Jacob's Story
Jacob was having bad headaches, felt dizzy often, had a decreased appetite, and lacked energy. He had quit his job, was frustrated and couldn't control his temper. Most of all, his head pounded – especially at night and it was only getting worse. One night the pain was so intense that he went to urgent care. He met with a triage nurse who asked him a series of questions about his current medications, symptoms, past diagnoses and overall health. She did not, however, ask Jacob if he had ever served in the military. And he didn't tell. But he had served – in fact, Jacob was a former Marine who had served with an infantry unit in Afghanistan. A stoic man, he did not like to discuss his military history, such as the fact that he was exposed to multiple traumas during his deployment, including brain-rattling explosions.
He was discharged from the Marines without a medical diagnosis, never sought treatment/evaluation through the VA or other healthcare provider, and assumed his current problems were not related to anything that happened in Afghanistan.
Without this information, the urgent care staff were at a loss. They sent Jacob home with extra-strength ibuprofen and told him to get a good night's rest. The pills didn't help. He returned a few nights later and they provided stronger medications. The pills still didn't help. This went on for several visits. Jacob became increasingly depressed and debilitated by the headaches and pain medications that didn't help. He was seriously considering ending his life, when his girlfriend took him one more time to urgent care to try and get relief for the headaches which were now excruciating.
They ran blood tests, and the phlebotomist – also a Marine – noticed a "Semper Fi" tattoo on Jacob's arm. The phlebotomist and Jacob began talking about their military experiences. It came out that not only had Jacob deployed to a war zone but that he had been exposed to large blasts from IED's (improvised explosive devices). The phlebotomist told the nurse and doctor. Eventually, Jacob was screened for Traumatic Brain Injury (TBI) and Post–Traumatic Stress Disorder (PTSD). With new, accurate diagnoses he was able to get the treatment he needed to control his headaches and also address other emotional and physical problems that had developed as a result of the TBI and PTSD. He was linked to the VA to establish a claim for service-connected disability compensation. Jacob has said that he does not know how long he would have lasted had he not gotten the help he needed. The triage nurse now always inquires about military service.