Pattern of Brain Damage Is Pervasive in Navy SEALs Who Died by Suicide

David Metcalf’s last act in life was an attempt to send a message — that years as a Navy SEAL had left his brain so damaged that he could barely recognize himself.

He died by suicide in his garage in North Carolina in 2019, at age 42, after nearly 20 years in the Navy. But just before he died, he arranged a stack of books about brain injury by his side, and taped a note to the door that read, in part, “Gaps in memory, failing recognition, mood swings, headaches, impulsiveness, fatigue, anxiety, and paranoia were not who I was, but have become who I am. Each is worsening.”

Then he shot himself in the heart, preserving his brain to be analyzed by a state-of-the-art Defense Department laboratory in Maryland.

The lab found an unusual pattern of damage seen only in people exposed repeatedly to blast waves.

The vast majority of blast exposure for Navy SEALs comes from firing their own weapons, not from enemy action. The damage pattern suggested that years of training intended to make SEALs exceptional was leaving some barely able to function.

But the message Metcalf sent never got through to the Navy. No one at the lab told the SEAL leadership what the analysis had found, and the leadership never asked.

It was not the first time, or the last. At least a dozen Navy SEALs have died by suicide in the past 10 years. A grassroots effort by grieving families delivered eight of their brains to the lab, an investigation by The New York Times has found. Researchers discovered blast damage in every single one.

It is a stunning pattern with important implications for how SEALs train and fight. But privacy guidelines at the lab and poor communication in the military bureaucracy kept the test results hidden. Five years after Metcalf’s death, Navy leaders still did not know.

Until the Times told the Navy of the lab’s findings about the SEALs who died by suicide, the Navy had not been informed.

The lack of communication has led Navy leaders to overlook a potentially critical threat to its elite special operators. When the commander of SEAL Team 1 died by suicide in 2022, SEAL leaders responded by ceasing nearly all operations for a day so the force could learn about suicide prevention. According to four people with knowledge of the commander’s case, his brain was later found to have extensive blast damage, but because the leaders were not told, they never discussed the threat of blast exposure with the force.

Evidence suggests that the damage may be just as widespread in SEALs who are still alive. A Harvard University study scanned the brains of 30 career Special Operators and found an association between blast exposure and altered brain structure and compromised brain function

That study was funded by Special Operations Command, which has been at the forefront of the military’s effort to understand the issue. The study’s main author briefed the command’s top leaders, including from the Navy SEALs.

“We have a moral obligation to protect the cognitive health and combat effectiveness of our teammates,” said Rear Adm. Keith Davids, commander of Navy Special Warfare, which includes the SEALs. He said the Navy is trying to limit brain injuries “by limiting blast exposure, and is actively participating in medical research.”

But without the data on suicides, a key piece of the problem was never discussed at the briefing.

The communication breakdown is part of a broader disconnect in the Defense Department, which spends nearly $1 billion each year on brain injury research but does comparatively little to ensure that the latest science on brain injury informs practices in the ranks.

Metcalf’s wife, Jamie, said that she had come to see his death as an effort to draw attention to a widespread problem.

In many cases, doctors treating the injured troops give them diagnoses of psychiatric disorders that miss the underlying physical damage. Much of what is categorized as post-traumatic stress disorder may actually be caused by repeated exposure to blasts.

The stories of the SEALs who died by suicide point to a troubling pattern in the elite force.

Their average age was 43. None had been wounded by enemy fire. All had spent years firing a wide arsenal of powerful weapons, jumping from airplanes, blowing open doors with explosives, diving deep underwater and learning to fight hand to hand.

Around the age of 40, nearly all of them started to struggle with insomnia and headaches, memory and coordination problems, depression, confusion and, sometimes, rage.

“The first thing people think is it must be PTSD, but that never made sense to me — it didn’t fit,” said Jennifer Collins, whose husband, David Collins, was a SEAL for 20 years and died in 2014.

Jennifer Collins is the reason that the brains of a high proportion of the SEALs who died by suicide made it to the Defense Department’s lab.

Her husband was in many ways a typical SEAL: smart, confident, easygoing and high-achieving. But Collins’ mental health took a sudden plunge when he was 45. He had left the Navy and started a civilian job teaching troops to operate small drones. One morning, he called his wife in a panic from a work trip, saying he had forgotten how to do his job and had not slept in four days.

In March 2014, three months after placing the frantic call to his wife, he drove to a secluded side street. He sent a text to his wife saying, “So sorry, baby. I love you all,” and ended his life.

When police came to the house to confirm his death, one determined thought floated to the front of Jennifer Collins’ mind.

“I told the police — I was adamant — that I wanted his brain donated to research,” she recalled.

The Defense Department in 2012 built a lab called the Department of Defense Brain Tissue Repository, whose goal was to gather the brains of deceased veterans to look for clues to the two most widespread injuries of recent wars: PTSD and traumatic brain injury. But two years after opening, the lab had no brains to study.

Collins’ quick decision meant that her husband’s brain was soon packed in ice and on its way.

That single brain revealed a pattern of damage that the head of the lab, Dr. Daniel Perl had never seen before. Nearly everywhere that tissues of different density or stiffness met, there was a border of scar tissue — a shoreline of damage that seemed to have been caused by the repeated crash of blast waves.

It was not chronic traumatic encephalopathy. It was something new.

The team published a landmark study in 2016 reporting the pattern of microscopic damage, which they called interface astroglial scarring.

Studies suggest that damage is caused when energy waves surging through the brain bounce off tissue boundaries and create a vacuum that causes nearby liquid in the brain to explode into bubbles of vapor. Those tiny explosions are violent enough to blow brain cells apart.

Perl shared with Jennifer Collins what he had found in her husband’s brain in 2016, and she made it her mission to get more families to donate.

For the next several years, she told anyone who would listen about his case, and brain donation became somewhat common for Special Operations troops. But little of what researchers have learned from those brains made it back to SEAL leadership.

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If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

This article originally appeared in The New York Times .