Traumatic Brain Injury (TBI) has become the signature injury of the Iraq war, where urban battlefields are marked by explosions from IEDs (improvised explosive devices) and vehicle accidents. Modern body armor and advances in battlefield medicine have succeeded in saving lives and protecting bodies, but they can’t always protect soldiers’ delicate brains from the impact of explosions.
At the Polytrauma Unit of the VA medical center in Palo Alto, we meet four TBI patients who are working to put their lives back together. Only some of them bear obvious wounds, such as a lost eye or a missing part of a skull, but all share in common serious injuries to their brains.
These veterans must relearn everyday things that we take for granted. Some struggle with simple motor skills, like picking up a pencil or walking normally; others grapple with memory loss and emotional difficulties, like one Army veteran who can’t remember giving birth to her own daughter.
Doctors at the VA Polytrauma Unit help patients cope using the latest medical knowledge and therapeutic techniques. Palo Alto is one of the VA’s four lead Polytrauma Centers set up specifically to treat TBI patients. The center offers some of the most advanced treatment available for veterans with brain injury. Remarkably, one of the biggest challenges doctors face may be an early and accurate diagnosis. Experts worry that many of the wounded in Iraq may be suffering from TBI without knowing it, putting themselves and their fellow troops at risk.
Update November 9, 2006
Since we left Ward 7-D, there’s been some progress to report.
Specialist Claudio Carreon has moved back to Arizona to be with her mother and two year-old daughter.
Staff Sergeant Jay Wilkerson is still at the hospital, but spends every weekend at home with his family.
Sergeant Frank Sandoval did have his polymer implant surgery, but it became infected and had to be removed. While waiting for a new implant, he’s back at home in Arizona with his wife and daughter.
Finally, Staff Sergeant Eric Cagle, who walked again for the first time during our visit, won a gold medal in the National V.A. Wheelchair Games in Alaska last July. He was discharged from Ward 7-D in October 2006.
Rehabilition centers mentioned in this segment:
- Palo Alto VAMC Polytrauma Rehabilitation Center (Ward 7-D)
- Tampa VAMC Polytrauma Rehabilitation Center
- Minneapolis VAMC Polytrauma Rehabilitation Center
- Hunter Holmes McGuire VA Medical Center
- The Defense and Veterans Brain Injury Center, for veterans with TBI
How you can help:
- Operation Helmet, provides helmet upgrade kits free of charge to troops in Iraq and Afghanistan
- Fisher House, provides free or low cost lodging to veterans and military families receiving treatment at major military and VA medical centers
- Brain Injury Association of America provides brain injury prevention, research, education and advocacy.
- VA Volunteer Service
General information about Traumatic Brain Injury (TBI):
- VA growing to improve care for wounded soldiers, US Department of Veteran Affairs
- Fisher House, provides free or low cost lodging to veterans and military families receiving treatment at major military and VA medical centers
- The Brain Injury Association of America, information and resources for patients, families, caregivers
- TBI Home, message boards, discussion groups and online support groups for caregivers and surivivors
- The National Resource Center for Traumatic Brain Injury
- The Centre for Neuro Skills, a large amount of information on TBI, including a map of the brain, information on how TBI happens
- Traumatic Brain Injury in the War Zone, The New England Journal of Medicine
- Psychiatrists May Soon See More Combat Veterans, Psychiatric News
- War Stories from Ward 7-D: Radio Story, California Connected reporting for KQED’s radio program The California Report
- Kentfield Rehabilitation Hospital, Specialized Brain Injury Program in Marin County
- Human Brain Map, BBC
- The Mind, BBC
- Why is Kevlar so strong? The Lawrence Berkeley National Laboratory
Listen to the commentary
Download this video
August 21st, 2006 at 11:35 am
We have a good follow on story regarding TBIs in the military and in the civilian world. We are currently training the military and civilian trauma centers across the U.S. and internationally for free and providing the capital equipment.
The program is based on the Brain Trauma Foundation (BTF) / American Association of Neurological Surgeons (AANS) guidelines. Since its complete adoption at Mission Hospital, Mission Viejo, CA, in 1997, TBI results have improved dramatically. The number of patients who are able to function normally increased 300%, mortality rates where reduced by 66%, and vegetative state was reduced by half. Yet, a recent survey done by the Traumatic Brain Foundation revealed that only about 1/3 of the trauma centers across the country have implemented the BTF TBI guidelines in any form, and of those, only a marginal fraction have implemented the guidelines to the full extent. In 2001 Mission Hospital won the prestigious Codman Award for their full implementation and improvement of the protocols and consistent increases in quality outcomes The Adam Williams Traumatic Brain Injury Initiative (AWTBII) was established to help Mission Hospital disseminate these protocols, train clinical staff and provide capital equipment used in these protocols for no cost to the receiving hospital. To date the AWTBII team has trained 10 Level I and Level II trauma centers across the United States.
November 10th, 2006 at 2:33 pm
In California, there are 7 state funded programs that provide services to adult survivors of TBI. They are funded by the California Department of Mental Health. The programs, Traumatic Brain Injury Services of California (TBISCA) are a great resource for adults who have sustained a TBI and need assistance re-integrating in the community. Visit us at www.tbisca.org to learn more!
November 10th, 2006 at 10:04 pm
What a great job on this story! I’m going to share with my students, many of whom won’t even recite the pledge of allegiance in class–these are high school students 15-18. I’m trying to find the poem that one of the soldiers recites at the end of the segment. I also fell in love with his brother and how he rubs his soldier brother’s back, something he didn’t do when they were kids. So typical. I wish my sister was alive so I could do that for her but she never had a chance in an auto accident 34 years ago at the age of 27. Both brothers expressed the value and love of siblings beautifully in his smile and devotion. As a former public radio reporter–nice job!
-anne burnett
November 11th, 2006 at 9:52 am
How do we make IRS financial contribution to VA for providing assistance at Ward 7D, Palo Alto?
Thank you,
November 11th, 2006 at 5:38 pm
Incredible program - I almost didn’t watch it - thank goodness I did - very powerful stories. I wish every one in the country could see this fine piece. Thank you for showing us the immense courage and effort of these soldiers who are up against such huge challenges.
November 13th, 2006 at 10:44 am
I would like to contact the Neurological Psychologist who was interviewed in the KQED program about Ward 7D. I am applying to PhD porgrams in Clinical Psychology and am considering specializing in Neurological Psychology and would like to talk with her about the field. If I could get her name I would be most grateful.
November 30th, 2006 at 5:11 pm
I watched the program last night, I had to get down on my knees afterwards and pray for Cladia, Jay, Frank, Eric and his Mother Linda and their families. We know that there is a war going on but we don’t know the pain and suffering it has caused many people. I will continue to pray for these men and woman in all my prayers. I want them to know that I do love them with the love of Christ. I pray that the Lord will touch each one of them with his healing powers as only he can do. I encourage everyone of us Citizens to pray for our Men and Women that are figthing a battle that is not ours it belong to the Lord.
God bless you.
February 28th, 2007 at 10:16 pm
Two important related stories to CALIFORNIA CONNECTED excellent segment may be found @:
PBS News Hour
Originally Aired:
February 28, 2007
Debate Format
Veterans Hospitals Struggle to Treat Brain Injuries
The Veterans Administration is unprepared to care for brain-injured Iraq war veterans once they leave rehabilitation centers and return home to VA hospitals, a new documentary reports. Veteran advocate, Paul Rieckhoff, [see: http://www.iava.org/ ] and the current Secretary of Veterans Affairs, Jim Nicholson, discuss treating the injuries.
Watch segment or read transcript:
http://www.pbs.org/newshour/bb/health/jan-june07/veterans_02-28.html
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ABC News
NEW YORK, Feb. 26, 2007
Bob Woodruff
“Turning Personal Injury into Public Inquiry”
Watch segment or read article:
http://abcnews.go.com/WNT/story?id=2904214&page=1
March 5th, 2007 at 12:48 pm
VA Leading the Way in Care for Traumatic Brain Injury
February 27, 2007
Nicholson: Another Example of VA Adapting to Needs of Newest Vets
WASHINGTON — The Department of Veterans Affairs (VA), long a leader in the treatment and rehabilitation of veterans with brain injuries, is continuing to adapt its programs to meet the needs of veterans from the Global War on Terror, with a variety of new services in place or underway.
The latest innovations for treating traumatic brain injury (TBI) in the newest generation of combat veterans returning from Iraq and Afghanistan includes mandatory TBI training for all VA health care professionals, screening all recent combat vets for TBI and creating an outside panel of experts to review VA’s TBI services.
“VA has adapted — and will continue to adapt — its world-class health care system to the unique medical issues facing our newest combat veterans,” said Secretary of Veterans Affairs Jim Nicholson. “VA is a nationally recognized leader in health care, and our system is dynamic. We are constantly striving to improve the care we provide to our veterans.”
Traumatic brain injury (TBI) can be caused without any visible injuries when explosives jar the brain inside the skull. Symptoms can range from headaches, irritability, and sleep disorders to memory problems and depression.
VA has developed a TBI course that is mandatory for all health care professionals. The course teaches primary care providers ways to diagnose TBI in patients who might not otherwise be aware they suffer from it.
Also starting this spring is a program to screen all patients who served in the combat theaters of Iraq or Afghanistan for TBI. The new screening will be offered at all 155 VA medical centers.
To ensure VA is taking advantage of the latest technology, treatment innovations and diagnostic insights, the Department will establish a panel of outside experts to review VA’s complete polytrauma system of care, including its TBI programs.
“Polytrauma” is a term that includes TBI and encompasses the other injuries typically found in blast victims, including amputations, burns, hearing and vision problems and psychological trauma.
VA operates four major polytrauma centers — in Minneapolis; Tampa, Fla.; Richmond, Va.; and Palo Alto, Calif. — that have interdisciplinary teams of specialists working together on the complex medical needs of each patient. VA also has 17 regionally-based polytrauma facilities that provide specialized care closer to veterans’ homes.
Each of VA’s 21 regional health care networks is establishing polytrauma support clinic teams to further improve case management for veterans with TBI as they return home from the hospital, and to help them in their transition to their communities.
VA’s innovations in the diagnosis and treatment of TBI patients began in 1992, when four VA medical centers dedicated special facilities to treatment, rehabilitation, professional education and research regarding brain injuries. In March 2003, those facilities received their first patients from the Global War on Terror, and in April 2005, they were officially designated as polytrauma centers, featuring teams of specialists in various medical disciplines and case managers working together to help veterans overcome severe injuries.
“Inpatient care in one of our four polytrauma centers is the beginning of a long road to recovery,” said Dr. Michael J. Kussman, VA’s Acting Under Secretary for Health. “We are establishing an extensive continuum of care that will enable our patients to achieve the highest level of function and ability.”
Among the special adaptations VA is providing for the care of TBI and polytrauma patients are case managers assigned to each patient, a greater emphasis and understanding of the problems of families during the initial care and long-term recovery, and state-of-the-art video-conferencing that permits top specialists to take an active role in the treatment of remote patients.
VA treated more than 5.4 million patients last year, accounting for about 55 million outpatient visits and 600,000 hospitalizations. About 205,000 of the 630,000 veterans who have served in Iraq and Afghanistan have come to VA for health care, with fewer than 7,000 being hospitalized.
All combat veterans have access to free health care from VA for two years after their separation from service, bypassing rules that require determinations of service-connected injuries or income levels.
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[Source: VA Govt News Release:
http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1302]
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