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Monday, November 28, 2022

OPINION:

Not everyone has a job that requires them to be ready for a blow to the head. Among an elite category of athletes, first responders and outdoor enthusiasts who knowingly take such risks are America’s fighting forces, who are exposed so often to traumatic brain injury (TBI) that Massachusetts General Hospital and the Boston Red Sox joined together to form the nation’s first private sector clinic for veterans called Home Base. The innovative TBI programs developed by Home Base have uniquely addressed the complex injuries suffered by our special operations forces members and veterans, assisting them in reclaiming their lives.

Head injuries are a silent killer, an invisible wound that ends jobs, marriages, mental health and even lives as the suicide rate among those who have suffered brings the high personal cost of war into homes across America.


The scale of the problem is immense. Recently, the sporting world watched in horror as Miami Dolphins quarterback Tua Tagovailoa suffered a concussion, resulting in scrutiny of NFL concussion standards. In baseball this year, “Marlins pitcher Daniel Castano suffered a ‘mild’ concussion” after taking a 104 mph line drive to the head. This month in England, a cyclist took his own life after struggling with the aftereffects of a head wound from a crash.

Those are serious incidents, multiplied by the hundreds of thousands in the military. “Between 2000 and 2021, the U.S. Department of Defense diagnosed more than 444,300 service members as experiencing at least one traumatic brain injury (TBI) during their military service,” according to Rand Corp. research.

Enter Home Base. What’s exciting about the program isn’t just the breakthroughs helping our service members; it’s also the treatments being developed for anyone who’s suffering the aftereffects of a head injury. 

During the intensive course of care, chronically suffering service members who’ve struggled for years can see a 50% to 75% reduction in their systems.

“Effective care begins with early diagnosis,” says Dr. Ronald E. Hirschberg, a physiatrist in Boston working with the program. “We have early identification in the cancer world and in the heart world. It’s mainstream, but not yet for head injuries.” When this technology becomes available to the military, sports teams or the public, it will become a game-changer.

But sadly, people often ignore the warning signs that tell medical professionals someone is in trouble. 

Mary O’Meara, Home Base nurse director and TBI nurse on the frontlines of treatment, says that after an initial recovery time, it’s important to watch for horribly debilitating headaches, vomiting, sleep problems, unusual anger and irritability, along with dizziness and memory issues, though one obstacle is often the very toughness of the people who need it.

“It used to be called ‘getting your bell rung,’” she observes. “No one wanted to admit that they lost consciousness and saw stars; they just kept going.” That pattern can be a problem when the mind is at stake.

The regimen of healing a head injury isn’t a single event or pill, but a series of treatments and exercises as the brain is retaught to process and given time to heal. Dr. Hirschberg notes that treatment includes physical therapy and plain old exercise for stress relief, skill building, and rebuilding pathways in the brain through repetition.

And then there is counseling to process all the changes taking place. At Home Base, focused so intently on those from the military, “veterans heal veterans,” observes Dr. Hirschberg, who majored in anthropology as an undergraduate. People understand your worldview and experience as well as connect to new survival tools embraced by your peers.

“The very bizarre thing about brain injury from trauma is that you’re only likely to get better,” says Dr. Hirschberg. But how soon and how much better?

For Ms. O’Meara, a Navy special operations specialist who cared for those whose job was disposing of bombs in the field, the aftereffects of TBI stick with her. A soldier’s marriage was in shambles as he struggled with anger, dizziness, and body and back pain, along with trouble thinking clearly. 

“It’s not that he was the worst case I’ve ever seen, but in two weeks, he went home without headaches, neck pain and dizziness. He could have a life,” she said.

Life really is on the line.

Suicide rates among those who’ve served are at record highs, in part because of debilitating health conditions. We need to innovate our treatment plans for the men and women suffering today. Home Base’s advances in traumatic brain injury treatment are an answer to the question of how best to say thank you for your service.

• Retired Army Brig. Gen. Jack Hammond serves as executive director of Home Base and its National Center of Excellence for Veteran Mental Health and Brain Injury. He also leads an advisory board at NanoDX focused on traumatic brain injury diagnostics.


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