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'Doctor Of Hope' Tackles Troops' Head Injuries

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By LINDSAY PETERSON

The Tampa Tribune

Published: August 15, 2008

TAMPA - The doctor clearly recalls the day five years ago at Walter Reed Army Medical Center when the wounded soldier wanted to show off his new prosthetic arm and legs.

There was one problem: The patient also had suffered a head injury in battle and couldn't remember where he'd put his new limbs.

Steven Scott, now of the James A. Haley Veterans' Hospital in Tampa, said that on that day, he and others suddenly realized that the military medical system "was missing something." Soldiers were returning from Iraq with multiple wounds, including serious head injuries, but no one was looking at how their brain damage affected their rehabilitation.

Scott began developing a program to treat the thousands of troops returning home with what he calls "the invisible wound," head trauma from roadside bombs and other improvised explosive devices.

Soon he was in Tampa as medical director of Haley's Polytrauma Rehabilitation Center. It's one of only five Veterans Affairs centers across the country that specialize in treating the multiple wounds that troops are bringing home from Iraq and Afghanistan.

Scott is also Haley's chief of physical medicine and rehabilitation. He spoke Thursday to the local chapter of the Military Officers Association of America at MacDill Air Force Base.

About 60 percent of today's 1.5 million war injuries are related to explosions, Scott said, and up to 10 percent of those injuries involve a blow to the head. In past wars, troops often died before they got to a doctor or hospital. Today, battlefield care is so sophisticated they are surviving at the highest rate ever.

"We're seeing the kind of injuries we've never seen before," Scott said. He calls head trauma "the signature wound" of the Iraq war. As the war goes on, the head injuries are becoming more severe.

Troops who serve multiple tours in Iraq often experience explosion after explosion. Each encounter alone might not be enough to cause serious damage, but together they can amount to major trauma.

For patients with the most serious injuries, what seems like a small change can be a great accomplishment, Scott said Thursday.

He described one man who seemed to be making no progress. One day, after 16 months of treatment, the man looked at his wife and she saw a spark of recognition in his eyes.

"That's what makes it all meaningful, something little like that," Scott said.

The patients at Haley set small goals. One is struggling to relearn how to flip a coin, preparing for the opening coin toss of a football game he has been invited to. The small goals stretch into large ones, Scott said, noting that this patient's ultimate goal is to run up the stairs of the football stadium.

Other patients are aiming simply to walk out the hospital doors.

Healing a serious head injury is a major emotional challenge, Scott said. "You have to think twice before everything you do," even the simplest things that should come automatically, such as taking one step forward.

More than anything, it takes hope, he said. "We're changing our thinking. ... Never say can't. ... Never say never."

Every day, researchers are learning new things about how the body heals and regenerates neural connections.

"I sometimes feel that maybe I'm a doctor of hope."

Reporter Lindsay Peterson can be reached at (813) 259-7834 or lpeterson@tamaptrib.com.

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