The trauma after the trauma
THE IRAQI insurgents' frequent use of improvised explosive devices has made traumatic brain injury the most characteristic lasting wound of this war. Its effects can range from a debilitating level of cognitive malfunction in the worst cases to depression, anger, and confusion in less severe ones. The nation must mobilize all its resources to treat victims of these injuries - even if that means using hospitals outside of the military and Department of Veterans Affairs system.
Congress heard testimony this year on the problems veterans and some active-duty troops have had getting care for this condition, which the Globe's Charles Sennott also documented in detail earlier this month. A bill that passed the Senate unanimously in August called for more partnerships between the VA and the private sector.
But the military and the VA have resisted authorizing use of facilities, such as the Spaulding Rehabilitation Hospital in Boston, that have extensive experience treating patients with head injuries. If the government continues to deny veterans or service members this option, Congress should mandate that the injured have the right to the best care possible, especially if it means their family members do not have to move hundreds of miles to be close to them during the long rehabilitation process.
The VA takes pride in its four multiple trauma, or polytrauma, rehabilitation centers in Minneapolis, Tampa, Richmond, and Palo Alto, Calif., which are backed up by 17 outpatient trauma centers, including one in Boston, for less severe cases. But relatives of veterans with traumatic brain injury say the polytrauma centers lack up-to-date equipment and are often understaffed, which leads to infections and unhygienic conditions. Many relatives say veterans have done better after treatment in private facilities.
Private care is costly, but only in the short term. After surgery, effective rehabilitative care and cognitive therapy can ensure a degree of recovery that heads off high medical and social costs in the future.
In a recent interview, Dr. Barbara Sigford, the VA's national director of rehabilitation, defended its care of traumatic brain injury victims, saying the polytrauma centers have state-of-the-art equipment and adequate staffing levels. In testimony to Congress in the spring, she said the VA "is committed to providing the highest quality of services."
But often the best way to provide that care is not at VA polytrauma centers that have their hands full with veterans from World War II, the Korean War, and the Vietnam War, but by working with Spaulding and similar hospitals. Injured troops and veterans deserve the best treatment the nation can deliver, not just what the VA offers. Congress must ensure that they get this care, and that the Defense Department and VA get the money to pay for it.
