Stand For The Troops

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Soldiers For The Truth has become Stand For The Troops. Our new name reflects exactly what we do on behalf of all concerned  Americans—stand for the troops—and more specifically, stand for our frontline troops, our young heroes who stand tall for us and our country out at the tip of the spear.   

 Our mission remains the same: to ensure that America’s frontline troops get the best available personal combat gear and protective equipment, including body armor and helmets. In fact, the military has been testing helmet sensors in Afghanistan for well over two years to evaluate the effect of IED attacks on our troops while the attacks continue to escalate with little being done to provide our warriors with more adequate head protection.   The sorry result is a near epidemic of troops suffering from traumatic brain injury (“TBI”) and post traumatic stress disorder (“PTSD”) from their service in Afghanistan and Iraq. 

While senior military officials acknowledge that PTSD is a serious and growing problem, diagnosis and treatment remains disjointed, not to mention that admitting to the disorder on record seem to be a career stopper.  Meanwhile new stories break daily about veterans taking their own lives or behaving erratically despite desperate pleas by the families, friends and fellow service members to the chain of command for more easily available, more effective treatment. 

As part of Stand For The Troops’ expanded mission, we’re mobilizing a task force of eminent medical professionals to evaluate existing PTSD treatment within the military and general communities so that a comprehensive, targeted, more effective treatment protocol can be established and offered for the benefit of our warriors. For too long the military has allowed frontline troops to resume active duty while suffering from this debilitating condition—all too often resulting in devastating consequences for both our brave warriors and their loved ones.  

 We as citizens have a responsibility to Stand For The Troops and not allow PTSD—and TBI—to be the legacy of the war in Afghanistan.

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Military News Highlights: December 21, 2010

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For Brain-Injured Soldiers, Top Quality Care From a Philanthropist, not the Pentagon

The primary health care plan for our active duty force, called TRICARE will not provide “cognitive rehabilitation therapy” (CRT) for treatment of traumatic brain injuries (TBI) because the treatment is “still unproven.”  Project Share, a charity based out of the Shepard Center for Brain and Spinal Cord Injury in Atlanta is singularly focused on assisting brain-damaged soldiers – their efforts, to serve as a model for the Department of Defense and provide CRT as a means to close the gap created by TRICARE and military hospitals that lack the expertise and staff to treat complex TBI injuries, are falling on deaf ears. 

The 2007 ECRI Assessment on Cognitive Rehabilitation for Traumatic Brain Injury report provides specific details on CRT costs and benefits.  CRT is not some hokey-incense burning-meditation protocol – it’s a proven therapy that our servicemembers need access to.

 Admitting that CRT is timely and oftentimes complex, the former Home Depot executive and philanthropist Bernie Marcus and founder of Project Share makes the compelling case that our servicemembers that are grievously wounded and affected by TBI deserve only the best treatment and options.    SFTT agrees!

NATO fails to deliver half of trainers promised for Afghanistan

The trap door out of Afghanistan is supposedly lined with the premise that the Afghan National Security Forces will stand up beginning in 2011 and begin to assume increasingly more security responsibilities – the trap door is the US/NATO exit plan.   But the required effort to make this possible will cost $6 billion per year in perpetuity and require a host of trainers and equipment resources – problem is, that by the end of 2010 NATO can only provide half of the required trainers.  Making matters worse is the ad hoc nature of the training effort and programs and the lack of accountability of ensuring training standards are being met – most startling is that Kabul (NATO) “is still discovering training programs operating around the country that headquarters commanders did not know existed.”   Can you imagine that?  A critical training mission staffed at 50% with a $6 billion tab and training programs that no one knows exists?

 25,000 Soldiers headed to Afghanistan in 2011

 The roster of units deploying to Afghanistan are as follows:

  •  I Corps Headquarters, Joint Base Lewis-McChord, Wash.
  • 159th Combat Aviation Brigade, 101st Airborne Division, Fort Campbell, Ky.
  • 82nd Airborne Combat Aviation Brigade, 82nd Airborne Division, Fort Bragg, N.C.
  • 3rd Infantry Brigade Combat Team, 1st Infantry Division, Fort Knox, Ky.
  • 3rd Infantry Brigade Combat Team, 25th Infantry Division, Schofield Barracks, Hawaii
  • 1st Infantry Brigade Combat Team, 25th Infantry Division, Fort Wainwright, Alaska
  • 3rd Infantry Brigade Combat Team, 10th Mountain Division, Fort Drum, N.Y.
  • 2nd Infantry Brigade Combat Team, 4th Infantry Division, Fort Carson, Colo.
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Military News Highlights: December 2, 2010

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‘Progress Made’ In Afghanistan’s Helmand Province

When interviewed by . Generic drugs that do so should have the same therapeutic effect and therefore the same benefits as their brand-name counterparts, but at less cost.

“But let’s talk a little bit about Marja, because I know that’s one you’ve been following. If you could come over and visit today I would take you down to the district center, where across the street is a very nice restaurant that’s opened up – two dining rooms. You can get a really nice chicken dinner there. There’s three major bazaars in town, all three flourishing. All of the activity now – all the enemy activity in Marja’s been pushed to the perimeter, where a few lone insurgents creep back, usually at night, and try to intimidate some of the locals. And have not done a very good job of it.”

When asked to comment on Sanjin, heartland of the current bloodbath that has claimed the lives of at least 14 Marines assigned to 3rd Battalion, 5th Regiment since mid-September, General Mills made no mention of this sacrifice but commented that, “It’s been tough fighting. It continues to be tough fighting. I think that Sangin is Marja, perhaps five months ago. And we are going to remain focused on that mission up there, and we will win.”

When they start serving chicken dinners in Sangin, I guess the General can claim victory.

The following two news reports from the New York Times add to SFTT’s recent discussion on combat related and sports related head injuries and trauma and the stark difference between the actions taken by the sports industry and lack of action and non-prioritization of these type injuries taken by the Congress, DoD, and the Services.

Scans Could Aid Diagnosis of Brain Trauma in Living

If athletes are subject to chronic traumatic encephalopathy (CET) as a result of sustained head trauma, then it’s obvious that US troops are prone to CET in the future as well due to combat related head trauma.   In fact, Boston-based researchers have developed new imaging techniques that confirmed CET in athletes brains with a history of head trauma.  Currently, CET can only be confirmed through a specialized brain tissue examination after death.  So imagine if you can monitor CET and its symptoms and treat these injuries effectively.  Why wait until you are on the morticians slab to confirm the obvious?  While there is more work to be done with the initial positive results of this new type of imagining and study, the question that remains is whether or not this type of sports/medical science will ever transfer over to DoD and its medical services as it identifies, monitors, and treats troops suffering from TBI. Probably not given their track record.

Ward Calls League Hypocritical on Safety

Maybe Pittsburgh Steelers wide receiver Hines Ward is onto something in his criticism of the National Football League’s recent call and emphasis on safety.  Ward’s take is that the league only toughened its stance because of a pending desire to extend the season to 18 games.   If DoD, the services, and Congress ever wake up and start addressing combat related head injuries and trauma properly maybe it’s because they want to extend the time spent on the battlefield as well.  Nah, just because 2011 turned into 2014 and beyond in Afghanistan doesn’t mean that there is going to be new emphasis placed on improving helmets and reducing head injuries and traumas.  In Afghanistan, its all systems forward without these types of safety and quality of life considerations.  Why should we kid ourselves and believe there was a purpose for “extending the season”.

Department of Defense Headquarters Staff Comparisons (2000-2010)

Senator James Webb requested a pre-and post-9/11 staff comparison of Department of Defense, Services, and Combat Command Headquarter as he studies the Department’s recent decision to axe Joint Forces Command.   After nearly a decade, of the 17 reporting headquarters there has been approximately 11,000 civilian/military staff personnel billets added.  If you only take uniform personnel back into the fold you could man at least two Brigade Combat Teams – imagine that!  Read more from Tom Ricks.

Dragon EOD Squad Leader Sergeant First Class “William”

Just in time for the holidays.  Your very own toy-set of body armor, Advanced Combat Helmet, and an M-4 carbine!  Enjoy!

  • The set is outfitted in the newer ACH, with older style Interceptor body armor in woodland camouflage, and helmet with woodland camouflage cloth cover.
  • Weapon: M4 Assault Rifle or M4 Carbine with Infrared Pointer / Illuminator, Aimpoint optic sight, Forward Hand Grip, tactical light attached under the barrel, retractable / extendable butt stock and removable magazine.
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MIT study suggests face shields could reduce blast-induced TBI

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A researcher from MIT claims that computer models suggest that face shields added to combat helmets could help reduce blast-induced traumatic brain injury or “TBI” for US military troops serving in combat zones.

Found below is the news release from MIT

QUOTE

MONDAY, NOV. 22, 2010, 3:00 P.M. ET

MIT Study: Adding face shields to helmets could help avoid blast-induced brain injuries

– Researcher releases computer models that show effect of simulated explosions

Simulated Blast Shield

Simulated blast shield (left) and cut-away

CAMBRIDGE, Mass. — More than half of all combat-related injuries sustained by U.S. troops are the result of explosions, and many of those involve injuries to the head. According to the U.S. Department of Defense, about 130,000 U.S. service members deployed in Iraq and Afghanistan have sustained traumatic brain injuries — ranging from concussion to long-term brain damage and death — as a result of an explosion. A recent analysis by a team of researchers led by MIT reveals one possible way to prevent those injuries — adding a face shield to the helmet worn by military personnel.

In a paper to be published Monday in the Proceedings of the National Academy of Sciences, Raul Radovitzky, an associate professor in MIT’s Department of Aeronautics and Astronautics, and his colleagues report that adding a face shield to the standard-issue helmet worn by the vast majority of U.S. ground troops could significantly reduce traumatic brain injury, or TBI. The extra protection offered by such a shield is critical, the researchers say, because the face is the main pathway through which pressure waves from an explosion are transmitted to the brain.

In assessing the problem, Radovitzky, who is also the associate director of MIT’s Institute for Soldier Nanotechnologies, and his research team members recognized that very little was known about how blast waves interact with brain tissue or how protective gear affects the brain’s response to such blasts. So they created computer models to simulate explosions and their effects on brain tissue. The models integrate with unprecedented detail the physical aspects of an explosion, such as the propagation of the blast wave, and the anatomical features of the brain, including the skull, sinuses, cerebrospinal fluid, and layers of gray and white matter.

“There is a community studying this problem that is in dire need of this technology,” says Radovitzky, who is releasing the computer code for the creation of the models to the public this week (for the code, please email: tbi-modeling@mit.edu). In doing so, he hopes the models will be used to identify ways to mitigate TBI, which has become prominent because advances in protective gear and medicine have meant that more service members are surviving blasts that previously would have been fatal.

To create the models, Radovitzky collaborated with David Moore, a neurologist at the Defense and Veterans Brain Injury Center at Walter Reed Army Medical Center, who used magnetic resonance imaging to model features of the head. The researchers then added data collected from colleagues’ studies of how the brain tissue of pigs responds to mechanical events, such as shocks. They also included details about what happens to the chemical energy that is released upon detonation (outside the brain) that instantly converts into thermal, electromagnetic and kinetic energy that interacts with nearby material, such as a soldier’s helmet.

The researchers recently used the models to explore one possibility for enhancing the helmet currently worn by most ground troops, which is known as the Advanced Combat Helmet, or ACH: a face shield made of polycarbonate, a type of transparent armor material. They compared how the brain would respond to the same blast wave simulated in three scenarios: a head with no helmet, a head wearing the ACH, and a head wearing the ACH with a face shield. In all three simulations, the blast wave struck the person from the front.

The analysis revealed that although the ACH — as currently designed and deployed — slightly delayed the arrival of the blast wave, it didn’t significantly mitigate the wave’s effects on brain tissue. After the researchers added a conceptual face shield in the third simulation, the models showed a significant reduction in the magnitude of stresses on the brain because the shield impeded direct transmission of blast waves to the face.

Radovitzky hopes that the models will play a major role in developing protective gear not only for the military, but also for researchers studying the effects of TBI in the civilian population as a result of car crashes and sports injuries. While the study was limited to a single set of blast characteristics, future simulations will study different kinds of blast conditions, such as angle and intensity, as well as the impact of blast waves on the neck and torso, which have been suggested as a possible indirect pathway for brain injury.

Source: “In silico investigation of intracranial blast mitigation with relevance to military traumatic brain injury,” by Nyein, M., Jason, A., Yu. L., Pita, C., Joannopoulos, J., Moore, D., Radovitzky, R. Proceedings of the National Academy of Sciences, 22 November, 2010.

Funding: The Joint Improvised Explosive Device Defeat Organization through the Army Research Office

Contact: Jen Hirsch, MIT News Office

E: jfhirsch@mit.edu, T: 617-253-1682

# # #

Written by Morgan Bettex, MIT News Office

UNQUOTE

SFTT Analysis

Clearly, this is very exciting information and we have to applaud Raul Radovitzky, his fellow researchers and MIT for sharing the computer modeling simulations with the general public.   Brain injuries are receiving considerable attention by the US Army and the Department of Defense and any improvements in combat helmet designs to reduce brain-related combat injuries  is of the utmost importance to troops serving in harm’s way.

SFTT and its supporters have labored long and hard to make sure our troops have the finest protective gear and combat equipment available.  The fact that better protective gear is available or that the technology exists to dramatically upgrade our existing “kit” doesn’t mean that this state-of-the-art equipment will ever be fielded by our troops.   As we have seen time and time again,  the “best” equipment options are often rejected by a military procurement process that operates with stealth-like secrecy and stonewalls Congress and the public on the efficacy of current combat equipment.

The questions we should all be asking ourselves and, most importantly, our military leaders are these:

  • How fast can current manufacturers of combat helmets produce a face shield based on the  “free” computer simulation information provided by MIT?
  • How fast and easily can a “face shield” be added to the Advanced Combat Helmet (“ACH”)?
  • How long would it take for the US Army and DoD to test combat helmet prototypes using  face shields?
  • Assuming the conclusions of the MIT research are confirmed, how soon can we expect US troops to be equipped with helmets using face shields?

This is a real opportunity for the Department of Defense to take the initiative to provide our troops with a state-of-the-art helmet to avoid the increasing incidence of combat-induced brain injuries that now affect well over 100,000 returning veterans.   The time to act is now!

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2010 Congress: The Services and the “Signature Wound”

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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.

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Medics Improvise to save lives on killing fields of Afghanistan

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In a compelling story published today by the Washington Post, “Military medics combine ultramodern and time-honored methods to save lives on the battlefield” of Afghanistan.

Key Highlights:

  • At 6:09 p.m., Dustoff 57 has just left this base deep in Taliban-infiltrated Kandahar province, headed for a POI, or point of injury. Somewhere ahead of the aircraft is a soldier who minutes earlier stepped on an improvised explosive device, the signature weapon of the wars in Iraq and Afghanistan. All the helicopter crew knows is that he’s “category A” – critical.  The trip out takes nine minutes.  Fifteen minutes have now passed since the soldier was wounded. Speed, simplicity and priority have always been the hallmarks of emergency medicine. The new battlefield care that flight medics and others on the ground practice takes those attributes to the extreme.
  • Four people run to the helicopter with the stretcher holding the wounded soldier. He lies on his back partially wrapped in a foil blanket. His chest is bare. In the middle of it is an “intraosseous device,” a large-bore needle that has been punched into his breastbone by the medic on the ground. It’s used to infuse fluids and drugs directly into the circulatory system when a vein can’t be found. It’s a no-nonsense technology, used occasionally in World War II, that fell out of favor when cheap and durable plastic tubing made IV catheters ubiquitous in the postwar years. Until they were revived for the Iraq and Afghanistan wars, intraosseus devices were used almost exclusively in infants whose veins were too small to find. On each leg the soldier has a tourniquet, ratcheted down and locked to stop all bleeding below it. These ancient devices went out of military use more than half a century ago because of concern that they caused tissue damage. Now every soldier carries a tourniquet and is instructed to put one on any severely bleeding limb and not think of taking it off.
  • Tourniquets have saved at least 1,000 lives, and possibly as many as 2,000, in the past eight years. This soldier is almost certainly one of them. They’re a big part of why only about 10 percent of casualties in these wars have died, compared with 16 percent in Vietnam.  On the soldier’s left leg, the tourniquet is above the knee. The tourniquet on his right leg is lower, below the knee; how badly his foot is injured is hard to tell from the dressings. His left hand is splinted and bandaged, too. Whether he will need an amputation is uncertain. The hospital where he’s headed treated 16 patients in September who needed at least one limb amputated. Half were U.S. soldiers, and the monthly number has been climbing since March.
  • After three minutes on the ground, the helicopter takes off.  Eleven minutes after lifting off from the POI, the helicopter lands at the so-called Role 3, or fully equipped, hospital at Kandahar Airfield, about 30 miles to the east of the also well-fortified Forward Operating Base Wilson. There, surgeons will take care of the injuries before transferring the patient, probably within two days, to the huge military hospital in Landstuhl, Germany, and there, after a week or so, to the United States. It’s been 28 minutes since the helicopter left Forward Operating Base Wilson.

SFTT Analysis:

  • Before every Grunt leaves the wire, they want to know if air or artillery support is readily available and more importantly, if required, will an aerial medevac be responsive – in Joe speak “Time on Target for Air and Arty and a quick Nine-line medevac request . . . how quick will the angels of mercy get here?”.   Quick means quick, the sooner the better obviously, since every minute counts.  Secretary Gates figured this out when he began his battlefield circulation tours in Afghanistan when he became Secretary of Defense and quickly realized that the “Golden Hour”, that period in time that is the standard from time of request for a medevac to arrival at the point of injury and back to medical care on a base, was not being met in Afghanistan due to lack of medevac resources and the distant out-posts that troopers were operating from.  Secretary Gates made it a personal mission to close the gap and ensure that troopers were supported by the “Golden Hour” standard and personally kept the pressure on logistics planners to increase medevac resources and establish medical unit facilities in support of all forward deployed personnel.   The only question SFTT raises regarding this issue is why did it take the Secretary of Defense to correct this situation?  
  • The Washinton Post online article provides a remarkable photo gallery,  – of note is:
    • the destructive nature of an IED that targeted a Mine Resistant Ambush Protected (MRAP).  The simplicity of a pressure plate device loaded with hundreds of pounds of fertilizer (and other components) can defeat US “resistant” vehicles.  More telling is that a device of this size takes time and local support to emplace;
    • grunts not wearing all of their protective gear – no throat, deltoid, or groin protectors – obviously a commanders call, but is the decision not to wear the complete armor suite because of weight and comfort?;
    • the chinstrap for the Advanced Combat Helmet is a flimsy strap of material – no chin pads are provided and the harness is simply used to hold the “brain bucket” in place.  At least the trooper is being medevaced for treatment of a possible TBI.
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Bloody Sunday: 16 (US Troop Casualties) vs. 6 (NFL Player Casualties)

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 I follow football.  High School, College, Professional – all levels, all kinds. It’s a blood sport.  So there was no way I could ignore the blaring RSS feed headlines on Monday morning announcing that this past weekend’s games will be forever known as “Bloody Sunday.” Sports Illustrated football analyst Peter King reported that “Last Sunday could go down as a seminal moment in NFL history,” because of the injuries sustained on the playing field and the impact on future play, rules and equipment.  The Vice President of Operations for the NFL, Ray Anderson, said that “We’ve got to protect players from themselves” as a result of the violent day.

I also follow the war and the troops.  You know, the ones who allow us to watch sports on weekends without having to worry about some mushroom cloud or Mumbai-style attack here on American soil.  The ones out there protecting that freedom thing, right? 

But, “Bloody Sunday” in the NFL?  Six vicious and violent hits?  Four concussions?  A couple of broken bones?  Oh, my . . . especially compared to how “Bloody” it was in Afghanistan last week.  And compare the changes the NFL is making for head injuries sustained by players, to DOD’s lack of concern for frontline troops.

Since January 2010, on average, 15 troops have been wounded in Afghanistan every single day.  Every. Single. Day. Period.  Simply put, that’s a lot of bloody days.  This past Sunday, there were 15 wounded troopers, and sadly, one killed in action; that equals 16 casualties.  Bloody indeed!  But maybe last Sunday in Afghanistan was simply a bad day, so for some perspective, let’s add up all the casualties from last week.  On average, there were over 100 troopers wounded in action, and 18 US service members paid the ultimate sacrifice and were killed in action.  15 deaths resulted from IED strikes, and 3 deaths resulted from hostile fire.  Of the 15 deaths resulting from IED strikes, 4 were killed in one vehicle, 3 were killed in another, and 2 were sharing another vehicle when they were killed by IED’s.[1]  Statistics that detail the type and extent of the more than 100 wounds suffered are not available (or accurate).  However, we can pretty safely assume that the troopers that survived IED blasts in Mine Resistant Ambush Protected (MRAP) vehicles suffered some type of mild-to-severe brain injury—or at the least were concussed—and  that these injuries clearly outpaced those suffered by football players last week. 

I’m comparing head trauma in football and combat, because everyone involved is wearing a helmet.  And if on a given Sunday, the spike in head trauma injuries prompts immediate change in policy and a new commitment to equipment upgrades by the NFL—but not the Department of Defense—then it seems to me that we should all take notice.

So what actions did the NFL take? The concern from head injuries and concussions forced the NFL to impose huge fines on three players this Tuesday for dangerous and flagrant hits and warned the league that violent conduct will be cause for suspension.  It only took the NFL 48-flipping-hours!  And I guarantee that helmets, padding, chinstraps, buckles, screws and straps for every single NFL football helmet is being inspected by equipment maintenance personnel and will be carefully repaired, replaced or some new whiz-bang safety component will be added.  I also guarantee that any and all big-contract players who suffered the slightest head injury have received top-shelf medical care and will most likely be forced to sit out a game or two to protect their team’s “investment.”

So what was the response from the Pentagon after last week’s bloody fray in Afghanistan?  Not a peep except to update the casualty data base and keep issuing sub-standard Advanced Combat Helmets to troops.   From what the troops report to SFTT, some troops obviously get Medevac’ed out of theater due to the severity of their injuries; but some don’t.  And for those who weren’t, maybe the mission profile will allow them to take a one-day or two-day respite from being outside the wire.  But probably not, in line with the old adage, “Every man strengthen the north wall.”  Most ludicrous is the appalling fact that no comparison can be made between frontline troops and NFL players regarding the quality of available medical care, the amount of investment in science and technology to improve the equipment and the commitment to provide long term treatment for traumatic brain injuries.  Must be nice to play in the NFL, and that is the bloody truth!


[1] Department of Defense and icasualties.org data.

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Staying in touch with the Discarded

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On long holiday weekends, warriors not deployed check on one another since they normally have a weekend pass or time off – and this past Labor Day was no exception.   The phone will ring, you see the caller ID nickname you assigned to someone you shared a foxhole with not long ago, you always stop what you’re doing and answer it.  “Have you heard …”, “…you doing alright …”, “… remember the time we…”, “…let me know if you need anything…”.  It goes on like that for however long it takes.  The kids ask afterwards “Who was that?”  You tell them, “RANGER 9”.  They know who that is.  They laugh, remembering the stories about this particular grizzled First Sergeant.  Over time these calls are more infrequent and you miss them — because no one at home understands your silence.  They try, but they don’t get it. 

So the phone buzzed today, the caller ID said CANCER GIRL.  Diagnosed at 22, she’s been fighting for her life for the past 18 months. The last time I heard from her she was having difficulties with her chain of command:  her landlord wouldn’t allow her to break her lease to move onto post and be co-located to the chemo drip and the chain of command never fixed the problem.  Instead, it took a determined and brave case manager to work her magic, but she told me afterwards she felt discarded.   She used the same sentiment this go round as well.  She’s off treatment for the time being and she has a new chain of command, but she’s still dealing with a host of issues and doesn’t have a clear status from the Physical Evaluation Board.

 Seems like it was only last week that the New York Times broke the story on how Warrior Transition Units (“WTU”) were “Warehouses of Despair.”   I asked her then if anything reported was true at her WTU.  “Absolutely.”  But that was this past April, more than four months ago, soon after which the Army started to spin and shifted the issue from “warehouses” to a few bad and despairing apples complaining to the press.  The Surgeon General relied on favorable ratings from recent Wounded Warrior satisfaction surveys to assuage any public outcry.  Then there were visits from  senior Defense and Army leaders to Warrior Transition Units and the fix was in.  In fact, the Surgeon General officially closed the case via a press briefing placing the fault inside Joe’s rucksack as sometimes due to soldiers entering service already mentally flawed with pre-existing conditions.  As a result, this put them at risk for successfully completing effective treatment or for obtaining essential services when they find themselves assigned to a Warrior Transition Unit. Plus, it greatly complicates, if not nixes altogether, getting fairly compensated for service-connected disabilities.

 “I feel like I don’t exist here.  It’s as if all of us here are on the Island of Misfit Toys.  We feel discarded.” “Has it gotten any better at the WTU?”  “No, it’s worse.” “What can I do?” “There’s not much anyone can do for us.  After all the dog and pony show visits, I thought it would return to business as usual, but it actually got worse.  The visits and what they said afterwards made it look like it was our fault for complaining and ever since then, the leadership believes they have a license to do anything.  And the other day, a classic TBI effects and PTSD crackup case that we thought for sure would rate a 70, 80, or 90% came back at 20% because he had a pre-existing condition before he entered the Army.”  “Let me guess, ADD?”  “Yes, Attention Deficit Disorder.” I tried to cheer her up, “But the surveys said everybody assigned to a WTU was as happy as a shiny whistle.”  “Yeah right, you know what we do with those surveys?” “No, what’s that?”  “We discard them, just like they do us.”

What could I say after that?

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New Helmet Sensor to detect Traumatic Brain Injuries

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BAE Systems unveiled its latest concussion sensor for soldier helmets, named Headborne Energy Analysis and Diagnostic System (“HEADS”).  Reportedly, about 7,000 1st generation sensors have already been installed in helmets of U.S. military warriors.   The new devices feature much more effective reporting capabilities that will hopefully help in getting medical attention quicker to those that need it.

The HEADS smart sensor is also designed to provide medical professionals with important data that may help determine the severity of a possible traumatic brain injury (“TBI”). The second generation HEADS sensor reportedly provides medical teams with a valuable diagnostic tool that utilizes radio frequency technology.   Spokesperson Colman claims that “With our new ‘smarter’ sensor, if a soldier is exposed to a blast, possibly sustaining a concussion, not only will the HEADS visual LED display be triggered at the time of the event, but once the soldier enters a specified area, such as forward operating base or dining facility, a series of strategically placed antennae will scan all available HEADS units and send data to a computer, identifying any soldiers who may have sustained a blast-related brain injury.”

The sensor itself is small, lightweight and can be secured inside virtually any combat helmet. Although imperceptible to the wearer, it is designed to continuously collect critical, potentially lifesaving data, including impact direction, magnitude, duration, blast pressures, angular and linear accelerations as well as the exact times of single or multiple blast events. That information is then securely stored until it can be quickly downloaded and analyzed by medical teams using a simple USB or wireless connection.

Compatible with most helmets, the HEADS sensor is unobtrusive and won’t interfere with additional helmet-mounted equipment soldiers may need, such as goggles and other sensors.

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Absentee Leadership in DC and Afghanistan: Frankly ma’am, I don’t give a damn!

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In an enlightening article on the current lack of leadership in DC and the killing fields of Afghanistan,  Leslie H. Gelb reports on the opening of a new medical facility in Bethesda, Maryland (near DC)  to treat active-duty soldiers and veterans suffering from brain injuries and psychological disorders. Unfortunately, this article is not about the brave men and women and their families who were on hand for the innauguration of this long overdue facility, but about those who chose not to attend.  I quote at length from Mr. Gelb’s eye-opening article published in the Daily Beast:

“It was inauguration day for the nation’s most modern facility for the treatment of active-duty soldiers and veterans suffering from brain injuries and psychological disorders—5,000 of them with families on hand. At the podium in Bethesda, Maryland, stood Arnold Fisher, the chief fundraiser for this precious center that may need to care for hundreds of thousands of victims, searching in vain for one White House official, one Cabinet officer, one member of the Joint Chiefs, one senator. He found none. And he asked again and again, ‘Where are they?’

“‘You are injured,’ Fisher said. ‘We are all here. Where are they?’

“Where were they? President Obama was in meetings and having a hamburger lunch with Russian President Medvedev. Secretary of State Hillary Clinton was also at these meetings, though not at the hamburger shop in Virginia. Michelle Obama, who has made caring for military families one of her top priorities, couldn’t make it; she was said to have given her final “no” at the last minute. She was accompanying Mrs. Medvedev on a visit to the Duke Ellington School for the Arts in D.C., where they watched a dance performance. Vice President Joe Biden also met with Russians and with Israelis. Defense Secretary Robert Gates sent his deputy William Lynn III. All four Joint Chiefs sent their deputies. General Eric Shinseki, secretary of Veterans Affairs, couldn’t make it. Not one among the legions of pro- and antiwar hooting senators could find the time. Only two members of the House of Representatives found their way to the ceremony.”

“But there was Fisher at the podium. A corporal in the Korean War, Fisher is now a successful real-estate developer, builder, and philanthropist. He avoids confrontation and the limelight, but he could not suppress his dismay about the absences that inaugural day. ‘Here we are in the nation’s capital, the seat of our government, the very people who decide your fate, the people who send you out to protect our freedoms. And yet, where are they?’  he asked the attendees. ‘And while we appreciate that much of our military leadership is present, our government should be behind this effort,’ he continued. ‘I know these are difficult times. I read newspapers. I see the news. And still, where are they? They call you out. You are injured. We are all here. Where are they?'”

Indeed, “Where are they?”   Where are the leaders with the conviction, integrity and proper sense of values that would not take the time to reach-out and honor those who have given so much for our country?  Our leaders and media assail the Chairman of BP when he refers to the “little people” of Louisiana, but what message does it send to our troops and their families when a hamburger photo-op with Russian President Medvedev is more important to our Commander in Chief than attending the innauguration to salute our heroes.  In fact, both Russia and the US have spilled blood in Afghanistan and it might have served a useful purpose if both Presidents had attended to reflect on the consequences of sending  young men and women to war.

It would appear that these brave heroes are treated as little more than disposable assets to further  foreign or military policy goals that few can articulate and even fewer understand.   Surely, our troops deserve better.  Let’s give our troops the leadership they deserve or, perhaps, those desk-bound military and civilian “leaders” should just pull a Clark Gable and tell grieving mothers:  “Frankly ma’am, I don’t give a damn!”

Richard W. May
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