In an explosive new report by ProPublica and National Public Radio (“NPR”) it would appear that the US military is seriously underestimating the brain damage or traumatic brain injury (“TBI”) caused by roadside bombs.   Officially, the military claims that 115,000 troops have suffered “mild” TBI, although ProPublica and NPR claim that “unpublished military reports” place the number much higher.

T. Christian Miller, ProPublica, and Daniel Zwerdling, NPR,   examined government records, previously undisclosed studies, and private correspondence between senior medical officials and conducted interviews with scores of soldiers, experts and military leaders.  Among their findings:

• Military’s doctors and screening systems “routinely miss brain trauma in soldiers. One of its tests fails to catch as many as 40 percent of concussions, a recent unpublished study concluded.  A second exam, on which the Pentagon has spent millions, yields results that top medical officials call about as reliable as a coin flip.”
• “Even when military doctors diagnose head injuries, that information often doesn’t make it into soldiers’ permanent medical files. Handheld medical devices designed to transmit data have failed in the austere terrain of the war zones. Paper records from Iraq and Afghanistan have been lost, burned or abandoned in warehouses, officials say, when no one knew where to ship them.”
• “Without diagnosis and official documentation, soldiers with head wounds have had to battle for appropriate treatment. Some received psychotropic drugs instead of rehabilitative therapy that could help retrain their brains. Others say they have received no treatment at all, or have been branded as malingerers.”

Maj. Remington Nevin, an Army epidemiologist who served in Afghanistan is quoted in the article as saying, “It’s obvious that we are significantly underestimating and underreporting the true burden of traumatic brain injury. “This is an issue which is causing real harm. And the senior levels of leadership that should be responsible for this issue either don’t care, can’t understand the problem due to lack of experience, or are so disengaged that they haven’t fixed it.”

Lt. Gen. Eric Schoomaker, the Army’s most senior medical officer, allegedly instructed local medical commanders not to speak to ProPublica and NPR.  He apparently emailed bases that “We have some obvious vulnerabilities here as we have worked to better understand the nature of our soldiers’ injuries and to manage them in a standardized fashion. I do not want any more interviews at a local level.”    Neverthelss, Lt. Gen. Schoomaker later  “acknowledged shortcomings in the military’s diagnosing and documenting of head traumas.   “We still have a big problem and I readily admit it,” said Schoomaker, the Army’s surgeon general. “That is a black hole of information that we need to have closed.”

“The long-term effects of mild traumatic brain injuries can be devastating, belying their name. Soldiers can endure a range of symptoms, from headaches, dizziness and vertigo to problems with memory and reasoning. Soldiers in the field may react more slowly. Once they go home, some commanders who led units across battlefields can no longer drive a car down the street. They can’t understand a paragraph they have just read, or comprehend their children’s homework. Fundamentally, they tell spouses and loved ones, they no longer think straight.”

Clearly, the extent of brain injuries are extremely difficult to diagnose and particularly so under battlefield conditions.  Nevertheless, there is mounting evidence that our brave frontline troops are not receiving a proper diagnosis and timely and adquate treatment for this crippling affliction.   SFTT applauds T. Christian Miller of ProPublica and Daniel Zwerdling of NPR for their thorough investigative reporting.