"Traumatic brain injury will be my generation’s Agent Orange."
Michael Spivey, a retired special operations soldier, served 23 years in the U.S. Army. In 2023, he participated in the Center for Brain Health’s 3-day evaluation and 3-week intensive outpatient program. The following is an excerpt from an interview with Spivey and his wife, Lauren Galliker, about his service, his injuries and his treatment in the Center’s Veteran care program.
How were you injured? What caused your TBI?
Michael: I’ve had my bell rung dozens of times in combat and training. I can’t even put a number on it. Whether it was bouncing my head off the aircraft coming out the door on a parachute operation or blowing door charges inside a confined area over and over, I never realized how many concussive events I experienced in a lifetime of service.
One of the biggest misconceptions about traumatic brain injury (TBI) is that it’s one event. Yes, I had one easily verifiable TBI event in 2004 while on patrol in Eastern Afghanistan. I was blown up and shot in the face, and evacuated to Germany for care. But I was back on active duty in Afghanistan a week later and involved in major combat actions a week after that. No one really understood multiple concussion syndrome back then. I wasn’t diagnosed with TBI until after I retired in 2018.
With combat warriors, it’s never one injury. It’s an accumulation. Even if you were enlisted and didn’t see live combat, we train as hard as we fight in combat. Injuries that happen during training are just as bad, sometimes worse.
This also makes it frustrating for Veterans who don’t have a “qualifying” event to get treatment. They tell the doctors at the VA, ‘I have these symptoms’, but because there is not one, singular event, it makes it nearly impossible to get a rating or treatment. I know SWCC boat drivers who spent 20 years pounding their bodies and brains off of waves and boats. I know guys on demolitions teams who spent weeks and months blasting charges in confined spaces. Yet, because they don’t have that singular event, the VA system doesn’t know how to rate or treat them.
"One of the biggest misconceptions about traumatic brain injury (TBI) is that it’s one event." — Michael Spivey
When did you first start noticing symptoms of your injuries, and what brought you to the Center?
Michael: In 2004, I received major hearing damage from the explosion and firefight. I heard nothing but constant ringing for about a year — bad tinnitus. I don’t have hearing at certain frequency ranges, but my brain has learned how to slowly dissociate from the ringing. I still suffer from the hearing loss to this day.
However, there was never a moment during service when I consciously acknowledged: I have a brain injury. There’s just no appetite for soldiers to get medical help. And it’s not completely a command thing. It comes down to duties and responsibilities. There’s this misconception that combat warriors don’t get help as a matter of pride. It’s the opposite. There’s a culture of supporting your team at all costs. We’re on small teams. If I go to a doctor and he says I can’t go back to work for a week, or ever, I let my team down, and probably end my career. And as an aviator? Everyone knows that aviators are more scared of being grounded by the flight surgeon than death.
Did you seek care when you retired?
Michael: When you come back from a deployment, they give you paperwork that asks you about exposure to toxic chemicals, blasts — everything. All you want to do is leave the facility and see your family, which you can’t do until you fill out the paperwork. So, you think we’re going to take the time to write down everything that happened right then and there? No.
Fast-forward 23 years later, I’m telling the VA and my spouse: ‘This is what’s happening, this is from combat or combat training.’ But when you say ‘Oh, I’m fine’ on that paperwork after deployment, it makes getting VA benefits challenging. Plus, many times, there is no documented medical paperwork to back up your claims from all your training injuries.
And here’s the thing: the VA isn’t the military. It is a government program that is trying to serve a lot of Veterans who may have no other resources. It’s like Medicaid on steroids. I’m lucky — I have health insurance coverage outside of the VA system, but unless you’re seeing a VA doctor who either is a Veteran or has seen other Veterans like me, they don’t necessarily understand the issues we have. Even with the coverage I have, I struggle to get help.
The Center for Brain Health doesn’t care if you have a full VA disability or no rating. They are there to bridge the gap and get you the help you need and deserve.
Lauren: It’s also important to understand how dramatically Michael’s personality changed in the three or four years prior to him being accepted into the Veteran program in 2023. He had always been an extreme optimist — always seeing the bright side, grateful for life, going through the day with a positive attitude.
By the time he got to the Center for Brain Health, he was angry in ways that were not getting better with the treatment he was receiving. His mental condition was deteriorating. I couldn’t understand it as a spouse. By the time I realized that we were in crisis — as opposed to just having a rough patch — it was hard to bring him back from the negativity and anger and frustration that was permeating everything in our lives.
Michael: I was frustrated with the VA system and the length of the process. We were in the pandemic, isolated. I had no motivation. No energy. Totally lethargic. I had to fight the VA just to get a colonoscopy, even though my father died from colon cancer. Eventually you just suck it up and move on to something else.
"I felt like I could trust Dr. Stewart and the team because they’ve got Veterans on the team .... They are not the VA, so I don’t have to worry about something I say having an effect on my disability rating." — Michael Spivey
How would you describe the 3-day evaluation at the Center?
Michael: Emotionally overwhelming. It’s a lot. I received more doctoring in three days than you can get in three years anywhere else. Trust is a big issue going in. The mental health aspect is jarring for most Veterans. On active duty, up until 2018, if you had a security clearance and you talked to a mental health professional, you’d probably lose your clearance. So that discouraged most warriors from exploring mental health resources.
It was a gut call, to trust the team at Tulane. There’s an ingrained culture of believing Veterans here — not me having to prove what I experienced. I felt like I could trust Dr. Stewart and the team because they’ve got Veterans on the team — Kenny, Tommy, Jeremy and the others. They’re like us. I felt like I could trust them with information I couldn’t talk about elsewhere. They are not the VA, so I don’t have to worry about something I say having an effect on my disability rating.
Was the intensive outpatient program as grueling?
Michael: It was different. The experience was phenomenal. Less overwhelming than the 3-day because I had a better understanding of the team, what they’re trying to do. They worked very hard to make our small group of Veterans be able to relate to each other in some way. This meant the things they were trying to expose us to were better accepted as a team.
Lauren: It was a very emotional experience. (Note: families are invited to join Veterans during the last four days of the IOP.) It was clear Michael was acquiring coping mechanisms and tools he didn’t have prior to the program. It was reorienting him to the light instead of the dark. I saw a fairly rapid turnaround in his general demeanor in his interactions with me and with others. Where his fuse had gotten incredibly short, he had a greater capacity for patience and communication and reflection instead of just lashing out.
For the family four-day, we were exposed — in a short period of time — to the program and therapies our loved ones were going through. We (the families/spouses) were our own little group. Heidi’s program on TBI/PTSD was very helpful and eye-opening. It gave me a better vocabulary to understand the symptoms, causes and effects of TBI.
"This program, this team isn’t here just to fix the brain. They fix the whole body." — Michael Spivey
Were there any surprises? Anything you didn’t expect?
Michael: They didn’t just help me understand and start the recovery process for TBI. You’re a whole body — a whole person — in this program. They put you on the path to addressing all of the issues, not just injuries directly related to the TBI. I have been dealing with back and shoulder issues for decades. They gave us MRIs and set us up with specialists in days! I was able to get shoulder surgery scheduled and completed by the end of the program.
I feel better than I’ve felt in 20 years. That’s my testimonial: this program, this team isn’t here just to fix the brain. They fix the whole body — the whole Veteran. Doc says it from the beginning: you can’t fix the brain if you don’t fix the body. This program does both.
Lauren: One of the things that’s been compelling for us is that participating in the program isn’t just about getting treatment for Michael. Every cohort, every group of Veterans that goes through the program, helps improve treatment for the Veterans who come after them. The Center’s team is learning more about acute care when brain injuries happen in training and battle, how the military can better prevent or deal with brain injuries. Their participation feeds research that helps us learn more about brain injuries.
"Every group of Veterans that goes through the program helps improve treatment for the Veterans who come after them.... Their participation feeds research that helps us learn more about brain injuries." — Lauren Galliker
Why was it important for you to donate to this program?
Michael: I am donating to this program because I truly believe in the work they are doing. Not just how they helped me, but how I have seen them help fellow Veterans. I love that they are a lean organization and that the money they raise goes directly to helping bring more of us into the fold. TBI research and the effects of 20+ years at war will be my generation’s Agent Orange. No one else has the appetite for facing these issues. We need programs like the Center for Brain Health to be at the forefront of research and treatment.
Since they are not a government program like the VA or TRICARE, their focus isn’t on just triage and pain mitigation. Dr. Stewart and his team are working with cutting-edge therapies to develop treatment mechanisms to help Veterans live their best lives. Every Veteran they treat is one more datapoint that helps paint a picture of the prolonged effects of multiple TBIs. But that doesn’t happen without funding. This program is supported through donations and fundraising efforts like 11K by Veterans Day.
I want people to understand that money the Center raises goes directly to paying for Veterans to get this focused, individual care — for the integrative therapies, for one-on-one evaluations and follow-ups with specialists, for travel, food and lodging. When you come here for the 3-day evaluation and the 3-week IOP, they pay for everything. By streamlining the treatment process, Veterans don’t have to go through other insurance or the VA to get try and get these treatments.
Dr. Stewart means it when he says, “once you’re with us, you’re with us for life.”
"I am donating because I truly believe in the work they are doing. Not just how they helped me, but how I have seen them help fellow Veterans. I love that they are a lean organization and that the money they raise goes directly to helping bring more of us into the fold." — Michael Spivey
The Center for Brain Health is proud to be a TBI Center partner in the Avalon Action Alliance. The Center for Brain Health Veteran care program is supported by generous funding from the Avalon Action Alliance, donations from the Priddy Family Foundation, the Goldring Family Foundation, community partners and ongoing fundraising efforts.