Here is something you don’t read in the newspaper or hear in the media. It has to do with the hidden cost of the Iraq War that nobody wants to talk about. This has to do with the new types of injuries that are causing neurologists to worry about the impact to medical care of hundreds of thousands of troops who are at risk for potentially disabling neurological disorders. For the first time, the U.S. military is treating more head injuries than chest or abdominal wounds, and it is ill-equipped to do so. They estimate that at least 30 percent of the troops who have engaged in active combat for four months or longer in Iraq and Afghanistan could be affected and some apparently without suffering a scratch or no external signs of trauma. Why? What makes this war any different than the Vietnam war? And why is this so much more of a problem?

According to a Washington Post article by Ronald Glasser, The biggest reason that troops are coming back with serious brain trauma is because with improved and highly skilled intensive medical care being so close to the troops, they are no longer dying from the kind of injuries that killed thousands in Vietnam. The ratio of wounded to fatalities in Iraq is 16 to 1; whereas in Vietnam it is was 2.6 to 1, so there are six times more wounded coming back to be cared for.

Another reason is the improvement in body armor that has dramatically been effective in preventing fatal wounds of the chest and abdomen. So, troops aren’t dying from crucial abdominal wounds but come back with missing arms, legs and severe head injuries. It has been estimated that two-thirds of all soldiers injured in Iraq who don’t immediately return to duty have traumatic brain injuries, and what’s deceiving is that they may look fine, but they’re not.

There is also the significance of the type of warfare Iraq presents, and this has to do especially with head injuries. What is different about Iraq is the hidden danger of IEDS or Improvised Explosive Devices. With these devices, the detonation of the 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. There are actually two blasts that rattle the brain of anyone nearby, the first blast of sound waves, then the second which is caused by the huge volume of displaced air flooding back into the area, again under high pressure. No helmet or body armor can defend against such a massive wave front. This is sudden and extreme differences in pressures which are routinely 1,000 times greater than atmospheric pressure.

The result? The devastating result is a “closed-head” injury that causes severe concussions, resulting in loss of consciousness and obvious neurological deficits such as blindness, deafness and mental retardation. Blast waves can leave a 19 year-old who could easily run a six-minute mile unable to stand or even to think. And, what’s worse is that our medical system is not skilled at treating these types of injuries because they cause a completely different kind of injury than a physical blow to the head such as in a bicycle accident.

With the Iraq type of injury, physicians speculate that the shock waves damage the brain at a microscopic, subcellular level. When the sound waves move through the brain, it seems to cause little gas bubbles to form and when they “pop”, it leaves little holes in the brain for which physicians are unprepared or unskilled to treat.

Military physicians are pushing for more long term care and rehabilitation of these brain traumatized soldiers. They are not even sure of the long term effects but what they have observed is memory loss, short attention spans, muddled reasoning, headaches, confusion, anxiety, depression and irritability. With the aftermath of Iraq not being the cemetery, but the orthopedic ward and neuro-surgical unit, this country faces another huge cost that is just beginning to be realized.

When you have people who dismissively state that the Vietnam War was much more catastrophic in terms of the number of deaths, you can counter with the fact that we have 6 times more injured today. In general, this war has been successful in some ways by reducing the number of deaths, but absolutely devastating in the number of injuries as compared to Vietnam.

But any way you look at it, war is not the answer and with the cost of it increasing every day, our voices against it should be getting louder and louder. Keep the pressure up to end this madness for the sake of the sanity of our injured loved ones coming home with more devastating injuries than ever. My heart goes out to them and their families…this price is just too high to pay.