ProPublica

Journalism in the Public Interest

Cancel

Top Officer Says Military Takes Brain Injuries ‘Extremely Seriously’

The Army's vice chief of staff says it takes the treatment of soldiers with mild traumatic brain injuries "very seriously." Gen. Peter Chiarelli said the military plans to evaluate soldiers exposed to nearby blasts by two separate tests before being returned to the battlefield. But our investigation has found problems with the tests now being used.

June 10: This post has been corrected.

Gen. Peter W. Chiarelli briefs the media on Nov. 17, 2009, at the Pentagon. On Wednesday, he defended the military's care of soldiers suffering from brain injuries. (Paul J. Richards/AFP/Getty Images)WASHINGTON, D.C.— Gen. Peter Chiarelli, the Army's vice chief of staff, defended the military's handling of soldiers who suffered brain injuries in Iraq and Afghanistan.

"We are taking this extremely seriously," Chiarelli said Wednesday in response to an investigation by National Public Radio and ProPublica which found the military is failing to identify and treat soldiers with so-called mild traumatic brain injuries. "There's no reason for us not to try to diagnose it."

Mild traumatic brain injuries, which are frequently caused by roadside blasts, leave no visible scars, but can cause lingering mental and physical damage. Officially, military figures show that about 115,000 soldiers have suffered mild traumatic brain injury since 2002. But we talked to military doctors and reviewed unpublished studies that suggest far more soldiers could have sustained such wounds. While most recovery quickly, estimates suggest that between 5 percent to 15 percent go on to develop cognitive problems.

In an interview on the NPR program "Talk of the Nation," Chiarelli said that the military had diagnosed thousands of soldiers with traumatic brain injuries, also called TBIs. But he said it was important to focus not only on TBI. Many soldiers are also suffering from post-traumatic stress, or PTS, a debilitating psychological wound that can be caused by the intense terror of being involved in a roadside blast.

Many soldiers suffer from both conditions at the same time, making it important to treat the symptoms, whatever the cause. He said the military was diagnosing and treating soldiers suffering from both wounds, which he described as the signature injuries of the wars.

"It's time we realize that TBI and PTS are real injuries," Chiarelli told Talk of the Nation host Neal Conan. "We've got to ensure our soldiers get the care that they need."

Chiarelli noted that the military is planning to implement a policy where soldiers exposed to nearby blasts will be evaluated by two separate tests to determine whether they have suffered a concussion before being returned to the battlefield. He said that doctors have advised him that soldiers at most risk of developing long-term problems suffer from multiple mild traumatic brain injuries, which are also called concussions.

"If either one of the exams in that 24-hour period indicates the individual had a concussion, they are pulled out of the fight until the concussion has an opportunity to heal," Chiarelli said. "The key here is not to have that second concussion while the brain has not recovered from the first."

But the NPR and ProPublica investigation found major problems with the two primary screening systems now used in the field. After a blast or blow to the head, soldiers take a paper-and-pencil exam called the MACE, or Military Acute Concussion Evaluation. In interviews, doctors and soldiers acknowledged that troops often manipulate the test to obtain a passing score and rejoin their comrades in battle.

A second computerized test used on the battlefield, known as the ANAM, or Automated Neuropsychological Assessment Metrics, failed to catch nearly half of all soldiers who had suffered a concussion, according to a recent unpublished study obtained by ProPublica and NPR. Lt. Gen. Eric Scoomaker, the Army's top medical official, recently testified in Congress that results from the test are no better than a "coin flip."

In recognition of the military's problems with screening, two Congressmen called for the military to implement legislation that would require veterans to receive individual, one-on-one evaluations for traumatic brain injuries and other battlefield illnesses.

Reps. Tom Rooney, R-Fla., and Michael E. McMahon, D-N.Y., cited the ProPublica and NPR investigation as further evidence of the need to pass the legislation, known as the Veterans Mental Health Screening and Assessment Act.

"Our troops and veterans deserve action to improve screening and detection of traumatic brain injuries," Rooney and McMahon said in a joint press release. "We hope the House of Representatives will move quickly to take up and pass this critical legislation."

Correction: This post originally said Gen. Peter Chiarelli was the Army's second in command. He is in fact the Army's vice chief of staff.

Some months ago, McChrystal noted ‘We’ve killed so many innocent civilians’; and, the killing of civilians has continued month after month. 

During months of agonizing closed-door ‘analysis and reflection’, we’re asked to believe neither Obama nor any General said:

“We’re entering an insurgency, fewer than a dozen of our men and women speak the language, fewer than that know anything of the culture,  we’ll be going directly into citizens’ homes, farms and villages, we’ll be heavily armed with high-tech lethal weapons, and we wont be able to tell friend from foe. What do you think the chances are that we’ll be killing innocent civilians?” 

If no one considered these things, then brain damage among the military apparently begins at the top, and the brain damage reported by our combatants is a consequence of the brain damage at the upper-most levels.

May our perpetual war machine grind to a halt (or at least a pause) before more men, women and children are harmed on all sides.

Marcie Hascall Clark

June 12, 2010, 9:40 a.m.

“There’s no reason for us not to try to diagnose it.”

That just does not ring true:
http://www.usatoday.com/news/washington/2008-03-17-tbi_N.htm

For more than two years, the Pentagon delayed screening troops returning from Iraq for mild brain injuries because officials feared veterans would blame vague ailments on the little-understood wound caused by exposure to bomb blasts, says the military’s director of medical assessments.
Air Force Col. Kenneth Cox said in an interview that the Pentagon wanted to avoid another controversy such as the so-called Gulf War syndrome. About 10,000 veterans blamed medical conditions from cancer to eczema on their service

“Our troops and veterans deserve action to improve screening and detection of traumatic brain injuries,” Tom Rooney, R-Fla., and Michael E. McMahon, D-N.Y. said in a joint press release.

The question of brain damage extends upward in the military to very highest ranks. Consider the following.

Two months ago, General McChrystal stated, ‘We’ve killed so many innocent civilians.’ 

Before the decision was made to send more troops into Afghanistan, McChrystal and other top US military men met for weeks with President Obama. During months of agonizing closed-door ‘analysis and reflection’, we’re asked to believe neither Obama nor any General said “We’re entering an insurgency, fewer than a dozen of our men and women speak the language, fewer than that know anything of the culture,  we’ll be going directly into citizens’ homes, farms and villages, we’ll be heavily armed with high-tech lethal weapons, and we wont be able to tell friend from foe. What do you think the chances are that we will be facing continued guerilla warfare and civilian insurgency, similar to Iraq, and that our men will continue to be placed in untenable situations in a losing effort, similar to Iraq?”

That know one considered these things, that our men and women continue have their lives sacrificed for nothing, and that Congress holds hearings to determine whether the incidence of brain damage is taken seriously by the military indicates the extent to which brain damage affects no only in our military, but in our civilian leadership.

I am 70% disabled from Vietnam, combat injuries, malaria, & PTSD. I feel for the many young men & women who have TBI in addition to other devastating combat injuries, or PTSD. The military has been treated like a kleenex by the Bush-Cheney Regime. There’s no way they could have cared about the miltary (Army & Marine Corps, particularly), to have sent so many to multiple tours.
  I hope that in the future, Congress, and in particular, the people, demand that Congress declare war the next time a President says we should go off and fight the next enemy. And, contrary to others, I believe a renewed Draft, w/no deferments, would once again neutralize all but the most egregious reasons for going to war.
  The Draft may have brought it’s own fair share of unqualified men into the military, but on the other hand, the Draft ALSO brought in a number of men (hopefully, in the future, and women) into the service who were NOT activated by the gung-ho,
let’s fight, fight, fight mentality that some in the all-volunteer military have.
  Defense of one’s country should be a common form of duty that every American has. This could be combined with Universal Service. But, when the need for more men & women to be assigned to the military, that should be the driver. In this way,
we will all be forced to examine war much more closely.
    Those who have PTSD, or permanent medical or emotional issues will struggle with them the rest of their lives. The politicians and their supporters who call for war when they know they’ll never serve, should understand that those days are over.
    Failure to enact such legislation will lead us down the same roads all other “empires” have gone. I’ve gone from seeing the last remnants of the Spanish-American War veterans, as well as WW I vets, @ VA hospitals, to seeing veterans from Panama; Grenada; the Gulf War; and now, the Iraq & Afghanisan Wars as well. There’s something very depressing to see such a new, mangled wave of American youth walking into VA hospitals & clinics from “the most recent war.”
    America needs to take a hard look @ what it does when it sends men & women to fight.

This article is part of an ongoing investigation:
Brain Wars

Brain Wars: How the Military Is Failing Its Wounded

The military has failed to diagnose brain injuries in thousands of soldiers returning from overseas.

The Story So Far

Traumatic brain injury is considered the “signature wound” of soldiers fighting in Iraq and Afghanistan. Official military statistics show that more than 115,000 soldiers have suffered mild traumatic brain injuries since the wars began. Shock waves from roadside bombs can ripple through soldiers’ brains, causing damage that sometimes leaves no visible scars but may cause lasting mental and physical harm.

More »

Get Updates

Stay on top of what we’re working on by subscribing to our email digest.

optional

Our Hottest Stories

  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •