Trauma preys in private on soldiers

The bomb blasts in Iraq reverberate among troops too tough to acknowledge the symptoms.

By WILLIAM R. LEVESQUE, Times Staff Writer
Published November 22, 2007

Florida National Guard platoon sergeant Ernie Rivera poses for a portrait in his room at James A. Haley VA Hospital. Rivera hopes his story in coping with traumatic brain injury will benefit the men he commanded and also other soldiers who may not realize they suffer from traumatic brain injury.
	[Chris Zuppa | Times]

TAMPA - The blast from the roadside bomb lifted Sgt. Ernie Rivera's truck off the ground.

Rivera figured he was lucky to escape alive.

But in the weeks and months that followed, he was plagued by headaches, nightmares, a loss of concentration, overall malaise.

"I thought I was going crazy," said Rivera, a platoon leader with the Florida National Guard. "But I was always taught that a good soldier just sucked it up and didn't complain."

Rivera wasn't as lucky as he thought. The blast wave from that December bomb left a telltale wound as real as any piece of shrapnel.

Traumatic brain injury, or TBI, has become the signature wound of the war in Iraq, afflicting thousands of soldiers exposed to bomb blasts. To many, it is frustratingly elusive, hidden like a lethal yet invisible virus.

Rivera, now being treated at the James A. Haley VA Medical Center in Tampa, said the Guard never instructed his troops about TBI's dangers or symptoms. Now he plans to write a letter to the 150 men in his company warning them about this invisible wound he fears they will ignore.

"I had never heard of TBI," said Rivera. "When they told me I had it, I said, 'What in the hell is that?'"

The Guard said its soldiers are told repeatedly about TBI and encouraged to seek medical help if they display its symptoms, from headaches to insomnia.

Soldiers, the Guard said, are screened for TBI when they return from a deployment and then several months afterward.

"Can we do better? Absolutely," said Major Gen. Doug Burnett, who heads the Florida Guard. "But I have to professionally and respectfully disagree with him. If somebody wasn't listening, that's not good."

Burnett said all of the men of Rivera's company have been questioned about TBI and none expressed concerns after returning from Iraq last month. All have been briefed about its symptoms, he said.

The general said the Guard realizes some soldiers may fear stepping forward, thinking that TBI carries a stigma, like battle fatigue, or that it will delay their return to family.

The military, which has a macho culture of living with pain, is continually working on education, Burnett said. Troops don't like to admit anything that might be perceived as weakness.

"This is a combat war wound as real as a soldier being shot," said Mitch Perryman, a Pinellas Park-based brigadier general with the Guard who commanded Rivera's brigade. "There is no shame or dishonor for those suffering from these things."

He took only aspirin

Rivera, 38, a father of two who lives in the Orlando area, said he was a gung-ho leader who didn't tolerate whiners.

"If they came to me about something I thought wasn't a big deal, I just told them to shut up and suck it up," Rivera said.

He saw a doctor after the roadside bomb went off in northern Iraq, near the Syrian border. The blast wave had harmed his hearing, and Rivera said it was suggested he be sent back to the States for treatment.

But he didn't think anything was seriously wrong. His men needed him. He refused the ticket home.

The symptoms got worse. Headaches. Vertigo. Insomnia. Poor concentration. Memory loss.

He angered easily. Usually meticulous with paperwork, he started making mistakes.

Rivera said he still functioned. His performance evaluations were excellent. He and his men saw combat. He won two bronze stars.

But the problem was getting harder to ignore. Gunfire and small explosions, constant in a combat theater, made him wince in pain. His mind felt scrambled. He took only aspirin.

By this spring, his superiors insisted he see a doctor again. By then, the company was doing noncombat duty. Rivera relented.

While waiting for treatment in Kuwait, Rivera blacked out. He hit his head, causing more damage. In June, he was back in the States.

He stuttered for the first time in his life. He had trouble walking. His right side was weak. He felt like a stroke patient.

It dawned on him that this was no malingerer's crutch.

"I was the fittest, hardest-charging guy in the unit," Rivera said. "But this came up and got me. Now look at me. I can't even walk right."

A Purple Heart he once scorned as undeserved is on its way. Rivera said he will accept it.

Doctors say the blast wave of an explosion can cause real damage to the brain and is something akin to shaken baby syndrome.

Dr. Steven Scott, director of the polytrauma unit at Haley where Rivera is getting treatment, said the adrenalin induced by combat may mask symptoms until later.

Many troops, he said, fully recover. Often, like Rivera, they must relearn some motor skills and receive speech therapy.

A band of brothers

Rivera said he is on at least six medications and has improved dramatically since arriving at Haley six weeks ago. He walks with a cane. He no longer stutters. He wears a hearing aid in each ear.

Scott said many soldiers ignore the signs of TBI and he knows of many men who refuse, like Rivera, to leave combat.

"It's like a band of brothers feeling," Scott said. "No matter how bad the symptoms, they want to go back and protect their brothers in arms."

Rivera worries about his men, especially the 42 from his platoon. The former members of the 124th Infantry Regiment are scattered around the state, including Tampa Bay. In retrospect, he remembers their symptoms: headaches, rage, insomnia, crying.

He wants to make sure they know they are eligible for free care at the Department of Veterans Affairs for the next two years.

He regrets having been so tough on them.

"I was like everybody else," Rivera said. "I thought you were weak if you had to go to the doctor for headaches."

His wife, Shirley, said the husband who left for war is now a changed man. The couple runs a small business setting up stores to use credit cards.

"He always fought for his men when they got in trouble," she said. "He's got a good heart."

William R. Levesque can be reached at levesque@sptimes.com or 813 226-3436.

How to get help

Soldiers who want more information about traumatic brain injury can call the post-deployment health team at 1-888-734-7299, the Florida National Guard says.

[Last modified November 21, 2007, 23:43:46]