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MELISSA BLOCK, Host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.

In this half-hour, we're going to focus on the terrible challenges troops face when they return from war with traumatic brain injuries and post-traumatic stress disorder. Studies suggest that hundreds of thousands of troops have suffered one or both. Previous investigations by NPR and ProPublica have found that tens of thousands have also failed to get adequate treatment.

TBI: How should they stop him?

NPR's Daniel Zwerdling has our story, which he reported with T. Christian Miller of ProPublica.

DANIEL ZWERDLING: Brock Savelkoul came close to getting killed in a gun battle in Iraq, but he and his unit shot their way out of that one. At the time, he never dreamed that his showdown would come in a pasture in North Dakota.

MEGAN CHRISTOPHER: Put your hands in the air. In the air. Put your hands in the air. Do it now. Stop! Stop! Drop your weapon.

ZWERDLING: September 21st, 2010. Savelkoul steps out of his black Tacoma pickup, and he squints. Squad cars from three counties and the Highway Patrol have chased him here. Now, he's run out of gas on a dirt road, and he's trapped like an animal in their spotlights. The Highway Patrol captured the whole showdown on cameras in their cruisers. Savelkoul has six guns, including a semiautomatic assault rifle, and hundreds of bullets.

A trooper named Norman Ruud, and the others, are crouching behind their doors.

NORMAN RUUD: Drop the gun.

Unidentified Law-Enforcement Official #1: Drop the gun.

RUUD: Put the gun down.

ZWERDLING: As we're hearing you shout at Brock Savelkoul, you're aiming right at him with your shotgun.

RUUD: Yes. You're aiming center of mass, center of body because you know that he's been trained to take lives, and he has the ability to use the weapons that he has very effectively.

RUUD: Drop the gun!

Unidentified Law-Enforcement Official #2: Drop it!

RUUD: Drop the gun, and nobody will get hurt.

CHRISTOPHER: Drop the gun, and step back towards us.

ZWERDLING: Back in high school, Brock Savelkoul was an all-around kind of guy. His big sister keeps the highlights of his life in a box.

ANGIE HEINZE: Most of these are when he was younger.

ZWERDLING: You can skip the picture where he's naked.

(SOUNDBITE OF LAUGHTER)

ZWERDLING: Brock's sister lives with her husband and two kids near Minot. Her name is Angie Heinze. She spreads photos and newspaper clippings of her brother on her living room carpet.

HEINZE: And then he got letters or, what do they call it when they do really good in sports? I think it's letters.

ZWERDLING: So here is a plaque. He lettered in football in 1999. He lettered in baseball, 1999. Senior athletic award.

Savelkoul's father is proud of him, too. When you walk into Bruce Savelkoul's mobile home in Minot, there's a huge deer head mounted on the wall. The antlers go to the ceiling.

BRUCE SAVELKOUL: Yeah, an exceptionally nice trophy for a 14-year-old boy.

ZWERDLING: Brock's father sells guns part time. He's a licensed dealer. And he loves to tell the story how his son shot this deer. He'd taken Brock hunting. It was pouring rain, miserable. And suddenly, Brock sees the buck.

SAVELKOUL: Started shaking like crazy.

(SOUNDBITE OF LAUGHTER)

SALVEKOUT: And he took my rifle and leaned on my shoulder, and fired away. And he downed the nicest buck that I had seen in 25, 30 years of (unintelligible) hunting.

ZWERDLING: And family and friends say Brock was kind. He loved to play practical jokes. And then came 9/11. Brock quit a boring job - he was building fences - and he joined the Army.

We talked to some of Savelkoul's commanders and Army buddies from Iraq.

MICHAEL KREBSBACH: He was one of the more normal guys that there were. I mean, he's your - he loved his country. He loved his family.

ZWERDLING: That's Michael Krebsbach. He fought with Savelkoul on his first two tours.

KREBSBACH: I watched Brock perform, and he did everything to the T. I guess you don't really expect, you know, psychological issues from anyone. But this guy, especially - like I said, he's - solid kind of guy.

ZWERDLING: But Savelkoul's family says when Brock came home after these first two deployments, he was distant, withdrawn. He got dramatically worse on his third tour, after the explosion. On January 16th, 2009, Brock was playing video games with four buddies in their Army trailer, near Baghdad. A rocket hit right outside.

JARED HOLLINGSHEAD: It's beyond words. You can't really describe it. It's just utter terror.

ZWERDLING: That's another one of Savelkoul's buddies, Jared Hollingshead. They were in the trailer together when the rocket exploded.

A day or two after the explosion, an Army brain specialist diagnosed all five soldiers with concussions, with traumatic brain injuries. Hollingshead and some of the others told us they could hardly function. They stumbled when they walked. A commander would give them instructions, and they couldn't understand them. They had crippling headaches.

HOLLINGSHEAD: Chronic headaches. At times, I had to just stop what I was doing and sit down.

ZWERDLING: But the soldiers say their commanders shrugged it off.

HOLLINGSHEAD: Nobody ever came back to us to follow up. It was pretty much just go to work.

SAVELKOUL: After that explosion in Baghdad, is what started it all.

ZWERDLING: Bruce Savelkoul, Brock's father.

SAVELKOUL: Then I knew something was wrong.

ZWERDLING: A couple months after the explosion, Brock went on to leave. He flew to Thailand, where a lot of soldiers go for R And when he first got there, friends took the usual party photos: Brock smiling, lots of girls. But then his family started getting freaky phone calls in the middle of the night.

SAVELKOUL: He was just absolutely terrified.

HEINZE: He was saying that, you know, the bad guys are after me; you're never going to see me again. Or to - I'm lost. I don't know where I'm at.

SAVELKOUL: He'd call me from a cafe. He said: Dad, I got to go. I said: For what? He said: They're after me; they're going to kill me.

HEINZE: There's a car bomb. I mean just - it didn't even make sense.

SAVELKOUL: I said: Who is going to kill you? He was so scared that his voice just trembled.

ZWERDLING: Brock's father and sister say to this day, they still don't know exactly what happened in Thailand. They called Brock's unit; the U.S. Embassy got involved. Apparently, the Thai police found Brock wandering around, disoriented. They sent him to an Army hospital in Hawaii and a few weeks later, the Army sent Brock back to his home base, at Fort Riley, Kansas.

HEINZE: It was not my brother. I mean, he just - he would just stare at you. He just, he wouldn't know what to say. He wouldn't know what to do. He was very nervous. He said he felt like a guinea pig 'cause every doctor he would see, they would try different medications. And there was lots of them. I mean, I would try to look them all up - and there were just lists of them. I'm like, you can't take all of these meds together. But...

ZWERDLING: And you're a nurse, right? I mean, you know about medications.

HEINZE: Right. Right, so I was kind of worried about that. But I had faith. I'm like, he's been seeing doctors. They know what they're doing, so...

ZWERDLING: But Brock kept acting psychotic. He said he was going to kill himself. So Brock's commander sent him to a private clinic that treats PTSD in troops. It's called Pathways; it's in California. Fred Gusman runs it. He says when soldiers like Brock have PTSD and a brain injury, it's a double whammy. It's like having two deadly infections at the same time.

FRED GUSMAN: Unfortunately, he's not unique. We see them all the time. I - you know - I have stacks of applications that have multiple problems like this.

ZWERDLING: Gusman's center usually treats soldiers for six, intensive months. He says they need that long. But Savelkoul wandered away from the center after only eight weeks. He seemed to have another psychotic break, and he ended up back at Fort Riley.

Gusman says this was a man who urgently needed treatment.

GUSMAN: Well, what we do know is that if you intervene early, you can - it's just like anything, like any kind of wound. Think of it as a wound, that if you let it go untreated, it festers. And it becomes more of a problem to fix.

ZWERDLING: Officials at Fort Riley and the Pentagon wouldn't talk with us about Brock Savelkou, and the kind of treatment he did and didn't get. But Army documents show that only a few months after Brock walked away from treatment, they ruled that he was unfit to serve. And they gave him a medical discharge and sent him home.

Brock's sister, Angie Heinze, says he was almost like someone with Alzheimer's.

HEINZE: Our mom had just passed away a few years ago. He couldn't remember when that was. Something would get brought up about what we did the day before, like what we had for supper or going to the kids' T-ball game or something, and he'd be like, I never went to the T-ball game.

ZWERDLING: So these were things that he had just done the day before, maybe.

HEINZE: Mm-hmm.

ZWERDLING: And what would you say?

HEINZE: I would remind him over and over. And it just got kind of frustrating. I mean, he just got that blank look - like, huh?

ZWERDLING: Of course, now that Savelkoul was out of the service, he was eligible to get treatment at the Department of Veterans Affairs. But the VA hospital that's closest to Minot is 230 miles away.

Did anybody in the military say to you, one issue here is that your son was injured by an explosion in Baghdad, and we need to investigate whether he might have persistent symptoms from this traumatic brain injury?

SAVELKOUL: Nobody.

HEINZE: Nope.

SAVELKOUL: And that's one thing that, you know, kind of bothered us. They discharged him from the Army. I'm not running down the Army. He loved the Army. But to send him home?

ZWERDLING: On September 21st last year, Brock's father wrapped up his shift driving his semi. He's a trucker. He came back to his mobile home, which he was sharing with Brock, and he froze.

SAVELKOUL: Thinking, oh, this might not be good.

ZWERDLING: Brock had trashed his own bedroom. He and Angie had built a wooden case for his Army medals. The Purple Heart he received for the explosion was gone.

SAVELKOUL: This had a glass case on it. There used to be glass there. It was hanging on the wall here, right over his bed. He got up on top of the bed, kicked the case in - glass all over the bed, the bedspread, all over the room.

Came out of the bedroom here, walked down the hall, and here on the range was a - oh, it was half of the grocery list, is what it was. And he had folded it over and wrote - it said: Dad and Angie, love you very much. There's no hope for me.

And then I walk into the bedroom. This is my bedroom, it's where I keep all my guns. He just had probably went about three-fourths crazy. He had cases open, just opened them up and threw them out, like this - and grabbed a gun out, and tried to get them loaded.

DPMS: Oh man, I've got to call the cops.

BLOCK: I am in pursuit of a black Toyota Tacoma, and we are approaching speeds of 105 miles an hour, southbound on Highway 85.

BLOCK: When we come back, we'll take you to the farm field where the police and highway patrol caught up with Brock Savelkoul, and we'll hear what happened next.

(SOUNDBITE OF MUSIC)

BLOCK: From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.

Now, back to the showdown with Brock Savelkoul, the veteran who was diagnosed with traumatic brain injury and post-traumatic stress disorder.

When we paused our story a few moments ago, he had piled six guns into his pickup, and was leading law-enforcement officers on a high-speed chase across North Dakota. NPR's Daniel Zwerdling tells what happened next.

ZWERDLING: Police reports say that Brock Savelkoul stormed into a convenience store. He pointed one of the guns at a terrified customer, and he said: Do you want to die? Then, Savelkoul took off.

PD: Attention all units, attention all units, Watford City PD is in pursuit of a vehicle, southbound Highway 85 from...

ZWERDLING: The videos from the highway patrol cars are chilling. Savelkoul tears down the highway. A line of police cars chases him, straight into the sunset. The sky is all purple and gray. You can watch this chase on npr.org.

Unidentified Woman #1: They won't stop for - and they have guns in their vehicle.

Unidentified Law-Enforcement Official #4: And how many guys are in it?

Woman #1: Just one.

ZWERDLING: The highway patrol sets up a blockade with metal spikes. But suddenly, Savelkoul swerves off the highway, and he drives across a farm field.

Unidentified Law-Enforcement Official #5: He's turning down Fairfield Pasture. Oh, he's turning around!

ZWERDLING: When you watch the video, it almost makes you sick. The cars are bouncing across the pasture. The camera goes up and down, and up and down. Savelkoul slams through a barbed-wire fence. Then suddenly, his pickup stops.

Unidentified Law-Enforcement Official #6: We've got him at 1860 131st...

ZWERDLING: He's run out of gas.

CHRISTOPHER: Stop, stop! Drop your weapon. He has a weapon in his right hand. Drop your weapon. Do it now!

ZWERDLING: More than half-a-dozen police and highway patrol cars screech to a halt just yards behind Savelkoul's pickup. One of the troopers is Megan Christopher.

CHRISTOPHER: Drop the gun. Do it now!

ZWERDLING: Christopher watches the video with us on a computer at the highway patrol office. Christopher is tall. She wears one of those broad, Smokey-the-Bear hats. She's been a trooper for only a couple of years, and she'd never negotiated with a gunman before this.

At this point in the standoff, the dispatcher has told them the gunman is a vet.

Unidentified Woman #2: Comes back to a Brock Savelkoul out of Minot.

ZWERDLING: And Christopher tries to establish some sort of connection.

CHRISTOPHER: Put the gun down, Brock.

BLOCK: How do you know my name? I started to use his name to try to kind of humanize it.

My name is Megan. Nobody needs to get hurt here, Brock. It's not worth it. Go ahead and lay that down.

ZWERDLING: Savelkoul doesn't lay the gun down. In fact, this standoff will last for two more hours - two freezing hours; it's sleeting. Christopher tries everything she can think of to bond with him.

CHRISTOPHER: It's not nice to make a girl beg. So please drop the gun, Brock. Go ahead and drop the gun.

ZWERDLING: It's not nice to make a girl beg?

CHRISTOPHER: Yeah, that's what I said. Try to be funny, you know, just trying to get it out of this just broken record of drop the gun, drop the gun, drop the gun, drop the gun.

ZWERDLING: But nothing seems to work. Savelkoul stumbles at times. He looks out of it. He shoots his pickup with the assault rifle. Then he waves a handgun toward the officers.

Now, all during the standoff, the troopers and police have hardly been talking with each other. Nobody's been coordinating a strategy. Still, the officers hold their fire.

CHRISTOPHER: He's walking closer to our vehicle.

ZWERDLING: Why haven't you shot Brock Savelkoul by now?

CHRISTOPHER: I don't know how he didn't get shot. For me, it came very close - very, very close.

ZWERDLING: At a couple points, Savelkoul yells at the officers.

BROCK SAVELKOUL: Why would you worry? (Unintelligible). I will not ever shoot - law enforcement agent.

CHRISTOPHER: He was saying he doesn't want to hurt anyone, he wouldn't hurt law enforcement. And I believed him. He didn't point the weapon at us. He wasn't threatening us. He was a man, standing there with a gun.

I understand what you're trying to do. You're trying to bait us into shooting you, and it's not worth it.

BLOCK: I want to go out in a blaze of glory. I want to go out in a blaze of glory.

Step away from the gun. I'm getting too much feedback here.

ZWERDLING: It's been two and half hours since law enforcement started chasing Savelkoul, and Megan Christopher finally convinces him to put down his guns.

CHRISTOPHER: Step away. Go ahead and kick that.

ZWERDLING: Suddenly, another trooper rushes forward, and he shoots Savelkoul with a taser, a stun gun.

After the taser has stopped shocking him, Savelkoul lays still on the ground. And trooper Megan Christopher kneels beside him. She touches his face.

CHRISTOPHER: And I put my hand on his cheek and just tell him, I'm Megan.

(SOUNDBITE OF CRYING)

ZWERDLING: What makes you cry now?

CHRISTOPHER: That I got to meet him. I actually wanted to go out and meet him and say thanks, you know, life is hard. This - it's definitely not the way to end it. There's a lot more out there.

KXMC: This is KXMC, CBS 13 Minot.

Unidentified Announcer #2: Watford City police have released details of an armed standoff...

ZWERDLING: The police threw Brock Savelkoul in jail. A local judge read off the charges.

C F: Charge is reckless endangerment, Class C Felony.

ZWERDLING: But the story caught the ear of the governor's office. They have a veterans advocate there. And late last year, the state freed Savelkoul on bail, and they sent him to an inpatient treatment program at the VA.

The first time we visited Savelkoul, he was just about to start treatment.

Unidentified Woman #3: Thanks for coming and visiting.

ZWERDLING: Savelkoul was sitting on a bed, in a locked ward at the VA hospital in Fargo. A nurse was giving his medications. Savelkoul said he couldn't remember loading weapons in his pickup that day. He couldn't remember that he also grabbed his Purple Heart, which he got from the explosion in Iraq. He said the only thing he could remember was he'd been wanting to die since he got home.

SAVELKOUL: Mainly, I guess I thought I was, you know, a failure for not finishing out or continuing my Army career.

ZWERDLING: But last month, we went back to Fargo, and we met with Brock Savelkoul again. He'd just finished more than two months of intensive treatment. He'd just turned 29. And he seemed like a different man.

(SOUNDBITE OF MUSIC)

ZWERDLING: Savelkoul is driving the same black pickup as the night he flipped out. But this time, he's smiling. He's going to counseling at the VA. He's checking out colleges.

SAVELKOUL: Without hope, you have nothing. Just waking up to the possibilities that I have, opportunities now to actually make some changes in how veterans are getting treatment for the future. And even if I'm just a friend that can tell them what I've been through, I know that can, hopefully, help them from going through the destructive path that I have gone through.

ZWERDLING: Just as we were putting this story together, a judge in North Dakota suspended the charges against Savelkoul, and he'll drop the charges in three years if Savelkoul keeps working on getting better.

Meanwhile, Savelkoul just bought a dog. It's a dachshund mix. He named it Lucky.

Daniel Zwerdling, NPR News.

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