Page 109 - JSOM Fall 2022

In 2012, the Academy of Sciences in the United Kingdom re­ cases were the sudden onset of a perceived loud sound, which
leased a report classifying neuroscience applications into two many described as “screeching, chirping, clicking, or pierc­
broad camps: performance enhancement and performance ing,” an intense pressure sensation or vibration in the head,
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degradation. Performance enhancement tools enhance cogni­ and pain in the ear or more diffusely in the head. Patients
tive performance, sensory perception, memory, concentration, had acute symptoms of dizziness, fatigue, impaired balance,
motivation, and situational awareness while negating sleep headache, and impaired concentration, but many symptoms
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deprivation, stress, pain, fear, and other negative emotions. became chronic years after initial onset. The directional and
Performance degradation tools are more likely to be weap­ location­specific details in the patients’ histories are unusual
onized and seek to degrade brain capabilities by impairing and “unlike any disorder reported in the neurological or gen­
performance, incapacitating, or potentially killing. There are eral medical literature,” providing the basis for increased sus­
four categories of neuroweapons: (1) drugs, or neuropharma­ picions of DEWs. 18
cology; (2) bugs, specifically, neurological bioweapons; (3)
waves, short for electromagnetic and sound waves; and (4) In recognition of the increased incidence of the non­traumatic
bytes, or information attacks (direct or indirect) on the brain. neurological impairments and potential implications to SOF,
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The recent cases of neurological AHIs mentioned in this article USSOCOM defined and provided guidance in the treatment
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are presumably from waves in the form of directed energy, of UBIs, now termed AHIs. The release of this guidance has
sonic, and ultrasonic weapons that use intense energy to inca­ begun an important, much­needed dialogue within the medi­
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pacitate, damage, or destroy. 12 cal community on treatment for AHI. However, the growing
concern of a non­lethal neuroweapon, such as DEWs, requires
Although such weapons may violate the intent of UN treaties, the development of a comprehensive medical defense strategy.
currently most neuroweapons fall into a legal and regulatory Such a strategy would focus on prevention, recognition, and
gap because they do not fit either the Biological and Toxin treatment, similar to that of chemical, biological, radiologi­
Weapons Convention (BTWC) or the Chemical Weapons Con­ cal, nuclear, and explosive materials (CBRNE) and hazard­
vention (CWC). This growing neurowarfare threat applies ous environmental exposures and requires military medical
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to all military forces, but the large global footprint of SOF in personnel to be the forefront of these efforts. Even though
more contested areas means they are uniquely engaged and USSOCOM has initiated the efforts in treating AHIs, the rec­
exposed to new forms of warfare. Because of their special­ ommended strategy proposed here is applicable to all military
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ized skills, SOF would be considered high­value targets for po­ medical personnel treating warfighters at risk.
tential adversaries. Therefore, SOF medical personnel should
be especially prepared to address the increasing potential neu­
roweapon threat because its implications and resultant stakes Medical Defense Strategy of Neuroweapons
are significant. Defense strategies countering WMD have been divided into
active and passive measures. Active measures include “defeat”
and “deter,” but these require technical knowledge of the
A New Domain of Casualties
weapon, the ability to detect the weapon, and intel regarding
The incidents in Cuba, dubbed the “Havana Syndrome,” are who is employing the technology. Passive defense measures in­
not isolated events. A similar incident occurred in Guangzhou, clude “protect,” “respond,” and “recover.” These measures
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China, in 2017. As many as 200 Americans, including pets primarily address the consequences of employment, which are
and children, have developed AHI symptoms after serving in at suboptimal in minimizing casualties but the best course of ac­
least fifteen different countries, including the United States. tion in a situation with such uncertainty. 19
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However, many did not immediately discuss their health con­
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cerns as they struggled to understand what was happening. Krishnan proposed a doctrine for neurodefense that includes
Eventually, many victims independently sought medical care, principles (detection, deterrence, reaction, and adaptation) in
and speculation began to circulate about the cause of these close alignment with WMD defense concepts, but a significant
symptoms. Greater awareness of neuroweapon threats could portion of his theory relies on knowing the presence, type, and
improve efficiency of case identification, allowing for faster user of neuroweapons. Unfortunately, at the present time, the
medical intervention. specific etiology of recent AHI cases is mere speculation or
currently classified, making employment prevention strategies
This information began to surface in the public domain only difficult to develop or discuss. This forces a passive or reactive,
in the past few years, and there have been several theories sur­ rather than proactive or active, medical management response,
rounding the origin of this mystery, including sonic weapons, like those to unknown chemical weapons. For that reason, the
microwaves, insecticides, crickets, and everyday aches and following recommended medical approach to potential neu­
pains, to name a few. Some of these theories corroborate what roweapons parallels counter­WMD passive defense strategies.
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victims report, whereas others claim these individuals are not Although no current cases have occurred on military battle­
“victims” but rather suffer from “mass hysteria.” However, fields but rather appear to have been directed at diplomatic
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a State Department–funded investigative team of neuroscien­ outposts and other government buildings, including the White
tists concluded the cause was most likely an intentional, di­ House, it is important to consider a strategy applicable to
rected use of a neuroweapon. Then, in 2020, the National combat missions.
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Academy of Sciences (NAS) released an extensive report that
suggested the most plausible etiology is some form of DEW. 18 Prevent and Protect
Protection and prevention require an understanding of the
In addition to providing a thorough analysis on etiology, the threat, development of protective measures based on that un­
NAS report documents the medical effects experienced by the derstanding, and detection of the threat to employ protective
AHI patients. The most common symptoms from the Havana measures. Body armor was developed and refined to counter

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