Real World Issues, Real Talk.
Iraq
BBC News – Iraq’s Maliki warns of Syria ‘proxy war’
Iraq’s Prime Minister Nouri al-Maliki has warned that arming either side in Syria will lead to a “proxy war”.
He was speaking at the opening of an Arab League summit which is discussing a joint plan with the UN to end a year of violence in Syria.
Syrian President Bashar al-Assad has agreed to the plan and will spare no effort to make it succeed, Syrian state news agency Sana reported.
The summit is the first such meeting in Baghdad for at least two decades.
President Assad’s remarks were contained in a message to the world’s emerging powers – Brazil, Russia, India, China and South Africa – who are meeting in Delhi on Thursday.
He said he would work to enforce the peace plan but “terrorism” must stop as well, Sana reported.
Iraqi murders put gay and emo youth on edge – CNN.com
Baghdad (CNN) — A recent rash of killings of people perceived to be gay or emo in Iraq has stoked fear within those communities, which worry the government might be unwilling or unable to protect them.
At least 14 such victims were killed in Baghdad in the past three weeks, according to a senior Interior Ministry official, who was not authorized to talk to the media.
Rights activists claim the number is actually much higher, with some suggesting dozens or more than 100 have been killed since February.
The killings appear to target people perceived to be gay, or emo — shorthand in Iraq for an in-your-face style of Western dress that favors tight clothes, long hair and the color black.
Most of the killings have taken place in Shiite neighborhoods like Sadr City, Shulaa, Ameen and Tariq, activists said.
“Ten days ago, I received a letter from militiamen threatening me that if they found me then they will not kill me like other ‘perverts,’ but they will cut my body into pieces,” a gay activist told CNN on Sunday.
The activist, who spoke on the condition of anonymity because of safety concerns, showed CNN a copy of a letter he said was distributed in Sadr City, identifying 33 potential “gay and emo” targets.
“We strongly warn every male and female debauchee, if you do not stop this dirty act within four days, then the punishment of God will fall on you at the hands of Mujahideen,” it read.
CNN could not confirm the authenticity of the letter.
The anonymous threats and murders come less than a month after the Interior Ministry released a statement on the so-called emo phenomenon, blasting it as Satanic.
It said the movement, which it described as young people wearing “strange and tight clothes with graphics such as skulls,” is being monitored by authorities with the goal of eliminating it.
To that end, community or “moral police” will be allowed to enter schools in the capital, the statement read.
The campaign and violence have had an immediate chilling effect among youth communities in Baghdad.
Teenager Kamel Saad told CNN he cut his hair so as not to become a potential target.
“I’m not the only one. All my friends in the school decided to change their hair style and change their clothes, too, even though we’re not emo or gay,” he said.
Saad said a group of men, who identified themselves as community police, entered his classroom two weeks ago and asked students to tell them about other students’ suspicious behavior.
“I thought it was about terrorism, but later, when the police explained more, we realized that they were talking about emo,” he said.
Car bomb and suicide attack in northern Iraq kill at least 12 people
By Al Arabiya with agencies
A car bomb followed by an attack by a bomber wearing an explosive vest killed 12 people in the northern Iraqi town of Tal Afar on Wednesday, police said.
A local official in Tal Afar said: “A parked car bomb exploded near a restaurant in central Tal Afar. Minutes later, a suicide bomber blew himself up in the crowd.”
Police and the official said 12 people had been killed and 15 were wounded in the attack. Tal Afar is near the border with Syria, about 420 km (260 miles) north of Baghdad and just west of the volatile northern city of Mosul.
via Car bomb and suicide attack in northern Iraq kill at least 12 people.
Wikipedia: Tal Afar is a city and district in northwestern Iraq in the Ninawa Governorate located approximately 30 miles west of Mosul and 120 miles north west of Kirkuk. →
For Iraqis, Aid to Syrian Rebels Repays a War Debt – NYTimes.com
By TIM ARANGO and DURAID ADNAN
FALLUJA, Iraq — Not so long ago, Syrians worked to send weapons and fighters into Iraq to help Sunnis fighting a sectarian conflict; suddenly, it is the other way around.
A belated celebration of the Prophet Muhammad’s birthday on the outskirts of this western Iraqi city on Saturday quickly took on the trappings of a rally for Syria’s rebels. Young boys waved the old green, black and white flag Syria adopted in the 1930s after declaring independence from the French. Others collected money to send aid and weapons to the fighters opposing President Bashar al-Assad’s government across the border.
“I wish I could go there with my gun and fight,” said Sheik Hamid al-Hais, a tribal leader interviewed at his compound in Ramadi, the capital of Anbar Province.
It is increasingly clear that Syria’s sectarian war is becoming the regional conflict that analysts have long feared. The rush of recent events — including bombings and assassinations in Damascus and Aleppo, and intensifying violence in northern Lebanon coming directly out of the sectarian hostilities in Syria — suggest that the Assad government now also faces antagonists across its borders.
Like Iraq and Afghanistan before it, analysts say, Syria is likely to become the training ground for a new era of international conflict, and jihadists are already signing up. This weekend, Al Qaeda’s ideological leadership and, more troublingly, the more mainstream Jordanian branch of the Muslim Brotherhood, called for jihadists around the world to fight Mr. Assad’s government.
Nowhere is the cross-border nature of sectarian hostilities more clear than in Iraq’s western desert, where Sunni Arabs are beginning to rally to the cause of the Syrian opposition and, in the process, perhaps strengthen their hand in dealings with an antagonistic Shiite-led national government in Baghdad.
A weapons dealer who operates in Anbar, who said he goes by the alias Ahmed al-Masri, said, “Five months ago I was told that the Syrian brothers are in need of weapons. I started to buy the weapons from the same guys that I previously sold to — the fighters of Anbar and Mosul. I used to bring them from Syria; now it’s the other way around.”
The man said he was selling mortars, grenades and rifles, and that his contact in Syria was also an Iraqi. In some instances, he said Iraqis were giving away weapons, and in those cases he charged money only to transport them across the border.
“It’s a good business, but it’s not easy money,” he said. “It’s risky, but this is life.”
Tribal leaders and security officials describe a small but increasing flow of weapons to Syria from Anbar Province and areas around Mosul, the northern city that is a headquarters for Al Qaeda in Iraq. For some weapons smugglers the price of an automatic rifle has increased dramatically — to $2,000 from about $300, according to one account.
Abdul Rahim al-Shammari, the head of the provincial council’s security committee in Mosul, said explosives and weapons were being smuggled through the border village of Rabia. A weapons trader in the area, who spoke anonymously because of the nature of his work, described smuggling weapons parts in empty cigarette cartons and said he recently made a $4,000 profit selling a PKC rifle. Across the border, he said, some Syrians were trading sheep and cows for weapons.
The sympathies for the Syrian rebels here in Anbar are borne from centuries-old tribal connections and, as a region dominated by Sunni Arabs, a shared sect.
“We have common tribes and a common border,” said Sheik Ali Hatem al-Suleiman, interviewed recently at his mansion in Baghdad, where he keeps a pet lion penned in the front yard. Mr. Hatem described Mr. Assad as a “butcher” and said that men in Anbar, his ancestral home, were already trying to help the opposition. “Yes, they are giving weapons. They have to,” he said, adding that Anbar tribal leaders were to meet this week to discuss ways to support the rebels.
Meanwhile, Al Qaeda in Iraq, whose membership has declined substantially in recent years, is trying to take advantage of the violence in Syria. A recent report by the McClatchy news agency quoted unidentified American officials as saying that Al Qaeda in Iraq was behind two deadly bombings in Damascus and probably also the bombing on Friday in Aleppo. In interviews, American officials in Baghdad said they believed that was likely, but had no evidence to confirm it.
On Saturday, Ayman al-Zawahri, the ideological leader of Al Qaeda worldwide, issued a statement urging Muslims in the region — he specifically mentioned Iraq — to support the uprising, according to the SITE Intelligence Group, which monitors jihadist communications.
In Jordan, the influential Muslim Brotherhood issued a call to arms of its own, calling it a duty for Muslims everywhere to oppose Mr. Assad’s government in Syria in a holy war, using any means necessary. “Supporting the Syrian people and Free Syrian Army is a duty, as they are facing the injustice and oppression of the regime,” the group said on its Web site.
On its Web site, Al Qaeda in Iraq, also referred to as the Islamic State of Iraq, has stated, “a lot of Syrians fought side-by-side with the Islamic State of Iraq, and it is good news to hear about the arrival of Iraqi fighters to fight with their brethren in Syria.” The group has also advised Syrian rebels to use the type of roadside bombs that proved so deadly in the Iraq war.
Some leaders in Anbar, where Al Qaeda has very little support, insisted that their region’s assistance to Syria is only humanitarian. Officials in Falluja have said they are establishing a camp in the expectation of refugees.
“The people here want to help the people of Syria, not with weapons, but with whatever other help we can give them,” said Faisel al-Esawi, a member of the Anbar Provincial Council.
Referring to Syria’s open acceptance of hundreds of thousands of Iraqi refugees during the war here, he said, “we need to stand next to the Syrian people, just like they stood next to us.”
The Shiite-dominated central government in Baghdad has walked a fine line with its policy toward Syria, offering outright support neither to the Assad government nor the opposition.
“We are immediate neighbors,” said Hosyar Zebari, Iraq’s foreign minister. “It’s like Mexico for the United States. With a change in Syria, everyone fears the spillover.”
Mr. Zebari added, “this doesn’t mean we support Assad’s regime. We can’t really oppose the Syrian people.”
Iran’s influence also factors into how Iraq calculates its Syria policy. The Iranian government is perhaps the closest friend of the Assad government, and Iraq does not want to alienate Iran, which exerts a degree of political control over the Iraqi leaders and backs militias here. There is also the fear that if Syria collapses, Iran will compensate for losing an ally in Syria by expanding its influence over Iraqi affairs.
In Anbar, the anger toward the central government’s Syria policy is palpable.
Hours before the gathering Saturday in Falluja, a similar event was held at a soccer stadium in Ramadi. In celebrating the birth of the Prophet Muhammad, attendees also waved the version of the Syrian flag in use before the Assad family assumed power.
“We’re here to support Syria and we want to stop the bloodshed,” said Sheik Muhammad Hamis Abu Risha. “We want the Iraqi government to support the people, not the killers. They are helping the Syrian government kill those Muslims.”
via For Iraqis, Aid to Syrian Rebels Repays a War Debt – NYTimes.com.
All U.S. troops to leave Iraq by the end of the year – The Washington Post
Update: 1:05pm from CNN – President Obama on Iraq withdrawal: “Our troops will definitely be home for the holidays.” — “US is moving forward from a position of strength. The long war in Iraq will be over by the end of this year”
By Scott Wilson and Karen DeYoung, Friday, October 21, 12:19 PM
The Obama administration has decided to withdraw all U.S. forces from Iraq by the end of the year after failing to reach an agreement with the Iraqi government that would have left several thousand troops there for special operations and training.
President Obama and Iraqi Prime Minister Nouri al-Maliki spoke Friday morning to cement that agreement in a scheduled telephone call, according to people familiar with the agreement who spoke on the condition of anonymity. White House officials have yet to disclose the contents of the call, but Obama is scheduled to deliver a statement at 12:45 p.m. on the agreement.
BBC News – Suicide bomb kills 50 at Iraqi police centre in Tikrit
A suicide bomber has killed at least 50 people outside a police recruitment centre in the Iraqi town of Tikrit, officials say.
At least 100 other people were injured in the blast in the town, some 80 miles (130 km) north of Baghdad.
The toll from Tuesday morning’s blast was the highest from a single attack since a Baghdad church siege in October which killed more than 50 people.
Violence in Iraq has ebbed in recent years, but deadly attacks persist.
The bomber – wearing a vest packed with explosives – was in the middle of about 100 volunteers who were waiting outside the building to be interviewed, witnesses said.
Most of his victims were police recruits, officials say.
via BBC News – Suicide bomb kills 50 at Iraqi police centre in Tikrit.
aborigine, anthropophaginian, anthropophagite, anthropophagus, brute, bush dweller, cruel person, head-hunter, ogre, ogress, primitive, ruffian, savage.
I’m on a thesaurus kick.
Pick any of the above and it describes these brutish cruel savages. Any “person” that would settle on blowing themselves up and kill innocent civilians is beyond comprehension by reasonable, true, persons.
I get you’re angry and your only ‘salvation’ is Allah and the purported virgins awaiting your naive butt in paradise. But contemplation would reveal you are no man, or woman, of faith. You are no more than a sociopath, a psychopath, a person devoid of real human emotion that would curb your sinister endeavors. You are animal, not a good Muslim fighting the “infidels.” You are a desperate and pathetic miscreant reverting to the most despicable of crimes to find some misplaced sense of purpose.
Anti-US cleric Muqtada al-Sadr returns to Iraq – Associated Press
BAGHDAD (AP) — Iraqi officials say anti-U.S. cleric Muqtada al-Sadr has returned to Iraq after a nearly three-year absence.
Mohammed al-Kaabi, a Sadrist official in Baghdad, said al-Sadr was in the city of Najaf at his family home.
An official with Prime Minister Nour al-Maliki’s office confirmed a plane carrying al-Sadr flew into the southern city earlier Wednesday afternoon. He did not want to be identified because of the sensitivity of the situation.
It was not immediately clear how long al-Sadr would stay in Iraq.
Al-Sadr has not been seen in Iraq since 2007. He left the country and has been living in Iran. His forces have presented some of the main opposition to the U.S. since the 2003 invasion.
via Associated Press.
Noone Is Perfect. Not Even The United States.
Historically uninformed and disingenuous rhetoric that ‘America does no wrong’ does nothing to further America’s interests
As I write this I am aware and prepared for the groundswell of responses that will deem me “un-American” and anything but a “patriot” (whatever that means nowadays). We are a proud people, and we have reason to be, but we also are people, and do therefore have flaws. Our people, our government, our nation, like the rest of the world’s civilization is anything but perfect.
The rhetoric that has seethed in the United States for a while, particularly in the last decade, has centered around American perfectionism. When W. Bush was pressed on the Iraq War, with the full disclosure of no WMDs and links to terrorism, W. asserted he still would have proceeded with the War in Iraq. On a recent appearance on FoxNews Rep. John Boehner pronounced America has nothing to be ashamed of. His shortsightedness, disrespect for history, and arrogance is (unfortunately) not harbored by just Boehner. Not once in this appearance did Mr. Boehner ever mention any “mistakes” America has made. Boehner, like many, seems content with wearing their rose-colored glasses that America is perfect.
Fact is that no one is perfect. Nothing is perfect. No nation is perfect.
We are all human beings and nations run by flawed humans. One commonality shared by each and every person across the globe is that we all make mistakes. Mankind, whether by design or not, is adept at making mistakes. What makes a truly wise person and nation is a keen ability to learn and rebound from mistakes.
This piece is not to launch and assault on our nation. Far from it. I believe we are an extremely intelligent and well-intentioned nation. However, to proceed with governance and international diplomacy as if we have never made a mistake only hurts our efforts. We must learn from our history, our mistakes, in order to ensure the sustainability of our nation, of our greatness. The excessive pride and bravado needs to take a backseat to honesty and humanity. Few people, and nations, will wish to work collaborate with and support a nation, the United States, that stubbornly believes it is flawless.
To recover economically and to effectively combat terrorism we will need the assistance and partnership of our international friends. The cavalier, and cowboy, United States cannot “win” the War on Terror alone. The “perfect” United States cannot sustain itself without some help abroad. We as a nation of men and women are a product of our flaws. No one person and no one nation is perfect. We must not dwell on our mistakes, but we should acknowledge and be cognizant of them as we proceed politically.
(And to satiate those of you that will call me “un-American” and lacking “examples”:
• Grounds for the Iraq War. No WMDs. No ties to 9/11. No links to terrorism; that is until WE went in and created a terrorist breeding ground.
• Supporting Sadaam Hussein’s ascension to power in Iraq. Yes, our shortsighted interests in implementing a savage, but secular anti-Iranian, leader in Iraq to stem any Iranian influence was essential. That was until that sociopath, Hussein, we put into power started attacking neighboring nations and slaughtering civilians…
• Supporting and then deserting the Afghans in their war against the Soviet Union. That boogieman of Communism certainly was a tremendous launching point for the Taliban, al-Qaeda, and bin Laden in the war ravaged nation of Afghanistan.
• Start of the Vietnam War. Dolphins or torpedoes? Who cares? They’re Communists, let’s fight!
• Infecting Guatemalans with STDs. Oops, our bad… Hey, if we didn’t do it who’s to say they wouldn’t have done it to themselves? It was our own effort at abstinence only education… Was the recent ‘our bad’ enough for the Guatemalans?…
• …)
The world’s largest energy companies are ramping up oil drilling in Iraq, focused on fields near Basra
RT @wsj: The world’s largest energy companies are ramping up oil drilling in Iraq, focused on fields near Basra http://on.wsj.com/acovzT
Newsweek: “The Warrior’s Brain”
One family’s terrifying medical mystery could represent the military’s next big crisis.
by Andrew BastNovember 08, 2010Video muted: click volume for sound Standing By Her Man Brooke Brown, the wife of Marine Lance Cpl. David Brown, explains how her life changed after her young husband returned home from Iraq with mild Traumatic Brain Injury and PTSD.The worst was the day Brooke Brown came home to find her husband with a shotgun in his mouth. But there had been plenty of bad days before that: after he returned from a deployment in Iraq, Lance Cpl. David Brown would start shaking in crowded places. Sitting down for a family meal had become nearly impossible: in restaurants he’d frantically search for the quickest exit route. He couldn’t concentrate; he couldn’t do his job. The Marine Corps placed him on leave prior to discharging him. Brooke quit her job to care for him and the children. The bills piled up.
It sounds like another troubling story of a war vet struggling with PTSD. But Brown’s case is more complicated. In addition to the anxiety, he suffered a succession of mild seizures until a devastating grand mal episode sent him to the hospital covered in his own blood, vomit, and excrement. There were also vision problems and excruciating headaches that had plagued him since he’d been knocked to the ground by a series of mortar blasts in Fallujah four years earlier.
Maya Alleruzzo� / AP for Newsweek.comPHOTOS: Four wounded warriors share their tales of dedication and anguish, valor and intense personal victory
Brown, now 23, didn’t have any visible injuries, but clearly the man who left for Iraq was not the same man who returned. “Our middle son clings to David; he knows something is wrong,” Brooke, 22, explained late this summer. “Our 4-year-old doesn’t know what caused it, but he knows Daddy’s sick and he needs help.”
But what kind of help does Corporal Brown need? His case perplexed civilian doctors and the Department of Veterans Affairs. The headaches and seizures suggest that he is suffering from the aftereffects of an undiagnosed concussion—or, in the current jargon, mild traumatic brain injury (TBI). But some of his symptoms seem consistent with a psychological condition, posttraumatic stress disorder (PTSD). Or could it be both—and if so, are they reinforcing one another in some kind of vicious cycle? The person who knows David better than anyone, his wife, thinks it was hardly a coincidence that one of his worst seizures came on the day last year that his best friend was deployed with the Second Battalion, Eighth Marines, as part of President Obama’s surge into Afghanistan.
David Brown’s symptoms have placed him at the vanguard of military medicine, where doctors, officials, and politicians are puzzling out the connection between head injuries and PTSD, and the role each plays in both physical and psychological post-combat illness.
Invisible Wounds
The military reports that 144,453 service members have suffered battlefield concussions in the last decade; a study out of Fort Carson argues that that number misses at least 40 percent of cases. By definition, a concussion is a shaking of the brain that results from a blow to the head. Typical symptoms include headache, memory loss, and general confusion. For decades, head injuries were a challenge mainly for civilian doctors, who studied the results of auto accidents and football injuries. The best treatment, it was generally thought, was rest and time. And in the great majority of these civilian cases, the brain heals by itself in as little as a week.
Concussions sustained on the battlefield are another matter, and a vexing one. According to the Department of Veterans Affairs, symptoms such as vision, memory, and speech problems, dizziness, depression, and anxiety last far longer in men and women returning from combat. Why? Doctors suspect that the high-stress combat environment stifles the kind of recovery that would normally occur. More often than not, those unlucky enough to suffer a concussion in Afghanistan, or especially in Iraq, do so in stifling heat, “which can make the effects of a concussion worse,” says David Hovda, director of the UCLA Brain Injury Research Center. Then there’s the question of reinjury before full recovery. If an injured fighter reports symptoms that match the concussion watch list, he or she is pulled from action for 24 hours. (There’s currently no test for a concussion besides self-diagnosis, though the military is actively pursuing biomarker tests that could be done on site.) But in a macho military culture, admitting unseen symptoms that can take you out of the action doesn’t happen as often as it should. “If you ain’t bleeding, you ain’t hurt,” says Brooke of the military culture around head injuries.
Blood or not, evidence is mounting that battlefield concussions from these two long-running wars could result in decades of serious and expensive health-care issues for a significant number of veterans. After all, TBI is a relatively new problem of modern warfare. Thanks to technological advances, warriors are surviving what once would have been fatal blasts–but the long-term consequences of the impact are still unknown. Two years ago, the RAND Corporation published a comprehensive study, “The Invisible Wounds of War,” which highlighted brain injuries as a massive, and little-understood, mental-health issue for returning combat veterans. This summer the nonprofit journalism site ProPublica chronicled challenges in diagnosis of head trauma and breakdowns in care within the military medical system. Around the same time, the Senate Armed Services Committee called the brass from each of the military branches and the Department of Veterans Affairs to testify on the topic, and at the hearing senators expressed concern that head trauma may be a factor in service-member suicide.
The military’s concerns have arisen during something of a boom in concussion research in civilian institutions, and new research in sustained head trauma in athletes shows that repeated concussions can lead to a condition called chronic traumatic encephalopathy. This disorder, which can present 10 to 15 years after the initial trauma, is linked to depression and suicidal thoughts, as well as Parkinson’s, dementia, and even a devastating neurological condition resembling Lou Gehrig’s disease. Another study found that those who abused drugs and alcohol after a TBI had drastically increased rates of suicide attempts.
Suicide is a serious threat to the military: an August 2010 report by the Department of Defense showed that the military suicide rate comes to one death every 36 hours. In the past, suicide has been associated with PTSD—an issue armed forces across the world have been struggling with for years. “Nostalgia” afflicted Napoleon’s troops fighting his endless campaigns far from home. “Traumatic neurosis” and “shell shock” overcame British troops in the trenches of World War I. Col. John Bradley, head of psychiatry at Walter Reed Army Medical Center, describes today’s PTSD as the inability to dial back on the instincts necessary for survival in combat even long after one is out of danger. “If you go back to your family and you still feel like you’re in mortal danger, that creates a problem,” says Bradley. A common estimate inside the military is that 20 percent of veterans in combat experience symptoms of posttraumatic stress. Some 2.1 million service members have been deployed to Iraq and Afghanistan—implying more than 400,000 potential cases.
Connecting the Dots
But in Iraq and Afghanistan, the symptoms of PTSD are often complicated by TBI—a condition seen as a consequence of the fact that, thanks to better battlefield technology and medical care, more soldiers are surviving blasts that proved deadly in previous wars. Figuring out what’s caused by PTSD and what’s the result of a head injury isn’t easy, especially since the symptoms of TBI overlap with those of PTSD. “You may have been injured, may have lost a buddy during an attack,” says Bradley. “Traumatic brain injury has both a physical and psychological component, and so does PTSD.” After a concussion, one is almost certain to have headaches, but headaches are also common among people with a mental-health disorder. Concussions cause trouble sleeping—and so can PTSD. Difficulty concentrating is common to both. “It’s very difficult to determine if it’s a psychological problem or the results of an organic brain injury,” says Terry Schell, a behavioral scientist at RAND.
Scientists are just starting to understand if and how the two are connected. It’s been shown in animal models that a head trauma can make one more susceptible to PTSD. “Minor traumatic brain injury does not necessarily cause PTSD, but it puts the brain in a biochemical and metabolic state that enhances the chances of acquiring posttraumatic stress disorder,” says UCLA’s Hovda, who is part of a civilian task force of doctors and scientists commissioned by the military to assess how PTSD and TBI affect troops. They’ll meet in December to discuss whether troops suffering from both should receive special medical treatment. Hovda also played a key role in the development of the National Intrepid Center of Excellence, a military medical facility in Bethesda, Md., devoted to the care of returning vets who suffer from PTSD and/or head trauma. “When they get to Bethesda, or get home, a lot of times individuals will be suffering from symptoms related to these multiple concussions,” he says. “They don’t understand that it’s related to a brain injury, and they become very depressed and confused.”
Murray Stein, a neurologist at the University of California, San Diego, is leading a consortium of doctors and specialists through several clinical trials investigating the long-term effects of concussions mixed with high-stress situations. Stein suspects there’s more to the long-term effects of battlefield brain injuries than we now understand. “Right now it’s extremely controversial,” he says. “It’s simply too simplistic to suggest [TBI] and emotional symptoms can’t be linked.”
There’s not a lot research as of yet. Early on in the Iraq War, Col. Charles Hoge, then the director of mental-health research at Walter Reed Army Medical Center, surveyed some 2,700 soldiers about battlefield concussions and PTSD, as well as the extent of their injuries and the state of their current mental and physical health (relying on self-reported measures like days of work missed). In 2008, The New England Journal of Medicine published Hoge’s findings: battlefield concussions existed, perhaps in significant numbers, but “cognitive problems, rage, sleep disturbance, fatigue, headaches, and other symptoms” that had become commonplace among service members back home resulted almost entirely from PTSD. Hoge argued that attributing postcombat symptoms to the effect of concussions, which “usually resolve rapidly,” could lead to a large number of military personnel receiving treatment for the wrong problem—treatment that could actually make things worse for the patient and put undue strain on the health-care system.
In an interview with NEWSWEEK, Hoge agreed that there was a connection between the two conditions. “PTSD and battlefield concussions are interrelated, and they have to be treated as such,” he said. But he’s also standing by his findings that one should not be confused for the other. In his new book, Once a Warrior, Always a Warrior, published earlier this year as a mental-health handbook for veterans and their families, Hoge reiterates that “concussions/TBIs have also become entangled and confused with PTSD.” Battlefield concussions, he writes, are best diagnosed at the time of injury, and the more time that elapses, the more difficult it becomes to link symptoms to the incident.
That much is true: with shoddy records of brain injuries from the early parts of the wars in Iraq and Afghanistan, many veterans who could be afflicted by the long-term effects of battlefield concussions will have little—if any—documentation to rely on in their claims for disability benefits. And as evidenced by Lance Cpl. David Brown, in some cases those men and women could require a significant amount of ongoing care.
The Path Ahead
There’s another, unsettling reality, of course: that PTSD and TBI are far from the only culprits for Brown’s mystery symptoms. “Headaches are almost useless as a diagnostic,” says Barry Willer, professor of psychology at the University of Buffalo and an expert on concussions. He notes that headaches present for a large number of illnesses. And depression, anxiety, and trouble sleeping? Those are often the result of living with an unexplainable illness. In reality, the troops are coming home with myriad medical issues, some new, like TBI; some, like PTSD, as old as war itself; and some a hybrid of the two. The question is whether we have the tools and treatments to figure out which is which.
Brown finally found some respite thanks to Tim Maxwell, a fellow Marine, who was pierced in the skull with shrapnel in Iraq and later lost his leg to mortar fire. Maxwell has established a quiet network of wounded warriors and maintains a Web site on the topic, SemperMax. Earlier this year, he got wind of Brown’s struggle and helped get him back into the Marines and into the TBI ward at the National Naval Medical Center in Bethesda. Today, Brown’s back at Camp Lejeune, readmitted to the Marines and working to get medically retired. “I spend most of my time over at the wounded-warrior tent doing rehab,” he says. He’s taking Topamax, a drug usually prescribed to epileptics to stave off seizures, and it seems to be effective, despite the side effects. “He’s lost his speech for 30 minutes a couple of times,” Brooke says, but he hasn’t had any more grand mal seizures. His wife is fighting for him at every turn. “I’m going to stand by my man,” she said in August, and then stiffened her spine. “He stood for me over in Iraq. The least I can do is stand by him now.”
