Trump Downplays U.S. Soldiers' Head Injuries, But Combat Brain Trauma Can Be Serious

Jan 22, 2020
Originally published on January 22, 2020 6:51 pm
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ARI SHAPIRO, HOST:

Around a dozen American service members have been flown from Iraq to Germany to be treated for head injuries. They were hurt when Iran attacked a base with missiles earlier this month. Today in a press conference in Davos, Switzerland, President Trump downplayed the severity of their injuries.

(SOUNDBITE OF ARCHIVED RECORDING)

PRESIDENT DONALD TRUMP: I heard that they had headaches and a couple of other things, but I would say - and I can report - it is not very serious.

SHAPIRO: Well, actually, research shows that these sorts of injuries can be very serious. We're joined now by Dr. David Cifu of Virginia Commonwealth University. He's the head of a nationwide research group looking at the effects of combat-related traumatic brain injuries.

Welcome.

DAVID CIFU: Thank you.

SHAPIRO: What was your reaction to President Trump's comments this morning?

CIFU: Well, you know, rather than take the obvious, you know, route - which is, you know, how can he not know about this? - I think what it actually reflects is a very common thing in America and, probably, the world in that people don't understand concussions or mild brain injuries and don't understand both how they're diagnosed and how they're treated but also, you know, how severe they can be. It's often called, you know, an invisible injury, which is fairly absurd. So, you know, it was actually more in line with that's what most people would think.

SHAPIRO: Given what we know about the Iranian missile attack, do you have any sense of how serious these injuries might be?

CIFU: All concussions, all brain injuries are serious. So they're serious. Let's begin at that point. The good news is that 95- to 98% of people with concussions who are diagnosed early on, who are managed in a comprehensive way, which the military knows how to do, are going to do well, are going to have wonderful short- and long-term outcomes. If you don't diagnose it and treat it early on, you're more likely to have long-term sequelae or problems or symptoms. If you don't treat those symptoms and manage them - and they're often very, very manageable - then you're likely to not only not get well and get better and feel good, but you also have a higher risk of having long-term what's called neurodegeneration - dementia, Parkinson's - as well as higher risks of suicide and problems like opioid addiction and chronic pain. So there's - you know, there's a reason to make these diagnoses and treatments. And - you know, and I'm hoping that we can bring that to light.

SHAPIRO: Does it tell you anything that these service members were flown to Germany for treatment rather than being treated in Iraq?

CIFU: Yeah, it does. During the active years of the conflicts up until two years ago, there was actually a concussive program in Iraq and Afghanistan that would have specifically diagnosed and treated these folks in a safe area, you know, of the country. But those were downsized, and they were - they're no longer there because of the lack of intensity of fighting and the lack of patients. So it's terrific that they took them to a place where there's expertise. You can't just do this if you don't know what you're doing, don't have experience. So it does show that they likely do have a concussion or even a worse traumatic brain injury and probably other secondary problems, but it also shows that they're doing the right thing, getting them managed by the folks that know what they're doing.

SHAPIRO: I know this is one of the most common injuries among American service members. How widespread is it?

CIFU: From the research that we've done and others have done over the last 20 years from this current conflict, we found that about 1 out of 5 - 1 in 5 service members who was in the battle...

SHAPIRO: Twenty percent.

CIFU: ...Area sustained one or more concussions or mild brain injuries during their tours - so 1 in 5. If we look at the total numbers of folks that were in Iraq and Afghanistan, we're looking at well over 300,000 individuals just from this conflict alone had one or more of these concussive events.

SHAPIRO: You know, when Iran first attacked this base, the report from the president himself was that no Americans were injured. Is traumatic brain injury the kind of thing that you might not know about immediately after an attack that might only manifest later?

CIFU: Yeah, in the civilian world in the U.S., only 1 out of 2 folks that have a concussion are ever recognized or formally diagnosed - so people with car accidents, sports, falls, et cetera. You know, so it's missed 50% of the time in the U.S. today. So the fact that it would be, quote, "missed or delayed" in diagnosis in a military setting when there is a lot of - you know, there's chaos going on, there's lots of other areas - doesn't surprise me at all. But, you know, the important thing is it's diagnosed now, and they're acting on it.

SHAPIRO: Dr. David Cifu of Virginia Commonwealth University, thanks for joining us.

CIFU: Thank you, Ari - appreciate it. Transcript provided by NPR, Copyright NPR.