ProPublica

Journalism in the Public Interest

Cancel

In Houston, Rep. Giffords Could Receive Brain Injury Treatment Thousands of Troops Do Not

As Congresswoman Gabrielle Giffords begins rehabilitative therapy in Houston after being shot in the head in Tucson earlier this month, she was transferred today to TIRR Memorial Hermann, a premier rehabilitation hospital renowned for its treatment of traumatic brain injuries.

On its website, the hospital calls itself “one of very few hospitals in the country designated as a model system for traumatic brain injury.” Among the techniques it relies on is cognitive rehabilitation therapy, a tailored type of medical treatment designed to retrain the brain to do basic tasks.

It’s a treatment that Rep. Giffords will likely end up receiving, if doctors’ general descriptions of her care plan are any indication. Dr. John Holcomb, a retired Army colonel and trauma surgeon at Memorial Hermann, has described Giffords’ treatment as a “tailored and comprehensive rehab plan” that includes “speech, cognitive, physical rehabilitation.”

If Giffords does end up receiving it, she’ll be getting a treatment that many troops don’t. As we’ve reported, the Pentagon’s health program, Tricare, has refused to cover cognitive rehabilitation therapy for the tens of thousands of service members who have suffered brain injuries in the line of duty. Tricare, which provides insurance-style coverage to troops and many veterans, does cover speech and occupational therapy, which are often part of cognitive rehabilitation.

We’ve called the hospital to get further details about Giffords’ treatment plan but have not yet received that information. News reports have described her treatment as using “high-tech tools to push the brain to rewire itself,” with a focus on her physical abilities, speech, vision, cognitive skills and behavior.

Traumatic brain injuries have different types and levels of severity, according to the Office of the Surgeon General. They can include penetrating injuries—like Giffords’—or mild brain trauma like the kind often sustained by troops in an explosion. The latter, as we’ve reported, has been called one of the signature wounds of the Iraq and Afghanistan wars, and tens of thousands of cases have been left undiagnosed by the military’s medical system.

Though top brain specialists have endorsed cognitive rehabilitation as an effective treatment for brain injury, Tricare officials have said that scientific evidence does not justify providing it comprehensively to troops.

To support that position, officials cite a 2009 Tricare-funded assessment of cognitive rehabilitation therapy—an assessment that internal and external reviewers have called “deeply flawed,” “unacceptable” and “dismaying,” as we reported last month with our partners at NPR.

Last week, Sen. Claire McCaskill, chairman of the subcommittee on contracting oversight, cited our findings while announcing an investigation into the Pentagon’s decision to deny treatment of traumatic brain injuries to troops. In 2008, McCaskill was one of 10 senators—including then-Senator Barack Obama—who signed a letter to Defense Secretary Robert Gates urging the military to provide Tricare coverage of cognitive rehabilitation “so that all returning service personnel can benefit from the best brain injury care this country has to offer.”

If it was not for our troops Giffords would not have a great country like ours to be a part of. Our troops deserve the best care in the world considering the fact that they are willing to sacrifice their lives to provide us with the freedom we have.

Jack E Lohman

Jan. 26, 2011, 4:05 p.m.

Indeed she should receive the treatment, and so should the troops.

Betsy Jacobson

Jan. 26, 2011, 4:13 p.m.

How can Congress deny appropriate health services to our troops when they have no idea what it’s like to need those services but can’t afford them. Congress’s health plan provides them with EVERYthing they need. Tha’t's why Gabby Giffords is getting what SHE needs, which pleases me, of course,  but our troops aren’t entitled to the same treatment, and their work venue is a bit more dangerous than those that work on the Hill.

M. Southworth Davis

Jan. 26, 2011, 4:19 p.m.

I sure hope that in the current congressional cost cutting that the military medical treatment for war wounds get the same treatment that congressional members receive. Cut anything else but not the military medical/mental treatments

This is unacceptable to me.

Its our troops that keep us free why should they receive less than the best.

Our troops deserve the best treatment our country can offer. She should get the same treatment they receive. The best treatment for all of them!

Treat the troops well or we will have the Ghosts of Cannae at the steps of the Capital in DC. The Romans learned this 2,000 years ago. Do we know nothing from history.

The house republican caucus voted last week to appeal Obama Care but also voted to a person to keep their own benefit package.

Its the same ole/same ole GOP. “what’s good for me is right” , screw everybody else.

I certain hope Rep Giffords gets the care she needs.

She is a fine representative and voted for Obama Care and every other opportunity to see that our soldiers/sailors/airmen got good medical treatment and that the middleclass working people of this country were treated properly.

God speed her recovery

Tri-care…government run healthcare…...
what Gifford has….private healthcare….which would you rather have????????

Kevin A. McDonald

Jan. 26, 2011, 6:22 p.m.

These men and women who fight our wars should recieve the finest quality care available. And should not given unproven, psycho-active and expensive brand name drugs in combat i.e Ambien, when proven and inexpensive drugs like amphetimines and barbituturates will work.

“The house republican caucus voted last week to appeal Obama Care but also voted to a person to keep their own benefit package.” These are exactly my sentiments, Truebee. Bravo!

I’ve donated 20 years of my life to help over 25,000 people with Fibromyalgia, gratis, of course, and no-one is offering me health care.  Something is wrong here.

Bro. Keith "X" Hudson

Jan. 26, 2011, 6:35 p.m.

Well, that’s the soldiers issue! As we say in the Hood. Because anytime you’d kill someone who haven’t done you nothing, just because the U.S. says so, you are an idiot! And you deserve everything that happens to you. There is no enemy on the planet that the U.S. has, so why are there wars? It’s call strong-arming in the real world!!! In Pakinstan, the U.S. is allowing the growth of Opium
which will eventually find its way in our community as Heroin!!! The soldier deserve more degradation than they’re getting, because of the acts they’ve committed, based upon greed, and not the alleged
protection of our liberties!!!!

Kevin A. McDonald

Jan. 26, 2011, 6:39 p.m.

These men and women, who fight our wars, deserve the best available.

Jack E Lohman

Jan. 26, 2011, 6:42 p.m.

Bro., that’s sort of a stupid view, because the vets are there committed to protect their families and brethren. If they were wrongly sent there by the politicians, repeal THEIR health care.

Jack Lohman
http://MoneyedPoliticians.net

Kevin A. McDonald

Jan. 26, 2011, 6:47 p.m.

These men and women, who fight our wars, deserve the best available. They are uproven, psycho-active and expensive substances, in combat, i.e. Ambien when proven, inexpensive alternatives are avaiable I.e. amphetiamine and barbiturate.

This is so typical of the direction this nation has been heading.  The people that have to sacrifice in services in so many venues are the ones most vulnerable. That is the wounded or maimed (physically and mentally) in the military, the elderly, the poor, the homeless, the underinsured and even the people who think that they are insured are often denied coverage because of loopholes. This environment is a constant source of stress.

Robert Quandahl

Jan. 26, 2011, 8:30 p.m.

You are twisting the facts. Tricare WILL cover this therapy as part of a comprehensive medical approach to brain injury. They will not and should not cover a technically unproven treatment as a stand alone treatment attempted to be applied without a total approach to the patients recovery.  Occupational, speech, and physical therapy are all covered, and these all incorporate cognative rehab.  The “high tech” tools being used consist of e-stim, saebo, and various other rehab tools available in any decent rehab hospital, all covered by Tricare.

I wish Congresswoman Giffords the best. I wish all our troops the best.  Aren’t we all equal under the law of the USA?? or are some “more equal”? Only the best for all of us—We the people…also serve at home—in our daily jobs and lives. We deserve the best—equal to the best our govt. gives itself.

loolllll…I’m sorry…I cannot help but be amused.

If you expect the Republicans to support our wounded, you truly do not comprehend the meaning of “chickenhawk”.

While Americans are off to war, Republicans are consolidating political and business power….they do not like veterans, for veterans both have a tendency to do “the right thing” rather than “the personally profitable thing” and serve as a reminder….every day..of the cowardice that typifies a Republican.

If you were a Republican - a “chickenhawk” - would you want a bona fide war hero in your office? Reminding your people of your demands for war, and your ability to avoid serving your country?

The Congresswoman is a member of the elite.  No longer servants of the people, she and her colleagues are regarded as the “special” people.  The folks who make it possible for the corporate blood suckers to drain the treasury.  She has a good salary, starting at 168,000 with great benefits.  She and her fellow congress/senate elites get health care and perks.  They are the new aristocracy unconcerned about anything but padding their pockets, peddling their influence, making unlawful war, and grabbing power.  These folks, for the most part, have not served in combat let alone the military at all.  They consider the troops as peons and dupes to be used in every way possible to secure the financial interests of this country.  Why should we expect our troops to get the same care as the politicians do, the troops (in their eyes) are in a much lower class…but they’ll “support” them.  I wish the congresswoman well and may she get better quickly.  I’ve never seen a gunshot victim with as many helicopters and police and security around them before.  I guess her class gets that sort of treatment.

Absolutely spot on Marian!
As I said before injuries that are not visible externally are the ones people suffer most from; you can repair a broken arm or a leg, but an injury suffered in your brain is the most hard to detect.
And the ones affected by it will have permanent distress into their lives throughout.

Arlene Wachman Weiner

Jan. 27, 2011, 5:34 a.m.

I’ve read some quite interesting comments here today. To Kevin A. Mc Donald, you are so right on! Ambien happens to be a great sleep med which causes no hangover effect such as a cheap barbituate. And BTW, it is now available in generic, both the Ambien and Ambien CR. Are not our troop worth it?

To ibsteve2u, Republican are a joke as far as I am concerned, and fools to think this gal would ever buy into their BS. They shame tis country of ours.

A brain is not actually good to a person. Well for this representative case she should be a good on having a surgery. she should be an equal leader that she must treat each and everyone as equal.

She is a member of American Royalty. You certainly don’t expect them to consort with the peasants on something like this do you?

I have NO words, maybe this one “Shameful”

I agree entirely with this article… However we need to look one step further -
Our Civilians do not receive even a fraction of the services that Rep. Giffords and even some of our troops are obtaining.  To the tune of 2.4+ Million Americans a year sustaining life altering Brain Injuries, they are lucky to get an aspirin: rehabilitation is beyond their grasp.

This story is so typical of corporate and government doucebag policy. You Americans are being ripped off by the system; and worst of all, they are screwing over your troops and that is not fair. You Americans need to kick ass in your own country and not in some far off country!!

Jim Greenberg

Jan. 27, 2011, 9:50 a.m.

I too agree that our troops deserve this level of treatment.  So, everybody is ok with raising taxes to make this possible?  Great, let’s do it.

ibsteve2u:  Way to show your ignorance.  Most Republican Presidents were in the Military or fought in a war…. How many Democrat Presidents have???  Not Obama…., Not Clinton ( he dodged the war) ....  nor have many Dems in office -  You are way off base… and have NO CLUE what you are talking about.  I would NEVER make such an ignorant claim that a Democrat does not like veterans…  but Dems ARE the ones that are AGAINST the war !!! 
Back on the Subject…  I pray for Congresswoman Gifford for a speedy recovery and all the help she needs to do so,  and I also believe all the Troops deserve equal treatments as well.  Too bad they cannot make the same salary !!!  They deserve it !!

Betsy Jacobson

Jan. 27, 2011, 4:39 p.m.

Aw, come on, let’s take partisan politics out of this. I’ve just started writing my book about being nice to people. It probably won’t get published, because people just don’t understand common decency any more.

Let’s be kind without power politics, please.  EVERYone deserves appropriate health care.  EVERYone shares an equal place on this earth, even ‘though lots of folks think they deserve more.

Let’s just try to make this earth as comfortable for the next person as we’d like it to be for ouselves.

Betsy Jacobson, a commoner

Robert Graham

Jan. 27, 2011, 6:59 p.m.

“We are all equal, but some are more equal than others.” Orwell hit it on the head! I personally never worried about her. Seems to me a headshot to ANY POLITICIAN is akin to drilling a hole through fecal matter! Now a statesman….. nah not to worry we don’t have any of those anymore. A statesman could never be a Republican or Democrat! A statesman CAN’T be bought!

Cognitive rehabilitation therapy (NO drugs :) is good for the injured soldiers and it is also good for the economy because the therapeutical procedures will create JOBs for therapists.

I also want to point out that there is another group of people with brain injuries that get even less help than the troops and they are vol. firefighters who suffer brain injuries. I am one of two fire fighters from the same department that suffered ruptured brain aneurysms. I am unable to work or drive due to stroke from operation. the other one is 50 years old and is now been placed in a nursing home. where is the help for us oh it is there if we want to pay for it   WITH WHAT?

Paul E. Micelli

Jan. 28, 2011, 7:29 a.m.

DOUBLE STANDARDS< what’s good for her should be available for ALL!! What makes HER better than OUR COMBAT INFANTRYMEN> THIS MAKES ME WANT TO THROW-UP.

Arlene Wachman Weiner

Jan. 28, 2011, 8:39 a.m.

to Ernie: Shame on The Fire Department! Is is like that everywhere in the US? Just G-d awful. What the hell is wrong with this country of ours? Lining the pockets of those who don’t deserve it and turning our backs on the brave men and women who serve this country of ours, especially at home where we need it most. And volunteers none the less! I truly am in shock! Something MUST be done to address this situation. My sincere appologies and thanks to you sir, for all you have endured and for being so kind as to help others. I only hope this does not make you bitter towards us all. “We” unfortunately do not represent the most grateful people for your dedicated service. My best you and your family…

Betsy Jacobson

Jan. 28, 2011, 9:32 a.m.

You are a sweet lady, Arlene Wachman Weiner.  Please continue to share your kindness and concern for other people..

Thank you.

This is arbitrary.  Congress / Governors (AZ) / insurance clerks and Doctors all have the same ability to determine what a patient needs.  Saving money is the most important thing when it comes to CARE.  Right?  As long as an insurance company can make profits, this is the most important thing.  That is what capitalism is all about. This is our system of choice.

Arlene Wachman Weiner

Jan. 28, 2011, 10:39 a.m.

Thank you for your kind words Betsy Jacobson.

To CharlesCT: I thought we WERE suppose to be a Democracy. It may now be a capitalistic society, but that is certainly NOT all of our system of choice.

Cliff Aldrich

Jan. 28, 2011, 2:51 p.m.

As the father of 3 sons 2 who are currently serving in the military,  with the oldest in Afghanistan and the youngest in MARSOC, I want the best health care and pay for them.
I live in Tucson and voted for Giffords, but she nor any other member of congress should receive better treatment than the newest E1.
Our system is broken and we as a collective people need to fix it.
When will we quit paying a 22 year old gifted athlete 18mil a year to dunk a basket ball, yet pay a 22 year old service member 24k a year if there lucky.
I beleive every 18 year old should serve 2 years in the military or service to our country organization before attending college or going on a mission or being payed to play sport. Then maybe they would have a better understanding of what

I foreshadowed this in earlier posting.Certainly Gifford should not get any ‘better’ treatment than the troops.The question remains as to whether cognitive ‘therapy’ is a ‘better’ rehab.treatment given the various studies that say it is not (see Kaiser Permanente).It’s an ill wind sometimes-maybe if she does have Cog.‘therapy’.for a good outcome it will strengthen the claim for the troops.Whilst not a supporter of Cog.‘therapy’this may be a useful circumstance to settle the matter once and for all.Whilst 1 case would only be anecdotal and not provide a basis for a claim to scientific validity why not use Ms Gifford?Congress use the troops-let the boot be on the other foot now.

Hopefully, cognitive therapy will work for Ms Gifford and can then be used for our troops.Tricare covers the lapband and gastric bypass for the overweight spouse or dependent young adult child of a service member, with very little out of pocket expense for the patient. I hope that the cost of cognitive therapy does not prohibit it from being used if proven to work.

Wouldn’t Congresswoman Giffords qualify for Federal Worker’s Comp. and not Tri-care since she was working and not on the front lines?

of course she’s getting better treatment then us (by I mean those in the military) she has money. I really don’t know why this shocks anyone…. o yeah it’s cause most of you are civilians who don’t know how little we actually make or what our lives are like. And o yeah by the way America is not at war The Army, Marines, Navy and Air Force are.

maybe we need to stop sending 3.1 B to Egypt every year and put it to use here

Contrasting the treatment available to Rep. Giffords with the lack of coverage for that treatment for injured troops in no way suggests that Rep. Giffords, or anyone, should have less than the best care. If she recovers fully enough to resume her job, and I hope she will, she could become a powerful advocate for things like gun control and better care options for all who suffer from traumatic brain injuries.

My comment about Cognitive Behavior Therapy (CBT) were not accepted by Pro Publica, so I’m going to repeat it.

What I said was that CBT is a successful therapy that can work very well in combination with a variety of brain modalities, both surgical and physiotherapeutic.

CBT has been proven to work as a successful therapy for TBI (Traumatic Brain Injury) and it was proven the study was flawed. Hopefully and unfortunately maybe Rep. Giffords condition will bring awareness to how little financial support is given to TBI survivors for therapy and support.

Granted U.S. military should receive the best medical care available for defending our freedom.

My company makes the Tailwind, a new device to treat brain-injury patients based on the latest research, but we have been unable to get anyone in the military to return our calls or give us an appointment so we can demonstrate it. It breaks my heart that our troops don’t have the opportunity to use the latest technology in their recovery efforts.

To Tammy Boyd.Cognitive Behaviour therapy has its supporters-probably amongst the most vehement being Dr. Adolph Grunbaum.  I believe his heart is in the right place but has not had the experience to know better.My own experience is that cognitive therapies are superficial and do not address the emotional effects of traumatic injuries-TBI and physical.This is not to say cog therapies are completely useless-like ‘counselling’ they may provide a starting place for further exploration of the psyche.Unfortunately they have been more recently seen as an end in themselves and so those promoting them as the be-all and end-all are in effect promoting a ‘short cut’ which may lead to a great deal of time and money being wasted.Point. Over the last few years the Australian govt at the behest of the Australian Psychological Society has provided a Medicare schedule number for cog behav therapy-the so-called 2710 ‘Care plan’.It has been a bonanza for psychologists with the govt paying out 1.2 billion dollars to the ‘therapists’.Here is the rub.A study has shown that this has been to little avail in the overall ‘mental health’ of the recipients in particular and the community in general.I think the Australian psychologists should have to pay the money back-that they have perpetrated a great fraud on the taxpayers,There is a vicarious learning opportunity for the the VA and DoD here..Better to pay the money to the injured troops in ‘compensation’.It can be amazing to see how much better one may feel after receiving such a payout The troops deserve it anyway.No doubt Congress.Giffords will get a compensation payment-why not the troops?

CBT saved my life. It is hardly superficial.  Having been through a few years of the “more accepted” therapies including Freudian, the only one that helped was CBT

Read the works of Aaron Beck, MD father of CBT or his first protege, David Burns.

Add a comment

Email me when someone responds to this article.

Get Updates

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

optional

Our Hottest Stories

  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •