Concussion center in Afghanistan offers full treatment for troops

Marine Sgt. Albert Carls, left, undergoes an evaluation June 5 by Navy occupational therapist, Lt. j.g. Tommy Neuens at the Concussion Restoration Care Center at Camp Leatherneck in Helmand province, Afghanistan.


By LAURA RAUCH | STARS AND STRIPES Published: June 24, 2012

CAMP LEATHERNECK, Afghanistan — Marine Sgt. Albert Carls can endure just about anything the war dishes out, except being pulled from his unit.

When he suffered a concussion in a series of improvised explosive device attacks that cost two men their legs in the Kajaki district, the way he saw it, he wasn’t really injured.

It didn’t matter that he was only a few feet from the secondary blast, or that it felt like someone smashed him in the head with a sledgehammer. He wasn’t bleeding and he could walk. What was a little dizziness and ear ringing, compared with a Marine who had lost his legs?

“If they gave me a choice, I wouldn’t have left,” said Carls, a veteran of three combat deployments who also suffered a perforated eardrum. “I was in denial of being injured.”

A Navy corpsman trained to identify concussions in the field sent Carls to the Concussion Restoration Care Center, a special care facility at Camp Leatherneck, in Helmand province. According to the center’s officer in charge, Cmdr. Todd May, concussions have become the No. 1 battlefield injury for Marines and sailors.

“Everyone in general has become far more aware of what concussions can do and the damage that can be caused,” May said. “We’re doing a better job of treating them and diagnosing them.”

Each patient receives a neurological evaluation to test thinking ability, and a mental health evaluation. They also undergo a balance assessment and may receive a CT or MRI scan.

Treatments are designed to be comprehensive and may include acupuncture, osteopathic manipulative therapy — a hands-on approach to detecting and treating problems with light pressure and resistance — occupational or physical therapy, counseling and chaplain visits. Rest, both physical and mental, is emphasized for all patients.

“We’ve developed an innovative, complimentary care to the approach of concussions,” said May, a Navy physician who also specializes in sports medicine.

“We start the process of healing here and make sure that they’re well enough to do their job, or we refer them back to the States to finish,” May said. “But the trail they start here follows them all the way through their care, through active duty, all the way through the VA.”

When Carls arrived, he found an atmosphere notably different than the war zone he left behind. The lighting was dimmed and quietness pervaded the halls.

“They keep telling me, ‘Sleep, sleep.’ No caffeine, no video games, just sleep,” said Carls a few days into his recovery. “It’s the first time in a while I’ve slept more than eight hours.”

Before the center opened, Carls would likely have been evacuated to Landstuhl Regional Medical Center in Germany and on to the States for care, never to return to his unit in Afghanistan.

“I don’t want to be here while all the Marines are fighting the fight,” said Carls, a Combat Cameraman attached to 1st Battalion, 8th Marine Regiment. “I feel like I’m cheating history if I’m not out there getting it.”

Then he thinks of his family.

“I owe it to my kids,” he said. “They need to have their dad.”

According to May, 98 percent of Marines treated at the center are returned to their units in theater. Before it opened in August 2010, the Marine Expeditionary Force in Regional Command-Southwest was losing about 20 Marines a month to concussions.

Aside from treating the physical symptoms, a team of mental health experts is on hand to help patients work through any combat stress that may have occurred as a result of the event that caused their concussion.

“There’s a lot of emotional stuff that goes on, and the psychologists work with people to help normalize the experience,” May said.

On the rare occasions when a Marine isn’t raring to go back to his unit, it triggers the team to look for other problems, often emotional.

Most, however, can’t get back soon enough.

“You should be able to be out there with your boys. You kind of feel helpless back here,” said Cpl. Charles Binkley, 22, a gunner with 1st Tank Battalion, 1st Marine Division.

Binkley was knocked unconscious when his Mine Resistant Ambush Protected vehicle rolled over an IED in Kajaki district.

“I got sucked into the truck instead of launched out,” he said. “I just remembered seeing a lot of stars.”

Nearly a week into his recovery, he still suffered from headaches, dizziness and sensitivity to light.

Still, he couldn’t help but think of his unit.

“The worst feeling you can really have [is] if something were to happen to them while you weren’t there.

“I’m comfortable behind my gun,” Binkley said. “That’s where I’d rather be.”



Marine Sgt. Albert Carls, who suffered a concussion in two improvised explosive device attacks, pauses at the Concussion Restoration Care Center at Camp Leatherneck in Helmand province, Afghanistan, on June 5.