4-STAR GENERAL: PTSD is a “Cruel Physiological Thing”

COMBAT GENERATION: BLOODLESS TRAUMA
Diagnosis: Battle wound

by Greg Jaffe
The Washington Post, July 18, 2010

The 300-pound bomb blasted Marine Staff Sgt. James Ownbey’s mine-resistant truck so high that it snapped power lines before it slammed to the dusty ground in western Iraq.

Ownbey, knocked briefly unconscious by the blast, awoke to suffocating black smoke and a swirling cloud of dirt. He felt for the vehicle’s door, then stumbled into the sunlight where he was joined by the rest of his woozy, three-man crew. Their bodies were sore, but they looked fine.

A Marine general visiting from Washington heard about the blast and came to see the survivors. As Gen. James F. Amos laid a hand on Ownbey’s neck, his aide snapped a picture, proof of the new vehicle’s efficacy against insurgent bombs.

"I have been asked . . . should you have figured this out sooner? Yeah, we should have. But we didn't. It has been evolutionary." - Marine Gen. James Amos(MCA)

“I kind of felt separated from myself,” Ownbey recalled of the aftermath of the 2007 blast. “It didn’t feel like anything was real.”
Two years after the explosion Amos and Ownbey met again, this time in a cramped room at the National Naval Medical Center in Bethesda.

Ownbey had been overtaken by terrifying panic attacks, puzzling memory loss and strange rib-snapping coughing fits that left him hospitalized for weeks at a time. Doctors diagnosed post-traumatic stress disorder (PTSD) and traumatic brain injury, caused by battlefield concussions.

For Amos, seeing Ownbey’s condition was the moment that the bloodless trauma of the Iraq and Afghanistan wars became tangible. “I thought we can’t do this anymore,” said Amos, referring to the military’s slow response to treating PTSD and traumatic brain injury.
Ownbey’s descent from dazed survivor to bed-ridden Marine exemplifies the debilitating passage of troops afflicted with PTSD and traumatic brain injury. His story also traces the military’s awakening.

Staff Sgt. James Ownbey, Marine combat engineer bedridden inside a Navy hospital two years after taking a direct hit from an 300-pound IED while driving a mine-resistant vehicle. In addition to multiple neuropsychiatic injuries, including severe PTSD, the blast damaged his pituitary glad function causing his weight to balloon from 165 to over 240 pounds.

Senior commanders have reached a turning point. After nine years of war in Afghanistan and Iraq, they are beginning to recognize age-old legacies of the battlefield – once known as shellshock or battle fatigue – as combat wounds, not signs of weakness. Gen. Peter Chiarelli, Amos’s Army counterpart, has been especially outspoken. “PTSD is not a figment of someone’s imagination,” Chiarelli lectured an auditorium of skeptical sergeants last fall. “It is a cruel physiological thing.”

The challenge facing Amos and Chiarelli has been convincing an undermanned force that PTSD and traumatic brain injury are real injuries that demand immediate care. The generals also have run up against an overburdened military medical system that is short on doctors and reluctant to take risks with new types of treatment.

“I have been asked . . . should you have figured this out sooner?” said Amos, who was recently tapped to be Marine Corps commandant.

“Yeah, we should have. But we didn’t. It has been evolutionary.”

Read the rest of this story and watch interviews with Staff Sgt. Ownbey and Gen Amos:
http://www.washingtonpost.com/wp-srv/special/nation/mental-wounds/TBI-1.html