Before Sergeant Joshua Lawton-Belous was sent back to the United States, he spent three months in a remote part of Iraq with no showers and barely any electricity.
As the head medic, he felt directly responsible for the health and well being of 82 other men stationed at the outpost with him.
"We were 40 minutes from the nearest doctor or physician. I was it," recalled the 23-year-old Vienna native.
So Lawton-Belous ignored the headaches that had been building since January. He tried not to pay attention to the fact that he was tripping over his feet more often than he should have been.
Then, one day in early May, Lawton-Belous couldn’t hide from his problems any longer. The soldier blacked out and fell into a patch of wire spread across the ground. When he regained conscience, Lawton-Belous found he had ensnared himself in a trap laid out for insurgents.
Examinations in Germany and central Texas uncovered that Lawton-Belous suffered from a traumatic brain injury.
Lawton-Belous endured several blows to the head during the two tours of duty he had in Iraq. A person dropped a grenade from above as his truck passed under a bridge. There were roadside mortar blasts, one so close that it cracked his vehicle’s window.
The cumulative effects of the blasts probably caused his brain injury.
"Those huge blasts, people sustain them now. Now, you survive those incidents," said Lawton-Belous.
The repercussions of a traumatic brain injury vary widely from patient to patient. Sitting in a Vienna Starbucks, Lawton-Belous is articulate and jovial but he said he could get flustered now as a result of the injury.
He has a hard time reading, for example, when music is playing in the background. He also starts to stutter if he gets aggravated. Family members say that never used to happen to him before the war.
Short-term recall also poses a problem. Lawton-Belous sometimes records himself and carries a notebook to make sure he remembers what he is doing and where he is. He keeps his calendar with him at all times to make sure he doesn’t forget appointments.
"I forget talking to people and things I just read," said Lawton-Belous.
The sergeant who walks with a cane has also developed a vestibula problem and has problems maintaining his balance. It can create optical illusions such as when a car drives by him and he feels like he is moving forward.
"If I shut my eyes, I won’t notice that I am falling until I hit the ground," he said.
Traumatic brain injuries have become the signature injury of the wars in Iraq and Afghanistan, according to Susan Connors, president and chief executive officer of the Brain Injury Association of America in McLean.
From January 2003 to April 2007, the Army’s Defense and Veterans Brain Injury Center treated 2,229 soldiers for traumatic brain injury at its nine facilities, said Chuck Dasey, the public affairs officer for Walter Reed Medical Center.
Soldiers with brain injuries are more likely to have a moderate or severe case than civilians, according to Connors.
"Only about 15 percent of the civilian population with brain injuries has a severe or moderate case. In the military, about half the cases are moderate or severe," said Connors.
Heightened awareness of traumatic brain injury has led to more reported cases in the military, said Dasey.
"There has always been brain injury in combat but there is a significant increase in awareness of this type of injury and how to treat it," said Dasey.
Connors said civilians are also more aware of the injury because of the recent stories coming out of Walter Reed and the National Football League. The death rate from traumatic brain injuries has fallen due to advances in medicine and pharmaceuticals.
To help with recovery, Lawton-Belous works on crossword puzzles and attends physical therapy at Walter Reed Medical Center in Washington, D.C. several times per week.
"There are high hopes that I will make a full recovery," said Lawton-Belous.
If Lawton-Belous makes a full recovery before his military contract expires in the fall of 2009, he will most likely be sent back to Iraq, especially since the Army is short on medics.
"Once you recover, it is a free for all … You go where they need you," he said.
Exactly one month after the Sept. 11 attacks, Lawton-Belous signed up to enlist in the U.S. Army. Still a senior at Madison High School, he had been watching the World Trade Center on television in German class when the second plane hit one of the two skyscrapers and brought it tumbling to the ground. He decided he wanted to serve his country.
"If I had to do it over again, I would have gone to college," said Lawton-Belous, who had been looking into college Reserve Officers’ Training Corps (ROTC) programs at the time.
He had originally hoped to become a linguist for the Army and fell into the medic position after he couldn’t get security clearance for the first position. As a medic, Lawton Belous had to treat soldiers who were injured during battle and he saw far more combat than he ever would have as a linguist.
"No one expects much of a medic until he saves a guy’s life. I saw things on a daily basis that would traumatize most people," he said.
His medical experience will hopefully come in handy in the future. Lawton-Belous hopes to either work in an emergency room or practice health care law. He is currently enrolled in classes at George Mason University.
"I am definitely getting out of the military," he said.