FORT BENNING, Ga.  –   According to the Defense Health Agency, nearly half a million Service Members have been diagnosed with a first-time traumatic brain injury (TBI) since 2000. TBI can cause patients to suffer from chronic headaches and memory loss, along with balance and vision issues. Martin Army Community Hospital’s Dr. Brian Ribeiro helps treat some of these Soldiers.
 
“I’ve always been interested in cognitive disorders,” shared Ribeiro. “I think this stems from caring for my youngest son who is autistic.”
 
The Massachusetts native graduated from the prestigious Warren Alpert Medical School of Brown University in 1985.
 
“I enjoyed learning about the human body, but disliked the anatomy lab,” recalled Ribeiro. “I smelled like embalming fluid for six months!”
 
The internal medicine physician ended up in Columbus because his wife, Lt. Col. Marie Trenga, retired out of Fort Benning. She is now the Associate Director of the Family Medicine Residency Program at Piedmont Columbus Regional. Ribeiro started at BMACH in September 1991. It was meant to be.
 
“I had practiced primary care internal for over 20 years and was looking for a change,” said Ribeiro. “I found out through a nurse who cared for my son years ago, Ms. Ute Chavers, that the TBI Clinic at the time was in need of another provider. This seemed like an opportunity I could not pass up.”
 
A typical day starts at 7 in the morning. On any given day, Ribeiro sees two to three new referrals and four to five follow-up appointments for established patients. Active duty Soldiers dealing with the aftermath of blast injuries, either from combat or training, make up the majority of his patient base. Bullets, shrapnel, falls, car crashes and assaults can also lead to brain injury.
 
“TBI is a constellation of symptoms such as recurring headaches, cognitive disorders, anxiety, irritability, sleep disorders and balance disorders to name a few,” said Ribeiro. “The most challenging is dissecting out all of the associated disorders that can accompany TBI (like chronic insomnia, anxiety, post-traumatic stress disorder) and designing a treatment plan with our team of providers. It’s like peeling an onion, each layer has its own uniqueness.
 
There is a lot we are still learning about TBI. There is ongoing research in newer methodologies for diagnosing acute TBI. Also a large ongoing interest in defining what constitutes TBI in the population with low level concussive events (particularly applicable to the military) and newer modes of treatment.”
 
Treatment typically lasts anywhere from four to six months. BMACH’s TBI Clinic offers a wide range of therapies including communication (speech and language), insomnia, occupational, physical, vestibular and visual (balance and vertigo), individual psychotherapy and bio-feedback. Ribeiro has cared for some patients for much longer.
 
“Sleep is the number one issue that I see in our clinic,” said Ribeiro. “You have to ask them how are you sleeping, do you sleep, are you waking up, what’s causing you to wake up … ‘well I’m having disturbing dreams.’ Okay maybe there are some behavioral health issues going on, that’s the second most common thing that I see.”
 
Ribeiro said the most enjoyable part of his job is the satisfaction of interacting with a patient and helping them with their problems.
 
“A former patient from my internal medicine days, a retired sergeant major, came up to me to say ‘thank you for saving my life.’ He then turned to my friend and said ‘your son is the best physician I ever had.’ Now what touched me the most was knowing I had helped someone … and my friend is like a surrogate father to me. It was particularly timely as I only recently experienced the death of my father to whom I had been very close to growing up.”
 
Ribeiro said he loves working with the best case managers, nurses, ancillary staff and administrators in the hospital. And although he will hate leaving his patients, he plans to retire in the next year and a half.
 
“I think most individuals do not understand how very challenging it has been for our Service Members. We have been at war for over 20 years,” explained Ribeiro. “This has taken a great physical and emotional toll on these men and women. It is such a privilege and honor to care for our Soldiers and retirees.”