Healing Combat Trauma

Happy Fourth of July - Veterans

Celebrating America's Independence Day and the veteran, from the Revolutionary War through to today's conflicts, here's a marvelous quote from  the pages of history:

"We have to remember that in the future we will want to keep before our children what this war was really like.  It is so easy to forget; and then, for the younger generation, the heroism and the glamour remain, while the dirt, the hardships, the horror of death and the sorrow fade somewhat from their consciousness." -- Eleanor Roosevelt

Keeping the conversation alive about just those topics this Independence Day...

PTSD Trauma for Veterans and Their Families is Predictable - "The Generic Effects of Combat"

In an article from Australia, there's a great quote about combat trauma/PTSD, and its very ordinariness.

(The article's topic is how "mental health problems caused by war service afflict veterans' families and children too.)  One of the premises of the article is that, based on a study, "Sons and daughters of Vietnam veterans are three times more likely to commit suicide than those of similar age in the general population (Australian Institute of Health and Welfare 2000, Suicide in Vietnam veterans' children: Supplementary report no.1).  According to the same report, "They are also more likely to die of accidental death, experience depression and abuse alcohol or other drugs."

That's the overall pretext for the article.  However, now comes the excellent quote, with a bit of preamble from the article itself, linked here:

According to Professor Hedley Peach, conducting research into veterans' sons and daughters is vital, not only to examine in detail the reasons behind their poor health but to set up support services that work for them.  He is also eager for doctors to consider war service when treating patients, as in many cases it could help diagnosis ....  Peach, a member of the scientific committee advising the Government on the feasibility study and professorial fellow at the University of Melbourne, says the Government should also consider studying grandchildren of Vietnam veterans to avoid more problems spiralling down through the generations.

''If the sons and daughters have got mental health problems and have young children themselves, what effect will that have on the grandchildren? We have to break the cycle.''

He suggests stressful familial environments could be behind the children's mental health problems, already highlighted by existing research. While many people with mental illness have a genetic predisposition to their condition, veterans were screened for mental illness before they went into the service, making stress a more likely factor in the children's ill health.

''In studies done by clinical psychologists running PTSD clinics for Vietnam veterans, children have reported a high level of dysfunction in families,'' he says. ''When we focused on Agent Orange so much in the past we missed the bigger picture. We are seeing the same sorts of problems in veterans of the Iraq and Gulf Wars, and fighters in World War II are now saying they suffered from the same problems. It is not due to any specific war, it is the generic effect of combat.''

Thanks to Kathie Costos for this reference...

PTSD, Puppies and Misplaced Values - We're Having the Wrong Conversation, America

Now that media coverage of SSgt. Travis Twiggs -- the five times-deployed Marine and gen-u-ine American hero who killed himself recently after a protracted and unsuccessful fight with PTSD -- has safely faded from view, America can go back to talking about what really interests it - like the Marine tossing the puppy off the cliff in Hawaii.  Here's a great quotable quote from Kathie Costos, a senior chaplain with the International Federation of Chaplains and a longtime, tireless advocate for veterans with PTSD, both personally and professionally on her blog, WoundedTimes, linked here.  After noting that a mention of the news update on "that jerk" with the puppy toss sent blog traffic sky-high, Costos said, most quotably -- "I hate the fact a puppy toss gets more attention than a Marine killing himself because the DOD and the VA won't do what they are supposed to do."  Amen, sistah.  (I don't believe that she's talking about the Twiggs case there, specifically, but just in general.)

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On this blog here, other than news about Travis Twiggs, which people were searching for because they cared about him, what really sends the hit meter aflying is any mention of THTIOKARR -- The Hotness That is Otherwise Known as Rudy Reyes -- who I mention from time to time only because, other than the obvious (hotness!!!), he seems to be an interesting amalgamation of "yin" and "yang" -- the reflective, centered, holistically-minded, nevertheless deadly warrior.  (Sort of the Bruce Lee Lite for our generation, or if Bruce Lee were a veteran, that sort of thing.)  That gives me hope that he's processing his own stuff, whatever that may be, from combat in as effective a way as possible, and being somewhat of a guiding light to others who have shared his experience.  On the other hand, I'm pretty sure people are just searching for photos of Rudy Reyes -- and where they're coming from is often fairly entertaining (defense installations everywhere, and multiple foreign countries, as well as our own.)  I enjoy learning news about Rudy Reyes, however faint, as much as the next person; or cringe over more news about the deranged puppy-tosser, but here's some veterans news we actually SHOULD care about, and it's happening NOW, and it affects us all:

From Brian McGough, at VoteVets, quoting Anne Weismann, general counsel for Citizens for Reponsibility and Ethics in Washington [CREW], in a blog entry linked here:

Today, [Citizens for Responsiblity and Ethics in Washington] CREW received a truly remarkable response from the Department of Veterans Affairs (VA) to its Freedom of Information (FOIA) request for documents relating to the VA’s abhorrent practice of under-diagnosing PTSD in veterans to save money. According to the VA, CREW is not entitled to a fee waiver -- meaning it has to pay for the costs of finding and copying responsive documents -- because there is no longer any public interest in this issue! Ignoring the wealth of news articles triggered by CREW’s and VoteVets.org's release of an internal VA email and the congressional hearing that release prompted, the VA claims that any records CREW requests “would not reveal anything new.”

(Those VA emails are at the heart of a Federal court case in San Francisco, put on by two veterans' rights groups suing the government over better care.  The judge in the case certainly seems to think they're relevant -- perhaps there are more, and that's why the requests were spurned.  Hey, can they even DO that?  They shouldn't be able to...)

But those don't seem to be the topics we're "alarmed" about -- how PTSD from combat trauma can be so bad it can kill you, and how the healthcare system in place to tend to veterans when they come back needs to do a better job of fully taking care of them.  No, instead we're searching for what amounts to celebutainment, and leaving the weightier matters -- for whom? If not us, who? It better be us, and all of us -- there isn't actually anyone else but us who oughta be caring, and who it concerns.  You don't have to actually put on combat boots to "get" that veterans are being underserved, particularly in the area of healthcare (TBI, PTSD, MST) and benefits (foreclosures! the GI Bill), and that it's up to us to care enough about it, that we do something about it, as a nation.  We CAN do that.  Otherwise, the note scrawled on the white board in the photograph, above, in Iraq, is really going to be our epitaph.  America isn't at war -- we're at the mall.

Editor's Note: Sign the petition for the new GI Bill, here. Love the slogan: "We sent them to war.  Why can't we send them to college?"  Why, indeed.

Another Expert's Quotable Quote on PTSD

A great quotable quote from PTSD expert, Frank M. Ochberg, M.D., who once said: "PTSD is a medical condition.  The most important thing we can do to help our loved ones with PTSD is to be the most informed person on your block about PTSD."

Honor the Dead, but Fight Like Hell for the Living

A suitable slogan to commemorate this past Memorial Day, and not far different from the motto of the Australian Vietnam Veterans Association, "Honor the Dead, But Fight Like Hell for the Living."  If we're ever going to make signficant progress on treating PTSD as a combat injury, that's what we're going to have to do.  And not just for the living, either -- for the ones who died from what they couldn't endure any longer, as well.

War: Is It Glory, or Hell? A Quote from Someone Who Knew

Just ran across this quote allegedly from Civil War general, William Tecumseh Sherman, famous/infamous, among other things, for his "scorched earth" tactics against the Confederate states.  He is supposed to have said, surveying the troops arrayed before him, "There is many a boy here today who looks on war as all glory, but, boys, it is all hell."  Sounds like someone who knew what he was talking about.

The Ballad of Travis Twiggs

I'm personally still reeling from the apparent murder-suicide of USMC SSgt. Travis N. Twiggs and his brother, Will Twiggs, as the cops closed in on them in Arizona yesterday.  (See umpteen shallow news reports for the same basic information, but no explanatory context or any insights as to why.)  Our previous blog entries about Travis Twiggs are here, here, here and here.

While I make my feeble attempt to sort through what is known and what is not, and blog about it later, I'm struck by one comment Twiggs made in the essay he published about his own signficant struggles with PTSD.  The comment is specifically about PTSD:

"I pray that no Marine or sailor, or any service member for that matter, ever has to go through what I went through." -- Travis N. Twiggs, RIP, 5/14/2008.

Superb Writing about a Vietnam Vet's PTSD and Subsequent Nervous Breakdown

GQ magazine has a superb, hauntingly beautiful (and eloquently written) article called "The Long Shadow of War."  The description reads, "As a young soldier in Vietnam, Cecil Ison saw something, something so horrific that he buried the memory of it for thirty years and swore he'd never allow it to surface again.  Then, on March 20, 2003 -- the day after we started bombing Iraq -- the past leapt up and grabbed him."

There's no two ways about it: this is the best writing I've read in years, especially on this topic.  The story is long -- but practically every sentence is a gem.  It covers most of the grand themes surrounding PTSD in really an epic sweep.  There's the Vietnam War itself, always a player; Cecil, the cantankerous Appalachian individualist at the center of the story; his lovely, long-suffering and adorable wife, who loves and attends to Cecil and his various states, and quilts something lovely for him and his brothers about their Vietnam experience; his two brothers who are also battling their own demons from war, but handling it differently; his mother, who sent all three sons off to Vietnam to fight; the VA and its therapists, who minister to Cecil in his nervous breakdown; the countryside, whose silence and remoteness helps nurture Cecil in his darkest times; and finally, the writer, Kathy Dobie, whose talent is just off the charts phenomenal.  (Although it's also a close race with Cecil himself, and his wonderful wry way of putting his life into perspective, when he can, reminiscent of the humor of that 60s icon, Richard Brautigan.)

An example, from Cecil, when Kathy the writer asks him if he's a Vietnam vet:

“Yes, I received a letter from the president of the United States one day,” he said with sardonic cheerfulness. “I was out playing Whiffle ball, just having a wonderful time, and I got the mail and it said, ‘Greetings. Your friends and neighbors have selected you to serve in the Armed Forces.’ At that point, I knew I had no friends and no neighbors.”

As just one small example of the writer's deep psychological attunement and her innate grace with language, she first bonds with Cecil, thinking about his breakdown, by sending him the opening lines from Dante's Divine Comedy: "In the middle of the journey of our life I came to myself within a dark wood where the straight way was lost."  He responds a few days later with, "The mind is a strange thing—how it can paint over harsh images for decades but then for some reason they can emerge as quickly as the bare wood on a whitewashed fence after a rain. (One thinks) this is something that other people experience but not me, until it strikes like a blow from a sledge hammer. You are most welcome to explore my condition. I’m still struggling with the fact that this is a real condition and many, many others struggle with the same thing…"

Dobie is the best writer I've read in I don't know how long, on a topic I absolutely love.  She's the author of a memoir about trauma called, The Only Girl in the Car: A Memoir, a fact which explains some of her sensitivity and emotional depth in the Cecil Ison story.  Apparently she sold that book to the publisher on the strength of the book's "brilliant writing and emotional power."  Fantastic.  What a wonderful treatment of a powerful topic, and a quirky, charismatic "hero."  (His wife is also a hero, and sounds just adorable.)

The Malady Gets a New Name (Humor)

Since there's very little humor to be found on this subject, I thought I would mention this morning's entry.  Looking over the blog statistics to see where this blog is being read, in and amongst the more serious readers, from the VA, the Pentagon, etc., I came across the search string that drew a schoolchild from the New York Public Schools here -- Brooklyn, to be exact.  He or she was looking for stories about "post-dramatic stress in soldiers coming back from Iraq or Afghanistan."  Post-dramatic, indeed.  That's some seriously dramatic stuff the troops have encountered in combat.  Wouldn't surprise me at all if it created trauma.  Cute, funny, but also...true.  Dramatic as in, way more than the ordinary person expects to see or experience.  I think the schoolkid had it right...

Journalism As the First Draft of History

"Journalism is the first rough draft of history" -- attributed to Phil Graham, publisher and co-owner of the Washington Post.

I read this quote for the first time today and just loved it.  In the context of all the good journalism that's come out lately, particularly from the Washington Post and the Boston Globe and NPR, but also CNN and CBS and others, documenting the plight of returning combat veterans and the care they receive (or don't), it's wonderful to know that ultimately what the journalists are doing is writing the first rough draft of history.  In the case of the recent series in the Boston Globe by Charles Sennott, the Globe gave Sennott a year to cover the return of a Marine battalion, the 1/25th, from Iraq -- and really absorb the adjustment experiences of the group, in order to write a full, comprehensive and compelling series of stories about them. 

In the future, we're going to be able to look back on this time as when individuals who maybe didn't have any direct relationship to a returning combat veteran nonetheless got educated, informed, or even become activists for the cause of veterans issues, particularly as they concern aftercare for combat-related injuries, both bodily and psychological.  Wouldn't that be a wonderful turn of events?   Making history is better than reading about it, certainly, but interestingly enough, journalists get to write its first draft.  We owe them a certain amount of thanks for that effort, especially when previously dark areas like veterans' care have the blinding light of public criticism finally shone upon them.  Not everyone looks up to notice how often it was journalists holding the spotlight.