Traumatic Brain Injuries: The Battle After the War

ARMOREL-- It's warfare the likes of which no one has ever seen before.   Soldiers in Iraq and Afghanistan face a host of hostile forces.  IED, or improvised explosive devices, can blast a hole in the side of an armored tank.  So what can they do to a human brain?

Traumatic brain injury is becoming the "signature" wound of soldiers returning from Iraq.  And while they survived the battle abroad, will they be able to battle a such long-term injury at home?  Far worse is what these devices, and rocket-propelled grenades, can do to the human body.  While soldiers survived the battle abroad, will they be able to battle such a long-term injury at home?

"When those headaches start coming on,  the whole right side of my face gets real tight and I can't hardly open my right eye." said Major US Army Commander Anthony Smith, a traumatic brain injury victim.

Major Anthony Smith defied physics and cheated death in Iraq.  "I was slammed into a concrete wall behind me so hard it cracked my Kevlar," said Smith.  "That's what caused me to go into the coma and stuff."  When he came to, Smith would discover his right arm amputated. He couldn't hear, walk, and could barely talk.

But, he still faired better than his commanding officer who had tried to help him.  The rocket-propelled grenade that destroyed Smith's kidney, tore through his abdomen and shattered his femur and right hip. had sheared his friend and rescuer in half.

"I remember the chaplain and he was trying to read the 23rd Psalm and I rose up and told him. Don't read that!," yelled Smith. "I'm not dead yet. That's for dead people!"

Not dead--but far from living the life he once knew--Smith discovered the most severe of his injuries aren't necessarily the physical ones, the ones you and I can see.

"First my ears will go to ringing and then when I start hearing the ringing in my ears, explained Smith matter-of-factly. "Then I start hearing the wailing and the crying."

Flashbacks, nightmares, anxiety and irritability.   All symptoms of traumatic brain injury, or TBI.  Smith is one of about 1,800 troops suffering from TBI's caused by penetrating wounds.  Neurologists worry that hundreds of thousands more are at risk of neurological disorders from IED's and mortars.

"It sounds like head injuries and traumatic brain injuries is sort of the hallmark injury of this conflict that we're in now, said Dr. John Campbell, a Jonesboro neurologist. "This kind of war in Iraq and also in Afghanistan."

Dr. John Campbell, formerly Lt. Colonel Campbell, in the United States Navy marvels at the ability of skilled medical professionals working to save lives in combat zones.   But the injuries they're up against are daunting.

"Service members are up against weapons that are detonating right next to them.  Not that this didn't occur in some of our vets from World War II, Korea and these other wars, explained Dr. Campbell. "But, we're seeing a higher percentage of it now."

Until ABC news correspondent Bob Woodruff revealed details of his own traumatic brain injury, few people understood what American troops face.  For the first time ever, the U.S. military is treating more head injuries than chest or abdominal wounds.

Here's why.  Detonation of a powerful explosive generates a blast wave of high pressure that spreads out at 1,600 feet per second from the point of explosion and travels hundreds of yards. The blast is a 2-part assault that rattles the brain against the skull.  The first shock wave is followed by another huge volume of air flooded back into the same area under high pressure.  No helmet or body armor can defend against that.

"When the brain is suddenly subject to these accelerations and decelerations, it can really cause shearing injury to the brain and disrupt some of the neurons and structure of the brain, said Dr. Campbell. "So, that's what can cause some of these injuries."

When sound waves move through the brain, they may cause tiny gas bubbles to form. When they pop, some physicians say there's a cavity or hole left behind.  And even soldiers who walk away from blasts with seemingly no injuries suffer from headaches, confusion, memory loss and depression--all symptoms of traumatic brain injury.  So when these troops come home--will they find adequate treatment?

"A lot of guys. The military's telling them. We can't treat it," said Smith.  "So, we're just going to put them in a nursing home."

In fact, The Washington Post says calls the Pentagon's failure to work with Congress to provide a steady stream of funding for research on traumatic brain injuries, "baffling."

"I think the VA is going to have to really ramp up and be able to meet that demand," said Dr. Campbell.  "The problem is going to be for service members getting back into society."  And will that life--be a live worth living?

"I thought that I was going to have my family, my job and my friends," said Smith. "My friends kind of faded off because I was kind of slow and too much to handle. My wife and I ended up getting divorced because she says she couldn't handle my post-traumatic stress syndrome."

Smith also lost his job as the Joiner Police Chief, but he's still fighting the decision in the courts.   Still, he remains undaunted--winning awards in the Paralympic and Endeavor games. Medals cover his walls.  He's even developed a better prosthetic device for swimmers, like himself.  And never for a moment, does he take for granted what could have been--and what might be for other soldiers yet to come home.

"You can't measure a brain injury," said Smith.  "Technically what the book says, I'm supposed to be incapacitated."

Smith is far from that.  Today, he is a motivational speaker who travels the country sharing a message of courage and hope.

But not every soldier is fortunate to deal with traumatic brain injury like Major Smith or even Bob Woodruff.  Traumatic brain injury can be a silent and debilitating problem.  Soldiers may try to pass the symptoms off as not important--but they are.

For more information these injuries, contact your local VA or the Defense and Veterans Brain Injury Center at 1-800-870-9244.