Between 2000 and the first quarter of 2023, the Department of Defense (DOD) documented a total of 479,953 traumatic brain injuries (TBIs); of those, 66,574 were experienced by members of the United States Air Force.¹ In 1992, Carl DeSpiegelaere, an Air Force weather officer, sustained a TBI in a car accident. At the time, shoulder strap seatbelts were not required for vehicles, so when the driver pulled into oncoming traffic and the car was hit, Carl’s head jolted, hitting, and breaking the jaw of the passenger next to him. Carl was immediately taken to the hospital where he was diagnosed with a closed-head injury with a brain bleed. Carl became comatose and was quickly intubated, chemically paralyzed, and transferred to a level-one trauma center. Upon further evaluation, doctors discovered that he had sustained some damage to his brain; however, his neurosurgeon felt that a surgical intervention was unnecessary. After remaining comatose for roughly 9 days, Carl was discharged from the intensive care unit and transferred to a Department of Veterans Affairs Medical Center (VAMC) to continue several different therapies in order to relearn basic daily functions.

Carl had originally planned to return to duty and serve in the Air Force until his retirement. He was placed on the Temporary Disability Retired List (TDRL), which allows Service Members to recover from their injuries in the hope of returning to active duty. After 18 months on the TDRL, Carl was offered an opportunity to come back to active duty; however, he had started a family and a career in the civilian sector and declined. As returning to active duty was off the table, Carl felt that the TBI did not need to be further explored medically. The reality was that Carl still experienced some lasting effects of his TBI, including headaches and confusion. He reached out to the VAMC Polytrauma Department, where he began to work on his mental health and memory and was placed on a preventative medicine to help with his headaches.

During this time, Carl worked with a case manager who informed him about the Congressionally Directed Medical Research Programs (CDMRP) and the Traumatic Brain Injury and Psychological Health Research Program (TBIPHRP). After doing some research on the program and how it helps the TBI community, Carl volunteered for the TBIPHRP as a consumer peer reviewer. Since summer 2022, Carl has participated as a consumer reviewer on three panels. He enjoys learning about new potential therapies and treatments for TBI through the CDMRP and values the personal experience he can bring to the table.

“Quantitative analysis cannot demonstrate the value of a research proposal to potentially improve a patient’s life,” Carl said.

Life has since continued for Carl. He works as a Supervisory Immigration Services Analyst in the Department of Homeland Security and enjoys spending time with his dog at the local dog park. Thirty years post-TBI, Carl is still unsure of the overall impact of his TBI. A recent neurophysiological evaluation revealed memory issues, and Carl is questioning his executive function. During his semiannual magnetic resonance imaging scans, doctors spotted a likely meningioma and were able to monitor it closely. He is unsure whether to attribute these conditions to the long-term effects of his TBI or to something else entirely. Despite this, he remains focused on the positives, pointing to the close monitoring of his health, which allows his care team to catch things early, as well as to the coping skills he has learned that help him focus better.

The views, opinions, and/or findings contained in this paper are those of the author(s) and should not be construed as an official Department of Defense position, policy, or decision.

References:

¹DOD Numbers for Traumatic Brain Injury Worldwide—Totals. 2000-2023 Q1. Health.mil. https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence/DOD-TBI-Worldwide-Numbers