As the Australian army’s highest-ranking officer was scrambling to workshop his response to accusations that Diggers’ brains have been exposed to avoidable trauma, the ex-special forces operator who has been the issue’s biggest agitator was meeting US defence officials in Washington.

Former lieutenant colonel Paul Scanlan wasn’t in the American capital on official Five Eyes intelligence-sharing alliance business. Nor was he a formal envoy of the Australian military he served for 27 years, including on multiple overseas deployments to Iraq, Afghanistan and East Timor.

His military background helped get him through the back door of Pentagon bodies such as the US Defence Health Agency, but Scanlan’s mission was decidedly personal.

A tall, striking veteran with a booming laugh and boundless energy, he believes the Australian Defence Force and the Department of Veterans’ Affairs have badly mismanaged the brain trauma caused by exposure to repeated blasts in training and battle, including in soldiers he served with. These blasts cause pressure waves that compress and, experts claim, damage brain tissue in soldiers, including those who have never seen action.

“The US interim guidance, as of 2022, is 4 PSI [pounds per square inch] per single exposure. Australia doesn’t have any guidance,” Scanlan says. “We’re also missing the cumulative blast exposure. You could be doing say 10 to 20 of these at three PSI, 20, 30, 60 PSI a day. And we don’t know what that long-term cumulative exposure is.”

Rather than lobby for change from afar — as many veterans and their families have done to drive the landmark devastating royal commission findings into veterans’ suicide last week — Scanlan has worked on getting inside the tent.

And because he believes the Australian military had been too resistant to change and unwilling to concede its failings, he has spent the past 18 months using his special forces networks and draining his personal finances to attend overseas military health and brain trauma conferences and workshops.

“I thought leaving the army I’d spend more time with my daughter. I’ve almost spent more time overseas, going to these conferences, often as the only Australian there, speaking to the researchers, finding out the information and coming back and then saying [to Australian officials], ‘Hey, you need to speak to this person. You need to speak to this person,’” Scanlan says, eyes welling with tears at the mention of his daughter.

“And if I was to make an observation of DVA [Australia’s Department of Veterans’ Affairs] and Defence, apart from a few key people, they’ve been completely disengaged.”

As he was meeting in Washington with the inner sanctum of the US military’s health division, the fruits of Scanlan’s relentless activism were materialising.

Not only did the royal commission last week recommend a dedicated blast impact research program— a finding made in no small part because of Scanlan’s lobbying of royal commissioner Nick Kaldas, with whom Scanlan previously worked on counter-terrorism— but Australia’s Chief of Army, Lieutenant General Simon Stuart, conceded the military had previously failed to adequately deal with the issue and vowed to overhaul its approach.

In an exclusive interview with this masthead and 60 Minutes, Stuart also apologised to veterans suffering from the potentially avoidable impacts of blast trauma caused by repeated exposure to heavy weapons or explosives.

“I say to anyone that we have failed … either individually or collectively … I’m sorry,” he said, while also conceding the military never properly weaved together a series of reports and studies that, if they had been viewed as a patchwork, would have highlighted that blast impact was a problem that may be seriously harming its members.

“There have been research and trials and other work going on since 2010, so far as I can ascertain. I think what’s been missing is sort of the golden thread of logic. We are where we are now, and I’m very focused on making sure that we fill in the gaps.”

The concessions are unlikely to resonate strongly with former Special Air Service Regiment sergeant Andrew Cave.

The Afghanistan veteran was once the epitome of an elite soldier: a tall and chiselled warrior and champion footballer who wanted nothing more than to put his fighting skills to the test on overseas deployments.

Having done so repeatedly, Cave became a case study in something else: the fight that veterans often face after their duty leaves them with physical or mental injuries.

Cave sustained both. Blast pressure was to blame.

He recounts in vivid detail the raging battle with the Taliban in 2006 when a rocket-propelled grenade exploded above his head, briefly knocking him out before he tried to get back to his feet to return fire.

“I remember just blood pouring like a tap. But I managed to drag myself into the vehicle and I tried to get hold of my machinegun. But then I just collapsed. And then the side of my face had completely opened up. One of the patrol members said they could have put a fist in the side of my head.”

Having skirted death, Cave returned home a deeply changed man. His physical injuries required intensive surgery, but patching his head back together was only the beginning. The blast impact caused significant brain trauma that affected Cave in ways that some in the medical and defence community struggled to comprehend.

Doctors ultimately diagnosed Cave as having both a traumatic brain injury and dementia. But after medically discharging from the army he had served for 25 years in 2011, he says the Department of Veterans’ Affairs challenged his diagnosis, seemingly intent on minimising the complex and debilitating mental health and processing problems that Cave was experiencing due to the blast pressure that had forever altered his brain.

He describes resistance by Defence and Veterans’ Affairs to recognising the impact of blast trauma— be it from one significant battlefield event or repetitive exposure during heavy weapons or explosives training— as “absolutely soul-destroying”.

“Not one commander has ever really approached me and talked about this,” says Cave.

Scanlan, though, was in touch. Cave was soon part of an international network of veterans and researchers lobbying military leaders and politicians to embrace a growing body of research linking the repeated exposure to blast pressure in training or combat to profound changes in the brain.

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These changes may cause symptoms similar to those experienced by sufferers of PTSD or chronic traumatic encephalopathy caused by high-impact sport, albeit with unique characteristics scientists are still working to understand.

Unsurprisingly, given the often-criticised pace with which large military institutions respond to what might be seen as non-urgent problems, change has come from the outside.

In the US, parents and spouses of veterans who have killed themselves after suffering the suspected effects of blast trauma have pressed Congress and the military to support legislative change to improve blast monitoring and ways to reduce the potential effects on the brain caused by training or combat involving exposure to blasts.

The New York Times published a series of landmark reports on the issue, revealing the findings of internal US military research highlighting the impact on the brain of repeated blast wave exposure.

Scanlan believes Australia is years behind the US in dealing with the problem, a claim partly backed up by his previous stint working within a division of the ADF devoted to science and technology.

Prior to leaving the military in 2021, Scanlan discovered internal research and reports warning of the effects of blast trauma on soldiers.

He said it was his discovery that the ADF had failed to commit to vital further research and reform that informed his decision to spend the past 18 months travelling Australia and the world to uncover the latest military health research and connect with key decision makers and advocates in America and Europe.

“If they [the ADF and the Australian government] want to do something about this, they could do it tomorrow. Are they doing enough? No. I go to all of these conferences, there’s no one from the ADF there. There’s no one from [Veterans’ Affairs] there. There’s no one from Defence Science Technology there. I’m the only Australian.”

Behind the scenes, Scanlan has spent months connecting US military health officials and researchers with their Australian counterparts.

In recent trips to the US, he met with leading blast brain-trauma campaigner Frank Larkin, a former Navy SEAL who served as the 40th US Senate sergeant at arms and whose son, also a Navy SEAL, died by suicide.

Scanlan also met advisers to Senator Elizabeth Warren, the chair of the Senate armed services personnel subcommittee and sponsor of the US Blast Overpressure Safety Act – bipartisan legislation that would direct the US Defence Department to better protect service members from blast pressure.

Among those Scanlan is championing back home is Dan Pace, a former Australian clearance diver who, urged on by senior defence officials, discharged from the navy to launch a technology and AI company focused on measuring blast impact, including by tracking changes in the brain.

Pace said promised funding support from the ADF never materialised, forcing him to remortgage his house to keep his company afloat.

The navy veteran insists his motivation isn’t financial but lies in ensuring service personnel are better protected from the blast waves that a growing body of data suggests may be contributing to veterans’ suicides.

Urged on by Scanlan, ex-brigadier Ian Langford, the former head of Special Operations Command in Afghanistan, emerged as the most senior former ADF member publicly raising the alarm about blast trauma.

“I can see the impact that it is causing, and I, as a veteran and as a former commander of these men and women … we owe them the obligation to look after them in their post-service life,” Langford said. “Now that we have the evidence, I think there’s a moral and compelling reason to act in haste.”

Army chief Stuart says that while the federal government will have the final say on the royal commission recommendations, he and his fellow service chiefs are embracing the call for change.

“I think we’re all in, in terms of what the royal commissioners have identified for us,” Stuart said, describing how he had already ordered all previous research to be gathered and is ensuring Australia is drawing on advances in the US and elsewhere.

“Look, we’re already working, I think in the spirit, if not the letter of that recommendation [on a blast impact program]. Personally, I think it’s a sensible thing.”

For Scanlan, the question of whether the ADF and the government are truly committed to change must be answered with new laws that fund and mandate reform.

Scanlan says Australia must follow the US lead and introduce a Blast Overpressure Safety Act that forces “the ADF to do something about it”.

Rather than limited trials or patchy data collection programs, Scanlan is also urging the ADF to commit to sweeping research, including into preventative technology, as well as baseline cognitive testing of all personnel along with collection of blast pressure data via body worn devices.

Scanlan warned that a failure to act fully on blast trauma would cost more lives and that until he saw real change, he would keep fighting.

“From Afghanistan, there are guys now from that who have committed suicide. And not just suicides. Families are being destroyed because of the effect it’s having. I think they deserve a lot better,” he said.

“The military ranks never scared me, or bureaucracy. There’s a problem here; let’s solve it. And if you’re not going to work with me to solve it, then I’ll solve it without you.”

If you are a current or former ADF member or a relative and need counselling or support, contact the Defence All-Hours Support Line on 1800 628 036 or Open Arms on 1800 011 046.

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