TBI care still has many problems, spouse says
By Rick Maze - Staff writer
Posted : Wednesday Oct 17, 2007 14:08:46 EDT

An Army wife’s testimony about her active-duty husband’s mental problems caused by a traumatic brain injury suffered in Iraq provided a solid example for the Senate Veterans’ Affairs Committee about the need to act quickly on improving treatment programs.

Ariana Del Negro, the wife of Army 1st Lt. Charles Gatlin, talked of problems getting help for her husband for the anxiety, hearing loss, chronic vertigo and debilitating headaches he began suffering after he returned home from a 2006 deployment to Iraq.

Gatlin had been hit by three concussive blows from one large car-bomb blast in Kirkuk in September 2006 — one blow from the explosion, a second when the engine block hit him in the back of the head and a third when he hit the ground, Del Negro said Wednesday.

Gatlin was treated in Iraq and returned to his unit but was medevaced from the combat zone four weeks later because of physical and mental problems.

Gatlin initially received treatment at Tripler Army Medical Center in Hawaii, where Del Negro said things did not go well, partly because the many specialists who were supposed to be treating him seemed unable to work together.

“No two specialists agreed about what my husband needed,” she said. “We spent our days shuttling from one appointment to the next, only to discover that the recommendations made by one provider were deemed unnecessary by another.”

Getting referrals also was a struggle, she said. “Despite his worsening symptoms, we had to fight for every referral he needed,” Del Negro said. And, some of the specialists had little or no experience with blast-related brain injuries, and didn’t seem to see any need for speedy treatment.

Del Negro said that because traumatic brain injuries don’t leave scars, some doctors seem to believe that service members claiming to suffer from such injuries are malingering or trying to avoid another Iraq or Afghanistan deployment.

“One of the physicians treating my husband in Hawaii made exactly this kind of accusation,” she said, noting it “added salt to an already open wound.”

As her husband’s ability to speak and think eroded, Del Negro said she began acting as his representative, “but the system at Tripler was far from encouraging and supportive of my efforts.” One doctor flatly told her that her outspokenness might be harmful to husband’s care.

Gatlin ultimately was referred to Balboa Naval Medical Center in San Diego for evaluation and treatment. The Navy hospital, working with the Sharp Memorial Hospital Rehabilitation Center that specializes in helping people recover from injuries, came up with a plan that allowed Gatlin to improve to the point that he has returned to duty in Hawaii, his wife said.

The Bush administration announced Tuesday it is ordering an overhaul of military medical programs to assign Public Health Service officers as coordinators of care for service members seriously injured in combat or combat related jobs. Because these officers are not part of the Defense Department or Department of Veterans Affairs, they can serve as impartial assistants in helping wounded service members with medical, rehabilitation and disability plans.

The recovery coordinator plan does not require congressional approval. A memorandum of understanding between the Pentagon, VA and Department of Health and Human Services, which oversees the Public Health Service, was signed in September. Full implementation is expected to take about a year.