Our blog yesterday about the Pentagon’s failure to follow through on mandatory testing for brain injury raises numerous issues worth commenting on, including the military’s outright failure to follow orders, the superficial approach to the diagnosis of brain damage and the magnitude of the problem that is being pushed on down the road to the next generation. Yesterday’s blog is here: https://waiting.com/blog/2010/06/611.html
The generals in essence are telling Congress that if they properly treated soldiers for TBI, there just wouldn’t be any soldiers left. They use the term “false positives” but that is really short hand for saying that too many soldiers are showing symptoms to treat them all. And frankly, the problem isn’t really the cost of treatment or even the availability of treatment facilities, although the second part of that could certainly get to be an issue. The problem is that if they followed anything close to the protocols for treating athletes with concussions, there might not be anyone left to fight the wars. You see, if we were talking athletes, we wouldn’t allow them to go back into the field until they were completely cleared of Post Concussion symptoms. Our military is already scrambling to find enough soldiers to fight two wars. Put any more on the sidelines and we would have to change our foreign policy.
While I may be one of the few civilians who fully understands the true implications of “no return to play” for soldiers, didn’t we promise to do better with this war? I have been blogging about the Nightmare of War Time Brain Injuries since http://www.tbilaw.com/blog/2008/06 (read bottom up) and specifically since http://www.tbilaw.com/blog/2008/06/suicide-and-terror-continues-for-our-iraq-and-afghanistan-soldiers.html
This problem with combat TBI is not a new problem. German, Japanese, Korean and Vietnamese artillery and mortars were far more potent than road side bombs. And while it is true that we are saving more severely wounded TBI soldiers, the mild and moderate survival rates are likely unchanged since World War I. What is different is that we have the capacity to diagnose MTBI now and we are supposed to care, because Congress and the American public says so.
The problem isn’t too many false positives. It is too many positives, too many soldiers with brain damage. It has always been true, since the day of the club and it will always be true – combat is hard on the brain. That is why the helmet was invented. What we as a society have to accept is that if we are truly to “be there” for our troups, we must pull them out of the field when they get a head injury. That means we either have to have more soldiers or fewer military ambitions and then apply all of the best medicine to help them when they do suffer a TBI. If we don’t, the correlation between soldiers, homelessness and suicide will be the same in 2050 as it was in the 20th century.
