Cpt. Andrew Berry had to readjust to life with brain injury.

NEW YORK, NY May 25, 2007 —Troops returning from the wars in Iraq and Afghanistan face many challenges getting life back to normal -- particularly those who have suffered debilitating physical injuries. But increasingly a class with mild-but-disturbing injuries is emerging. They’re soldiers who might not seem to have been injured at all, only to find out later that they’re steadily losing hearing, eyesight, memory and other brain functions. WNYC’s Fred Mogul has more.

BERRY: You guys that are all worry-warts, don’t worry – I’ll make sure you know everything you need to know before you take this test.

REPORTER: Andrew Berry trains security guards for Allied Barton, one of the world’s largest private security companies. He is also a captain in the U.S. Army Reserves. He served in Iraq from mid-2005 to mid-2006, training Iraqis. Berry never sustained life-threatening injuries, but he got his bell rattled frequently. One day, returning to base, his vehicle was hit by a roadside bomb.

BERRY: There was no traumatic damage, just the concussion alone threw everyone around in the trucks. I knew I had a bloody nose and a little blood coming out of my ears, and just wiped it down not thinking anything was going on, and just tracked on.

REPORTER: Berry was almost hit by enemy mortars a dozen or more times and once was knocked unconscious. And when the tank unit he was fighting with returned fire, the noise was close to deafening. He didn’t think anything of it at the time. But gradually, and especially after he came home, he started noticing problems.

BERRY: My sleeping habits are poor. I can lay in bed for two days without sleeping. And some nights when I'm sleeping, I’ll have some bad nightmares, and it wakes me in a very cold sweat, where it looks like I came out of a swimming pool or a shower.

REPORTER: He was always a details guy, but his attention-span was deteriorating and he was forgetting all kinds of things. And then there was his hearing.

MASON: Driving around in the car, I’d ask my wife to turn the radio on. And she’d say, “It’s on,” and I would laugh it off, “Yeah, I knew that. Just turn it up a little.” And she knew what I was getting at.

REPORTER: Berry went to the East Orange V.A. Medical Center near his home in New Jersey, where he found out he had Traumatic Brain Injury. TBI is the result of an event or series of events that violently pound, shake or physically penetrate the head, damaging cells and altering brain chemistry. It can be severe, moderate or mild. In this last, less obvious category, cases are emerging more slowly among returning vets. Specialist Michael Mason says people are often misdiagnosed. Or, they simply don’t connect their symptoms to explosions that didn’t seem to injure them so badly.

MASON: Mild TBI is notoriously difficult to test for, because the cognitive impairments can be so subtle, that it may not be picked up on your typical brief neuro-psychological examination. It can range from a simple persistent headache to a new kind of agitation or frustration level you never had before.

REPORTER: Traumatic Brain Injury is different than Post-Traumatic Stress Disorder, though many people with TBI also have PTSD. PTSD is the result of psychological shock. Someone with PTSD has ongoing problems dealing with events they’ve experienced. The symptoms overlap – for example agitation and sleeplessness – and so do some of the therapies. Mason is a brain injury case manager at the Neurological Research Institute in Tulsa. He says the two syndromes need to be “teased apart.”

MASON: You’re going to want to find out what are the true cognitive deficits created by the brain injury. Are they hyper-stimulated? Has there been sensory loss? Whereas PTSD, you need to have more of a psychiatric oversight: Will talking therapies assist this person, or is it going to be a matter of anxiety medications and that kind of thing?

REPORTER: At the War-Related Illness and Injury Study Center in the East Orange V.A., a medical team screens soldiers and veterans for various physical and mental conditions. One recent day, the team discussed an Iraqi war veteran they would only call “Mr. Clark.”

STAFF: Did you hear anything about his exposures? -It sounded like his symptoms were resolving, now that he’s been back a few months . . .

REPORTER: Patients come in for an entire day of testing – a process the V.A. would not let us observe. They undergo physical, psychiatric and neurological testing and talk with a variety of specialists and counselors. At the end of the day, the whole team sits down and discusses each case before the patient leaves.

STAFF: We talked about environmental exposure issues. He had concerns about depleted uranium exposure . . .

REPORTER: The team then talks to the patient, referring him or her to others within the VA system for treatment, counseling, group therapy or further diagnosis. Dr. Patricia Findley says the follow-up is the key part.

FINDLEY: We don’t just evaluate and send the veteran off, we do stay in touch with them. We have to do case management. It’s all the typical negotiation of services, brokering for services, connecting and teaching the veteran how to do that for themselves. For the rest of their lives, they’re going to have to do that.

REPORTER: The constant coming and going can be challenging, especially for people who don’t live anywhere near a V.A. Captain Berry is lucky. He’s only about seven miles away from the East Orange center.

BERRY: I have to come in about once every two weeks. I have to come here to get new prescriptions. I’m going to be seeing a new doctor to get some new testing for the TBI . . .I choose to come here, not because of the war-related injuries that are treated for free, I come here because I’m satisfied with the doctors. I’m satisfied with the staff.

REPORTER: These days, Berry wears small, barely visible hearing aids in each ear. Although his TBI is considered Mild, he still has problems with short-term memory and concentration. He writes things down religiously and works at getting back his “edge.”

BERRY: Like my comprehension edge. I’m trying to get my comprehension back a little bit.

REPORTER: Is there any knowing – speculating, predicting – whether things will come back?

BERRY: If they don’t, I can live a fruitful life just the way I am. I’m very basic. I can just live doing what I’m doing…/EDIT/ … if this is the way it’s gonna be, it’s the way it’s gonna be.

REPORTER: The V.A. says about 3-thousand T.B.I. cases have been identified so far, but many experts think there are many more relatively Mild cases out there either mis-diagnosed or not detected at all. Finding and treating them will be difficult. Unlike Capt. Berry, many veterans aren't fortunate enough to have a nearby V.A., a stable job and a supportive family.