Iraq war: Epidemic of invisible brain damage?

The Washington Post published an article on April 8 by on the invisible head trauma created by the high-powered explosives being used by the U.S. military in Iraq. Forensic psychologists who evaluate combat veterans should be on the alert for neurological sequelae, as described in the following article by pediatric nephrologist Ronald Glasser:

This is the new physics of war. Three 155mm shells, linked together and combined with 100 pounds of Semtex plastic explosive, covered by canisters of butane or barrels of gasoline, can upend a 70-ton tank, destroy a Humvee or blow an engine block through the hood of a truck. Those deadly ingredients form the signature weapon of the war in Iraq: improvised explosive devices, known by anybody who watches the news as IEDs.

Some of the impact of these roadside bombs is brutally clear: Troops are maimed by projectiles, poisoned by clouds of bacteria-laced debris and burned by post-blast flames. But the IEDs have added a new dimension to battlefield injuries: wounds and even deaths among troops who have no external signs of trauma but whose brains have been severely damaged. Iraq has brought back one of the worst afflictions of World War I trench warfare: shell shock. The brain of a soldier exposed to a roadside bomb is shocked, truly.

About 1,800 U.S. troops, according to the Department of Veterans Affairs, are now suffering from traumatic brain injuries (TBIs) caused by penetrating wounds. But neurologists worry that hundreds of thousands more -- at least 30 percent of the troops who've engaged in active combat for four months or longer in Iraq and Afghanistan -- are at risk of potentially disabling neurological disorders from the blast waves of IEDs and mortars, all without suffering a scratch….

Here's why IEDS carry such hidden danger. The detonation of any powerful explosive generates a blast wave of high pressure that spreads out at 1,600 feet per second from the point of explosion and travels hundreds of yards. The lethal blast wave is a two-part assault that rattles the brain against the skull. The initial shock wave of very high pressure is followed closely by the "secondary wind": a huge volume of displaced air flooding back into the area, again under high pressure. No helmet or armor can defend against such a massive wave front.

It is these sudden and extreme differences in pressures -- routinely 1,000 times greater than atmospheric pressure -- that lead to significant neurological injury. Blast waves cause severe concussions, resulting in loss of consciousness and obvious neurological deficits such as blindness, deafness and mental retardation. Blast waves causing TBIs can leave a 19-year-old private who could easily run a six-minute mile unable to stand or even to think….

Almost as daunting as treating TBI is the volume of such injuries coming out of Iraq. Macedo cited the estimates, gleaned at seminars with VA doctors, that as many as one-third of all combat forces are at risk of TBI. Military physicians have learned that significant neurological injuries should be suspected in any troops exposed to a blast, even if they were far from the explosion. Indeed, soldiers walking away from IED blasts have discovered that they often suffer from memory loss, short attention spans, muddled reasoning, headaches, confusion, anxiety, depression and irritability….

The unseen damage can be long-lasting. Most of the families of our wounded that I have interviewed months, if not years, after the injury say the same thing: "Someone should have told us that with these closed-head injuries, things would not really get all that much better."

Children Being Jailed for Temper Tantrums

The April 9 New York Times has an op-ed piece by Bob Herbert on an alarming trend of criminalizing very young children who throw temper tantrums or otherwise misbehave in school. A disproportionate number of these children, not surprisingly, are African American. The editorial, "6-Year-Olds Under Arrest," follows:

When 6-year-old Desre'e Watson threw a tantrum in her kindergarten class a couple of weeks ago she could not have known that the full force of the law would be brought down on her and that she would be carted off by the police as a felon.

But that's what happened in this small, backward city in central Florida. According to the authorities, there were no other options.

"The student became violent," said Frank Mercurio, the no-nonsense chief of the Avon Park police. "She was yelling, screaming - just being uncontrollable. Defiant." ...

The child's tantrum occurred on the morning of March 28 at the Avon Elementary School. According to the police report, "Watson was upset and crying and wailing and would not leave the classroom to let them study, causing a disruption of the normal class activities."

After a few minutes, Desre'e was, in fact, taken to another room. She as "isolated," the chief said. But she would not calm down. She flailed away at the teachers who tried to control her. She pulled one woman's hair. She was kicking.

I asked the chief if anyone had been hurt. "Yes," he said. At least one woman reported "some redness."

After 20 minutes of this "uncontrollable" behavior, the police were called in. At the sight of the two officers, Chief Mercurio said, Desre'e "tried to take flight." She went under a table. One of the police officers went after her. Each time the officer tried to grab her to drag her out, Desre'e would pull her legs away, the chief said.

Ultimately the child was no match for Avon Park's finest. The cops pulled her from under the table and handcuffed her. The officers were not fooling around. In the eyes of the cops the 6-year-old was a criminal, and in Avon Park she would be treated like any other felon.

There was a problem, though. The handcuffs were not manufactured with kindergarten kids in mind. The chief explained: "You can't handcuff them on their wrists because their wrists are too small, so you have to handcuff them up by their biceps."

As I sat listening to Chief Mercurio in a spotless, air-conditioned conference room at the Avon Park police headquarters, I had the feeling that I had somehow stumbled into the middle of a skit on "Saturday Night Live." The chief seemed like the most reasonable of men, but what was coming out of his mouth was madness.

He handed me a copy of the police report: black female. Six years old. Thin build. Dark complexion.

Desre'e was put in the back of a patrol car and driven to the police station. "Then," said Chief Mercurio, "she was transported to central booking, which is the county jail."

The child was fingerprinted and a mug shot was taken. "Those are the normal procedures for anyone who is arrested," the chief said. Desre'e was charged with battery on a school official, which is a felony, and two misdemeanors: disruption of a school function and resisting a law enforcement officer. After a brief stay at the county jail, she was released to the custody of her mother.

The arrest of this child, who should have been placed in the care of competent, comforting professionals rather than being hauled off to jail, is part of an outlandish trend of criminalizing very young children that has spread to many school districts and law enforcement agencies across the country.

A highly disproportionate number of those youngsters, like Desre'e, are black. In Baltimore last month, the police arrested, handcuffed and hauled away a 7-year-old black boy for allegedly riding a dirt bike on the sidewalk. The youngster was released and the mayor, Sheila Dixon, apologized for the incident, saying the arrest was inappropriate. Last spring a number of civil rights organizations collaborated on a study of disciplinary practices in Florida schools and concluded that many of them, "like many districts in other states, have turned away from traditional education-based disciplinary methods -- such as counseling, after-school detention, or extra homework assignments -- and are looking to the legal system to handle even the most minor transgressions." Once you adopt the mindset that ordinary childhood misbehavior is criminal behavior, it's easy to start seeing young children as somehow monstrous.

"Believe me when I tell you," said Chief Mercurio, "a 6-year-old can inflict injury to you just as much as any other person."