LINDA WERTHEIMER, Host:
Our story showed that some commanders do not believe that concussions, which are also called mild traumatic brain injuries, are really injuries. NPR's Daniel Zwerdling has the story, which was co-reported by T. Christian Miller of ProPublica.
DANIEL ZWERDLING: The Army's announcement should make it easier for soldiers who get concussions from explosions to get Purple Hearts. But General Pete Chiarelli says this is about more than the medal itself. Chiarelli is the number two general in the Army. He says the Army's main goal is to diagnose every soldier who has TBI, and then give them better treatment. But Chiarelli says the new guidelines on Purple Hearts send an important message to every commander.
PETE CHIARELLI: It's important to all of us. That shows to everyone that these hidden injuries are truly injuries. Those injuries must be treated, and soldiers must receive the entitlements when they suffer those injuries at the hands of the enemy.
ZWERDLING: An Army spokesman says the new guidelines are not official yet. They're sitting on the chief-of-staff's desk. He's the number one general. They're waiting for his signature. But General Chiarelli says he started looking into this issue late last year. First, he asked commanders who run the Army's awards program a simple question: How many soldiers who suffer TBIs have been rejected for Purple Hearts? Dozens? Hundreds? Thousands? And the commanders couldn't answer.
TOM QUINN: We don't have a reliable database.
ZWERDLING: In other words, you have thousands and thousands and thousands of records having to do with Purple Hearts and other awards on paper, and boxes - basically - in a warehouse.
QUINN: That is a fair statement.
ZWERDLING: How long would it take you? How many man-hours would it take you to find that answer?
QUINN: I couldn't even speculate.
ZWERDLING: Weeks, months?
QUINN: I couldn't give a number. It would be a huge task.
ZWERDLING: So Chiarelli said OK, let's do a sample investigation. They pulled nine files of soldiers who got TBIs. Three of those nine got Purple Hearts, as the regulations say they should. A couple soldiers did not get Purple Hearts because their TBIs were not caused by enemy action. As for the other four soldiers, Chiarelli says they clearly deserved Purple Hearts, but their commanders didn't award them.
CHIARELLI: What's clear to us is that there's confusion about concussion in the Purple Heart. There's confusion on the part of commanders, and there's confusion even on the part of doctors. And it just really upsets me. And it's hard for me to sit here and talk to you and in some way, make you feel that your reporting brought us to this place. But it did.
ZWERDLING: And here's why some commanders and doctors have been confused: When a soldier gets a concussion, the standard treatment right afterward is simple. Doctors tell them to get some rest, and to take some over-the-counter pain pills for their screaming headaches. But NPR and ProPublica found that some top commanders have been saying: Wait a minute; if that's the only treatment those soldiers are getting, those concussions aren't really injuries; no way they should get Purple Hearts.
WERTHEIMER: Yes, they should. A concussion is potentially serious. Sometimes, it can cause permanent brain damage, no matter what the treatment is.
NATHAN SCHILLER: My reaction is that pretty much, it's about time.
ZWERDLING: Nathan Schiller was injured in two explosions in Iraq. Army records document it. Now, his brain doesn't work right anymore. But commanders have rejected Schiller for a Purple Heart - twice. He says the Army's new guidelines are a step in the right direction.
SCHILLER: I want to believe General Chiarelli, that he wants to help, he wants to make a stand. But he's one person. You know, if they just make a big deal out of this for the next couple months because of what you guys at NPR are doing and things like that, and then it kind of just filters away, it'll just be like everything else. It'll just disappear, you know? If they keep track of the system and keep track of what's going on in it, I believe it will get better.
ZWERDLING: General Pete Chiarelli says he's determined to make it better. He's already spreading the word.
CHIARELLI: Good afternoon to all of you, leaders of the brigade. I really appreciate your being here today.
ZWERDLING: Unidentified Man #1: Climb to glory, sir. Third Brigade, 10th mountain. We've got our entire team here. Our battalion commanders and sergeant majors are here along with...
ZWERDLING: Chiarelli says every time a brigade is about to deploy now, he gives them a one-hour talk about concussions - or TBIs - and other invisible injuries. His main point is, you have to treat them seriously.
CHIARELLI: Next slide, please. Now, this slide shows you the enormity of the problem. Unfortunately, soldiers affected by...
ZWERDLING: And then Chiarelli drives the point home. He gives a sermon on Purple Hearts.
CHIARELLI: I promise you I still got leaders out there - and I got leaders out there even after I talk to them like I've talked to you today - that will deny soldiers a Purple Heart when they get a concussion. You don't have to lose eyesight or lose hearing or anything else. You are diagnosed by a doctor or a medical professional. If that doctor diagnoses you with a concussion, you are - based on enemy action - you are entitled to a Purple Heart, end of subject.
ZWERDLING: Army officials say they're going to send that message to military groups and veterans organizations all around the world.
CHIARELLI: Unidentified Man #2: Climb to glory, sir.
ZWERDLING: Daniel Zwerdling, NPR News.
WERTHEIMER: See our original investigation, and learn about the history of the Purple Heart, at NPR.org.
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