Navy Capt. (Dr.) Carlos Williams (center) with former U.S. presidents George W. Bush (left) and Bill Clinton at the graduation of the Presidential Leadership Scholars Program in 2015 (Courtesy Capt. Carlos Williams).
'Your best life'
Caring for a TBI patient is not just a one-disease process, he said. The neurological and rehabilitative aspects, for instance, go hand-in-hand with the engagement of patients' family members. And because TBI is often a life-long struggle, learning to live with one's injuries is paramount.
"Learning resiliency from them, and learning how to make this work for you, so you can achieve your best life, that's what it really boils down to," said Williams, adding that the family therapy program has really taken off in the last few years.
With TBI injuries, so many aspects of one's life are affected profoundly. Sleep, balance, cognition, hearing, and speech, to name a few. That means that everything you know as normal has changed, Williams said. It's enough to make the patient feel that they are an entirely different person. And families must adjust to the new norm as well, especially since many manifestations of TBI are behavioral in nature.
NICoE admits about six new patients a week, or 24 per month, who do intensive four-week programs, Williams explained.
Williams said he often hears that the wars in Iraq and Afghanistan are all but over. But that's not true, especially for someone who has yet to be diagnosed for post-traumatic stress disorder, for instance, or a head injury that has yet to be treated.
"No one wants to be taken out of the fight. No one wants to be sidelined because of injury," he said. "So they cope with it, they try to deal with it, until they can't deal with it anymore. What makes NICoE and the Intrepid Spirit Centers so unique is that we take care of you where you are."
Some service members had their first concussion 10 years ago, he explained, but they dust themselves off and keep going.
For 2021, Williams explained how the COVID-19 pandemic opened the door to tele-health, which will enable a wider group of services. "It has really and truly improved access to care."
But the big picture for this year is the network, he said. "Showing the MHS our value as a network, and not just individual entities. ... My primary objective is to make sure that people see the value of this organization and the value of caring for patients with TBI, and then codifying this network of Spirit Centers. I want it to be known."
Williams' plans for 2021 are ambitious, but he realizes that TBI is a tricky field.
"It's not like a surgery," he said. "You have to rely on the patient (to communicate). It's about 'How do I feel?' I can't go in and surgically repair a TBI. Not in this case. These are psychological wounds of war. Some of them have physical implications to them, too, and we fix those and work with those. But the challenge is, how to you access these outcomes?
"We want to see patient outcomes. They went back to a job. They got a promotion. They stayed in the military longer. Those are the stories that make us know that what we do matters."