Tuesday, November 25, 2008


I'm so far from expert on the subject that I probably ought not bring it up. But I read this article this morning, about a four-star general revealing his psychological difficulties on returning home from Iraq (to a base right down the road from here). Despite increased awareness of the problem, it's my impression that there remains, in the military, denial at best and denigration at worst, aimed at those who suffer combat stress. So I admire the guy for putting it out there. As far as I know, he's the first flag officer to do so.

I'm certain there's a broad spectrum, and the extremity of one's experience must be the biggest factor; but there's preparation, support, and maybe internal mechanisms for coping, all of which affect the ultimate outcome. That there should be residual mental effects of spending time at war ought not to be surprising. In fact, I'd say it ought to be assumed in all cases. We ask people -- especially the young and less-than-fully educated -- for a year or so to abandon civilization, to learn to kill, to accept "collateral" casualties, to live in constant touch with death and the possibility of death; and then we expect them to return home and resume normality like putting on a pair of pants.

In Vietnam, I had it relatively good. I never held a rifle (when I flew, I had a pistol in my survival vest, along with a silk cloth printed in several languages with a guarantee of reward in return for help, and a rubber-sheathed hacksaw, suitable for hiding where the sun don't shine), always slept in a bed, ate warm food. Dubbed -- for cause -- "Rocket City", Da Nang Air Base was a constant target of rocket attacks. They rained in more nights than not, and sometimes during daytime. I lived in "Gunfighter Village," home of all the pilots, right alongside the flight line, which was a prime target. On the other hand, the rockets were aimed mostly by leaning them onto a tripod of dirt and crossed bamboo and fired off in our general direction. (Symbolic of the insanity of the whole war, the rockets were often set up in "friendly villages," which, by definition, meant GIs couldn't do anything to take them down without permission from the village chief, who'd be killed if he gave it. In the daily security briefings we officers received, we'd be told where they were coming from and how many to expect.)

In they came, regularly. Far enough away, the sound was a whump, often associated with a physical (real, or imagined?) sensation in the torso, as if from a subwoofer at a rock concert. They'd come in groups, "walking" closer, and as they did, the thump would evolve into a crash.

It was a big base. The odds for a given individual were pretty good, and that was consoling. My number came uppish once, when my barracks was hit. With only minimal injuries, I tended to others -- one with part of his shoulder blown away, into the hole of which I stuffed a tee shirt -- before getting attention myself. Being the only doc living out there with the pilots -- the others were together in the "medical hootch," a jeep or ambulance ride away -- it fell on me with every attack to don a helmet and a flack vest and run to the clinic while Cobra helicopters thwacked the air overhead and fired their gatling guns into the jungle at 6- or 700 rounds per minute, tracers lighting the night. Trotting awkwardly, trying to be low to the ground, it was too surreal to be entirely scary. I never could quite believe it was me.

Here's my point: as comfortable as my circumstances were, as different from the experience of the guys out there in the jungle, sleeping in muck, killing and being killed, it had an effect on me. I still hate the sound of helicopters; every time I hear a military jet (a Navy air base is not far from here) it reminds me of the ambient sounds of Da Nang. As does a certain kind of siren, sounding like the rocket warnings we'd hear a few seconds before the first one hit. In my case, that's about it: no nightmares, no (increase in my usual) depression, no difficulty returning to normal life when I got home. Just an occasional memory, triggered by particularly disliked sounds.

But neither was it entirely negligible. In me: educated, self-aware, well-supported, minimally exposed.

Money is tight, and will be tighter. I'd hope Barack Obama has the guts to take on military spending (Item one: the missile defense shield! Then maybe a few overseas bases). But one thing that must not be cut -- in fact ought to receive more money -- is care of vets coming home. This other report from today's news shows how, for the outgoing administration, "support our troops" has been a load of horse shit.


Baysage said...

As you know, Sid, a four-star frigging general can say anything he wants. Can claim he's had PTSD since high school. Who's going to ruin his career by calling him a pussy? Which is what happens to the rest of 'em.

Frank Drackman said...

Hey Sid, finally somethin we can agree on, the massive waist, fraud, and abuse in the Military Industrial Complex Budget. I'm bettin the General's a malingerer though..have you ever seen how todays Generals live, even in a combat zone?? He probably freaks out every time he stays in a Holiday Inn Express, cause they only get 1 HBO channel unlike the 42 he got in his satellite equipped General's quarters. I still suffer from a little of the PTSD my self, that year in northern Italy was HELL I tell you!!! Every once in a while I'd have to work and couldn't enjoy a fine aged Lager out in town!!The Horror!!! And is there a bigger waste of bone and sinue than Military Chaplains??? Its a testimony to the basic goodness of the military fighting man that these guys aren't summarily shot on the battle field...

rlbates said...

Frank, my brother-in-law is a military chaplain based at Ft Lawton, OK currently. He DOES a lot of GOOD with counseling those young men who return from battle (or just entered the military) with issues like PTSD. He spent a year in Iraq early in the war and did counseling there too. They don't just "preach".

Anyway, I really stopped by to wish you a Happy Thanksgiving, Dr Sid. Take care.

Sid Schwab said...

The same to you and yours, Ramona.

Robert said...

Sid I disagree with the denial part of your argument. I sat in a class 2 days ago where I was told this was a real and recognized problem, and that all soldiers returning from Iraq are screened for it. The Army is also spending money on development of treatments for it involving virtual reality, they have been testing it on Iraq and Vietnam vets with some success. I can't really speak for the line side, except for maybe it takes longer to change their perception. From a military medical student's perspective it something that is a concern to the medical corps as a whole. Dr. Drackman I can't tell if your kidding or not but I'm sure you know that most generals spend more time in the lower ranks then in the upper ones.

Ellen Kimball said...

Sid, I have enjoyed getting to know you better this year.

Your compassion and understanding are welcome by this Netizen and many others.

I thank you for your military service, and wish you and your family a very Happy Thanksgiving and our best for the coming holiday season.

Peace, love and happiness --


robd said...

- a rubber-sheathed hacksaw, suitable for hiding where the sun don't shine) -
presumably to keep it sterile for surgical use?
Is PTSD in the non-military medical world handeled better?

Frank Drackman said...

Hey Robert, good on ya for goin the Military Route, I don't regret a minute of my Heroic service. Definately consider bein a Flight Surgeon for a year or 2. Even one ride in the backseat of a Super Hornet is worth the boredom of taking care of the healthiest patients in the world...We got screened fot PTSD back in 91' except it was like most Military Screenings, some Sergeant screamin "Any Y'all got any MENTAL problems, fill out these Forms" while we were standin in line to turn in our weapons at the Armory. And hope you're goin to a REAL school and not that USUHS waste of Tax dollars, why does the Military need its own Medical School anyway??

Anonymous said...

Here are some primary source links to military and veterans mental health:

PTSD Combat

General Guide on Combat PTSD

Army Behavioral Health

Soldier, Civilian and Family Resource Center

I hope you had an enjoyable Thanksgiving.

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