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Revisiting the Demons of PTSD: Returning to Iraq in Virginia a Year and a Half Later

Today I am attending a conference on Caregiver Operational Stress Control.  This brought out my “demons” as I was faced with the stories of others who had been to the same places that I have been in Iraq, and experienced similar things that I experienced on my return.  This is a re-posting of something that I wrote in March at the very beginning of this blog.  At that time I had very few readers.

I am glad to be at this training today.  I needed to take a Xanax when I arrived because I don’t do well with these kind of events anymore.  The intial session and a video of Dr Heidi Kraft talking about her expereinces at Al Taqaduum where I was based out of.  I was scheduled for another meeting but I knew that I needed to be here.  So I asked my Department Head who was going to the meeting if I could stay and he allowed me to do so. God bless him.

I received a note from a new friend in another country’s military, a physician with multiple tours in Afghanistan.  He is dealing with many of the things that I discuss in this essay and had a bad day that took him back to Afghanistan.  I am sure that he is not alone as I deal with many people in my Medical Center who have similar experiences.  Yesterday I was walking down a hallway near our Operating Room and I saw a pretty good sized blood spill on the floor. I was surprised at my reaction as I kept seeing it in my mind the rest of the day and flashbacks to Iraq and the TQ Shock Surgery Trauma platoon where I was pulled into a couple of the last major mass casualty events where 10-15 Marines or soldiers came in at a time. I began to see those wounder Marines on the tables and can visibly see those Marines, their wounds, even tattoos… I hope this helps break the code of silence.  I wrote this on a particularly rough day and will repost some of those early essays as they are still very relevant.  Peace, Steve+

964Trying not to Show my Stress and Exhaustion after 2 weeks out while in between flights at Al Asad

The feeling of abandonment and aloneness, separation and disconnection run deep for those returning from unpopular wars in which the majority of the citizens take no part.  The effects are devastating.  It is estimated that at least 100,000 Vietnam veterans have taken their lives in the years after that war.  Last year the Army had its highest number of active duty suicides ever recorded, January and February of 2009 have been banner months for Army suicides.  Of course as I noted in my previous post these numbers don’t include reservists and Guardsmen who have left active duty or veterans dischaged from the service.  Neither do they include the host of service men and women who died from causes undetermined.

Many veterans attempted to return to “normal life” and family following the war. Many only to have marriages fall apart, continue or leave untreated alcohol and drug addictions acquired in country which often follow them back destroying lives, families and careers.  Most felt cast aside and abandoned by the goverment and society. Many got through and return to life with few visible effects, but the scars live on.  My dad would never talk about his experience in the city of An Loc in 1972 where he as a Navy Chief Petty Officer was among a small group of Americans operating an emergency airstrip in the city which was besieged by the North Vietnamese and Viet Cong for 80 days.  I do know that it affected him, he wasn’t the same when he returned, he was a lot more tense and had some problems initially with alcohol.  He never talked about his time there.

I have seen the effects of this in so many lives,  I remember a Vietnam vet who attempted to kill himself with a shotgun blast to the chin in Dallas during my hospital residency.  He forgot to factor in recoil and blew off his face without hitting his brain or any major arteries.  He survived…talk about having something to be depressed about later.  I have seen the tears as veterans rejected by the country during and after than war begin to seek community with their wartime brothers, men who had experienced the same trauma followed by rejection and abandonment by the people that sent them to Southeast Asia.  One only has to talk to veterans of the Ia Drang, Khe Sahn, Hue City, the Central Highlands and Mekong Delta or read their stories to know what they have gone through.  LTG Hal Moore and Joseph Galloway in We Were Soldiers Once..and Young and We are Soldiers Still have deeply penatrating and soul searching views of Vietnam as does Bing West in The Village. Bernard Fall does the same from a French perspective in Hell in a Very Small Place and Street Without Joy. Alistair Horne’s book A Savage War of Peace discusses and tells the story of many French soldiers in Algeria, who fought a war, won it militarily and had their government abandon them, bringing out a mutiny and coup atempt by French Soldiers who had fought in Indochina, were almost immediately back in action in Algeria with little thanks or notice from thier countrymen.  Abandonment is an ever present reality and “demon” for many of us who have served regardless of our nationality, French, Canadien or American who have fought in wars that have not engaged the bulk of our fellow citizens. Go to the Vietnam Veterans Memorial in Washington DC and tocuh it, trace the outline of a name, look upon the makeshift memorials and tokens of remembrance left by comrades who came home and understand the sorrow and the sacrifice.

Unfortunately we would like to think that this is something out of history that we have learned from and applied the lessons and in doing so no longer have an issue.  Unfortunately this is not the case.  There are many, depending on the study anywhere from8-20 percent of returning Iraq and Afghanistan veterans who suffer from some type of PTSD, Combat Stress reaction or other psychological malady incurred during their tour. Similar numbers are reported by the Israeli Armed Forces in from the 1973 War forward.   The British are seeing the same now as their veterans return from war.  Canadian Forces assigned to the UN command during the Rwanda genocide suffer horribly from PTSD. The mission commander, LTG Romeo Dalliare now a Senator in the Canadian Parliament is a leading spokesman for those who suffer from PTSD. His book Shake Hands with the Devil is a study of how military professionals were exposed to atrocities that they either were forbidden to stop or lacked the combat power to do so even if they wanted to.  These men and women tell their story in a video put out by Canadian Armed Forces.

105Convoy along Route Uranium

I am not going to rehash stories that I have recounted in my other posts dealing with PTSD here, but both I and many men and women that I know are scarred by the unseen wounds of this war.  We gladly recognize, and rightfully so, those who suffer physical wounds.  At the same time those who are dying inside are often ignored by their commands or if they come out are shunted into programs designed to “fix” them.  In other words make them ready for the next deployment.  I am not saying here that there is an intentional neglect of our service men and women who suffer from PTSD and other issues.  I do not think that is the case, but it is a fact of life. The military is shorthanded and stretched to the breaking point. Many Army Soldiers and US Marines have made 3-5 deployments since 2003. The Navy has sent over 50,000 sailors, not including those assigned with the Marines into “Individual Augmentation” billets in support of operations in Iraq, Afghanistan, the Horn of Africa and other fronts in this war.  The Navy personnel, as well as Air Force personnel who perform similar missions often do not have the luxury of going to war and coming home with a particular unit.  We serve often in isolation and incredibly disconnected from our commands, our service is often misunderstood.  Now there are efforts by the services and some commands to do things better to support our sailors, some of these at my own hospital.  However as an institution the military has not fully made the adjustment yet.

Many sailors feel abandoned by the country and sometimes, especially when deployed by the Navy itself.  I have debriefed hundreds of these men and women.  Almost all report anger and use terms such as being abandon, cut off and thrown away by the service and the country.  Those from all services who work in unusual joint billets such as advisers to local military and police forces in Afghanistan and Iraq feel a sense of kinship with each other, often feel a connection to the Iraqis and Afghans but are often not promoted or advanced at the same rate as others who have served in conventional forces in traditional jobs.  There was a film called Go tell the Spartans staring Burt Lancaster about Army advisers in the early stages of Vietnam.  If you see it and have been to Iraq with our advisers you can see some of the same dynamics at work.

At this point we are still engaged in Iraq and Afghanistan.  These wars divided the nation and the veterans, though better treated and appreciated by society than most of thier Vietnam counterparts have no memorial.  Words of thanks uttered by politicans and punits abound, our Vietnam era and other fellow veterans in their latter years come to the airports that we fly in and out of to say thank you, but our numbers are rising, the war rages on both in country and in our minds and lives are being lost long after soldiers have left the battlefield.

not a happy camperNot Doing Well on Leave about 5 months After my Return from Iraq

We have to do a better job of ensuring that those who sacrifice so much do not feel that they have been cut off and abandoned while they are in theater and especially when they return. When it is time we need a memorial on the Capitol Mall for those who served in these wars.  I don’t know when that will be, but I do hope to see it in my day.  Sure it’s only symbolic, but symbols can be healing too, just look at the black granite wall rising up from the ground and going back down into it, filled with the names of those who gave their lives and made the supreme sacrifice in Southeast Asia.  Simply known by most as “the Wall” it has become a place of healing and rememberance.  A place to say thank you, goodbye and amen.

Peace and blessings, Steve+


Filed under healthcare, iraq,afghanistan, Military, PTSD, Tour in Iraq, vietnam

Hollywood and Recruiting Since Vietnam

I have been thinking about how Hollywood occasionally helps military recruiting in the post-Vietnam and all-volunteer era.

Back in World War II Hollywood Moguls signed on to further the war effort with films which were entertaining but also inspiring to those on the home front.  Films like Wake Island, they Were Expendable, Destination Tokyo, The Fighting Sullivans, the Flying Tigers, The Memphis Belle (1943), and Thirty Seconds over Tokyo all helped bolster the war effort.  Stars like Jimmy Stewart served in combat.  These were the high tide of patriotic war films.  In the post war era more films about the war were made until Vietnam made war films a riskier proposition for studios.  With the exception of The Green Berets and a few Second World War themed films such as The Longest Day, In Harms Way, The Battle of the Bulge and Patton war films became much more anti-war and often anti-military.  Such films as Catch 22, M*A*S*H, Go Tell the Spartans, Kelly’s Heroes showed this while films like Platoon, The Deer Hunter and Coming Home showed the dark side of Vietnam.

In the 1970s some films like Midway began the return of film makers to more positive looks at the military. After the election of Ronald Reagan Hollywood began to produce more military themed films.  Some were fully endoresed by the Department of Defense and others not.  Some were designed to make the miltary look good and well, some which were not intended to do so had the opposite effect.


The most successful of these films dealt with the Navy and Marine Corps, those dealing with the Army and Air Force were not as successful, though the Iron Eagle series with Louis Gossett Jr. had a pretty good run.  Films like Top Gun thrilled young audiences with both the story of Naval Aviators, a great musical score and some really hot and sensual scenes.  The Hunt for Red October was another thriller in which Tom Clancy made the Navy look great.  An Officer and a Gentleman had some of the most memorable Drill Sergeant scenes of any film, with Louis Gossett Jr. in the role of Gunnery Sergeant Foley destroying and rebuilding a class of OCS candidates led by Richard Gere.


Once again a good story well acted and some great love scenes and musical score made this appeal to the younger generation.  I was across the Puget Sound when this was being filmed having my own ass ripped by an Army Special Forces, Ranger and Vietnam veteran Drill Sergeant.  I could relate to Richard Gere crying “I’m not going to DOR, I’ve got nowhere else to go.” Thank you Sergeant First Class Harry Ball for making me a better person by destroying all preconceptions that I had about myself and rebuilding me.  Judy when she first saw the movie asked if I had a Puget Sound Deb but alas, I did not.  I was too busy cleaning latrines with a toothbrush for any extra-curricular activities even if I was so inclined. Clint Eastwood’s Heartbreak Ridge was a positive portrayal of a Marine taking over a Recon Platoon before going into Grenada.


A Few Good Men was not supposed to be a film that made the Marines look good.  Director Rob Reiner attempted to get permission of the Marines to film at Guantanamo Bay but was unable to do so because of the script.  The film turned out to be a cult classic among many Marines.  Jack Nicholson’s portrayal of Colonel Nathan Jessup became a hit.  The line You ant the Truth, you can’t handle the truth!” followed by the rest of the speech is classic.  The character that Nicholson was based on was a real CO of Gitmo.  He was relieved after about a year into his two year tour.  A former CO of mine who served under that man at another duty station said that officers and enlisted alike lived in fear of him. More recent films such as Saving Private Ryan and the Band of Brothers HBO mini-series brought positive attention to the men of the greatest generation.  Films about Iraq have varied.  Perhaps the best is Taking Chance with Kevin Bacon playing a Marine LtCol. escorting the body of a young Marine killed in action home.

So it is interesting to see how Hollywood sometimes helps and sometimes hurts recruiting.  We’ll have to see what the next batch of war films turn out to be like.

Peace, Steve+


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More on our Unsung Heroes-Military Advisers, Past and Present


Iraqi COP on Syrian Border

While many people know about conventional military campaigns through the plethora of books, articles and electronic media outlets, the subject of advisers is on that is seldom touched upon.  This is true in history, journalism and media. It is not a glamorous subject.  There are few books, articles or movies on the subject.  Part of this is because advisers don’t have all the heavy duty gear that looks good in print or on TV.  They serve with foreigners, and unfortunately, many Americans have no interest in other people, their history or their culture.  So the advisers labor in obscurity.  Living among the soldiers of the nations that they are in they serve in small teams, often far from any support if they get in trouble. Advisers have often stayed after the bulk of American forces leave.

This is not new.  It was the case in Vietnam.  Take the story of Captain, later Colonel John Ripley, adviser to a Vietnamese Marine Battalion, Ripley was awarded the Navy Cross for his actions on Easter Sunday 1972.  This was hte day that the North Vietnamese opened their Easter offensive.  Ripley under intense fire blew up major highway bridge over the Dong Ha.  Supported by fires from his Vietnamese Marines he would dangle under the bridge for three hours, rigging 500 pounds of explosives to it.  His actions prevented 20,000 NVA soldiers and over 200 tanks from crossing the river near the DMZ.  His actions are recorded in The Bridge a Dong Ha. Similarly, Captain, later Major General Ray Smith was awarded the Navy Cross for his actions with a small Vietnamese Marine unit on April 1st 1972. These men’s exploits were not uncommon.  Unfortunately the majority of the Vietnam era advisers have been forgotten.  The film Go Tell The Spartans starting Burt Lancaster told the story of a team of advisers at the beginning of the Vietnam War.

Unfortunately the military itself doesn’t always treat these men and women with the respect that they deserve. Adviser tours are often not treated the same as service with “big battalions.”  The duty is not glamorous.  Many times advisers and trainers are chosen from men passed over for higher level command at the Lieutenant Colonel and and Colonel level. In the current wars I have met many of these men.  Devoted, honorable and professional, they serve in places where their decisions and example will impact Iraq and possibly Afghanistan in ways that the big battalions can never will.  Many of these men are in the twilight of their careers and many times volunteer for one last chance to serve in combat.  Others are pulled from the Reserves, and some even pulled out of retirement.  I knew men in each category.  Younger officers and staff non-commissioned officers are often pulled out of traditional assignments for adviser duty.  They often assume greater responsibility, advising and sometimes even directing units far larger then they would in a normal assignment.  They have to be diplomats, trainers, mentors, and advisers to foreign officers senior in rank to them.  In the case of some Iraqi officers, men who have served in several wars commanding troops on the front lines.  To do the job right advisers have to learn the language, culture and traditions of the units that they advise.  It takes maturity, wisdom and tact to do this work.  Junior officers and non-commissioned officers also serve in these capacities at the battalion and company level.   I had the opportunity to serve with many of these men in isolated camps, they are to be admired and congratulated for the tremendous work that they do.

Navy and Air Force personnel often are found advising medical, logistics and civil engineering units.  Likewise they are also found in reconstruction and development teams.  In these places women as well as men advise the indigenous personnel.  They often, especially in Afghanistan share the same dangers of those who advise combat  units. This was the capacity that LT Choe and LTJG Toner were killed.  She was a Medical Service Corps officer.  LTJG Toner was a Civil Engineer Corps Officer.


Meeting with Bedouin Family

Before I went to Iraq in 2005 I knew a Marine Corps Captain who was pulled from our unit to serve as a battalion level adviser in Iraq.  In Iraq this young Marine Officer had a bounty on his head.  A Chechen sniper attempted to take him out.  The bullet hit the lip of Kevlar helmet, just above his left eye. less than an inch lower it would have gone through his forehead.  The Iraqis found and eliminated the sniper. The Captain survived and finished his tour.  He kept the helmet.  A Gunnery Sergeant serving with an Iraqi infantry company was wounded in a convoy action.  He told me his stories and how his return back to the states was.  It was difficult, but he said that he would not have missed the assignment, saying that “his Iraqis” were like brothers to him.

As a chaplain in the largest operational area I was able to see the diversity of our teams, the conditions that they lived and the people that they worked with.  I prepared by reading about the Army Chaplains who served in this role during the Vietnam War.  It was actually just part of a chapter of the Army Chaplain Corps History of the Vietnam War.  However, that chapter taught me something that I figured would have to be true.  I had to be out and about with them. I good friend of mine followed me into Iraq.  He went to a different area with Army advisers in Mosul.

My tour not only allowed me to serve with these men and women but to work with the Iraqis and see things that many Americans never get to see.  One of the more interesting events was getting to speak to the first class of female Iraqi Police Officers in Ramadi.  There were also the foot patrols with the Port of Entry teams at Al Waleed on the Syrian Border.  Our little team met with Iraqi officials and mingled among a crowd of several thousand Iraqis waiting to be processed back into the country.  Since this was the busiest port of entry into the country it was the site of a lot of terrorist activity, weapons and currency smuggling.  In another place we were with a Brigade senior adviser who had to have a Iraqi Colonel who had just taken command of a unit fire his logistics officer who was selling coalition fuel on the black market. It was a very tense exchange.  The accused officer even tried to involve me in the conversation, saying that if people followed God that they would be honest.  Our senior adviser asked him if God would approve of him betraying his country.  The officer was fired.  The senior adviser later told us that this officer had put a price on his head before this confrontation.  All through the meeting my assistant, RP2 Lebron sat menacingly to the side enforcing peace in the the tense moment.  Thankfully the new Iraqi commander, who had taken over from a corrupt General was an old pro and had the job of cleaning house.  Things got better after that.  I was with one team when one of their favorite Iraqi officers was killed while out with his troops.  Our guys were saddened by the loss.

Like I said on my previous post, these are the unsung heroes of the Iraq war and the war in Afghanistan.  Their sacrifice and service needs to be vocalized.  This part of the war is now part of my life. The story of these men and women needs to be told.  I will not let them be forgotten.


With Advisers and Iraqi Border Troops

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