Like many soldiers who suffered a concussion, Junge has trouble remembering details of what happened after the explosion. He believes a medic might have given him headache medication, but has no documentation of the treatment. Nor has Junge received rehabilitation or other treatment for ongoing mental difficulties. A former B-2 bomber mechanic, he sometimes struggles with simple tasks, such as building a tree house for his kids. He gets irritated easily.
He forgets details and the names of common household items. It's across the board from top to bottom. If it's not a visible injury, it's kind of looked as a non-injury," he said. For the families of soldiers with mild traumatic brain injuries, the Purple Heart is sometimes the only outward sign of the serious internal trauma endured by their loved ones. And it's like, I'm married to a totally different person," said Holly Junge, Derrick's wife, breaking down in tears as she spoke. Congress, the military and veterans groups have wrestled for decades over how to define which injuries are worthy of the Purple Heart.
After the invasion of Panama, a debate erupted when a soldier received the medal for heat stroke. Two years ago, an Army psychologist raised a furor by suggesting that the Purple Heart should be given to soldiers suffering from post traumatic stress disorder, or PTSD. The Pentagon specifically banned giving the award for the disorder, saying that PTSD is a secondary effect not directly caused by the enemy.
The decision remains controversial. Mild traumatic brain injuries, however, are not supposed to be part of the debate.
For at least 50 years, military regulations have recognized concussions as an injury meriting the Purple Heart. But now, in wars in which roadside bombs are the enemy's best weapon and with tens of thousands of soldiers suffering mild traumatic brain injuries, some military officials argue that giving the Purple Heart for concussions would lessen its value, according to sources and internal documents reviewed by NPR and ProPublica.
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Mild traumatic brain injuries have become more common in Iraq and Afghanistan because of insurgents' heavy use of explosive devices and armor which has better protected soldiers from life-threatening injuries. In late , Col. Edward Neely, an Army neurologist then serving in Iraq, sent an impassioned e-mail to a group of fellow medical officers with the subject line "More Purple Hearts for Those Who Deserve It.
Neely said some senior medical officials opposed giving out the Purple Heart for invisible injuries. He said one fellow medical officer -- whom he did not identify -- told him that he feared creating "another John Kerry" by giving out the Purple Heart for concussions.
During the presidential campaign, some political opponents mocked Sen. Kerry, D-Mass. In the last of these actions, Kerry also received a Bronze Star.
Neely declined to comment for our story. But a fellow officer said that "no more John Kerrys" became a catchphrase among some medical officers in Iraq who felt that mild traumatic brain injuries were not serious enough to merit Purple Hearts. The officer, who did not want to be named for fear of damaging his career, said commanders often relied on technicalities to block awards.
For instance, the military defines a "medical officer" as a physician with officer rank. That means that soldiers treated by nurses or combat medics would not necessarily qualify.
Russell, the Army neuropsychologist, and Col. Rodney Coldren, an Army epidemiologist, alluded to this attitude at the National Academy of Neuropsychology conference. They told the audience that the Purple Heart "clouds everything" in diagnosing concussions in the field. Coldren, who traveled to Iraq in to study testing for mild traumatic brain injuries, said he found "vast under-diagnosis" of concussions, and not just because electronic reporting systems were failing.
Veterans groups that focus on the Purple Heart support awarding it in cases of concussions, as the regulations spell out. Other veterans groups expressed anger that soldiers with brain injuries were not being recognized for their wounds. The system for awarding Purple Hearts can be opaque, especially for soldiers in war zones. They often do not get a response in writing, receiving only verbal notifications that they have been turned down.
Even when they do get letters, the reason for denial can be vague, such as a lack of proper documentation. NPR and ProPublica contacted more than a dozen officers to determine who, exactly, had turned down the Purple Heart applications of Scheller, Hopkins, Junge and other soldiers. The officers either did not comment, or said they could not recall the cases. Soldiers turned down for the Purple Heart can appeal, but face a grinding administrative battle to reverse the decision.
If they have no documentation of their wounds, they must find witnesses and gather sworn statements, an especially daunting task for those who have cognitive deficits as a result of brain injuries. After surviving two roadside blasts in Iraq in , Capt. Jonathan Brooks fought for 14 months to receive a diagnosis confirming that he had suffered a concussion that resulted in lingering symptoms. The process was so complex that she co-founded a group, Recognize the Sacrifice , to help other soldiers apply for the medal. Caleb told me a story about his ex-wife, Allyson.
When I got home, the dead dogs were still in the house. He wanted to talk about the day his entire unit died, how he thought he heard their falling, burning voices from a desk in an empty room at headquarters. He wanted to talk about how his ex-wife called him a murderer and then made him take out the trash. He wanted to talk about his friend Valarie who made dinner for her dead husband every night.
He wanted to talk about how all of it was still there, every day, the blood in his mouth, the screaming, his dead buddies. He wanted to talk about after the war. You could hear it coming down the hallway.
Boom, he said, slapping the table. A few customers turned their heads. It was so tall it had to lean down to get its head through. In this really deep voice it said, I will kill you if you proceed. The customer across from us got up to leave.
It starts to choke me. Kip was taking the punishment for me. The air conditioner groaned and strings of dust swirled in the rushed, grated air. Caleb turned sideways, leaned his back against the wall, and rested his legs on the booth. The white looked clean against his skin. They spent millions training me how to go to war, but they never taught me how to come home. It can come after you and kill you and it will destroy you.
Brian had been stationed at a Fallujah checkpoint with his buddy Chris. The guys were bored. Not much had happened that day until a white van started coming up the road toward them, picking up speed.