By Caroline Alexander
Photographs and Audio by Lynn Johnson
Brain injuries caused by blast events change soldiers in ways many can’t articulate. Some use art therapy, creating painted masks to express how they feel.
“I THOUGHT THIS WAS A JOKE,” recalled Staff Sgt. Perry Hopman, who served as a flight medic in Iraq. “I wanted no part of it because, number one, I’m a man, and I don’t like holding a dainty little paintbrush. Number two, I’m not an artist. And number three, I’m not in kindergarten. Well, I was ignorant, and I was wrong, because it’s great. I think this is what started me kind of opening up and talking about stuff and actually trying to get better.”
Hopman is one of many service members guided by art therapist Melissa Walker at the National Intrepid Center of Excellence (NICoE), which is part of Walter Reed National Military Medical Center, in Bethesda, Maryland. Images painted on their masks symbolize themes such as death, physical pain, and patriotism.
According to the U.S. Department of Defense, between 2001 and 2014 some 230,000 soldiers and veterans were identified as suffering from so-called mild traumatic brain injury (TBI), mostly as a result of exposure to blast events. The variety of symptoms associated with the condition—headache, seizures, motor disorders, sleep disorders, dizziness, visual disturbances, ringing in the ears, mood changes, and cognitive, memory, and speech difficulties—the fact that they resemble symptoms of post-traumatic stress disorder (PTSD), and the fact that exposure to blast events often was not logged in the early years of the campaigns in Afghanistan and Iraq make it impossible to pin down casualty figures.
Despite the prevalence of the condition, the most fundamental questions about it remain unanswered. Not only is there no secure means of diagnosis, but there are also no known ways to prevent it and no cure. Above all, there is no consensus within the medical community about the nature of blast-induced injury or by what mechanism blast force damages the brain.
Brain trauma from blast force is the signature injury of the Iraq and Afghanistan campaigns, afflicting hundreds of thousands of U.S. combat personnel. Although unseen, the damage strikes deeply into a soldier’s mind and psyche.
INSIDE THE PROTECTIVE BUNKER I waited with the explosives team, fingers wedged firmly in my ears. Outside, shot number 52, trailing a 20-foot length of yellow-and-green-striped detonating cord, was securely taped to the wall of a one-room plywood building with a steel fire door. There was a countdown from five, a low “pow,” and a dull thump in the center of my chest. The thump is the hallmark of blast. “You feel the thump,” one team member told me. “I’ve been in blast events where we’re actually hundreds or even thousands of feet away, and I still feel that thump.”
The mystery of what that thump does had brought me to a World War II bombing range some 40 miles southeast of Denver. Back then it was used to test half-ton ordnance; now it serves to study controlled explosives used by soldiers to blast holes through walls and doors in combat areas—standard practice in modern warfare. The eventual objective of these tests is to discover what that blast thump does to the human brain.