Skip main navigation

Military Health System

Clear Your Browser Cache

This website has recently undergone changes. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.

Sergeant Major of the Marine Corps: “Ask for Help” for TBI

Image of Sergeant Major of the Marine Corps: “Ask for Help” for TBI. Concussions and TBIs are a significant health issue which affect service members and veterans during times of both peace and war. Between 2000-2023, there were a total of 468,424 first-time cases of TBI in the military worldwide, with just over 80% being considered mild TBI.

U.S. Marine Corps Sgt. Maj. Troy Black recognizes that traumatic brain injuries can be a part of being in the military.

“There is no way to remove stress from combat. There is no way to remove concussions or TBI from combat,” said the 19th sergeant major of the Marine Corps on “Picking Your Brain,” a podcast from the Traumatic Brain Injury Center of Excellence.

Black joined U.S. Navy Capt. Scott Cota, branch chief of TBICoE, and moderator Amanda Gano on the podcast to raise awareness and educate service members about TBI and the resources available to recover from injuries.

The interview covered topics such as how service members should reach out if there’s an issue, and how warfighter brain health is a key factor in the Marines.

Concussions and TBIs are a significant health issue which affect service members and veterans during times of both peace and war. Between 2000-2023, there were a total of 468,424 first-time cases of TBI in the military worldwide, with just over 80% being considered mild TBI.

Warfighters May not Talk about TBI

As a Marine, Black has encountered numerous potentially concussive events and has “led by example by seeking care for his injuries,” said Cota.

Black noted he has lived through several concussive related events, and would have himself checked out if he felt something was wrong, but acknowledged not all service members do the same.

The group talked how about warfighters are often hesitant to seek help or talk about a possible TBI they may have suffered.

According to TBICoE, there are several reasons why a service member may be reluctant to seek help for a TBI, such as:

  • Stigma of weakness or unfitness for duty
  • Fear of judgment
  • Misconceptions about TBI
  • Perception of mental health issues
  • Cultural norms
  • Unrecognized TBI

“Stigma first starts with the individual,” said Black. “Ask for help. Be open with it. The invisible injuries are as important as the visible injuries.”

Black commented that there have always been concussive events in the military and on the battlefield throughout history, which has led to a better understanding of TBIs.

“In the last 20 years, we now have technology and [an] understanding of TBIs that are different now,” said Black. “The knowledge, the capability, the communities’ ability to understand the brain differently, has changed. But concussions have not.”

“What we have learned over time is that every time you are around an event, [TBIs] just culminate,” he added.

Black mentioned that TBI doesn't always occur after just one event; it is often this culmination of several events. These events do not always happen on the battlefield; they often happen at garrison during training.

“All the small events add up,” said Black. “All these things compound.”

Diagnosing TBI More Rapidly

Cota mentioned that things like triage tools, and more rapid decision making in the field are needed to diagnose TBI more efficiently and quickly.

“Our big thing on the MHS side is looking for resources to help with recovery to get you at your optimum level,” said Cota. “The resources throughout MHS and that we offer here at TBICoE, can assist with understanding TBI and how to recover from TBI.”

“So, it's just a matter of requesting that support, and they can easily do that across the spectrum,” Cota said.

MHS medics are also trained in the Military Acute Concussion Evaluation 2. MACE 2 was created to quickly evaluate a warfighter for a TBI, and is a standardized exam used to evaluate mild TBI, or concussion, in a combat or other deployed settings.

The Automated Neuropsychological Assessment Metric has also been a game-changer, according to Black.

“Getting the baseline at pre deployment, then at post deployment–that was phenomenal,” said Black. “That is an advance. We must learn about how the brain works.”

Black also noted that sometimes being able to recognize TBI in yourself or others is important, even in stressful situations.

“The responsibility of the individual is to say, ‘Yeah, my bell's rung. I got to pull out of here for a minute until I can recover,’” said Black.

Common Symptoms of Possible TBIs

  • Confusion
  • Difficulty finding words
  • Difficulty making decisions
  • Memory loss
  • Poor concentration
  • Slowed thinking
  • Anxiety
  • Feeling depressed
  • Irritability
  • Mood Swings
  • Balance problems
  • Nausea and vomiting
  • Dizziness
  • Fatigue
  • Headaches
  • Ringing in Ears
  • Sensitivity to light
  • Blurred or double vision

Getting Diagnosed Improves Readiness

“Our job is to ensure someone can be in the fight. Not to find reasons to remove them from the fight,” said Black.

Setting an example is important for a Marine, Black noted.

“Know your Marines and look out for their welfare,” said Black. “When we communicate with each other, when we are open, we can help.”

Cota mentioned that a cultural shift is happening in the U.S. Marine Corps and has been “supportive with individuals getting assistance no matter what it is for.”

“We want to share knowledge and real experiences so that the warfighter understands that it is important to maintain cognitive capability as well as physical, mental and social capability,” said Cota.

“The acting, thinking, ready, capable, resourced and trained individuals in the military are the difference between success and failure in combat or warfare with any enemy,” said Black. “We train, we fight, we win. That’s what we do.”

TBICoE resources for providers can be found here and for service members and families here.

Listen to the entire episode of “Picking Your Brain” with Black on DVIDS.

You also may be interested in...

Video
Nov 6, 2023

The Warfighter Brain Health for Leaders Training Video

The Warfighter Brain Health for Leaders Training Video

The Warfighter Brain Health for Leaders Training video is an essential resource for enhancing the Department of Defense's Warfighter Brain Health Initiative. It empowers military leaders with strategies for preventing, protecting against, and managing brain injuries. Additionally, the video enhances leaders' abilities to assess and recognize symptoms ...

Fact Sheet
Nov 6, 2023

Warfighter Brain Health After TBI: Guidance for Leaders

.PDF | 895.85 KB

This TBICoE fact sheet, Warfighter Brain Health After TBI: Guidance for Leaders, condenses the basics of recognizing, reporting, and preventing TBI in service members. It updates and supersedes the Line Leader Policy Guidance fact sheet and includes a list of what the DOD has defined as potentially concussive events and outlines leaders’ ...

Publication
Sep 29, 2023

Mild TBI and PTSD Clinical Pearls

.PDF | 924.82 KB

TBICoE's "Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Clinical Pearls," is a new supplemental product to the detailed research review. This resource is designed to be brief and provide key actionable “clinical pearls” that should be considered in the treatment of service members with comorbid mild TBI and PTSD.

Publication
Sep 29, 2023

TBICoE Research Review: Mild TBI and PTSD

.PDF | 435.28 KB

This research review provides an in-depth summary of the available clinical research on the topic of co-morbid mild traumatic brain injury and posttraumatic stress disorder. Specifically, this review will address symptoms, anatomy, diagnosis, and treatment of mild TBI, PTSD, and the unique circumstances associated with the presentation of both.

Video
Sep 21, 2023

TBI and Low-Level Blast Exposure: What Medical Providers Need to Know

TBI and Low-Level Blast Exposure: What Medical Providers Need to Know

This educational video, produced by the Traumatic Brain Injury Center of Excellence, focuses on the effects of low-level blast and traumatic brain injury. Its purpose is to provide supplemental information on low-level blast to health care providers and beneficiaries.

Video
Sep 12, 2023

BACH Hosts TriStar Skyline CEO and CMO

BACH Hosts TriStar Skyline CEO and CMO

Blanchfield Army Community Hospital hosted Mark Miller, Chief Executive Officer, and Dr. Kevin Hamilton, Chief Medical Officer, both with TriStar Skyline Medical Center, and provided them with a tour of the facilities including the Intrepid Spirit Center in anticipation of the future partnership with them.

Article
Aug 16, 2023

Walter Reed’s NICoE Scientists to Present New TBI Battlefield Biomarkers Research During 2023 MHSRS

Dr. Ping-Hong Yeh all smiles at Walter Reed in preparation for presenting new biomarkers TBI research at 2023 MHSRS. Photo Credit: DOD Ricardo Reyesguevarra

Walter Reed National Military Medical Center is pleased to announce that researchers from the National Intrepid Center of Excellence will present a groundbreaking study on diagnosing traumatic brain injuries during the 2023 Military Health System Research Symposium.

Technical Document
Jul 20, 2023

Infographic: What is the Acute Concussion Care Pathway?

.PDF | 714.95 KB

TBICoE developed this infographic as a quick reference tool that demonstrates application of the standardized acute concussion assessment and care process. By adhering to this established pathway of care for mild TBI, providers across the MHS can ensure a reduction in unwarranted variation and foster an integrated, standardized system of readiness and ...

Fact Sheet
Jul 18, 2023

Low-Level Blast: Fact Sheet for Service Members

.PDF | 867.41 KB

Low-level blast is defined as blast generated from firing heavy weapon systems or explosives in combat or training environments. Exposure to low-level blast does not typically result in a clinically diagnosable concussion, also known as mild traumatic brain injury. Both providers and service members should be aware of the potential effects of low ...

Skip subpage navigation
Refine your search
Last Updated: January 22, 2024
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery