ENCINITAS, CALIF. — At a community hospital here, doctors and therapists are working to help Marines overcome what is often called the signature injury of the Iraq war: brain trauma with no visible wounds.
"It's the silent injury," said Jessica Martinez, an occupational therapist at Scripps Memorial Hospital Encinitas. "With every blast they suffer, their brain is rattling like a yolk in an egg."
Marine Lance Cpl. Brian Vargas was a high school football player. Now, even though he looks fit, he cannot toss the football with his buddies, let alone be part of pickup games with other off-duty Marines.
"I can't catch anything," he said. "I can't remember any plays."
Vargas, 20, was subjected to innumerable mortar and roadside bomb blasts while patrolling the insurgent stronghold of Hit in the Euphrates River Valley. In mid-January he was shot in the hand and cheek by a sniper and airlifted to Germany and then the United States for treatment.
He has the classic signs of post-concussive injury.
"My thinking has gone down," he said. "I can't remember what I did this morning. I have trouble putting memory and speaking together. I'm trying to learn to speak as clearly as possible."
Lance Cpl. Keene Sherburne, 20, who was injured when a bomb exploded under his Humvee in Fallouja, is frustrated at the slow pace of his recovery.
"I can't read," he said. "I used to love it, but now I hate it. I pick up a snowboard magazine, and I get so mad because I don't understand it."
For most of the Marines, who come here from nearby Camp Pendleton, the regimen is six hours a day, three days a week. Physical therapists work with them to restore their balance, hand-eye coordination and stamina. Counselors work on behavioral changes and anger management. Occupational and speech therapists work on language skills and on restoring their memories.
In one exercise, Marines listen to words being defined and then are asked to repeat the definitions. Sometimes their wartime experiences intrude.
Asked to define "cherry," Vargas could not remember, but he recalled something else: "That was the name of the street I was walking over when I got shot."
Experts say studies of civilians with mild to moderate brain injuries suggest that they can recover. But it remains unknown whether military personnel, whose injuries are coupled with the experiences of war, have similar chances.
