Brothers in Arms, Partners in Healing: A Story about a Breakthrough in Treating Post-Traumatic Stress

Ryan Evans (0:10)

You are listening to the War on the Rocks podcast on strategy, defense, and foreign affairs. My name is Ryan Evans, the founder of War on the Rocks. This is a different kind of episode for us. Our guests are Erik Won and Jeff Lindquist, both veterans. Erik was a doctor in the Navy who worked very closely with Marines, which is how he met Jeff, the Marine. They have a pretty remarkable story that I'm going to let them tell, but it's an amazing journey of discovery that they went on together for a treatment that promises to relieve post-traumatic stress, which afflicts so many veterans, first responders, sexual assault victims, homeless people, and so many others across our country.

This is a different episode for us, but tell us how you stumbled upon this idea for this technology, and of course springs from your own background as well.

Erik Won (0:54)

So the technology was developed by a team of neuroscientists, psychiatrists, and some neurosurgeons as a way to customize an existing treatment called trans-cranial magnetic stimulation or TMS for short, and how to personalize it to each individual based on brain imaging, something called an electroencephalogram. TMS had been FDA cleared for depression for a number of years, but there were some limitations to it, and they were finding that the response rate would hover around 50 percent, some studies could get as high as 60 to 65 percent, but they wanted to see if they could improve upon those numbers by customizing the treatment. And one of the tools that they could use to improve the customization piece was an electroencephalogram. And specifically in the EEG, they were looking for disruptions in neural connectivity, and if they targeted those areas, they felt like they could improve the response rate.

Ryan Evans (1:46)

And if one of our listeners was looking at a room where you get this done, it would look, it's an MRI machine, right? Or it looks like an MRI machine?

Erik Won (1:52)

It's much simpler than an MRI. So MRIs are, number one, very expensive tools. They're labor-intensive and time-intensive, whereas an EEG is a very portable unit, smaller than a suitcase. It looks like kind of a bicycle helmet that goes on the head, and in about 15 to 30 minutes, you can get a pretty sophisticated neuroimage. What's different about EEG, much the same way an electrocardiogram's electrophysiologic picture of the heart, we get these electrophysiologic pictures of the brain. They're a little bit different in the sense they're not still images. They're actually dynamic images that are taken over a time domain, where you can see in millisecond resolution kind of how the different areas of the brain are talking to each other. And the disruptions that we can see in that network function is specifically what we're trying to target and improve.

Ryan Evans (2:35)

And so you're at this stage, chief physician CTO at Boeing. Why did this catch your interest?

Erik Won (2:41)

In a prior life, I was a Navy flight surgeon. I had the honor of deploying with the Marines. We unfortunately sustained some of the first casualties of Operation Iraqi Freedom. So I had a number of friends, brothers and sisters, who were struggling with the signature injuries of the war, which were post-traumatic stress and traumatic brain injuries. And anything that could help them was worth looking at. And we had tried just about everything. Medication management, talk therapy, EMDR, you know, transcendental meditation. And when I was hearing about this, I at least wanted to explore it. And ultimately, I thought there was enough scientific backing to send in a friend. And that's when I gave a call to Jeff, a couple of my other, our other friends, fellow crew chiefs, that said Jeff was struggling.

Ryan Evans (3:25)

Now, how did you two first meet?

Jeff Lindquist (3:28)

We first met when I was deployed, when I was, when I came on HMM 268 He was the flight surgeon. So as a crew chief, that's our, he keeps us up or down, right? So that's how our relationship developed back in 2000?

Ryan Evans (3:40)

Yeah, it was been, yeah, 2000 So you guys met in 2000, and then you deployed to Iraq in 2003 with your unit.

Jeff Lindquist (3:46)

We actually deployed on a Westpac before that, 2001 We were actually on the Boxer, USS Boxer, when 9-11 happened. That was our evolution. We came back home and were prepared to be the first wave out to Iraq in 3

Ryan Evans (3:59)

And what was that deployment like?

Jeff Lindquist (4:00)

On some regards, it was like an exercise, like some kind of exercise where we go out and do something in the sandbox somewhere. And in the other regards, up until the first night of the war, when we had the first casual, some of the first casualties and lost a plane, lost, I think it was eight British Marines, and four of ours, so 12 casualties in total. It was really, at that point, to be quite frank with you, I don't have a great memory of what happened, just everything kind of got numb, right? And I had the honor of escorting the remains back to the United States.