Toll of multiple concussions on soldiers serving in Iraq still a serious problem

(David Furst / AFP / Getty)

The Indiana sergeant was sitting in the passenger seat of the lead truck when it was hit by an IED.

As soon as he saw that his driver and gunner were ok, he ran out into the searing heat to check on the others in the convoy and help load the disabled vehicle onto a flat bed.

When he finally climbed into the back seat of our Humvee, I saw his hand was shaking so hard he could barely lift the bottle of water to his lips. He was diagnosed with a concussion and spent the night in the base hospital for evaluation and was released the next day. (I haven't named him because I don't have his permission to discuss the incident.)

But this week I learned that the same sergeant had been hit by another IED. The Army is tight lipped about details. It informs the family as soon as possible, but tries its best not to scare them with the realities.

A family member I'm in contact with said that the Army told her the sergeant was hit again but, that in her words, "he's ok and back to work." A few days later she got a phone call from him. He said he and few of the guys were "hurt," but like a good soldier following operational security, the sergeant didn't give her the details, just said it was another concussion. She said he sounded very tired, and "not fully recovered," adding that she wasn't even supposed to know that much.

I recall another incident, an active duty sergeant, also from Indiana, stationed near Bayji, one of the warmest guys I'd met, both to hanger-oners like me, and regular Iraqis. One evening I rode with his unit on a patrol up in the mountains to one of Saddam's old palaces. Then I saw him by chance almost a month later at the large supply base outside Tikirit. He told me his MRAP had been hit by a large IED up in the same mountains the day before. He and some other guys in the vehicle had to be medivac-ed out to the hospital on base. He said he had a concussion. He was still smiling but he looked tired and disoriented.

I was stunned. If his MRAP, a vehicle highly-resistant to IEDs, had taken a bad enough hit for them to be evacuated out by helicopter, it must have been a serious bomb.

I don't mean to be sensational or to scare families. The new armor on the Humvees and the MRAPs are saving lives every day. But the public needs to be reminded there are still a lot of IEDs on the roads in Iraq, and that they maybe less deadly now, but the risk of soldiers suffering from multiple concussions is still high.

A regular infantry guy is going shrug this off. Many, especially Guardsmen assigned to convoy security, have had their vehicles hit multiple times and will tell you the stories laughing. They act like getting blow up is part of the job, and unfortunately it is.

But a much-discussed January 31st, 2008 study in the New England Journal of Medicine suggests a link between mild traumatic brain injury (i.e., concussions) and PTSD and physical health problems 3 to 4 months after the soldiers return home.

"Researchers at Walter Reed Army Medical Center and the Uniformed Services University of Health Sciences examined the cases of 2,525 soldiers three to four months after serving in Iraq, they found that a remarkable one-sixth had suffered at least one concussion during their yearlong deployment — typically during combat or from a blast. These same soldiers turned out to be at higher risk for PTSD than those who hadn't had a concussion — about three times higher for soldiers who had been knocked unconscious by concussion, and nearly twice as high for those who had a concussion without blackout," TIME Magazine summarized in a great article on the NEJM study.

The abstract of the study concludes that, "Soldiers with mild traumatic brain injury, primarily those who had loss of consciousness, were significantly more likely to report poor general health, missed workdays, medical visits," but the positive news was it wasn't necessarily permanent...

"However, after adjustment for PTSD and depression, mild traumatic brain injury was no longer significantly associated with these physical health outcomes or symptoms, except for headache."

For soldiers it's a rite of passage, even a badge of honor, to get hit and survive with only a concussion, but the rest of us have to be aware of the costs.