How Video Games Helped Treat a Burned War Veteran

Have you ever gotten so immersed in a video game so fully that you lost track of time? You're climbing the mountains of Skyrim or cruising the universe in Mass Effect, and the next thing you know it's evening and you haven't eaten anything in eight hours.

For Sam Brown, a soldier who was badly burned in combat several years ago in Afghanistan, video games were more than an escape. They were a vital part of an experimental treatment, removing him from the searing pain of reality by immersing him in a snow-covered digital world.

A terrific story published in GQ tells Brown's tale, beginning with a harrowing retelling of the burns he sustained in Kandahar, Afghanistan, when his transport hit an IED.

Burns are particularly difficult for doctors to treat, not just because of the damage done to a person's tissue, but because of a burn wound's overwhelming, lingering pain. The descriptions of his morphine- and dilaudid-assisted cleanings are excruciating to read, and a give mere inkling of the agony he must have felt while in immediate recovery.

As he healed, the biggest challenge was keeping Brown's flexibility. According to the article, his scar tissue had "gone into overdrive," and his scars had begun to look "like some kind of mutant armor." He was losing mobility, and if he wanted to have even a fraction of his past flexibility, he would need to do regular physical therapy to stretch out his tissue. As the GQ reporter points out, "It was like stretching-and ripping-a plastic milk jug. On a scale of 1 to 10 the pain was easily a 9."

Enter video games. Hunter Hoffman, a cognitive psychologist who had been experimenting with virtual reality as a way to help treat arachnophobes, had discovered that his virtual reality games were also a fantastic distraction for those undergoing physical therapy for burns. He had used his game SpiderWorld to distract a burn victim from his pain, inspired by how hypnosis served the same function; it killed pain not by any chemical means, but simply by distracting the patient.

In time, Hoffman became head of the Virtual Reality Analgesia Research Center, which is also known as HITLab. There, they build new software to help burn victims be sufficiently distracted from their treatments that they could ignore the pain. Interestingly, commercial video games didn't work as well—in a test, Mario Kart performed less effectively than the comparatively simple SpiderWorld.

The article's description of Brown's first treatment is remarkable in how it recreates his first submersion into a simple game called SnowWorld, which presented a snow-covered wonderland that sounds like a simplified version of the snow-dusted plains of Skyrim. (See SnowWorld in action in the Science Central video here.) As he played the game, Brown listened to Paul Simon's "You Can Call me Al" from Graceland (Great choice!) and got into a snowball fight with a number of simple digital enemies.

Before Sam knew it, the game was over. His therapists were taking off the goggles. "We're already done?" He still had a whole village of igloos left to liquidate.

When they went through the list of questions, Sam was surprised to hear himself say that his observed pain had only been a 6. The therapists were pleased, and maybe a bit surprised as well, to tell him that they had gotten more range of motion than previously.

"Really?" But it was true, Sam had only been vaguely aware of the pain, mostly when it had caused him to muff a shot. The game play was like a white noise that canceled out the pain-as great a relief as he'd gotten so far during therapy, better even than morphine.

No, video games won't chemically kill pain, but they can serve as enough of a distraction from it that they have real therapeutic value. The image to the side, posted to the HITLab website, demonstrates the reductions in pain-related brain activity as volunteers recieved thermal pain stimulations while playing SnowWorld. As you can see, VR causes a significant reduction in pain.

Hoffman's VR programs are still in the test phase, but they've been gaining an increasing amount of visibility over the past few years. But based on the response they're getting from patients and Pentagon higher-ups alike, it sounds like they're on to something.

Burning Man [GQ]