Dr. Maria Mouratidis is an expert on TBI and
The wounds of war are serious and each new
war seems to generate new kinds of wounds.
The current wars in Afghanistan and Iraq are
no exception. Service members from these two
wars are coming home with injuries that have
never been seen before by medical experts. They
are also recovering, which would have been
impossible in wars such as Vietnam.
Dr. Maria Mouratidis, a Bethesda Naval Medical
Center expert on traumatic brain injury
(TBI) and post-traumatic stress disorder
(PTSD), recently spoke on “Trauma and Resilience:
Mind, Body, and Spirit,” at the National
Library of Medicine. TBI occurs when sudden
trauma causes damage to the brain. It is rapidly
becoming one of the most frequent injuries in
the United States—1.4 million people are diagnosed
each year. TBI is also one of the major
injuries resulting from the two current wars.
Improvised explosive devices (IEDs), or homemade
bombs, are the major cause of TBI and
PTSD in returning servicemen. The injuries are
mostly seen in men under age 25. Because of
the nature of IEDs, the wounds pose many new
challenges, said Mouratidis.
“With land mines, for example, you generally get
clean-cut shrapnel wounds,” she observed. IEDs,
however, are filled with such destructive substances
as nails and ball-bearings, toxic chemicals
such as rat poison, biological toxins and
radiological materials. The wounds themselves
are jagged, irregular and varied because of the
varied contents and pressure. The shock wave
from an IED, for example, can burst an intestine.
While it took an average of 2 weeks for
wounded Vietnam War soldiers to arrive in
the U.S., today injured servicemen and women often arrive at Navy within 2 days of their injuries. They travel on planes that
are basically flying intensive care units.
“They get here so fast that often their watches are still set on Baghdad time,”
Once they arrive in Bethesda, “we begin the Battle of Bethesda,” to save the
patient’s mind, body and soul, she said.
Craniotomies—operations in which part of the skull is removed to allow a swelling
brain room to expand—are performed. Also, after patients heal, one or more
plastic surgeries may be needed, to repair damage.
Families are flown in and a multidisciplinary team of physicians, psychologists,
physical therapists, nutritionists and even a Golden Retriever therapy dog
named Laura Lee all help in the patient’s recovery. One of the biggest issues, said
Mouratidis, is that many returned servicemen and women don’t show the effects
of TBI/PTSD until months after they come back.
“The injuries can be quite serious, yet they are not easily discernible in some cases,”
NLM has a role in helping returning veterans and their families. On MedlinePlus.gov, the library’s consumer health web site, one can find the latest information
on PTSD and TBI.
Within MedlinePlus is another resource, “Go Local.” Using it, consumers can find
health facilities and services in their localities, including clinical social workers,
marriage counselors, adult day care for those with TBI and hospitals that have
services geared towards patients with PTSD/TBI. The site is updated constantly
so that the latest information is available.
Despite the horrific nature of many war injuries, Mouratidis emphasizes a message
of hope. As one injured veteran, who had been blinded in his left eye by an
IED, said, “My right eye is getting stronger every day.”