Suicide Watch by Sarah Stillman
The director of the National Institute of Mental Health says that more Iraq and Afghanistan veterans may die from suicide than from combat. So why isn't the Pentagon protecting our soldiers off the battlefield?
Post Date Monday, May 19, 2008
As the Iraq war grinds into its sixth year, policy-makers in the U.S. would do well to remember the story of Phineas Gage. For those in need of a refresher, the 25-year-old construction foreman lost a hunk of his frontal lobe back in 1848 when a three-foot iron rod shot through his left cheekbone and out the top of his head. Miraculously, Gage could walk and talk again just minutes after the accident, staying conscious on the three-quarter-mile oxcart trek into town, where doctors patched his wounds and sent him on his merry way.
But the tale didn't end there. In his post-accident years, Gage transformed from a levelheaded foreman into a forgetful, quick-tempered roustabout. He threw fits of "the grossest profanity" and wrestled with depression. He found it difficult to keep a job, and harder still to keep a woman. In the notebooks of his physician, Dr. John Harlow, America received its very first public account of the long-term demons unleashed by traumatic brain injury (TBI).
160 years after Gage's accident, medical experts are calling TBI the "signature wound" of the Iraq war.
An astounding 60 percent of troops entering Walter Reed Army Medical Center suffer from brain trauma as their primary or secondary malady, typically the result of an improvised explosive device. The physics look something like this: A roadside bomb sets off a blast wave that travels at a speed of 1,600 feet-per-second toward a soldier's vehicle. On impact, the blast rattles the soldier's brain against his or her skull--often leaving no visible scratches, but prompting closed-head traumas that can be hard to diagnose: torn cerebral tissue, internal bleeding, and relentless swelling of the brain's inner cavities.
Much like Phineas Gage, soldiers with serious TBI often suffer from irreversible forms of cognitive freefall, such as the loss of memory and language. As for emotional consequences, they also tilt towards depression, volatile moods, and all manner of creative self-destruction.
The long-term behavioral consequences of TBI--an ironic byproduct of new battlefield advancements such as Kevlar helmets that protect soldiers' lives but not always their cortical lobes--might offer the missing link in the growing debate over Iraq veterans' unprecedented suicide rates. According to new U.S. Army statistics, five soldiers try to kill themselves each day, compared to one soldier per day before the Iraq war.Last Monday, Dr. Thomas Insel, director of the National Institute of Mental Health, issued a controversial prognosis for the coming generation of American veterans: "It's quite possible that the suicides and psychiatric mortality of this war could trump the combat deaths," he told an annual gathering of the American Psychiatric Association. "We don't yet know how to predict who is going to be the person to be most concerned about."
Dr. Insel's prognosis drew on a recent 500-page study by the RAND Corporation, which concluded that
among the nearly 1.7 million who have served in Iraq and Afghanistan, some 300,000 veterans suffer from Post-Traumatic Stress Disorder (PTSD) or major depression, with nearly half of all cases going untreated. The study also highlighted a less widely-covered trend: Some 320,000 troops returning from both wars are plagued by traumatic brain injuries--again, with only half seeking treatment.more...
http://www.tnr.com/politics/story.html?id=78f6ef54-a282-454b-a8f7-1c4db913cdc7
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