Gray Team

Last updated
The Joint Neurosciences Inspection Team
ActiveJanuary of 2009 to September 2011
Country United States
Nickname(s)Gray Team
Commanders
Current
commander		 Colonel Christian Macedonia, MD

The Gray Team, currently[ as of? ] evolved into the Grey Team, and more formally known as the Joint Neurosciences Inspection Team, was the name given to a series of special inspection units commissioned by the Joint Chiefs of Staff to serve as mechanism to help improve the care of American forces serving in Iraq and Afghanistan. Their missions were particularly focused on the "invisible wounds of war" such as traumatic brain injury or post traumatic stress.

Contents

The original Gray Team was composed of hand-selected active duty members all of whom had prior deployment experience in a combat zone and relevant medical expertise . The original team had at least one representative from each of the four armed services branches. Col Macedonia appointed Col Michael Jaffee to be the clinical lead given his role as National Director of the Defense and Veterans Brain Injury Center (DVBIC).

The original Gray Team traveled to a number of deployed bases and combat medical facilities from all branches of service across both Iraq and Afghanistan. They were focused on identifying barriers for implementation of screening and acute management of TBI and concussion. The team reported directly to the Joint Chiefs of Staff. The largest impact was changing the military’s system from a symptom-based system in which a service member had to admit to having a symptom from a concussion or TBI to an incident-based system in which any service member involved in a blast or situation considered high risk for concussion would be screened and evaluated regardless of whether or not they self-reported any symptoms. This represented a paradigm shift and was the first time military combat policy was combined with medical guidelines. This paradigm shift has had lasting impact and is still in place today.

Subsequent Gray Team missions focused on having civilian researchers who worked with the military to have an opportunity to experience the environment and forward medical facilities and to further evaluate the implementation of changes established by the original Gray Team.

The military Gray Team should not be confused with the non-profit organization Grey team who was inspired by the military team to adapt the name in order to further help veterans suffering from the invisible wounds of war.

Notable members of the original Gray Team which operated overseas as part of the military were: Colonel Christian Macedonia (Army/JCS), lead Colonel Michael Jaffee (Air Force/DVBIC), co-lead Colonel Geoff Ling (Army/DARPA) Colonel James Hancock (USN/USMC) – now RADM Hancock , Lieutenant Colonel Shean Phelps (Army/USAARL), Special Operations advisor - now NASA JSC , Major Justin Campbell (Army/JCS), Military Police advisor

As of 2016, a non profit was formed as the Grey Team by U.S. military veteran Cary Reinbach, implementing solutions for U.S. military active-duty and veterans to reduce and eliminate PTSD related suicides. www.GreyTeam.org

Grey Team's comprehensive health and wellness programs directly heal all the invisible wounds of war including, but not limited to: traumatic brain injuries, post-traumatic stress disorder, chronic pain, self-medication, and isolation.

To accomplish this goal, Grey Team has built a world-class headquarters in Boca Raton, Florida complete with one-on-one personal training, infrared detoxification, low-level laser therapy, acupuncture for pain relief, 3D body scanning, community safe-spaces, and much more.

History: There were four teams in total between January 2009 and September 2011, composed of service men and women from across the armed services as well as civilian scientist volunteers. Each member of the team was nominated by the various armed services and approved to serve on the team by Admiral Michael Mullen, the Chairman of the Joint Chiefs of Staff. [1] Each Gray Team was commanded by Colonel Christian Macedonia, MD, the Chairman’s medical sciences advisor. [1] [2]

Origins

Admiral Michael Mullen assumed the office of Chairman of the Joint Chiefs of Staff in August 2007. By that point, there had been numerous reports including print newspaper stories by Gregg Zoroya at USA Today [3] [4] and the publication of the RAND Report Invisible Wounds of War [5] criticizing the US military’s weak response to traumatic brain injury and post traumatic stress disorder. Determined to avoid the mistakes made in previous conflicts (Agent Orange, Gulf War Syndrome), he established an office within the Joint Staff to work on these issues giving the experts in this office direct daily access. In 2008, he recruited COL Christian Macedonia to be his Medical Sciences Advisor. They jointly worked on the Gray Team concept and launched the first mission in January 2009. [1]

Nickname

The team's name came from the brain's grey matter. [6]

Notable members

Members have included:

Related Research Articles

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Traumatology</span> Medicine branch

In medicine, traumatology is the study of wounds and injuries caused by accidents or violence to a person, and the surgical therapy and repair of the damage. Traumatology is a branch of medicine. It is often considered a subset of surgery and in countries without the specialty of trauma surgery it is most often a sub-specialty to orthopedic surgery. Traumatology may also be known as accident surgery.

<span class="mw-page-title-main">Concussion</span> Medical condition

A concussion, also known as a mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness; memory loss; headaches; difficulty with thinking, concentration, or balance; nausea; blurred vision; dizziness; sleep disturbances, and mood changes. Any of these symptoms may begin immediately, or appear days after the injury. Concussion should be suspected if a person indirectly or directly hits their head and experiences any of the symptoms of concussion. Symptoms of a concussion may be delayed by 1–2 days after the accident. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness.

<span class="mw-page-title-main">Wounded in action</span> Military term used for persons wounded by enemy action

Wounded in action (WIA) describes combatants who have been wounded while fighting in a combat zone during wartime, but have not been killed. Typically, it implies that they are temporarily or permanently incapable of bearing arms or continuing to fight. Generally, the Wounded in Action are far more numerous than those killed. Common combat injuries include second and third-degree burns, broken bones, shrapnel wounds, brain injuries, spinal cord injuries, nerve damage, paralysis, loss of sight and hearing, post-traumatic stress disorder (PTSD), and limb loss.

<span class="mw-page-title-main">Combat stress reaction</span> Medical condition

Combat stress reaction (CSR) is acute behavioral disorganization as a direct result of the trauma of war. Also known as "combat fatigue", "battle fatigue", or "battle neurosis", it has some overlap with the diagnosis of acute stress reaction used in civilian psychiatry. It is historically linked to shell shock and can sometimes precurse post-traumatic stress disorder.

Closed-head injury is a type of traumatic brain injury in which the skull and dura mater remain intact. Closed-head injuries are the leading cause of death in children under 4 years old and the most common cause of physical disability and cognitive impairment in young people. Overall, closed-head injuries and other forms of mild traumatic brain injury account for about 75% of the estimated 1.7 million brain injuries that occur annually in the United States. Brain injuries such as closed-head injuries may result in lifelong physical, cognitive, or psychological impairment and, thus, are of utmost concern with regards to public health.

Post-concussion syndrome (PCS), also known as persisting symptoms after concussion, is a set of symptoms that may continue for weeks, months, or years after a concussion. PCS is medically classified as a mild traumatic brain injury (TBI). About 35% of people with concussion experience persistent or prolonged symptoms 3 to 6 months after injury. Prolonged concussion is defined as having concussion symptoms for over four weeks following the first accident in youth and for weeks or months in adults.

<span class="mw-page-title-main">Chronic traumatic encephalopathy</span> Neurodegenerative disease caused by head injury

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia.

<span class="mw-page-title-main">Madigan Army Medical Center</span> Hospital in Washington, United States

The Madigan Army Medical Center, located on Joint Base Lewis-McChord just outside Lakewood, Washington, is a key component of the Madigan Healthcare System and one of the largest military hospitals on the West Coast of the United States.

Post-traumatic amnesia (PTA) is a state of confusion that occurs immediately following a traumatic brain injury (TBI) in which the injured person is disoriented and unable to remember events that occur after the injury. The person may be unable to state their name, where they are, and what time it is. When continuous memory returns, PTA is considered to have resolved. While PTA lasts, new events cannot be stored in the memory. About a third of patients with mild head injury are reported to have "islands of memory", in which the patient can recall only some events. During PTA, the patient's consciousness is "clouded". Because PTA involves confusion in addition to the memory loss typical of amnesia, the term "post-traumatic confusional state" has been proposed as an alternative.

Shell shock is a term that originated during World War I to describe the type of post-traumatic stress disorder (PTSD) that many soldiers experienced during the war, before PTSD was officially recognized. It is a reaction to the intensity of the bombardment and fighting that produced helplessness, which could manifest as panic, fear, flight, or an inability to reason, sleep, walk, or talk.

The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) is a United States Department of Defense (DoD) organization that provides guidance across DoD programs related to psychological health (PH) and traumatic brain injury (TBI) issues. The organization's official mission is to "improve the lives of our nation’s service members, families and veterans by advancing excellence in psychological health and traumatic brain injury prevention and care."

The Naval Center for Combat and Operational Stress Control (NCCOSC) is a U.S. Navy Medicine organization established to promote psychological health in the U.S. Navy and Marine Corps. It is a culturally relevant center that leverages sound medical knowledge to improve resilience, preserve psychological health, improve care for sailors, marines and their families and facilitate Navy Medicine research efforts on psychological health and traumatic brain injury.

Concussions and play-related head blows in American football have been shown to be the cause of chronic traumatic encephalopathy (CTE), which has led to player deaths and other debilitating symptoms after retirement, including memory loss, depression, anxiety, headaches, stress, and sleep disturbances.

Concussions, a type of mild traumatic brain injury, are a frequent concern for those playing sports, from children and teenagers to professional athletes. Repeated concussions are known to cause neurological disorders, particularly chronic traumatic encephalopathy (CTE), which in professional athletes has led to premature retirement, erratic behavior and even suicide. A sports-related concussion is defined as a "complex pathophysiological process affecting the brain, induced by biomechanical forces". Because concussions cannot be seen on X-rays or CT scans, attempts to prevent concussions have been difficult.

A sports-related traumatic brain injury is a serious accident which may lead to significant morbidity or mortality. Traumatic brain injury (TBI) in sports are usually a result of physical contact with another person or stationary object, These sports may include boxing, gridiron football, field/ice hockey, lacrosse, martial arts, rugby, soccer, wrestling, auto racing, cycling, equestrian, rollerblading, skateboarding, skiing or snowboarding.

The Military Acute Concussion Evaluation (MACE) is an American medical screening and documentation measure that is used to gauge the severity of symptoms and cognitive deficits after a diagnosis of a concussion has been made. Taking less than 15 minutes to administer, it involves collecting a history of the injury event and the symptoms experienced at that time, followed by a brief neurological screening, and a similarly short cognitive test. The score is presented with a listing of symptoms endorsed and a red or green light regarding the neurological screen. All cases of a concussion result in mandatory restricted duty for 24 hours followed by immediate reevaluation via the MACE. Similarly, the MACE is most effective if given within 24 hours of the injury event to fully gauge the level of possible brain injury. The MACE has been distributed to all branches of the US military. It is currently used in DVBIC and the US Department of Veterans Affairs (VA) Veterans Health Administration are partners in clinical care, education, research and care coordination for veterans and active-duty service members who have sustained a traumatic brain injury.

<span class="mw-page-title-main">Geoffrey Ling</span>

Geoffrey S. F. Ling is a medical doctor who retired from the United States Army as a colonel and was the CEO of On Demand Pharmaceuticals. He served as the founding director of the Defense Advanced Research Projects Agency (DARPA) Biological Technologies Office from 2014 until 2016. He was considered to be the "US Army's premier subject matter expert on traumatic brain injury (TBI)", and was for years the only neuro-intensive care specialist in the US military.

<span class="mw-page-title-main">Kit Parker</span>

Kevin Kit Parker is a lieutenant colonel in the United States Army Reserve and the Tarr Family Professor of Bioengineering and Applied Physics at Harvard University. His research includes cardiac cell biology and tissue engineering, traumatic brain injury, and biological applications of micro- and nanotechnologies. Additional work in his laboratory has included fashion design, marine biology, and the application of counterinsurgency methods to countering transnational organized crime.

Christian Macedonia is a medical doctor and a retired United States Army officer. From 2009 to 2011, he led the Gray Team which was tasked to improve the care of American forces serving in Iraq and Afghanistan.

References

  1. 1 2 3 4 5 6 7 Hamilton, Jon. "How A Team Of Elite Doctors Changed The Military's Stance On Brain Trauma". NPR. All Things Considered, NPR. Retrieved 23 August 2016.
  2. 1 2 3 4 "What if PTSD Is More Physical Than Psychological?". The New York Times. 12 June 2016.
  3. ↑ "USATODAY.com - Key Iraq wound: Brain trauma".
  4. ↑ "Col.: DOD delayed brain injury scans - USATODAY.com".
  5. ↑ Terri, Tanielian; H., Jaycox, Lisa; M., Adamson, David; Audrey, Burnam, M.; M., Burns, Rachel; B., Caldarone, Leah; A., Cox, Robert; J., D'Amico, Elizabeth; Claudia, Diaz; Christine, Eibner; Gail, Fisher; C., Helmus, Todd; R., Karney, Benjamin; Beau, Kilmer; N., Marshall, Grant; T., Martin, Laurie; S., Meredith, Lisa; N., Metscher, Karen; Chan, Osilla, Karen; Liccardo, Pacula, Rosalie; Rajeev, Ramchand; S., Ringel, Jeanne; L., Schell, Terry; M., Sollinger, Jerry; E., Vaiana, Mary; M., Williams, Kayla; R., Yochelson, Michael (1 January 2008). "Invisible Wounds of War".{{cite journal}}: Cite journal requires |journal= (help)CS1 maint: multiple names: authors list (link)
  6. ↑ Weinberger, Sharon (21 September 2011). "Bombs' hidden impact: The brain war". Nature. 477 (7365): 390–393. Bibcode:2011Natur.477..390W. doi: 10.1038/477390a . PMID   21938046.
  7. ↑ "How a Team of Elite Doctors Changed the Military's Stance on Brain Trauma » McKnight Brain Institute » University of Florida".
  8. 1 2 Campbell, Justin S.; Koffman, Robert L. (2 October 2014). "Ecological Systems of Combat and Operational Stress: Theoretical Basis for the U.S. Navy Mobile Care Team in Afghanistan". Military Behavioral Health. 2 (4): 316–326. doi:10.1080/21635781.2014.963761. S2CID   108630775.
  9. ↑ Campbell, Justin S.; Pulos, Steven; Haran, F. Jay; Tsao, Jack W.; Alphonso, Aimee L. (4 May 2015). "Psychometric Investigation of the Abbreviated Concussion Symptom Inventory in a Sample of U.S. Marines Returning from Combat". Applied Neuropsychology: Adult. 22 (3): 170–179. doi:10.1080/23279095.2014.891510. PMID   25153983. S2CID   1365073.
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