The wounds of war
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BRAIN INJURIES and psychological illnesses are becoming the signature wounds of today’s wars. Because of the increased use of improvised explosive devices, a 2008 study by the think tank RAND estimates that 19 percent of soldiers in Iraq and Afghanistan experience possible traumatic brain injury. Invisible to the eye and difficult to test, these cognitive injuries are even trickier to diagnose because many symptoms overlap with post-traumatic stress disorder and depression, which also affect nearly 20 percent of troops. In order to get the best treatment and avoid re-injury, the Armed Forces and soldiers themselves need to better recognize the symptoms of these traumas.
Brain injuries can result in serious impairments. One soldier in a recent study needed to cling to a wall just to stay upright. Another gets lost repeatedly in his own neighborhood.
To gain a better understanding of combat brain injuries, the Sports Legacy Institute and the Boston University Center for the Study of Traumatic Encephalopathy are setting up a brain registry for servicemen. By pairing examinations of soldiers’ cognitive health over time with post-mortem brain tissue examinations, the centers hope to help researchers develop imaging tests for toxic proteins that are present in damaged brains and brains with Alzheimer’s.
Until then, the Armed Services must be more cautious with soldiers’ cognitive health. According to RAND, of those reporting probable brain injuries, 57 percent had not been evaluated by a physician. Computerized tests that examine athletes for concussions have been administered to soldiers deployed in the last year. After setting a baseline for each soldier before deployment, retesting can identify soldiers in trouble before they harm themselves or others. Yet, only one division is retesting all its soldiers.
Soldiers with probable brain injuries must also be encouraged to rest. The severity of brain damage rises dramatically for each subsequent injury, and those with symptoms must not be in high-risk situations. Despite pressure to return to combat, avoiding even small mental exertions like reading can greatly improve recovery time.
But no available treatment will matter unless soldiers become better at identifying problems. Educational programs can help soldiers recognize symptoms and deficits before they become life-threatening. The stigma of psychological illness often prevents soldiers with these symptoms from coming forward. Wider awareness will not only increase the likelihood that a sick soldier might seek help, but also can decrease the overall stigma by showing that these symptoms are a product of war - not a sign of weakness.
