A year to the week ago, I sat next to a ten year combat veteran on a flight from San Diego to Washington D.C while returning from Society for Neuroscience. Though I am not usually one to have a deep conversation with a complete stranger while packed like a sardine in full jet, I ended up having a very memorable conversation with this man whom I will call Bill. Though he was in plain clothes, I noticed his dogtags and asked him in what branch he served. He seemed willing to talk and told me that he was a Staff Sergeant in the Army and had served for 10 years. Bill had very peculiar mannerisms and he started to put back quite a few gin and tonics while on the flight. I told him about my uncle and grandfather serving in the army as non-commissioned officers, and he seemed to appreciate my knowledge of the military.

                Bill constantly shook his right leg, and I noticed that he had chewed his fingernails down to his cuticle. This behavior began to stop after he had about four drinks. He asked me about my trip to San Diego, and I told him about my work in the lab and some of the projects of my labmates. I happened to mention that Tory Gray was planning on doing a study with Traumatic Brain Injury (TBI), and at that moment, he began to open up. Bill had served for 8 years in Iraq and Afghanistan before an IED took out his vehicle near Baghdad on a routine night patrol. Judging by his expression, I knew that he had suffered little injury compared with others whom were with him. In the explosion, he suffered TBI, and had undergone extensive rehabilitation for both his head and right leg which suffered considerable injury. Bill also suffered from PTSD, and had attended a veteran’s awareness conference in San Diego which was simultaneous with SfN.  

                Bill was a sad case to see. He continued to drink on the flight until the attendant cut him off, but perhaps the most disturbing part was a running dialogue he gave me for the purpose of my “education.” He tried to explain how a combat veteran with PTSD thinks. “1,2,3,” he said. “Everything happens in threes. Allah Akbar, Allah Akbar, Allah Akbar, and boom… you’re friends face is on your flack jacket.” I remember this quote distinctly, and I tried to figure out what he meant by “everything happens in threes.” I have my theories, but I will save them for myself.

                22% of injures in combat are TBI, and 60-80% of all injuries involving explosions also include TBI. The combination physical injury and mental injury can make it very difficult for veterans to recover quickly. While many people may suffer concussion symptoms for only a few months, many veterans with TBI report symptoms up 18 and 24 months after their injury. PTSD accounts for much of this persistence as many of the symptoms overlap with those of TBI, and veterans who have experienced years of combat are at severe risk for developing PTSD especially when combined with TBI. Soldiers with PTSD/TBI have a difficult time returning to their life in the states. “You just don’t turn it off,” Bill said. This war has seen a dramatic increase in TBI, and many more soldiers are being diagnosed with PTSD. I am sure that we all know that the field of combat has changed, though none of us can truly understand what that means.

                Bill also mentioned that the military made Bill’s diagnosis quite difficult, and they continued to tell him that he would get better. They had prescribed him anti-anxiety medication, and informed me that it helps only so much. Much to my surprise, Bill was scheduled for redeployment into combat despite his severe symptoms, and I can only imagine where he is now. Very soon, we will have many veterans returning home from combat, and they’re lives will be difficult. After you are discharged from the military, therapy and proper treatment for PTSD/TBI can be expensive despite government programs aimed at helping soldiers, and many veterans turn to substance abuse to ease their pain. If the government is willing to overlook this trend, then maybe it is up to civilians to encourage and fund treatment programs for those who have experienced unimaginable horrors. I know people like Bill are searching for help and answers, and they should not be difficult to find.

http://www.ptsd.va.gov/public/pages/traumatic_brain_injury_and_ptsd.asp