War on the Brain: Understanding TBIs

Finally, Boothby entered a civilian rehabilitation program, and he's made steady progress. "It's a struggle for us to make him go to therapy," said his wife, Megan, who's pregnant with the Boothbys' fifth child. "He doesn't like it and he doesn't think that he needs it."

Many of those whose brains have been rattled by the explosions of IEDs and other munitions may not even know they've suffered TBIs and many more show no physical signs.

While someone suffering from TBI may look and act normal — like Boothby and Landay, who look physically fit — they can actually be impaired.

A preliminary study by the American Psychological Association in February noted, "It is possible to have a traumatic brain injury in the absence of any observable physical damage to the brain. Difficulties after a traumatic brain injury include headaches, sleep difficulties, decreased memory and attention, irritability, depression and slowed mental processing."

'I Know He's in There Fighting'

For some victims of IED blasts, the consequences are dire. Marine Sgt. Shurvon Phillip's Humvee was shredded by an IED in May 2005. The explosion crushed his skull, deprived his brain of vital oxygen and left him paralyzed and unable to speak.

Phillip is still mute, but now is able to sit up in a chair, lift one of his arms and thumb-wrestle with one hand. Each movement requires a Herculean effort, and his appearance is still a shocking sight to the Marines who stop by his home to visit and cheer him up.

Each week, a physical therapist works with Phillip for two hours. He sees a speech therapist for one hour a week. An aide is there to assist his mother, Gail Ulerie, with Phillip's care for 40 hours each week. All are employees of the Veterans Administration hospital in Cleveland where Phillip lives with Ulerie, who is his primary caregiver, 24 hours a day, seven days a week.

When Woodruff recently visited Phillip, he asked Ulerie, "Did you think, when he first started coming out of it, waking up, that it would be this bad?"

"Well, I didn't think it was going to last this long," Ulerie said in an accent reflecting her Caribbean roots. "The first time when he opened his eyes and he saw me, he would just like stare at the ceiling all the time or have his eyes closed. I would always keep talking to him and telling him, he can do better and I know he's in there fighting."

Ulerie hovered over her son, tending to his intravenous lines, removing the spittle and phlegm that collects in his mouth and squeezing his cheeks to move the paralyzed muscles of his face. She takes hope from seeing the successful recoveries of other TBI patients.

"His brain was deprived of oxygen, so I knew that his recovery would take a little bit longer," she said optimistically. "Whenever I see someone else who has recovered really quickly, I just praise the Lord and say, 'That's gonna be Shurvon one day.'"

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