Aftershock: The Blast That Shook Psycho Platoon
Five soldiers injured in the same 2009 bomb blast are a case study in a new epidemic among America’s troops, who are grappling with a combination of concussion and post-traumatic stress disorder.
Staff Sgt. James Hopkins, a Missouri native with a slight build, sharp face and a love of Red Vines candy, was sitting on his bed in a room next door to the rest of the men. He was talking to his wife on Skype. The blast force threw him to the floor. "It was just loud and thunderous. The living quarters actually shook. It was like if I were to stand next to the biggest Fourth of July explosion ever."
Spc. Jared Hollingshead was standing when the blast hit. The stocky Texan remembered "a bright flash of light, a very loud bang and everything goes blank after that. It was the most heart-wrenching thing you'll ever go through. It feels like your whole body clamps up. It's beyond words. It's utter terror."
Shane Fuller, then a corporal, was sitting with his back to the wall, listening to music on his laptop computer. "I just slumped over from the force of it," said Fuller, a Missourian who joined the Army after the lawnmower engine factory where he worked shut down. "All I could hear was ringing for 10 to 15 seconds."
An Iranian-made 107mm rocket had just slammed into one of the 12-foot-high concrete blast walls that protected the soldiers' housing compound, blowing a football-sized hole into the wall. Shrapnel, jagged and red hot, shredded the thin shell of the trailer, puncturing it with holes. Lights crashed down from the ceiling. Power went out. Fuller miraculously escaped physical injury, though shrapnel pierced the wall around him and ripped apart a Missouri State flag hanging above his head.
The men remember the next few minutes haphazardly, like a movie in which they duck in and out of the theater. In the dark and smoke that filled the trailer, several of them heard Savelkoul call out: "I'm hit, I'm hit!" A piece of metal from the rocket had burned his leg, making him the only soldier to suffer an external injury in the blast. Junge groped through the dark for a flashlight. Hopkins staggered out of his room to check on his men. Hollingshead grabbed his rifle. Fuller, who had blacked out, came to with blood streaming from his nose. Several ran to Savelkoul, dragging him to a nearby bunker.
Within minutes, combat medics arrived and took the men to a nearby medical clinic. They cleaned and bandaged Savelkoul's wound. They checked out Fuller but determined he had no injury. Though medics are supposed to check soldiers exposed to a blast for concussion, none of the men remembers talking about traumatic brain injury -- though all admit their memories were hazy. According to a doctor who reviewed their medical charts, none were diagnosed with concussions.
The men felt lucky. Nobody had died, nobody was seriously wounded, as far as they could tell. "I looked at it as though it wasn't a huge deal," Junge said. "You look at yourself and you say, nothing really happened to me."
By the next morning, Junge and several others went back on patrol.
As chance would have it, two weeks earlier, Lt. Col. Mike Russell -- then the Army's most senior neuropsychologist -- had landed in Iraq to begin a study of concussion at the behest of the Army's surgeon general. One of the first graduates of the neuropsychology program at Walter Reed Hospital, Russell had spent much of his career studying traumatic brain injury at Army hospitals and combat zones all over the world. He was something of an iconoclast in the military. Blunt-spoken and easily frustrated with bureaucracy, Russell decided the best way to find patients for his study was simply to hang out in military clinics, seeking blast survivors. He happened to hear about the rocket attacks at Camp Liberty and asked to examine Savelkoul and his comrades personally.
After assessing them at a field clinic on base three days after the blast, Russell concluded that five of the soldiers in the blast that night had, indeed, suffered mild traumatic brain injuries. The signs were obvious, Russell said, showing up clearly in the daylong battery of neuropsychology exams he performed. "When you work a lot with acute concussion, you actually kind of recognize even the look of a person who has been acutely concussed, which is kind of a dazed expression, a little bit unfocused, a little bit slow to respond," Russell said. "Several of them had significant gaps in their memory. And it wasn't clear how long they were unconscious. The last thing they remember is they were playing video games. The next thing they remember, they are outside the trailer in a shelter. Some minutes had actually passed where they weren't recording memories. That's post-traumatic amnesia. And that's your classic symptoms of a concussion."
For each of the men, Russell entered two diagnoses in their electronic medical records:
2. Post concussive syndrome
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.