A Service of brainline.org
Bringing Traumatic Brain Injury into Focus
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Army veteran and documentarian Justin Springer tells the story of four service members who struggle in the wake of blast-related brain injuries.
Justin Springer studied film at Tulane University before joining the Army in 2003. He served two tours in Iraq with the Army's First Infantry Division. “Along Recovery,” a documentary, was born from his experiences serving alongside dozens of soldiers struggling with traumatic brain injuries. Justin separated from the Army in 2008 and is currently a producer for the Denver-based production company, Image Brew.
BrainLine: Why did you want to make this documentary?
Justin Springer: During my second deployment in 2007 in Baqubah, my unit spent most of its time driving in four-vehicle patrols looking for and cleaning up after explosions. It was very hazardous. Our vehicles took a lot of hits; we were often protected from the effects of shrapnel, but not from blast waves. I started to notice changes in a lot of my buddies.
At this time, at the height of some of the most intense fighting in Iraq, no one really knew or talked about traumatic brain injuries, especially those resulting from blast waves. The Army had not yet implemented the concussion screening and care protocols that are now in place. Guys were getting 5-6 concussions in addition to the regular sleep deprivation and intense stress that came from our missions. Sometimes they’d get to rest for a day or a few; some went right back on a mission; others were evacuated. The effects of TBI were clearly affecting our missions. There were no standards, no guidelines; no one really knew what to do to help these soldiers in a consistent and effective manner.
Once stateside, I kept noticing how brain injury had changed these guys. Many of them were in denial. They insisted they were fine, when it was clear that cognitively and behaviorally they were not. They sloughed off questions about not being able to sleep for more than 1-3 hours at a time, they were supervigilant, and they tried to push their nightmares and fears into boxes deep inside themselves. Other guys knew they were different. One guy I knew from patrols had been a real hard-charging guy. Back in the states, he was no longer that guy. He was quieter, less intense. He said he knew he wasn’t so sharp anymore. He wondered where his old self had gone. Many soldiers with brain injury didn’t know where to get help, or didn’t want it. Most didn’t even know what they’d ask for even if they did seek care. Some became suicidal.
Since I had been lucky enough to have avoided a direct hit while in a vehicle, I started to wonder what these guys were going through — physically and emotionally. Coming home after being in combat is hard enough, but with a brain injury on top of that … well, I started to think about TBI as a major issue and I wanted to document it on film. What’s it like for a guy to go through this “signature” wound of the war?
BL: How did you find your four subjects?
JS: In 2008, I put together a proposal to get permission from the Department of Defense (DoD) to film at Brooke Army Medical Center (BAMC). It took a few months, but finally, the Army gave me the go-ahead and completely opened their doors to me. Initially, I spent time in the clinics, working with the doctors and staff who shared the evacuation lists with me. From there, I was able to find four guys with different levels of injury who would be emblematic of the myriad short- and long-term challenges of brain injury.
BL: When you chose your four subjects and started filming, did you have certain expectations or thoughts on what story the film would tell?
JS: I didn’t start with any expectations of what the film would end up like. That worried me, but I just followed these guys and their families and let the stories tell themselves. I did start capturing their stories from the beginning of their journey with TBI. I thought that was important. I started filming each guy less than a month after his injury; three of them had been evacuated out of Iraq.
BL: What did you learn while filming these stories?
JS: When I was filming, I thought a lot about where these guys were in their lives. They were all 19-20 years old when they deployed to Iraq. Most kids that age are in school, coming of age, figuring out who they are and what they want to be. For these guys — for a lot of soldiers fighting in Iraq and Afghanistan — to experience that trauma, that intense stress in conjunction with the rush of hormones and youth … well, war is one long, crazy emotional event. Part of recovery, I learned, is being able to come to terms with what you have seen and done. But having a TBI can make that process significantly more painstaking.
BL: How did your background in the Army help you work with your four subjects and their families while filming?
JS: I started making this film with an ominous feeling. I pictured going to BAMC and finding soldiers with horrible, life-long issues from brain injury. But by educating myself and talking to a lot of doctors, rehab specialists, and patients and their families, I learned more about what TBI is and what it can do. I also learned, most importantly, that the more positive outlook a soldier is given, the more support, the more individually tailored his strategies, the more positive his outcome. It is difficult for anyone to be patient, to let time help in the healing process, but especially so for a soldier who is conditioned to be a disciplined doer 24/7. But ironically, that time and patience are crucial in the recovery process.
BL: What did you learn about how people deal with TBI and PTSD? Is one issue worse than the other, or is the combination of them the hardest?
JS: There still seems to be a lot of controversy about these two conditions in the medical community. Should you treat one and not the other? What is causing these symptoms — TBI, PTSD, or both? How do you differentiate the two? Is that differentiation necessary?
Soldiers are lucky at BAMC because TBI and PTSD are treated like an umbrella issue. The symptoms overlap and there is less emphasis on putting labels on why someone is depressed or anxious or unable to sleep and more emphasis on simply figuring out how best to treat all of the symptoms.