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Spc. Wayne Robinson spent the bulk of his five-month tour in Kuwait and Iraq on guard duty. For a while, he and his fellow soldiers in the Army’s 2nd Armored Cavalry Regiment worked in unbroken 12-hour shifts, standing watch in the towers at Camp War Eagle, in the Sadr City area of Baghdad, during the summer of 2003. They struggled to keep awake during mind-numbing stretches of time when nothing at all happened. The only respite from boredom came in the form of incoming fire.
“We got shot at mostly, like, every time,” recalls the 22-year-old, who grew up in Southeast D.C. “Sometimes we didn’t know where the gunfire was coming from.”
When Robinson returned home to Prince George’s County, Md., in December 2003, his body insisted he stay on guard duty. He found himself pacing throughout his mother’s District Heights home until 7 a.m. some mornings, in spite of his efforts at sleep. He felt compelled to drink anything that had caffeine in it, and when he caught himself dozing off, he’d keep active playing video games.
“I didn’t know what was going on,” says Robinson. “My body was basically making me feel like I was on guard, even though I knew I wasn’t.”
When Robinson heard about the surge in violence in P.G. County since he’d shipped off—there have already been 139 homicides this year as of Dec. 6, the most since the mid-’90s—he no longer felt safe walking around the neighborhood at night. He would turn back and head home rather than walk past a stranger on the sidewalk. If he heard the steps of someone walking behind him, Robinson would step off to the side and allow the person to pass ahead of him. “In Iraq, you never know if you’re gonna wake up,” he says. “Here, it’s like, Who’s the dumbass who’s gonna put a bullet in my back?”
Robinson preferred to stay home all day and night, cleaning up and helping out his mother. He was used to taking orders in the war, and now he didn’t know what to do with himself. He was annoyed easily, and sometimes he snapped at his 15-year-old brother, which he never used to do. Sometimes footage of Iraq on CNN would prompt flashbacks.
“I felt like everything had changed around me, like I was 47 years old,” he says. “You beat yourself up trying to figure out who you are. You wanna get back that life you had four years ago. But you realize that you can’t get it back.”
Robinson’s mother, frightened by his behavior, urged him to visit a psychiatrist at the Department of Veterans Affairs (VA) clinic in the District. Earlier this year, he was diagnosed with post-traumatic stress disorder (PTSD), a psychologically debilitating condition causing intense nightmares, paranoia, and anxiety. He was prescribed five different medications, and now he can usually fall asleep by 4 a.m.
There are thousands of Operation Iraqi Freedom soldiers across the country like Wayne Robinson. They are coming home with minds twisted by what they’ve seen and done in Iraq.
A December 2003 Army study, published in the New England Journal of Medicine, found that approximately 16 percent of soldiers returning from Iraq were suffering from PTSD. But that study is already out of date.
Now, after a particularly bloody summer and fall, many military and mental-health experts predict that the rate of PTSD will actually be nearly twice what the Army study found, approximately the same level suffered by Vietnam veterans. Others think it could spike even higher and note that rarely before has such a rate of PTSD manifested itself so early in a military action.
At the same time, there is mounting concern over the agency charged with helping suffering soldiers: the VA. Numerous reports show the VA is unable to provide enough of the essential services veterans desperately need.
“I don’t know how many people are going to be seeking treatment or whether the demand is going to be met by available resources,” acknowledges Matthew Friedman, executive director of the VA’s National Center for PTSD. “What I am confident is that people who come for treatment will get good treatment.”
Yet the VA chronically has underfunded mental-health programs and currently projects a $1.65 billion shortfall in those programs by the end of 2007.
“If we don’t give the VA what it needs immediately, the consequences will be lifelong and devastating,” says Steve Robinson, executive director of the National Gulf War Resource Center.
The emerging scenario is that of a generation of new veterans whose psyches are in tatters, their families scarred by the strangers their loved ones have become—and of an exhausted health-care system holding its breath.
“When you kill someone in combat, two things can happen,” says Sgt. Walter Padilla, Charlie Company, 1st Battalion, 12th Infantry Division. “The crazy ones go crazier. Or nothing happens.”
In October 2003, Padilla was commanding a Bradley fighting vehicle near the Iraqi city of Kirkuk, rounding up insurgents and fending off mortar attacks.
On a break one day, Padilla’s company headed to a deserted area a few miles from base to practice marksmanship. When gunfire rang out from a nearby village, Padilla wheeled his Bradley around to investigate. He saw two groups of armed men arguing over a pile of wood. The Bradley rumbled closer, and the men began shooting.
“Everything slowed down. I lost sense of time. I saw nothing, felt nothing,” he says. “Then I opened up with the machine gun.”
After Padilla gripped the trigger long enough, he moved in for a closer look.
“You’re walking up on something you’ve done with your hands. You see the back of brains blown out. You know it’s either him or you! But I’d never seen anybody dying.”
When Padilla’s unit was shipped back to Fort Carson, Colo., in late February 2004, his life unraveled.
While he was gone, his wife had filed for divorce. He began having terrible dreams about Iraq. He grew paranoid any time he left home.
One morning, on his way to work at Fort Carson, Padilla glimpsed the lights of an Air Force jet. He swerved his car off the highway and grabbed his cell phone to call his commanding officer—“I thought it was a tube flash from a mortar,” he says.
At a bar one night, he argued with a stranger over a pool table. Doesn’t this guy know I’ve fucking killed people? Padilla thought incredulously.
That night, he lay awake, contemplating whether he should rush out into the night and search for the stranger. He shoved some sleeping pills in his mouth and fought to let it go. “If I’d have found him, I would have beat him over the head with a bar stool,” he says.
While Padilla grasped at his ghosts, Washington bureaucrats were hearing about another nightmare. On March 25, 2004, Dr. James Scully, medical director of the American Psychiatric Association (APA), testified to the House Appropriations Subcommittee on Veterans Affairs and Housing and Urban Development, and Independent Agencies.
Scully, a Navy veteran, reported a 42 percent increase in VA patients with severe PTSD, with only a 22 percent increase in money spent on PTSD services. The disparity was particularly “startling,” he said, because there were more vets using the VA for psychological help than ever—nearly half a million.
It was only the latest blow for an institution that has struggled for decades to fulfill its mission.
A mammoth, federally funded agency, the VA began treating veterans’ health problems in 1930, charging a sliding fee based on a variety of factors. But in the wake of the 1991 Gulf War, the system swelled out of control. The soaring cost of civilian health insurance, combined with aging World War II, Korea, and Vietnam vets, pushed droves of people toward the VA, where everything was cheaper.
In 1995, the VA began realigning its health-care system, and it opened hundreds of outpatient clinics. Yet by 2001, only half provided mental-health services, according to the National Mental Health Association.
Again, funding was a factor. In 2003, the previous decade had seen a 134 percent jump in vets seeking care, with only a 44 percent increase in the budget.
In April 2003, as U.S. troops pushed toward Baghdad, Dr. Joseph T. English, chair of psychiatry at St. Vincent’s Catholic Medical Centers of New York, told the same House subcommittee that veterans were waiting an average of 47 days to get into PTSD inpatient programs and up to a year at some outpatient facilities.
VA Secretary Anthony Principi (who resigned on Dec. 8 as part of the Bush administration’s cabinet shuffle and will leave office when his successor is confirmed by the Senate) had commanded a Navy gunboat in Vietnam and understood PTSD. He also knew that with combat-dazed vets beginning to trickle home from Iraq, he needed to move quickly. So he commissioned a task force on the VA’s mental-health services.
In a revealing June 3, 2004, memo to VA Undersecretary for Health Dr. Jonathan Perlin, Principi wrote that the task force had discovered four major deficiencies: Mental-health services were scattered; substance-abuse programs had been reduced; the VA’s mental-health leadership hadn’t been diligent in overseeing the situation; and there was no coherent mental-health strategy. Principi ordered agency brass to begin plugging the holes immediately.
While the VA worked on a long-term plan to implement reform, the agency’s Special Committee on PTSD delivered an October report to Congress, warning that with more soldiers with PTSD arriving home, services needed beefing up. In the 1980s, the VA had recommended there be teams of PTSD counselors at all VA medical centers. Two decades later, the report noted, barely half of the 163 facilities had them.
The VA plan estimated it would take $1.65 billion to remedy the situation by 2008.
The committee conceded that the VA couldn’t be expected to treat psychologically troubled vets from Iraq and Afghanistan while still caring for those already in the system. “If the human cost of PTSD and its related disorders is staggering, so are the long-term medical costs to the VA associated with chronic PTSD,” the report stated.
In April 2004, the House Veterans Affairs Committee urged Congress to pump an additional $2.5 billion into the Bush administration’s $27.1 billion VA health-care budget for 2005. On Nov. 20, Congress added $1 billion to that budget—$1.5 billion short of the committee’s recommendation. And although Congress earmarked an additional $15 million for PTSD, few think that money will make much difference.
Sgt. Dave Durman did a tour in the Mekong Delta back in 1969. He was 18 and had joined the Navy the minute he got his draft notice, even though some of his buddies had already gone and died there. “I think it was because I just really loved the water,” Durman says.
Durman also loved working on the supply ship where he was stationed and the adrenaline that pulsed through him whenever his unit supported the Marines on missions around the South Vietnamese coast. He loved it all so much that he stayed in the Navy for nine years and, in 1995, joined the Virginia National Guard’s 1032nd Transportation Company, 10 miles from his home in Kingsport, Tenn.
In February 2003, Durman’s unit was sent to Kuwait. He was 52 years old.
Two months later, the 1032nd crossed into Iraq, charged with shipping supplies from the southern city of Talil 300 miles north to Balad. Other convoys had been attacked on the same route, so Durman and the 19-year-old soldier who rode with him slung their flak jackets protectively over the outside of both truck doors. “You could stab a hole through those doors with a knife,” Durman says.
During one August haul, Durman came upon a group of Iraqi police who had just shot two children for stripping a car on the side of the road. He drove right by their bodies. “We’re told not to interfere with domestic affairs,” he says quietly.
“I didn’t want to get personally close to the Iraqis, because I knew we might have to shoot them,” he continues. “I’d look into their eyes and they all looked like gooks.”
In September, Durman’s unit shipped back to Virginia. It was then that the nightmares started, about Iraq, but also things he’d buried—his abusive childhood, Vietnam.
His girlfriend, Teresa A. McKay, noticed that Durman, once confident and kind, now broke into random sweats and angered easily. He drank too much whiskey and bought a .357-caliber pistol. Their sex life, McKay said, went “190 degrees different.”
To McKay, a former nurse who’d worked with homeless Vietnam veterans, Durman’s behavior looked disquietingly familiar.
Indeed, Vietnam provides the clinical and historical framework for PTSD and Iraq. Before Vietnam, treatment of a soldier for the psychological effects of battle was not really treatment at all, even though PTSD had long been acknowledged under a variety of names.
In 1871, former Union Army medic J.M. Da Costa wrote about a condition caused by heavy fighting. He called it “irritable heart,” a name changed shortly thereafter to “soldier’s heart.”
During World War I, according to VA psychiatrist Jonathan Shay, veterans returning home with soldier’s heart were told by military doctors they had “shell shock,” or “combat neurosis.”
After World War II, says Shay, when tens of thousands of soldiers were hospitalized with psychiatric problems, doctors diagnosed the majority with paranoid schizophrenia.
“The diagnostic spirit which prevailed was based on Plato’s idea that if you had good parentage, good genes, a good education, then no bad things could shake you from the path of virtue,” says Shay.
During Vietnam, that Platonic ideal began to shift. In 1970, 20 young vets from the group Vietnam Veterans Against the War (VVAW) called psychiatrist Robert Jay Lifton to speak with them about the war. The vets didn’t trust the VA or the military, but knew they needed to calm the devils they’d brought home.
Lifton, who had studied Hiroshima survivors and been an Army psychiatrist, began meeting in New York with the group in informal rap sessions.
He was shocked by the extent of the veterans’ traumas.
“These men talked about a particular combat situation that had a level of extremity which was new, even to me,” Lifton says.
Prompted by the rap sessions, VVAW opened up dozens of storefront counseling centers—places where Vietnam veterans could speak with other vets about their experiences, a crucial part of treating what was then known as post-Vietnam syndrome. Even though vets were now openly sharing their traumas, the VA wouldn’t accept a diagnosis of the condition.
“This was because many of them were talking about atrocities, and that process was associated with a political view of the war,” says Lifton.
Finally, in 1979, the VA opened up its own network of storefront vet centers. A year later, the APA included PTSD in the third edition of its Diagnostic and Statistical Manual of Mental Disorders.
When the congressionally mandated National Vietnam Veterans Readjustment Study concluded in 1990 that 30 percent of Vietnam vets suffered from PTSD, not many were surprised.
By then, Lifton and VA psychiatrists such as Friedman had become leading experts on PTSD, pushing the condition into psychiatric and public consciousness.
Through group and individual therapy, and sometimes medication, the VA was helping veterans heal, though the process could sometimes take years.
But by the time U.S. soldiers touched Iraqi soil, because of the enormous growth in the number of vets seeking mental-health services and the VA’s failure to adequately respond, the advances in PTSD treatment were being compromised.
As Crystal Luker tells it, May 5, 2004, was the day her husband’s platoon ran into trouble.
As usual, on that afternoon, Spc. Ron Luker was patrolling a section of Baghdad with his 1st Cavalry Division platoon.
“There was a lieutenant in the first Humvee, Ron was in the second, and his platoon sergeant was in the third with a group of privates,” Crystal says.
A 19-year-old specialist from Tulsa, Okla., named James Marshall, whom Ron had been looking after, also rode in the third Humvee. As the convoy snaked through a teeming Baghdad street market, there was an explosion.
“The lieutenant was yelling over the radio for all of them to haul ass back to the base because they were coming under fire,” Crystal says.
When Ron Luker, who was driving, looked behind him, he was horrified. The third Humvee was gone. He flipped his vehicle around and hurtled back down the street.
Crystal says Ron told her that when they found the Humvee, the force of the blast had blown the flesh from two of the privates all over the seats. When Luker looked in the back, he saw Marshall, wrapped around the vehicle’s .50-caliber gun.
“When Ron tried pulling James’ body out, his hands just went right inside of him. He pulled James’ flak jacket back, and his chest was gone.”
Before that day, Ron Luker had called and written home religiously, unburdening himself to the woman he’d fallen in love with at a Mariposa, Calif., restaurant four years before. But when he came home to Fort Hood, Texas, for a week in August, things changed dramatically.
That first night, at a welcome-home barbecue, Luker cornered his wife in the kitchen.
“He asked why I’d been avoiding him and said that I didn’t want to be around him,” Crystal says. When Ron started cursing, some Army friends pulled him away. “You didn’t come all the way home to fight with your wife,” they told him.
As the week went on, there was more arguing. Crystal says Ron accused her of cheating while he was gone. He rifled through her purse and the bedroom drawers, and he repeatedly listened to old phone messages, searching for proof.
“I told him, ‘You’re scaring me! You’re not acting right, Ron!’” Crystal says.
Ron also seemed bothered around his three daughters. In an emotional revelation, he told his wife why.
“He said he’d turned into a monster in Iraq. How he couldn’t bounce his kids on his knee when he’d shoved guns in women’s faces and busted into houses and pushed kids on the floor. He kept saying, ‘I’m just trying to remember who I was before.’”
Ron Luker’s problems are typical of the growing numbers of PTSD soldiers. And he is indicative of another alarming statistic—soldiers experiencing PTSD early.
VA psychologist Scott Murray explains that because typically many vets don’t manifest symptoms of PTSD for as long as 15 months, this incidence may represent the tip of a very large iceberg. “This early on, PTSD is much higher than anything we’ve seen in previous conflicts,” Murray says. “We anticipate the numbers are only going to keep getting higher.”
Psychologist Kaye Baron currently treats some 70 soldiers and their families in a private practice in Colorado Springs, near Fort Carson. From clinical discussions she’s had with soldiers, Baron thinks the PTSD rate could spike as high as 75 percent.
Such a rate, Lifton says, is inexorably tied to the nature of the Iraq war.
“This is a counterinsurgency being fought against an enemy which is hard to identify, and that leads to extraordinary stress,” he says.
According to Shay, the issue with the most potential for psychological torment is whether soldiers feel they’ve been led into battle for a noble cause.
Shay, who compared the Vietnam veteran’s battle experience to that of Achilles in his book Achilles in Vietnam: Combat Trauma and the Undoing of Character, wrote how the Greek hero felt betrayed by his arrogant general, Agamemnon, whose disrespect of a priest of Apollo brought down a plague on the Greeks.
“If a soldier has experienced a betrayal of what’s right by those in charge, their capacity for social trust can be impaired for the rest of their lives,” Shay says.
Indeed, Durman says he first began feeling uncomfortable in Iraq when it became clear there were no weapons of mass destruction there. He says his unit was furious when Gen. Tommy Franks retired midwar, while the rest of National Guard and Reservists were subject to the Army’s “stop-loss” policy, which extends soldiers’ deployments.
Padilla and Luker were outraged when they saw the Iraqi children playing in human sewage gurgling through the streets while the Army did nothing. “I thought we were here to help these people,” Padilla says.
That sense of betrayal translates into what Shay calls “complex PTSD”: nightmares, paranoia, violence, self-hate, and crippling distrust.
Shay, who likened the Vietnam veteran’s homecoming to Odysseus’ tortured return to Ithaca in a second book, Odysseus in America: Combat Trauma and the Trials of Homecoming, says that after Vietnam, “Vets were coming home and burning through their social capital. Everything in their life was being destroyed or used up.”
Robinson’s late-night anxiety, Padilla’s bar fights, Durman’s drinking, Luker’s accusations about his wife are all examples of a similar dynamic.
According to the VA, veterans with PTSD are more apt to be jobless, impoverished, homeless, addicted, imprisoned, and without a stable family. They are three times more likely to die within a given time frame than the general population, according to a 2201 report from the VA’s PTSD committee.
Many of the soldiers Baron treats tell her they want to get far away from their lives at home.
“They just want to go off in the mountains,” she says. “And be by themselves.”
Since returning from Iraq, Wayne Robinson and Dave Durman have started therapy at VA facilities, where they’re likely getting some of the most advanced care in the world.
Meanwhile, Walter Padilla is trying to leave the military and says he’ll get help once out. Ron Luker is still in Iraq; Crystal Luker says she’ll drag her husband to the VA if she has to.
These soldiers won’t be alone. So far, more than 10,000 veterans from Iraq and Afghanistan have sought psychological help from the VA.
Despite the challenges such numbers predict, Harold Kudler, co-chair of the VA’s Special Committee on PTSD, says: “We’ve never been so prepared,” pointing to unprecedented cooperation with the Department of Defense, intensified PTSD outreach, and the 206 storefront vet centers.
But some say that preparation is not enough. “You can only provide the services for which you have the resources,” says Murray. “There has to be significant improvement in an allocation of funds to make that occur.”
“The heads of the VA health-care networks are all trying to figure out how the hell they’re going to manage,” says Rick Weidman, director of government relations for Vietnam Veterans of America.
As for the VA’s mental-health plan, which estimated an extra $1.65 billion was needed to fix things fully, VA spokesperson Laurie Tranter says: “We cannot comment on this now. The plan is still being finalized.”
Still, all the money and services in the world will not necessarily solve the pain of PTSD.
In 1968, a young soldier named Lewis Puller came back from Vietnam without his legs and parts of his hands, blown off by a Viet Cong land mine. Puller, the son of the most decorated Marine in American history, soon became a veterans’-rights advocate and later a Pentagon lawyer. He married a politician, had two children and, in 1991, wrote a Pulitzer Prize– winning book called Fortunate Son: The Healing of a Vietnam Vet. Popular on Capitol Hill and among veterans, Puller had seemingly risen from the physical wounds and the depression and alcoholism that haunted him for years to live a remarkable life.
On May 11, 1994, 26 years after returning home, Puller shot himself.
Amid an outpouring of grief, one Vietnam vet wrote an e-mail to Shay, who published it in Odysseus in America.
“I get real tired of hidin’ and runnin’ from the demons,” the vet wrote. “Am I the only one? Has it crossed anyone else’s mind? You think maybe Lew was right? Is it the only real escape? I got questions. I’m out of answers.”CP
Dave Jamieson of the Washington City Paper and Barbara Solow of the Independent Weekly in Durham, N.C., contributed reporting to this story.
Dan Frosch is a former staff writer for the Santa Fe Reporter and currently a New York-based freelance writer for the Nation, In These Times, and other publications.