New CU institute helps veterans, retired athletes overcome brain injuries

November 22nd, 2017

The co-founder of Home Depot is betting $38 million that a network of centers anchored at the Anschutz Medical Campus will pay off handsomely in better lives for veterans and retired athletes who have sustained life-changing traumatic brain injuries.

The Marcus Institute for Brain Health (MIBH), which launched on the wings of a five-year grant by Bernard Marcus’s Atlanta-based philanthropy, is just getting going. It looks like smart money so far.

Army Sergeant Spencer Milo in Afghanistan leaning next to a wall with a dog and puppies sleeping beside him.
Army Sergeant Spencer Milo in Afghanistan in January, 2011. Two weeks later, a suicide bombing attack would lead him, as a patient, to the TBI recovery program that inspired the Marcus Institute for Brain Health, where he’s now helping patients.

The institute, announced in May, quietly started seeing patients in July. By January, says James Kelly, MD, a longtime University of Colorado School of Medicine Department of Neurology professor and the Marcus Institute’s executive director, they will have ramped up to their planned capacity of five new patients a week. But that’s only the start, Kelly said.

The Institute’s model is to combine specialist expertise in the physical, psychological and social aspects of brain injury with the broader resources available at major academic medical centers such as UCHealth University of Colorado Hospital (UCH).

“This will be a clinical coordinating center for a network of academical centers that would like to partner in veteran care for TBI and psychological health issues,” Kelly said.

The five-year grant will get things rolling and enable veterans to get the help they need – free of charge – regardless of discharge status.

Help for brain injuries

As the network’s first node, UCH will set the tone for those that follow. It’s a mutually beneficial relationship – the MIBH, based on the second floor of the CU Anschutz Health and Wellness Center, is a resource just steps away from hospital clinicians who recognize patients who could benefit from the MIBH expertise; UCH and its CU School of Medicine faculty offer access to experts in neurology and neuroradiology, psychology, psychiatry, physical therapy, speech therapy, addiction medicine, sleep problems, pharmacy and more. The MIBH will make use of UCH’s medical imagers and sleep labs, and the institute will integrate with the UCHealth electronic health record, Kelly says.

Dr. James Kelly
Dr. James Kelly,a longtime CU Neurology faculty member, is helping both veterans and retired athletes adapt after careers that have sometimes punished their brains.

The MIBH will also reach beyond traditional health care tools to provide help for brain injuries. Depending on the patient’s needs, acupuncture, acupressure, yoga, HeartMath, equine therapy, canine therapy and art therapy and music therapy could come into play, Kelly says.

Christopher Filley, MD, who leads the CU Neurology’s behavioral neurology program, serves as the MIBH’s senior scientific advisor. In addition to clinical work, he will guide multidisciplinary research on traumatic brain injury and related psychological disorders and integrate it with existing neurobehavioral programs at UCH and the CU School of Medicine.

He called the MIBH “a wonderful addition to the services we offer, and a great educational and service opportunity.”

The word “addition” is important, the MIBH’s leaders emphasize. While Filley has already referred to the MIBH former athletes he’s treated in the UCHealth Neurosciences Center’s Neurobehavioral Clinic, not everyone needs the sort of intensive outpatient program the MIBH specializes in, he said.

“The institute is about very specialized, very complicated patients who need more than what’s been available,” Filley said.

CU roots

Program participants spend all day, five days a week at the MIBH for up to four weeks. It’s a model that’s been proven to work at Kelly’s former employer: The National Intrepid Center of Excellence (NICoE) at Walter Reed National Military Medical Center in Bethesda, Md. Kelly, NICoE’s founding director, played a big role in establishing that program.

Long recognized as one of the country’s top TBI experts, Kelly had served as the Chicago Bears’ team neurologist and co-authored the sports concussion guidelines of the American Academy of Neurology. He was asked to lead the nascent NICoE in 2008, just after becoming the first chairman of the Defense Health Board’s Traumatic Brain Injury External Advisory Subcommittee for Military Clinical Care, Research and Education. Primarily through the lens of concussed athletes, Kelly was an expert in treating TBI, post-traumatic stress (PTS) and related neuropsychological problems long before the wars in Iraq and Afghanistan produced some 360,000 TBI cases and counting.

The Marcus Institute for Brain Health differs from NICoE in two important ways, Kelly said. First, its focus is on military veterans whose TBI was sustained at least six months before, whereas NICoE is for active-duty personnel. Second, the MIBH also treats retired athletes – a wrinkle that wasn’t initially envisioned for the center, Kelly said – but one which he asked the Marcus Institute to consider. It was both a return to Kelly’s clinical roots and a karmic closure.

“Now we’re taking it back to the sports world, bringing the lessons learned in the military,” Kelly said.

There are more subtle parallels, too, he said. Military members must transition to civilian life. Many athletes, particularly elite ones in sports like hockey and football, which produce many of TBI cases, must transition to “mere-mortal life,” as Kelly put it.

“The commonalities are striking,” Kelly said. “They’re dealing with so many of the same issues.”

Identity crisis

Spencer Milo, the MIBH’s Director of Veteran Programs, Communications and Strategic Development, said a big part of that transition is evolving their identity, which the MIBH’s program emphasizes.

Spencer Milo
Spencer Milo is now a civilian who provides help for brain injuries.

“These folks spend their entire careers building an identity – be it that of an athlete or a soldier – and then you get separated from that either by situation or by choice,” Milo said.

He spoke from experience. In January 2011, the Army staff sergeant was steps away from a child Afghan suicide bomber when the boy detonated his vest. The TBI he sustained wasn’t his first. Milo was medically retired from the Army two years later at age 28. Before that, he had spent time at NICoE, which he says saved his life.

“From the moment I went there, I remember having conversations like, ‘Wouldn’t it great if this program was available for veterans as well?’” Milo said.

Now he says, his role is to help patients develop that new identity – one that includes the soldier, sailor, Marine, airman or athlete, but also emphasizes the civilian and mere mortal they will be for the rest of their lives. In that regard, Milo provides an onsite role model, Kelly said.

“The plan is to help people make the transition that he’s already made,” Kelly said.