From the New York Times, I'm Sabrina Tavernisi, and this is The Daily. A mass shooting last fall by an army reservist in Maine prompted my colleague, Dave Phillips, to search for answers about whether the soldier's service could have been a factor. Today, the surprising answer Dave found, and how it may change our understanding of the effects of modern warfare on the human brain. It's Wednesday, March 13th. Dave, you've been working on a series of stories on injuries to soldiers in the US military. Last week, there was a sudden and unexpected discovery related to that reporting you'd been doing. Tell me about it.

What I've been looking into for a couple of months was the idea that soldiers can be injured just by firing their own weapons, by standing next to the blast of a mortar or launching a rocket from a shoulder fire rocket launcher. Some of these big, heavy weapons, the blast wave is strong enough to really injure their brains. I'd been working on that over a couple of months because it's very new and there's a lot of uncertain stuff. I was still working on it in October when I got a call from the New York Times National Desk, and they said, Hey, there's been a mass shooting in Maine. We need your help. The suspect was in the military, so I dropped everything and got on it.

Right, because you're the guy who covers military affairs, so they call you.

Right. The situation was that there's a 40-year-old man in Maine named Robert Card. He'd been a sergeant first class in the Army Reserves for almost 20 years. He killed several people in a small town in Maine, in a restaurant and in a bowling alley. Then he goes on the lamb, and the whole region is in lockdown for two days. After a massive manhunt, they eventually find his body 15 minutes away from the shooting the shooting site, he had shot himself in the head. In the aftermath, his family said that he had been hearing voices. Started right after he had gotten some hearing aids last spring. He grew to have these nearly constant paranoid delusions that people at the supermarket, people on the street, even people in his own family, were saying terrible things about him, essentially saying that he was a pedophile. He grew obsessed with these delusions that just simply were not happening. The army saw this, and they tried to intervene. In fact, he was actually hospitalized for two weeks by the army, but ultimately, it was not enough. He committed these shootings, which killed 18 people. Whenever any veteran is involved in any crime, our first move is generally to ask the Pentagon for that person's background.

We want to know, is there anything in their military record that can help us understand the present by looking at their military past.

And so did you find anything in this main shooter's military records?

In the case of Robert Card, the answer is really no. Remember, we've been at war for more than 20 years and more than a million people have deployed, many of them multiple times. He had been in the military that whole time. He had never deployed.

Never in Iraq or Afghanistan.

Never in Iraq or Afghanistan. Never even in Germany or Korea. He also had a really hum drum job. The official title for it was Petroleum Supply Specialist.

What does that mean?

Essentially, you're the gas guy who makes sure that the tanks and the Humvees and everything else has enough fuel to run. Pretty dull. There was nothing at all in his service that suggested it had anything to do with what had happened.

At this point, you're like, Okay, nothing to see here. This mass shooting is probably totally unrelated to his time in the military because he never deployed, right?

Well, not quite. I actually picked up one thing that I thought might be really tied to this and potentially extremely important, and that was his hearing aids.

What was it about his hearing aids?

Well, here's a guy who's 40 years old, a young, fit guy who has hearing aids. I would expect that from somebody who worked around artillery cannons or worked around mortars, worked around tanks. In the military, you see it all the time. But this guy didn't seem to have any of that. He's like a petroleum supply guy. And so I was thinking, okay, something here doesn't make sense. And I was able to track down some people who had actually served next to Robert Card in his platoon. And they said, yes, he had been a petroleum supply specialist years ago. But in 2014, he switched over to a training battalion where he was exposed to lots and lots of blasts. Basically, what this battalion did is every summer, they held a summer camp for cadets at West Point that taught them how to use all sorts of weapons, taught them how to use machine guns, grenade launchers, shoulder-fired rockets, and handgranates. And that's where Robert Card worked, I learned. Every year in the summer, he was on the hand grenade range where about 1,200 cadets would come through, and most of them through two grenades. So every year, he's getting exposed in the course of a few weeks till 2000 grenade blasts.

Now, according to the military, this is safe, this is fine, no problem, move along. But emerging research, like the stuff that I've been reporting I'm hearing about in the previous months, had shown that this repetitive blast from firing your own weapons can be really damaging. I thought, okay, Robert Card was exposed to a lot of blast. Maybe that could help explain what happened to him.

What did you do next? How do you start to answer that question?

Well, we knew that the answer would be in Robert Card's brain, that if he did have a brain injury from repeated blast exposure, you can see it. What I learned soon soon after was that the main state medical examiner knew that, too. In fact, after he died, they had saved his brain and then shipped it to Boston, where one of the best brain labs that looks at traumatic brain injury is at Boston University. These folks specialize specifically in documenting CTE in football players and other contact sports athletes.

So, Dave, is the thinking here that maybe Robert Card had something like CTE, that it's that injuries like we see in football players?

Well, they didn't know. The only way to figure it out was to essentially slice his brain into slices that are about the 10th of a thickness of a piece of paper. Then they look at it under two microscopes, a normal optical microscope and a really detailed electron microscope that can look at things on a subcellular level. In the first microscope, they're looking for CTE, which is easy to see. They can stain it brown and it creates these floral patterns around blood vessels in the brain. But when they looked at it, they didn't find that. If you're just exposed to blast, maybe that's not a big surprise because the research suggests that blast exposure leads to something else, something that really doesn't have an accepted name yet, but in a sense is damage to the wiring that that's deep in the brain. Under the second microscope, that's essentially what they found in Robert Kard's brain. What they're looking at is the cables in the brain. So your brain has outside of the brain, gray matter, which is where thoughts happen. And inside the brain is white matter that is essentially wiring that connects all that gray matter together.

So it can talk to itself. It can understand itself. It can act. But it turns out that when blast waves surge through the brain, those long, stringy pieces of white matter essentially get whipped really hard, hard enough that they get frayed or broken. Think of it like the cable you use to charge your iPhone. You can twist that and twist it up and untwist it, and it'll be fine. But it's the repetitive over and over that causes problem. Imagine twisting your iPhone cable 10,000 times, and then it might still there, but you plug it in and it doesn't work anymore. And so that's what they're looking at in Robert Card's brain.

So the results were definitive. Despite never having served in combat, Card really suffered pretty severe brain damage from these repetitive blasts at this training camp, it seems like.

Right. We have to be careful because we can't definitively say with Robert Card right now that not only those grenade blasts caused this injury, but that that injury caused his behavior. What we can say is that it's a very, very good match. It certainly seems that that's the case.

Dave, what is the implication of this?

Well, this is something that means so much more than just what happened to Robert Card or what happened in a shooting in Maine. That's because for years, the military has known that blasts from combat, from roadside bombs, from enemy attacks are dangerous, and they can damage the brain. But they haven't known what the effect of training is, because most of the people who served in the military also went overseas. They might have gotten hit by an IAD. They might have experienced something traumatic in combat. If they come back with brain injuries, it Very hard to say, are those brain injuries tied to firing their own weapons? But Robert Card is almost like a control study. We know that he never went overseas. He also never played football in high school. He was never in a serious car accident. He didn't do a lot of things that could have caused a brain injury to him. As far as we know, the only thing that could have damaged his brain is this blast injury of working on the grenade range. And so if that is true, that means that a lot of the brain injury that is happening in the military is being caused by the military.

That's a big deal.

We'll be right back. Dave, what exactly did the military know about brain damage caused by blasts, and when did it know it?

Well, it starts with the IED problem. During the height of the wars in Iraq and Afghanistan around 2005, 2006. If you remember, roadside bombs were the leading way that insurgents were hurting American forces. And so the United States poured a ton of money into trying to understand, okay, these blasts that these guys are experiencing, these men and women, they appear fine. They get up and walk away, but there's something going on there. It's not like you're missing a limb or something.

So when someone walks by, you may look absolutely normal, but it's a very invisible wound.

The military started gathering these stories and even shared some of these interviews. When I came home, I was not the same person.

And when I got out, I didn't think that I had any issues or mental health issues that would affect me in the civilian life. I found that I was having trouble controlling my emotions sometimes, my anger.

Soldiers were coming home complaining to military leaders of all sorts of problems, Feeling different, acting different, thinking different. I ended up losing a job because I was getting violent. Started another job, was getting violent there, was real irritable, hard to deal with. I was self-medicating, trying to hide feelings and things like I had the suicidal thoughts. They were almost coming back as different people. The Defense Department poured hundreds of millions of dollars into this, starting probably around 2008. Trying to answer the question of what blast is dangerous and why. They started getting answers, but it was still really murky. In 2012, they set up a brain bank to essentially collect collect brains from anyone and everyone they could get who was in uniform because this injury couldn't be seen through an MRI, through a PET scan, through the normal things that we think of for imaging the brain. It was too subtle, but you could slice it up and see it in the brain. What they were seeing was this telltale scarring in the white matter. At the same time, there were a lot of families that got results back from this brain bank and saw that characteristic scarring in the white matter.

They knew that their loved ones had been affected by blast. They also knew that enemy blasts were only a small fraction of what their loved one experienced. How could you untangle what was training caused and what was caused by the enemy? A lot of these families, they started taking this information to Congress. In 2018, they said to Congress, The military is not taking blast seriously enough. They don't understand it. They can't tell who's injured. They need to do something. Congress, at that point, passed a law forcing the military to look at this research and figure out how we can track this. But here we are in 2024, and a lot of those questions are still not answered.

Then, of course, came CARD, which seems to give us something of a new data point, a new answer.

That's right, because the military, for all of this time, they had been saying, Well, this is complicated. We did some studies, but we still don't have clear answers. They would hem and ha and essentially use the lack of a definitive answer as a way to postpone action. But here's Robert Card, and he's really important because the only thing he's been exposed to is grenade blasts. That's supposed to be safe. Something did happen after all those years of research. The military, they finally put in place a safety threshold that basically said above this power of blast, there could be hazard. They use a number for that. They measure blast in 4 pounds per square inch. That's the strength of the blast wave hitting anybody. But you can think of that 4 as a safety level. Anything higher, probably dangerous. Anything lower, supposed to be safe. And that's why card is so important, because if he was only exposed to grenades and he has a blast injury, those grenades come in not at four, not even at 3.9. They come in at like one PSI or maybe one and a half. So that suggests that this safety threshold that got put in place is way off.

And that's really important, not just for Robert CARD, but for all sorts of troops who are training right now because they There are many weapons out there, mortars, shoulder-fired rocket launchers, big artillery that come in at higher levels, some of them as high as 8 or 9 PSI. What that threshold doesn't take into account is Yet we're not just talking about one blast. We're talking about hundreds or thousands of blasts. How does that change how any blast is a threat or a hazard?

Essentially, all of this study and research didn't actually translate into procedures that kept soldiers safer.

Right. It's sometimes frustrating for me to see this research because there are brilliant people who are building computer models that model how energy waves go through brain matter, or they are very carefully blowing up lab rats and then cutting open their brains to see the effects. None of that expensive and time-consuming research has many any difference to the people in uniform.

Dave, how many vets are we talking about here? I mean, how many people may be suffering or at risk of this brain damage? Do we know the scale here?

That's a really hard question to answer. We know that more than 450,000 people have been diagnosed with a traumatic brain injury by the military since 2000. But that probably leaves out tens of thousands of people who, like Robert Card, were exposed to repeated blasts and may have a brain injury but never were diagnosed.

So the universe is potentially very large.

That's why this is such a huge deal.

Dave, stepping back for a second. It seems like what we're learning here through this example of Robert Card is bringing us into a moment where we're rethinking what it means to have combat trauma, right? That it might actually have a lot more to do with the physical blast than with the mental or psychological trauma that one goes through in, say, a combat deployment.

One thing that I've been reporting about for years is when soldiers come home different and why. I started out really focusing on post-traumatic stress disorder and just the horror of and how that can change and erode your character. Then I learned that traumatic brain injury can be a big part of that and that those two things may be tangled together in ways that are impossible to unravel. But what What's really interesting about Robert Card and other people I've talked to who've never deployed, but they've been around a lot of blast, is if you sent them into a typical army clinic and had them list their symptoms, they would probably get diagnosed diagnosed with PTSD. They're sleepless. They have anxiety. They have panic attacks. They are socially withdrawn. They're depressed. There are all these things that we have long thought are products of war of combat that may actually be an underlying condition that is not related to war at all. To put it in the plainest terms possible, it's basically related to a workplace safety issue that we haven't acknowledged or addressed.

When Johnny comes home different from the war, it might not actually be the war.

It might not actually be the war. But I also think that there's a broader implication beyond the military. We can see it in Robert Card, right? Here was a man whose blast injury wasn't understood, who did something horrendous. And so I think we have to think about what is the cost of not doing anything here? Now, of course, we don't know for sure that Robert Card did this because of his blast injury, but we do know that he had profound injuries deep in his brain. And we also know from talking to people that he served with that it's not just Robert Card. Other people that serve with him on the grenade range are also struggling. A number of them are getting help for pretty persistent mental health problems. One of his best friends was just recently hospitalized for a psychiatric crisis, and he's now facing a domestic violence charge. How do we look at those people differently now after seeing Card? How do we look at this problem in a way that tries to prevent that from happening?

Dave, I'm curious if you've heard from the family of Robert Card since this diagnosis, and I wonder what this diagnosis has meant to them, if anything.

Well, they didn't get a choice when his brain went to the lab. That was the decision of the state, which really wanted to understand in whatever way it could what had happened. But when they got these results back and the family sat around their kitchen table listening to the doctor who looked into his brain and learned there was damage in a way that I think was really surprising to them, it allowed them to have some forgiveness. To not see their brother, their son, as a monster, but to see him as somebody who was hurt.

It gives them a different story about their brother.

Absolutely.

Dave, thank you.

Thank you.

We'll be right back. Here's what else you should know today.

My assessment in the report about the relevance of the President's memory was necessary and accurate and fair.

On Tuesday, in a tense appearance before the House Judiciary Committee, former Special Counsel Robert Herr testified about his investigation and February report into President Biden's handling of classified documents. You could have written your report with comments about his specific recollection as to documents or a set of documents, but you chose a general, pejorative reference to the President. The four-hour session quickly descended into a brutal partisan fight. In his report, Herr had called Biden, an elderly man with a poor memory, a conclusion that had infuriated Democrats. Republicans, for their part, grilled her about his conclusion that the evidence was insufficient to charge Biden with a crime.

Here's what I see. Biden and Trump should have been treated equally.

They weren't. And that is the double standard that I think a lot of Americans are concerned about. And accused her of protecting Biden. You exonerated him. I know that the term will That word is not a fear in the report. Mr. Hur, it's my time. But her made clear during the testimony that his report had not cleared Biden of wrongdoing, rejecting a suggestion by Democrats that it had. Today's episode was produced by Jessica Chung, Claire Tennisketter, and Olivia Nat, with help from Sydney Harper. It was edited by MJ Davis Lynn, contains original music by Dan Powell and Marion Lozano, and was engineered by Chris Wood. Our theme music is by Jim Brunberg and Ben Lansberg of WNDYRLE. That's it for The Daily. I'm Sabrina Tavernisi. See you tomorrow.