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)

O'Brien had been through multiple previous explosions _ troops average one a month, a study found _ and each raises the risk that the next one will do harm. Soldiers and Marines are proud and reluctant to go "off mission" just because "they get their bell rung," said Dr. Michael Kilpatrick, a top Defense Department physician.

"Most of the treatment is explaining the situation and giving the tincture of time _ giving it time to heal," he said. If no big symptoms appear in eight to 12 hours, "they're probably ready to go back."

Officers also face pressure to return troops to duty, said Jordan Grafman, a neuroscientist who studies TBI at the National Institutes of Health.

"People don't want to lose these guys from their command _ they can't replace them fast enough," he said.

During a surprise visit to Iraq with President Bush on Labor Day, Gen. Peter Pace, chairman of the Joint Chiefs of Staff, said the military was "much smarter about this now," and urged troops to watch for signs of TBI and post-traumatic stress.

"They are every bit as much battle injuries as is a bullet or shrapnel. It is OK, it is OK to seek help for those kinds of war wounds, and I ask you all to help your buddies understand what you see in them," he said.

But that was long after O'Brien was hurt. His TBI was not diagnosed for months, until his hip injury landed him back at Fort Campbell in Kentucky. By then, the Army needed help treating TBI and was contracting with private rehab centers like Schneider's at Vanderbilt.

Malone and O'Brien had become friends, helping each other cope with wounds.

"They were sent to us together," Schneider said.

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"I'll need to get milk and bread and eggs. Milk and bread and eggs. Next thing you know, I drive right by Wal-Mart," O'Brien said.

"I can vaguely tell you what we talked about at the beginning of this conversation," Malone said.