White House Chronicle

News Analysis With a Sense of Humor

Brain Injuries From Blasts Driving Young Vets to Suicide

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We all get a warm glow when we hear the airline gate agent inviting active-duty service members to board early. What isn’t said, isn’t known, is that some of those young men and women will die eventually by their own hands, and at nearly three times the rate of civilians in the same under-34 age group.

Veterans, particularly young veterans, men and women, are in danger of walking on the dark side in terrible isolation, despair and misery — in a darkness so extreme it defies comprehension by those who are in the light.

These veterans are the victims of traumatic brain injury, a hard-to-diagnose and treat brain wounding by the force of shock waves from explosive blasts. The shock waves can cause minute tears or other damage that medical imaging and blood tests can’t detect in a living patient.

Frank Larkin, who heads up Warrior Call, an organization devoted to helping TBI-afflicted veterans, knows the problem in a savagely personal way: His son, Ryan, a decorated Navy SEAL, took his life at age 29. He was a victim of TBI.

Larkin is a former Navy SEAL, a police officer, a Secret Service agent and a U.S. Senate sergeant at arms. He is a passionate advocate for research, understanding, compassion and giving veterans an ecosystem in which they can feel secure, comforted and part of a tribal continuance that extends from the time in service to life in the civilian world.

Thomas Bowman, a Marine for 30 years and later the Republican staff director of the Senate Veterans’ Affairs Committee and deputy secretary of the Veterans Administration in the first Trump administration, knows the issue from its institutional challenges.

Larkin and Bowman joined me and my colleague, Adam Clayton Powell III, on the PBS and SiriusXM Radio program “White House Chronicle” to discuss a disturbing uptick in veteran suicide from TBI.

When a sufferer seeks and receives medical help, the chances are it will be treated as psychological rather than physical in origin. Bowman stresses how important records and continuity of monitoring are. He believes artificial intelligence will be a great asset in managing veterans’ medical histories and ensuring they are seen as a continuum, not a series of disjointed episodes.

Larkin says his son became withdrawn and “stopped smiling, as if a mask had been put over his face.” He knew his problem, but he was unable to overcome it, even with a dedicated support system. Before he took his life, Ryan asked that his brain be donated to science.

TBI victims can suffer from frequent headaches, sleeplessness, brain fog and shortened tempers. Drugs, alcohol and homelessness complicate and worsen their predicament.

Larkin says young veterans can find themselves “in a very dark place, suffering invisible wounds.”

Things are getting worse on the battlefield. Drones are an increased source of brain damage. These, Larkin and Bowman point out, are unlike mortars and improvised explosive devices: They explode on the same plane as soldiers’ heads.

Not all the damage takes place on the battlefield. Some of it can be part of routine training, the frequent exposure to everything from a soldier’s weapon to artillery and mortar live-fire practice.

Larkin and Bowman speak of the good work at the Department of Veterans Affairs, but also of the numbing bureaucracy there. Larkin regrets the loss of 30,000 personnel at the VA in recent government trimming.

Nonetheless, the rate of veteran suicide is going up, according to the latest VA report. The overall rate for veterans of all ages, based on data through 2023, was 35.2 deaths per 100,000 people, up from 34.7 deaths per 100,000 in 2022. The suicide rate for civilians of all ages was half the rate.

Suicide among veterans is the 12th-leading cause of death for veterans overall but the leading cause of death for veterans under 45, the VA report found.

As a former homicide detective, Larkin believes these suicides are underreported. He says this is sometimes to protect a family and for other reasons.

All suicides are terrible but particularly when the victims are young and have come to that bleak place because they served.

Watch Out When the Political Class Forgets Cause and Effect

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Anyone who has spent time in criminal court knows this: One of the characteristics of lawbreakers is a poorly developed sense of cause and effect.

At the low end, the folly of the defendants is always on display. The young man who takes a gun with him on a night of drinking. He has increased his chances that he might use it and spend the rest of the useful years of his life in prison.

The shoplifter who keeps at it despite past convictions faces undetermined years behind bars. The burglar who robs a house and, while there, calls home on a cell phone, which will ping off the nearest cell tower, negating any alibi. The murderer who posts on social media.

This poorly developed sense of cause and effect isn’t confined to the lawless. It is rife in the political class, in both cohorts, but primarily these days in the ruling Republican cohort.

We, as a nation, appear to have forgotten that actions have consequences. Those consequences ricochet down through the decades, even the centuries.

Bomb people, and you will get a massive refugee problem.

Deny medical funding, and you will get overburdened emergency rooms.

Underfund science, and the talent will pop up somewhere else, like the universities of Europe and Asia.

Cut off immigration, and you will have deflation from population decline.

Create stateless people — they are still people, still there — and they will become a burden.

Don’t raise taxes to cover the $39 trillion national debt, and the interest payments on the debt will be so enormous that there will be little left for the business of governance.

Action has consequences, just as inaction has consequences. Winston Churchill said: “A decision not taken is nonetheless a decision.”

Here are just some areas where the effect may linger long after the cause has lost its currency — long after the action, which seemed to be “a good idea” at the time, was taken:

Cause: Traduced allies, vitiated treaties and long-term friends abandoned with abusive disdain while rewarding the deplorable with praise, recognition and encouragement.

Effect: The slights and the negations won’t be forgotten, but the reason for them will have faded with the perpetrators. America diminished as a global power, taking a seat beside Brazil or Argentina, damned by a history of causing damaging effects for passing motives.

Cause: Profligate use of the presidential pardon.

Effect: A further temptation to abuse power and advance corrupt patronage. Friends go free.

Cause: The abandonment of the sacred right to see a judge, to identify the accuser, to be tried by a jury of your peers.

Effect: A lawless state of injustice and cruelty, the state out of control, thugs loosed on the people.

Cause: Undermine the elections by falsely claiming that they were rigged.

Effect: A fundamental weakening of democracy and the supremacy of the ballot. All elections are doubted and more easily overturned. The system is undermined.

Cause: Sustaining a lie in the belief that if you claim it long enough, it will sow doubt.

Effect: Truth becomes what those who have power say it is, whether it is about an election, immigrants, the cost of wind turbines or climate change. Truth becomes a commodity in short supply in the political marketplace.

All governments make mistakes, and most go too far in the service of political ideas, which have legitimacy for a time and then fade. This time it is different. The list of political actions that will have detrimental effects in the future and substantially threaten our world leadership is long.

Since the end of World War II, we have led the world in everything from creativity to moral example, from generosity in foreign aid to genius in medical science, from legal thought to environmental protection.

Now, political exigency is undermining that. Petty, small triumphs in what are often just the culture wars have effects that diminish us worldwide, and harbinger a more troubled future for us and the world.

Any day, in the heat of a political moment, another cause may leave an effect that will damage the decision-making mechanisms of the Senate. If the filibuster goes, both parties would rue the effects, long and often.

If it goes, the cause will be forgotten, but the effect will endure.

The Buoyancy of Immigrants and Their Success in Science

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I have been exploring the heights of scientific endeavor in reporting on artificial intelligence, from its use in medical research (especially promising) to its use in utilities and transportation. It is notable that many of the high achievers weren’t born here.

They have come here from everywhere, but the number of Asians is notable — and in that group, the number of women stands out.

As an immigrant, I am interested in why immigrants are so buoyant, so upwardly mobile in their adopted countries. I can distill it to two things: They came to succeed, and they mostly aren’t encumbered with the social limits of their upbringing and molded expectations. America is a clean slate when you first get here.

A friend from Serbia, who ascended the heights of academe and lectured at Tulane University, said his father told him, “Don’t go to America unless you want to succeed.”

A South Korean mechanical engineer who studied at American universities and now heads an engineering company that seeks to ease the electricity crisis, told me, “I want to try harder and do something for America. I chose to come here. I want to succeed, and I want America to succeed.”

When I sat at lunch in New York with an AI startup’s senior staff, we noticed that none of us was born an American. Two of the developers were born in India, one in Spain and me in Zimbabwe.

We started to talk about what made America a haven for good minds in science and engineering and we decided it was the magnet of opportunity, Ronald Reagan’s “shining city upon a hill.”

There was agreement from the startup scientists-engineers — I like the British word “boffins” for scientists and engineers taken together — that if that ever changes, if the anti-immigrant sentiment overwhelms good judgment, then the flow will stop, and the talented won’t come to America to pursue their dreams. They will go elsewhere or stay at home.

In the last several years, I have visited AI companies, interviewed many in that industry and at the great universities like Brown, UC Berkeley, MIT and Stanford, and companies like Google and Nvidia. The one thing that stands out is how many of those at the forefront weren’t born in America or are first generation.

They come from all over the globe. Asians are clearly a major force in the higher reaches of U.S. research.

At an AI conference, organized by the MIT Technology Review, the whole story of what is happening on the cutting-edge of AI was on view: faces from all over the world, new American faces. The number of immigrants was awesome, notably from Asia. They were people from the upper tier of U.S. science and engineering confidently adding to the sum of the nation’s knowledge and wealth.

Consider the leaders of top U.S. tech companies who are immigrants: Microsoft, Satya Nadella (India); Google, Sundar Pichai (India); Tesla, Elon Musk (South Africa); and Nvidia, Jensen Huang (Taiwan). Of the top seven, only Apple’s Tim Cook, Facebook’s Jeff Zuckerberg and Amazon’s Andy Jassy can be said to be traditional Americans.

A cautionary tale: A talented computer engineer from Mexico with a family that might have been plucked from the cover of the Saturday Evening Post lived in the same building as I do. During the Trump administration, they went back to Mexico.

There had been some clerical error in his paperwork. The humiliation of being treated as a criminal was such that rather than fight immigration bureaucracy, he and his family returned voluntarily to Mexico. America’s loss.

Every country that has had a large influx of migrants knows they can bring with them much that is undesirable. From Britain to Germany to Australia, immigration has had a downside: drugs, crime and religions that make assimilation difficult.

However, waves of immigrants have built America, from the Scandinavian and German wheat farmers who turned the prairies into a vast larder to the German Jews, who moved to Hollywood in the 1930s and made America pre-eminent in entertainment, to today’s global wave that is redefining Yankee know-how in the world of neural networks and quantum computing.

The Wild, Fabulous Medical Frontier with Predictive AI

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When is a workplace at its happiest? I would submit that it is during the early stages of a project that is succeeding, whether it is a restaurant, an internet startup or a laboratory making phenomenal progress in its field of inquiry.

There is a sustained ebullience in a lab when the researchers know they are pushing back the frontiers of science, opening vistas of human possibility and reaping the extraordinary rewards that accompany just learning something big.

There has been a special euphoria in science ever since Archimedes jumped out of his bath in ancient Greece, supposedly shouting, “Eureka!”

I sensed this excitement when interviewing two exceptional scientists, Marina Sirota and Alice Tang, at the University of California San Francisco (UCSF) for the independent PBS television program “White House Chronicle.”

Sirota and Tang have published a seminal paper on the early detection of Alzheimer’s disease — as much as 10 years before onset — with machine learning and artificial intelligence. The researchers were hugely excited by their findings and what their line of research will do for the early detection and avoidance of complex diseases like Alzheimer’s and many more.

It excited me — as someone who has been worried about the effect of AI on everything, from the integrity of elections to the loss of jobs — because the research at UCSF offers a clear example of the strides in medicine unfolding through computational science. “This time it’s different,” said Omar Hatamleh, who heads up AI for NASA at the Goddard Space Flight Center in Greenbelt, Md.

Human expectations are being revolutionized in laboratories like the one in San Francisco.

Sirota said, “At my lab … the idea is to use both molecular data and clinical data (which is what you generate when you visit your doctor) and apply machine learning and artificial intelligence.”

Tang, who just finished her Ph.D. and is studying to be a medical doctor, explained, “It is the combination of diseases that allows our model to predict onset.”

In their study, Sirota and Tang found that osteoporosis is predictive of Alzheimer’s in women, highlighting the interplay between bone health and dementia risk.

The researchers used this approach to find predictive patterns from 5 million clinical patient records held by UCSF in its database. From these, there emerged a relationship between osteoporosis and Alzheimer’s, especially in women. This is important as two-thirds of Alzheimer’s sufferers are women.

The researchers cautioned that it isn’t axiomatic that osteoporosis leads to Alzheimer’s, but it is true in about 70 percent of cases. Also, they said they are critically aware of historical bias in available data — for example, that most of it is from White people in a particular socioeconomic class.

Sirota and Tang said there are contributory factors they found in Alzheimer’s. These include hypertension, vitamin D deficiency and heightened cholesterol. In men, erectile dysfunction and enlarged prostate are also predictive. These findings were published in “Nature Aging” early this year.

Predictive analysis has potential applications for many diseases. It will be possible to detect them well before onset and, therefore, to develop therapies.

This predictive analysis has been used to anticipate homelessness so that intervention — like rent assistance — can be applied before a family is thrown out on the street. Institutional charity is usually slow and often identifies at-risk people after a catastrophe.

AI is beginning to influence many aspects of our lives, from telephoning a banker to utilities’ efforts to spot and control at-risk vegetation before a spark ignites a wildfire.

While the challenges of AI, from its wrongful use by authoritarian rulers and its menace in war and social control, are real, the uses just in medicine are awesome.

In medicine, it is the beginning of a new time in human health, as the frontiers of disease are understood and pushed back as never before. Eureka! Eureka! Eureka!