Feature: Wednesday, December 15, 2004
Soldier’s Heart

Thousands of Iraq War veterans face serious psychological problems and a system ill prepared to help them.

By Dan Frosch and Peter Gorman

Matthew Williams was 19 years old when he enlisted in the Army in 2002. While he wanted to fight for freedom, he didn’t want to kill anyone, so he joined the medic corps. “I thought I might be the difference between someone dying and going home to see their family,” he said. “That was a good feeling.”

The young Arlington man never killed anybody in Iraq, and most of the time no one was trying to kill him. But he saw the carnage up close and bloody. And he and his ambulance crews were attacked as their convoys traveled the roads between the medical hospital at Al-Asad and places like Fallujah, where heavy fighting was going on. He remembers riding shotgun on a military truck one day, his M-16 at ready, when “this guy comes riding toward us on a bicycle with a baby on the back. When he gets close, he reaches one hand behind his back, and I sighted him up because I thought he might have a weapon. And as he rides by, he pulls out his hand in the shape of a gun and pretends to fire at me. The only reason I didn’t fire was because I knew the bullet would take out the baby along with the guy, and I didn’t want to do that unless I was absolutely sure it was a weapon.”

When Williams’ unit finished a year’s deployment in April, they rolled back to Fort Carson in Colorado, where they were given a battery of physical and mental tests, over $14,000 in pay, and a month’s leave, and were told to get ready to be redeployed to Iraq on their return. Williams came home thinking everything was fine. It wasn’t. His sister almost didn’t recognize him. “He was drinking excessively,” she said. “He couldn’t talk to people, would just walk away from them. Then one day our dad’s little dog jumped into the new Mustang he’d bought, and Matt just picked him up and threw him 30 feet. This was a guy who absolutely loved animals.”

When he got back to Fort Carson, Williams asked the Army for help. He was seen by a military psychiatrist. “Dr. Newman said they were short-handed and didn’t have anyone for me to talk with. He put me on a waiting list for therapy and gave me a month’s supply of an anti-depressant ... and told me they might have someone when I finished that.”

They didn’t. When Williams returned after a month he was given a three-month supply and told to come back when that was done. Then he failed a drug test for marijuana, then another, and was offered an early, but honorable, discharge. Williams, who’d been decorated with a Combat Merit Badge, an Army Commendation, and several other citations, took the discharge. He returned home, kept drinking, and finally tried to kill himself.

Joshua Peterson’s troubles took another form. The first time he hit his wife, Kristin, she was asleep in their bed. Awakened by Joshua’s fist smashing into her face, she ran, terrified and crying, to the bathroom to wipe the blood spurting from her nose. When she looked back into the bedroom, he was punching at the air, muttering how she was coming after him and how he was going to kill her. But his eyes were closed.

Peterson was appalled the next morning to realize what he’d done, but he doesn’t remember the night or the nightmares. Neither can he remember punching his wife again in his sleep a few weeks later, this time driving her front tooth through her lip, as he murmured over and over that he’d never go back.

For six months last year, Peterson helped build an oil pipeline across Iraq as a specialist in the Army’s 110th Quartermaster Company. On the same highway where Private Jessica Lynch was ambushed, he saw the rotting bodies of Iraqi soldiers dangling out of their tanks. One time Peterson’s truck broke down and he was surrounded by a group of Iraqi children, some throwing rocks, others toting AK-47s. “I kept thinking, ‘God, I can’t handle this,’ ” the 24-year-old said with a hollow laugh.

Since Peterson came back to Richmond Hill, Ga., in August 2003, these memories have turned him into a man Kristin often doesn’t recognize — a man who lashes out in anger at her and their toddler, a man whose awful dreams tell him to beat his wife because she’s an Iraqi.

There are thousands of Operation Iraqi Freedom soldiers across the country like Matthew Williams and Joshua Peterson. A December 2003 Army study, published in The New England Journal of Medicine, found that about 16 percent of soldiers returning from Iraq were suffering from Post Traumatic Stress Disorder (PTSD), a psychologically debilitating condition causing intense nightmares, paranoia, and anxiety. Now, after a particularly bloody summer and fall, many military and mental health experts predict the rate of PTSD will actually run nearly twice what the study found, approximately the same level suffered by Vietnam veterans. Others think it could go even higher and note that rarely before has such a dramatic rate of PTSD manifested itself so soon after combat.

Those troubled veterans, by and large, will go knocking on the door of the Department of Veteran Affairs. And many will find that, just like the military that often couldn’t adequately equip them in Iraq, the VA, according to numerous studies, does not have many of the essential services the 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,” acknowledged Matthew Friedman, executive director of the VA’s National Center for PTSD. “What I am confident [of] is that people who come for treatment will get good treatment.”

Yet the VA chronically has under-funded 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,” said Steve Robinson, executive director of the National Gulf War Resource Center.

The emerging scenario is that of a new generation of veterans — many of whom were psychologically unprepared for what happened to them and around them — and of an exhausted healthcare system holding its breath.

While veterans like Williams and Peterson were dealing with their personal nightmares, Dr. James Scully was testifying before Congress about a national nightmare. In March 2004, Scully, a Navy veteran and medical director of the American Psychiatric Association, testified before the U.S. House subcommittee responsible for VA funding. Scully reported a dramatic 42 percent increase in VA patients with severe PTSD in the previous five years, with only a 22 percent increase in money spent on PTSD services. The reduction was particularly startling, he said, because more vets are using the VA for psychological help than ever — nearly half a million at last count.

It was the latest blow for an institution that has struggled for decades to fulfill its mission. A mammoth, federally funded agency, the VA’s healthcare system has been treating veterans since 1930. But in the wake of the first Gulf War, pressures on the system swelled out of control. The soaring cost of civilian health insurance combined with an aging population of World War II, Korea, and Vietnam vets, pushed droves of service people toward the VA where everything was cheaper.

In 1995, the VA began realigning its healthcare system and opening hundreds of outpatient clinics. Yet by 2001, only half of the clinics provided mental health services, according to the National Mental Health Association.

Again, funding was a factor. Between 1996 and 2003, the VA noted 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, chairman of psychiatry for 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 in-patient programs and up to a year at some outpatient facilities.

VA Secretary Anthony Principi had commanded a Navy gunboat during Vietnam and understood PTSD. He also knew that with combat-dazed vets beginning to trickle home from Iraq, he needed to move. He commissioned a task force to upgrade the VA’s mental health services on short notice. (Principi resigned recently as part of the Bush Administration’s cabinet shuffle but remains in office until his successor is confirmed.)

In a revealing June 3, 2004, memo to VA Undersecretary for Health 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 leadership hadn’t been diligent in overseeing the situation, and there was no coherent mental health strategy. Principi ordered VA brass to begin plugging the holes immediately.

While the VA worked on a long-term plan for implementing the reforms, 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. During the 1980s, the VA had recommended that teams of PTSD counselors be placed at all VA medical centers. Two decades later, the report noted, barely half of the 163 facilities had them.

The committee predicted that it would take about $1.65 billion by 2008 to fix things. Without extra funding, the committee conceded, 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.

The House Veterans Affairs Committee urged Congress to pump an additional $2.5 billion into the Bush Administration’s VA healthcare budget for 2005. But by November, with the budget poised for passage, it seemed unlikely that the warnings from veterans groups and VA doctors who sat on the PTSD Committee would be heeded.

Those VA doctors knew that, given the chance, they could treat the disorder better than anyone. They have been on the cutting edge of PTSD since it was first diagnosed in a war whose lessons now seem distant.

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 died there. “I think it was because I just really loved the water,” Durman said.

Durman also loved working on the supply ship where he was stationed and the adrenaline that pulsed 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. Then in 1995 he joined the Virginia National Guard’s 1032nd Transportation Company, based 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 because, Durman said, “you could stab a hole through those doors with a knife.”

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,” Durman said quietly.

In September, Durman’s unit shipped back to Virginia. It was then the nightmares started — about Iraq, but also about 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 pistol. Their sex life, McKay said, went “190 degrees =.


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 the PTSD cases coming out of 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 stress disorder caused by heavy fighting. He called it “irritable heart,” a name changed shortly thereafter to “soldier’s heart.” During World War I, veterans returning home with soldier’s heart were told by military doctors that they had “shell shock” or “combat neurosis.”

After World War II, according to VA psychiatrist Jonathan Shay, 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,” Shay said.

During Vietnam, that Platonic ideal began to shift. In 1970, 20 young vets from the group Vietnam Veterans Against the War asked former Army 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, began meeting in New York with the group in what became known as “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,” he said.

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 PTSD. Still, despite the growing number of vets clearly suffering, the VA wouldn’t accept PTSD as a diagnosis. “This was because many of them were talking about atrocities, and that process was associated with a political view of the war,” Lifton said.

Finally, in 1979, the VA opened up its own network of storefront vet centers. A year later, the American Psychiatric Association recognized PTSD as a legitimate medical diagnosis. And when the National Vietnam Veterans Readjustment Study concluded in 1988 that 30 percent of Vietnam vets suffered from PTSD, not many were surprised. By then, Lifton (who never worked for the VA) and individual VA psychiatrists like Matthew Friedman had become leading experts on PTSD, helping push the condition into psychiatric and public consciousness.

Through group and individual therapy, and sometimes medication, the VA for some time now has been helping psychically wounded veterans to heal, though the process could take years. But by the time U.S. soldiers set foot on Iraqi soil, the VA’s failure to keep up with the enormous growth of its clientele was already causing advancements in PTSD treatment to be compromised.

A new conflict, which bore an uneasy resemblance to Vietnam, would test those advancements even further.

As Crystal Luker tells it, May 5, 2004, was the day her husband’s platoon ran into trouble.

As usual, on that afternoon, Spec. Ron Luker, 27, was patrolling a section of Baghdad with his 1st Cavalry Division platoon, whose stateside home is Fort Hood in central Texas. “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 said. A 19-year-old specialist from Tulsa 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 said. When Luker looked behind him, he was horrified. The third Humvee was gone. He flipped his vehicle around and hurtled back down the street.

Crystal said Luker 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. In the back, Luker found 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, 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 earlier. But when he came home to Fort Hood 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 recalled. When Luker 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 said her husband accused her of cheating while he was gone. He rifled through her purse and the bedroom drawers” and repeatedly listened to old phone messages, searching for proof. “I told him, ‘You’re scaring me! You’re not acting right, Ron!’ ” Crystal said.

Luker 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 fit into a particular trend now evident among veterans of the Iraqi conflict — that of soldiers who are experiencing PTSD almost immediately upon their return from the fighting, as opposed to the usual PTSD pattern of delayed reaction. In some cases, the PTSD symptoms are even more frightening than Luker’s: At Fort Bragg, N.C., home of the elite Special Forces Command, four soldiers — three of whom had recently returned from the Afghanistan conflict — killed their wives in the space of six weeks in 2002. Two of them subsequently killed themselves. Despite the obvious, Army Special Operations Command spokesman Ben Abel was quoted by a respected French news agency as denying that there was a link between the war and the murders. “We don’t have reason to think it was stress-related,” Abel said.

In Columbus, Ohio, three soldiers from the same Fort Benning infantry battalion, which was engaged in some of the Iraq war’s bloodiest early battles, were charged in February 2004 with the murder and subsequent burning of the body of a fourth soldier from the same battalion. A San Antonio soldier from that battalion has been charged with concealing the crime. In a separate incident, another soldier from the battalion was charged with an unrelated murder outside a Columbus nightclub on the same night.

For some soldiers, the demons are closing in even before their tours end. U.S. Army Spec. Joseph Suell of Tyler took his own life two months after being deployed to Iraq and only days after the 24-year-old had e-mailed his wife Rebecca that, “Over here, you never know what’s going to happen next. So I just keep my faith in Jesus and keep my eyes open.” Suell, who’d planned on being a career soldier, was one of 24 American military people who killed themselves in Iraq between April 2003 and April 2004.

VA psychologist Scott Murray says most vets traditionally don’t feel the effects of PTSD until at least 15 months after the experiences that cause it — and it can take years for symptoms to appear. “This early on, PTSD is much higher than anything we’ve seen in previous conflicts,” Murray said. “We anticipate the numbers are only going to keep getting higher.”

Psychologist Kaye Baron currently treats some 70 active soldiers and their families in a private practice in Colorado Springs, near Fort Carson. Many of the soldiers she treats tell her they only want to get far away from their lives at home. “They just want to go off in the mountains,” she said, “and be by themselves.”

Based on clinical discussions she’s had with soldiers, Baron thinks the PTSD rate among Iraq war veterans could spike at 75 percent.

Such a rate, Robert Jay Lifton said, is inexorably tied to the character of the war itself. “This is a counterinsurgency being fought against an enemy who is hard to identify, and that leads to extraordinary stress,” he said.

According to Jonathan Shay, the issue with the most potential for psychological torment is soldiers’ doubt about whether the cause they’ve been led into battle for is a noble one. In his book, Achilles in Vietnam: Combat Trauma and The Undoing of Character, Shay wrote about how the Greek hero felt betrayed by his arrogant general, Agamemnon, whose actions brought down a plague on the Greeks. The battle experiences of many Vietnam veterans caused them to feel much like Achilles, he said. “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.”

Indeed, Dave Durman said he first began feeling uncomfortable in Iraq when it became clear there were no weapons of mass destruction. He said the soldiers in his unit were furious when General Tommy Franks retired mid-war, while the rest of the National Guard and reservists were subject to the Army’s “stop-loss” policy, which is still being used to extend soldiers’ deployments. And Ron Luker was outraged when he saw Iraqi children playing in human sewage gurgling through the streets while the Army did nothing.

That sense of betrayal translates into what Shay calls the nightmares of “complex PTSD”: nightmares, paranoia, violence, self-hate, and a crippling distrust.

Beyond the emotional stress of killing people in a goal-less war, there are additional stress-inducers being borne by the soldiers in Iraq that will certainly add to the number of PTSD cases the military and the VA will have to deal with.

According to Joyce Riley, RN, spokesperson for the American Gulf War Veterans Association and a former captain in the Air Force Reserve, the anthrax vaccine, exposure to depleted uranium, and the effects of Larium (mefloquine, used as a prophylactic against malaria) are all doing great harm to the troops. “I don’t think there’s any question of that. Anthrax vaccine can cause chronic health problems that resemble the Gulf War syndrome: fatigue, memory loss, headaches, sleep disturbance, muscle and joint pain. Larium has side effects that include paranoia, anxiety, hallucinations, suicide, violence, and psychosis. All of these things contribute to PTSD and suicide attempts. Hell, we’ve got people on death row for crimes we believe they committed as a result of these medications — to say nothing of the uppers and downers the military provides some of the troops. We’re turning these kids into emotional zombies.”

As for depleted uranium, she said, “We’ve got entire troops sick from exposure to it. The U.S. military uses it in shell casings, in 500-pound bombs, and even in the lining of tanks. We’ve used maybe 10 times more DU in Iraq than we did in the first Gulf War. A lot of those troops aren’t just sick, they’re dying. The bottom line is that they’re being affected by a number of things. And they have physical problems. And as long as the Department of Defense denies there are physical problems, they are an army left to die.”

Col. James A. Polo, a physician and chief of the Department of Behavioral Health at the Evans Army Community Hospital at Fort Carson, believes those alleged problems are mostly the product of someone’s overworked imagination. “If a kid is having bad effects on Larium, we take them off and give them something else,” he said. “And the depleted uranium — well, I’m not an expert on that, but we’ve been assured the danger is minimal.”

Time will reveal the actual effects of anthrax vaccinations and exposure to massive amounts of DU in the air. And while the military might intend to take soldiers off Larium if they are having any of its horrendous side effects, the reality is that there is not always someone in the field who would even recognize the symptoms, since they so often mimic general battle stress disorders.

One official military policy is adding immensely to the litany of traumatic stress-inducing elements in Iraq: the “stop-loss” program, whereby troops due to return home are told their tours are extended, and many are required to serve a second deployment to Iraq — the first time in modern U.S. warfare that second tours were not voluntary. Yet another stress-inducer: the lack of equipment that many soldiers are dealing with — pointed up most recently by an Army specialist’s much-quoted question to Defense Secretary Donald Rumsfeld. “Why do we soldiers have to dig through local landfills for pieces of scrap metal and compromised ballistic glass to uparmor our vehicles?” he asked. Rumsfeld’s response: “You go to war with the army you have.”

In a subsequent interview, Maj. Gen. Gary Speer, the deputy commanding general of US forces in Kuwait, said that every vehicle that is deploying to Iraq from Kuwait has at least “Level 3” armor—armor for its side panels, but not necessarily bulletproof windows or protection against explosions that penetrate the floorboards, so common in convoy attacks.

Halliburton, Vice President Dick Cheney’s old company, was hired to help in Iraq with many of the resupply jobs traditionally done by the military, from bringing mail to the troops to supplying drinking water and spare parts. It’s a job they have not always done well.

“Don’t even get me started on that,” said Sharon Allen of Fort Worth, whose son is about to leave for his second tour in Iraq. “When my son was there the first time, the people at Halliburton said they couldn’t bring anything because it was too dangerous. They told my son’s company to come get water if they needed it. My son says the only way he kept his tank running was to steal parts. How are he and his crew supposed to support soldiers on the ground if they don’t even have an operating vehicle?”

One sergeant at Fort Hood — who asked that neither his name nor his unit be identified — said that when he’s training men he prefers to tell them the truth. “I tell them they’re not fighting to eliminate weapons of mass destruction because there were none and are none. I tell them we’re not fighting because Hussein harbored Osama, because Hussein hated Osama and would have had him killed if he’d have stepped foot in Iraq. I tell them we’re not fighting for our freedom because no one was threatening it. I tell them the truth: We’re fighting for oil so that their fellow Americans can drive SUV’s and burn gas. That’s all they’re fighting for. That and their own asses. Then I tell them to get home safe. I just can’t lie to them.”

Since reporting on this story began in October, Joshua Peterson and Dave Durman have started therapy at the VA. They’re likely getting some of the most advanced care in the world. They’re also lucky: Peterson’s mother-in-law knows a VA psychiatrist, and Durman was already enrolled, thanks to his time in the Navy.

These soldiers won’t be alone. So far, more than 10,000 veterans from Iraq and Afghanistan have sought psychological help from the VA, and there’s every indication the numbers will jump significantly.

Despite the challenges these numbers predict, Harold Kudler, co-chair of the VA’s PTSD Committee, said: “We’ve never been so prepared,” and points to unprecedented cooperation with the Department of Defense, intensified PTSD outreach, and the 206 vet centers.

But some say that preparation is not enough. “You can only provide the services for which you have the resources,” said psychologist Scott Murray. “There has to be significant improvement in an allocation of funds to make that occur.”

On Nov. 20, Congress added $1 billion to the Bush administration’s $27.1 billion VA healthcare budget for 2005. The amount fell $1.5 billion short of what was recommended by the House Veterans Affairs Committee. And while Congress earmarked an additional $15 million for PTSD, few think that money will make much difference.

“The heads of the VA healthcare networks are all trying to figure out how the hell they’re going to manage,” said Rick Weidman, director of government relations for Vietnam Veterans of America.

As for the VA’s mental health plan, which called for an extra $1.65 billion to fix things fully, VA spokesperson Laurie Tranter said: “We cannot comment on this now. The plan is still being finalized.”

Polo, at Fort Carson, claims that with the mental health evaluations done on each soldier before and after deployment, the Army is doing the best it can. “We offer group therapy for folks who have anger or stress issues, and we have individual treatment for those who need one-on-one therapy. We also have drug and alcohol abuse programs, family relations programs, and offer psychotropic medication to those who need it.”

However, Polo’s group at Fort Carson — six psychiatrists and a total of 35 primary therapeutic caregivers — is dealing with 15,000 men and women coming through the base at a given time, most of them readying for deployment or just returning, which doesn’t allow for much time per soldier.

Polo, who has already been deployed once to Iraq and will go back there soon, is proud of what the military is doing for soldiers therapeutically, but he also admits that among soldiers there are steep emotional barriers to even seeking help. “No one wants to be the weak link,” he said, “and soldiers often feel that if they admit to stress or emotional problems, their fellow soldiers will look down on them, see them as weak. Most studies show that there are a large number of soldiers who won’t come forward to say they need help. They want to tough it out” — like Matthew Williams, who even after his suicide attempt doesn’t admit to having PTSD.

Polo couldn’t say why Williams didn’t get the help he needed. “We [evaluate] a lot of soldiers,” he said. “We’re not perfect. But while I can’t comment on specific cases, I will say that if this fellow had really asked for help, he would have gotten it.”

Williams disagrees. “Soon as you walk in, they’re looking to give you pills,” he said. “I didn’t want pills. I wanted to talk with someone who knew what it was like over there.”

Cathy Wiblemo, deputy director for healthcare at the American Legion, says a veteran’s chances of getting mental help are vastly greater with the VA than with the military itself.

“The military is an infant in this sort of treatment. It’s easier to put those people out and let the VA take care of them,” she said. “The military has had a situation where it’s taboo to even talk about mental issues,” much less treat them.

But while the VA doctors are leaders in treating PTSD, she said, the agency’s funding is “hopelessly inadequate.”

“You’re looking at kids being extended or sent back involuntarily, and the effect of that on these soldiers is very different than the first Gulf War vets,” she said. “Those PTSD figures are going to soar much higher ... and the VA simply won’t have the space, the physicians [or] the psychiatrists ... to provide what they need.”

Peterson’s dream-induced violence, Williams’ suicide attempt, Durman’s drinking, Luker’s accusations about his wife are powerful examples of a similar dynamic. According to the VA, veterans with PTSD are more apt to be jobless, impoverished, homeless, addicted, imprisoned, without a stable family and three times more likely to die younger than the rest of us.

One of the other men with whom Williams served was also put on a waiting list for therapy. He got drunk and wrapped his car around a pole before anyone was free to see him. He was also given an early but honorable discharge. “He’s living on the streets in Dallas now,” Williams said. “Homeless.”

Meanwhile, Williams has met with VA, and said the doctors think “they might be able to fit me in” for counseling. Ron Luker is back in Iraq, and Crystal Luker says she’ll drag her husband to the VA if she has to when he gets home.

Still, all the money and services in the world couldn’t heal the ravages of PTSD for some.

In 1968, a young soldier named Lewis Puller came back from Vietnam minus his legs and parts of his hands, which had been 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 above the physical wounds and the depression and alcoholism that haunted him for years, to live a remarkable life.

But on May 11, 1994, more than a quarter-century after he came home, Puller shot himself. In the end, the soldier’s heart hurt too much.

Amidst an outpouring of grief, one Vietnam vet wrote an e-mail to Jonathan Shay, which Shay published in one of his books. “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.” l

Dan Frosch is a New York-based freelance writer for The Nation, In These Times, and other publications. Peter Gorman writes frequently for Fort Worth Weekly. Barbara Solow with the Independent Weekly in Durham, N.C., also contributed to this story.

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