One in an occasional series.
Any day now, Lisa Mathews' husband will be on American soil after a yearlong tour of duty in Iraq.
When his week of deployment-ending activities at Fort Dix is over, Staff Sgt. Joseph Mathews II, an Army National Guardsman in the 56th Stryker Brigade Combat Team, will walk through the front door of his Northeast Philadelphia rowhouse. He will be back into the daily, chaotic lives of his wife and children.
Only then, when the family is reunited, will Lisa be done with her contribution to the military - serving as the lone caretaker of their five children, three of whom have special needs.
"I'll be excited and happy - and pretty much relieved knowing I'm going to get help with the kids," says Lisa, 32.
The Mathewses are among thousands of U.S. military families whose children have medical conditions requiring special services and care. The Pentagon estimates that 115,000 to 175,000 out of about two million children of service members have special needs, a percentage that generally mirrors the nation at-large.
Among military families, though, there is a higher percentage of children with conditions that require more complicated and costly treatments, says Heather Hebdon, director of a federally funded nonprofit called Specialized Training of Military Parents, which helps families navigate bureaucracies to get services for disabled kids.
Hebdon says she is unaware of a conclusive explanation for why that is so, though there might be a pragmatic reason. "The benefits are good," Hebdon says.
Parents often join military service to get better health insurance for their families through the military's benefits program, TRICARE, which can offer a better option than the care available to them in the civilian world, she says.
That works out well for the Mathewses and their kids: Tyler, 8; Theresa, 7; Shawn, 6; Cheyanne, 5, and Anthony, 4. It's especially helpful for Tyler, Shawn and Cheyanne, whose special needs are summed up on medical evaluation forms:
Shawn has attention-deficit/hyperactivity disorder, is very easily frustrated, and rises to anger quickly.
Cheyanne has an autistic spectrum disorder, including delayed social and play skills.
Tyler's autism is more severe than Cheyanne's. He has "impaired communication skills, delayed social skills and sensory sensitivities."
The condition of firstborn Tyler did not dissuade them from having more children. "I always wanted a big family," says Lisa, a regular at her Catholic church.
Joe's family has no autism history; Lisa's health inheritance is unknown because she was adopted.
"I just feel bad Lisa has to take care of everything," says Joe, 38, during an emergency leave home last spring - which Lisa sought - to help stabilize his family.
The visit worked, but then he was gone again.
When the kids are home and Daddy is not, their rowhouse can rumble with chaos. Sleep for Lisa is rutted with early-hour awakenings and no Joe to take the night shift.
On this August day, the kids are enjoying a treat they earned by being cooperative. The night before the family watched movies and ate popcorn. Instead of sleeping in the two bedrooms upstairs, Lisa let everyone have a slumber party in the living room.
By 10 the next morning, the living-room carpet still is covered with sleeping bags, sheets, and blankets; the children remain in pajamas. The sour scent of urine is in the air: One child wet a sheet.
Lisa comes downstairs wearing baggy shorts and a T-shirt. She seems more tired than usual. Her pace is slowed by surgery she had the previous week to remove an ovarian cyst.
She instinctively folds bedding, separates the soiled sheet, and cleans up behind a sick dog as she casually asks the children who needs breakfast. Little Debbie cakes count as breakfast this morning, which means some of the kids have eaten.
The living room is quickly tidied, just in time for the arrival of Tyler's behavioral therapist. By day's end, three other workers will visit.
"I hurt my hand," Theresa, 7, says to the therapist, and holds up the injury she got while playing the day before.
Theresa likes attention, too.
"She's been a godsend since Dad's been gone," Lisa says. "Theresa's been the second mother."
Lisa has an extra concern this day.
She is checking her cell phone and e-mail to see if Joe remembers today is their ninth wedding anniversary. She already has sent him a text message saying "Happy anniversary. Thinking of you."
With an exasperated edge to her voice, Lisa says she hasn't heard from Joe in more than a month.
At the beginning of his tour, the family had daily video calls via the Internet. Lisa and the kids grew used to those chats, but then a week passed with no contact. The kids and Lisa grew concerned.
"Kind of keep us in your prayers there," she had told one of the kids' therapists on the phone.
Finally, Joe called.
This time, his response comes quickly, via a text message before lunch: "Right back at you, My Love. By the way, I'm on my way to Baghdad should be back in Taji but with sandstorms, who knows? I am surprised that I got your message. love you. tell the kids I said hello. I miss you all."
The text message lightens her mood and she immediately phones Joe's mom to report the communication. Lisa is lucky to have relatives nearby for support, including Joe's family and Lisa's grandmother and father, who lives in the rowhouse next door where Lisa was raised.
Celebrating her husband's message ends when more therapists arrive. One comes in at 12:30 p.m., to work with Tyler on his fine-motor and social skills. Another pops in at 2 to help the whole family deal with stress. The last person comes at 3 and goes over the alphabet with Cheyanne.
Lisa greets the visitors and makes sure they have what they need. She checks whether Tyler and Cheyanne are paying attention and praises them when they give a correct answer. Lisa mixes in her housework and gives Shawn, who has been playing a computer game, his medicine.
She also uses the time when therapists are around to tend to herself. She is an introverted person who doesn't allow herself many luxuries. All Lisa needs is family, the workers who help out, and a friend or two. Strangers make life more complicated.
In the late morning, Lisa sneaks upstairs and takes a shower. As the water runs, Theresa goes into the bathroom to talk with her mom. It's a rare opportunity without siblings around.
Theresa poses a question she was asked earlier in the day: What would you do if you had a magic wand? The 7-year-old had said a bigger house, a pool, a nice bicycle.
Lisa's answer: "I'd build a moat around the house so it's just our family."
Joe Mathews was a roofer and an Army National Guard reservist in 1997 when he first saw Lisa Lazarus. She and Joe, two Northeast Philly kids, met at a wedding reception after Joe passed the table where an unhappy Lisa was sitting.
"I was having a miserable time. Everyone was in couples," Lisa says. "I got happy when he smiled."
They married in 2000 and soon started their own family.
Joe left roofing when he was offered a full-time National Guard position in January 2001. He initially served out of Allentown and had his first tour in Iraq cut short when Shawn had trouble at birth. Joe was at the Philadelphia National Guard Armory until his current deployment.
Being in the Guard has brought steady work and good benefits. The benefits cover 80 percent of the kids' special needs. Supplemental insurance covers the rest. Lisa did try once to get respite care through TRICARE but chucked the effort because of the paperwork. The services at Fort Dix, in New Jersey, are too far away, though that may change. When Joe returns, he could be assigned to Fort Dix and the family would leave Philadelphia to live on base.
Military medical benefits fall short or are too hard to tap for many other families. TRICARE and a special program within it for serious health conditions do not cover the full cost of many treatments. Plus, some coverage ends when the service member retires.
Efforts exist on Capitol Hill to expand TRICARE coverage of treatment for disabled children. Among the leading advocates are Pennsylvania Democrats Rep. Joe Sestak and Sen. Arlen Specter.
But the toughest obstacle for military families in getting all the coverage their special-needs children need may be a pillar of military life: the reassignment.
A constellation of education, social, and health services often surrounds special-needs children. That constellation needs to be reestablished whenever service members and their families move to a new base.
Lisa and Joe don't talk about his service or the war in Iraq - they have differing opinions that don't need to be rehashed. Lisa dresses the house in red, white and blue and proudly tells the kids their daddy is a hero. She just wishes the military hadn't deployed the father of three special-needs kids.
The workers have left by 4 p.m. and reward time has arrived. Everyone dons their swimsuits and piles into the minivan for the short trip to the Fox Chase Swim Club.
All of the kids except Shawn go in the pool immediately. Lisa sits on a chaise and talks to Emily Fauser, 41, a mother of two and a pal she made this summer at the club. She and Emily, who has friends in the military, hit it off right away.
Lisa is enjoying the chitchat with an adult, the sun, the prospect of Joe's return. Then, she pulls off her cover-up and takes a running leap into the pool.
"I give her credit," Fauser says. "I don't know how she does it."
Contact staff writer writer Carolyn Davis at 215-854-4214 or firstname.lastname@example.org.