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The signature wound of the Iraq war

Many troops in Iraq with brain injuries may be returning to duty. That's right -– they're  not getting treatment –- not even getting a break –- but going right back into the field. We've been reporting on the enormous numbers of brain injuries among Iraq vets for the past two nights. (Read part one here; part two here.) I'll reiterate the numbers and the reasons below. We could not fit this aspect of the story in these two reports, so I want to point it out here. 

According to the VA doctors who run the rehabilitation programs for brain injuries, when troops are wounded in the field they are evacuated immediately if they have any obvious wounds. But the signature enemy weapon of this war has been the roadside bomb – the IED.  The human brain is the consistency of gelatin and the force from the explosion shakes it ferociously. Many thousands of troops in Iraq have felt the blast of an IED. If they are knocked unconscious, according the VA docs, they too are evacuated to a field hospital for evaluation. But if they are not and if they do not complain of a problem, they remain on duty.

Specialists in brain injury know all too well that people can suffer brain problems without losing consciousness. One of the most frightening aspects of brain injury is that brain-injured people often lose the ability to know something is wrong.

Dr. Harriet Zeiner, a VA psychologist and brain injury specialist, was recently on a conference call with medical officials at several military  treatment facilities including hospitals in Iraq. "One of the things commanders are trying to determine," she says, "is that after someone has been exposed to five and six concussive blasts are they still battle ready? Frankly, that floored us. You could have very significant effects from one exposure, and now they're trying to figure out if people who've been exposed five and six times should be going back into battle."

To follow up on those comments, I called the Pentagon several times to request an interview with someone who would explain the policy of what field commanders do to determine if troops are suffering brain injury, and what is the policy for returning them to duty. My requests were denied repeatedly.

But beyond that problem, as we have been reporting, the toll of brain injury in this war is enormous. Almost 18,000 troops have been wounded according the Department of Defense. The VA doctors say that two-thirds of them have been injured by IED blasts and two-thirds of those exposed to blasts suffer some brain injury -- ranging from a mild concussion to permanent damage. Brain injuries -– thousands of them –- could be the legacy of this war just as much as post-traumatic stress and problems from exposure to Agent Orange persisted among many of the troops who served in Vietnam.