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The Pentagon Turns to Alternative Medicine to Fix Damaged Soldiers
Yoga is now a mainstay at Walter Reed and other military hospitals, and even part of routine training for personnel.
By Katie Drummond / Source: Wired
The general is surprisingly good at meditation. It's not just the impeccable posture -- that might be expected of a man long used to standing at attention. It's his hands, which rest idly on his knees, and his combat boots, which remain planted firmly on the floor. Over the next several minutes, Lt. Gen. Eric Schoomaker, the Surgeon General of the Army, will keep his eyes closed and his face perfectly relaxed.
Few in this hotel conference room, where three dozen have assembled to mark the 10th anniversary of the Samueli Institute, a research organization specializing in alternative therapies, are able to match Schoomaker's stillness.
Even as our first speaker implores that we "close [our] eyes... feel the chair, feel the air, feel the breath going in and out,' this motley crew of professors, bejeweled clairvoyants, military personnel and Einsteinian-haired futurists tap their toes, shuffle papers and ogle paper plates of fruit and croissants.
"Wherever you've come from, wherever you imagine you're going, you're actually only doing it right now, in this moment." Our meditation guru for the day, Dr. Wayne Jonas, is not only a retired Army medical officer and former director of the holistic branch of the National Institute of Health. He's also the leader of the organization we've met to celebrate.
Schoomaker is here because he has a health crisis on his hands. And he's betting on guys like Jonas to help cope with it — despite the obvious institutional schisms between Schoomaker's organization and this one.
The Pentagon is turning to alternative medicine to help alleviate the devastating symptoms of Post-traumatic stress disorder that afflict more than 250,000 military personnel; soothe the brain trauma that's left thousands more with tremors, speech impediments and memory lapses; and assuage the chronic pain that lingers after grueling, repeat deployments.
The Samueli Institute might be the Pentagon's best chance at making alt-medicine work. Or, at least, figuring out if it even stands a chance.
Thanks to leadership with years of experience in military circles, not to mention a billionaire benefactor with friends in prominent places, they've got no shortage of resources with which to do just that. More than half of the Institute's $13.5 million in annual funding is provided by congressional funding (or "earmarks'), the Department of Defense and Veteran's Affairs.
The Institute is currently running 67 studies within its military program. And its research is responsible for nearly all of the Pentagon's alternative health initiatives, including a successful yoga program at Walter Reed and the introduction of acupuncture to the combat zone.
But it isn't all inner peace and holistic healing. The Institute was founded by a Fortune 500 billionaire with a history of financial scandal. They pay their director nearly half a million dollars each year. Almost all their military studies are funded by congressional earmarks that reek of preferential treatment. And little of their research fits the medical community's gold standard.
In their defense, Institute leaders tell me that it makes sense for certain congressmen to offer funding for Institute research — because those same reps also advocate for alternative medicine. They tell me that their director is a talent unlike any other and their billionaire founder has a clean track record, and exhort that all their research is rock-solid.
So is this the place where seriously injured, often devastatingly traumatized soldiers can find salvation in downward facing dog? If they can at all? The prospect sounds too good to be true. And, as I learned on my own close exploration of the Pentagon's closest alt-medicine ally, that salvation isn't yet a sure thing.
'We Have Failed Soldiers'
The wounds suffered in this decade's wars are unlike those of previous conflicts. And despite millions in research funding and dozens of new procedures and protocols, the military's struggled to make them much better.
Ironically, soldiers are suffering these new ailments because more of them are making it home. The survival rate of soldiers injured in Iraq and Afghanistan is greater than 93 percent. Compare that to a 76 percent rate in Vietnam, or 69 percent rate in World War II, and it's clear that military medicine has made impressive strides in keeping wounded soldiers alive.
Army Staff Sgt. Victor Medina is but one example. Over the course of three deployments to Iraq and Afghanistan, Medina's convoys were struck by IEDs a handful of times.
Specially designed vehicle armor saved him from injury — until June 29, 2009. As his convoy performed a routine patrol in Iraq, Medina's side of the vehicle was hit by an explosive projectile.
"Mostly I just remember a blur and a lot of confusion…. Later, I was told I'd lost consciousness,' Medina tells me. "I really thought I was dying."
In earlier wars, Medina very well might have. But a medic accompanying his convoy offered immediate help. Medina was in a trauma clinic mere hours later, undergoing diagnostic tests and getting checked for injury. This rapid, thorough care saw Medina diagnosed that very day with a moderate traumatic brain injury — and later flown back to Fort Bliss by Medevac helicopter when his health deteriorated.
But with an unprecedented number of survivors, military docs are seeing epidemic rates of three health problems. Post-traumatic stress disorder, a condition characterized by depression, insomnia and rage, afflicts more than 250,000 of today's soldiers. Traumatic brain injuries (TBIs) like Medina's, which lead to memory lapses, moodiness and learning problems, affect thousands more. And chronic pain, caused by everything from herniated spinal discs to nerve irritation following amputations, is a mainstay among soldiers and veterans.
For these ailments, the Pentagon doesn't have surefire fixes. And unfortunately, their efforts to better treat the conditions have been hampered by missteps.
Military leaders have been vilified for inadequate record-keeping, mismanaged research funds and an over-reliance on brain injury and PTSD tests that often don't work. "We have failed soldiers,' retired Col. Mary Lopez, who used to manage the Army's TBI testing, told ProPublica last year. "It is incredibly frustrating because I can see first-hand the soldiers that we've missed, the soldiers that have not been treated, not been identified, [or] misdiagnosed.'
Actual medical care is sometimes even worse. For all three conditions — PTSD, chronic pain, and TBI — prescription drugs are the primary mode of treatment. Narcotic painkillers, antipsychotics and sleeping pills have been handed out in record numbers. Many soldiers have eventually become hooked on the pain pills that are being given to them.
But if anything, the drug abuse and addiction borne of that strategy is becoming a medical problem of its own and may want to consider seeking prescription drug rehab: 73 percent of accidental deaths among military personnel last year were linked to prescription drugs. One such fatality, that of Sgt. Chris Bachus, elicited headlines simply due to the stunning quantity of pill bottles found near Bachus' body — 27 different ones — after his overdose.
For mental health woes, military doctors also offer therapy. But even the best has a middling success rate, and retains fewer than 50 percent of enrolled soldiers.
Of course, research funded by the Pentagon has made significant progress in unraveling PTSD and TBI. Experts are developing a massive database of brain injuries, working to determine whether brain scans or blood tests can spot either condition, and even investigating neurological indicators that a soldier is vulnerable to mental health problems before deploying. A new collaborative network, the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, has been set up to provide cutting-edge, comprehensive research and leadership to guide military clinics and hospitals treating soldiers and veterans.
None of that progress, however, is likely to show tangible results in time to help today's soldiers.
The DCoE's first director, Brig. Gen. Loree Sutton, quickly made a sharp turn toward alt-medicine: In its first year of existence, the center budgeted several million for the study of just about any non-traditional therapy — from yoga to bio-energy — that showed even an iota of promise in healing the wounds of this generation's war.
"This new theme is a big departure for our cautious culture,' Dr. S. Ward Casscells, the Pentagon's assistant secretary for health affairs, said at the time. "We are struggling, [and] we are increasingly willing to take a hard look at even soft therapies.'
Of course, before military doctors could prescribe yoga over Prozac, the Pentagon had to show that it worked. They needed research.
Practitioners of alternative medicine don't exactly have a lot of that. The gold standard of medical research, a double-blind and placebo-controlled trial, is a lot easier to conduct when comparing sugar pills to potent pharmaceuticals than when comparing yoga to stretches that aren't, well, actual yoga.
Still, a body of supporting evidence — both scientific and anecdotal — is growing. Scientists are using cutting-edge neurological scans, including MRIs, to show that meditation incurs significant brain changes, including a reduction of the amygdala, a region of the brain associated with anxiety and stress and thought to be one of the loci of PTSD.
And experts at top hospitals, including Georgetown and Harvard, have demonstrated that yoga curbs stress hormones and reduces self-reported levels of chronic pain. As for acupuncture, it's arguably the most studied of the three: A recent meta-analysis of dozens of studies concluded that acupuncture really can outdo placebo where pain relief is concerned, and a groundbreaking study released just this weekconcluded that acupuncture therapy curbed blood levels of neuropeptides triggered by the "fight or flight' response.
The stories from soldiers and veterans who've benefited from alt-medicine are even more compelling than the research.
For CJ Keller, a former Marine who spent eight months deployed to Iraq, yoga became "the perfect medicine' to alleviate pain and quell insomnia and anxiety. "A lot of us [in the military] might think yoga's too flaky,' he tells me. "But you need a lot of discipline, focus and concentration. There are parallels.' Keller's so convinced that yoga can help military personnel and veterans, he this summer completed teacher training and now offers a free class for veterans at Baltimore's Charm City Yoga.
Tony Bailes, a former Army combat medic, found relief in acupuncture. Even with prescription painkillers, his back pain was persistent. So Bailes tried acupuncture. "My back pain was gone' in two weeks, he says. Bailes, like Keller, found the experience so remarkable, he's decided to pursue a career in acupuncture.
The science and the stories make it clear: Something about alt-medicine is working.
But many of the studies on alt-medicine aren't. Where meditation is concerned, for example, the National Center for Complementary and Alternative Medicine in 2008 warned that although research into alternative practices had improved, "most clinical trials on meditation are generally characterized by poor methodology,' and that the same was true for other alternative therapies, making it tough to determine their legitimacy one way or the other.
The Army's Surgeon General, Eric Schoomaker, addresses conference attendees.
The Samueli Institute, founded in 2001, wants to change that. The organization's mandate is to conduct rigorous studies on alternative therapies, find the ones that work, and usher them into the mainstream.
Initially, the Institute's studies were mostly oriented toward civilian medicine. Susan Samueli, the wife of Fortune 500 billionaire and Broadcom founder Henry Samueli, started the Samueli Institute after her three kids suffered allergic reactions to antibiotics. She switched the entire family to holistic medicine, and says she felt strongly that the therapies deserved more serious recognition.
But Susan's not an accredited physician. If her pet project was going to take off, it'd need a more reputable representative. So Susan hired Dr. Wayne Jonas. With a lengthy history in the Armed Forces and a former top job at the National Institutes of Health, Dr. Jonas was a seasoned, well-respected researcher. He also gave more credit to alternative medicine than did most doctors
"I had seen things work; amazing things,' Dr. Jonas, who conducts staff meditation sessions at the Institute three mornings a week, tells me of patients who helped will their own recovery, saw improved outcomes through prayer or even mitigated lifelong pain using acupuncture. "It may not yet be written down in a five-star medical journal. That doesn't render it illegitimate.'
With Dr. Jonas aboard, the Institue scored its first — and incredibly bizarre — Pentagon contract.
In 2001, Darpa asked Jonas and his colleagues to re-evaluate a collection of controversial research by Dr. Jacques Benveniste, which not only claimed that water molecules had active memories, but that they could recall the presence of substances dissolved to infinitesimally small concentrations in their midst. The finding seemed to explain a basic tenet of homeopathy, in which remedies are created by dissolving extremely minute amounts of a curative ingredient into water.
Benveniste even stated that those "memories' could be digitized and transferred via email. In other words, homeopathic cures on every home computer.
In what should have surprised no one, the Institute concluded that "digital effects were not reproduced by our investigators.'
But the research did yield one finding for Jonas. He realized that alt-medicine would likely garner plenty of interest from the military community — and the Institute would make an ideal hub for the Pentagon to explore it.
To make that happen, he hired longtime military clinician Joan Walter, who for 10 years had worked with the traumatic brain injury program at Walter Reed Medical Center. Walter in 2005 became the director of a new branch at the Institute, aptly named "Military Medical Research.'
"When I was offered a position here, they knew there was a natural fit with the military,' Walter, a brusque and poker-faced rock of a woman, tells me. "It was up to me to figure out how the Institute could best serve what the Pentagon's needs were.'
Her leadership would accelerate the Institute's relationship with Pentagon leaders. A series of meetings spawned three distinct realms of research collaboration between Samueli experts and military doctors: Chronic pain relief, PTSD and TBI, and performance optimization in combat.
"All three are areas of utmost importance in the armed forces,' Walter says. "And all three are areas where, they know and we know, the military hasn't found adequate solutions.'
Before long, Walter had started up several research projects at various military hospitals and clinics. Her relationships with Walter Reed leaders led to one of the first-ever studies on yoga for PTSD symptoms, done collaboratively between Walter Reed doctors and Samueli researchers. The hospital's subsequent yoga program was introduced in 2006, and has since been widely replicated at other combat hospitals.
On a break from the conference, I walk down the main drag in Alexandria, Virginia, to find the Institute itself.
Sequestered on the sixth floor of a nondescript brick edifice, it's a maze of beige walls and neutral rugs, artificial plants and conventional artwork. Only two features remind me that I'm not, in fact, meandering through a lawyer's office: an enormous, framed portrait of Henry and Susan Samueli in the lobby, and a gargantuan poster on one wall that lists dozens of military research projects conducted by the Institute.
I happen upon Matt Fritts' office down one of many zig-zagging hallways. Opulently decorated with Tibetan prayer flags, statuettes and meditation paraphernalia. I've found the guy who runs yoga research.
‘We know it works.'
"Our mission is to take these ideas that have been dismissed, and see whether there's any merit to them,' Fritts, formerly of the NIH and an avid yogi (he was recruited by the Institute from his part-time gig as a local yoga teacher), tells me. "If there isn't, we're open to acknowledging that.'
Maybe so. But between the guided meditation sessions, the prayer flags, and the unrelenting talk about the power of alt-medicine, the Samueli staff don't exactly appear to be skeptics.
Objective or not, the Institute has made marked progress in adding academic heft to alt-medicine. Its first decade focused on preliminary studies, meant to collect evidence showing that procedures like meditation and acupuncture actually worked. Research leaders with the Institute would plan research agendas, often in collaboration with military clinicians, secure funding, and then typically partner with a military base or hospital — including Brooke Army Medical Center or sometimes a VA facility — to conduct on-location research.
Yoga, thanks largely to the Institute, is today widespread in military hospitals. Fritts is now working on a new yoga-meditation hybrid, called "iRest,' that's showing promising results in alleviating PTSD symptoms.
Acupuncture is another realm where the Institute's had marked success. In 2006, it led a peer-reviewed pilot study that found acupuncture could decrease pain levels by 23 percent, compared to patients receiving standard care, among injured Air Force personnel. Meanwhile, Institute leaders were working alongside Col. (Dr.) Richard Niemtzow to develop a protocol for war-zone acupuncture.
Now, military leaders readily embrace medical acupuncture for pain relief and PTSD treatment. At Joint Base Andrews, Maryland, doctors run the military's first full-time acupuncture clinic, where they use the therapy to alleviate pain among Air Force pilots, who often can't pop narcotic painkillers before flights.
"[Acupuncture is] one treatment that's absolutely ready to be rolled out everywhere,' (Col.) Dr. Richard Petri, a doctor at Fort Bliss and an advocate for alternative medicine, tells me. "There's been rigorous research, in combat and out. We know it works.'
Other Institute research has led military doctors to similar conclusions. Their 2005 clinical trial on yoga, for one, offered 18 soldiers the chance to partake in 10 weeks of classes. The findings concluded what myriad studies since then have too: Yoga can significantly reduce self-reported symptoms of post-traumatic stress, including rage, insomnia and anxiety.
Some of the Institute's research, however, hasn't been so fruitful. Myriad studies have long dismissed, derided and downright mocked the idea of homeopathy, but Samueli researchers still investigate homeopathic processes to this day. Institute researchers also investigate the merits of placebos, "the physics of consciousness,' biofield therapy and psychic healing.
"I'm convinced there are mysteries we haven't solved yet,' Dr. John Ives, a former NIH researcher who now works at Samueli investigating far-out science, tells me. "We're going to keep looking into these areas until we know, for sure, one way or the other. Right now, I'd say the jury is still out.'
Some Samueli researchers plan to keep pushing the limits of out-there investigation. Others, meanwhile, will be busy implementing successful findings: The Institute's biggest priority over the next decade is to transform research into real programs for soldiers and veterans.
Fritts, for example, is currently conducting a nationwide survey of every military medical clinic, to find out what treatments they offer. From there, he and his colleagues will zero in on locations that remain reliant on conventional medicine, and recommend holistic programs.
And in 2012, much of the alt-medicine the Institute endorses will become even more common in the Army. Alongside Samueli teams, Army brass have approved several comprehensive pain management centers that use modalities like massage, yoga and acupuncture in addition to conventional treatment. Four will be established in the coming year, with dozens more in planning stages. And the Institute has already been contracted to evaluate the first-ever clinic, established at Tripler Army Medical Center, for efficacy.
But despite an organizational mandate to uphold rigorous research standards, and a large volume of published studies and papers, the Institute doesn't do much of the placebo-controlled, double-blind research that's upheld as the gold-standard of medical study.
They told me that's because such trials are "a methodology designed for drug research,' rather than alternative therapies.
Rather, the Institute's approach has relied largely on comparative effectiveness research, the process of measuring a therapy of interest (yoga, for example) against another available therapy (such as painkillers). Such an approach "more accurately and realistically assesses the benefits of introducing one or more new therapies to the existing options,' Institute leaders told me.
Furthermore, they don't think placebos are entirely useless. "It has been demonstrated that almost all medical interventions benefit from the placebo effect,' they tell me. "To the extent that the placebo effect can enhance healing, we should include it in our research, rather than control for it.'
Friends in Need
After the conference's first round of panels, attendees pause for bathroom breaks and green tea. As Schoomaker and Wayne Jonas shake hands warmly, chatting like old friends, it's abundantly clear that the Institute has won the Pentagon's resounding endorsement.
But how the Institute managed to win such favor might have to do with its patrons: Henry Samueli, ranked #263 on the Forbes 400 List and worth an estimated $1.7 billion, is not only a successful business man (and the owner of the Anaheim Mighty Ducks). He also knows how to play politics.
Samueli doles out plenty in campaign contributions: Over $25,000 to Rep. Jim Moran and $40,000 to Rep. Peter Visklosky, among around a dozen others. Both men have earmarked generous sums for the Institute: Moran with $1.6 million for the Institute's military research in 2010, and Visklosky with the same amount in 2008.
"The past Congressional supporters of the Institute are individuals who are committed to some of the same ideas as the Insitute,' Samueli representatives told me via e-mail. "It should not surprise anyone that Dr. Samueli has chosen to support these members in their campaigns, just as any other citizen might choose to support the campaigns that advocate for issues that matter to them.'
‘I can't be cured. But I can be healed.'
For a time, though, the Institute did see a dip in contributions. In 2007, Samueli pleaded guilty to partaking in a $2.2 billion stock fraud scheme orchestrated by Broadcom executives. Charges were dismissed two years later because of what U.S. District Judge Cormac Carney dubbed "shameful' prosecutorial intimidation tactics, but many Reps either returned campaign money or "cut ties' with the exec.
In 2010, however, they made a comeback: According to the Center for Responsive Politics, the Institute reaped $7.6 million in congressional earmarks, all of them for Pentagon-related studies. Samueli's representatives tell me the figure was closer to $6.6 million.
The Institute also pays Dr. Jonas disconcertingly well: Last year, he earned a salary of $471,000. That's quadruple the payday for leaders of charities this size, according to Sandra Miniutti at Charity Navigator.
"We do not see salaries of the level of Mr. Jonas until we approach charities that are much, much larger,' she tells me. "You might want to ask them about that.'
I did. The Institute told me that they calibrate salary using metrics that include more than just charity size. Not to mention that Dr. Jonas "is internationally acknowledged as both an expert and leader in the fields of complementary and alternative medicine and research…as well as the credibility of working within the Army as a physician.'
"[His] uniqueness as a CEO is evident,' Institute representatives told me via e-mail, "And his compensation should be understood within the context of the impact and mission the Institute seeks to achieve under his leadership, rather than by comparison to other charities with similar budgets.'
No matter how they get their funding, there's no question that Institute research has helped plenty of military personnel. Staff Sgt. Medina, for one, underwent 16 months of conventional rehab — physical and speech therapy, cognitive exercises, prescription drugs — but still suffers serious TBI symptoms that include a persistent stutter, headaches and memory lags.
He now swears by frequent acupuncture, massage therapy and meditation. "A human touch can sometimes do more than drugs,' he tells me of his routine, which was recommended to him by Col. Petri at Fort Bliss.
It's troubling to wonder whether grateful soldiers and vets, like Medina, might be the byproduct of politics and perfect timing; an influential business tycoon and a bloated appropriations budget.
Then again, Medina doesn't much care. He feels better now than he has since before the accident, and is no longer taking the pain medication he once relied on.
"Doctors don't know how to cure traumatic brain injuries yet,' he says. "I had to accept that I can't be cured. But what I've learned, what I'm so thankful for, is that I can be healed.'
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