‘There is a bias toward invisible wounds, injuries'

Sixty-six percent of the most seriously wounded soldiers returning from Afghanistan and Iraq have “invisible” injuries of brain trauma or post-traumatic stress, which their families and society will be dealing with at great cost for decades, said Gen. Peter W. Chiarelli, the Army’s vice chief of staff.

“The truth is, because we don’t see these injuries, they don’t receive the same level of attention as amputations, burns, shrapnel injuries,” Chiarelli said. “There is simply a bias – and I really mean that – there is a bias either conscious or subconscious toward invisible wounds and injuries. It exists everywhere, including in the medical community.”

Chiarelli made his remarks Monday at Defense Forum Washington, a one-day conference on support for wounded warriors and families as they struggle to heal and regain stable lives. The annual event is co-sponsored by U.S. Naval Institute and Military Officers Association of America.

Before Chiarelli spoke, April Marcum, wife of retired Air Force TSgt. Tom Marcum, described for attendees how her husband saw that bias from the medical community when he returned wounded from Iraq in 2008. A combat arms training and maintenance specialist with 12 years in service, Tom had been in charge of an armory on Ali Air Base Iraq when a mortar round fired by insurgents exploded 35 yards away, knocking him unconscious.

When he could, Tom called April to say that, except for a headache, he was OK. A medic told him he should rest a couple of days before returning to duty. But when Tom’s tour ended several weeks later and he returned to Moody Air Force Base, Ga., April could tell he wasn’t himself.

“He still had the same headache. He was confused at simple things. He had short-term memory loss. The last straw for me was the day he called me on his way from work, and said, ‘I can’t remember how to get home,’” April recalled, tearing up. Tom, at her side, let April speak for the family.

“The local medical community, including the Air Force medical clinic doctor, seemed to be reluctant to help,” April continued. “Tom’s primary care doctor implied Tom was trying to get out of work. This was a slap in the face to both of us” considering that, with two boys to raise, neither Marcum had ever complained during any Tom’s various deployments.

“Then the doctor made this statement: ‘I’ll write you a prescription for Motrin but you really need to suck it up and go back to work,’” April said.

Eventually Tom got a thorough evaluation at the poly-trauma unit of the VA Medical Center in Tampa, Fla. Doctors diagnosed traumatic brain injury with an orbital wall blowout fracture behind an eye. A shoulder required surgery. Tom also had hearing loss, vision deficit and post-traumatic stress disorder.

April said she had to quit her teaching job to care for her husband and raise their sons. While living on 70-percent disability payments from the Air Force, and Social Security Disability Insurance, the Marcums have exhausted their savings, she said.

Chiarelli, after his own remarks, took a question from April about how the Army conducted some tests on her husband and the Air Force later would not accept the results because they appeared on an Army evaluation form.

“I honestly believe it relates back to the stigma” tied to these invisible wounds of war, Chiarelli told her.

To reach military columnist Tom Philpott, email milupdate@aol.com or write to Military Update, P.O. Box 231111, Centreville, VA 20120-1111.