ProPublica’s Brain Wars

Posted: February 14, 2011 by Leanne Osmond in #3 Propublica

Mild Traumatic Brain Injury. A bit of an oxymoron, isn’t it?

ProPublica, with the help of NPR, took a look at how so many soldiers coming back from the conflicts in the middle east (specifically Iraq and Afghanistan) are slipping through the cracks in the medical system.

When soldiers are involved in roadside bombs or the detonation of  improvised explosive devices (IED’s), the injuries are not always visible. Unlike those who lose arms or legs in these types of traumatic incidents, the ones who suffer from brain injuries more often than not become the soldiers who get left behind.

It has been estimated that since the wars began, about 115,000 soldiers returning from the middle east suffer from mild traumatic brain injuries. However, this estimate likely doesn’t carry much weight when it comes to accuracy. Head injuries in the army have become widely underreported, and even when reported it’s not always a guarantee that a report of the injury will make its way to a permanent medical file. In fact, it has been learned many soldier’s medical files have been burned, rather than transported, when field medical units shut down or move.

The tests used by the US Military to diagnose brain injuries have been proven faulty to say the least — one test has been shown to leave up to 40 percent of brain injuries undetected. Another test, the Automated Neuropsychological Assessment Metrics (ANAM),  was called as reliable as a coin flip by the Army’s most senior medical officer, Lt. Gen. Eric Schoomaker. These types of tests get even less reliable when army doctors help soldiers pass battlefield tests by giving them hints, or repeating questions until the correct answer is given.

A 50-50 chance of proper treatment doesn’t seem appropriate to give anyone, let alone the country’s bravest men and women. People suffering from mild traumatic brain injury lose some basic brain functions such as reading comprehension, memory, and concentration. Often, these symptoms are paired with confusion, dizziness and issues with vertigo. Luckily for most these symptoms subside after a few weeks, however 5-15 percent of the injured see a continuation of these symptoms for months, and in some cases, years after the initial trauma. Researchers have dubbed this category as the “Miserable Minority”.

If head traumas go unreported, people in the miserable minority may find themselves facing a lot of difficulty to get treatment. Military doctors often dismiss their symptoms as being associated with Post-Traumatic Stress Disorder (PTSD), which is common for many soldiers returning from war zones. Treatment for PTSD however, will not give the proper rehabilitation to help cope with the brain damage. Treatment for mild traumatic brain injuries give patients “cognitive rehabilitation therapy” and helps to  treat problems with balance resulting from trauma within the inner ear.

ProPublica’s paired investigation with NPR of the failed diagnosis in thousands of soldiers is a good example of investigative journalism in the public interest. There was no personal gain in this piece, aside from a ProPublica ego-boost perhaps.

The public needs to know what is happening to their troops both overseas, and when they come back home. They need to know head injuries are majorly down-played and underreported, and that military doctors are helping soldiers pass battlefield tests, sending them back into conflicts long before they are ready. Once the public knows things like this, maybe then change will begin. According to the ProPublica/NPR investigation the US Military is considering removing soldiers involved in blasts from the battlefield, as a sort of “time-out”. Considering what ProPublica and NPR found out on the issue, I hope the military does more than consider it.

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