When the dust cleared, after an improvised explosive device ripped through a military patrol vehicle on a road in Iraq, one East Valley soldier’s only thought was to save his fallen comrade, even as he slipped in and out of consciousness.
The fallen comrade was a Marine who had lost his arm after the vehicle triggered an explosive-laden booby trap.
U.S. Navy Hospital Corpsman Kevin Ivory, meanwhile, suffered injuries to his brain, which were unseen and apparently not as urgent as the fallen Marine’s wounds during that 2006 incident.
Like many veterans returning from Iraq and Afghanistan plagued by injuries that can’t be seen by the naked eye, Ivory today receives care locally for his traumatic brain injuries, or TBI.
In some cases, TBI is more debilitating than the loss of a limb, and with harsher psychological effects than post-traumatic stress disorder, or PTSD.
Today, veterans are returning from Operation Iraqi Freedom and Operation Enduring Freedom (Afghanistan) with traumatic brain injuries at an alarming rate, regional VA medical officials report.
The phenomenon is linked to the use of improvised explosives in the two war zones, and the repercussions are felt by veterans who are returning home in need of care long after the blasts.
Phoenix’s Carl T. Hayden VA Medical Center and its southwest clinic in Mesa recently received the designation of a trauma center, which includes additional medical staff to help the growing number of local veterans.
The local VA’s recent designation as a trauma center for brain injuries is directly linked to the swelling number of veterans receiving treatment here. Reinforcements include four new medical professionals to assist the existing staff of nine in treating the 14,500 local veterans afflicted with TBI and PTSD.
According to the center, in 2008 there were 27,592 visits for mental health related treatment, including those with traumatic brain injuries.
So far this year, the medical center has experienced more than a 19 percent spike in veterans receiving mental health treatment, or 32,917.
Along with more medical staff trained to handle PTSD and traumatic brain injury cases, comes some increased funding, too, said Phoenix VA spokeswoman Paula Pedene.
In 2008, the budget for the Phoenix VA medical center was $351 million; in 2009, that amount grew to $368 million, or about a 5 percent increase.
The funds will be split among the Phoenix center and its satellite facilities, including the Southwest Extension Clinic in Mesa and the Thunderbird VA Health Care Clinic in the West Valley, Pedene said.
Debbie Dominick, the VA medical center’s program manager for Operation Enduring Freedom and Operation Iraqi Freedom veterans, said traumatic brain injury is an old type of war wound newly experiencing a surge in returning veterans.
By the time they arrive at her door, many have had surgeries to repair the damage, others require extensive treatment for things like memory loss.
“All go through a definitive diagnoses process,” Dominick said.
She said the medical professionals at her center are charged with “looking at the brain globally, which means the entire brain.”
Veterans leaving the military enter the care of the VA medical center, undergoing a two-hour assessment, MRIs, CT Scans, among other things, she said. Some of the veterans are unaware that they have been impacted by nearby explosions — sometimes internalizing the pain — quietly.
“Even the blast can have an effect,” she said.
Dominick added that it was her job to encourage veterans to take the assessment, consider the treatment options and get help.
“The shrapnel is attacking your body, but the blast is attacking your mind,” she said. Dominick said it wasn’t until 2003 that military and VA officials began to see a pattern of veterans returning with brain injuries related to the lingering effects of explosions.
She has worked solely with traumatic brain injury patients since the center created her role in 2005. Patients receive treatments including psychiatric sessions, speech therapy, vocational therapy; many participate in a weekly TBI meeting along with their family members.
“Many of them are dealing with memory issues,” Dominick said. “We’ve created tricks and brain booster tips to help them remember things.”
The trick is putting patients and the right treatment together, she said.
Traumatic brain injuries and post-traumatic stress disorder go hand in hand, VA medical officials say. Often, the veterans who are wounded at war feel the effects of those injuries long after their bodies have healed.
VA Medical officials say part of that healing process requires the necessary treatment, as well as a hand from family, friends and the community.
VA clinical psychologist Leslie Telfer said although her expertise is PTSD, she works side-by-side with the TBI staff.
“There is overlap in symptoms; and PTSD AND TBI are very treatable,” she said.
“I think the biggest public misconception about PTSD is that veterans are on the verge of exploding, and that people ought to stay away from them,” she said. “I think that’s really a misconception. The veterans are more fearful. They need their family and friends to stay close.”
A PURPLE HEART
U.S. Marine Corps Cpl. Brent Phillips is an Iraqi veteran who was wounded in action. He received the Purple Heart for his injuries, including getting struck by shrapnel, a bullet, and an eye injury that required multiple surgeries.
“I wear shades because I can’t see outside. I have no iris and my eye doesn’t adjust to light,” he said recently at his home in east Mesa where he lives with his girlfriend and three children.
The 27-year-old is receiving counseling for post-traumatic stress disorder and traumatic brain injury related to the incident on June 25, 2003.
Phillips said he was on patrol with other Marines in a convoy when his vehicle was struck by four rocket-propelled grenades and heavy enemy fire from handguns. He was struck by a bullet and shrapnel from the explosion, nearly blinding him in one eye, Phillips said.
Weeks after that day, he woke up in Germany, bruised, bandaged, and unable to use his right eye.
“When I initially woke up... I thought I was in Iraq,” said Phillips of his first experience coming to in a hospital bed in Germany. “I didn’t remember the attack.”
Phillips said he underwent several surgeries on his eye, which left him with little more than the ability to tell night and day out his right eye. That was before an experimental surgery, of which he was the first recipient, to place a titanium plate around his eye amid other procedures in restoring his sight.
“When I woke up after the surgery, it was like night and day,” said Phillips of the surgery. “I could read the label off a water bottle.”
Through treatment received at Mesa’s Southwest Extension Clinic, as well as downtown at the Carl T. Hayden Veterans Administration Medical Center, Phillips said he is coming to grips with his lingering war injuries.
“When people hear that you have PTSD, they think, 'Oh, he’s going to dive under the table at the sound of a tire blowing up,’” he said. “Or when someone has a traumatic brain injury like my short-term memory and spelling issues, they have a perception that you’re useless.”
Phillips said his aim was to change that perception. That’s precisely what drove him to join the local chapter of the Military Order of the Purple Heart, through which he has spoken publicly about his experience, and on the broader topic of furthering benefits in the state for returning veterans.
“One of my biggest regrets is that I can’t go back,” he said.
Kevin Ivory, the 24-year-old Iraqi veteran, worked as a Navy field corpsman with a Marine Corps unit in Iraq.
Marines typically call Navy field medics “Doc” since they are the unit’s only lifeline between the front and where doctors and surgeons are often posted miles away in the heavily fortified and guarded zones.
He served two tours — 2005 and 2006.
The Scottsdale resident said he had two close calls, and one deal breaker.
“After the third time, there was nothing anybody could do to make me want to go back there,” the young, former West Valley athlete said on the campus of the University of Phoenix, where he now works as an online education counselor.
During his second tour, while patrolling Iraq on Aug. 31, 2006, a pressure plate with three improvised explosive devices (IEDs) triggered beneath Ivory’s truck.
The vehicle was tossed 15 feet in the air and Ivory was thrown 50 feet from the truck receiving blunt force trauma to his head, according to VA medical records. A Marine he was riding with in the vehicle lost an arm — but he survived.
The months that followed included stays at medical facilities in Iraq, Germany, and the United States.
His new road to healing in the Valley was plagued by memory loss and speech difficulties stemming from his brain injuries. Ivory said he has seen speech pathologists, and received many one-on-one counseling sessions with VA medical professionals.
They have become his mentors.
“It’s a personal relationship,” Ivory said. “If I don’t call for a couple of days, they call me and ask if I’m still alive.”