Healing Combat Trauma

The Blunt Truth: Combat Veterans, PTSD and Medical Marijuana

There's a great article on the Web from the Salem (Oregon) News-Record of June 11, 2007, called "Marine Combat Vet Discusses Iraq, PTSD and Medical Marijuana," linked here.  The former Marine in question is Nicholas Burgin, and the subhead to the article is, "The courage of an Iraq War veteran continues in his honesty about PTSD."

In the tradition of Tony Neff's story, "All I Want is What I Deserve," about getting his veterans benefts for a service-connected disability, linked here, Nicholas Burgin's story is another great, first person narrative account of his experience, and what actually happened to him.  (We're in the process of seeing if we can get Burgin's permission to reprint his story in full, here, because it would help so many readers.)

In the meantime, read his story, while it's still up on the Web, or save yourself a copy of it, for future reference.  It's powerful.  And don't neglect reading the comments section, either, that follows the article.  A whole lot of people checked in and said they knew what he was talking about, and they agreed, from Vietnam vets through other OIF/OEF combat vets.

Burgin is a young Marine who, like a highly decorated Marine with PTSD we've blogged about here, Daniel Cotnoir, worked in mortuary affairs for the Marines in Iraq - a more gruesome job hardly exists -- and saw enough stuff to last a thousand lifetimes.  Later on, of course, Burgin had trouble with the memories, and despite trying everything recommended to him, found one and one thing only that helped him ease the pain.  He details his struggles, and his victories, in the excellent, first person narrative, and closes with the line, "Take what you will from this story, but I know for a fact marijuana has saved my life numerous times."  Good for him.

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In the 60s, draft dodgers and anti-war types in the U.S. made their way to Canada to ride out the Vietnam war.  Many stayed for years.  Today, with an all-volunteer military, "escaping" to Canada isn't nearly so popular; but if anyone compares the drug laws in the U.S. and Canada re: marijuana use, and finds themselves overly hassled by the perspective in the U.S. that it's still a criminal offense, they might start to find Canada more attractive again.  Depending on whether the party in power is liberal or conservative, their drug policy waxes and wanes, but more than 51% of Canadians are in favor of decriminalizing marijuna use, says the BBC, and using is often treated differently there than selling (possession v. intent to distribute).

Israeli Military's Proactive Plan for Identifying and Treating Soldiers Who Have PTSD

Here in the U.S., in our usual myopic way, we can get bogged down in the news about returning servicemembers with combat trauma and PTSD and forget just how many other countries in the world have struggled with this problem as well, and often found their own solutions.  Internationally, Japan, Israel, Australia, England and Canada frequently search the Internet for news about who's doing what, and what's working, for treating PTSD worldwide -- according to data from Google's analytical trends.  Today, the Jerusalem Post has an article about how Israel's Defense Ministry is about to unveil a plan for evaluating and treating soldiers systematically who have been exposed to PTSD as part of their military service.  (The article in question is linked here.)  Their expectation is that 2,500 Israelis suffer from PTSD, in a country where military service is compulsory, and conflicts in the region frequently boil over into sustained violence. 

The significance of the Israeli announcement is that the soldiers will be treated according to a "set psychological and medical format," meaning systematically and methodically.  Their understanding is that PTSD treatment succeeds better if initiated earlier, so evaluating all soldiers soon after military service will increase the chances of favorable treatment outcomes.  According to the article, three years ago the military started thinking through how to create a protocol that would involve every soldier, and optimize chances of finding and treating PTSD.  The protocol was developed by Zeev Waisman and Dr. Dan Dolfin.

Two interesting comments from the article express a vision that the U.S. might be wise to emulate:

"A soldier who comes out of battle will immediately be evaluated and we will see what type of treatment he needs," Waisman said. "Nothing is done today in a regulated fashion and we want all treatment to be according to a protocol."

The process begins by inserting the soldier's profile into the system which will then offer several courses for treatment that could include medicines, psychological therapy, family therapy, sex therapy and others. Waisman said that the Ministry of Defense hoped to convince other organizations to adopt the new format which will be evaluated in two years.

Stateside, it's not even clear that the various branches of the Armed Forces share a similar protocol for identifying and treating PTSD -- most likely, they do not.  With far more servicemembers at risk for PTSD than the Israelis have, we could do worse than to imitate what the Israeli Defense Ministry is putting into action as a plan to deal with PTSD, and return exposed servicemembers to better mental and emotional health.

British Soldiers Journey Back to Confront Ghosts from Combat Past

Because a percentage of our readership comes from abroad, and because the topic we cover is relevant internationally, today we note that the British press reported yesterday in two different articles how veteran combatants from the Falklands conflict are journeying back to confront the ghosts of their combat experience.  The Scotsman (Scotland) and the Guardian (England) both have articles on the subject, with much shared content between the two. 

The award-winning Guardian, consistently a great source of news and perspective, notes that "Two hundred and fifty Falklands war veterans - many still suffering psychological trauma from the conflict - will return to the islands this week. Their arrival and tour around local battlefields is timed to coincide with the 25th annual Remembrance Day Service [the British version of our Veteran's Day] since the 1982 Argentinian invasion." Furthermore, "among the former servicemen and women flying out are a group diagnosed with post-traumatic stress disorder (PTSD) who are hoping to exorcise the ghosts of the past."

The excellent Guardian also has new video they've created to honor the 25th anniversary of the war -- "watch the soldiers who were there relive their experiences and follow the war as it unfolded" -- and, if you're a history buff or just blank on what the Falklands War was all about, there's WIkipedia and this interactive guide on the Guardian's own site to clear up the confusion.

The Scotsman adds detail as well:

"SEVENTY former servicemen still battling with the psychological trauma of fighting in the Falklands War will fly to the islands today to face the ghosts of 25 years ago. The men, suffering post-traumatic stress disorder (PTSD), are among a group of 250 veterans from the 1982 conflict taking part in an anniversary pilgrimage to the battlefields in the South Atlantic.

For most of the men on the heavily over-subscribed [meaning, far more people signed up than were actually able to go] visit it will be their first time back since the British victory over Argentina.  The islanders - the population is less than 3,000 - are throwing open the doors to accommodate the party, including 15 relatives of those who died in the conflict, in their homes.  Organizers of the visit said that many local people have taken a week off work and offered their services as drivers for the party. One has even put a plane at their disposal to take them to outlying islands where they fought.

The event is being organized jointly by the main Falklands veterans body the South Atlantic Medal Association, and Combat Stress, the charity that works with ex-servicemen and women who are suffering psychological disabilities.  Combat Stress is providing around ten trained clinical support staff.

As well as those suffering PTSD many making the visit suffered major physical injuries such as losing limbs. Colonel Mike Bowles (retired), the chairman of the organizers, said: "Some of these guys did go through horrific experiences and saw horrific things. "I think going back and being able to be in a place and think about it and sit and maybe have some people around you, does help people come to terms with it."

But Col Bowles said the trip was also about seeing how the islands that they fought to liberate are thriving in 2007, and meeting the islanders themselves.  A total of 255 British servicemen and more than 600 Argentineans were killed in the war which ended the 74-day occupation of the islands.

Editor's Notes: (Highly miscellaneous.)  We've written about Combat Stress before.  See hyperlink.  It's the British variant on our term, combat trauma.  It's also the name of a service organization for combat veterans who suffer from PTSD in England. 

On a more serious note, notice how this event is happening 25 years after the conflict.  There seems to be a gigantic, painful lag in experiencing symptoms and confronting the past -- perhaps because of how painful it is, or how deeply the memories are buried.  This is consistent with our Vietnam veterans making trips back to Vietnam in recent years to confront the ghosts of their pasts there, and with decorated war heroes from that conflict, such as Max Cleland, who for many years headed the VA, taking 20+ years to realize that he was suffering from combat trauma himself.  In other words, it's likely to be a long, hard wait for veterans from Iraq and Afghanistan to be able to confront these experiences themselves, though we hope through many related efforts the cycle time is much shorter, for their sake. 

As Maxine Hong Kingston told me when I asked her how quickly vets were interested in writing (even for themselves) about what they'd gone through, she said that in her experience it had taken 20 years to come forward.  Perhaps that time from now on can be shorter -- but I think it underscores the gravity of the experience, and what these veterans have suffered, that it generally speaking takes that long.  Ouch.  Let's have as a goal, trying to close that particular loop, gracefully and graciously, with current veterans in a whole lot less time.

Children of War -- Traumatized

Great article in the Guardian today -- British paper -- about the generation of Iraqi children growing up traumatized by the current war.  Click here to read.  One quote from the article suffices: ""Sherif Karachatani, a psychology professor at the University of Sulaymaniya, said: "Every day another innocent child is orphaned or sees terrible things children should never see. Who is taking care of the potentially enormous damage being done to a generation of children?"

Canada's Only In-Patient Program for PTSD

An article from several years ago in the Psychiatric Times describes Canada's only in-patient program for PTSD sufferers.  The program, at a location called Homewood Health Centre, is located in Guelph, Ontario; and is modeled on a program in Philadelphia, PA., developed by psychiatrist Sandra L. Bloom, M.D., in the 1980s.

Combat Trauma in the UK

There's a sad story in the Scottish news website, ScotlandonSunday.com, about a severely-injured UK veteran of the Iraq war's experience back home in Scotland.  The article is entitled, "Veterans Abandoned After UK's 'Vietnam'."  Apparently, services aren't nearly up to par, and the biggest reason the article offers is that UK public sentiment is as much against the war in Iraq as it was in the U.S. against Vietnam.  Several people are quoted in the article as saying that Operation Iraqi Freedom has become the UK's Vietnam.  With little public sympathy behind the war -- as many as 2/3 are opposed to it -- there's little public embracing of the warriors who come back from the war, and they find it's too uncomfortable to talk about it with others who just don't understand. 

Additionally, services for veterans have been severely curtailed, so veterans are returning to poor care and little psychosocial support, for a war they weren't really that interested in fighting in the first place.  Read the article for a greater sense of what's going on in the UK, but let's hope that their veterans can get the care they need at this time, not later on after they've suffered even more.  One of the only great lessons for us in the U.S. after Vietnam is that we at least are coming around to understanding treating veterans better and more quickly.  It would be a shame to watch the UK suffer through what we've already lived in this regard.  Let's hope they don't have to and can fix the situation before it needlessly becomes any worse.