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By Associated PressTraumatic brain injuries make up 14 to 20 percent of casualties in combat.
WASHINGTON - Brain injury specialists at the Army's premier medical center have taught Spec. Jamie Brown how to exercise his mind.
He is learning to recall the last thing he read and remember the next place he is going, just as he learned to be a cook and college student in civilian life - and a forward artillery observer for the Indiana National Guard.
Brown, 22, knows progress can be slow after a grenade explodes in your tent and the blast sends you hurtling into a metal pole.
Brown came to Walter Reed in a medicated stupor in early December. At the combat hospital in Iraq, he learned that he had lost a kidney, his adrenal gland and spleen. His pancreas was damaged. Shrapnel in his stomach caused a stabbing pain.
And his brain was damaged.
Brown became a patient in the Defense and Veterans Brain Injury Center at Walter Reed. It is one of eight brain injury facilities run jointly by the departments of Defense and Veterans Affairs. The centers report that traumatic brain injuries now account for 14 percent to 20 percent of casualties for those who survive combat.
Brown was lucky, his doctors said. His brain damage was mild enough to permit recovery, even though he was not wearing body armor or his helmet.
"He's made remarkable progress," said Dr. Lou French, a neuropsychologist who has been guiding Brown through rehabilitation.
French and other specialists have tried to improve Brown's memory, problem solving ability, speech, use of language and speed in making decisions.
Among the techniques are:
a short story about a storm, with a dozen details to be recalled.
plastic balls, arranged in patterns, to be duplicated by the patient with the fewest number of moves.
14 minutes of nonstop concentration on a computer screen, with a mouse click needed every time a designated letter appears.
pictures of objects to identify, as common as an acorn and as infrequently seen as a mathematical protractor used for measuring angles on paper.
"It was very draining," Brown said.
Brown was injured on Nov. 20, 2003, in Iraq while sitting in his tent. He said he was watching a movie when a grenade exploded about 8 feet away.
"The next thing I know, boom. I can remember feeling the heat, I can remember seeing the dirt and the sand fly everywhere," he said.
Brown arrived at Walter Reed two weeks later. For a while, every day was a blur. His weight had dropped from 170 pounds to 110. He awoke one day to find his wife next to him.
"My first day of full consciousness," he said.
Brown's first test of retention and memory "suggested he wasn't retaining things the way he should," French said.
"He had a tendency to get an idea in his head and he couldn't let it go. There would be one part of a story he would keep repeating. He couldn't remember other parts," the doctor said.
Someone with major brain trauma often loses confidence, said Dr. Deborah Warden, national director of the government's brain injury network.
She has seen brain-injured soldiers wait until the mess hall was about to close before arriving for meals, just to avoid crowds, the cacophony of many conversations and the sudden sound of a dropped tray.
Many soldiers experience what she called blast-plus injuries: the initial explosion which can jar the brain, followed by the kind of blunt trauma Brown experienced when he hit his head.
A neurologist and psychiatrist, Warden said she is trying to link together the experiences of blast victims to see whether there is a common thread in their injuries that may lead to new treatments. "It's important for us to find out if blast patients are different," she said. "We're looking into it vigorously. We're linking together their stories about injuries, problems, the immediate aftermath."