Troops cheat on brain-injury tests to stay with units
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By Gregg Zoroya, USA TODAY
WASHINGTON — Troops in Iraq and elsewhere have tried to avoid being pulled out of combat units by cheating on problem-solving tests that are used to spot traumatic brain-injury problems, military doctors say.
New versions of the tests were sent into Iraq late last month to prevent the cheating, says Air Force Lt. Col. Michael Jaffee of the Defense and Veterans Brain Injury Center in Washington, D.C.
"With highly motivated individuals, be they athletes, be they our servicemembers in harm's way, there is a motivation to stay with the unit and stay on the job or stay in the game," he says.
The tests, administered by medics in the field, are the military's primary means of uncovering subtle signs of brain injuries from exposure to blasts.
Reports of cheating began surfacing in Iraq during the summer, says Col. Brian Eastridge, a trauma surgeon who supervises medical care in Iraq and Afghanistan from his office in Baghdad.
Troops had obtained copies of an older version of the test and memorized key words used to gauge short-term memory, Jaffee says. Those who fail areas of the test undergo more sophisticated exams for diagnosing brain injury.
If symptoms persist, soldiers are sent home. If symptoms get better in days or a few weeks, patients can be sent back into combat, doctors say.
At the Landstuhl Regional Medical Center in Germany, cheating was found in a handful of cases about four months ago, says Army Col. Stephen Flaherty, the hospital's chief of surgery.
Landstuhl is where all troops evacuated from Iraq or Afghanistan suffering from illness, injury or wounds are delivered before going home.
Words were substituted to stop the cheating, Flaherty says.
"We know what they are doing," he says. "We're just trying to protect them, make sure they are healthy and get back to fully functional status as soon as possible."
Earlier in the war, Jaffee says, military physicians noticed some cheating, particularly among Marines at Camp Pendleton in California, where testing started in 2004.
By cheating, he says, troops risk being "exposed to a second concussion or mild traumatic brain injury. It could have more devastating effects not only on their health, but on the mission's success, or perhaps on the safety of the people on their patrol."
About one-third of war casualties brought to Walter Reed Army Medical Center in Washington, D.C., have some form of brain injury, Army records show.
The Pentagon lists 4,471 brain-injured casualties from Iraq and Afghanistan, but the actual number is likely higher because many cases go undetected.
The most common are mild brain injuries that come from being close to an explosion from a roadside bomb, mortar round or grenade. Eighty percent of wounds in Iraq are caused by explosions, Jaffee says. Even if there are no obvious wounds, there can be a brain injury, he says.
The symptoms are being temporarily dazed, confused or "seeing stars," according to Pentagon literature on brain injury.
New versions of the brain-injury screening test are arriving in Iraq and will be delivered to medics, Eastridge says.
"Now that we're disseminating alternatives, I think we should pretty much be able to get rid of that (cheating)," Eastridge says. "It's the military culture. … For the most part, we have a lot of hardworking people over here who would be very disappointed to leave … their people behind."
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