Thousands of GIs Cope With Brain Damage

Bryan Malone, an Army specialist, left, and Eric O'Brien, right, an Army staff sergeant, pose at Vanderbilt University Medical Center, Aug. 2, 2007, in Nashville, Tenn. As a result of a rocket attack on a Baghdad gym where the two were working out, they both suffer from traumatic brain injury, the "silent epidemic" of the Iraq war. (AP Photo/Mark Humphrey) (Mark Humphrey - AP)

"It's the so-called invisible injury. It's where a troop takes 10 times the normal time to pack his rucksack ... a complicated injury to the most complicated part of the body," said Dr. Alisa Gean, a neurosurgeon at the University of California, San Francisco.

Diagnosing it is imprecise _ damage rarely shows up on CAT scans or other tests.

Treating it is even more difficult. Lacking a cure, doctors focus on symptoms _ headaches, anxiety, vision problems, etc. But they lack good treatments for some of these, too, and are considering some experimental approaches being pushed by private companies with little proof they work.

Many troops get no care at all. Some are sent back to fight with their brain injuries undetected, especially if they had no obvious wounds.

What happened to Eric O'Brien and Bryan Malone shows the scope of this problem.

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O'Brien, a 32-year-old Army staff sergeant from Iowa's Quad Cities, was teasing Malone, 22, a specialist from Haughton, La., in a Baghdad gym last summer.

"I told him and his workout partner: 'Put some more weight on it,'" prompting the men to get up. Seconds later, a rocket hit where they had sat. They survived, but a pressure wave from the blast coursed through their brains.

"I patted myself down head to toe, making sure I wasn't missing a limb," and felt odd, like "I must be missing a chunk of my head,'" O'Brien said. He remembers little else except walking through debris to pick up his iPod and sunglasses.

As for Malone, an air conditioning vent had fallen on his head and he had shrapnel wounds. He had multiple surgeries, spent several months in Walter Reed Army Medical Center and now has titanium mesh reinforcing his skull.

O'Brien, however, had shrapnel removed from his scalp and then was sent back to his unit _ "no antibiotics, no pain medication or anything. They just sent me on my way."

When he later complained of pain, doctors gave him Motrin. When he discovered a trickle of blood from his hip, they said he would be fine. Six weeks later, when he could barely walk, tests revealed shrapnel in his hip. By then, he was having headaches and trouble sleeping.