Image: Jim Miklasszewski
By Jim Miklaszewski Chief Pentagon correspondent
NBC News
updated 12/8/2004 7:50:03 PM ET 2004-12-09T00:50:03

In the sixth floor speech therapy lab at Walter Reed Army Medical Center in Washington, Specialist Hugo Gonzalez is working to rebuild what he's lost.

“Sometimes the word... sometimes the word that I really know, that I really want to use, sometimes they just don't come out,” says Gonzalez.

Gonzalez sustained a serious brain injury in a roadside bomb blast and firefight one night in Iraq. It was captured on film although he never saw it coming.

“I didn't realize what happened to me until four days later when I wake up from a coma,” says  Gonzalez.

His doctor is Lou French.

“If he had not received immediate medical intervention, it's unlikely that he would have survived,” says Dr. French.

He's not alone. Physicians at Walter Reed are treating brain injured soldiers from Iraq and Afghanistan with greater frequency than in past wars. Today, nearly two out of every three soldiers injured in combat, who end up at Walter Reed, also have some type of brain injury — blast injuries mostly.

“In terms of the doctors who are taking care of these patients, we're pretty busy right now,” says Dr. Deborah Warden at Walter Reed.

Part of the reason is that doctors are better at spotting mild brain injuries they once might have missed. But modern body armor also means soldiers are surviving injuries to their torsos that once might have killed them. Yet, even with helmets, their heads are still vulnerable.

For Gonzalez, the violent shockwave from the blast severely rattled his brain, causing potentially fatal swelling. Battlefield surgeons removed 20 percent of his skull to relieve the pressure. That piece of skull will be re-implanted next month. In the meantime Gonzalez wears a helmet for protection. He's had a lot of time to think about what happened.

“I wasn't playing with GI Joes up there,” says Gonzalez. “That was real war. Real bullets flying over our heads.”

Gonzalez and his family know he is lucky. His prognosis is good.

“I have a lot… a great will to live. I am going forward,” he says.

There are those with brain injuries who aren't so lucky. The battlefields of Iraq, it seems, have found a new kind of victim.

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