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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  1. Mike  November 6, 2010

    I appreciate this entry very much because it carefully and specifically highlights the methods of deception and sleight of hand used by the lobbying culture to avoid responsibility, buy time, create diversions and delay decision making on Capitol Hill.

    These methods are also used in political conventions, sometimes in trials, other times at shareholder meetings and all manner of venues where large, powerful entities fear that their sins may come to light.

    There’s an important distinction here. These tactics are used here to pull the rug out from under our troops with the attitude that if they hit their head and get a TBI as a result, “oh well, they signed up for it.”

    This kind of thing is why all children go through a phase of major moral awareness, about what is right and what is wrong, and as children they cannot fathom how anyone could do the wrong thing once they have discovered a moral truth. The strength of that developmental phase is supposed to leave a lasting impression on brain development and result in people with basic character. Later, the work ethic phase and the nurture surrounding it are supposed to teach a person how to get back to their own good character self by work and amendment.

    How many lies, betrayals and how much trauma does it take to reroute those brain pathways and set a human being morally adrift to the extent that they will stand up before those to whom they are responsible and work hard to deceive them with no discernible sign of empathy for the victims of their lies? It is a kind of brain damage of its own, however, is reversible by one’s own decisional force. The troops can’t do that so easily with their TBI’s, however.

    There are sick people walking around wielding power at the Pentagon and in the lobbying firms and in the board rooms of defense contracting firms. Some have a firm grip on certain weak-minded or otherwise compromised persons in congress.

    For every soul in this process who has ever taken the oath to defend the country against enemies foreign and domestic, that oath is a starting point. The domestic enemies are not always people: they are lies entertained and rationalized or avoided within one’s own mind. Dispel those, haul them to the dump, and then something better actually becomes possible. What if just ten authoritative, influential people in the entire process suddenly went sane-sober-honest on us? That ignition could go a long way.

    An environment to reward and honor those who change for the better needs to exist. At present, those deemed whistleblowers fare worse than others in their subsequent careers. That speaks to a deeper corruption in our society by which a truth-teller is feared because every institution is piling up dark secrets that it doesn’t want to purge.

    What is the one thing needful for each each person within each high level institution to begin their road to change and set the tone for others’ recovery from this terrible epidemic of moral dislocation and its damage to others?

    Courage. Perhaps SFTT and like organizations could put together a fund to help support and find work for people whose careers are ruined because they have told the truth about the wrongs done and lies told to betray the troops and their families. I’d donate to it.

    The subject has been breached before:


  2. Dr. Michael Russell  March 31, 2011

    There is an improved helmet to replace Kevlar coming out soon — the next generation helmet design is stalled with an essential quandry: can we change army culture enough to change the helmet from a durable item to an expendable one? The only way to get NFL quality protection for the troops is a helmet design that “sacrifices itself” to cushion the blow or absorb the blast–much as a modern car crumples to save the driver. Essentially this is a helmet that will need to be replaced after a major event. Logistics and army culture don’t appear ready to support this idea–which would involve monthly helmet inspections and frequent replacements in a combat environment.

    • Richard May  April 7, 2011

      Thank you for your contribution Dr. Russell. I’d much rather see a disposable helmet that “does the job” than having “disposable” service men and women fielding protective gear that it is simply not up to the latest safety standards and battlefield conditions. We at SFTT would be most interested in learning more about this new helmet design. Some suggest that 1 in 4 service members that have been in combat suffer from PTSD and TBI. If the disposable helmet helps address this serious problem, we are all ears and member of Congress would be most interested.

  3. Mike  May 8, 2011

    How about the costs of long term disability care paid for by VA or Medicare? That’s a lot more expensive by far than helmet standards with enforcement. Besides, since when are Kevlar helmets repaired and re-requisitioned after they’ve been shot or blasted?

  4. ben892  November 22, 2011

    Fantastic post : appreciate your finding the time to publish the idea, I will be to learn more.

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