By Carol Kerr
Public Affairs Office

June 1, 2008—"You can and must make a difference in the lives of Soldier with traumatic brain injury," said Lt. Col Nikki Butler in a speech that won top billing in the Army War College's 10th Annual Speaking Competition.

"Persistent headaches, memory loss, inability to sleep, and inability to do daily tasks are all signs and symptoms of what has become known as the signature injury of wars in Afghanistan and Iraq: mild traumatic brain injury," she revealed in the first minutes of her speech. She referred to a recent Rand study that estimated nearly 320 thousand servicemembers are suffering from some form of MTBI. These are due to increased exposure to blast injuries, improved body armor and better medical care in the field, resulting in higher rates of survival than previous conflicts.

"As opposed to the physical injuries that you can see, she said, "MTBI affects moods, thoughts and behaviors, often going unrecognized and unacknowledged and thereby remaining invisible to Family members, fellow servicemembers and society in general." Very often...service members will deny or delay seeking assistance because of that perceived stigma of asking for mental healthcare."

"Mild traumatic brain injuries are cumulative. Troy Aikman, Mohammed Ali, Steve Young are all professional athletes, all had repeated blows to the head that left them dazed, confused and sometimes unconscious, she said, noting long term effects on their careers and health. "The effects of traumatic brain injury do not accrue sequentially, but exponentially. Servicemembers with MTBI are twice as likely to suffer from PTSD, four times more likely to suffer from depression.

"What can you as leaders do to make sure your unit can accomplish its mission while protecting your Soldiers?

"Professional sports teams have their athletes tested cognitively prior to the start of every season and, each time their bell is rung, they are retested to determine if there's a change in response time. Believing that Soldiers are akin to professional athletes, the 101st Airborne Division, prior to its recent deployment had all of its Soldiers tested. They will retest those same Soldiers when they return from those deployments.

"It is up to you to make sure your Soldiers are tested predeployment to establish their baseline, and again post-deployment to identify those Soldiers who might not report an injury.

"It is not only the Soldiers' equipment that needs resetting. It's their minds as well," she concluded. "Your involvement is crucial to get beneath the skin and identifying those invisible wounds,"

Butler was one of eight Army War College students to address students, staff and faculty in the two-part competition that profiled skill in persuasive speaking and in delivering impromptu remarks. The "people's choice" vote gave audience members a voice in the judging—and echoed the official judges' vote.

LTC Nikki Butler (PT) is serving as the Senior Rehab Specialist for the Proponency for Rehabilitation and Reintegration, OTSG.