Hidden Battles on Unseen Fronts

by Patricia Driscoll

  A medic treated his bullet wound and Bear went back to business until the convoy returned to its Forward Operating Base almost a week later. “There was a lot of frustration over the red tape during our missions. We lost fifteen guys in the time I was there. We’d be in the midst of an RPG attack and be taking twenty or thirty rounds, and then we’d have to call in for permission to engage the enemy: ‘Would it be appropriate to return fire? We have two men down.’ I felt like here we are, soldiers trained to fight, and all we can do is to watch our comrades fall by the wayside.”

  His frustration built up over the months as it became more and more difficult to tell who was friendly and who was not. “We knew not everyone was the enemy, but no one told us how to tell the difference. I wound up killing a twelve-year-old boy because I thought he was an insurgent getting ready to throw a grenade. I killed a man and his wife and the small child she was holding in her arms when their car wouldn’t stop at our roadblock. When reality set in and I realized what I had done and was a part of I tried to talk to my superiors, but they basically said, ‘Suck it up and drive on.’ It’s one of those demons I’ll always live with as a soldier.”

  Iraq wasn’t Bear’s first experience with military service. After graduating from high school and attending a vocational school to study computer graphics, he joined the Army in 1987. By 1990 he was serving with a Special Forces unit. “I was searching for an identity. I was born Blackfoot and Cherokee but I was adopted into a white family and never came to terms with my ancestry. It took me ten years before I came to grips with being a Native American.” In 1996 he met Aiyana (“Flowering Blossom”) at a Native American drumming circle. A few years older, divorced with a daughter, Aiyana brought love and serenity into Bear’s life. “She and I got to talking and learned that we were both interested in exploring more about our spiritual heritage.” They stayed together for fourteen years.

  “When the towers got hit, I was working in the Post Exchange at March Air Force Base. It wasn’t long before I got a certified letter saying they were going to activate my old unit.” In February 2003 he started 90 days of training at Camp Roberts, a 42,000-acre base in central California, and then shipped out to Iraq. Before leaving, he and Aiyana were married on the 14th of April. Six months earlier he had reunited with his biological mother, sister and brother through a birth registry in Nevada. “I left three families when I deployed to war: my adopted family, my biological family and Aiyana.”

  It would be August 20, almost a month after he was injured, before Bear was flown back from Iraq to the United States. “I was in crazy pain but they told me to perform my duties, so that’s what I did. When I got back to Fort Lewis they fixed my leg and discovered damage to my eye and ears due to the blast. But my worst injury was Post-Traumatic Stress Syndrome and no one recognized that condition, not even me, not back in 2003.” He would spend the next year fighting for his sanity.

  “The year at Fort Lewis was bad. My first therapist was an Army Major who refused to believe I had PTSD. She thought that it all related back to being spanked as a child. I got so angry that I slapped her. She pressed charges for that and I almost got an Article 15. Instead they labeled me ‘unstable’ and didn’t allow me off the base.” At one point John was reviewed by a medical board to see if he was capable of being redeployed to Iraq, but was deemed “a threat to the military” and “suffering from a moral flexibility.”

  “I trained so long and so hard that I did what I was told, totally cut off from my emotions. But eventually it came back to haunt me. I had to pay for all that.”

  On February 1, 2004, Bear was retired from the Army with 100 percent disability, 70 percent PTSD. It would be years before his Traumatic Brain Injury from repeated exposure to IED blasts would show up in a CATScan prescribed only because he’d lost all feeling in his right arm. He returned to his family in Oceanside, California, changed.

  I couldn’t relate to anyone when I first got home. I couldn’t hold my wife or my fifteen-year-old daughter. I felt like I was stained. I saw blood on my hands. I had night terrors. I’ve been prescribed up to thirteen medications a day in various combinations, depending on my levels of anxiety and depression.” Bear isolated himself in front of his computer for almost two years. “I became a hermit. It took me a year and a half just to spend twenty minutes inside of a WalMart. People thought I was crazy, but to me they were the ones not connecting the dots. Today it’s the same. If I never left home again, I’d be happy.”

  Bear knew he was in for a long haul after an incident at a grocery store. “I was next to a lady pushing a cart and talking on her cell phone. Her little boy should have been in the booster seat but instead he was running around pulling things down from the shelves and dropping them. Finally the lady yelled and smacked him. I went up to her and said, ‘Lady, if you hit him again I’ll break your arm and shove it up your ass. You should spend less time on the phone and more time taking care of your kid.’ She said, ‘How dare you speak to me like that!’ and I replied, ‘Lady, I’ve earned the right. I bled on the battlefield for you.’ When things like that happened, I just withdrew more.”

  John recognized low tolerance for things people said or did that, before he went to Iraq, would have “rolled right off my back.” After four years of intense therapy, sometimes as often as three times a week, he is coping better with his level-four PTSD, but still grapples with “My evil twins: general anxiety and panic attacks.”

  Early on he also knew his PTSD was affecting his marriage. While he sat paralyzed with anxiety and depression Aiyana was left to run the household, from managing their finances to taking care of the pets, the children, the cooking and the cleaning. When Bear overdrew their bank account with his debit card, they decided she would give him a monthly allowance instead. By 2007 they were wise enough to get some marriage counseling. “There were only so many times that she could hear the same excuse: ‘I’ve got PTSD.’ We had to work through the issues. Now I have a weekly chore list I’m supposed to do but I still forget about it, and that causes trouble.” In the fall of 2008 Bear and Aiyana separated. He now lives in an apartment near his biological family in Las Vegas, where he continues to recover from his PTSD.

  MEDALS

  Army DSC, Silver Star, DoD DSM, Bronze Star, Purple Heart, Joint SVC Commendation, Army Commendation, Army Good Conduct Medal, USA Reserve Achievement Medal, Army National Guard Achievement, Army Defense, Army NCO, Army Service, Army Overseas Ribbon, Army Presidential Unit, Joint Meritorious Unit, Combat Action Badge.

  “The photo captures everything that Americans wanted to believe about the Iraq war in the earliest days of the invasion in 2003. PFC Joseph Dwyer, an Army medic whose unit was fighting its way up the Euphrates to Baghdad, cradles a wounded boy. The child is half-naked and helpless, but trusting. Private Dwyer’s face is strained but calm.”

  —“Losing Private Dwyer,” Lawrence Downes, The New York Times, July 15, 2008

  12

  THE WEAPON OF CHOICE—PATIENCE

  By Charles “Chip” West, PhD

  As reported by the Rand Corporation in the spring of 2008, Post-Traumatic Stress Disorder (PTSD) is one of the top three most frequently occurring “hidden” conditions our soldiers are bringing back from deployment to Iraq or Afghanistan; the other two are major depression and Traumatic Brain Injury (TBI). Combat Stress Reaction, a term used inside the military, is generally a short-term condition that is not interchangeable with PTSD.

  PTSD is classified as a psychiatric disorder, the symptoms of which can be treated. But it presents unique challenges. As a carryover of an intense, real-life experience, PTSD seems to lurk in the shadows, a part of you but not quite part of you. Most people with PTSD feel a troubling loss of self-control as a result. Post-traumatic symptoms defy the willpower war veterans repeatedly muster day after day as they try to move on with their lives. But why does PTSD so often trip up those who suffer from it even as they recognize and do their best to cope with this illness? What is
it about psychological trauma that stands apart from other human experience?

  Trauma is an intense experience that for many people is not processed by their nervous system like other episodes in their lives. It connects with a deep survival mode in the human mind that engages when we are participants in, or witness to, a scenario of real danger to life and limb. Penetrating our “safety zone,” traumatic events expose our mortality and serve as a permanent reminder that feelings of personal safety from moment to moment are not guaranteed. You feel in the midst of the traumatic event or later recognize—through physical sensations perhaps rather than through clear feelings or thoughts—that the threat was powerful enough to shatter your faith in a continuous stream of safe moments. To have unusual personal reactions or “symptoms” in the wake of such an experience is quite normal. Reactions to trauma only move into the realm of PTSD when they endure over time and are consistently disruptive to your life as you now try to lead it.

  No predictive model has yet been devised that can reliably distinguish the at-risk from the immune to PTSD. It can inflict anyone. Most notably, courage and bravery are separate attributes from susceptibility to PTSD. Soldiers can win the Purple Heart and have performed courageously in countless ways known only to the soldiers themselves, yet still can suffer from PTSD. What does that say? Character flaws are not the reason PTSD emerges. A prior history of traumatic experiences can count as a factor, as can certain life values related to the “shoulds and should-nots” of human behavior that you saw violated in the war zone, yet PTSD does not spare the courageous and inflict the weak-minded. There are few blacks and whites and many shades of gray.

  Because your war zone experience went on for months, with daily exposure to danger for which you were trained with fellow soldiers, you lived the military culture of grinding on through life-threatening experience as routine. The routine threat, however, never invited complacency, and you were forever vigilant and ready to protect against it for the survival of your fellow soldiers and to accomplish your mission. Your PTSD was enmeshed in this culture, but you didn’t have the luxury of down time to experience its symptoms. While in theatre, as we read in the experience of Sergeant John Radell in the previous chapter, you had to “suck it up and drive on.” But now PTSD is like throwing gas on the fire of cultural differences you already feel with civilians upon your return from the war. Your own family and loved ones know you have changed, but you cannot bridge over to them from where you are because you cannot describe what happened to you “over there.”

  You risk suffering in isolation because of fear of being judged—a feeling that increases the sense of alienation from yourself and leads you to not feel at home in your own mind and body. You have changed as a function of your war zone experience. You feel different from other people and estranged from some aspects of American culture that used to have a comfortable familiarity. All those feelings that alienate you from others make it that much more challenging to trust anyone enough to let them help you.

  Mustering the courage to allow others to help you even while you feel unsafe is one of your bigger challenges. As Second Lieutenant Sylvia Blackwood-Boutelle recommends in the next first-person account,

  “You have to get ‘Team You’ together. You can’t be afraid to ask for help.” Patience is needed on the road to recovery. You cannot control how long it will take to free yourself of active symptoms—those day-to-day anxiety and panic attacks that paralyze—you can only keep supporting yourself and allow others in.

  As you engage the next challenge in your life, you have to patiently respect your pace of recovery. If you return to civilian work, you will have limited control over what you are exposed to and get “triggered” into PTSD symptoms from time to time. Riding in a car in heavy traffic, you will have times of barely holding panic in check. But you are doing the work with yourself that you have to do—slowly building a new track record of safety in the world. You do so because there is no simply snapping out of the consequences of the traumatic experiences you have had. The key is not trying to avoid experiences that trigger symptoms, but having the resiliency to push past them.

  You also need patience when it comes to accessing the right level of care. You have to be a relentless advocate for yourself. You are entitled to good care, but pursuing that care can be very frustrating if your sense of entitlement is not in sync with the resources of your local health care system. Managing this frustration will by itself test your capacity to champion your own recovery. Let other people partner with you in identifying what programs and services are accessible to you.

  When you investigate treatment options, you will discover that there are so-called “evidence-based” treatments available that do not involve drugs. Evidence–based refers to the fact that these procedures have been through trials of scientific testing that support the claim that their use leads to positive outcomes. Underlying several of the treatment methods is the idea that repeated, controlled exposure to reminders of the original traumatic events while under the supervision of a trained mental health professional allows your nervous system (including the power plant of your nervous system, the brain) to settle down. A successful outcome is remembering clearly what happened while learning to dampen down the more extreme emotional and physical response to the event(s). You may still need to talk with a professional about the bigger picture of your experience—like the question of where to go from here—but you have unhooked yourself from the daily dread of being triggered into a gut-wrenching reliving of the trauma.

  Above all, keep the faith that you can restore some balance to your life again as a civilian. Obtaining well-deserved benefits from the government does not fill the vacuum left when you have not yet found a new productive and meaningful use of your time. Not surprisingly, veterans who return to work in some capacity have an easier time with a host of adjustment issues, including the management of PTSD symptoms. Anchor efforts to help yourself around a new focus, occupation or mission, for the more you build from where you are now the more resilience you will find within yourself.

  13

  A WOMAN AT WAR

  The Story of Army Second Lieutenant Sylvia Blackwood-Boutelle

  “Death was all around you all the time. It was war, after all. People were being injured, killed; people I knew, friends. But no one talked about the gore. We denied it because if we didn’t deny it we’d mess up our careers.”

  On the evening of March 29, 2007, Sylvia Blackwood-Boutelle was taking the subway to a reception. She was working in Crystal City as chief of media relations for the Special Inspector General for Iraq Reconstruction, and social events after work were ordinary occurrences. But as the train pulled up to Metro Center she blanked on where she was going or why, and she panicked. “At that moment my whole life came crashing down. I found my way home and cried the entire night.” By 4 a.m. she had pulled out her Leatherman knife intending to slash her wrists. “Then I saw my son’s face and I realized I just couldn’t kill myself.”

  At sunrise she drove to a VA medical center, sobbing the entire way. “I got myself to the hospital in DC and begged them to admit me. I waited for hours before they finally let me talk to a doctor.” Sylvia spent the next week in 3D East, the psychiatric ward. “I was locked down with twenty men and a couple other women,” she remembers. “The place was empty. Barren. There was nothing to do but walk the corridors and pray that your meds would kick in long enough to make the panic attacks go away for a few hours. I spent a lot of time joking around with everyone about how crazy we all were.”

  She would talk to a number of psychologists during that week, but none of them offered any remedy for her mental anguish. “A friend of mine, who was a doctor in the Air Force, made some calls and found me a space at the Fort Thomas PTSD residential women’s clinic in Kentucky.” The clinic provides highly personal care to only a few veterans at a time with hours of group and individual therapy each week. It was there that Sylvia learned she had Post-Traumatic Stress Disor
der. She was forty-two, a mother of a seven-year-old boy and a veteran of three deployments to Iraq.

  Recognizing her PTSD didn’t make it go away or any easier to cope with. “When I returned to the house in DC where I was renting a room from two women, one of whom was a veteran of the Iraq war, I discovered they had kicked me out. They’d packed up all my stuff in boxes and put the boxes in a storage unit. I went to live with friends fifty miles outside Washington and commuted to my job in Crystal City, until my car was stolen a couple of months later. Basically you could say that for the next year I was always on the verge of homelessness and always battling PTSD.” This wasn’t how her career path was supposed to unfold.

  Sylvia grew up in a military family. Her father was a colonel in the Army, and her mother had been a staff sergeant in the Air Force. After graduating from high school Sylvia left for Los Angeles. “I wanted to be a rock star, and naturally the only place to do that was LA. Of course that didn’t work out and eventually I came to my senses and decided to go to college.” She graduated with a degree in English literature from San Francisco State, and by 1994 had joined a Civil Affairs unit out of Oakland Army Base, first as a reservist and then going active duty so she could make enough money to buy a car.

  By 2000 she’d been married six years and was in the process of volunteering for Bosnia when she discovered she was pregnant. She went back to being a reservist, but then in September 2003 she was called up to serve with the 222th Broadcast Operations Detachment in Baghdad. “When I found out that I was going to Iraq I went numb all over. I had less than two months to prepare for leaving my two-year-old son, Holden.” Sylvia trained at Fort Lewis, Washington for a month, and then on November 13 flew directly to Baghdad. “It was so cold there, especially on the convoys. We had Vietnam era vests, no heavy coats. I spent Thanksgiving at Logistics Support Area Anaconda, or ‘Camp Anaconda’ outside of Balad Airbase… we called it ‘Mortaritaville’.”