28 April 2009 by: Michael Bond, Magazine issue 2705
Editorial: Concussed, stressed or just sick of war?
ONE look at the effects of a bomb blast suggests that you’d have to be extremely lucky to emerge from one unscathed. If you were not burned by the explosion or blasted by shrapnel, the chances are you’d be hit by the shock wave. Travelling at several hundred metres per second, this causes massive fluctuations in air pressure which can knock you unconscious, rupture air-filled organs such as eardrums, lungs and bowels, and stretch and distort other major organs.
Soldiers serving with coalition forces in Afghanistan and Iraq know only too well how devastating bombs can be. The effect of shrapnel on bodies – amputated limbs, broken bones, lacerated and burned flesh – is plain enough. Less obvious and harder to understand are the long-term effects of the shock wave on the brain.
Weeks, months, or sometimes years after being concussed in an explosion, thousands of soldiers are reporting a mysterious clutch of problems. Dubbed post-concussion syndrome (PCS), symptoms include memory loss, dizziness, headaches, unexplained pains, nausea, disturbance of sleep, inability to concentrate and emotional problems.
The US military and veterans’ groups see PCS as a growing problem, and the US government is pouring millions of dollars into investigating it. Some doctors, however, particularly in the UK, believe that for many patients the symptoms ascribed to PCS are not caused by concussion at all, but by the shock and stress of wartime events. It may even be getting mixed up with post-traumatic stress disorder (PTSD), an acknowledged psychological reaction to disturbing events. “Some people are saying it’s a hideous mistake and that we’re talking up a problem,” says Simon Wessely, a psychiatrist and director of the King’s Centre for Military Health Research at King’s College London.