The invisible wounds of war

A Benedictine friend sends this report by Greg Dobbs, published yesterday in the Rocky Mountain News:

It is a crude way to put it, but "they are dropping like flies." That's how one soldier I spoke with characterized the spike in suicides among servicemen coming home these days from war. With bodies intact, but minds wounded - sometimes mortally.

It's not a new phenomenon - mental trauma is a normal reaction to the abnormal horror of war. Back in the Civil War it was called "soldier's heart." In World War I, it was known as shell shock. In World War II, battle fatigue. After Vietnam, it was called Post Vietnam Syndrome. Nowadays it has a formal name: post traumatic stress disorder, or PTSD.

But it is an invisible wound, and soldiers with injured minds often haven't gotten the treatment they needed. Some have been discouraged from even seeking treatment because of the ghost called "stigma." Some have only been told to "suck it up," get back out there and fight! Which has cost our armed forces dearly.

According to a RAND Corp. report last month, the wars in Iraq and Afghanistan have wounded the minds of 300,000 Americans. That's because trauma is cumulative: some servicemen have been back to the battlefield as many as four times, and particularly in Iraq, they live with fear 24 hours a day because, unlike most previous wars, there is no "rear" to the front line - they are always surrounded; there is no safe haven.

That is a recipe for wartime PTSD. And for some, a prescription for suicide.

According to the military's own numbers, suicides were up 20 percent last year over the year before, with six times as many suicide attempts as there were the year before the war began. In the Veterans Administration it's even worse. E-mails, recently exposed in a federal court case, showed an average of 18 suicides a day among vets, and twice as many attempts, about a thousand a month.

In our HDNet documentary we interviewed victims of PTSD. One young infantryman who went to Iraq from Fort Carson, having seen friends blown up and himself crushed by "survivor's guilt," came home diagnosed with PTSD. But when I asked him to describe his treatment, he laughed and said, "Didn't exist." Even when he got "mental health" appointments, his line commanders made him work so he'd miss them. Eventually, he took a kitchen knife and cut his wrists. He was saved, but six hours after being released from the psych ward, he was sent back to his unit to train for redeployment to Iraq.

A Marine out of Camp Pendleton told us he came back with PTSD and was put on overnight guard duty - armed. He called his mother one night with a gun in his mouth, telling her he had killed so many innocent Iraqis, he didn't deserve to live. She kept him on the phone, praying neither battery would die, as she drove six hours to save him.

Our third interview was with the Massachusetts parents of a Marine reservist. Their son had come home and started drinking heavily - a symptom of PTSD - so they committed him to a VA hospital. But the VA wouldn't treat his PTSD until he stayed sober - like a doctor refusing to treat your head cold until you stop sneezing. Three weeks after his release, he hanged himself with a garden hose slung over a beam in his parents' basement.

What these guys - and many others - had in common was, they got wounded in the line of duty, but didn't get the treatment they deserved. In the active military the barriers were bureaucracy, stigma and the culture of courage. In the VA it was just a systemic nightmare of red tape, short staffing, long forms and long waits - obstacles that are hard enough to navigate if you're not disturbed, virtually impossible if you are.

What's the impact of these avoidable inefficiencies? More trauma - which means more PTSD, and more suicide. The Army itself warned a couple of months ago that as the number of troops in Iraq was surging, the number of mental-health providers was declining. That does not bode well for the future.

Nor does the Pentagon's take on PTSD and suicide. The top Pentagon psychiatrist told me that, most of the time, the crisis that leads to suicides is the breakup of relationships. And when it's not about relationships, it's about legal or financial problems. When I told the Massachusetts Marine reservist's parents about this, they used a word I wasn't able to put to put on television.

It's fair to say that at least a few positive changes are taking root. The new commanding general at Fort Carson, who lost one of his own sons to suicide and another to combat, is teaching troops and commanders that asking for help is a sign of strength, not weakness. Several state National Guard units have pilot programs for "reintegration." They invite Guardsmen returned from war and their families to come for counseling and bonding 30, 60 and 90 days after returning home.

Some who come back from war have been driven over the edge not just by combat, but by their experiences when they got home. They are casualties just like casualties on the battlefield. The difference is, if we ever build a Vietnam-type wall to honor the victims of Iraq and Afghanistan, their names won't be on it.

Former Rocky Mountain News media critic Greg Dobbs reports for a documentary program World Report on HDNet Television.

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