A few months ago, a debate began in military and veteran circles that may continue for years: Whether the Purple Heart, traditionally reserved for awarding to those killed or wounded in battle, should be extended to include also "invisible wounds" of battle, like PTSD. There are no easy answers.
Said an article at the time, in the Wall Street Journal:
"The dispute reflects a broader question roiling the military: Can psychological traumas, no matter how debilitating, be considered equivalent to devastating physical wounds?
Supporters of awarding the Purple Heart to veterans with PTSD believe the move would reduce the stigma that surrounds the disorder and spur more soldiers and Marines to seek help without fear of limiting their careers.
“These guys have paid at least as high a price, some of them, as anybody with a traumatic brain injury, as anybody with a shrapnel wound,” Dr. John Fortunato, who runs a military PTSD treatment facility in Texas, told reporters recently. Absent a policy change, Fortunato told reporters, service members will mistakenly believe that PTSD is a “wound that isn't worthy.”
Opponents argue that the Purple Heart should be reserved for physical wounds, as has been the case since the medal was reinstituted by Congress in 1932. Military regulations say the award should go to those with injuries “received in action with an enemy.” Some opponents also note that PTSD can be faked, which can't easily be done with a physical wound.
“The Purple Heart was meant to be a badge of honor to show you were wounded in battle,” said Bob Mackey, a retired Army lieutenant colonel who fought in the first and second Iraq wars. “I've been in combat three times. There's stuff I've had to deal with. But it's substantially different from being physically hurt.”
Mackey said the biggest difference is that some veterans may be diagnosed with PTSD even if they never saw combat or fought an enemy – requirements, historically, for receiving a Purple Heart."
Military.com also conducted a poll on its website about the issue (see graphic), and only about 1/3 (33%) of the respondents voted "yes" to awarding the purple heart for PTSD. 58% voted "no," and another 9% rode the fence, saying "perhaps" -- but only if PTSD were diagnosed in the war zone, which really affects far fewer people.
The IAVA's Ray Kimball wrote a good op-ed piece at Military.com in favor of expanding the award -- that's linked here.
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The more you talk with veterans who have PTSD, the more you realize how long the effects can be -- vets who are still struggling mightily with events that occurred 40, 50, sometimes even 60 years before (as well as a lot more recently than that.) The sheer extent of the suffering, to me, puts this allegedly "invisible wound" on a par with ones that can be more clearly seen. Though seriously, I bet if you ask a knowledgeable spouse or family member, the so-called "invisible" wound of PTSD is fairly easy to "see" in the the effect its had on the life of the veteran, and his or her family. Studies like the one conducted on Vietnam veterans in Australia even shows residual effects on family members of veterans with PTSD into the second generation. It may be "invisible," though I don't think it particularly "is," but it's certainly also "the gift that keeps on grieving," as one veteran so aptly put it.
It's weird and a tad unpleasant to see a divide developing (or perhaps the divide was always there, and is just now being articulated) between those with external and internal injuries -- especially since the ones injured externally seem to be the ones "pooh-poohing" the validity of the more internal injuries. Then, of course, there are those who've suffered both kinds. Max Cleland comes to mind, the former Secretary of the VA, who decades after Vietnam learned he had PTSD, in addition to his obvious physical wounds as a triple amputee -- we blogged about him, here -- as do some other veterans who have unfortunately passed on. Perhaps we need to hear more from those veterans who understand both types of injuries, and learn which side they argue in this debate.
Typically, suffering begets compassion -- people can be fairly un-feeling about topics they've yet to have experienced personally, discounting motives and pain quotients alike -- so who better to understand which types of wounds really "count" than those who have cruelly suffered both? My guess is it's going to be from this corner that the rest of us learn how to more properly weight the stunning, substantial and frequently lifetime effects of this so-called "invisible wound" we refer to as PTSD.
