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Military Policy Impedes Research On Traumatic Brain Injuries


Hundreds of thousands of American troops have suffered some form of traumatic brain injury from the shockwave of explosions in Iraq and Afghanistan. TBI is linked to cognitive problems, depression, even suicide. One of the best ways to learn more is to study the brains of troops killed in action. And that's why the Pentagon set up a brain bank. But as NPR's Quil Lawrence reports, the Pentagon inadvertently made it nearly impossible for the bank to find donors.

QUIL LAWRENCE, BYLINE: Valerie Pallotta testified before the Senate recently about a subject she never wanted to know so well - suicide among veterans.


VALERIE PALLOTTA: If you could just bear with me. It's - it's been only six weeks since my son ended his life.

LAWRENCE: Her son, Joshua, served on a mortar crew in the mountains of Afghanistan. He had a harder time back home in Vermont.


PALLOTTA: Our son was pronounced dead from a self-inflicted wound at 2:17 a.m. September 23, 2014 at the age of 25. His death certificate should have stated the cause of death as PTSD or Traumatic Brain Injury, not from a self-inflicted wound.

LAWRENCE: The link between TBI and suicide is not known for sure. Nothing much about TBI really is. Dr. Daniel Perl, who directs the military's TBI brain bank, he's trying to change that.

DANIEL PERL: We hope our research will lead to a better understanding of what's going on here, sorting out what is related to TBI, what is related to PTSD.

LAWRENCE: Dr. Perl had been director of neuropathology at Mt. Sinai medical school in New York for 24 years. The Pentagon recruited him to set up its brain bank. It opened in 2012 as part of the $70 million Center for Neuroscience and Regenerative Medicine.





PERL: Hi. So...

LAWRENCE: In an office park, a 10-minute walk from a Metro station outside Washington, Perl and his colleagues have rooms full of high-powered microscopes and vaults for brain specimens. Perl showed me a big glass slide the size of an index card.

PERL: We're looking at the section of the brain - this is the surface of the brain - but here, this is all damage. In a sense, we learn more from the way the brain is attempting to heal areas than we do from the actual damage itself.

LAWRENCE: But that slide he's holding up, that's a tissue sample from a civilian donor. To really understand blast injuries, Perl needs to look at the brains of people killed at war. The brain bank has capacity for more than 600 specimens. Right now, it has only six from the military - six.

But you don't know why you're not getting them then?

PERL: I really don't know why that's not happening.

LAWRENCE: It's not happening for a bunch of reasons. The Armed Forces medical examiner does an autopsy on every single American killed at war. Autopsies in past wars led to medical breakthroughs. But a spokesman at the examiner's office said current law doesn't allow collaboration with the brain bank. That means the medical examiner can't provide specimens to the brain bank. That's true even if a soldier wanted to donate. Troops can check a box, just like on a civilian driver's license, to indicate organ donor status. But the brain bank is not allowed to approach families of the fallen - even the ones who signed up to be donors.

PETE CHIARELLI: I think it's really kind of a failure of the system to really think through the problem.

LAWRENCE: Retired Army General Pete Chiarelli says everyone agrees on the urgent need to understand TBI, and that the brain bank is the way to do it, but it's not happening.

CHIARELLI: Dr. Perl came to me late in the time that I was vice chief of staff of the Army, and I tried to work through this. Like most things, it gets bottlenecked when you start talking to the lawyers.

LAWRENCE: Chiarelli says if military families could be approached, many would want to donate for the sake of helping other soldiers.

CHIARELLI: It's not too late to begin recovering from that. But I think there's been a huge opportunity lost.

LAWRENCE: An opportunity lost because when the American combat role in Afghanistan was at its peak - and troops were dying - the military didn't get access to donors. The hope back then was that brain research might have helped find ways to treat TBI on the battlefield. It's too late for that now with the U.S. combat mission ending in Afghanistan. But Dr. Perl thinks the brain bank can still do plenty of good. He says his mission now is to help treat what he fears could be problems later in life for veterans - Chronic Traumatic Encephalopathy - like boxers and professional football players get.

PERL: This is the most important work I've ever done and we're going to make a very important contribution to the country and to our service members.

LAWRENCE: Perl says he thinks treating TBI over the long-term could end up costing more than the wars. A Pentagon official told NPR a new policy on brain tissue donations has been in the works for more than a year. But, he said, it's too early to discuss it. For now, the Pentagon's brain bank is fully staffed, state-of-the-art and virtually empty. Quil Lawrence, NPR News. Transcript provided by NPR, Copyright NPR.

Quil Lawrence is a New York-based correspondent for NPR News, covering veterans' issues nationwide. He won a Robert F. Kennedy Award for his coverage of American veterans and a Gracie Award for coverage of female combat veterans. In 2019 Iraq and Afghanistan Veterans of America honored Quil with its IAVA Salutes Award for Leadership in Journalism.