Healing Combat Trauma

"All I Want Is What I Deserve" -- a Soldier's Own Story of Service, Injury and Neglect

Tony Neff is a 22 year old Army veteran, now disabled, who served in South Korea, Kuwait and Iraq.  This Frederick, Maryland native, from a military family, was trained as an arc welder, but is also an excellent, clear writer.  Recently he took the time to write out the story of what happened to him since his injury, and it offers a very compelling, straightforward look at the life of a disabled veteran.

Tony's original injury, while service-related, may not reek of the glory of combat, but his story nevertheless shows how completely life up-ending a disability is in one so young.  It also shows how not getting the care you need in the field, or even afterwards, can result in a progressively worsening condition.  Tony's original back injury, never properly diagnosed or treated, has reduced this big, strapping, and need I re-emphasize, young guy to first a cane, now a wheelchair.  Now back in the U.S., but still being treated by the V.A. system, this weekend he went to the Emergency Room, because he'd lost feeling in his leg.  Perhaps almost as hard, this hard-core truck enthusiast had to give up his beloved Dodge Ram SR10 truck because he couldn't afford the payments.  Really, who could afford anything on the miserly $212 a month Tony currently gets for what seems like fairly complete disability?  Reading his story, you're struck by how, in the civilian world, Tony would have a great case for medical negligence, with the possibility of a jury payout that would far exceed his being able to get his truck back.  In the military, though, no such luck.  Tony now suffers from PTSD, as a result of his combat experience, in addition to his injury, so he's currently undergoing a new round of evaluations for his PTSD disabilty as well.

Take the time to read Tony's story, written in his own words, and see if you don't agree with him that what this soldier wants is only what he deserves.  And with an umpteen billion dollar budget for warfare, can't we find more than a measly $212 a month for this injured soldier?  It's just plain wrong and un-American to separate a man and his truck!  Download tony_neff.pdf

Editor's Note: Tony's pic is up on the Frederick News-Post online, as a hometown hero.  Follow this link to go there.  Tony is also an ardent supporter of the National Fallen Heroes Memorial, and would appreciate your support for that good work.  Click here to follow that link.

Vietnam Veteran Writes His First Person Account of Combat-Related PTSD

John Powers, tireless veterans advocate, recently told me about a book he's been reading, that's now available on Amazon.  The book is "First Person: Combat PTSD," and it's by Rob Honzell, Sr, M.S.  

According to the author, it's a "first person account of my life's journey, before, during and after serving in a Marine Recon Combat unit in Vietnam."  He adds that the book should be of interest to PSTD sufferers, families of PTSD sufferers, professionals treating PTSD patients and clients, and the general public as a whole."  Just to let you know it's out there, and it sounds very relevant.  Click here for the link to the book on Amazon.

One Marine's Slow Realization That He Has PTSD

The Washington Post has a brief article on Sunday by Tom Ricks, about one Marine's return from multiple tours of duty in Afghanistan and Iraq, to find that he has PSTD.  Tom Ricks is famous to many of us as the author of multiple books about being in today's military.  In fact, it's one of his books that inspired Nate Fick to become a Marine -- without which we wouldn't have had the benefit of Fick's excellent book, One Bullet Away: the Making of a Marine Officer.

The Marine Ricks profiles in the short piece is Staff Sgt. Travis Twiggs.  Apparently the full article about Twiggs is available in the January issue of the Marine Corps Gazette.  Ricks writes:

People sometimes talk about the sacrifices made by U.S. troops without grasping just what that means. In the January issue of the Marine Corps Gazette, a Marine infantryman, Staff Sgt. Travis Twiggs, recounts how he slowly came to recognize that he was suffering from post-traumatic stress disorder (PTSD) after serving one tour in Afghanistan and two in Iraq.

While you're visiting the Gazette site, you might want to check out the "Letter on PTSD from MEF Commanding Generals," which we've linked, here.  It wouldn't win any awards for clear, compelling writing -- unlike Ricks' or Fick's -- but it has an interesting graphic at the end, chock full of too much information, which nevertheless calls for PTSD to be treated early, and to be treated like any other injury, without stigma.  That is, if I'm reading the graphic right.  In which case, that's great.

Editor's Note: Tom Ricks is the Washington Post's military correspondent.  He's also the author of Making the Corps (the book that persuaded Nate Fick to become a Marine), and the controversially-titled Fiasco: the American Military Adventure in Iraq.

Don't Make it a Blue Christmas - Veterans, Depression, Suicide and the Holidays

There is a dominant impression that many of us have that suicide somehow spikes at the winter holidays.  Fortunately this turns out to be just a myth -- though there is an increase in suicide after the holidays -- perhaps in part because of the general letdown after a period of increased stress, combined with frequently crummy weather and potentially mounting financial pressure from holiday overspending.  Even if suicide didn't peak anywhere near this time of year, it's still worth looking at what can be done to help people feeling the pressure and stress of the holiday season.  Combat veterans (and their families) face special stresses at holiday times, including increased time with family and friends, often increased exposure to alcohol and drugs, and the special pangs of realizing loved ones -- combat buddies -- are no longer with them or able to celebrate the holidays with their own families (survivor's guilt).

Fortunately there are some decent resources out there for lending a hand.  First off, the generic but helpful ones; secondly, the more veteran-specific ones.

Good, generic advice:

• "Ten Tips for Coping with Holiday Stress" 
• "How to Remain Sober and Healthy During the Holiday Season"
• "Dealing with Grief in the Holiday Season"

An excellent one on "Coping with a Family Member's PTSD During the Holidays;" and

Veteran-specific advice:

• Article by a Vietnam-era vet, who tried to kill himself on his first Thanksgiving back after combat.  He's got a very interesting point of view in this article.  One of the things he says is that since he arrived in Vietnam first on Christmas morning, it was hard for him for years afterward to ever have a good Christmas.  He covers all the big topics from his point of view, including anger, flashbacks/hallucinations, fear, dread, hyper-vigilance, anxiety, intimacy issues, drug and alcohol abuse, avoidance/immersion, sleep disorders, guilt, memory loss/cognitive dysfunction, intrusive thoughts, and depression.  Pretty good stuff, and he definitely can relate.  He also talks about "anniversary reactions," which is another important topic in the discussion of veterans and combat trauma.
• Patience Mason's wonderful advice for veterans and their families.  This is a link to an article specifically on "PTSD and the Holidays," and it's quite comprehensive and excellent.  She also covers the anniversary reaction the veteran may be having, and talks about how to create a healthy balance between who can handle what at the holidays, without fostering resentment and anger between the veteran and his or her loved ones.  Excellent stuff, again from someone who can relate.

Report Calls It "Highest Year Ever for Army Suicides"

USA Today has a story today about how an upcoming report will show that this past year, more Army soldiers killed themseles than ever before.  As the article states, "A total of 109 suicides this year would equal a rate of 18.4 per 100,000, the highest since the Army started counting in 1980. The civilian suicide rate was 11 per 100,000 in 2004, according to the Centers for Disease Control and Prevention [the CDC].

According to Senator Patty Murray, whose office shared the statistics with USA Today, and who is quoted in the article, "The military hasn't erased the stigma surrounding mental health issues, so troubled soldiers often do not seek help."  "I want to say I'm surprised...But when we're not doing everything we can to deal with mental health, when we know the Army is under such stress, it's not a surprise. It has to be a wakeup call."

(Although honestly, we should be well past wake-up call on this one.)

The article also mentions efforts the Army has made to combat the problem, including "mandatory training for every soldier about mental health and establishing a program to study its suicides."   However, a troubling angle to the whole suicide phenomenon is this one -- "Research released by the Army in August shows that almost 70% of suicides in 2006 were spurred by failed relationships."

Meaning, the soldier was already under significant stress, and the death of a key relationship just piled one more stressor on, and became the proverbial "straw that broke the camel's back."

If there's a concept like "total load" with mental health issues, it could very well be that ordinarily, people are capable of handling "only so much" stress, and when more gets added to the pile, it's hard not to topple under the strain.  Each person may have their own "breaking point," whose relative location changes regularly, according to how much stress they're under, or how much support they can count on (in addition to a number of other things.)  We're also talking about a younger military here than in years past, including many who didn't expect to be signing up for such extended tours, or possibly even war in the first place (okay, they should have considered it, but many did not).  Reservists in particular -- I can think of several people I know who joined to get better civilian benefits, and weren't remotely thinking they'd end up serving in Iraq or Afghanistan.

It will be interesting when more data comes out, and is studied in greater depth, to also take a look at prevalance of suicide, and see what else it's linked to.  There's already some concern, backed up by studies, that PTSD affects some troops more than others, and suicide would seem logically to follow those same trends.

In the meantime, thanks to Patty Murray for being a great supporter of veterans.  As a longtime Washington state resident, I remember her first being elected to office, and being derided and dismissed during the campaign as a "mom in tennis shoes," whose background as a teacher didn't qualify her for anything political.  As her background material indicates, she's the daughter of a disabled World War II veteran, and she's turned out to be an ardent veterans supporter, and the first woman to serve on the Senate Veterans Affairs committee. 

For media coverage on the great things she's done to support veterans, read the lower half of this page from her Senate website.  As one Seattle newspaper describes her, she's a "workhorse, not a showhorse" -- and thankfully a very committed veterans supporter.  We need more.  (This link to Project Vote Smart shows her voting record.)

Editor's Note: In related and current news, read the transcript of Todd Bowers, IAVA's director of government affairs, remarks as he testified before Congress yesterday on the topic of veterans suicides.  The transcript of his remarks is linked here.

Military Psychologist Faces Own Combat Trauma

The military publication, the Voice of America, has an article today called, "Combat Psychologist Treats Trauma, and Deals with Her Own," about Heidi Squier Kraft, who served as a Navy psychologist at the combat hospital in Al-Asad, Iraq, and has recently published a book about her experiences called, Rule Number Two: Lessons I Learned in a Combat Hospital.  Here's what the basic information about the book is:

Book Description
When Lieutenant Commander Heidi Kraft's twin son and daughter were fifteen months old, she was deployed to Iraq.A clinical psychologist in the US Navy, Kraft's job was to uncover the wounds of war that a surgeon would never see.She put away thoughts of her children back home, acclimated to the sound of incoming rockets, and learned how to listen to the most traumatic stories a war zone has to offer.One of the toughest lessons of her deployment was perfectly articulated by the TV show M*A*S*H: "There are two rules of war. Rule number one is that young men die. Rule number two is that doctors can't change rule number one." Some Marines, Kraft realized, and even some of their doctors, would be damaged by war in ways she could not repair. And sometimes, people were repaired in ways she never expected. RULE NUMBER TWO is a powerful firsthand account of providing comfort admidst the chaos of war, and of what it takes to endure.

About the Author
Heidi Squier Kraft spent nine years as a psychologist for the US Navy before leaving active duty in March 2005. She lives in San Diego with her husband and children.

Click here for a link to the article in the Voice of America.  The article is a little surfacey, but still worth reading, about the special considerations of a trauma care provider who's also exposed to the same trauma in combat.  If you want to read more about women troop's experiences in the Iraq war, try also Band of Sisters: American Women at War in Iraq, by Kirsten Holmstedt.  And if you want to read a book about a combat doctor's time in Iraq, read the aptly-titled, On Call in Hell: A Doctor's Iraq War Story, by Cdr. Richard Jadick, or A Doctor Looks at War: My Year in Iraq, by Michael C. Hodges.  Those books aren't necessarily going to focus much on combat trauma, but at least they're tangentially on the topic.  And if you just plain miss M*A*S*H, there are a couple of cool items on YouTube: a tribute to the show, with a great choral version of the theme song, Suicide is Painless, playing in the background; and a straight-up acoustic guitar version of the song which is also wonderful, below: 

"Listening is an Act of Love" -- Book & Project

Just in time for the holidays -- when families and friends traditionally gather to spend gobs of potentially boring OR bonding (and sometimes, both!) times with one another -- here's an idea whose time has definitely come.  Listening is an Act of Love is a new book by Dave Isay, as part of the national StoryCorps Project, which encouraged average citizens to tell their stories to interested others, who recorded them and assembled them for future listeners, in no less than the Library of Congress, so they'll be available to all Americans.  Here's what some impressive people had to say about the project:

"Dave Isay's vision of collecting the everyday stories of Americans is so simple and yet so powerful. Listening Is an Act of Love will make you laugh, cry and think. These stories come from the souls of individual Americans. Collectively, they are who we are as a people. You cannot read this book without feeling proud of your country." -- Former U.S. Senator Bill Bradley

"StoryCorps asks Americans to reflect upon their experiences, their times of travail, their achievements. In so doing, these individuals create an encompassing national narration: a people's hopes, fears and aspirations, all rendered poignantly to attentive listeners whose respect has enabled, finally, a presentation of a people's mind, heart, soul." -- Dr. Robert Coles, James Agee Professor of Social Ethics, Harvard University

"This book is absolutely remarkable. Listening is an Act of Love is history in the richest sense of the word, the kind that makes people feel like they count. It's a celebration of the lives of the uncelebrated. In our world today people feel helpless, but once they speak of their lives they become alive! This is what our country is all about. Never has a book been more timely or necessary."  -- Studs Terkel, prolific writer and master oral historian.

Here are three ways to get involved: 1) buy copies of the book, for yourself and to give as holiday gifts this season.  2) interview some people you know who might have stories to tell -- get them talking about the stories only they can tell, and record them for posterity, too, as part of this project.  Details on how to do that at the StoryCorps Project website, linked here.  (Don't force anyone to talk about anything they don't want to, but be a receptive, inquisitive audience for those who do.)  3) go to a book signing of the author, whose book tour is about halfway complete at this point.  Details on the book tour linked here.

Some background information about StoryCorps:  StoryCorps is an independent nonprofit project whose mission is to honor and celebrate one another’s lives through listening.  By recording the stories of our lives with the people we care about, we experience our history, hopes, and humanity. Since 2003, tens of thousands of everyday people have interviewed family and friends through StoryCorps. Each conversation is recorded on a free CD to take home and share, and is archived for generations to come at the Library of Congress. Millions listen to our award-winning broadcasts on public radio and the Internet. StoryCorps is the largest oral history project of its kind, creating a growing portrait of who we really are as Americans.

Editor's Note: The book title itself is interesting.  Sounds a little bit like the Paul Tillich quote we wrote about earlier, here, that the "first duty of love is to listen."

More Coverage on "New England's Own" Readjusting to Life after Combat

Emily Rooney, from WGBH -- Boston's public television station -- does a great piece interviewing Charles Sennott, from the Boston Globe, who spent a year covering a battalion of Marines' return from Iraq, and Sgt. Mark Wills, one of the Marine reservists, from the same battalion. Both Sennott and Wills are a great interview, and highlight various issues, pro and con, about readjustment issues, including combat trauma; and Rooney does a nice, pleasant, competent job talking to them about their experiences. Excellent, informative stuff about veterans issues -- well worth watching.  Click here for the link.  Click here to read the earlier blog entry that mentions Sennott's excellent, recent series in the Globe, called "A Promise to Keep."  One additionally interesting factoid is that the Marine battalion that Sennott profiles, the 1/25th, is almost entirely made up of reservists, whose issues can be slightly different on returning, because they typically only see each other about once a month, unlike active duty.

(For a multipart series on the same battalion's homecoming and aftermath, focused more on the injury and recovery of Cpl. Patrick Murray, see the series in the Providence Journal-Bulletin, linked here.  That includes video as well.)

If you want to see the other excellent videos from the Sennott series in the Globe, "A Promise to Keep," including "Coming Home," "The Roulette Wheel of Death," and "Moving On," check out the earlier blog entry, linked here.  Kudos to the Boston Globe for giving Charles Sennott a year to follow this story and do it justice, and to Emily Rooney, for doing a great job, too, highlighting the work in a much shorter amount of time.

Nate Fick's Inspirational Stance on Veterans Care

Last year around this time I had the pleasure of meeting Nathaniel Fick, author of the stupendous One Bullet Away: the Making of a Marine Officer.  (Here he is at the Marine Ball at the Harvard Business School, where he is an MBA candidate, signing a few copies of his book.)  Whenever I think of combat trauma, I think of how inspirational Fick's own words on the subject were.  Writing in an article in the Boston Globe from August 28, 2005, entitled, "Coming Home...to What?" Fick wrote about the need to take veterans' psychological health seriously on their return from combat, possibly even mandating screening for combat trauma/PTSD.  Said Fick at the time:

The screenings are only one step in the long process of reintegrating combat veterans, but mandating them would correct a dangerous oversight and better serve both veterans and the communities where they live. To have value, though, the screenings must be done right.  Members of the active-duty forces are already subject to post-deployment mental evaluation, as are the National Guards of several states. These screenings often involve little more than filling out forms.

I remember slogging through my own mental health questionnaire after leaving Iraq, answering questions such as ''Did you ever feel that your life was in imminent danger?" Yes.  Or ''Check all that apply: I saw the dead bodies of a) enemy combatants; b) American forces; c) civilians; d) all of the above." D.

Answers like mine should have prompted some sort of follow-up, but none came.

Psychological screenings in a vacuum are worse than a waste of time because they give a false sense that someone has been ''cleared." The main lesson of my experience is that the recovery process takes time, and healing only happens in community. Screenings can be gateways to those communities, both formal ones such as therapy groups and counseling sessions, and the informal networks of friends, neighbors, and colleagues with whom we live.

In a war whose burden is borne almost exclusively by the tiny minority in uniform and their families, veterans' care is one place we can all make a difference."

Nate Fick's book, One Bullet Away: the Making of a Marine Officer, is well worth reading, as is the rest of his writing.  But most of all, I appreciate his inspirational stance on veterans issues -- that taking care of veterans really is the second half of the social contract, if the first half is sending them off to war on our behalf.

Writing Down the Bones

If you're in the San Francisco/San Jose Bay Area this weekend, you might think of attending the Mindfulness & Writing Retreat, led by Maxine Hong Kingston, Wendy Johnson, & Therese Fitzgerald to be held Friday, November 9th through Sunday, November 11th at the Ben Lomond Quaker Center, in Ben Lomond, CA.  For further information, contact the Community of Mindful Living, at (831) 338-8026.  There's a Zen Buddhist / silent meditation retreat component to this, but my understanding is that it's also about veterans and writing out the painful experiences they've endured, to the degree they feel ready or interested in doing so.  The cost is under $200 for the three day retreat, and the accommodations are intentionally fairly bare-bones.  And it sounds like it's an annual Veterans' Day weekend event for Maxine Hong Kingston and the writing group of veterans.

Maxine Hong Kingston's recent book, an anthology of pieces by veterans and interested others, is called Veterans of War, Veterans of Peace. It's the winner of the 2007 Northern California Book Reviewers Special Award in Publishing, and was recently featured in a special by Bill Moyers on PBS.  The publisher, Koa Books, calls it "a harvest of creative, redemptive storytelling—nonfiction, fiction, and poetry—spanning five wars and written by those most profoundly affected by it."  And Moyers says, ""No one I know personally has done more to help veterans themselves bear witness to unspeakable experience than Maxine Hong Kingston."

For more than twelve years, National Book Award-winning author Maxine Hong Kingston has led writing- and-meditation workshops for veterans and their families. The contributors to this volume—combat veterans, medics, and others who served in war; gang members, drug users, and victims of domestic violence; draft resisters, deserters, and peace activists—are part of this community of writers working together to heal the trauma of war through art. On Friday, May 25, 2007, Bill Moyers Journal on PBS featured Maxine Hong Kingston and Veterans of War, Veterans of Peace.

Reading their words, we witness worlds torn apart then rebuilt. This epic and timely work is the distilled wisdom of warriors and their loved ones, expressing themselves with breathtaking artistry and truth.  Maxine Hong Kingston’s books—The Woman Warrior, China Men, Tripmaster Monkey, The Fifth Book of Peace, and others—have won critical praise and national awards. President Bill Clinton presented her with a National Humanities Medal in 1997.

John (Super) Powers, Friend of Vets

John Powers is the singular driving force behind something truly amazing, called "the Resource Guide for Veterans," now available for download in PDF form on his exceptionally thorough website, Operation Vets, linked here.  (Be sure you have a copy of the free Adobe PDF Reader before attempting to download.  You can get that here.) 

The focus of the Veterans' Guide is on Rhode Island, the smallest state in the country, although the structure of it could be expanded to cover every state in the entire country -- let's just say, we can imagine all of them need one!  John, a recent college graduate, worked on the Guide for over a year, and the work he did is both comprehensive and totally original --to the best of our knowledge, there is no other guide in the U.S. like this.  The quality of the work that John did -- before he even began the graduate degree program in social work that he's now enrolled in -- was a true "labor of love," inspired by a veteran friend of John's from high school days, who'd gone on deployment and come back troubled.  John Powers was recently profiled by Vietnam veteran and journalist Bob Kerr in the Providence Journal Bulletin.  Read the original article here.  Wherever John goes in life, from this point forward, he's already done some of what anyone else would consider their best work, in a lifetime of effort.  In honor of the upcoming Veteran's Day, be sure to check out both John's site, and his superlative guide.  John is a true, though young, hero and authentic "FOV" -- "Friend of Veterans."

(If by chance you happen to be on Facebook, check out the group called "From Combat to Campus: Vets in School," that we recently started together, to give veterans who are in school for the first time, or back in school after deployment, some resources and ability to connect with one another.  That's the non-profit commercial interruption.  Now back to the regularly-scheduled program.)

Here's what John has to say about his site:

Operation Vets was created in July 2007. The ideas and the resource guide I created began in October 2006. After graduating from high school in June 2002, one of my childhood friends went off to the Marines as I enrolled at the University of Rhode Island. When he came home for Operation Enduring Freedom in 2005, I saw how war can drastically affect a persons life. The transition from soldier to civilian was not easy for him, nor was it easy for all of our returning soldiers.

I wanted to learn more about combat, the effects of being in war, the effects it has on the families back home and more importantly I wanted to find out how I could help and truly “Support our troops”. I began reading, writing, and researching all the resources available to soldiers and families. I realized the Department of Veterans Affairs (VA) system was being overloaded with new veterans filing claims, for physical ailments, combat stress injuries, anxiety, depression, post traumatic stress disorder, the list goes on. The process of filing claims through the VA system can be stressful and time consuming.

As I found out through talking with soldiers coming back from War, they don’t need anymore stress than they already have to deal with. I fully understood that not only are the soldiers affected, but the families are directly affected as well. They need support and help just as much as the returning soldiers do. If soldiers and families don’t get the help they need it could have devastating affects on the soldier, the family, the children, and society in general. Our country is undoubtedly in a time of War and politics rule the news stations. I am trying to take the politics out of the equation and focus on our soldiers, our veterans, and their families.

Soldiers stories need to be heard, wounds need to be healed, regular civilians need to get involved and our country needs to unite just like it did after the attacks on 9/11. I refuse to allow our returning soldiers to “slip” through the cracks as many have, since returning from Iraq or Afghanistan and even Vietnam. These soldiers served our country and it’s time we serve our soldiers.

Read other blog entries we've done about John and his commitment to veterans here and here.

No One Who Goes, Comes Back Unchanged

In the category called, "Something Good We've Been Missing," here's a story we entirely missed, in an online publication called "GOOD," which profiles a number of veterans and their experience in wartime. Again, apolitical coverage -- just a little consciousness-raising that the vast majority in this country is sorely in need of, about what it really means to go to war.  It's a photo series, with commentary, introducing us to a number of "typical men and women" who served in combat.  Their stories, and the photos that accompany them, are compelling.  Do yourself the favor of acquainting yourselves with these cool Americans.  The pull quote alone that introduces the article,tells the story: "One-and-a-half million Americans have served in Iraq and Afghanistan. Not one of them came home unchanged."  In the introduction to the article, Paul Rieckhoff, Executive Director of the Iraq and Afghanistan Veterans of America, writes:

The statistics are shocking: more than 11,000 soldiers have been wounded by roadside bombs; more than 50,000 have sought treatment for post-traumatic stress disorder; and 150,000 have submitted a claim for disability. Undiagnosed brain injuries—serious concussions that can cause memory loss, vision problems, and even depression—are affecting as many as 300,000 troops who have come home.

But when you look at the numbers, it’s easy to forget that they represent individual stories: lives put on hold, families under strain—above all, tremendous personal sacrifice.

He also says, compellingly,

I’ve found that the faces of the troops tell us the most about the war. Their eyes reflect their pride in their service, pain at the loss of friends, and the memories that linger long after they return home. In a way the numbers simply can’t, the faces of combat veterans bring the reality of a distant war home. That’s why images like these are so important; they remind us that “the troops” aren’t some abstraction to be supported by a bumper sticker or a catchphrase. The troops are America’s sons and daughters, a diverse group, coming from all parts of the country and every walk of life.

This is great writing, with heartfelt concern behind it, as impetus.  There's kind of a harsh joke circulating lately, with its origins in a photo on a wall in Ramadi, Iraq, that says, in paraphrase, "America isn't at war -- the Marine Corps is at war.  America is at the MALL."

As we get ready for Veteran's Day in America on November 11th, it's not a bad idea to prepare for it in our own hearts, by actually giving a damn about those who served, not only in these wars but in previous ones as well, and what their quality of life is like now.  "Support our troops" can and should become more than just convenient lip service.  It could become heartfelt concern and caring, and best of all, for the veterans' sake -- actual constructive action on their behalf.

Blogged Reports from Brown Conference

For those of you who like me are crying salty tears about missing what sounds like it was a stupendous conference at Brown University in Providence, Rhode Island over the weekend, here are a couple of first-person reports from the same blogger about what the conference was like to attend. It really sounds fantastic.  I still wish I'd been able to go.  (Sigh.)  (The conference was on first person narratives coming back from the war in Afghanistan and Iraq, featuring many of the authors who wrote them, as well as interested others.)

First person report about the events of the first day; first person report about the events of the second day.  (Referencing those blog posts here does not imply an endorsement of the rest of the blog's contents -- I'm particularly interested in, as I hope you would be, the impressions from going to that conference itself.)

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If you've never seen "The War Tapes," by Deborah Scranton, one of the featured speakers at the conference, now might be a good time to try to find it on DVD.  Scranton is a filmmaker who put video cameras in the hands of various New Hampshire National Guard members, as the war in Iraq was beginning, and asked them to record what they saw, with the permission of their superiors.  What came back was some interesting footage, which she put together into a documentary that covers how three "regular guys" go to Iraq and get changed by the experience.  I saw the film at one of its first screenings on Cape Cod last year, met one of the featured participants, Sgt. Steve Pink, and really was impressed.  Apparently Scranton was a live wire at the conference, and one of it's most interesting participants.  (Here's a link to Scranton's blog, which includes a link to buying the DVD.) (The movie has since gone on to win a number of awards, including "Best Documentary," Tribeca Film Festival, and "Best International Documentary," BritDoc Festival.)

More Good Reads on Healing from Combat Trauma / PTSD

Continuing the theme from the previous post, on more good reads becoming available on recovering from PTSD and combat trauma.  Remember, we've re-organized our book lists.  Therapeutic titles on the left hand column; first-person narratives -- great for understanding what combat veterans went through -- on the right.  Now back to the list of new additions to our combat trauma and PTSD recovery bookshelf:

Nam Vet: Making Peace with Your Past, by Chuck Dean.  Dean is one of the co-authors, with Bridget C. Cantrell, Ph.D., of Down Range: to Iraq and Back, with a foreword by Lt. Col. Dave Grossman, U.S. Army (Retired), author of On Killing and On Combat.  Nam Vet gets some great reviews from Amazon.  Click here to follow the link.  Dean was one of the first paratroopers sent into Vietnam in 1965.  From the book descriptin: "Although the Vietnam War officially ended in 1975, it still rages in the lives of thousands of veterans and their families. This book not only tells why so many Vietnam veterans suffer from flashbacks, depression, fits of rage, nightmares, emotional numbing, and broken relationships, but it offers solid answers and gives hope. It reveals the way to peace on the subject of post-traumatic stress."

Another story from a Vietnam era veteran:

My Tour in Hell: A Marine's Battle with Combat Trauma, by David W. Powell.  More good reviews on Amazon.  From the editorial reviews: "Powell articulates the healing process very well and has given a tremendous gift to the veteran community of any generation." -- Fr. Phillip G. Salois, National Chaplain, Vietnam Veterans of America.  "This book provides a first-person account of how combat trauma evolves and is a testament to Traumatic Incident Reduction." -- Judy Bronson, PhD, LCSW.

and this one from the wife of a Vietnam veteran, whose PTSD drove him to suicide:

Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War, by Penny Coleman.  This reasonably unsung book got a starred review from in Booklist, from the American Library Association -- a group who we can assume has seen a few good books in their time ;-).  From their review:

Coleman was once married to a Vietnam veteran who committed suicide rather than live with his horrific war memories, and she asserts that the military hasn't learned the most important lesson of all the last century's wars, that the chance of becoming a psychiatric casualty, of killing oneself due to untreated post-traumatic stress disorder (PTSD), is greater than that of death by enemy fire. Some contend that there have been more Vietnam vet suicides than there are names on The Wall. The risk seems even higher for those serving in Iraq, where the army reports a suicide rate three times greater than normal within its ranks. How does Coleman know the lesson she points out hasn't been learned? For starters, the aforementioned army reporting doesn't associate the suicides with combat but instead blames "underdeveloped life coping skills." Further, Coleman cites many reports and experts substantiating that the military downplays the psychic toll of modern combat and routinely denies veterans' requests for psychiatric medical intervention. Punctuating this alarming presentation is a heavily researched history of what was once called shell shock and the tragic, in-their-own-words stories of 12 women, each of whom is a surviving relative of a Vietnam veteran who committed suicide.

and several specifically therapeutically-oriented titles (a bit more expen$ive, too!):

Haunted by Combat: Understanding PTSD in War Veterans Including Women, Reservists, and Those Coming Back from Iraq, by Daryl S. Paulson.

and these (the following ones will cover PTSD and therapeutic approaches more generally -- in other words, not specifically for combat veterans):

Experiential Treatment for PTSD: the Therapeutic Spiral Model, by M. Katherine Hudgins.

Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies, edited by Edna M. Foa.

and

The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms, by Mary Beth Williams.

Empathy versus Sympathy

It was interesting to read in Kimberly Dozier's story on NPR recently, one comment that she made about empathy versus sympathy.  We've talked about that before on this blog, somewhat obliquely; and it was nice to hear the same sentiment expressed by another.  Dozier, you'll remember, is the CBS news reporter who was seriously injured in a car bomb explosion in Iraq.  She recently published an op-ed piece in the Washington Post, simply entitled, "War's Wounds Need More Study," a topic she could speak about from intimate experience.  In the question and answer session that followed, here's one interesting snippet of what she had to say::

On a personal note, I hate sympathy, thanks, and so do the injured troops I've met. Makes my stomach turn. Empathy is welcome, however, and appropriate for anyone injured in that conflict, whatever any of us think about ...it....

(Click here to read the NPR story; or listen to the audio file.)

What is it about those two words that makes them so different?  Language arts teachers would probably say it has something to do with the difference between connotative and denotative meaning.  What the words literally mean is one thing -- denotative -- but it's the accretion of context that's changed them in our ears, so that when we hear them, we hear something different - perhaps the difference between compassion and pity?  "Sympathy" is basically, "I feel sorry for you," emphasis on "I" (the 'me').  Empathy has come to mean, "I'm sorry with you," emphasis on "you" (the 'other').  There really is a difference.  Some say, as Dozier's comment underscores, that it's a difference you can actually feel.

Veterans Helping Other Veterans

Watch the public service announcement, PTSD is implied, from the National Veterans Foundation, featuring Dan Lauria.  Short and sweet, in the sense of being brief and to the point, constructive and helpful.  The NVF is staffed by veterans, for veterans, and has a toll-free number, available 24/7. That toll-free number is 1-888-777-4443.  The NVF calls itself "The Lifeline for America's Veterans".

                                                                     

Good Video about PTSD and Re-Adjustment

William R. Keating and the the Norfolk County District Attorney's office in Canton, Massachusetts has put together a wonderful, 10 minute video that's on YouTube about what PTSD is, to raise awareness about the struggles that returning combat veterans may be going through.  The video is ten minutes long; and while it's completely good and effective at what it does, it would be even better if it were the first in a series about the challenges veterans face in readjusting to civilian life.  However, in ten short minutes, it manages to cover many of the issues, show veterans where help can be found, and put a relatable, human face on the topic of PTSD and combat trauma.  Good for Massachusetts -- it makes me proud to be from there.  The title of the video is the fairly generic, but still cool "PTSD and Veterans: Beyond the Yellow Ribbon."  Special thanks to the Norfolk County DA's office for taking the time to make this video available to the public.

(Note: Don't worry -- the video isn't just some guy talking -- it's pretty comprehensive.  They just picked an odd still to illustrate it with.  And while its focus is current returning vets, there is a wide selection of veterans interviewed in the video, including those from previous wars.)

British Soldier Wins Award for Speaking Frankly about Combat Trauma / PTSD

There's a fantastic article in the British paper, the Guardian, today entitled, "You Can Teach a Man to Kill, but Not to See Dying," by Mark Gould.  (The Guardian, for those who don't know it, is a superb newspaper that frequently wins awards for its design and content, including the National Newspaper of the Year, given by the British press association.)  This article is about an ex-soldier who served in the Falklands War, winning a national mental health award for speaking "frankly and forcefully on the mental distress of war veterans."  You can listen to him talk about combat trauma (called "combat stress" in the UK) in the audio clip here, but be sure to come back and read the article as well -- it's wonderfully written and full of great, quotable quotes from the ex-soldier himself.

The award-winning ex-soldier, Chris Duggan, a Welshman, is remarkably forthright about his experience - what caused it, how far down he spiralled, and what eventually helped pull him back out.  At least in America we've given very little consideration to wars like the Falklands conflict, and even the more recent Gulf War, in which we participated, when it comes to combat trauma.  There's an overall sense that if the conflict didn't go on "that" long, how bad could the experience have been?  Perhaps especially when contrasted with wars that dragged on for years.  However, depending on what the combatants experienced, their pain and suffering is equally raw.  Duggan does a superb job of telling the truth about his own experience, and it's great to see the work won an award.  He also mentions, positively, the group "Combat Stress," which provides assistance to soldiers in the UK who've experienced combat trauma or PTSD.  We blogged about them earlier, in March of 2006.  Click here for that blog entry.

Duggan is refreshingly blunt and candid about his experiences, which is part of what makes it so worth listening to.  And he has some unforgettably graphic quotes -- deservedly so -- about combat trauma and its effects on the human mind and body.  Three cheers to Duggan and the British mental health awards for responding so positively to truth-telling from a veteran. 

Today's Vets Owe Debt of Thanks to Vietnam Vets

Another interesting article that was circulated widely on the Web a while back is this seemingly open letter to veterans from a Marine office reservist serving in Iraq.  The letter was allegedly first published in the Veteran of Foreign Wars publication, "Reveille," and was written by USMC Major (now retired) Brian P. Bresnahan.

Biographical note: Brian P. Bresnahan is a 1992 graduate of UNL and a (retired) major in the United States Marine Corps Reserve who lives near Benedict, Nebraska. A veteran of Operation Iraqi Freedom, Maj. Bresnahan was stationed eight miles west of Fallujah during 2004.  He writes in his letter:

"A guy gets time to think over here and I was thinking about all the support we get from home. Sometimes it's overwhelming. We get care packages at times faster than we can use them. There are boxes and boxes of toiletries and snacks lining the center of every tent; the generosity has been amazing. So, I was pondering the question: "Why do we have so much support?"

In my opinion, it came down to one thing: Vietnam. I think we learned a lesson, as a nation, that no matter what, you have to support the troops who are on the line, who are risking everything. We treated them so poorly back then. When they returned was even worse. The stories are nightmarish of what our returning warriors were subjected to. It is a national scar, a blemish on our country, an embarrassment to all of us.

After Vietnam, it had time to sink in. The guilt in our collective consciousness grew. It shamed us. However, we learned from our mistake. Somewhere during the late 1970's and into the 80's, we realized that we can't treat our warriors that way. So, starting during the Gulf War, when the first real opportunity arose to stand up and support the troops, we did. We did it to support our friends and family going off to war. But we also did it to right the wrongs from the Vietnam era. We treated our troops like the heroes they were, acknowledged and celebrated their sacrifice, and rejoiced at their homecoming instead of spitting on them.

And that support continues today for those of us in Iraq. Our country knows that it must support us and it does. The lesson was learned in Vietnam and we are better because of it.

Everyone who has gone before is a hero. They are celebrated in my heart. I think admirably of all those who have gone before me. From those who fought to establish this country in the late 1770's to those I serve with here in Iraq. They have all sacrificed to ensure our freedom.

But when I get back, I'm going to make it a personal mission to specifically thank every Vietnam Vet I encounter for their sacrifice. Because if nothing else good came from that terrible war, one thing did. It was the lesson learned on how we treat our warriors. We as a country learned from our mistake and now treat our warriors as heroes, as we should. I am the beneficiary of their sacrifice. Not only for the freedom they, like veterans from other wars, ensured, but for how well our country now treats my fellow Marines and I. We are the beneficiaries of their sacrifice.

Semper Fidelis,
Major Brian P. Bresnahan
United States Marine Corps

Three Gifts You Can Give Returning Veterans That Will Last a Lifetime

Three gifts that you can give returning veterans that will last them a lifetime, so says USMC Brigadier General Timothy C. Hanifen, 2nd Marine Aircraft Wing (Forward), are the following: "understanding," "support," and "affirmation."

Writes Hanifen:

The combat phase of the campaign in Iraq is winding down [this was first published in February of 2006] and now the hardest job of all begins-winning the peace. Soon many of our fellow citizen-Soldiers, Airmen, Sailors, Marines and Coast Guardsman-both active and reserve will return home with their units or as individuals. All have served and participated in an extraordinary campaign of liberation that was fought in a manner that reflected not only the determination of the American people to do what was necessary but also reflective of our value to spare life whenever and wherever possible.

As these veterans begin returning home and people are asking themselves what they can do to celebrate their return, honor their service and remember those that have fallen in the performance of their duty. After every war or major conflict, there are always concerns about the emotional state of returning veterans, their ability to readjust to peaceful pursuits and their reintegration into American society. People naturally ask themselves "what can we do or what should we do?" The purpose of this message is to offer that there are three very important gifts that we personally and collectively as a society, can give to these returning veterans. They are "understanding, affirmation and support".

With "understanding", I am not speaking of sympathy, empathy, consoling or emotional analysis.  Rather, I offer that we, to the best of our ability, need to comprehend some of the combat truths learned and experienced by these returning servicemen and women. Their perspectives and their personal experiences will shape each of them and our society in large and small ways for years to come. Though we were not there, our comprehension and respect for their "truisms" will be part of the gift that will truly last them and us for a lifetime.

The truth every combat veteran knows, regardless of conflict, is that war is about combat, combat is about fighting, fighting is about killing and killing is a traumatic personal experience for those who fight. Killing another person even in combat, is difficult as it is fundamentally against our nature and the innate guiding moral compass within most human beings. The frequency of direct combat and the relative distance between combatants is also directly proportional to the level of combat stress experienced by the surviving veteran. Whether the serviceman or woman actually pulled the trigger, dropped a bomb or simply supported those who have, I've yet to meet any veteran who has fought and found their contribution to or the personal act of killing another human being particularly glorious. Necessary-Yes. Glorious or pleasurable-No. In combat, the veteran must psychologically distance themselves from the humanity of their opponent during the fight. The adversary becomes a target or an objective or any number of derogatory epithets that separates "them from us". Combat becomes merely business-a job that has to be done, part of your duty and killing-a necessary result. It's a team job that needs to be done quickly, efficiently, unemotionally and at the least cost in lives to your unit, to innocents and with the most damage inflicted in the least time to your adversaries. Then you and the team move forward again to the next danger area and fight. The only sure way home is by fighting through your opponents as quickly and efficiently as possible. Along the way you quietly hope or pray that your actions will: be successful; not cause the loss of a comrade; the death of an innocent; or that you'll become one of the unlucky casualties yourself. You stay despite your fears because the team-your new family of brothers or sisters, truly needs you and you'd rather die than let them down. You live in the moment, slowly realize your own mortality and also your steadily rising desire to cling to and fight hard for every second of it. You keep your focus, your "game face" on and you don't allow yourself the luxury of "too much reflection" or a moment's "day dreaming" about home, loved ones, the future or your return. You privately fear that such a moment of inattention may be your or worse, because of you, a comrade's last.

So if I may caution, please don't walk up to a combat veteran and ask him or her if they "killed" anyone or attempt well meaning "pop" psychoanalysis. These often-made communication attempts are awkward and show a lack of understanding and comprehension of the veteran. They also reveal much about the person who attempts either one. Instead, please accept there is a deep contextual gap between you both because you were not there. This chasm is very difficult to bridge when veterans attempt to relate their personal war experiences. Actual combat veterans are the one's least likely to answer the question or discuss the details of their experiences with relative strangers. Most likely they will ignore you and feel as though they were truly "pilgrims" in a strange land instead of honored and appreciated members of our Republic. So accept and don't press. One note of personal caution for your awareness- If a combat veteran does answer or appear to openly revel in the number of adversaries they've personally slain then they either haven't or they are likely part of society's 2% sociopaths. In either case, I would recommend you beware and quietly distance yourself. Their enthusiasm and behavior are not normal for a true combat veteran. But here is what you can do. Don't ignore them or the subject. Please feel free to express your "gladness at their safe return" and ask them "how it went or what was it like?" These questions are open-ended and show both your interest and concern. They also allow the veteran to share what they can or want. In most cases, the open door will enable them to share stories of close friends, teammates or some humorous moments of which they recall. Again, just ask, accept but don't dig or press.

The second gift is "affirmation". Whether you were personally in favor of the war or against it no longer matters at this point. As a Republic and a people we debated, we decided and then we mustered the political and societal willpower to send these brave young men and women into combat in hopes of eventually creating a better peace for ourselves, for the Iraqi people and for an entire region of the world. More than anything else, the greatest gift you can personally give a returning veteran is a sincere handshake and words from you that "they did the right thing, they did what we asked them to do and that you are proud of them". We need to say these words often and the returning combat veteran truly needs these reassurances. Also please fly your flag and consider attending one or more public events with your families as a visible sign of your support and thanks. Nothing speaks louder to a returning veteran than the physical presence of entire families. Those Americans attending these events give one of their most precious gifts-their personal time. Numbers matter. Personal and family presence silently speaks volumes of affirmation to those you wish to honor.

The third gift is "support". Immediately upon return there will be weeks of ceremonies and public praise applauding the achievements of the returning units and their veterans. But the pace of life in America is fast and it will necessarily move rapidly onward towards the next event. Here is where your support is most needed to sustain the returning veteran and you can make the most difference in their lives for years to come. Continue to fly your flag. If you are an employer, then simply do your best to hire a veteran who is leaving service or if he or she was a Guardsman or Reservist, welcome them back to a new job within the company. All reserve personnel know that the economic life of the company has continued in their absence. It has to do so in order for the company to survive and prosper. They also know it is likely their jobs have since been filled. Returning veterans are always unsure whether or not they will find or have employment upon return. As an employer, if you can't give them an equivalent job because of downsizing then extend them with your company for three to four months so they can properly job hunt. Please take a personal interest in them and their families and use your extensive list of personal and professional contacts to help them land a better job-even if it is with one of your competitors. The gratitude they will feel for you, your personal actions and your company is beyond words.

For everyone else, the greatest gift you can give to continue support will take 10 seconds of your time. In the years to come, if ever your paths cross with one of the hundreds of thousands of veterans of this or any other conflict, then simply shake their hand and tell them "thanks" and that "they did a great job!" Your words show you understand, you affirm their service and you continue to support them. Teach your children to do the same by your strong example. Though veterans may not express it, every one of them will be grateful. If this message rings true with you, then let us each give these returning veterans these three gifts that will truly last them a lifetime.

(This article has been published in a number of places on the Web, but I first ran across it in a posting on MarineParents.com, from 2/24/2006.)

How Do Veterans Want Us to Listen to Them?

As the Christian existentialist philosopher (how do you combine those two widely divergent concepts in a single sentence, or a person? Ahhh, never mind) Paul Tillich once said, "the first duty of love is to listen."  The question of the hour should be, how do returning combat veterans from Afghanistan and Iraq want us to listen to them?  What would that be like? Undoubtedly, with compassion, concern, empathy over sympathy, nonintrusive listening versus active probing, and certainly, without judgment.  As we learn more, we'll share it.  Undoubtedly many veterans (especially from Vietnam, and others who have been home a while) will have ideas on how best to listen and care.  On what listening would look, feel, sound like to them.

Good Compassion and Bad Compassion - Worry

There's such a thing as "good" concern for others -- compassion -- and "bad" concern -- worry.  One of the most interesting explanations for this somewhat obscure or initially hard to follow concept is here, in 365 Tao, by Deng-Ming Dao.  He writes, "Worry is an addiction that inferences with compassion."  And explains it further:

"Worry is a problem that seems to be rampant.  Perhaps it is due to the nature of our overly advanced civilization; perhaps it is a measure of our own spiritual degeneracy.  Whatever the source, it is clear that worry isn't useful.  It is a cancer of the emotions -- concern gone compulsive.  It eats away at body and mind."

So if that's what bad compassion is, and we've taken a look at what good compassion can be -- how do we manifest this best with the veterans in our lives, either personally or as a community among whom veterans live?  For this, we turn to combat veterans for their own advice.  And thank you for providing it, to those who only hope to understand.

Here's a great description from Bay Area poet and Vietnam veteran, Ted Sexauer:

We will soon be welcoming home the first of another generation of emotionally damaged veterans. Many will have trouble relating to people who have not seen what they've seen.

How shall we honor them without endorsing the inhumanity that all war -- including this war -- embodies? They will need deep understanding. If you know returning veterans, don't press them with probing questions, but give them room to talk. Listen even when they tell you things you don't want to hear. Let us, if we can, move beyond "us versus them" thinking.

(Sexauer, who is now a peace activist -- though that's not the point of his inclusion here -- is one of the veterans whose work is featured in the anthology edited by Maxine Hong Kingston, entitled Veterans of War, Veterans of Peace -- listed in our sidebar, and featured in a recent Bill Moyers documentary on PBS.)

Film on PTSD from "Saigon to Baghdad"

The Nevada News, a publication of the University of Nevada at Reno,  had an article this week entitled, "The Battle Continues: Life after War," about the screening of a social work graduate student's documentary film about veterans and PTSD, called "Saigon 1965 to Baghdad 2007.P  The film by Michial Nolan examines Post Traumatic Stress Disorder (PTSD) in veterans from previous wars (i.e., Vietnam) in the context of delayed activation or reactivation of PTSD as a result of the current war in Iraq.

Says the article:

Nolan’s film depicts service personnel experiences in Vietnam, the Gulf War, Afghanistan and Iraq. Two veterans will attend the screening to talk about their experiences. One gentleman will talk about his journey to self-discovery over the last 40 years.

“In conducting the research to produce my film, I found that many veterans from wars other than the war in Iraq were experiencing a reactivation of PTSD based off of images they saw via media,” Nolan said. “In 1999 there were 90,000 cases of PTSD reported. By 2004 that number had increased to 161,000. The projected cost of treating this condition over the last 40 years is between $350 and $700 billion.”

Based on a suggestion from University of Wisconsin professor Craig Werner, Nolan included music in his film to assess PTSD reactivation in Vietnam veterans based on popular music listened to during that time. Some of the songs included are “Another Saturday Night,” by Sam Cook, “Lodi,” by Credence Clearwater Revival, “A Little Help From My Friends,” by Joe Cocker as well as “Chain of Fools,” by Aretha Franklin.

“I want veterans to know that I appreciate their service and have a commitment to understanding the impact war takes on them,” Nolan said. “The film came together so well; I can’t watch it without being moved.”

John Powers - Student Advocate for Veterans

In the spirit of Abraham Lincoln and caring for his brother in the field (and beyond), here's an item about a fellow American who's making a difference, not just on his university campus, but in a much broader field.  About a month ago, we published a blog entry here entitled, "John Powers -- Whoever He Is, Rocks!" -- which was essentially following up on a great story by Bob Kerr, Vietnam veteran and journalist, in the Providence Journal Bulletin.  Click here for a link to Kerr's original article, for as long as it stays up on the Web.

Since then, we've had the pleasure to get to know Powers, as well as read more of his writing about veterans issues, a topic about which he's clearly passionate.  Powers just started graduate school in Rhode Island this fall, and his guide to veterans resources in Rhode Island is about to be published.  But if you want to know more about where his commitment to veterans comes from, read this quite moving article online at Orato.com, about why as a recent college graduate, new grad student, and foremost private citizen, he's also a Veterans Advocate.  Here's the link.

If you're on FaceBook, Powers has several veteran-related interest groups, as well as a his own website, through which you'll shortly be able to order copies of his veterans resource guide (primarily focused on Rhode Island resources.) 

Helping the Warrior to Make Peace (with Himself or Herself)

Catching up on some items worth noting -- here is an Interesting blog post from back in May, by an Anglican priest - referencing the well-known. British World War I poet, Wilfred Owen.  The blog entry focuses on helping the warrior to make peace within, and is well worth reading, about the effects of war on the soldiers who fight them, from a spiritual perspective.

Veterans Write Out the Trauma of War

An interesting weekend, to be sure.  Got to meet Maxine Hong Kingston, and hear a panel from the book she recently published, Veterans of War, Veterans of Peace, at a book festival in Northern California.  Apparently Maxine Hong Kingston, a prolific and gifted author, National Book Award winner, and longtime UC Berkeley professor, has been leading a writing group for veterans for the last 15 years.  Out of the group has come the recently-published book, which she and panel members read from - selections of prose and poetry that capsulates the veterans' experiences of combat and beyond.  The incomparable veteran journalist Bill Moyers interviewed Maxine Hong Kingston about her work with veterans in a special showing of his program around Memorial Day of this year.  The program is found in its entirety on the Web, by clicking this link.  You can read the transcript of the interview here.  The book is available from Amazon here.

The program was interesting, the veterans' selections from their own writings were moving, and Ms. Kingston is the epitome of both soulful and completely adorable in person.  More to follow on what the veterans actually said.

Watch HBO's "Alive Day Memories: Home from Iraq"

BTW, now that HBO has shown its excellent special, "Alive Day Memories: Home from Iraq," you can watch the entire film on its website.  Here's the link. 

Well-deserved props to HBO, James Gandolfini, and everyone involved for getting this vital story out there.  Realistically, the film shows nine or ten people's valuable stories -- but nine or ten out of the more than 27,000 military who have been injured in Afghanistan and Iraq, so far.  That's almost 30,000 people coming home and needing to cope with the massive adjustments to their lives, families, living accommodations, pride, and dreams for the future.  And it's just the beginning of the adjustments -- there's a long road ahead.  Let's hope we still are giving this topic the compassionate, effective treatment it deserves in another few years -- and from here on out as well.  The vets, and their families, deserve it.

"Alive Day Memories" on DVD in October

"Alive Day Memories: Home from Iraq" -- the sure-to-be-spectacular HBO documentary, scheduled to show this Sunday evening at 10:30 p.m. -- is also scheduled to be released on DVD on October 23, 2007, according to Netflix.  Click this link to learn more about the documentary, and to read the stories of some of the individuals interviewed by James Gandolfini for the film.  Watch the entire ALIVE DAY MEMORIES special on HBO.com beginning Sunday, September 9 at 11:30pm, immediately following the premiere.  Read the interview with executive producer James Gandolfini here.

"Alive Day Memories: Home from Iraq" on HBO

HBO will air a documentary called "Alive Day Memories: Home from Iraq" next Sunday, at 10:30 p.m.  Check their schedule for more details.  This was the description on HBO's website:

A new generation of veterans is returning from Iraq. For these survivors, two days will forever memorialize their lives: their birthday and their Alive Day--the day they narrowly escaped death. This HBO Documentary Films production presents the first-person stories of ten Alive Day heroes as told to Emmy®-winning actor James Gandolfini. From a conflict that has left more than 25,000 Americans wounded, the film explores the physical and emotional cost of war through the simple, heartbreaking words of ten young soldiers who survived near-fatal wounds while serving in Iraq. The stories are augmented by harrowing footage from the war-torn streets of Iraq.

Today's San Jose Mercury-News (San Jose, CA) has an article about one of the soldiers profiled in the documentary, and his struggles after injury (though not particularly PTSD/combat trauma).

"Iraq Never Leaves Us" - PTSD & the Military

The Department of Veterans Affairs PTSD Information Center website has a presentation on it these days called "Iraq Never Leaves Us," by Bob Page, Chief Petty Officer, U.S. Naval Reserve.  Here is a link to that presentation.

The VA website says that "In this presentation, Bob Page shares his story to provide the viewer with an “up-close and personal” view of “What’s it like over there?” in the combat theater of Iraq via his personal photos. NOTE: This special feature is not a course, but instead a story of one veteran's experiences."

Women Combat Vets and PTSD

NPR has a story today on "All Things Considered" about the special hardships of women combat vets, and how they're often at risk for the dual assault of PTSD and sexual trauma from their combat experience.  This story illustrates that gender differences can exist in how men and women experience PTSD. 

Patient Advice for Those "Home from War"

Patience Mason, author of one of the finest post-Vietnam era books on healing from combat trauma and PTSD (see sidebar), has released a wonderful article on her blog about how to handle coming "home from war."  She directs readers to the PDF copy of the article if they'd like to read it in its most legible form.  That article is linked directly here, from her publishing company, Patience Press.  If you want to learn more about Patience Mason (and you should!), here's a link to more information she's provided.  Her book, Recovering from War, is one of the seminal works on combat trauma and its effect on veterans and their families alike.  Well worth reading and well worth familiarizing yourself with.  Patience is often said to be a virtue - but this Patience is also a very important ally for veterans and families in recovering from PTSD.

PTSD: The Hardships of Homecoming

A reporter colleague turned us on today to a series of articles she'd written in the Herald News of West Paterson, NJ recently, profiling a soldier and his family having difficult re-adjustment issues back from the war with untreated PTSD.  The two-article series draws a vivid and compelling picture of the difficulty of life back on the home front, for both the combat veteran with PTSD, and his immediate family, who often bears the brunt of re-adjustment turmoil.  The first article in the series is linked here; the second is linked here.  The reporter, Andrea Gurwitt, does a great job painting a picture of the hardships involved: the scene at the child's birthday outing at Chuck E. Cheese is particularly poignant.

"Suffering Caused by the Sheer Horror of War"

Dr. Gene Bolles (see previous post) talks at length about the reactions of injured military under his care to what they had seen and heard, and conveys in a compelling way the debilitating nature of what vets have undergone in wartime.  Bolles was the chief surgeon at Landstuhl Regional Medical Center in Germany for several years during the current Iraq war, and he says that his unique position as a civilian, not a military leader, allowed some of the injured to confide in him what they were really feeling about what they'd seen and done, without fear of repercussion.  Bolles talks about that, and more, in the linked article, from a politically biased (but nonetheless interesting) website.

Many, many things Bolles says stand out.  Almost too many to list, conscientiously.  See what stands out to you when you read it.  He sounds like a very reasonable, very experienced, and very compassionate individual who himself is bearing the burden of such an onslaught of trauma.

"Sh*t, Meet Fan"

Independent "journalist" Jay Shaft has been passionately pursuing a cause of his own recently, sharing the trials and tribulations of troops who apparently got quite a bit more than they bargained for, when they signed up to go to Iraq or Afghanistan.  Shaft, who paints himself as a counter-culture revolutionary with little obvious background in conventional journalism, nevertheless claims to have interviewed military members with bad attitudes about the war, extensively, and shares their letters in some of his writings. (The article in question is "Letters from Iraq, Part I.")  It's tempting to apply the expression, "like watching a train wreck," to the letters he produces.  They are written by people on the verge -- and sometimes seemingly past -- full emotional collapse.  They don't want to be in war, they're fully traumatized by what they've seen and done, and they feel like no one is listening to their pain.  Shaft is.  (Can that be his real name, or is this a bad sixties reference?  Can you dig it?!)  And Shaft is equally hell-bent, and more power to him, on making sure those voices get heard.  Now, for whatever its worth, the only we became aware of Shaft's work was through a website based in New Zealand.  Maybe what he's saying is just too radical for the American media to pick up.  Not really sure.  But his compilation of outraged cries for help is highly worth reading, if only to sensitize us to what it feels like to be somebody who really doesn't want to be there, well after the fact they've figured that out, and for whom war has become true personal and psychological torture of the self.  The scary sensation in Shaft's writing is that we're encountering people with fullblown PTSD symptoms, and they're frequently still very much in the military, contemplating anything, including sadly suicide, as a way to get out.  These people are desperate, and Shaft is giving them a voice -- their own.  Not to be missed, for the sheer power of the content.  It's like listening to real-time interviews with passengers on the Titanic as they drown.  Very intense stuff.  So far Shaft's work is the most radical we've read, about how participants feel about the war when it's lost its appeal for them, to put it mildly.  It'll be interesting to see whether Shaft's work will be discredited or sought out.  In either case, he's a radical man on a radical mission -- and it'll be worth watching to see what comes of it.

A Wounded Warrior Speaks

The L.A. Times recently carried an Op-Ed piece from Lt. Col. Timothy Maxwell, a severely injured Marine who wanted to speak out about his experience of going, as he put it, from the "A Team" (before injury) to the "B Team" (after injury).  Frequently in this war we hear of people who in a previous war might have died, their injuries were so severe; but thanks to their stronger, protective armor, or faster battlefield care, or any combination of that and sheer luck, some wounded manage to survive what otherwise would have been certain death.  Lt. Col. Maxwell is one such person.  HIs injuries were devastating; and his aggressive stance, post-injury, to do whatever takes to get back to health is impressive and laudable.  But even with the phenomenal focus, willpower and drive he brings to the situation, Maxwell has to admit, it's no easy job being injured, or coping with the feelings of failure and frustration that arise when a great deal of your career self-esteem is tied up in your physicality and ability to perform.  Since no one can do a better job capturing that sense than someone actually going through it, Maxwell's op-ed article is well worth reading.  It's also great to see that in Maxwell's future plans are caring directly for other injured military, and making sure they and their families get what they need to survive what can be a very long, very tiring battle of its own: the battle back to health and wholeness.  Read Maxwell's piece - it's highly recommended.  And he pulls no punches about what an easy task getting well is going to be, for him or any of the other injured.

Max Cleland, Decorated Vietnam Vet and Former VA Head, Has Combat Trauma

There's a very interesting article from the April 3rd issue of Salon, by Max Cleland, Vietnam era triple amputee, and head of the Veteran's Administration under President Jimmy Carter.  Cleland worked hard to establish VA medical centers across the country and to establish the diagnosis of PTSD.  In this article, he reflects on his own experience with the Vietnam war, and the concern he feels over what Iraq veterans are experiencing in combat and afterwards.  And he makes a very telling admission, about how combat trauma has affected him, even decades later:

"I go to Walter Reed Hospital now for trauma counseling. For my own self. Because it never ends. I've got post-traumatic stress disorder. Didn't know I had it. Anxiety and fear and all that crap. And it never goes away. But you can submerge it into a higher cause like politics.

"So here I am, back at Walter Reed, thirty-seven years later, dealing with the trauma of Vietnam. I never got the counseling back then. But I look down the hall, and it's still 1968. Seeing all these young Iraq War veterans blown up, missing arms and legs and eyes, I just can't stand it. It triggers all of my stuff from Vietnam. And these young men had the same grit and courage that we had going off to war. You go up to 'em, and say, "How ya doing, son?" "Fine, sir!" they answer. But years later, it will take its toll. They just don't know yet."

A link to the full article is here.

Also in the article, Cleland remarks about the declining budget dollars available to fund crucial VA services, like counseling for returning vets and their families.  Says Cleland, "Looking back on my career, I am proud of being the Veterans Administration head and dealing with the aftermath of the Vietnam War, in particular, putting together the program for veterans' centers, which deals with the emotional aftermath of war for veterans and their families. Thank God for that program, because it is being swamped by a new crew of Iraq War veterans. They are dealing with depression, anxiety attacks -- stuff like that.  We have created a quarter of a million Iraq War veterans. In Vietnam, we had eight and a half million veterans.  We are adding to that quarter of a million number every day.

"Walter Reed is swamped with bona fide casualties.  Particularly amputees. The VA is swamped. They don't have enough resources. Senator Craig, a hard-core Republican from Idaho who is on the Senate Armed Forces Committee, admitted that the VA medical program was about a billion dollars short. The private counseling program is where it is most short. That is what ought to be beefed up. With all these Iraq War veterans coming home, their families will also need counseling."

The Personal Narratives of War

One of the points that Patience H.C. Mason makes in her groundbreaking book about working with veterans of the last big war (Vietnam), is how important it is to get a feel for what the war was actually like to go through, even if the veterans in your life don't seem to particularly want to talk about it right now.  Patience, whose husband is a Vietnam vet and author of the famous war memoir, "Chickenhawk," spent a hefty first third of her book describing the Vietnam war through veterans' eyes.  Today, there is a wealth of "personal narratives" or "eyewitness accounts" of what it's like to have gone through the current wars of our era, whether the Gulf War, Afghanistan, or Iraq.  Part of establishing a compassionate understanding of what veterans' trials and tribulations really have been, besides an attitude of intentional listening, is to familiarize yourself with just what they've actually been through.  An online search at Amazon or your local library system, online, specifically for "personal narratives -- Iraq war," for example, should yield as many as 30 books to read.  For some of the authors who've written these books, the writing process alone was cathartic -- a way to process the burden of what they've experienced.  Reading those same narratives might turn out to be cathartic as well.  It's the opposite of escapism -- grounding yourself in what someone else has gone through, so you can attempt to care about it and them more constructively.

Paddling the Canoe Without Tipping It

The inimitable Chaplain John Morris, quoted in the equally inimitable Pine Journal of Cloquet, Minnesota, as it wraps up its four part series on returning veterans, called "The Long Road Home," had these highly quotable things to say, in an article published today:

“Going into combat is a little like canoeing across the lake of life,” said Morris.  “When you leave for war, it’s like standing up in the canoe and upsetting the balance of family life.   While you’re gone, your family takes over the paddling, but when you return,  you’re likely to jump out of that canoe and flip it, swamping it.  Many families have been faced with bailing out that canoe, and they suffer extreme duress over something they thought would be joyful.  A lot of families can become exhausted from paddling that canoe through life.”

"He encouraged returning soldiers to seek whatever help they need so they can make a successful adjustment back into the life of the community.  And if the community is committed to helping them, he said, that period of readjustment faces a much greater chance of success."

The article also concluded that it was wiser for "anyone seeking advice and direction ... to contact any of these resources rather than to try to “tough it out” on their own. (The resources are very Minnesota-specific, but the concept is good overall).  Kudos to the Pine Journal on a truly excellent, yet homespun series of practical, well-written articles, that should be a guide for other papers nationally to do the same.

Soldier Describes the Emotional Burden of War

A decorated Army Iraq veteran, with a master's degree, shares the pain he feels:

“I am a man who carries the emotional scars of tragedies that have befallen me.  From my initial activation for the World Trade Center disaster, to my deployment to Iraq in 2003.  Seeing so much destruction and death, and having lost friends in both catastrophes changes a person.

I don’t go out and have wishes of committing violent acts, nor do I see apparitions.  I just have developed very little tolerance for ignorance and unsophisticated thinkers – who believe that all soldiers are trained just for killing, and that there is no compassion for human life.  If you know someone who’s been over to Iraq, please remember one thing: he or she is not the same, and it’s a burden in their lives that they were there, and what the saw.  Show your love and support, and never turn your backs on them.”

Jonathan Shay Quote

"If military practice tells soldiers that their emotions of love and grief -- which are inseparable from their humanity -- do not matter, then the civilian society that has sent them to fight on their behalf should not be shocked by their "inhumanity" when they try to return to civilian life." (In, "The Importance of Thwarted Grief," p. 67, in Achilles in Vietnam, by Jonathan Shay, M.D., Ph.D.)