Losing their minds

Jan. 5, 2006 | After fighting in heavy combat during the initial invasion of Iraq, Spc. James Wilson reenlisted for a second tour of duty. Now 24 years old, he loved the life of a soldier.

In the fall of 2004, his 1st Cavalry Division was mostly fighting in Sadr City, a volatile sector of Baghdad. On Sept. 6, Wilson was manning a .50-caliber machine gun atop a Humvee when a bomb or bombs went off directly under the vehicle, rocking his head forward and slamming it into the machine gun. A fellow soldier told Wilson that his Kevlar helmet had been split open by the impact. The heat from one blast felt like "a hair dryer" on his skin, multiplied "times 20," Wilson later wrote in his diary. To the best of his recollection, the force of the blast also knocked the gun from its mount, smashing it into his leg.

Although battered in the attack, Wilson didn't appear badly hurt -- on the outside, at least. But in the days that followed, the young soldier from Albany, Ga., says he often felt "really dizzy, lightheaded and dazed." Two weeks after the battle, Army medics felt Wilson was suffering from post-traumatic stress disorder and evacuated him out of Iraq for medical evaluation. Wilson was first flown to Landstuhl Regional Medical Center in Germany, where wounded troops are stabilized, and then sent to Walter Reed Army Medical Center in Washington, D.C., in October 2004.

After arriving at Walter Reed, Wilson repeatedly told doctors that he had experienced a hard blow to the head during combat in Iraq. He suffered from symptoms strongly associated with a traumatic brain injury, which occurs when the brain is rocked violently inside the skull, tearing nerve fibers: seizures, short-term memory loss, severe headaches with eye pain, and dizzy spells that have made him vomit. During a visit to the Pentagon around Christmas 2004, Wilson got so dizzy he vomited "all over" the carpet while meeting Deputy Secretary of Defense Paul Wolfowitz in his office.

Despite Wilson's description of his injury and his symptoms, Walter Reed officials repeatedly questioned his mental state and the authenticity of his combat story. In a June 2005 memorandum from an Army Physical Evaluation Board, some Walter Reed doctors stated that Wilson exhibited "conversion disorder with symptoms of traumatic brain injury." Conversion disorder holds that symptoms such as seizures arise from a psychological conflict rather than a physical disorder. Col. James F. Babbitt, president of the Physical Evaluation Board, accused Wilson of being a liar. "I believe that the preponderance of the evidence available to the Board supports an alternative diagnosis  one of malingering," Babbitt wrote in that memo.

Wilson and his wife, Heidi, who has been staying with him at the hospital, vigorously fought the psychological diagnosis and furiously sought medical treatment. The malingering charge was especially painful. "I want my dignity, pride and respect back," Wilson says. After serving his country, being accused of misleading doctors, he says, "is the worst thing in the world."

Today, Wilson is thin and has a shaved head. He often clenches his eyes shut, as if to squeeze at the pain in his skull, or search out an elusive word or memory. Whenever a dim detail of his combat duty bubbles up in his mind, he types it into his diary. He holds his hands awkwardly, with his thumbs folded over his palms. His speech is at times slow and slurred. "I have been dealing with this all year because no one would help me," he says.

On Dec. 19, 2005, more than a year after he was admitted, Walter Reed finally sent Wilson to a neurological center to be treated for traumatic brain injury. Neuropsychological testing done at Walter Reed on Oct. 11, 2005, led officials to conclude that "there was no indication of malingering." According to a neurosurgeon with extensive experience treating combat head injuries, an October 2004 MRI of Wilson, combined with a description of his symptoms, showed that he should have been treated for a traumatic brain injury right then. Medical experts say the failure to treat a brain-injury victim promptly could hinder recovery.

Spc. Wilson is not alone among Iraq veterans who have been misdiagnosed or waited for treatment for traumatic brain injury. Other soldiers interviewed at Walter Reed with apparent brain injuries say they too have been deeply frustrated by delays in getting adequately diagnosed and treated. The soldiers say doctors have caused them anguish by suggesting that their problems might stem from other causes, including mental illness or hereditary disease. According to interviews with military doctors and medical records obtained by Salon, brain-injury cases are overloading Walter Reed. As a result, a significant number of brain-injury patients are falling through the cracks from a lack of resources, know-how, and even blatant neglect.

Next page: Why the Iraq war has led to an alarming increase in brain injuries