I've been reading articles about the effects of modern medicine in the war on Iraq. Soldiers who previously would have died from serious injuries to the head, skull, and brain are now being saved from death. The Washington Post reports there are currently more than 4,700 casualties of the war on Iraq and the reason the number is not larger can be attributed to the marvels of modern medicine.
Why might this be a problem?
Injuries to the brain (traumatic brain injuries or TBIs for short) are the most prominent injuries of this war. Medical advances allow the military to patch up soldiers and ship them home alive. The Bush Administration does not count them as a "casualty", so we do not recognize them as a "casualty" of war, but I think this is grossly inaccurate. It gives us an unrealistic idea of how many "casualties" there really are and what the cost of this "war" really is.
Having worked intermittently with survivors of head injuries in the state hospital this causes me great concern. Traumatic brain injuries can cause any myriad of problems, from behavioral to cognitive to emotional to physical. Your brain controls everything, so when it's compromised it has the potential to compromise the entire system. What worries me the most are those who are affected behaviorally and cognitively. I'm no expert on this, but the few patients I've worked with who had TBIs were explosive, impulsive, and their higher thinking (judgment, impulse control, emotional control, etc.) was seriously impaired. I worked with a factory worker in the state hospital who had a TBI. By his history he was a mild mannered, outgoing, well-liked person. After the TBI he was hospitalized for shooting his mother in the face with a shotgun because the coffee she served him was too hot. This type of impulsive, violent behavior is not uncommon in some patients with TBIs and assaultive behavior is common.
Medication can be tried to help with the impulsivity and violent outbursts, but its effect is only minimal from what I understand. (If you know more about this, please enlighten me). I wonder if anyone is explaining this to the mothers and fathers, the husbands or wives, the children, of the veterans we are returning home in this condition? What effect will having impulsive, explosive people wandering around in our society have? How many soldiers are wandering around with TBIs? How are they going to interact with their wives or husbands? With their children?
The New England Journal of Medicine states,
"among surviving soldiers wounded in combat in Iraq and Afghanistan, TBI appears to account for a larger proportion of casualties than it has in other recent U.S. wars"
and cites an estimate of 22% of all injuries treated involve TBIs. The Veterans for Common Sense website quotes from various doctors,
"'Unfortunately, this may be what we are now creating, a whole population of people who are going to be mildly to moderately brain-injured,' said Dr. Sheldon Goldberg, medical director of Porter Adventist's rehabilitation unit. 'Just as Christopher Reeve's spinal-cord injury brought spinal- cord injury into the limelight for the public to try and understand, I think very sadly our returning Iraq veterans are going to be bringing traumatic brain injury into the limelight now.'"
"'When you consider that 1.5 million people have served in Iraq [and Afghanistan], that's 150,000 to 300,000 people who have TBI, and that's an enormous, enormous problem that requires immediate action,' said Paul Sullivan, executive director of Veterans for Common Sense, a nonprofit advocacy group for vets."
A USA Today article warns that,
"The newly discovered brain damage at the cellular level can be permanent — especially after repeated exposures to blasts".
As someone who works in a culture that is already heavily laden with domestic violence and trauma this makes me shudder. But these are not casualties? Not only is the soldier a casualty, but his entire family is compromised by this very debilitating injury.