- WASHINGTON -- US Army First
Sergeant Colin Rich felt a pain that reached from the back of his head
down to his toes. It was, he would later recall, "literally very sharp
and dull at the same time." He slammed face-first into the hard December
- Rich, who had been directing his unit in a brief but
intense firefight in a remote area along the Afghanistan-Pakistan border,
immediately knew he had been shot in the back of the head. "I can
clearly remember the feeling of pain, anger, and helplessness as the battle
raged on around me," Rich, from New Boston, N.H., recalled yesterday.
- More than nine months later, his visible scars have healed
but Rich suffers the enduring effects of brain trauma: His vision has only
half returned, and he experiences mood swings and bouts of depression.
- Rich's experience is not uncommon for US troops. According
to military officials, roughly 20 percent of the wounds suffered by the
troops in Iraq have been severe brain injuries. And Major General Kevin
C. Kiley, commanding general of the North Atlantic Regional Medical Command,
said that figure does not even take into account milder neural injuries.
He estimated that as many as 70 percent of the wounds suffered by US forces
in Iraq had the potential for resulting in brain injury.
- Such injuries are not confined to combat: 1.5 million
people sustain traumatic brain injuries annually in the United States,
according to the National Brain Injury Research, Treatment, & Training
Foundation. And 50,000 Americans die from these injuries each year.
- Brain injuries are as old as battle, but only in the
last dozen years has the US military made a concerted, coordinated effort
to examine and track these wounds.
- "What is becoming obvious from the nature of injuries
we have seen over the last six to eight months [is] . . . bringing a lot
of awareness to the front of the battlefield that troops that get up after
the detonation and say `I'm OK' -- they may not be OK," said Kiley.
"We see that with sporting events: A quarterback gets hurt, you give
'em time off. We need to do that with our troops."
- Rich's injury was not so subtle: While the bullet was
slowed enough by his Kevlar helmet to save his life, it "punched a
hole slightly larger than a silver dollar in my skull," he said yesterday,
addressing the 2003 Congressional Brain Injury Awareness Fair. Five fragments
penetrated his skull, four of which were removed in surgery. He will carry
the fifth, lodged too deeply in his brain to safely reach, for the remainder
of his life.
- Rich, 40, considers himself a father twice over, to his
two children and to the men in his unit. But now, he said, he has been
forced into the uncomfortable position of depending on others. The 18-year
veteran has returned to Fort Bragg in North Carolina, but dreams of rejoining
his unit in Iraq.
- After the 1991 Gulf War, Congress founded the Defense
and Veterans Brain Injury Center at Walter Reed Army Medical Center to
more closely scrutinize neural injuries. The center is funded at $5 million
annually, though last year it received an extra $5 million. This year it
has only received $9.1 million, though advocates in Congress hope to add
$2.9 million when members of the House and Senate reconcile their versions
of the Iraq supplemental spending bill.
- That funding is paying off, Kiley said, in a greater
understanding of the injuries and an enhanced ability to detect cases far
more subtle than Rich's. "The piece that excites me is the idea that
we're in the position now where we can start to recognize the very mild,
very sophisticated brain injuries," Kiley said.
- Virtually all who suffer the injury, Kiley and others
said, require extra attention because, unlike lost limbs, severe neural
trauma is not always easily spotted. Though Rich's scars are still visible,
he said, people tell him that they would not know he was disabled. "Head
injuries are there," Rich said. "You don't have to see them."
- - Robert Schlesinger can be reached at email@example.com
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