In 1992, Alan Beck injured his head in a car accident. Despite months of rehabilitation, the incident has left him forgetful. He recently lost $3,000 cash that he’d just been paid. His marriage ended because his wife couldn’t cope with his mood swings. He couldn’t maintain his job as a TV producer on a prestigious show.
“Twenty-three years later, it is still impacting my life,” says Beck. His face is drawn older than his 53 years. His words sometime slur and his struggle to speak can make him appear drunk. He hasn’t had alcohol since he was injured. He hasn’t been able to hold down a steady job and relies on his gift for photography to pay most of his bills. He is usually even-tempered but irritability can flare up quickly, a hallmark in three-quarters of those who have a traumatic brain injury (TBI).
TBI is, scientists tell us, an unseen epidemic. The Centers for Disease Control and Prevention says that it sees 2.2 million emergency room visits a year — 280,000 hospital stays, and 50,000 deaths. These figures do not include veterans. “Total combined rates of TBI-related hospitalizations, ER visits, and deaths climbed slowly from a rate of 521 per 100,000 in 2001 and then spiked sharply in 2008 and continued to climb through 2010 to a rate of 823.7 per 100,000.”
The reason for the spike? The wars in Afghanistan and Iraq had the military start to screen for TBI in 2006. The Pentagon says it has documented half a million cases of TBI. But it is still an injury we don’t understand very well.
There are probably around 8 million Americans living with TBI, and many have not been accurately diagnosed. Their mood swings, anger, concentration problems, depression, clear fluids draining from their eyes or nose, headaches, persistent nausea, tiredness, and sleeping problems (among other issues), are often wrongfully diagnosed. The impact of a TBI can often reveal itself as late as two decades after the traumatic event. It also mirrors symptoms of post-traumatic stress disorder, and can even coexist with or add to those symptoms, according to the National Institutes of Health.
Among adolescents and adults who receive rehabilitation for TBI, two in 10 will die five years post-injury, and nearly four in 10 will experience declines in function from the level of recovery one to two years after their injury. The leading causes of nonfatal TBI within the United States are falls (35 percent), motor vehicle-related injuries (17 percent), and strikes or blows to the head from or against an object (17 percent), such as sports-related injuries.
However, according to research by Johns Hopkins University, since 2001 at least 260,000 injuries result from wars. Many victims are like Chief Petty Officer John Fleming, recipient of a Bronze Star with Valor after accompanying the Navy SEALs on more than 77 missions. An explosives ordnance disposal technician, during his service he unearthed and destroyed many improvised bombs. Years later, he began forgetting things and having trouble organizing ideas. He was demoted. Medical tests revealed that he had suffered a mild TBI, likely from a truck rollover in Iraq nine years before combined with being so close to countless explosions.
His brain injury is similar to those sustained by many football players and is almost a guarantee of dementia (whose onset could occur as early as at age 36). Notably, one does not have to experience an actual concussion for a TBI to occur, subconcussive injuries as well as other unseen damage can have just as bad effects.
Fleming’s medical diagnosis did not impress his military superiors and he is now locked in a legal battle with them, as are thousands of others documented by researchers at Baltimore’s Johns Hopkins Hospital — not merely in an effort of retaining their jobs, but in hopes of receiving the medical care they desperately need. Johns Hopkins has found that only one in five veterans who sustained TBI between 2003 and 2010 actually had their issues documented. It is estimated that some 32,822 soldiers did not receive the treatment they deserved.
For most, their worst battle is to get the military to acknowledge the damage and give them the medical treatment and care they deserve, according to the Journal of Head Trauma Rehabilitation.
Sports injuries, especially hard contact sports like boxing and football, are primary villains of TBI. As the evidence has been accumulating, some key players have withdrawn from the game and many parents are concerned about the impact that playing a contact sport may have on their kids’ future. A recent presidential budget included a $5 million increase for research into sports-related TBI in children.