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TBI (Traumatic Brain Injury), Iraq and neuropsychology

You prob­a­bly have seen the news about Bob Woodruff’s own recov­ery and his arti­cles now to raise aware­ness about the plight of Iraq vet­er­ans.

In the arti­cle “A First­hand Report on the Wounds of War”, we learn how

  • Woodruff, 45, is launch­ing a mul­ti­me­dia cam­paign that includes appear­ances Tues­day with Oprah Win­frey and on “Good Morn­ing Amer­i­ca,” and the release of a book (In an Instant) writ­ten with his wife, Lee, about their ordeal.”
  • Woodruff’s report­ing packs an emo­tion­al punch because he is, quite sim­ply, a man who cheat­ed death. Nev­er before had an anchor for an Amer­i­can broad­cast net­work been injured in war. Woodruff instant­ly became a sym­bol of the dan­gers that jour­nal­ists face in Iraq, and is try­ing to use his high­er pro­file to illu­mi­nate the plight of sol­diers who strug­gle with these injuries far from the spot­light.”

This is not an iso­lat­ed exam­ple but part of a larg­er, and grow­ing, prob­lem. The Dis­cov­er Mag­a­zine arti­cle Dead Men Walk­ing: what sort of future do brain-injured Iraq vet­er­ans face?” dis­cuss­es what a great work the mil­i­tary is doing to pre­vent deaths of injured sol­diers in Iraq-with the unin­tend­ed con­se­quence that reha­bil­i­ta­tion ser­vices back in the US are com­plete­ly over­whelmed.

Neu­rophiloso­pher puts this prob­lem in a wider con­text with DoD is neglect­ing troops’ men­tal health.

For a bet­ter pre­spec­tive, this is a quote from our inter­view with Dr. Elkhonon Gold­berg on Cog­ni­tive Train­ing, talk­ing about the birth of mod­ern neu­ropsy­chol­o­gy dur­ing World War II:

Of course there weren’t advanced neu­roimag­ing tech­niques those days, so sci­en­tists could only spec­u­late about what hap­pened in healthy brains. But they could care­ful­ly ana­lyze what hap­pened with patients who had suf­fered any kind of seri­ous brain prob­lem, from strokes to trau­mat­ic brain injury. And this is how neu­ropsy­chol­o­gy was born: Alexan­der Luria, Vygotsky’s dis­ci­ple, and my own men­tor, was com­mis­sioned to help reha­bil­i­tate Russ­ian sol­diers with brain injuries dur­ing WWII. This pro­vid­ed invalu­able clin­i­cal mate­r­i­al for under­stand­ing the mech­a­nisms of the healthy brain. Much of mod­ern cog­ni­tive neu­ro­science rests its foun­da­tion in Luria’s work.”

We were recent­ly con­tact­ed by a trau­mat­ic brain injury sur­vivor who says:

As to your ques­tion, in 1967 there was not any neu­ro rehab giv­en to me. My par­ents nev­er told me that I should be affect­ed by the brain injury, so I was on my own to fig­ure things out…how to walk, talk, read, write and speak in com­plete sen­tences. I am not sure what to tell you with regards to spe­cif­ic ways that I taught myself. I just did it. Dogged deter­mi­na­tion, per­se­ver­ance in the face of dif­fer­ent fac­tors and then tweak­ing things as I grew old­er. I do not have a neu­ro road map to give you to give to oth­er peo­ple for their spe­cif­ic recov­ery. My only sug­ges­tion is that they should not give up on them­selves or let oth­er peo­ple place lim­i­ta­tions upon them. I am still tweak­ing life. Hope this helps.”

Good quote: “My only sug­ges­tion is that they should not give up on them­selves or let oth­er peo­ple place lim­i­ta­tions upon them. I am still tweak­ing life.”

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4 Responses

  1. David Wagner says:

    The idea that we don’t know enough about TBI to do more than burr-hole to relieve pres­sure is sil­ly, like we are lim­it­ed to the med­i­cine of pyra­mid builders.

    First, you reduce inci­dence of injury. Until 2006, line infantry and reservists were still being con­cussed by sec­ondary impact with the unpadded insides of their own hel­mets. The Army and Marine com­mands had to be arm-twist­ed by activists and Con­gress to issue all troops the $125 inte­ri­or hel­met padding that was stan­dard for airborne/SOF troops.

    IED-blast­ed troops that would not be allowed to return to col­lege sports until they had recov­ered men­tal acu­ity, are being ‘returned to duty with­in 3 days’, the mea­sure of effi­cien­cy in mil­i­tary med­i­cine.

    SecArmy Geren is still with­old­ing the 2007 Army TBI Task Force Report from Con­gress, 8 months after it was com­plet­ed.

    It is an ongo­ing scan­dal, from the re-injury of impaired sol­diers, to the months of wait­ing to BEGIN treat­ment after dis­charge. Write your Rep­re­sen­ta­tive and remind them that we have a duty too, to know what we are vot­ing on.

  2. Alvaro says:

    David, you are right in that much is known on how to help pre­vent TBI in a vari­ety of con­texts, from bat­tle to sports to dri­ving. And there are clear guide­lines on how to help the rehab process.

    I agree with you that what has been hap­pen­ing is far from what should hap­pen. Thanks for remind­ing us.

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