuries, half of which are severe enough that they may permanently impair thinking, memory, mood, behavior and the ability to work.

Medical treatment for brain injuries from the Iraq war will cost the government at least $14 billion over the next 20 years, according to a recent study by researchers at Harvard and Columbia.

Jill Gandolfi, a co-director of the Brain Injury Rehabilitation Unit of the Veterans Affairs Palo Alto Health Care System, where Corporal Poole is being treated, said, "We are looking at an epidemic of brain injuries."