If war erupts in the Persian Gulf, those who play numbers games in the Pentagon say as many as 30,000 American soldiers could come home in boxes. Among the living could be 10,000 injured soldiers with serious head wounds. They will be given a hospital bed and precious little else and it is an outrage.
The U.S. military, which promises lifetime medical care for veterans, has no head-injury rehabilitation units in its hospitals. There will be no therapy for the impairments that plague a soldier with Iraqi lead in his or her skull. The common American health insurance policy will cover head-injury rehabilitation for civilians, but a soldier who risks life in the desert must simply lie in bed and hope for recovery.Our associates Jim Lynch and Paul Parkinson examined this gap in medical coverage offered to American soldiers. The Pentagon is inexcusably behind the times. Private hospitals have had head-injury programs for years - long enough to persuade insurers to finance the care. But the Pentagon remains skeptical, calling the therapy "unproven," and often refusing to pay for it unless that therapy will return a soldier to active duty. Thousands of Vietnam veterans are victims of this policy. Many had their heads patched up as though doctors were treating broken ankles, and then were sent back to active duty, some with a handful of pain killers.
Richard Shannon was shot in the head in Vietnam in 1968. When he returned to active duty, "I couldn't even remember how to spit shine my boots." Shannon was placed on kitchen duty and dropped in rank. Finally he was booted out of the Army and told to check into a Veterans Administration hospital. There he got drugs to control seizures. He lived for years on a $160-a-month disability check from the government. In 1983, Shannon got a good look at his medical files. He learned that a piece of his brain had been surgically removed 15 years earlier as part of the initial treatment for the bullet wound. "If they had just helped to reteach me to do simple things," he told us. "I'm not nuts." The VA agreed to re-evaluate Shannon's case and gave him compensation for 100 percent medical disability.
Other Vietnam vets are still trying to get access to modern therapy. Thomas Murphy survived a bullet in his head during his first combat mission in Vietnam. The only "therapy" he got was a psychiatric drug called Haloperidol. Not until 1987 did the VA agree to pay for therapy from a private head-trauma program. Murphy was making progress, and then the VA told him it planned to cut off financing for the therapy last fall. Only after Sen. Bob Kerrey, D-Neb., and Rep. Thomas Carper, D-Del. , intervened on his behalf and the Vietnam Veterans of America organization protested, did the VA change its mind and agree to continue paying, at least for the time being. Murphy doesn't know when the rug will be pulled out from under him again.
"When soldiers join the military, they think they have cradle-to-grave medical coverage, but they don't," said Dr. Andres Salazar, director of the Vietnam Head Injury Study. Not only does the government shortchange its vets with head injuries, but for the past 10 years, federal funding of head-injury research in general has been almost non-existent. The bright spot on the horizon is Dr. James Holsinger, the new chief medical director of the VA. He has put head-injury rehabilitation facilities on the top of his priority list, but it will take years to bring the VA up to speed. Holsinger says that for a Persian Gulf war, he could supply 17,000 beds within 72 hours. The head injury victims will be taken care of, but not as well as the VA should be able to treat them a few years into the future.