Reports: Military Fails To Diagnose Brain Injuries

The military's medical system is failing to diagnose brain injuries in troops who served in Iraq and Afghanistan. NPR's Daniel Zwerdling and T. Christian Miller, of the nonprofit investigative news organization ProPublica, talk to Steve Inskeep about a new series of investigative reports. They looked into the military's system of caring for soldiers, who suffer from traumatic brain injury.

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STEVE INSKEEP, host:

If you meet an American soldier named Victor Medina, you will see no sign that he was seriously wounded in Iraq. You will not see any sign, but you can hear it. As we are about to hear, Victor Medina is suffering from a traumatic brain injury he sustained in Iraq. The evidence suggests he is one of tens of thousands of American troops with that same injury.

And now our investigative team has found that the military fails to care for many of those troops. NPR's Daniel Zwerdling is one of the members of the team looking into this. Danny, good morning.

DANIEL ZWERDLING: Good morning, Steve.

INSKEEP: I suppose, first, we should clarify: we're not talking, here, about Post Traumatic Stress Disorder, which has been reported about a lot.

ZWERDLING: Right. Traumatic brain injury has been called one of the signature injuries of the wars in Iraq and Afghanistan. When there is a blast, it shoots a shockwave that goes through helmets, through skulls, through soldier's brains, and it causes - it damages the brain's circuits...

INSKEEP: This is not a psychological problem, it's a physical problem of the brain.

ZWERDLING: That's right. And researchers still don't fully understand what happens. But Victor Medina came back - he was in a blast last summer, almost exactly a year ago - and he today he's a different man. When he came back to Fort Bliss in El Paso, Texas, he went to see the top brain neurologist. And here is the neurologist's diagnosis. That's the medical record.

INSKEEP: He's handing me this memorandum here. It's rather long, but let's just read a couple of quotes. The doctor says that Victor Medina has symptoms that are likely due to chronic anxiety, chronic headaches, and he goes on to say I am concerned that he may be slipping into a cycle of playing the sick role. So, the doctor doesn't think Medina's very sick. What did you find?

ZWERDLING: Listen to a clip of Victor - and this is Victor reacting to that diagnosis, seems to be playing the sick role.

Mr. VICTOR MEDINA: When the d-doctor t-tells me I'm p-playing s-s-s-sick, you know that the d-d-doctor came across m-m-m-my...am I g-going crazy? It's just like I have to s-s-s-s-struggle to, you know, t-to get it tre-tre-treated.

ZWERDLING: And he never stuttered before the blast.

INSKEEP: And just to be clear: we're not doctors. He eventually was found to have traumatic brain injury, correct?

ZWERDLING: That's right. By a neuropsychologist outside of the military. And incidentally, we've talked to many soldiers who have, at the same base - Fort Bliss in El Paso, Texas - some who have gone to the same doctor. And when you look at their medical records, over and over again, the doctor says the main cause of their cognitive problems, like Victor's, are headaches and anxiety, not the blast.

INSKEEP: NPR's Daniel Zwerdling is part of a team that looked into the Army's apparent failure to take care of soldiers returning from Iraq with traumatic brain injuries. Another member of that team is T. Christian Miller. He works with ProPublica, a group of investigative journalists. And why did you take on this project now?

Mr. T. CHRISTIAN MILLER (ProPublica): We took on this project because a few years ago it was a big issue in 2007 with the Walter Reed scandals. And in that point in time, the military promised they were going to fix the system to diagnose and treat soldiers who have this traumatic brain injury. We decided to look back and see, well, what has happened since then, and what we found is not a pretty picture.

We found that the military, even today continues to not diagnose these soldiers; they don't document their injuries in the battlefield and they don't always get the best treatment.

INSKEEP: What do you mean by not diagnose?

Mr. MILLER: Literally, you see, from the battlefield back to bases in the U.S., a doctor will see a soldier who's just been in a blast and they won't note it on their medical records. We talked to a doctor who just as recently as last year saw five patients who'd been a bomb blast, and when he looked at their records, not a single one of them had a notation that they had been in a concussive incident like that.

INSKEEP: Daniel Zwerdling.

ZWERDLING: A lot of the medical staff in the military have never been trained to diagnose traumatic brain injury. They were, you know, pediatricians and podiatrists before they went to war. And also in addition to that, there are some people in the military who just do not believe that traumatic brain injury is a serious issue. As one general said to us, you know, we do not want to believe what we cannot see.

INSKEEP: Well, let's talk a little bit more about the military's response to your reporting on this. And we're going to hear that reporting the next couple of days on NPR's ALL THINGS CONSIDERED.

So, what did the military do when you began looking around at allegations of thousands of cases of brain injuries being undiagnosed or untreated?

Mr. MILLER: When the military found out we were looking into this, they tried to shut us down. We went to Lieutenant General Eric Schoomaker, who is the surgeon general of the Army - that's the highest-ranking medical official - and we found out that he had sent out emails telling his local commanders not to talk to us. And Danny, when we went there, confronted him with this email and asked him what it meant.

INSKEEP: Let's listen to this tape of Daniel Zwerdling and the general.

ZWERDLING: These are very flat emails. Keep quiet. Do not talk to people like NPR and ProPublica.

Lieutenant General ERIC SCHOOMAKER (Surgeon General, U.S. Army): You didn't read the first part. It says in order to standardize responses and information with non-DOD audiences...

ZWERDLING: But standardizing responses, I think a lot of people interpret that as let's have the same corporate line. Let's make sure nobody says something that we don't want them to say.

Lt. Gen. SCHOOMAKER: Listen, if we're not doing things in a standardized way, we need to hear from people. This is to make sure that whomever is speaking from the corporate perspective understands what the corporate strategy is.

INSKEEP: Daniel Zwerdling.

ZWERDLING: But when we also presented all the evidence we had found about how the military has failed to diagnose and treat TBIs, Dr. Schoomaker said, you know what, you're right?

Lt. Gen. SCHOOMAKER: We still have a big problem, and I readily admit it, from the point of injury to that first organized care. That is a black hole of information that we need to close.

INSKEEP: So how, gentlemen, will you try to fill that black hole of information in the next couple of days on ALL THINGS CONSIDERED.

ZWERDLING: Well, this evening we're going to have a story that lays out in detail how the military has failed to diagnose and keep track of these traumatic brain injuries. And then the following night, we're going to take you to a base where Victor Medina is - Fort Bliss in El Paso, Texas - and introduce you to a bunch of soldiers who say they have been screaming to get help.

INSKEEP: NPR's Daniel Zwerdling, thanks very much.

ZWERDLING: Thank you, Steve.

INSKEEP: And T. Christian Miller of ProPublica, thanks to you.

Mr. MILLER: Thank you.

INSKEEP: And you can read findings from our brain wars investigation by going to NPR.org or ProPublica.org.

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