Matt Crossman, Special to ESPN.com 8y

The things she carries: The story of Paraswimmer and U.S. Army Sgt. Elizabeth Marks

I. Scars

COLORADO SPRINGS, Colo. -- U.S. Army Sgt. Elizabeth Marks ponders a question from the barista: What kind of coffee would she like? Mild, medium, dark roasts -- the bronze, silver and gold of coffee. She smiles and offers a ready answer: "Whatever kind has the most caffeine." Fresh from a grueling morning swimming practice and weightlifting session, Marks needs the energy. She grabs her cup, walks upstairs and snags a seat by the window. A few miles to her left, Pikes Peak climbs 14,114 feet into the crisp blue sky.

Marks, 25, has stolen away from the Olympic Training Center to savor this steaming cup of black coffee at a hipster cafe before going to "therapy," or what she calls it when she gets work done on a tattoo that covers much of her right leg, which was severely injured when she deployed to Iraq as a combat medic. Her left leg sits in an IDEO (intrepid dynamic exoskeletal orthosis), a prosthetic device that makes it possible for her to walk. She doesn't go anywhere without it.

The tattoo tells her life story. She puts her cup on the table and leans down to her right to examine it. She rubs her hand along it, pointing out the highlights, like an author flipping through her memoir.

The dominant feature is a crow, battered and bruised but still very much alive and vibrant. That represents her. The entire tattoo is gray and black except for a red cross on the crow's ankle bracelet. The cross represents her work as a combat medic in the Army. There are dog tags that will eventually bear the name of her father, James Marks, a Vietnam veteran she adores. When the tattoo is completed -- many hours of therapy from now -- an American flag will be the bed upon which the rest of it lies.

The tattoo covers some of the scars from her war injuries -- and getting inked there was far more painful than on normal flesh. Several scars remain uncovered. She gets criticized, she says, almost entirely by women, for wearing a swimsuit that allows her scars to be seen. "I earned them, so I'm going to wear them," she says.

And so she does. Scars dot her neck, arms and legs -- the left one was slightly more damaged than the right. People sometimes ask why she hasn't undergone plastic surgery. TV producers often want to put makeup on them, and photo editors sometimes airbrush them out. All of which annoy her, as if they want to erase part of what made her who she is.

Her scars are rough-earned symbols of triumph over adversity. She sees the fact she survived those scars as a means to help others believe they can survive their own scars, whatever the source. All the medals she has won and will win, all the accolades, all of that is certainly great but is also beside the point. Medals are a means, not an end. She joined the Army to help soldiers as a combat medic, and swimming is the way she does that now.

"When I step onto the blocks, I never think, 'I want to win,'" she says. "I think, 'I want to pour all of myself into this race because there are people who can't physically, mentally or emotionally, do that.' So it's my way of performing for them."

She hopes to collect more material for the living mural on her leg this summer. The U.S. Paralympic trials will be held in June in Charlotte, North Carolina, in advance of the Paralympic Games in Rio de Janeiro in September. Marks' goal is to make the team in four events. She is a strong contender to win a medal, perhaps even gold, in the 100-meter breaststroke, in which she is ranked No. 1 in the world in her classification.

She wants to win medals not for the medals' sake but for the story of perseverance behind them. Marks joined the Army at 17, was wounded in Iraq at 19, recovered to become a world-class Paraswimmer, nearly died of a mysterious, unknown lung disease and regained her status as one of the best Paraswimmers in the world despite ongoing complications from the lung disease.

That's a lifetime of adversity crammed into eight years. Marks spent four years thinking about how to tell that story in her tattoo. She wrote in her journal about the meaning behind each image. She took very seriously the pursuit of finding the right person to turn her ideas into art. She walked into a tattoo parlor one day and described to the man there what she wanted. He tried to talk her into getting a different crow, one flawless, pristine, perfect.

He didn't understand her at all.

II. Dog Tags

Marks graduated from Arizona Project Challenge, a now-closed military high school, at 16. Her mentors there were largely former military, so she decided to join the Army. Her dad, who was wounded in Vietnam, tried to talk her out of it. He's glad he failed. "She proved me wrong," he says.

When Elizabeth (her friends call her Ellie) enlisted at 17 -- the same age James joined the Marines 40 years earlier -- she wanted to be as much of a soldier as a woman could be. She asked to be given a job that would bring her closest to combat. She was assigned to be a combat medic.

Before she left for Iraq in 2009, her father gave her his dog tags. She now calls them her most prized possession, and she carried them everywhere she went in Iraq, just as he had carried them everywhere he went in Vietnam. She considered the dog tags an emblem of him, "my favorite person in the world."

James Marks worked in maintenance at a VA hospital for three decades. He lived in such a way that Elizabeth always knew his children were his top priority. "He's a selfless man in every essence of the word. He will listen to someone for hours just so someone has him to listen," she says. "He just absolutely genuinely cares about people, especially people who are struggling. He's the most amazing person I've ever met."

Elizabeth Marks loved being a combat medic immediately and absorbed the care-giving ethos of that job. For the first time in her life, she felt as if she belonged.

She won't discuss any details of her deployment, including what happened to cause her injury, but she suffered serious injuries to both hips in Iraq in 2010. As she was hospitalized in Landstuhl, Germany, she overheard all kinds of scary things, the worst of which concerned a medical discharge from the Army. The military was the only place she had ever felt comfortable, and she was at risk of losing that.

If anybody understood what she was going through, it was her father. She called him. He told her to figure out the most important thing and write it down. She pulled out a piece of paper and wrote "FFD" -- short for "fit for duty." And since then, through painful rehab and recovery, twice, that has remained her motivating principle. She would do whatever it took to again become fit for duty so she could return to serving her fellow soldiers.

She carried that piece of paper from Germany to San Antonio to Colorado to San Antonio to Colorado. It is tacked up in her office, an ever-present reminder of what she has overcome.

 

III. A Ring

From the hospital in Germany, Marks was sent to San Antonio to begin rehab. Twice she applied to be declared fit for duty, twice she was turned down. She reached a turning point in 2012, when she started swimming. "It's hard to have the rug pulled out from underneath you and trying to find a new way to stand," she says. "Swimming afforded me that."

The pool became, as she put it, "my happy place." To make up for the lack of strength in her legs, she developed a unique stroke using her arms and her core. "I was so drawn to swimming because it's such a challenge. When you swim, it's not just, you go really hard and then you're done. It's, where are my hands at? Where are my arms at? What is my body doing? How am I breathing?" she says. "It's a very intellectual sport in that you are always thinking."

On top of all that, she was fast. Though her experience was limited, Marks showed so much potential as a swimmer that she was accepted in July 2012 into the Army's World Class Athlete Program, a unit comprising elite athletes who are on active duty. Being in WCAP means, essentially, that her job in the Army is to swim. The Army declared her "fit for duty" the same month.

Although she found success early in her swimming career, it gave her little joy. She felt selfish. Confused about her own emotions, she talked to U.S. Army Sgt. Ryan McIntosh, whom she met while they were both rehabbing in San Antonio. He lost his right leg below the knee when he stepped on a mine in Afghanistan in 2010. They call each other "Battle," which connotes a fellow soldier who is like a brother and a best friend.

"I should feel great," she told him, "and I feel awful."

McIntosh knew how badly Marks wanted to be a medic again. He knew, and still knows, that, as much as Marks loves being a swimmer, she loves being a soldier more and sees herself as a soldier first, everything else second. He has so much respect for her as a soldier that when he calls her an athlete, he does so almost reluctantly. He uses air quotes when he says the word, which makes her laugh out loud.

He told her she was experiencing survivor's guilt and that she was not "just" a swimmer. He told her she could still help people. It would not be exactly the same as her work as a medic, but it could be similar. She could inspire people to not give up no matter how dire the circumstances. "I think you can save people in any realm of life by motivating them," McIntosh says.

Swimming had already given Marks her life back. Now she would use her own suffering to help others. "There's no better way to repurpose pain," she says.

***

Marks met Sgt. Nicholas Titman (now retired) at the Olympic Training Center in Colorado Springs. They had much in common. Both had been hurt on deployment and become Paraswimmers. At first, their relationship was mentor-athlete. Marks used a GoPro camera to record Titman's practices, then analyzed his strokes with him, pointing out ways he could improve.

They discovered they were going through similar relationship struggles. Marks told Titman that, if he ever needed to talk, she was there to listen. He called her late one night and spilled his guts to her. "She sat there for hours upon end and listened to me, just listened to me sob," he says. "If she hadn't been there for me in my dark times and my rough times in life, I really don't know where I would be at today. She truly cares about people and wants to help make a difference in people's lives."

Marks' heart breaks for soldiers who never find help. "I had a battle buddy downrange who was a phenomenal medic. Very smart, very hardworking," she says. "He always seemed to pour everything he had into what he did. I always had a great deal of respect for that, and I always kind of wondered why [he was passionate about seemingly mundane things]. Even when it didn't really lead to anything, he just had this passion and love for what he did."

She adopted his approach into her own life. That helps her push in practice when she doesn't want to push anymore. "I think about the passion he applied, and how that changed my life," she says. She hopes other people see a reflection of his passion in her.

Back at the coffee shop, Marks holds up her right index finger -- her trigger finger. It's bare now. But when she swims, she wears a ring from 22Kill.com, which derives its name from a Veterans Administration report that suggested as many as 22 veterans kill themselves every day.

That battle buddy was one of them.

IV. Coin

In early September 2014, Marks flew to London for the Invictus Games, an international competition for Para-athletes created by Britain's Prince Harry.

She wasn't feeling well before she left, and, when she landed, her health rapidly deteriorated. She went to the hospital. Fluid filled her lungs. Unable to breathe, she was placed into a medically induced coma. Doctors from the UK's Papworth Hospital put her on extracorporeal membrane oxygenation life support, an external lung machine. The treatment saved her life.

She was flown to the same hospital in Germany where she had been treated after being hurt in Iraq. Her first memory is of Sept. 26, which sticks out in her mind because she had to concentrate very hard just to write "26" on a form. She was transferred back to San Antonio, to the same hospital she went to after she was hurt in Iraq.

And she started the recovery process all over again. This time, though, was different. She felt comfortable in San Antonio because she already knew people at the hospital. And she had her swimming coaches, teammates and bosses from WCAP rallying around her. WCAP could have given up on her, as this was the second arduous rehab she faced. Marks says she will be forever grateful for what WCAP officials told her: We're here for you. Come back when you're ready.

It was sooner than anybody expected.

***

Marks and Haley Barenbaum train together at the Olympic Training Center. They share goofy senses of humor, a love for the original three Star Wars movies and a deep passion for swimming that stays in the pool when they aren't in it. Barenbaum refers to Marks both as a big sister and as mama bear because she protects and nurtures her friends.

Marks calls Barenbaum "Panda" because, when Barenbaum, who has achondroplastic dwarfism, sneezes, it reminds Marks of that YouTube video of a panda sneezing. ("It scares people," Barenbaum says. "It doesn't sound like it should be coming out of someone who is 3 foot 9. It sounds like it should be coming out of someone who is like 8 feet tall.")

Barenbaum was cat-sitting for Marks' adopted strays -- Floyd, Willie and Kiki -- when Marks flew to London for the Invictus Games in 2014. Barenbaum was scared when she first heard of Marks' illness, but she was confident her friend was getting the best possible medical care, and whatever anxiety she had at the time has been washed away by Marks' remarkable recovery.

Marks returned to the pool on Oct. 23 -- less than a month from when she emerged from her coma. "There was no, 'OK, Ellie, let's get back in the pool.' There was a lot of, 'Ellie, should you really be in the pool right now?'" Barenbaum says. "She's a tough woman. Nothing really can ever break her down."

The workouts were slow at first, and Marks occasionally listened when coaches told her to dial back her practices. As Marks swam herself back into shape, it became clear that the condition of her legs had gotten worse, among other ongoing complications from the respiratory illness, which was never identified. She was reclassified as a Paraswimmer and now competes against swimmers who are amputees.

Marks returned to competition in December 2014 in the Can-Am games, and, in February 2015, she traveled to the World Military Swimming and Para-Swimming Open in Fontainebleau, France. There were only two women registered to compete in the 100-meter breaststroke -- Marks' strongest event -- so they swam against the men.

Five months after nearly dying, Marks beat the men and won gold. She laughs as she describes standing on the podium next to two men who were still as tall as she was, even though she was on a higher pedestal. One of the men she beat was a French soldier who saves military dogs. He gave her a coin that commemorates his work. It's common in the military to give out such coins as a sign of respect; Marks has many of them. She carries that French coin with her often. "Things hurt. It's hard," she says. "It's nice to have a little reminder or something to think back on that makes your heart feel whole again."

On the coin is an inscription in French, which translates as: "To save those who save us."

V. Gratitude

In January, Marks set a world record in the 50-meter breaststroke and an American record in the 200-meter breaststroke.

As the 2016 Invictus Games, held earlier this month in Orlando, Florida, approached, Marks thought back on the Papworth doctors and nurses who had saved her life. She remains in awe of their skills and knowledge. When she arrived in Orlando for the competition, she found Prince Harry, whom she had met at a competition in 2013. She told him that, if she won a gold medal, she wanted him to present it to her. She hoped in particular to win the 100-meter freestyle, which she considers her most challenging race, and she had something special in mind for the gold medal.

Marks always has an assistant walk with her to the starting block, and, at the Invictus Games, Titman served that role. As she prepared for the 100-meter freestyle final, she peeled off her jacket. In its left pocket were her dad's dog tags -- she keeps them there before every race. She finds it comforting to run her fingers around them. She put the jacket in a bucket next to the block.

On her right trigger finger was her size 6½ ring from 22Kill.com, an homage to her battle buddy.

In her swimming bag was the coin from the Frenchman.

She races wearing two caps; the one snug to her head is always from someone she has mentored. On this day, it was a white cap given to her by Titman. On top of that she wore a blue cap, as required as a member of the U.S. team.

The scars on her legs, neck and arms were visible to anyone close enough to see them. Same for the red cross on her right leg.

She took the prosthetic device off of her left leg and gave it to Titman. She climbed onto the block, put her left hand on Titman's shoulder and leaned on him for balance. She remained that way until the starter said, "On your marks," after which she reached down to get in the ready position.

Then something weird happened. On the sidelines, coaches and other swimmers shouted, "Goggles!" repeatedly. The competitor next to Marks had forgotten to pull down her goggles. Marks stood up, thinking that because of the confusion there would be a false start. But the horn signifying the start sounded anyway, and she wasn't ready.

She dove in, last, behind everybody else.

She started swimming.

When she was two strokes from the turn, her coach tapped her on the head with a pad at the end of a stick. The contact let her know that it was time to flip. It was necessary because one lingering symptom from her London illness is that she's blind while swimming.

She flipped and swam back to where she began, back toward Titman. Despite the late start, she won easily; indeed, she won gold in all four events she entered. But when she touched the wall, she had no idea she had won, and she was only vaguely aware of where she was.

Another lingering effect of the near-death experience in London is that swimming deprives Marks of so much oxygen that she gets disoriented. She needs help getting out of the pool, and someone has to walk her away from the water and stay with her. She sometimes needs up to 10 minutes after a race before she can be left alone.

Eventually she realized she had won the gold medal she so deeply wanted. But she didn't want it for herself. After Prince Harry presented her with the gold medal, she took it off of her neck and gave it back to him, in a moment that went viral after photographers captured it. She asked him to take it back to Papworth and give it to the doctors and nurses who saved her life, a small token of appreciation, from one caregiver to a whole group of them, for a debt she can't repay.

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