Marines Who Fired Rocket Launchers Now Worry About Their Brains

Jul 25, 2018
Originally published on July 27, 2018 7:14 pm

Chris Ferrari was just 18 the first time he balanced a rocket launcher on his right shoulder and aimed it at a practice target.

"Your adrenaline's going and you're trying to focus on getting that round to hit, and then you go to squeeze that trigger and, you know."

Boom!

The report is loud enough to burst the eardrums of anyone not wearing military-grade hearing protection. And the blast wave from the weapon is so powerful it feels like a whole-body punch.

"It's exhilarating," says Chris's buddy Daniel, a former gunner in the Marine Corps who asked that we not use his last name to protect his privacy. "When you feel a concussive wave, it's an awesome thing. It fills you with awe."

It also may do bad things to your brain.

Studies show that troops who repeatedly fire powerful, shoulder-launched weapons can experience short-term problems with memory and thinking. They may also feel nauseated, fatigued and dizzy. In short, they have symptoms like those of a concussion.

It's still not clear whether firing these weapons can lead to long-term brain damage. But Chris and Daniel suspect that, for them, it may have.

While in the Marines, Daniel and Chris spent two years in the late 1990s firing a rocket launcher called the shoulder-launched multipurpose assault weapon, or SMAW.

They were a team. Chris loaded the rockets. Daniel pulled the trigger. Then they would switch places.

And together, they fired hundreds of rounds in training exercises around the world.

"That's me and Daniel at the base of Mount Fuji, posing for a picture with our SMAW," Chris says as he leafs through an album of photographs Daniel put together.

The SMAW is one of several modern weapons light enough for one person to carry but powerful enough to blow up a tank.

Daniel and Chris say they felt like their brains had been rattled every time they fired the SMAW. And they fired it a lot.

"Chris and I were incredibly good shots," Daniel says.

"We never missed," Chris adds. "We were always selected by our sergeant and our leaders to do the firing because they wanted to see the explosion, you know, they wanted to see the target get hit."

But as the two men fired the SMAW again and again, some of the thrill began to fade.

Every shot "felt like the world was caving in on you," Chris says.

The U.S. military limits the number of times troops can fire heavy weapons like the SMAW in a single day. But the limits are based on concern about hearing loss, not brain damage.

And 20 years ago, safety wasn't taken very seriously, Daniel says.

"I remember they were saying you're only allowed to shoot three of these things a day because it's, like, really bad for you," he says. "And then I would shoot three and then you [Chris] would shoot three. And then the guys 10 feet from us would shoot six and then the other team would shoot six."

Chris had a lot of headaches, and sometimes couldn't think straight after a day on the range. "You feel odd and you feel out of place and you feel exhausted and tired," he says. "But, you know, you're a Marine and you learn to put it away."

Until you can't.

For Daniel, that happened during a joint training exercise in Malaysia. Their platoon was still setting up, Chris says, "and all of sudden out of nowhere: Boom!"

Malaysian troops just a few feet away had fired an antitank weapon called the AT4. The blast wave hit Daniel hard.

"I was, like, absolutely dizzy," Daniel says. "I was absolutely disjointed. I felt nauseous, like I really felt like I needed to throw up."

So Daniel told his sergeant. "And it was just: 'Shut your face. Are you complaining? Why is everyone else OK and you're not?' "

Blast injuries overlooked

Back then, in the 1990s, the military pretty much assumed a fighter's brain was fine unless there was some external sign of injury.

That was because, at the time, no one really understood how an invisible blast wave could damage the brain without leaving a mark, says Tracie Lattimore, who directs the Army's traumatic brain injury program.

"The science wasn't up to speed," she says. "It just didn't exist."

But since 2007, Lattimore says, the Department of Defense has spent about a billion dollars studying traumatic brain injuries, including those caused by blast exposure.

At first, the research focused on bomb blasts, especially those from the improvised explosive devices that had become common in Iraq and Afghanistan.

But over time, Lattimore says, the military's research has expanded beyond IEDs to include the effects of blasts from weapons like the one Chris and Daniel shot.

"If you talk to us in a year from now, I think we're going to have exponential growth in our knowledge coming out of these current studies and our future studies," Lattimore says.

Eventually, that could help the hundreds of thousands of veterans who have fired these weapons in the past couple of decades.

But right now, people like Daniel and Chris have no way to know whether firing heavy weapons could have affected their brains.

Chris wonders whether all those blasts might be the reason he once landed in a military hospital for two weeks.

It happened after a weeklong training exercise in the California desert near Twentynine Palms. Thousands of troops took part and Daniel and Chris fired lots and lots of rockets. They also set off lots of explosives.

Several days after the exercise ended, Daniel noticed that Chris was awake in the middle of the night.

"He just got up and started walking out of the room in his stinking underwear," Daniel says. "And I was like, 'Hey Chris, what's going on?' And he was just kind of like looking through me."

"I don't remember it," Chris says. "But I know that they put me in the hospital and thought I had spinal meningitis or something."

He didn't. And the doctors never pinpointed another cause. They clearly thought something was wrong with his brain. But at the time, no one would have thought to ask whether the problem was caused by the weapons Chris had fired.

Chris's military career ended one morning when his platoon left on a bus and he didn't get on it. Ultimately, he got a bad conduct discharge.

It's been nearly two decades since Chris and Daniel fired the SMAW.

They've both settled in Northern California, which is where they grew up. And they both have symptoms that could be from a brain injury — or something else.

Chris has lots of questions.

"Why does this hurt on my body? Why do I feel lost? Why can't I concentrate on stuff as long [as I used to]?"

Chris also has trouble controlling his emotions, something he says wasn't a problem before his military service.

For Daniel, it's his memory that's the problem.

"I used to be photographic. Now I'm forgetful," he says. "I'm 40, that's ... I don't know, man. Maybe I'm getting old."

Both Chris and Daniel have problems with balance and orientation. For Daniel it can happen when he turns his head quickly or stumbles.

"I lose my spatial orientation," he says. "I don't know where I am. Vision gets blurrier. Even sound is kind of muffled."

These are common symptoms of damage to the brain's vestibular system, something that affects many people who have experienced a traumatic brain injury from a bomb blast or blow to the head.

Uncertain coverage for care

But Daniel and Chris were never in combat and never were injured in any obvious way during training. That means it's not clear whether they are entitled to care from doctors and hospitals run by the Department of Veterans Affairs.

Chris has never tried to get care from the VA. But Daniel has. And he learned that the VA doesn't have an obvious category for people like him.

Daniel had never connected his symptoms with his time as a Marine until he heard a radio story on NPR suggesting that certain military weapons might be powerful enough to give the shooter a traumatic brain injury.

"I went back to the VA and I said I want to be tested for TBI," he says. "And they said great."

They handed him a questionnaire. The first question asked where he had been in combat. But he hadn't been.

The second question asked: "Were you hit by an IED?" Daniel says it went on: "Was it a grenade explosion? Was a bomb dropped too close to you?" So I couldn't actually answer the questionnaire."

All he'd done was fire a rocket launcher in training exercises, over and over and over.

VA doctors see quite a few veterans like Daniel, says Dr. Joel Scholten, who's in charge of physical medicine and rehabilitation for the VA. He says the conversation usually goes like this:

"While I was training we fired a certain type of weapon. I felt dizzy or had some ringing in my ears after that."

Then Scholten asks if the veteran was ever near a bomb blast or took a blow to the head. Many say yes. And for them, VA guidelines call for a full examination for traumatic brain injury.

But for veterans like Daniel, coverage is uncertain. That's because there still isn't clear evidence that training with heavy weapons can cause long-term problems with things like memory, thinking and balance.

"These symptoms are what we call nonspecific," Scholten says. "So they're not unique to traumatic brain injury, and in fact there is no symptom that happens only with traumatic brain injury or concussion."

From a medical perspective, the lack of a box to tick is not a big deal. Treatments usually focus on improving a patient's symptoms, regardless of the cause.

"For instance, someone with cognitive or concentration impairments, we would focus our therapy on how to improve concentration," Scholten says.

But paying for therapy is another matter. The VA gives priority to veterans whose medical problems can be linked to their service.

And since military scientists still aren't sure whether firing a powerful weapon can have long-term effects, Daniel says the VA is sending him the bill. He's being asked to pay out of pocket for high-tech brain scans and other tests.

"I love the VA," Daniel says. "I have nothing bad to say about the VA. The individuals there get it. They really do. But their hands are typically tied by their process."

Studies now underway should help clear up whether people like Daniel could have been harmed by the weapons they fired, Scholten says. And the results of those studies will be used to update the VA's guidelines on who gets checked out for a traumatic brain injury.

"In the next iteration, will we or should we expand to include training exposures?" Scholten says. "Possibly so."

If they do, it could mean evaluating the brains of tens of thousands of veterans who trained with weapons like the one Daniel shot.

You can contact Jon Hamilton at jhamilton@npr.org.

Copyright 2018 NPR. To see more, visit http://www.npr.org/.

ARI SHAPIRO, HOST:

Now the story of two Marines whose brains may have been injured by the powerful weapons they once fired. Military scientists are investigating whether the blast waves from these shoulder-fired weapons can damage a shooter's brain. NPR's Jon Hamilton reports that the two veterans in this story think they already know what that investigation will find.

JON HAMILTON, BYLINE: Chris Ferrari was 18 the first time he balanced a rocket launcher on his right shoulder and aimed it at a practice target.

CHRIS FERRARI: Your adrenaline's going, and you're trying to focus on getting that round to hit and listening to your guide to walk you onto the target. And then you go to squeeze that trigger and, you know...

(SOUNDBITE OF EXPLOSION)

HAMILTON: Chris says feeling the blast wave from that weapon was the biggest rush he'd ever experienced. And his buddy Daniel, who asked that we not use his last name, had the same reaction.

DANIEL: It's exhilarating. When you feel a concussive wave, it's an awesome thing. It fills you with awe. I would love to feel that blast today.

HAMILTON: Daniel and Chris spent two years in the late 1990s firing a rocket launcher called the Shoulder-Launched Multipurpose Assault Weapon or SMAW. They were a team. Chris loaded the rockets. Daniel pulled the trigger. And together, they fired hundreds of rounds in training exercises around the world. Chris points to a photo in a scrapbook.

FERRARI: That's me and Daniel at the base of Mount Fuji posing for a picture with our SMAW rocket launchers.

HAMILTON: The SMAW is one of several modern weapons light enough for one person to carry but powerful enough to blow up a tank. These weapons produce an explosion in the barrel that's as powerful as a small bomb. So Daniel and Chris had their brains rattled every time they fired the SMAW. And they fired it a lot.

DANIEL: Chris and I were incredibly good shots.

FERRARI: We never missed (laughter). We were always selected by our sergeant and our leaders to do the firing because they wanted to see the explosion. You know, they wanted to see the target get hit.

HAMILTON: But as the two men fired the SMAW again and again, some of the thrill began to fade. Chris says every shot was like taking a punch.

FERRARI: It felt like the world was caving in on you. Like, the pressure just was, like - and the heat and the debris and the dirt and the things that would, like, kick up around you. And then it was over with.

HAMILTON: The military limits the number of times troops can fire a heavy weapon in a single day. But the limits are based on concern about hearing loss, not brain damage. And Daniel says they weren't taken very seriously.

DANIEL: And I remember they were saying like, you're only allowed to shoot three of these things a day because it's, like, really bad for you. And I just remember someone mentioning three. And then, like, I would shoot three, and then you would shoot three. So...

FERRARI: Six.

DANIEL: ...That's - we're around six. And then the guys 10 feet from us would shoot six. And then the other team would shoot six.

HAMILTON: Chris says he had a lot of headaches and sometimes couldn't think straight after a day on the range.

FERRARI: You feel odd. And you feel out of place. And you feel exhausted and tired. But, you know, you're a Marine. And you learn to, you know, put it away.

HAMILTON: Until you can't. For Daniel, that happened during a joint training exercise in Malaysia. Chris says their platoon was still setting up.

FERRARI: Then all of a sudden, out of nowhere, boom (ph). Nobody was ready for it.

HAMILTON: Malaysian troops just a few feet away had fired an antitank weapon called the AT4. The blast wave hit Daniel like a fist.

DANIEL: I was, like, absolutely dizzy. I was absolutely disjointed. I felt nauseous. Like, I really felt like I needed to throw up.

HAMILTON: So he told his sergeant.

DANIEL: And it was just, shut your face. Like, are you complaining? Like, why is everyone else OK and you're not?

HAMILTON: That was 20 years ago. Back then, the military pretty much assumed your brain was fine unless there was some external sign of injury. Tracie Lattimore, who directs the Army's traumatic brain injury program, says no one really understood how a blast wave could affect the brain.

TRACIE LATTIMORE: The science wasn't up to speed. It just didn't exist.

HAMILTON: But Lattimore says since 2007, the Department of Defense has spent about a billion dollars studying traumatic brain injuries, including those caused by blast exposure. At first, the research focused on bomb blasts. But now, Lattimore says, it includes the effects of blasts from weapons like the ones Chris and Daniel shot.

LATTIMORE: If you talk to us in a year from now, I think we're going to have exponential growth in our knowledge coming out of these current studies and our future studies.

HAMILTON: Eventually, that could help the hundreds of thousands of veterans who fired these weapons in the past couple of decades. But right now, people like Daniel and Chris have no way to know whether firing heavy weapons could have affected their brains. Chris says all those blasts might be the reason he ended up in a military hospital for two weeks. It happened after a weeklong training exercise in the desert near Twentynine Palms, Calif.

(SOUNDBITE OF GUNFIRE)

HAMILTON: There were thousands of troops, and Daniel and Chris fired lots and lots of rockets. They also set off explosives. Several days after the exercise ended, Daniel noticed Chris was awake in the middle of the night.

DANIEL: He just got up and started walking out of the room in his stinking underwear. And I was like, hey, Chris, what's going on? And I was, like, looking at him. And he's just kind of looking through me.

FERRARI: I don't remember it. But I know that they put me in the hospital, and they give me spinal taps. And they thought I had...

DANIEL: Spinal meningitis.

FERRARI: ...Spinal meningitis or something.

DANIEL: Which makes no sense.

FERRARI: We - yeah. And we never knew what happened.

HAMILTON: The doctors thought something was wrong with Chris' nervous system, but they never suspected the culprit might be repeated blasts from the weapon he fired. Chris' military career ended when his platoon left on a bus one morning and he didn't get on it. It's been nearly two decades since the two men fired the SMAW. They both settled in Northern California, which is where they grew up. And they both have symptoms that could be from a brain injury or something else. Chris says he has lots of questions.

FERRARI: Why does this hurt on my body, or why do I feel lost, or why can't I concentrate on stuff as long? Or like, my - these fingers - you know, for the last four or five months, it just - there's no feeling no more.

HAMILTON: Chris also has trouble controlling his emotions now. And Daniel says at least one part of his brain just doesn't work as well as it used to.

DANIEL: Memory. I used to be photographic. Now I'm just having simple - you know, just at work, stuff I do all the time I'm, like, forgetful. I'm, you know, 40 (laughter). That's - I don't know, man. Maybe I'm getting old.

HAMILTON: Chris and Daniel also have problems with balance and spatial orientation, common symptoms of damage to the brain's vestibular system. What makes their symptoms so puzzling is that they were never blown up by an IED. They were never injured in combat. So both men think maybe it was all those rockets.

FERRARI: (Unintelligible) Really the only thing that could have been a factor. I mean, it's the only thing really, you know, I had gone through.

DANIEL: I truly don't know if it's the case for you, Chris. I just know that it's the only thing that makes sense to me now. So to be honest, I'm looking for answers.

HAMILTON: And so is the U.S. military. Jon Hamilton, NPR News.

(SOUNDBITE OF THEO CROKER'S "THIS COULD BE (FOR THE TRAVELLING SOUL)")

SHAPIRO: Tomorrow, how the VA's health care system is responding to veterans like Daniel and Chris.

(SOUNDBITE OF THEO CROKER'S "THIS COULD BE (FOR THE TRAVELLING SOUL)") Transcript provided by NPR, Copyright NPR.