Brain injuries in Iraq put attention on invisible war wounds

FILE - In this Jan. 13, 2020 file photo, Iranian bombing caused a crater at Ain al-Asad air base in Anbar, Iraq. Ain al-Asad air base was struck by a barrage of Iranian missiles, in retaliation for the U.S. drone strike that killed atop Iranian commander, Gen. Qassem Soleimani. The Pentagon now says 50 service members have been diagnosed with traumatic brain injury caused by the Jan. 8 Iranian missile attack on an air base in Iraq where U.S. and coalition troops had taken cover in advance. (AP Photo/Ali Abdul Hassan)
FILE - In this Jan. 13, 2020 file photo, Iranian bombing caused a crater at Ain al-Asad air base in Anbar, Iraq. Ain al-Asad air base was struck by a barrage of Iranian missiles, in retaliation for the U.S. drone strike that killed atop Iranian commander, Gen. Qassem Soleimani. The Pentagon now says 50 service members have been diagnosed with traumatic brain injury caused by the Jan. 8 Iranian missile attack on an air base in Iraq where U.S. and coalition troops had taken cover in advance. (AP Photo/Ali Abdul Hassan) (Copyright 2020 The Associated Press. All rights reserved.)

WASHINGTON, D.C. – The spotlight on brain injuries suffered by American troops in Iraq this month is an example of America's episodic attention to this invisible war wound, which has affected hundreds of thousands over the past two decades but is not yet fully understood.

Unlike physical wounds, such as burns or the loss of limbs, traumatic brain injuries aren’t obvious and can take time to diagnose. The full impact — physically and psychologically — may not be evident for some time, as studies have shown links between TBI and mental health problems. They cannot be dismissed as mere “headaches” — the word used by President Donald Trump as he said the injuries suffered by the troops in Iraq were not necessarily serious.

Gen. Mark Milley, chairman of the Joint Chiefs of Staff and a veteran of combat in Iraq and Afghanistan, told reporters Thursday that the number of service members diagnosed with TBI from the Jan. 8 Iranian missile attack in Iraq was still growing. Later, the Pentagon said it had reached 64, up from the 50 reported earlier this week. Milley said all are categorized as “mild” injuries, but in some cases the troops will be monitored “for the rest of their lives.”

Speaking alongside Milley, Defense Secretary Mark Esper said the Pentagon is vigorously studying ways to prevent brain injuries on the battlefield and to improve diagnosis and treatment. Milley said it's possible, in some cases, that symptoms of TBI from the Iranian missile attack on an air base in Iraq on Jan. 8 will not become apparent for a year or two.

“We're early in the stage of diagnosis, we're early in the stage of therapy for these troops,” Milley said.

William Schmitz, national commander for the Veterans of Foreign Wars, last week cautioned the Trump administration against taking the TBI issue lightly.

“TBI is known to cause depression, memory loss, severe headaches, dizziness and fatigue,” sometimes with long-term effects," he said, while calling on Trump to apologize for his “misguided remarks.”

Rep. Bill Pascrell, Jr., a New Jersey Democrat and founder of the Congressional Brain Injury Task Force, faulted Trump for displaying “a clear lack of understanding of the devastating impacts of brain injury.”