Army Admits that it Doesn't Understand Short and Long Term Consequences of Concussion and TBI

Full Article at: 'We Just Don't Know'
The Army vice chief of staff explains why inconclusive science is complicating the treatment of wounded warriors.
Pete Marovich / ZUMAPress.com


"If there's a member of the brass who's taken mental-health issues in the military head on, it's four-star Gen. Peter Chiarelli. On his second deployment to Iraq, he served as commander of all coalition ground forces. Since then, he's gone before Congress to explain the Army's work on the invisible wounds of war and created a suicide-prevention task force. When word got out that NEWSWEEK was investigating the science of battlefield concussions, his office lined up an interview with articles editor Andrew Bast. Excerpts:

How well do we understand the short- and long-term effects of mild traumatic brain injury (MTBI), or battlefield concussions?
I don't think we do. The vast body of medical understanding of these wounds will show you that we just don't understand. It's science that's just not that well developed. I use the example of open-heart surgery. You can go to two doctors for the same problem, and one may use different antirejection drugs and different postoperative requirements, but it is all a very well-developed science. The science of the brain, however, is not. That's what causes the huge issues we've got here.

What are the issues, exactly?
The comorbidity issue between posttraumatic stress [PTS] and TBI are huge. One of the biggest problems we have is that every soldier who is in a blast, and has some kind of a behavioral-health issue after the fact, thinks they have TBI. Some of them do, but some don't. They may have PTS or some other behavioral-health issue. And the drug regimen for the two is very different. So if a doctor makes a mistake and diagnoses someone with PTS who has TBI, the drug regimen would be different.

Can you explain that term, comorbidity?
Comorbidity is the sharing of symptoms. The symptoms are much the same for PTS and TBI. So when you have similar symptoms, it's very difficult to make a diagnosis. We're not being criticized for the way we're working with soldiers who've lost arms or legs. If you were at the Army 10-miler the other day, there were hundreds of wounded warriors on prostheses. These are mechanical injuries, and we're very good at treating those. But [on brain injuries] what has been hard is that people really feel we are letting them down. The problem is that we just don't know. You'll find a lot of people who will come to you with the answers, but I think if you were to talk to the specialists, they will tell you that very little that's come to their attention that they have researched has proven to be effective."