NEJM: 'TBI's long-term follow-up -- slow progress in science and recovery'

July 13, 2016

WASHINGTON - Eleven years ago in the New England Journal of Medicine, medical journalist Susan Okie, MD, first introduced readers to two U.S. Army veterans who suffered traumatic brain injuries in Iraq, and the challenges they faced in the recovery period after returning home. In the July 14 issue of the NEJM, Okie describes her follow-up interviews with the soldiers, and the slow journey to recovery that continues more than a decade later.

"Visiting with [Jason] Pepper and [David] Emme .... I've observed ample evidence of healing, not just in how they sound and what they're able to do, but in how they seem to experience feelings and dreams," Okie writes in the NEJM Medicine and Society article, "TBI's Long-Term Follow-up -- Slow Progress in Science and Recovery."

Okie details the personal journeys of each man through years when they did and didn't have medical care. She explores how each encountered symptoms so often associated with TBI and PTSD: sleeplessness and nightmares, irritability, depression, guilt and anxiety.

Each man's recovery is "slow" -- Pepper only received a comprehensive TBI evaluation at a VA hospital this year -- but both continue to make progress, Okie says, and she attributes both men's resilience to a common factor.

"Although surgical and medical treatment were crucial to Emme and Pepper initially, close personal relationships have sustained them over the past decade," she writes.

Okie observed that Emme survived a critical setback likely because a long-standing friend reached out to him just in time. And she says for Pepper, it appears that his marriage and devotion to family "helped him survive periods of grief for what he'd lost."

"For both men, courage, pride in having served in the military, and loyalty to their fellow soldiers have been additional sources of strength," she says.

Okie is a clinical assistant professor of family medicine at Georgetown University School of Medicine.
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About Georgetown University Medical Center


Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC's mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization, which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award (UL1TR001409-01) from the National Institutes of Health.

Georgetown University Medical Center

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