Iraq war's unseen injuries

Troops suffer brain traumas from repeated bombings

ENCINITAS - At a community hospital here, doctors and therapists are working to help Marines overcome what is often called the signature injury of the Iraq war: brain trauma with no visible wounds.

''It's the silent injury,'' said Jessica Martinez, an occupational therapist at Scripps Memorial Hospital Encinitas. ''With every blast they suffer, their brain is rattling like a yolk in an egg.''

Marine Lance Cpl. Brian Vargas was a high school football player. Now, even though he looks fit, he cannot toss the football with his buddies, let alone be part of pickup games with other off-duty Marines.

''I can't catch anything,'' he said. ''I can't remember any plays.''

Vargas, 20, was subjected to innumerable mortar and roadside bomb blasts while patrolling the insurgent stronghold of Hit in the Euphrates River Valley. In mid-January he was shot in the hand and cheek by a sniper and airlifted to Germany and then the United States for treatment.

He has the classic signs of post-concussive injury.

''My thinking has gone down,'' he said. ''I can't remember what I did this morning. I have trouble putting memory and speaking together. I'm trying to learn to speak as clearly as possible.''

Lance Cpl. Keene Sherburne, 20, who was injured when a bomb exploded under his Humvee in Fallujah, is frustrated at the slow pace of his recovery.

''I can't read,'' he said. ''I used to love it, but now I hate it. I pick up a snowboard magazine and I get so mad because I don't understand it.''

Maj. Gen. John M. Paxton Jr., commanding general of the 1st Marine Division, said Marine leaders became concerned when they noticed that some Marines returning from Iraq were ''struggling emotionally.''

''It's like football or boxing injuries. You never know the cumulative effect,'' he said.

The surgeon general of the Army ordered a report done on traumatic brain injuries and possible treatment plans. The report is due May 1. Two battalions from Camp Pendleton have been selected for another study on brain injury assessment and treatment in Iraq.

One preliminary study at Walter Reed suggests that patients with mild traumatic brain injury are at greater risk of developing post-traumatic stress disorder than patients who have suffered even greater brain injuries through direct wounds.

Many of the symptoms of mild brain trauma and post-traumatic stress disorder overlap: anxiety, memory loss, depression, loss of concentration.