The signature wounds of the “War on Terror” are ones not readily visible to the human eye; the disability resides in the mind and body of the soldier and the complexity that is the human brain. Many times these wounds of warfare do not rear their ugly heads immediately, but can manifest when warriors return to their lives in America. Traumatic Brain Injury and Post Traumatic Stress Disorder are the hidden injuries and the new battlefront for military health care professionals.
As the military forges onward into a new century with a streamlined military arsenal, the Department of Defense and Veterans Affairs must now zero in on the complex and unpredictable world of mental health issues.
The science of mental health treatment varies with each recipient and the hidden battles combat veterans fight on a daily basis upon return need to be uncovered in order to restore faith and ensure the health of the military’s readiness for future battles.
While watching the battles unfold on cable news can be compelling, so too are the stories of these everyday heroes who battle physical therapy for visible and invisible injuries. The glamour may be on the battlefield, but the compassion plays out everyday as veterans overcome the odds and stare down the demons of war.
The real war stories
For those who serve during wartime often enter the military knowing full well what may lie ahead. The gritty courage of soldiers, their determination and their love of country makes America’s all-volunteer armed forces the best in the business. If the U.S. wishes to guarantee this tradition the military must keep its promise, as the Surgeon General says Navy Medicine - “World Class Care…Anytime Anywhere” for the military and families of returning warriors.
When soldiers are hurt in the line of duty, they often refer to their injury as “Alive Day” – meaning they are breathing and the hard work of recovering begins anew. A different battle must be waged, one that will test their inner courage and tenacity for life.
One such story comes from the book “Hidden Battles on Unseen Fronts.” The book details many stories of these brave soldiers who must face a new enemy – their own bodies.
For Army SPC Walter Blackston it would be that fateful September day that would result in his call to duty from the Army Reserve. His real-world experiences lent much needed improvements in the way communications were handled for Medevac crews in the Middle East. His confidence and skill garnered him multiple medals and citations while on duty.
However, a week before Blackston was to return home he went out to pick up injured servicemen from a Black Hawk helicopter crash. The chopper went down in the middle of a field, unfortunately for Blackston the large field would be filled with landmines and on his way back to his vehicle with injured soldiers, Blackston’s partner took a bad step- the blast killed the soldier, Blackston survived.
He was stitched up and told to have his injuries checked out when he returned stateside in a week. As it turned out that week-long wait would cost the Army Reservist major nerve-damage in his arms. Blackston would require multiple surgeries for the next three years on his arms and spine – he would also discover symptoms of PTSD and TBI after he recovered from the visible injuries.
Not only did the Army Reservist fight for his life while he received treatment at Walter Reed Army Medical Center he overcame the horrific living conditions at the infamous Building 18. (It was not uncommon to hear military personnel complain of mold, cockroaches, rats and robberies on a regular basis.)
This led to a low point in SPC Blackston’s life. He attempted to commit suicide twice unaware that his yet to be diagnosed TBI was worsening by the day.
As he described, nearly three years later the Army released Blackston and declared him fit for duty, despite the fact that he was treated for PTSD for more than a year. “The scarring was so terrible. The skin had healed like a web under both my arms but they only rated me 20 percent disabled,” he explained.
From this moment Blackston’s life spiraled out of control and he explains there were times when he didn’t know where he was and there was no job waiting for him. Oftentimes it is the wait for VA benefits to kick in that does the soldiers in. First Blackston drained his savings, and then he borrowed money from his family and finally maxed out his credit cards. He lost his house, his car, his fiancée and “his mind.”
While waiting to receive his benefits, Blackston was finally diagnosed with TBI. With the discovery of the new problem he realized his fate was increasingly in his own hands. The benefit folks at the VA were not sympatric to Blackston’s dilemma and asked him to move home with his parents at the age of 47.
However, he was having none of this. Out of frustration he demanded to see a VA supervisor. Once the supervisor entered the room, Blackston removed his shirt and shouted “this is what I live with every day.” The supervisor off the VA was humbled and apologized.
The goal was not to make someone feel sorry for him, but give him the tools he would need to get back on his feet. This episode resulted in a 90 percent disability rating and the new beginning he was looking for. His new paycheck would be $2,500 per month, only a portion of what he made in the private sector, but a start. (Since that was a service-connected injury incurred in combat I question why VA does not counsel these individuals to be reevaluated by DoD as they are probably entitled to a full DoD military disability retirement in addition to their VA benefits. These additional funds from DoD would give Blackston approximately $1,500 tax-free, plus all the benefits that come with a military retirement.)
The Army Reservist’s proactive role in his recovery has given himself the tools needed to go on. He admits thoughts of suicide still come and go, but his new found faith in God has given him the strength he needs to get up everyday.
Although Blackston’s symptoms of TBI are still persistent his commitment to therapy pushes the ball closer to the goal line. “I just want to lead a fruitful life…It’s all on me. And if I had one thing to say to vets like myself it would be, ‘We earned the right to be proud of who we are.’”
Stories like these are not uncommon with the Operation Iraqi Freedom and Operation Enduring Freedom veterans. What the military should be embarrassed about is not that these guys come home battered and broken, but the treatment or lack thereof for these volunteer forces.
Not only do they give their body and minds for this country if they are injured they often lose their families in the process. The romantic notion of World War II (albeit the men in WWII died on the battlefield and didn’t survive catastrophic injuries the “War on Terror” soldiers are now surviving) when men went to war and came home to adoring significant others, is less likely. Today’s soldiers face a myriad of hidden injuries, loss of income and find themselves in the bureaucracy health care.
Self-assessment of PTSD is not working
In the private sector if a patient is diagnosed with a psychological ailment they are given a battery of tests by a trained professional in the mental health field. When soldiers return from the warzone they are given a questionnaire “self assessment” to determine their mental state.
The screening questions revolve around the traumatic events they faced on the battlefield; “Have you had nightmares about it or thought about it when you did not want to? Have you tried hard not to think about it or went out of your way to avoid situations that reminded you of it? Are you constantly on guard, watchful or easily startled? Do you feel numb or detached from others, activities or your surroundings?”
Approximately 30 percent of the armed forces questioned about mental health last year reported having some trouble acclimating to life stateside. Of these numbers the VA doesn’t have the clinical practitioners needed to treat all the returning soldiers.
This is where the Department of Defense and VA need to open up all available resources, including TRICARE and allow returning soldiers to get treatment, with state-of-the-art remedies from the private sector. It has been estimated that treating PTSD within the military ranks would take approximately three years. And just as there’s more than one way to skin a cat, there is more than one way to treat PTSD.
As of 2009 the VA trained more than 1,200 mental health providers while the DoD has more than 600 mental health clinicians for the delivery of PTSD treatment.
Currently the military relies on multiple pills to alleviate mood swings. The soldiers take uppers, downers and sleeping tablets. One veteran even admitted he was taking up to 40 pills a day and still he wasn’t improving.
It wasn’t until this veteran found Dr. Rick Levy, a clinical psychologist who specializes in mind-body medicine, did this soldier’s quality of life improve. For those who are open to alternative treatments, they can obtain sanity without heavy drugs. After years of medicated treatments, Dr. Levy was able to use psychotherapy and clinical hypnosis as a method to abate PTSD and curtail other medical problems that often require medication.
With all the tools from Dr. Levy, the veteran was able to reduce his pill count to just three. He now leads a productive life. Once he learned the story behind the story, this soldier was able to regain control over his life with clinically guided meditation.
While this treatment may not work for everyone, the military needs to accept alternative methods of treatment for PTSD to ensure the mental health of all our military personnel.
I know best
From day one armed forces are taught to think about the mission first, their unit second and themselves last. So when the mission is complete, military personnel are sent home and the questionnaires presented many soldiers don’t answer openly or honestly for fear they may break the military code.
Take Army Second Lieutenant Sylvia Blackwood-Boutelle. She was called to duty and would serve in Iraq. She would be serving on the front lines as a reporter for the military. Her ability to report the news alongside Time magazine and the New York Times was exciting to Boutelle. The only caveat the military expected was for her to report positive stories.
Upon her return home to her family Boutelle was asked to take the PTSD questionnaire. She exhibited positive factors on her first assessment. She displayed all the symptoms for PTSD; however she was having none of it. She asked to retake the test. She admitted later that she had answered every question differently because she didn’t want to ruin her career.
“I’m a high-energy person. I figured I could deal with it myself,” Boutelle explained. This method of dealing with her emotions landed her back in Iraq until she couldn’t stay busy enough to push the PTSD aside.
Her emotional state continued to unravel without professional treatment. Once she realized she needed therapy she reached out and overcame the stigma associated with PTSD. “You have to get ‘team you’ together. You can’t be afraid to ask for help,” Boutelle said.
She remains in the Army and hopes to pursue a writing career when she finishes her PTSD treatment.
The sad truth of warzone trauma
In the words of Dr. Joseph, Roshi, MD, PhD, “Ours is a disposable culture; our children, our elders, our ill and infirm…are often ignored, overlooked, forgotten or mistreated.” He goes on to explain the impacts of war are legend and the invisible wounds radiate deep and wide into a person’s life.
Dr Roshi also believes Congress can’t fix the problem by simply throwing money at it. The real fix will come in the form of effective treatment for mental health issues, for the soldier and their family. Inside the broken mind a soldier can provide immeasurable strength, he says. “Resilience runs deep, but its resources need to be nurtured,” Roshi said. “It is like a seed that has been buried in a disaster; it needs tending, attending.”
Another doctor, Mitchell Tepper, PhD, MPH admits changes need to be made in the mental health care arena.
“Our service members get some of the nation’s best medical and physical rehabilitation services, but access to mental health services is both limited and often ineffectual, as it is in the civilian health care arena. We need to work more aggressively to identify and get into treatment those struggling with depression, combat-related stress, PTSD and mild brain injury.”
To that end, Dr. Roshi concludes that families affected by the side-effects of war also need to gain mental health care treatment to ease the burdens associated with care-giving duties and sporadic behaviors related to TBI and PTSD symptoms.
There are countless stories like these across the country. Many service members are able to cope with the extreme environment that war presents and those soldiers are to be commended for their service to America.
But for those who come back with major injuries, nightmares, amputations and the inability to return to a normal life, the U.S. owes those more. They given up their quality of life, many lost their significant others to divorce while others taken their lives. For the ultra- tormented soldiers who turn to drugs and alcohol to suppress their fears and depression, the DoD and VA need to do more.
America is built with the courage of those who serve in the armed forces; they should never feel like they let anyone down or take their own lives because they fail to receive adequate treatment. The men and women in uniform must be treated with respect and dignity.
In a world filled with movie stars, professional athletes and comic book superheroes – Americans should always remember the true heroes are the unsung leaders in the military, their guts, candor and determination to serve proudly should be the benchmark by which children look to when it comes to heroes they can believe in.
References and organizations that focus on veterans
Give an Hour- founder Barbara Romberg focuses on national network of mental heath professionals who provide free mental health services to U.S. troops and their families.
VA Suicide Prevention Hotline- Focuses on military veterans in immediate trouble.
Polytrauma Transitional Rehabilitation Program- Located at the Minneapolis VAMC, this program focuses on the TBI and PTSD issues that accompany major trauma.
Rick Levy, PhD- is a licensed psychologist in private practice who is the leading pioneer in mind-body medicine. His groundbreaking work has garnered him media exposure on Prime Time, FOX News, ABC and other print publications.
Dissemination and Training Division of the National Center for PTSD- located in the VA’s central office in Palo Alto Health Care System. Studies based on evidence-based psychotherapies.
Come Home Project/Deep Streams Zen Institute- Dr. Joseph Bobrow Roshi, MD, PhD. Focuses on alternative treatment for TBI and PTSD issues.
The Sexual Health Network, Inc. and SexualHealth.com- This organization deals with the sexual issues that accompany major trauma, TBI and PTSD. These conditions can dramatically impair a person’s capacity for intimacy.
Veterans Education Project- A group that trains veterans to share their stories and life lessons with classrooms and communities. The group also supports military families to provide support for veterans and educate others on the issues troops face on their long journey home.
For more stories; http://www.examiner.com/examiner/x-10317-San-Diego-County-Political-Buzz-Examiner