When Em was old enough to go to school in Waterloo, Ian walked her there every day, even after other boys teased him.
When Em tried to run away at age 13 because of a spat with her mother, Ian ran after her, executing a perfect driveway tackle.
“Take your punishment,” he said. She walked back to the house and did.
When Ian enlisted in the Army, she was proud. When Em enlisted in the Air Force, he was.
But when Em walked into Ian’s room at Walter Reed Army Medical Center last May, it was her hardest time as a sister.
She looked at his unblemished face, his seemingly unscathed body, and wondered how such a tiny ball bearing, propelled from an improvised explosive device in Iraq, could enter her brother’s neck, chip off a piece of vertebra
to lodge in his spinal cord, and leave him paralyzed from the neck down and unable to speak.
So this was her duty as a sister, one too hard for her parents. She told Ian to blink – once for yes, twice for no – and asked him this:
“Do you want to be taken off life support?”
Ian blinked once.
How would she tell her parents? Em’s father, Steve Ralston, served eight years in the Army but has a poet’s soft heart. Her mother, Sue, gave birth to Ian near an Army base in Germany and, 22 months later, to Em near a base in Texas.
Sue’s photographs are always of her boy and girl together. Here’s a favorite of Em’s. Whenever Dad was away on duty, Mom would spread a blanket in the living room to pretend they were on the beach. As the camera flashed, Ian stretched out his arm to pull his sister back on the blanket, away from trouble.
Here they were in high school – Ian the wavy-haired football player at Waterloo West, Em the artsy photographer – with ironic grins. Em would never say it then, because frankly there were times when she couldn’t stand him, but she looked up to Ian, especially after he joined the Army in 2004.
He had always wanted to be a soldier, wearing a battle outfit every Halloween, so when he finally enlisted he made it a point to never sit on the sidelines, even as a combat medic. He didn’t want to be just some “punk medic.”
Em had never thought of joining the military before Ian signed up. But by 2006, she found herself in front of an Air Force recruiter, wanting to make her brother proud.
Ian teased her for joining the Air Force but inside he was proud, too.
“Don’t act like a girl,” he advised her before training. “Don’t complain. And take everything in stride.”
So she did. Instead of standing on the sidelines in her duties in public affairs, she learned to drive military vehicles and do what the others had to do, just like her brother.
Ian came home from his first Iraq deployment in 2008 much quieter. He had seen friends die. He hit the deck during the Fourth of July after a kid threw a firecracker in the street.
They shared their first Christmas together that year as brother and sister in uniform.
The next year, Army Sgt. Ian Ralston headed back to Iraq. And a few months later, Senior Airman Emerald Ralston headed to Afghanistan with the 10th Mountain Division.
“Keep your head down,” Ian told his sister.
Em was preparing for a convoy to a remote area for five months after a couple of weeks at Camp Spann, 200 miles north of Kabul.
She called her parents, asking for prayers. It was May 29. All she heard were her mother’s sobs, interrupted by only this: “Ian got hit.”
He had been on a convoy with the 4th Stryker Battalion Combat Team, 2nd Infantry Division, which was to be one of the last combat divisions to leave Iraq.
He was looking out the armored vehicle’s open back hatch as it passed under a bridge. An IED hanging from the bridge exploded. He fell into the hatch. He thought he was dead but through ringing in his ears he heard David Wissman, his combat medic buddy, call his name. Then nothing.
Em had been told not to cry in the military. She didn’t. She boarded a transport to Germany, where Ian would arrive, saved for now by Wissman, who breathed for him. A day later, Em and Ian flew to Walter Reed.
And this is where Em’s father rushed to the intensive care unit and saw his daughter, standing before him wearing an Air Force sweatshirt with its shiny silver logo. They hugged. She finally cried.
“I just couldn’t fathom how brave and strong she was, to be the one to ask her brother if he wants to live,” Steve Ralston said.
They began taking Ian off medications that clouded his thinking. And Em tried one more time, going to his side, asking again.
“Do you want to be taken off life support?”
This time, he blinked twice.
Em, 23, has not left her 25-year-old brother’s side since. Each day she sees him become the brother she knew. Only three days after he blinked his answer to live, with the family gathered around his bed, Ian whispered words. Em was the only one who could make out his breathy words, so she put her ear near his mouth.
“You’re still …” he whispered, struggling to continue.
Em finished the words she instinctively knew he was trying to say, the ones she had heard before.
“… better looking than dad.”
They all laughed. Ian was coming back.
He knew he couldn’t move but didn’t know the extent of it until overhearing doctors in the hallway a few days later. He broke down.
Ian asked his sister: “What are my chances?”
“Of what?” Em asked.
“Of recovery.”
“This,” she told him, “is the long haul. It’s a long journey. We’re going to get through this together.”
He fought hard every day to improve. And 13 days later, Ian and Em took a flight to the Veterans Affairs Spinal Cord Injury Center in Minneapolis.
There she was joined by Ian’s girlfriend, Nicole Sanders, whom he’d met in Washington state two years before. Em and Nicole have been caring for him since.
Doctors had told him he would never talk or eat on his own and likely never breathe without a ventilator.
“Over the years,” said Dr. Marilyn Thompson at the VA, “I’ve seen every imaginable response to this. The initial response is people don’t want to live. Then they think it’s not real and it won’t last. In Ian’s case, the family came face to face with it.”
Ian won’t recover the use of his arms and legs, barring advancements in stem cell transplants in the future, but how well he can function in the world is as much dependent on his family support as anything medical, Thompson said. And she has seen nothing like his sister’s dedication.
It’s a cold Minnesota December morning and Ian is in physical therapy.
Em and Nicole, who have traded off staying in his room at night, are like skilled nurses, switching ventilator tubes, adjusting sling straps, and keeping Ian’s head steady. Em has seen things a sister shouldn’t, bathing and dressing him, but it has bonded them even closer.
Every day, they have seen his spirits brighten, his will grow stronger. He has learned to talk through the ventilator in his trachea. He has learned to eat on his own and breathe for up to six minutes at a time on his own.
On this day, he is strapped into a stationary bicycle, electrical signals pulsed into his muscles to keep his legs toned, so if stem cell research advances, he will be a candidate.
“A lot of it has to do with his determination,” Em says. “He’s going to do it, no matter if it hurts or not.”
The goal is to get home a few days before Christmas. He has learned to work his motorized wheelchair with puffs and sips through a tube. An accessible van with a ramp is ready for the drive home.
Em has tried hard to know what he feels. Once, she spent an entire day without touching her face to know what it is like not to be able to scratch an itch. She spent a night trying not to move, just staring at the ceiling.
It didn’t work. She just had to look forward – and look to Ian for inspiration.
The three spent evenings watching action movies. Ian says he agreed to watch a “chick flick” about every third time. They even went on an outing to see his favorite football team, the Iowa Hawkeyes, play Minnesota at the nearby stadium in November.
“We try to have a good time,” Ian says in a breathy voice. “I’ve accepted this. No point in feeling sorry for myself. I’m just trying to keep these girls entertained.”
He pulls pranks on them. One time, he pretended he couldn’t breathe.
Often, the alarm on his ventilator is set off because he is laughing.
He feels blessed to be alive, Em wrote in a military newspaper essay about Ian, one of her last duties in the Air Force.
“My brother is one of thousands of men and women who protected our freedom,” she wrote. “He spent his career saving the lives of others. Now he is on the other end of the spectrum.”
Over the weeks and months that followed, Em decided to give up her career. She was granted a discharge to help care for her brother at home.
“The way I look at it, this is what my job is now. What I have given up is nothing. I can stand on my own two feet. He’s given up so much for his country.
“Really, I was given the opportunity to do something worthwhile. If I can help him get through a day, it’s more than I ever did in the Air Force.”
Veterans holding American flags line the gravel road this past Tuesday. The maroon van carrying Ian, Em and Nicole comes into view on the snowy white horizon.
Ian and Em Ralston are home in time for Christmas. Home from war.
Home to the country house a few miles north of Waterloo that was remodeled by hundreds who donated time and money. Em has an upstairs apartment. A bedroom and living room added to the home’s main floor are for Ian and Nicole.
Steve Ralston, 46, a website developer with a happy face and ponytail, says it is important they each have their own space. He and his wife, Sue, have rooms on the main floor in the older part of the home.
Ian puffs into the tube controlling his wheelchair and emerges into the cold, covered by a Hawkeye blanket.
“Thank you all very much,” he says, as the crowd claps.
“Welcome home,” people yell. “And have a Merry Christmas.”
All Sue Ralston can think is, “This is my son and my son is home.” All Steve can think is that they are done with war this Christmas.
“I don’t think I deserved the salutes from those guys,” Ian says of the flag-bearing veterans on the road, “but it meant a lot.”
While he surveys the home, looking out to a tree-lined pasture outside his window, his sister hauls in oxygen tanks and luggage. In the luggage is a little pill container, holding the ball bearing that doctors removed in September, the one that changed his plans.
Ian wants to study history in college someday; Em may study neuroscience.
“Maybe I can’t fix him now, but maybe I can fix him in the future,” she says.
She will also write a book about her brother, inspired by his will and honor and formed in her stirring Air Force essay.
“I thought I was ready for war,” she wrote. “Now I have to prepare for a fight of a different kind: The fight to help my brother live his life.
“He certainly has taught me how to live mine.”