Sure, “Bloody Sunday” shows sports helmets need fixing. But what still resonates for me is the shocking state of our young warriors’ helmets and the little attention paid to the “Bloody Days” everyday in Afghanistan and Iraq.

The key issues of course are what’s being done to prevent these egregious combat-related head injuries and exactly who is responsible?

Our senior military leaders?  Congress?  A combination of both? 

If you Google “TBI congressional hearings” you get 23,000 hits, the majority of which confirm that the Congressional focus is on sports-related head injuries versus combat-related head injuries (aka Traumatic Brain Injury).

If you Google “TBI the signature wound of the wars in Iraq and Afghanistan” you get 14,000 hits, demonstrating that the majority of policymakers and military leaders have actually done very little. In fact, it’s pretty much just the same old standard boilerplate lip service.

That’s because Congressional hearings simply don’t materialize out of thin air.  Oftentimes, a current event or failed policy will cause legislators to call for a hearing.  But unless there’s a constituency with well-connected “K” Street lobbyists, the committee staff will routinely develop a reactive schedule of hearings to support legislative priorities on the radar-screen within their respective committees to consider relevant testimony as they prepare to leverage pending legislation.

This year alone there have been six congressional hearings related to head injuries – four on sports-related head injuries and two on combat-related injuries. 

One of the two Congressional hearings before the Senate Armed Services Committee included TBI.  However, the TBI topic and witnesses were added to a previously scheduled hearing only after Pro Publica reported on the inadequate policy attention given TBI which alerted Chairman Levin to the problem.  In other words TBI hadn’t been scheduled –and the lesson learned is that it often takes either lobbying or the spotlight of investigative reporting to prompt Congressional action. The squeaky wheel syndrome.

What these six hearings do reveal however is that the sports-related injury hearings focused on a combination of prevention (i.e. improving equipment) and treatment (specifically the impact these injuries have on physiology, including motor skills, long term brain damage and cognitive rehabilitation), while the combat injury related hearings were solely concerned with treatment of TBI—with nary a mention of prevention such as improving the equipment.

The point is that after almost a decade of sustaining gruesome head injuries in combat there is little-to-no congressional focus on prevention of these injuries.  I’m not talking about the tactics, techniques and procedures of defeating the IED threat—which is a completely different argument and issue—but actually improving the combat helmet! 

 So why is the focus on treatment, not prevention?  My best guess is that the Services continue to follow the Code of Silence and do very little to actually schedule or focus Congress to fix this problem.  After all, in a culture where anyone who comes forward pays a harsh price, why volunteer to air dirty laundry in such a public forum?

So what does happen when the Services are called before committees to answer uncomfortable questions, since they’re not about to raise their hands on their own? 

Our sources have confirmed that each Service and their legislative liaisons fight tooth and nail to:

• Control every witness (i.e. reduce the rank of the witness – less liability at the top);
• Submit reports past their due dates (i.e. drag heels on timeliness and blame the bureaucracy): and,
• Short-change statements in order to minimize exposure and keep a tight lid on policy (i.e. release prepared remarks and statements to committees at the last possible moment).

So if the Services are unwilling to own up to the problem and make prevention the priority, is there anywhere in the public record where military leaders have focused on replacing the Advanced Combat Helmet as opposed to after-the-fact treatment? 

The tragic answer is no.

A cursory review of each Service’s Annual Posture Statements confirmed more focus on treatment, but little to none on prevention:

• The Chairman of the Joint Chiefs briefly mentions “treating the hidden wounds of war” in his statement.
• The Army Chief of Staff didn’t even mention TBI. Seriously, has this man been to Walter Reed lately?
• The Commandant of the Marine Corps does better than his Soldier counter-part and

  reported that the Corps has a formal screening protocol for Marines who suffer concussions or who are exposed to blast events in theater and that Naval medicine remains at the forefront of researching and implementing pioneering techniques to treat traumatic brain injury.

• The Chief of Naval Operations reported that Navy Medicine has reached out to its civilian colleagues and established partnerships with civilian hospitals to improve the understanding and care for those affected by traumatic brain injuries. 
• The Chief of Staff of the Air Force made no mention what so ever of TBI  “signature wounds.” 

Finally, I briefly mentioned that hearings beget legislation and appropriations.  So what are the fruits of the legislative labor in regards to directing and funding prevention? The committee notes that the Army is accelerating research and development of materials to increase personal protective equipment while reducing its weight. They recommend an increase of $3.0 million (in Program Element 64601A ) for next-generation helmet ballistic materials technology (2010 National Defense Authorization Act Committee Report). Chump change to the Military Industrial Congressional Complex, an insult to America’s frontline troops—and a confirmation of the sad fact that sometime, somewhere prevention will be addressed only if an organization such as ours starts applying the necessary pressure.

Yet right now, more than a week after the NFL’s “Bloody Sunday,” I guarantee you that league leaders, owners and investors are making detailed plans to spend hundreds of millions of dollars redesigning helmets and gear, revamping training and keeping players accountable for violating policies – all to protect their human investment. And how do they plan to do that?  By preventing further injuries to their players in the first place.