War /

The Pentagon has raised the number of casualties following Iran’s attack on a US base in Iraq this past January 8. The new figure marks the fourth time Washington has recalculated the number of injured forces after initial reports indicated no servicemen were harmed.

The US military now records 64 cases of mild traumatic brain injury (TBI) from the attack. While most injuries are typically thought of in a more physical sense, such as bodily harm, brain injuries have often slipped under the radar, at least in the time immediately proceeding from an attack, due to the nature of TBIs. 

One reason they are often overlooked is due to the nature of brain injuries. 

“In this particular case, TBI, that takes some time to manifest itself,” said Gen. Mark A. Milley alongside Defense Secretary Mark Esper. “It’s not an immediate thing, necessarily. Some cases it is, some cases it’s not.”

TBI is the most common form of injury, according to the Defense and Veterans Brain Injury Center, and the numbers certainly backup the statement. Since 2000, more than 408,000 US troops have suffered brain trauma, according to reporting from The Wall Street Journal.

Furthermore, brain injuries differ from person-to-person both in severity and symptoms.

“Your brain is a very fragile part of your body even though it’s encased inside your skull,” Milley said. “The injuries to the brain, the unseen wounds of war, for example, those can be serious or not so serious — depends on the individual, depends on proximity to the blast. And sometimes they are lifelong, sometimes they resolve themselves in weeks or months.”

Brain injuries are more difficult to diagnose as opposed to a broken arm, for example. Randy Reese, executive director of Disabled American Veterans, said symptoms can include blurred vision and irritability, but they can also be more persistent and last longer in the form of depression, and memory and coordination loss. It is not uncommon for the effects to be lifelong. 

On the sidelines of the economic conference in Davos, Switzerland, in January, US President Donald Trump dismissed brain injuries. A press interview went as follows: 

Question: “Mr. President, a question on Iran: Initially, you said repeatedly to Americans that after Iran retaliated for the Soleimani strike, no Americans were injured. We now know at least 11 U.S. service men were airlifted from Iraq. Can you explain the discrepancy?”

Answer (Trump): “No, I heard that they had headaches, and a couple of other things. But I would say, and I can report it is not very serious. Not very serious.”

Question: “So you don’t consider a potential traumatic brain injury serious?”

Answer (Trump): “They told me about it numerous days later. You’d have to ask Department of Defense. No, I don’t consider them very serious injuries, relative to other injuries that I’ve seen. I’ve seen what Iran has done with their roadside bombs to our troops. I’ve seen people with no legs and with no arms. I’ve seen people that were horribly, horribly injured in that area, that war — in fact, many cases put — those bombs put there by Soleimani, who is no longer with us. I consider them to be really bad injuries. No, I do not consider that to be bad injuries. No.”

Veterans groups, including that of Reese, took umbrage with the president’s remarks.

“It just appears the commander-in-chief is somewhat out of touch regarding the seriousness of this injury,” Mr. Reese responded. “There is no mild TBI that doesn’t have consequences.” 

Paul Rieckhoff, founder of Iraq and Afghanistan Veterans of America, called Trump’s statement “counterproductive” to efforts to diagnose and treat TBI. “He really displayed remarkable ignorance,” Rieckhoff said.

However, the Pentagon and veterans groups agree there is more progress to be made in treating TBI. 

“I think for many people this is a learning process,” Esper said. “This is something we’ve come to learn about over the past 10 to 15 years as we’ve seen IED attacks on our forces in Iraq and Afghanistan. So again, this is an injury we need to keep educating everybody about.”