Brain trauma the 'signature injury' for Iraq vets

On Mar. 19, 2004, Corporal Justin Bunce was on patrol in the Iraqi city of Husayba on the Syrian border when a bomb exploded in the wall of a cemetery. The blast sent shrapnel into nearly every part of his body and knocked Bunce into a coma for four days. When he was airlifted to Landschtul military hospital in Germany, doctors found that some of the shrapnel had lodged in the left frontal lobe of his brain. "Because of my injury, making new memories is hard as hell," Bunce, now 25, told a recent gathering on war and brain damage in Washington. "I've been leaving myself a dozen voice mails every day." More than 4,000 U.S. veterans of Iraq and Afghanistan have been diagnosed with traumatic brain injury, most often from gunshots or blasts from roadside bombs. "My left side is paralyzed so I put it to good use. At least I can write on it," he said. "By the end of the day, it looks like it's tattooed." Because of its frequency, many are calling physical brain damage the "signature injury of the Iraq war". Most observers believe the real number of soldiers suffering from traumatic brain injury is much higher. A recent Army study found that 18 percent of troops who have been to Iraq (approximately 320,000 people) likely suffered at least some brain damage from improvised explosive devices, or IEDs. Despite the severity of his injury, Justin Bunce is lucky. His father is retired Air Force Colonel Peter Bunce, a politically connected lobbyist who now works as president and CEO of the General Aviation Manufacturers Association. As a result, he's been able to navigate the myriad of Pentagon and Veterans Affairs Department bureaucracies necessary to get his son top-notch care at Walter Reed Medical Centre, the Defense and Veterans Brain Injury Center in Charlottesville, Virginia. But even with all that care, Justin still walks with a cane. Parts of Justin's body remain paralyzed. "He still has shrapnel is his brain and he lost his right eye over there," father Peter Bunce notes. Peter Bunce says his son's life will never be the same. "The other shrapnel wounds from the rest of his body have healed but when you have a left frontal lobe injury, part of the governor that keeps you and I from saying things that we might be thinking but not vocalizing kind of goes away. When you take a 25-year-old man -- especially when there are young ladies around -- the things he says are unpredictable and definitely a lot of the time not appropriate." Most of the estimated 300,000 US soldiers and veterans who have suffered brain injury have not had an experience as dire as Justine Bunce. "I was exposed to my first possible traumatic brain injury when a 75-pound tank hatch fell on my head," said Sergeant Patrick Campbell, a National Guardsman who now serves as legislative director for the organization Iraq and Afghanistan Veterans of America. "I knocked myself out," he said. "And because I was the medic I told everyone 'I'm good. Let's go.' But I knew that I wasn't." It was one of many head injuries Campbell sustained in Iraq. "While I was in Iraq, I was involved in many motor vehicle accidents," he said. "We flipped a tank. We flipped a humvee. While I was there, I had a mortar rocket land about 15 feet from me. Thankfully, I was standing on the other side of a wall but just the wave of air [from the munition] almost knocked me over." Like most servicemen who served in Iraq, Campbell has not received treatment for traumatic brain injury. And on the surface, he doesn't seem to need it. A former student body president at the University of California, Berkeley, Campbell is now enrolled in law school at Catholic University in Washington. But Campbell says he's noted a change since his service in the war. "I have a real trouble remembering things," he said. "If I'm going somewhere I have to write it down. I write things on my hand all the time." At the urging of health care advocates, he took an on-line test for traumatic brain injury, which concluded that he has "severe short-term memory loss". He hasn't gone into treatment for the condition, but nonetheless found the test helpful. "It helped me understand what was going on in my life," he said. "For a lot of these guys coming back who are trying to deal with who they've become, understanding what happened to them will begin that process." Legislation proposed by Senator Barack Obama would mandate that the Pentagon screen all soldiers for traumatic brain injury when they return home from war. Senator Hillary Clinton has a bill that would appoint a Pentagon medical advocate for all patients with brain injuries to help them navigate the system surrounding their treatment. The pair is leading the pack of Democratic hopefuls for the presidential nomination. It's unclear, however, when or if Congress will vote on either of those bills. Veterans groups doubt either of them will be passed into law this year.