Some weapons used by the U.S. military are so powerful they can pose a threat to the people who fire them. Today, we meet two Marines, William Wilcox and Michael Lozano, who spent years firing missiles and rockets, then developed the same rare brain condition: arteriovenous malformation, or AVM. The condition sends high pressure blood from a tangle of abnormal blood vessels directly into fragile veins, which can leak or burst. Most AVMs are caused by genetic changes that affect the growth of blood vessels, so the connection between weapon blasts and AVM isn't always immediately clear. But NPR's brain correspondent Jon Hamilton reports that recent research suggests that blast waves can alter genes in the brain — and that the evidence is even stronger for less extreme blood vessel changes.Have questions or story ideas? Let us know by emailing [email protected]!Listen to every episode of Short Wave sponsor-free and support our work at NPR by signing up for Short Wave+ at plus.npr.org/shortwave.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy
Chapter 1: What is the main topic of this episode?
You're listening to Shortwave from NPR. Hey, shortwavers. NPR's brain guy and sometimes shortwave substitute host is with me today. Hello, John Hamilton.
Hello, Regina Barber.
So you've been on the pod many times with me, also substituting for me while I was away. Thank you very much. Thank you for making fun of me on the show.
I had a great time making fun of you. Not that I want you to go away again or anything.
Of course. I mean, people can't live without me. We're going to turn things a little bit more serious, though, today, John. You're actually joining us today to follow up on an episode we did actually a few months ago, right?
Right, Gina. Back in August, we talked about how some people who fired powerful weapons in the military can end up with brain damage. We talked about concussions or maybe a more serious traumatic brain injury. And then there's this early research about arteriovenous malformations or AVMs.
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Chapter 2: What are arteriovenous malformations (AVMs)?
Yeah. Can you remind me what an AVM is?
Yeah. It's this malformed tangle of veins and arteries that can cause a stroke. So usually, you know, blood from the heart travels through the arteries and then through these tiny blood vessels called capillaries before it goes back to our veins and then back to the heart. Those capillaries act as a kind of a buffer.
They take this turbulent, high-pressure blood from the arteries and they smooth it out before it reaches the veins, which really aren't made to handle all that pressure and turbulence. In an AVM, Blood from the arteries goes directly back to the veins, and that can lead to a hemorrhage in the brain.
That's devastating. And you talked to a Marine named William Wilcox, right?
Chapter 3: How can military service lead to AVMs?
I did. And today I want to bring you a story just about AVMs. It's with Wilcox and another Marine, both of whom had this rare condition. I talked to them both about their experiences, which have some remarkable parallels. William Wilcox, I went to his house in Virginia, talked to him and his wife.
And then the other man, Michael Lozano, he lives in Colorado and runs the War Horse Ranch, which offers what's known as equine therapy to veterans and other people who are recovering from trauma. So today on the show, veterans and a rare brain condition called an AVM.
Well, here are John's really powerful reporting written up for our companion show, All Things Considered. It will be told with the voices of these two veterans, William Wilcox and Michael Lozano, and one of their doctors and some researchers about whether firing heavy weapons may have caused their AVMs. I'm Regina Barber.
Chapter 4: What experiences do veterans William Wilcox and Michael Lozano share?
And I'm John Hamilton. And you're listening to Shortwave, the science podcast from NPR.
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Michael Lozano and William Wilcox have a lot in common.
I originally was a tow gunner.
I was a tow gunner from 97.
I served in two different units at Camp Lejeune.
I was part of 2nd Combat Engineer Battalion at Camp Lejeune. I went to 29 Palms. Two weeks out of the year, we did 29 Palms.
Each trained extensively with weapons like the tow, a missile system small enough to mount on a Humvee and potent enough to disable a tank. Wilcox says the most intimidating weapon was a shoulder-fired rocket launcher called the SMAW.
Imagine a 300-pound linebacker hitting you in the chest at full speed. Boom! It rattles your cage.
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Chapter 5: What symptoms did Wilcox experience related to AVM?
I took Excedrin basically like candy. I used to drive home during lunch and pop some Excedrin, take a nap or whatever, you know, just to get the headaches to go away.
In 2000, Wilcox moved to the private sector. Despite the headaches, he thrived. Fast forward to 2014. Wilcox and some friends go to Penn State for homecoming. They're watching a band. Wilcox feels a headache coming on.
I go out of the bar, I sit down on a bench, I put my elbows on my knees like this, and I notice that I'm losing control of my arms.
His brain was bleeding. The cause? A tangle of abnormal blood vessels called an arteriovenous malformation, or AVM. The condition sends high-pressure blood from the arteries directly into fragile veins, which can leak or burst. Wilcox recalls an ambulance ride to a local hospital, then a helicopter ride to the medical center in Hershey.
Emergency surgery removed the AVM and probably saved his life.
I spent about three weeks at Penn State Hershey relearning how to walk, cognitive therapy.
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Chapter 6: What happened during Wilcox's medical emergency?
Wilcox got better, but not enough to go back to his computer job. He has a big scar, several titanium screws in his skull, and memory lapses.
I don't know if I already mentioned this. Sorry, I do have brain damage.
But Wilcox says his biggest challenge is epilepsy.
When I have, you know, a cluster of seizures, it's brutal. It wears me out physically, emotionally. I take a tremendous amount of medicine.
For years, Wilcox did not connect his brain hemorrhage with his military service. Then a friend told him about another Marine gunner with an AVM. Michael Lozano and his wife Valerie run the War Horse Ranch near Steamboat Springs, Colorado. It's a place for people who've experienced trauma.
We have 10 horses and a donkey. So we have to have the donkey. Where's the donkey? He's out here. He's probably right back here.
Lozano grew up in Ventura, California, skating, surfing, a happy childhood.
So when I turned 18, actually 17 and a half, I joined the Marine Corps.
That was in 1991. More than a decade later, after 9-11, he was sent to Iraq. Lozano shows me a video. His squad is rescuing a disabled tank on a bridge. Lozano is in a Humvee.
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