Face of Defense: Soldier Counts on Training, Teammates

By Army Sgt. Ginifer Spada

210th Mobile Public Affairs Detachment

NANGARHAR PROVINCE, Afghanistan, June 13, 2011 – May 13 was just another day -- another mounted patrol in the mountainous area outside of Combat Outpost Honaker-Miracle, Afghanistan, Army Spc. Brian Walker said.

“We get shot at all the time, every day," said Walker, an infantry radio operator assigned to Company C, 2nd Battalion, 35th Infantry Regiment, Task Force Cacti, 3rd Brigade Combat Team, 25th Infantry Division, Task Force Bronco. "We are bringing them the fight.”

But for Walker, a Johnson City, Tenn., native, this wasn't just another day. He was riding in the lead vehicle of a mounted patrol when it hit a roadside bomb.

“I don’t remember much from that day," Walker said recently while recovering in a hospital at Bagram Airfield. The parts he does remember, however, speak volumes about his team and their training.

“Everyone was doing exactly the right thing," Walker recalled. "Everyone fell back on their training and did exactly what they were supposed to do."

Army Staff Sgt. Simon Bachmann, Walker's squad leader, echoed Walker’s sentiments.

“As soon as everything popped off, everyone did the right thing," he said. "The driver got them through the kill zone, [and] everyone in the truck began buddy aid. They all responded to a ‘T.’ They reacted perfectly.”

The truck commander, gunner and two other soldiers all suffered shrapnel injuries. While Walker’s injuries were minor, he lost consciousness multiple times, and was sent to the traumatic brain injury clinic.

Although Walker is not fully recovered, he said, he is doing much better than when he arrived at the clinic. Bachmann said he isn't surprised at Walker’s progress.

“He’s a good guy -- really friendly, and motivated," Bachmann said. "He likes to work and get stuff done.”

Walker received a Purple Heart Medal, presented to him by Army Maj. Gen. Dan Allyn, Regional Command East and Combined Joint Task Force 1 commander, and the command’s senior enlisted advisor, Army Command Sgt. Maj. Saia Vimoto.

“I was honored -- I mean, the command sergeant major and commander of the biggest base in Afghanistan," Walker said. "I was just honored."

Walker said the pace at Bagram Airfield's traumatic brain injury clinic is in stark contrast to that of Combat Outpost Honaker-Miracle.

“This is the first time a whole week has gone by without me getting shot at,” he said.

Although the more relaxed battle rhythm at the clinic is helping Walker recover, he is anxious to get back to his fellow soldiers and to do his job.

“I know that they need me," he said. "I want to get back and do my job -- get back and be there for the guys.”

Walker and Bachmann agreed that everyone in their platoon shares the same dedication to each other and their jobs here. The 2nd Platoon Renegades, as Walker and the other soldiers from his platoon are known, are at the beginning of a year-long deployment to one of the most dangerous areas of eastern Afghanistan.

Marines in Afghanistan Test New Concussion Care

By Cheryl Pellerin

American Forces Press Service

WASHINGTON, Jan. 27, 2011 – A new concussion care program being fielded by the Marine Corps in Afghanistan is giving psychiatrists, physicians and even chaplains and sergeants a better way to treat those with the No. 1 battle injury, military combat medicine experts said today.

Navy Cmdr. (Dr.) Charles Benson, 1st Marine Expeditionary Force psychiatrist and 1st Marine Division’s deputy surgeon, and Navy Cmdr. (Dr.) Keith Stuessi, director of the Concussion Restoration Care Center at Camp Leatherneck in Afghanistan, spoke with Pentagon reporters in a video teleconference.

The Navy-Marine Corps effort, launched in August and called the Operational Stress Control and Readiness Program, or OSCAR, has two parts, Benson said.

“The first part [includes] psychiatrists and psychologists who we field with the combat team,” Benson explained. “These are organic embedded assets in the division’s regiments and battalions. They live with the troops, train with the troops and get out in the field with them.”

Such an arrangement, he added, “allows the Marines to come forward to the psychologists and psychiatrists [and] kind of breaks down the barriers and allows the [providers] to become very effective at … delivering mental health care.”

The second part of the program offers special training to medical officers, corpsmen, chaplains, religious personnel and key leaders at the sergeant and first sergeant level so they can deliver basic mental health care to troops in harm's way.

“Those folks constantly monitor their Marines,” Benson said, “helping them with simple issues and understanding at what point [a Marine with an injury] needs to be referred back for more comprehensive care.”

Together, the programs “have generated quite a bit of success out here in Afghanistan,” the psychiatrist said, treating concussions and musculoskeletal injuries -- the No. 1 nonbattle injuries of the war.

Stuessi, a sports medicine doctor, described a typical Concussion Restoration Care Center success story.

“I first saw Lance Corporal Smith on Jan. 3, three days after he was medevaced to Bastion Role 3 hospital because of injuries suffered from [ a roadside bomb] blast while on a routine convoy,” he said.

Smith was discharged from the hospital and referred to the outpatient concussion center, where he completed a questionnaire about the blast and his symptoms, and went through a neurologic exam and a neurocognitive test.

“Lance Corporal Smith and I discussed the symptoms -- a constant headache, dizziness, trouble concentrating and sleeping, moderate low-back pain and occasional nightmares, along with repeated thoughts of the blast,” Steussi said. “Over the next 11 days, all these symptoms were addressed by our specialists, who are located under one roof.”

Smith saw a physical therapist, an occupational therapist and a psychologist, and then Steussi used acupuncture to treat Smith’s headaches and insomnia.

Between appointments, Smith stayed with other Marines at a wounded warrior facility.

“During his last visit,” Steussi said, Smith “was completely asymptomatic” and returned to his unit.

Although concussion is a physical injury, Benson said it’s related to mental health.

“When folks have a mild traumatic brain injury, sometimes their symptoms have a psychiatric flavor,” the psychiatrist said. “They might have difficulty sleeping or nightmares and anxiety along with that. And sometimes folks who have straight-up psychiatric symptoms like depression might also have insomnia and problems that look a mild traumatic brain injury.

“There's an awful lot of overlap and symptomatology between the two entities,” he added. “We think it's important to work on these as a team and address both issues at the same time to try to get a Marine back on his feet and heading in the right direction.”

Having psychiatrists and psychologists embedded in regiments and battalions gives troops who might not naturally turn to a mental health provider a range of ways to seek help, Benson said.

“Most of the best OSCAR and OSCAR Extender Program outreach happens when it's not really a formal sort of thing,” he added. “It's like when you're sitting at breakfast eating your toast and a Marine sits across from you and says, ‘Hey, Doc, you got a moment?’ And then you start chit-chatting.

“Or you might be waiting in line or something and they know you because they see you out there in the field,” he continued. “They understand that you can relate to what they're going through, and they feel more comfortable coming to chat with you.”

Ultimately, Benson added, the program should help to reduce the stigma attached to seeking mental health care.

“When you're in combat, when you're deployed, you're going to have feelings,” he said. “Things are going to come up. It's best if you talk about them and seek out help.”

Steussi said center providers have treated and returned to full duty about 320 concussion patients, collecting data on each case along the way.

“We're in the process of reviewing the data so that in the future we can better treat Marines and sailors,” he added, “and use the information to [develop] policies for treatment here, out at [forward operating bases] and in the field.”

New Helmet Sensors to Measure Blast Impact

By Donna Miles
American Forces Press Service

Jan. 7, 2008 - Soldiers from the 101st Airborne Division preparing to deploy to Afghanistan are being issued sensors that attach to their helmets to measure the impact from blasts, roadside bombs and other activities. About 1,200 "Screaming Eagles" already have the new sensors, and the rest will receive them within the next month, said Maj. William Schaffer, a product manager in the Army's Program Executive Office Soldier, based here.

Meanwhile, troops from the 4th Infantry Division are scheduled to receive helmet sensors with similar capabilities before their deployment to Iraq this fall, Schaffer said.

The sensors gather data on impacts ranging from a dropped or kicked helmet to a vehicle crash to a nearby weapon firing or explosion, Schaffer explained. They measure two specific actions: the energy wave generated by the "event," and the "acceleration" or jolt that follows.

In the short term, data collected through the sensors is expected to help the Army improve the helmets and other protective equipment it provides its soldiers, Schaffer said.

A longer-term application – one Schaffer emphasized the medical community isn't yet ready for – is to use impact data to help diagnose traumatic brain injuries.

"With the number of IEDs that we're seeing in Iraq and the traumatic brain injury that's coming out of it, obviously somewhere down the line we are looking at correlating the blast and the injury," he said. "But in the near term, we are looking at developing a more protective piece of equipment. The advanced combat helmet we have out there is the best in the world, but we are always looking at ways to make our products better, and this is a great way to start."

Gen. Richard A. Cody, Army vice chief of staff, ordered the helmet sensor program in June. Three months later, the Program Executive Office Soldier had come up with several potential helmet sensors and was putting them through extensive testing at Aberdeen Proving Ground, Md.

Within six months of getting its marching orders, officials narrowed the field to the most promising models: one mounted externally and one internally. "We came up with two of the best sensors, and we're now preparing to field both of those," Schaffer said.

The model going to the 101st Airborne Division attaches to the back of the advanced combat helmet, protected by a hardened casing that is covered by a camouflage flap. It weights about 6 ounces and has a six-month battery life. The sensor remains in a "sleep" mode, automatically turning itself on and capturing data from an event, then turning itself off. It has enough memory to store data on 527 events between downloads.

To download the sensor, a soldier simply connects it to a computer using a USB port, hits "save" and sends the data to a secure database.

An internally mounted model to be fielded to the 4th Infantry Division sits under the padding in the crown of the helmet. It has a rechargeable battery, but otherwise has the same capabilities as the externally mounted sensor.

"One is protected by the helmet itself, and one by the hardened casing around it," Schaffer said. "Both measure impact and acceleration."

Initial input from 101st Airborne Division soldiers shows they are happy to play a part in helping the Army improve its helmet protection, Schaffer said. He noted that many of the soldiers have experienced blasts or accelerations during past deployments and recognize the value of the sensor technology in developing the next-generation combat helmet.

"This shows everybody that the Army cares," Shaffer said. "We have got the best equipment in the world, but we are not resting on our laurels. We are always looking forward, always looking for the next generation of protective equipment to take care of the soldiers."