Traumatic Brain Injury. At last, a name for what was wrong with her husband since his return from Iraq.
Posted in , Dec 3, 2013
I didn’t know a lot about medicine or battlefield wounds, but I knew my husband. I knew Jim. And this wasn’t Jim.
Not that I suspected anything that day he called me from Iraq, August 21, 2007.
I’d answered the phone at our house at Camp Lejeune, North Carolina. “Honey, I’m calling from a hospital,” Jim said. “I was in an incident. In a lot of pain, but I’m okay. Don’t worry.”
Don’t worry? Jim’s job as a sergeant in the Marine Corps was defusing mines. A day didn’t go by without me worrying.
He told me the armored vehicle he was traveling in had triggered a 300-pound bomb buried under the road. The truck catapulted 30 feet in the air.
“They say I didn’t come to for five minutes,” he said. “They’re gonna keep me for a few days, but I’ll be able to come home on leave next week with the rest of my unit. Good news, huh?”
“The best,” I said. I hung up and thanked God for watching over him. He’d been gone seven months on this most recent deployment. I couldn’t wait to see him, to do all the things we loved to do as a family again–walks in the woods, a trip to the beach, watching a movie together.
The night his unit came home I took the kids, Jolene, 11, James, 9, and Logan, 4, and drove to the base to meet him. Jim hobbled off the bus and I ran to him, arms open wide. But he pulled away. “I’m sorry,” he said. “It was a really long flight. And I’ve got a splitting headache.”
Odd. Jim never complained. Ever. Marines are the toughest of the tough. I gave him the car keys. Jim turned out of the parking lot and eased into traffic. Without warning he pulled over to the shoulder, stopping the car.
“That pothole,” he said. “Why is it there? How long has it been like that?”
“Honey, it’s okay,” I said. “It’s just a pothole.”
He took several deep breaths, staring at the pothole. Finally we got back on the road, but no one said a word the rest of the way home. This was Jim’s third deployment. There was always an adjustment period when he came back. I just needed to give him space. Not push. Let him ease into things again.
Once in the house, Jim ran to the bathroom. Ten minutes later he had to go again. “I feel awful,” he said, slumping on a chair. I felt his forehead. He was burning up. I got him some Tylenol and a glass of cold water. He gulped it down.
He was too uncomfortable to sleep. By morning he was in agony. I took him to the emergency room. They did blood and urine tests and a CT scan of his kidneys. The doctor’s questions made him agitated. I explained about the explosion, how it had knocked Jim out, his constant urination, his pain.
“The CT scan isn’t showing any kidney abnormalities,” the doctor finally told us. “It could be a lot of things. Something neurological? Psychological? If he doesn’t improve, come back.” He wrote a prescription for sleeping pills. I took Jim’s hand and slowly led him to the car.
Jim was the one who’d taken charge of our future and joined the Marines. He was 28 then. We were married, with two kids, living in the tiny Florida town where I’d grown up, where I thought we’d grow old together.
Jim was making a good living as an electrician, working for his father, but he wanted to do something more, to serve his country. And so in the summer of 1999 he’d enlisted. It was hard leaving my family and friends, the church I’d gone to my whole life. I cried nearly the entire way to Camp Lejeune.
He left for Kuwait two weeks later. I took care of getting our family settled–enrolled our oldest in school, found a mechanic when the car broke down, fed us on Jim’s modest pay, got one job handling billing for a dentist and another teaching aerobics. I stayed busy. It was how I coped.
Then came 9/11. Jim had grown up in New York City. The terrorist attacks hardened his resolve. His country needed him. Reenlisting wasn’t even a question. He’d found his purpose. And a job he loved, disarming bombs, a precarious tangle of wires the difference between life and death.
Jim couldn’t go back to Iraq with his unit when their leave ended. He didn’t improve. In fact, he got worse. His fever wouldn’t break. He had coughing fits that lasted for hours. What scared me even more were the personality changes–mood swings, anxiety, fits of anger, forgetfulness.
We kept going to the emergency room. But all the doctors did was treat the most immediate problems. No one could tell us what was really wrong with him.
I called everyone I could think of, got the names of specialists and searched the internet for answers. One day I came across a site about brain injuries and how they affect everything–the entire body, memory, emotions. Could that be what was wrong with Jim?
I took him to specialists, at every appointment filling out pages of medical history, telling each doctor what the other doctors were saying, each one adding a different medication. Beta blockers for high blood pressure. Antipsychotics to control his mood swings. Antidepressants. Fourteen different pills a day.
When I asked about brain injury the answer was the same: “There was just the one concussion. I don’t see how that could be the issue.”
I had to quit both my jobs to take Jim to doctors’ appointments. He gained almost 100 pounds in a year. He was constantly short of breath. He was angry, paranoid.
The smallest things–a sudden noise, a ball bouncing his way when the kids were playing–would unnerve him. He couldn’t remember even simple things.
One day he looked at me, his eyes cold, piercing. “Who are you?” he barked. For half an hour he interrogated me. Then he jerked his head and asked me in a normal voice what we were having for lunch, as if the whole episode had never happened.
I was so shaken, I cried out to God. Lord, this isn’t Jim. What’s happened to the man I married?
It would be months before I found the answer. Late one night in March of 2009 Jim woke me up gasping for breath, moaning in pain. I called the paramedics. By then it had become almost automatic. Another trip to the ER.
This time the doctor who examined Jim didn’t hesitate. “Your husband is in extremely critical condition,” he said. “We need to get him to the Naval Hospital in Bethesda, Maryland, as soon as possible.”
A medevac jet flew us there in less than an hour. They whisked Jim away. I sat in the waiting room and prayed. A doctor came to talk to me.
“I’m sorry,” he said. “Jim’s too weak for us to even operate. He’s bleeding internally. Dozens of clots in his lungs. His ribs are, well, they’re shattered. His bones are brittle, like an old man’s. I don’t think he’ll make it through the night.”
I kept vigil by his bedside. God, you’re the only one who can help Jim now. I’ve done all I can.
Jim hung on. By morning, he was strong enough to undergo surgery to remove the clots and the blood, two liters, from his lungs.
That afternoon I met with a team of doctors in a conference room. “Has anyone ever discussed the possibility of Jim having a traumatic brain injury?” one of them asked.
“No,” I said. I thought of the website I’d looked at all those months ago. “Do you think that that’s what happened to him?”
He nodded. “So many soldiers are coming back from the front with concussions,” he said. “We’re learning more about the effects. They’re much more serious than we once thought.
"Our brains are soft, like gelatin, and the impact of hitting against the hard skull can cause lasting damage. It can affect our bodies, all the functions we need to live, and also our personalities, our memories, how we perceive the world around us. I know this is difficult to hear...”
Traumatic brain injury. TBI. After nearly two years of searching for answers, more than anything I felt an incredible sense of relief. I knew there was more I had to learn. That the journey ahead wouldn’t be easy. But at last I felt certain Jim and I would have the help we so desperately needed.
In the days that followed I learned much more about TBI and the care that Jim would need.
The impact from the explosion had injured his pituitary, a tiny gland at the base of the brain that secretes hormones regulating all kinds of body processes, including blood pressure, temperature, metabolism, water absorption, bone growth.
Apparently pituitary dysfunction was fairly common among TBI patients, but underdiagnosed because the wide-ranging symptoms made it difficult to pinpoint a cause.
For the next year Jim was treated and cared for by the team at Bethesda, doctors, nurses, therapists and social workers. We lived in nearby lodging for wounded vets.
Help came from everywhere. Jim’s father moved into our house at Camp Lejeune to be with the kids. So many people came to the hospital to show their support. Even the Marine Corps commandant. Hearing Jim’s story, everything we’d gone through, affected him deeply.
As a result of that meeting, new guidelines were written for treating troops with possible traumatic brain injuries. No longer can a serviceman be given a cursory exam and be sent back to his unit. An examination by a neurologist is required, along with at least two weeks of down time.
Today, Jim would never have been put on a plane as soon as he was.
In March 2012 Jim received a medical discharge from the Marines. Now we live in a quiet neighborhood in West Virginia, between the three hospitals where I take him for regular care.
His condition is stabilizing. But he can’t drive. Will probably never be able to hold a job. A sudden noise still unnerves him. He’s easily confused. His mission these days is to be a great dad and husband.
Jim’s father stayed on with us to help out. I’m studying to be a nurse as a way to support my family. More than that, it’s the path I feel certain God has set for me. He is giving me the strength to help my husband.
Just the other night, Jim tapped me on the shoulder. “Want to watch a movie?” he asked. I smiled and put my hand in his. He squeezed hard and pulled me close. Our life will never go back to what it was before his TBI. But Jim is still here, still fighting, like a good Marine.
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