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What You Don’t Know Can Kill You

A pattern of brain injury

U.S. Navy SEAL qualification training (SQT) students fire their M4A1 carbines from the prone position during a 36-round shooting test. U.S. Navy photo by Mass Communication Specialist 2nd Class Michelle Kapica/Release

The New York Times has a devastating article about a pattern of brain injury in soldiers that’s gone unrecognized for years. “Shell shock” is a colloquial term not used these days. PTSD has replaced it. Ironically, the original term could be more accurate.

The story examines a pattern of suicides among elite combat troops, Navy SEALs, some of whom have never been injured (gifted article):

The military readily acknowledges that traumatic brain injury is the most common injury from recent conflicts. But it is struggling to understand how many of those injuries are inflicted by the shock waves unleashed by troops’ own triggers.

[…]

People’s brains can often compensate until injuries accumulate to a critical level, {Dr. Daniel Daneshvar, chief of brain injury rehabilitation at Harvard Medical School] said; then, “people kind of fall off a cliff.”

Examination during autopsy of SEALs’ brains after suicide have revealed microscopic damage invisible to MRIs and not seen among civilians.

Combat never seemed to faze Mr. Collins, but near the end of his Navy career, he started to change in subtle ways that Ms. Collins pieced together only in retrospect. He began to avoid social gatherings. He struggled to sleep. He started to make strange, obsessive family schedules and become irritated when they were not followed. Some simple chores, like raking leaves into a tarp, started to confound him. He would step out the door to go to work, realize that he had forgotten his keys, go back inside to get them and then forget why he had returned.

All were signs of brain injury. But at the time, the military generally associated brain injury with big blasts from roadside bombs — something Mr. Collins never experienced. No one was telling the troops that repeated exposure to routine blasts from their own weapons might be a risk.

Mr. Collins’s mental health took a sudden plunge when he was 45. He had left the Navy and started a civilian job teaching troops to operate small drones. One morning, well before the sun was up, he called his wife in a panic from a work trip, saying he had forgotten how to do his job and had not slept in four days.

Since I just posted about being an engineer, when I began reading the following section I knew where it was going before it got there:

Dr. Perl said privacy rules bar him from discussing specific cases, but members of the families who provided brains to study say the lab found interface astroglial scarring in six of the eight SEALs who died by suicide. The other two SEALs, including Lieutenant Metcalf, had a different type of damage in the same blast-affected areas. Star-shaped helper cells called astrocytes in their brains appeared to have been repeatedly injured and had grown into gargantuan, tangled masses that barely functioned. The lab plans to publish findings on the astrocyte injuries soon.

Recent studies suggest that damage is caused when energy waves surging through the brain bounce off tissue boundaries like an echo, and for a few fractions of a millisecond, create a vacuum that causes nearby liquid in the brain to explode into bubbles of vapor. Those tiny explosions are violent enough to blow brain cells apart in a process known as cavitation.

Firing thousands and thousands of rounds from rifles tucked next to their cheeks in training if not in actual combat have left these men scarred in ways only a microscope can reveal. But their spouse and families see it in their behavior.

The men who died by suicide represent only a small fraction of the career SEALs with signs of brain injuries after years around blasts.

Now what? Energy weapons?

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