Ed Timperlake was VA assistant secretary for Public and Intergovernmental Affairs from 1989 to 1992, and served in the U.S. Marine Corps as a fighter pilot and squadron commander.
One of the little-known facts of the wars in Afghanistan and Iraq is that the nature of combat wounds has changed dramatically.
For most of human history, the most common combat wound was a piercing injury. Primitive spears, the Roman gladius, medieval lances and bullets all create piercing wounds, and battlefield medicine was largely focused on treating these types of injuries.
As an assistant secretary for the U.S. Department of Veterans Affairs during the George H. W. Bush administration, I saw up close how VA health care responded to the after-effects of these combat wounds. But in the years since, veteran care reflects an entirely new and complex type of injury.
A study published in the Journal of Trauma and Acute Care Surgery in 2012 noted that between 2005 and 2009 — the early years of the wars in Afghanistan and Iraq — nearly three in four combat wounds were the result of “explosive mechanisms.” This fact was reflected in the Iranian missile attacks on U.S. forces in Iraq last month, which resulted in 109 troops sustaining varying degrees of head injuries.
Most of these troops have returned to duty, but one of the most common and least seen aspects of these injuries is hearing loss. The auditory sense is highly vulnerable to explosive mechanisms and, unlike most of the human body, many tissues associated with hearing do not regenerate themselves. When they are destroyed, they are destroyed forever. Tinnitus, otherwise known as ringing in the ears, while less serious than absolute hearing loss, is still harmful in the long term and is pervasive among troops serving in Afghanistan and Iraq.
Hearing loss is personal for my family. One of my nieces was born with significant hearing loss, and another is pursuing her doctorate at Gallaudet University, developing better ways to accurately test and address hearing loss. My own hearing has been degraded due to military noise. I can never forget the roar that reverberated through my head the first time I was catapulted from the deck of an aircraft carrier. As a young Marine Corps fighter pilot, the “scramble orders” I and my squadron mates received in response to threats from Cuban MiGs resulted in ear-shattering experiences with every sortie, for months at a time.
Today, more than 1.25 million veterans suffer from hearing loss, with nearly two million suffering from tinnitus. Combined, they represent the top two service-connected disabilities addressed by the VA. To its credit, the VA is doing a good job of addressing the problem with hearing conservation programs and high-tech hearing aids.
But the Defense Department is playing catch-up on the issue. After having issued faulty hearing protection to active-duty forces over the past decade, leading to countless cases of unnecessary hearing loss, the Pentagon is now testing several different styles of hearing protection for troops in the field, and confidence is high that the next generation of combat hearing protection will represent a substantial improvement.
Once these troops muster out of uniform and transition to veteran status, a large part of the challenge in helping these vets with hearing loss is technological. Low-cost hearing aids that simply amplify sound do little good, often making background noise too loud to provide any meaningful improvement in hearing conversation, music and other audible intelligence.
The private sector is making good progress on developing and improving this technology with Bluetooth capabilities and even fitness trackers, offering hope to veterans with hearing loss as they re-acclimate to civilian life.
The prospects for better hearing protection and improved service to veterans with hearing loss and tinnitus is encouraging. But we have to keep our eye on the ball to make sure our warfighters get the combat gear they need, and that veterans receive the care they earned through their sacrifice.