Combat Stress and Moral Injuries...Or, PTSD.

Stephen Sherwood returned from Iraq in the summer of 2005, along with the rest of his brigade combat team which included the 506th Infantry Regiment.  You know of this regiment from the mini-series "Band of Brothers." 

          

"Longtime friends said Sherwood came back from Iraq a changed man.  After a few days, he took down the American flag in front of his house and scraped the SUPPORT OUR TROOPS sticker off his car.  On the day of the argument [with his wife, 03 August 2005], Sherwood's wife told him about an affair she had started while he was in Iraq.  Hours later, he shot her five times in the face and neck, then killed himself with a single shotgun blast.  In his pocket, police found a newspaper clipping stating that 30 percent of troops returning from Iraq developed mental-health problems.  Fort Carson assured the media it carefully screens every soldier and Sherwood's postdeployment health assessment did not indicate he was "high risk."  - "Lethal Warriors," David Phillips, pg 97.

Sherwood's screening didn't indicate that he was high risk because he, like many (perhaps most) in his unit and others, lied on that screening.  Some senior soldiers suggested that filling the screening out truthfully would give Sherwood and his comrades a one-way ticket to the shrink, that they would be denied their block leave, and perhaps be kicked out of the infantry.  It was also perceived as being contrary to the Soldier's Creed.

I am an American Soldier.

I am a Warrior and a member of a team. I serve the people of the United States and live the Army Values.

I will always place the mission first.

I will never accept defeat.

I will never quit.

I will never leave a fallen comrade.

I am disciplined, physically and mentally tough, trained and proficient in my warrior tasks and drills. I always maintain my arms, my equipment and myself.

I am an expert and I am a professional.

I stand ready to deploy, engage, and destroy the enemies of the United States of America in close combat.

I am a guardian of freedom and the American way of life.

I am an American Soldier. [Emphasis added by author.]

The Soldier’s Creed makes it hard to ask for help.  If the creed doesn’t, the motto of the 506th is "Stands Alone." By all accounts, this motto was taken to heart by the soldiers of the 506th.  But there are some things during which our soldiers shouldn't stand alone.  Are we failing our combat veterans?  Are we giving them the support they need when they return from doing what it is we sent them to do; to kill and be killed on our behalf?  I ask myself these questions daily. 

I have been doing a great deal of reading about combat stress injuries, or moral injuries as Dr. Jonathan Shay calls them.  Or PTSD, as you likely know it.  This began, ostensibly, as research for character development for a novel that I’m writing, and that's what I continue to tell myself. The more I read, however, the more engrossed I became in the subject, and convinced that we need to do more.

As an aside, the problem with the name PTSD is that it suggests that it's simply a disorder.  I don't think it's a disorder.  I think, as do many mental health professionals, that it is an injury.  And like a shattered leg, it should be treated, and treated comprehensively.  Unfortunately, you can't see moral injuries at first glance.  But the hell they wreak on both the returning combat veterans and society is readily visible.  Or at least it should be, if only we were looking.  Very few seem to be looking.  In his book, quoted above, David Phillips shows us what it’s like when we do look.  Maybe that scares us and we continue to pretend that everything is well.  Maybe combat veterans scare us.  All part of the same problem, no?

You don't have to understand what it's like to be in combat (or have been in combat) to understand how a man or woman can be changed by that experience.  You don't have to have "walked a mile in his shoes" to be empathetic.  To suggest that would be foolish.  But I feel that it is our duty as Americans to at least try to understand and empathize.  I don't want you to patronize veterans with shows of faux sympathy.  But you should try to understand. 

You can easily see the missing limbs and burned skin from IED attacks, but as it stands right now, we can barely recognize the legitimacy of the psychic scars that many of our veterans bear.  They could by lying after all.  They could be malingerers.  They could be trying to shirk their duty.  They could be, as we called them in the Marine Corps, “shitbags.”  If so, they should be ostracized and discharged.  Better to err on the side of caution, right?  To banish them?  To cast them off?  

Here is an SNCO talking to a junior enlisted man:

"Soldier, you got hit by five IEDs, countless ambushes, and saw your entire squad killed.  Your best friend bled out and died in your arms.  You couldn't tell who the enemy was; everyone there seemed to hate you.  But other than the brain fluid that seeped out of your ears that one time your Humvee was launched 10 feet in the air by a buried 155mm round, you didn't suffer a scratch.  You're fine.  So you have nightmares?  We all do.  Suck it up.  Don't be a wimp.  Here's a fat reenlistment bonus.  Go get drunk and get laid and blow off some steam.  Oh, and by the way, we're going back in 8 months.  Dismissed." 

Suck it up.  But what if they can’t just “suck it up”?  What happens when they are in distress, psychologically and emotionally, and the above SNCO is their support system?  The answer is: Nothing positive.

Consider this: If you're going to tell yourself and others that these men and women are protecting your freedom and protecting your way of life, you should want understand that the ramifications of them doing that duty go far beyond physical disabilities.  Shouldn't you? 

We have this image of victorious WWII veterans returning home and stoically and smoothly transitioning from warriors to peaceful civilians.  That vision, through decidedly rose colored glasses, is the gold standard.  The problem is it's not really true.  Moral injuries were present in WWII veterans (just read some of the autobiographies of the aforementioned Band of Brothers) and have been present in returning veterans since antiquity.  In fact, Homer's Iliad and the Odyssey, which I take from Dr. Shay, could be interpreted as a brilliantly crafted metaphor for moral injuries.  This is not a new phenomenon, but is instead as old as warfare itself. 

Furthermore, it is nothing to be ashamed of, and we need to change the way we think about moral injuries.  We're doing this.  We're getting there.  But we're not there yet.  I don't know if we'll ever really get there, and I offer no solutions other than to ask that you inform yourself and your loved ones, even if they haven't been touched by the long tendrils of war.  I offer no solutions because I, well, I'm not that smart.  But this is a burden that we all share, like it or not.  And we, like our veterans, should shoulder that burden.

Not all combat veterans have moral injuries, PTSD, combat stress injuries, etc.  I'm not saying that.  So all you uninformed arm chair generals (and even a few of you combat veterans) can refrain from telling me that our warriors are just that; WARRIORS with no room for such touchy-feely mental weakness ("OOH RAH, HOO AH, STANDS ALONE!").  I don't want to hear that and I won't hear it because it's not weakness.  It's reality.  If you don't believe that combat changes the brain, and in turn the man, I simply point you to one of the dozens of studies that show real, concrete changes in the way the brain works after prolonged exposure to combat and other stressful situations.  Some people are changed more than others, and rarely is this change for the better.  Inform yourself.  Read.  Learn.  We all stand to gain from it.

If you are a veteran and you feel like there is something wrong, but don't understand what, educate yourself as well and seek help.  We haven't always done enough for you, and those like Stephen Sherwood and countless others, as well as their families, have paid for it.  But help is out there.  I ask that you stop worrying about what it will do to your career, and worry about what it will do to your existence as a human being. 

What to read?  Where to start?  There are thousands of books on this subject.  Some better than others.  My recommendations, which I've personally read, are as follows, in no particular order.

• "Achilles in Vietnam" and "Odysseus in America" by Dr. Jonathan Shay.
• "On Combat" and "On Killing" by Col. David Grossman.
• "An Operators Manual for Combat PTSD" by Dr. Ashley R. Hart II.
• "Lethal Warriors" by David Phillips.

When you're done reading them, check out their bibliographies.  If you want more suggestions, contact me or your local Veterans Advocate.

I'm not advocating the neutering of our fighting men.  I'm just advocating that we take some responsibility when we turn our men into trained killers and unleash them upon our enemies.  Even Lethal Warriors sometimes need help.  Who's going to give it to them?

Morning Coffee (100)

You’ve waited with impatiently, with baited breath, as a day turned into days and those days turned into a week and longer. But here it is, our 100th Morning Coffee together. It’s been over a year since we began having Coffee together, and I hope that I’m able to continue to join you in your mornings for a long time; for as long as I’m capable of Brewing. I had planned on doing some grand bit to celebrate the 100th, but other things got in the way day after day, so I think I’ll just see where it goes this morning.

"Politics Man, Politics…!":

So much has happened since our last get together that it’s hard to know where to begin. Politically, it seems as though we’re light years from where we were a week or so ago, but at the same time, it feels as though we haven’t moved an inch. We’ve had a Democratic debate and Super Tuesday, neither of which have done much to solve the Left side of the political race. Super Tuesday seemed pretty lame, actually. You know, it’s hard to imagine any lasting, substantive changes in our political system (due to a variety of reasons), but I would love to see many changes implemented. Finding an alternative nomination process would be one of many.

Once nominations are confirmed, presidential politics today (and perhaps politics at all levels) is like watching the Kansas City Royals and the Tampa Bay Devil Rays play a baseball game. Both teams, like both candidates, suck but at the end of the day, one of them is absolutely, positively going to be the winner no matter how ugly the game is played by both teams. The main difference is that in this game, the crowd (fans) must vote on who wins, and the crowd rarely votes on what matters (though one could argue when you’re talking about these two teams, what matters?). Instead of winning because they have a better pitching staff or a nasty lineup, the Devil Rays have cooler uniforms, so they should win. Or, the Royals are an older team, and thus more experienced, so they should win. The Rays might have a pitcher who is terrible year in and year out, but happens to have a good year and picks up a fat contract; the Rays are the frontrunners because now they’re richer. Never mind the fact that this guy will probably still be terrible. Then you’ve got the sports commentators telling you who you should vote for as the winner. No candidate will ever be perfect, nor will any baseball team ever go an entire season without losing. But can’t we find better “teams” than the political equivalent to the Royals and Rays?

Okay, now that I’ve gotten the obligatory analogy off my chest, I’ll conclude this tirade by summing up Super Tuesday. It did end with McCain being the clear Republican front runner. But on the Democrat side, little was decided. Huckabee, about whom you might have first heard in an earlier edition of the MC, did surprisingly well and may have positioned himself nicely for the VP slot on McCain’s ticket. I, for one, was not terribly surprised by Huck’s showing, as I stated earlier that the man might very well be the Republican nominee. I didn’t think he was as out of the race as virtually every pundit suggested. The evangelical base is too strong, and that’s where he has appeal. He probably won’t win the nomination, and that’s probably a good thing, but he’s still right there. And if McCain were to win the Presidency, Huckster could end up our President through succession.

Conservatives Worse Fear: A Republican Nominee:

It sounds strange that conservatives fear a McCain nomination. He is, after all, a Republican, and Republicans are generally conservative. They don’t fear a McCain nomination because they think he’ll lose. Instead, they fear it because they fear he’ll win. That’s mind-blowing. Conservative pundits like Rush Limbaugh, Glenn Beck, Ann Coulter and others dislike McCain so much that they’ve proclaimed that they’d vote for Hillary Clinton before they would vote for McCain. And the sentiment is trickling down to the masses (which is quite sad because it indicates clearly that a majority of people get their opinions from people on the radio). Several people have come up to me stating that they’d vote for Clinton before McCain. They can’t really articulate why, exactly. But they know they don’t like him for some reason. I actually asked the first person to say this to me if his name was Rush Limbaugh. His reply to me was something about McCain being a POW and that POWs learn to live by telling people whatever they want to hear and that they’ll lie and etc, etc. I was quite taken aback by this, and called him on the fact that such a sentiment would mark all POWs as liars and thus unworthy of listening to in any capacity. Weird.

My question to conservatives is this: which would you rather have name Supreme Court Justices, McCain or Clinton? Remember that the Supreme Court makes rulings on Constitutional matters…like Roe v. Wade. I know how obscenely important a person’s choice is to you (or more accurately your revocation of that choice), so you might want to remember the fact that our next President might have the chance to nominate three Justices. McCain is pretty much pro-life whereas Clinton is pro-choice. It seems that on this issue, which is oftentimes the most important consideration for conservatives, McCain is the clear winner. But because conservatives dislike McCain’s stance on immigration and campaign finance reform (which they irrationally view as a usurpation of the 1^st Amendment right to free speech), they would vote for someone who, in their view, tacitly supports the murder of unborn children. Amazing, isn’t it, the herd mentality of these people, bleating the catch phrases and opinions of their radio gods.

Limbaugh and Beck and their ilk lament over what they see as a slow death of conservatism, but really, their incessant whining merely illuminates the problems with such strict adherence to ideology. They’d sell their souls and their vote to someone they considered a few months ago to be the devil simply because the likely GOP candidate isn’t what they view as the ideal conservative. You will continue to hear about this (if you pay attention to such things). You will continue to hear Limbaugh and Coulter and Beck say that conservatives should cast their votes for Clinton rather than McCain. You’ll hear all sorts of nonsense, like that Clinton is more of a conservative than McCain. My advice to you is to learn what you can about the candidates and then vote for the one that is the least distasteful to you. If that’s Clinton, then vote for her. Just remember, you will always be sacrificing some of your ideals, because no one candidate is going to represent you with 100% fidelity unless you get off your ass and run yourself.

I thank Roland Martin at CNN for providing a good article on this, though it’s been reported on for about a week by various news outlets.

Down with the Sickness:

Al-Qaida in Iraq (AQI) has a new weapon against Coalition forces: women. I know what you’re thinking, but it’s not sexual seductions. And it’s not just any women. These women are highly skilled in the arts of terrorism. Why? Because they have Down’s Syndrome. Last week, two separate women were used in attacks on crowded markets during which 70 people lost their lives. The women probably didn’t even know what they were doing until they spontaneously detonated. They weren’t the only ones surprised by their explosion because their illness likely helped them get past security check points. The explosives were hidden under their traditional garb. This isn’t new, but the use of women as suicide bombers is still fairly novel, so they get past security easier than young men. Add the fact that the women had a severe illness, well, who’s going to stop and vigorously question and/or frisk someone with Down’s? I’m guessing that security details will scrutinize women and disabled people more now. This is the ever-changing game of cat and mouse that the Coalition plays with AQI.

The Loss of National Treasures:

Harry Richard Landis past away. He was 108 years old and only one of two remaining WWI veterans. Landis didn’t see combat in the Great War because he was still in training when the war ended, but he is, like the 4.7 million other US military members of the day, considered a WWI vet. In 1941, Landis tried to sign up to fight the Germans (seeing as though he missed his shot the previous time), but was deemed too old (at 42). This is a man who admits that he didn’t want to fight in WWI, but then volunteered to go fight in WWII. Such honor. His story’s pretty interesting, as he went on to manage S.S. Kresge Co. (later to be named Kmart) all through the northeast.

The last remaining US veteran of that war is Frank Buckles (107). The Canadians have John Babcock (107) as their last remaining vet. The last German veteran, Erich Kaestner, passed away on New Year’s Day at 107. With that in mind, there could be as few as two WWI veterans left on the entire planet.

Raymond Jacobs recently died as well. Jacobs, who you may have never heard of, claimed to be the last living member of the original group of Marines that first raised an American flag on Mount Suribachi during the Battle of Iwo Jima. As you know, the famous photo shows a second flag raising. No records exist which can verify Jacobs’ claim and all his contemporaries are already dead, so we may never know who really was involved in that first flag raising, as Jacobs also disputed the official identifications of the Marines in a picture taken by Louis Lowery.

There is a lot more that I wished to discuss with you during the past week, but much of it is OBE, or overcome by events. As in no longer relevant. So I’ll end now. Until next time.

Word of the Day: Mien (noun): Air, bearing, or demeanor, as showing character, feeling, etc: a man of noble mien.

On This Day in History: The Mongols burn the Russian city of Vladimir (1238). The US bans all Cuban imports and exports (1962). Slim pickings today; see the last few days for some interesting happenings throughout history.

“When a true genius appears, you can know him by this sign: that all the dunces are in a confederacy against him.” – Jonathan Swift.