Gina Hardy never had much of a chance to enjoy her husband's homecoming from Iraq. Warren Hardy, a decorated veteran of the Iraq War, had sustained an undiagnosed traumatic brain injury when his armored personnel carrier rolled over a land mine near Tikrit.
"You see pictures of soldiers coming home, reuniting with the families and … everything is great," said Gina. "We didn't have that kind of reunion. When I saw him for the first time, I was disappointed. He was just different, and I couldn't understand why."
Hardy was sent to Iraq with the first armored division in 2004, and was injured by the land mine a few months into his tour. An eyewitness to the explosion said Hardy's 14-ton vehicle went 10 feet into the air. Military doctors diagnosed Hardy with knee problems, but he wasn't screened for a head injury, even though he blacked out after the explosion.
"When I went into the combat hospital," said Hardy, "all they did was look at my knees and X-rayed them. And they put down on my emergency sheet, [I] have a lump on my head. They gave me two days' rest and then returned me to duty, and I went straight back onto patrol again.
"I just don't think the doctors at the time really understood … the new kind of injury that I had coming out of Iraq."
After the blast, Hardy immediately felt like a different soldier. "I was always banging my head against obstacles," he said. "And it's like my memory of what's around me wasn't keeping the information. So I would always end up with these cuts and scrapes on my head. I just didn't feel as smart. I knew there was something wrong, [but] it never dawned on me that I had a head injury that way. I just noticed that something was different."
When Hardy returned home, he was unable to concentrate and would have unprovoked outbursts. He could walk and talk, but with his memory failing him, he found it impossible to return to work as a software engineer.
"Nothing, nothing sunk in," said Hardy. "And the harder I tried, the more frustrated I got. I used to be a software engineer. I had an incredible memory. And now I am struggling."
Around the same time, the Hardys -- who already had one daughter, Autumn -- welcomed a set of triplets: Erik, Preston and Thomas. And the financial pressure on the family was mounting.
"I was panicking," said Gina. "I am like, 'Well, what, what are we going to do? What's he gonna do?' We were living off our savings, which was disappearing quickly."
It was during a routine visit to the Veterans Affairs hospital that doctors finally examined Hardy for brain injury. He began to understand what was happening inside his head.
"That whole time he had been suffering from the effects of the brain injury, and it had never been evaluated," said Harriet Zeiner, a neuropsychologist at the Palo Alto VA hospital. "I worry that there are many more Warrens out there. We're getting 20 people a month coming in that door that we're picking up in other ways. These folks end up having brain injury and permanent residual effects for the rest of their lives."
While advances in body armor and battlefield medicine are saving the lives of many servicemen and servicewomen, it is nearly impossible to fully protect the head from the concussive wave of an IED. Thousands of American GIs could be suffering from mild TBIs without even knowing it.