The Warrior's Brain

By Bast, Andrew | Newsweek, November 22, 2010 | Go to article overview

The Warrior's Brain


Bast, Andrew, Newsweek


Byline: Andrew Bast

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The Warrior's Brain

One family's terrifying medical mystery could represent the military's next big crisis.

By Andrew Bast

The worst was the day Brooke Brown came home to find her husband with a shotgun in his mouth. But there had been plenty of bad days before that: after he returned from a deployment in Iraq, Lance Cpl. David Brown would start shaking in crowded places. Sitting down for a family meal had become nearly impossible: in restaurants he'd frantically search for the quickest exit route. He couldn't concentrate; he couldn't do his job. The Marine Corps placed him on leave prior to discharging him. Brooke quit her job to care for him, her toddler, and the new baby. The bills piled up.

It sounds like another troubling story of a war vet struggling with PTSD. But Brown's case is more complicated. In addition to the anxiety, he suffered a succession of mild seizures until a devastating grand mal episode sent him to the hospital covered in his own blood, vomit, and excrement. There were also vision problems and excruciating headaches that had plagued him since he'd been knocked to the ground by a series of mortar blasts in Fallujah four years earlier.

Brown, now 23, didn't have any visible injuries, but clearly the man who left for Iraq was not the same man who returned. "Our middle son clings to David; he knows something is wrong," Brooke, 22, explained late this summer. "Our 4-year-old doesn't know what caused it, but he knows Daddy's sick and he needs help."

But what kind of help does Corporal Brown need? His case perplexed civilian doctors and the Department of Veterans Affairs. The headaches and seizures suggest that he is suffering from the aftereffects of an undiagnosed concussion--or, in the current jargon, mild traumatic brain injury (TBI). But some of his symptoms seem consistent with a psychological condition, posttraumatic stress disorder (PTSD). Or could it be both--and if so, are they reinforcing one another, in the vicious cycle that doctors refer to as co-morbidity? The person who knows David better than anyone, his wife, thinks it was hardly a coincidence that one of his worst seizures came on the day last year that his best friend was deployed with the Second Battalion, Eighth Marines, as part of President Obama's surge into Afghanistan.

David Brown's symptoms have placed him at the vanguard of military medicine, where doctors, officials, and politicians are puzzling out the connection between head injuries and PTSD, and the role each plays in both physical and psychological post-combat illness.

Invisible Wounds

The military reports that 144,453 service members have suffered battlefield concussions in the last decade; a study out of Fort Carson argues that that number misses at least 40 percent of cases. By definition, a concussion is a shaking of the brain that results from a blow to the head. Typical symptoms include headache, memory loss, and general confusion. For decades, head injuries were a challenge mainly for civilian doctors, who studied the results of auto accidents and football injuries. The best treatment, it was generally thought, was rest and time. And in the great majority of these civilian cases, the brain heals by itself in as little as a week.

Concussions sustained on the battlefield are another matter, and a vexing one. According to the Department of Veterans Affairs, symptoms such as vision, memory, and speech problems, dizziness, depression, and anxiety last far longer in men and women returning from combat. Why? Doctors suspect that the high-stress combat environment stifles the kind of recovery that would normally occur. …

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