CAMP LEJEUNE, N.C.  –   CAMP LEJEUNE, NC – The sculpture near the clinic entrance is an incomplete circle. The art piece is the first thing a patient sees as they approach the Intrepid Spirit Center at Camp Lejeune, North Carolina. The imperfect circle is a symbol of the Intrepid Spirit Centers, but the symbol is more than a structure. It’s a reminder that what might be incomplete and imperfect is just right for this place.

“The vast majority of people who come here get better,” said Dr. Tom Johnson, a neurologist and retired U.S. Navy captain. Johnson is one of four current employees of ISC Camp Lejeune who was present for inception of the clinic.

“In 2011, it was really a different culture. A lot of times service members would have issues with mood, memory, sleep, concentration that were significant due to the invisible injuries. There was really no evidence readily available from physical exam or blood test or routine structural imaging modalities like a CT scan or MRI. So, all of these people look normal, but they couldn’t function very well. It was a new idea to set up a clinic for something we couldn’t really see what was causing it.”

What began as an idea around 2011-2012 morphed into nine operational Intrepid Spirit Centers across the United States. Construction is underway for a 10th clinic at Fort Bliss, Texas. According to the Intrepid Fallen Heroes Fund website, each clinic is 25,000 square feet and costs $13 million to build. Lejeune’s location officially opened October 2, 2013.

The mission of an ISC is to care for those who have suffered a traumatic brain injury and associated comorbidities such as chronic pain or post-traumatic stress disorder. Intrepid provides an interdisciplinary care team to create individual treatment plans for patients, meaning all services are together under one roof.

“Holistic means we are treating the whole person,” said U.S. Navy Lieutenant Commander Jessica Forde, clinic director. “Pharmacological is one option for treatment of physical symptoms, but we also look at the interplay of how your emotional health contributes to things like chronic pain and other medical conditions. By treating what might seem like unrelated symptoms, you look at the whole person and get this synergistic effect of treating it altogether.”

Intrepid offers traditional clinical services and offers a range of treatments from behavioral health, like psychology and family therapy, to rehabilitation services such as physical therapy or speech-language pathology. ISC Camp Lejeune focuses on active-duty personnel and treats retirees and dependents on a space available basis. According to Forde, ISC Camp Lejeune has cared for approximately 20,000 beneficiaries throughout the last decade and has a 90% return-to-work rate for military.

“I’m a better person,” said former patient Worth Parker.

Parker is a retired lieutenant colonel with the U.S. Marine Corps. Parker suffered multiple traumatic brain injuries during his 27 years with the Marines including three combat deployments. Parker, struggling to cope with insomnia and memory issues, sought the help of ISC Camp Lejeune in 2020.

“Intrepid Spirit illuminated medical things to work on…it made me realize I wasn’t a bad father, husband, that I was pretty good actually, but I could be better at dealing with TBI, insomnia, and unacknowledged issues,” Parker said.

Marine Corps Gunnery Sergeant Paul “Buck” Chambers was a patient for Intrepid before the Lejeune site was built.

“Before it was a skeleton system. I would go from one building to another trying to remember appointments while having a brain injury,” said Chambers. “To see what was there when I came through [the program] the first time, I am so happy to see what it has become.”

Chambers was injured in a suicide bombing in Afghanistan in 2012. Chambers was treated for a TBI and being “petrified of not being able to serve,” he pushed ahead and dealt with symptoms. Chambers sought treatment again in 2022 when vision issues and migraines became unbearable.

“As servicemembers, when we put our bodies and our minds, on the line for the nation. We are told we are going to be military athletes. So, when we get injured, we hope to be treated with the same kind of care as a professional athlete.”

With 10 years between treatment periods, Chambers benefited from advancements in brain health care by signing up for multiple program modalities including art therapy and music therapy. Through physical acts of painting or piano playing, service members may discover a pathway to intellectual healing that works for them.

“I quickly realized it wasn’t about becoming a Picasso or a Beethoven. More importantly, these were gateways to therapy that have helped me unlock and process things that I haven’t been able to really cope with in over a decade; specifically, shame over losing Marines in the battlefield,” Chambers explained. “It’s not that I will ever completely be over any of that. It’s that I’m able to process it in a way now that I know I don’t need to hold this shame and guilt on me. I wasn’t able to tap into some of those things if it wasn’t for the opening that music therapy and art therapy gave me.”

The environment for TBI-related conditions has shifted through the past 10 years since ISC Camp Lejeune opened its doors. The original population of service members had returned from deployments with combat-related trauma. Now, the population consists more so of those with cumulative effects from head injuries, chronic pain, or traumatic events.

“Now with the way technology has changed with measuring heart rate variability or functional MRIs, what were invisible injuries of war, you can now see a change in physiologic and neuroanatomic function,” said Johnson.

For Johnson, monitoring a patient’s heart rate variability, the intervals between heartbeats, can help experts better understand one’s nervous system or a “fight-or-flight” response. Functional MRIs display and compare activity levels of different portions of the brain.

“I think what is clearly happening at Camp Lejeune is things that have been dismissed, like TBI or PTSD, as a sort of weakness, they have reframed how they view it. It’s viewed more as predictable, physiologic response to chronic stress. There’s a lot less stigma, so treatment is now sought more frequently and earlier.”

Pursuing treatment at ISC Camp Lejeune is encouraged among military peers as the impact is recognized not just for the individual but also for their families.

“You aren’t doing yourself a service by saying, ‘I’m not that bad.’ I was just grinding through life, trying to make things work,” said Chambers. “Now I have hope. I have focus. I have a purpose, and I know that things are going to be okay because there are people out there that truly care. I wouldn’t have been able to get anywhere if it wasn’t for the passion providers have toward helping service members.”

To say Intrepid’s journey has come “full circle” may be slightly inaccurate. Rather, the circle is never complete. As long as Intrepid offers care, there will be an unending hope for healing.

ISC Camp Lejeune plans to celebrate its 10-year anniversary on Nov. 15 with a ceremony to honor clinic staff and patients.