Charles Gatlin and Ariana DelNegro; Veterans Leadership, TBI Consumer Reviewers

Gatlin: Well, we deployed in '06 timeframe to Kirkuk, Iraq. I commanded a Light Infantry Scout Platoon during the deployment. Unfortunately, I was hit with a 4,000 pound VBED, vehicular-borne explosive device. I was knocked unconscious and subsequently evac'd.
I've hit a plateau where I'm not going to get any better. It was difficult walking that road back. I couldn't think. I couldn't talk. I couldn't eat straight. I still can't use my hands but at that time I had trouble using the left one, memory problems, lapses.

DelNegro: Because I knew my husband before his injury, I was able to see the little differences after his injury and I was able to relay those differences to the physician who may not otherwise have been able to detect them.
And I think being a caregiver of a patient with TBI really is-it's important that the caregiver be integrated into the medical care process.

Gatlin: It is critical that you have a caregiver, and one that is up to speed and knowledgeable and has the patience and charisma and dexterity and stamina to deal with the patient. I was lucky. I'm walking and talking to you right now. I have all my fingers and toes. There are others out there that weren't so lucky. And they're having a very difficult road to come back.

DelNegro: The greatest frustrations that we had were trying to express to clinicians that he had symptoms that really did warrant treatment. I was nominated by Tripler Army Medical Center to participate as a Consumer Reviewer for CDMRP. What's important to me as a caregiver to participate as a Consumer Reviewer in the care review process is to really highlight some of the peripheral issues that come into play as it relates to family and as it relates to the patient.

Gatlin: It's an excellent opportunity for people with experience, for people that have actually been to the fight and seen the fight and the horrors of the fight and what's coming back from the fight to be able to put their, in my case, fingerprints on policy, procedure, and guidelines.
When I review the proposals, the thing that really excites me the most is innovation. I think innovation and transitional feasibility are the two key components.

DelNegro: I would like to encourage PIs to identify some of the intrinsic differences between blast-related traumatic brain injury and of brain injury sustained in a civilian setting such as a car accident because I think that understanding the differences between those two injuries will help influence treatments down the road.

Gatlin: I think a critical focus for a potential PI or PIs on a project would be to understand the study pool and the possible recruitment of the study pool. I mean it's one thing to sit behind a desk 500 miles away and have somebody else recruit people, but when you can come down to that level-that tier one foundation-and see, meet, and interact with your potential recruits you're going to understand them, their needs, and in return that's going to help you tweak your focus and aim for your objective. You're going to have a clear understanding of all the battlefield operating systems in place. You'll have a clear understanding of some of the psychological and physical issues that the potential recruitment pool is going through, and you'll by virtue of that you'll understand, and hopefully it will be made obvious at this point some of the roadblocks that you're-that are going to pop up along the plan.
If you can gather this intel and see the human face of this at an earlier stage, when the critical stage comes when this has to implement into a plan you'll be able to hurdle the roadblock with no problem.

DelNegro: Going forward, I hope that other consumers will come forward and apply what they've learned from their own experiences to the benefit of others. I think it's very important that those with truly something to share have the ability and the platform to share it and this is that opportunity.

Gatlin: I think it's critical that CDMRP brings in more consumers who have real-time experience. These men and women that have seen the face of combat that are coming back can either directly or indirectly influence procedure and policy that ultimately is decided from the panel reviews.

DelNegro: My job was to give him access to care. It was his decision whether he wanted to maximize that care and be it based on who he was as an individual and who he is as an individual, he really made the most of it fortunately, and it's made all the difference.