Iraq War's Signature Wound: Brain Injury
Friday, September 15, 2006; 7:19 AM
PALO ALTO, Calif. -- Lance Cpl. Sam Reyes bears scars from three horrific attacks in Iraq, but his most debilitating wound cannot be seen.
He recovered from the chest wound delivered by a machine gun-toting insurgent and the bullet wound to his back that came during an ambush. He survived the severe burns and broken ribs inflicted by a suicide bomber who struck a lightly armored 18-wheeler and killed 12 of Reyes' fellow Marines.
But a traumatic brain injury from that truck explosion initially went undetected, and it continues to cripple him long after Reyes returned home with a clean bill of health.
The blast sent a powerful shock wave through his brain tissue, bursting blood vessels and smacking his brain against the inside of his skull.
"I thought I was a mess-up, just damn near dumb," Reyes, 22, said about the mysterious fogginess that remained. "I thought I was just a failure at this. I was recognized before as being the best. I knew my stuff real well. It made me feel like I wasn't a Marine no more."
Doctors say traumatic brain injuries are the signature wound of the Iraq war, a byproduct of improved armor that allows troops to survive once-deadly attacks but does not fully protect against roadside explosives and suicide bombers.
So far, about 1,000 patients have been treated for the symptoms, which include slowed thinking, severe memory loss and problems with coordination and impulse control. Some doctors fear there may be thousands more active duty and discharged troops who are suffering undiagnosed.
"People who were hit by lightning, a lot of energy goes through their systems and their brains are cooked," said Dr. Harriet Zeiner, a neuropsychologist at the VA hospital in Palo Alto. "A lot of that happens in (improvised explosive device) blasts. Your brain is not meant to handle that energy blast going through it."
The injury, a loss of brain tissue, shares some symptoms with post-traumatic stress disorder, which is triggered by extreme anxiety and permanently resets the brain's fight-or-flight mechanism.
Battlefield medics and military supervisors often fail to spot traumatic brain injuries. Many troops don't know the symptoms or won't discuss their difficulties for fear of being sent home.
"Most of us are used to the Vietnam War, where people didn't trust the government," Zeiner said. "That's not going on here. A lot of these guys want to go back, they want to go help their buddies."
Some of the most devastating effects of traumatic brain injuries _ depression, agitation and social withdrawal _ are difficult to treat with medications, said Dr. Rohit Das, a Boston Medical Center neurologist who treats injured troops at the VA Boston Healthcare System.