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Assessing The Injuries After Iranian Missile Attack

SCOTT SIMON, HOST:

Eleven U.S. service members suffered concussive injuries in Iran's January 8 ballistic missile strike on the Ain al-Assad air base in Iraq. Defense One, an online defense news site, reported this week that the wounded were transferred to hospitals in Germany and Kuwait. Now, a statement from the U.S. Central Command confirmed the injuries despite President Trump's claim that, quote, "no Americans were harmed during the attack."

Dr. Stephen Xenakis is a neuropsychiatrist and former brigadier general in Washington, D.C. Dr. Xenakis, thanks so much for being with us.

STEPHEN XENAKIS: Good to be with you.

SIMON: Help us understand. What is a blast concussion?

XENAKIS: So a blast concussion is like a concussion where the blast wave, in fact, causes microscopic injuries to the brain.

SIMON: And, Doctor, based on your experience, what does it say to you that these service members have been sent abroad for treatment to U.S. defense facilities?

XENAKIS: Well, it indicates that there's probably something serious that needs to be evaluated. I mean, this incident occurred about a week ago. Most of the times - and these soldiers, service members who have been afflicted will recover within a day or two. But if they've persisted, it means that something's more serious happened. And they're being transferred to the medical center in Landstuhl, which is the largest hospital that the Department of Defense has outside of the continental United States to evaluate the service members and then start the first phases of treatment.

SIMON: And again, based on your experience, Doctor, do you know what that evaluation and care might look like?

XENAKIS: There's an extensive physical examination, a neurological examination to see if there are any problems with motor movement, any problems with sensory perceptions. The service members can have balance problems, and that's another sign that they've had a fairly significant exposure. And then there'll be MRIs to see if there's any other parts of their body - organs may have been also injured.

SIMON: I guess we need to understand just because a missile that explodes doesn't necessarily physically harm a U.S. service member. There are still potentially very serious injuries that just the concussive blast can inflict.

XENAKIS: Absolutely. You know, the IED blast has been called the signature injury of this war, not only because many casualties lost their limbs, particularly their legs, but also because we've seen these kinds of problems in their thinking. They've persisted. And it's like the football players. Over time, they can go on for many months, sometimes years, and sometimes we'll see that they didn't have PTSD at the start. But it'll show up as their mental state seems to get worse.

SIMON: The statement issued said the service members will probably go back to duty after treatment, but is that always a good idea?

XENAKIS: It's mixed. The service members themselves very much don't want to think of themselves as being injured, but, in fact, if they have been, then they're going to be struggling. And the clinician has to be sensitive to the pluses and minuses of returning the person to duty and getting them supportive care if that's really what they need.

SIMON: Dr. Stephen Xenakis, a psychiatrist and former brigadier general, thanks so much for being with us.

XENAKIS: Thank you so much.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.