Hidden Battles on Unseen Fronts

by Patricia Driscoll

  The National Intrepid Center of Excellence is designed to provide leading-edge services for advanced diagnostics, research, initial treatment planning, family education, introduction to therapeutic modalities, referral and reintegration support for warriors with PTSD, complex psychological health issues, and/or TBI. The planned 75,000-square-foot facility is being funded by the Intrepid Fallen Heroes Fund, a not-for-profit agency that raises money to support military service members and their families. It is expected to be complete in the fall of 2009 in Bethesda, Maryland, the current home of the National Naval Medical Center and future site of the new consolidated Walter Reed National Military Medical Center.

  The newest component to formally be included in the DCoE core network is the Tele-Health and Technology Directorate and Center, also known as “T2.” This emerged from the need to have high-technology, advanced state-of-the-art care through innovation. This center fosters comprehensive programs that develop, standardize and deploy technologies for psychological health and TBI. It ensures psychological health and TBI providers are available to all service members and their families on a 24/7 basis, and effective access to care will be provided in underserved areas.

  The conflicts in Iraq and Afghanistan have brought challenges not anticipated from past wars. Ironically, it’s because of incredible advances in battlefield medicine and selfless devotion to duty that more service members are surviving battlefield injuries that would have been fatal in previous wars. The DCoE is currently moving forward with a unique momentum as the Department of Defense organization providing our service members and their families with the best possible care for psychological health and traumatic brain injury.

  17

  A NEVERENDING BATTLE

  The Story of Army Corporal Jonnei Campaz

  “Out of desperation we got together all our jewelry, more than $2,000 worth, and pawned it for $300 to pay our gas and electric bills.” But they couldn’t pay their rent. Jon wrote his Congressman. “I said, ‘I’m a disabled veteran and my family is going to get thrown out of our house.’ They wrote back that they were not a federal agency so there was nothing they could do. No one wanted to help us.”

  In 1993 when Army Corporal Jonnei (“Jon”) Campaz was honorably discharged after spending eighteen months at Walter Reed Medical Center recovering from injuries received during Operation Desert Storm, the subject of brain injury or Post-Traumatic Stress Syndrome never came up. “No one sat me down and talked to me about mental conditions. They classified me as 20 percent disabled due to my injuries, but I was walking again. I was outta there.”

  Figuring his migraines, nightmares, flashbacks, irritability and jumpiness were “just part of what happened when you were in combat,” Jon assumed that he had no choice but to tough it out. He’d joined the Army right out of high school. Now, three years later, he was 21 and on his own.

  He married a soldier whom he had met at Walter Reed when they were both patients. They moved back to Merchantville, New Jersey and tried to make a life for themselves. They had a little boy, Korey, but Jon’s mental state started to impact their life together almost from the beginning. “I didn’t adjust well to civilian life and I took it out on everyone around me. I’d left the Army so bitter. I was angry at everything. I couldn’t concentrate. My wife and I fought all the time. Maybe I was bipolar, I don’t know. There were a lot of highs and then low lows. I had migraines, like some sort of chronic hangover headache, almost every day.” Jon and his first wife divorced. Afterward Jon, who had custody of his son, started dating Dee, an English woman and single parent of Donoven, four years younger than Korey. Everyone got along so well that it soon became obvious theirs was a family in the making. They got married in 2001 and rented a townhouse in Lumberton, New Jersey, with an option to buy. Jonnei started making good money in the mortgage industry and Dee got a job as a file clerk.

  Ever since he’d returned from combat Jon had had recurring nightmares and flashbacks to the evening of February 16, 1991, the last time he can recall being in the Gulf. “We were driving along about 22 miles outside of Kuwait, and everyone was relaxed, just joking around. Suddenly the Bradley in front of us exploded. Boom. It was on fire; people were screaming. We jumped out of our Humvees and took positions. Then another Bradley was hit. Boom. We started running toward the vehicles.

  “It was complete chaos, dark. It was crazy. We were taking fire and shooting back. You could see gun flashes. I remember trying to pull a guy out of one of the Bradleys. He was on fire and I could smell his flesh burning. Then I heard another explosion and I felt something hit me and that’s the last thing I remember.” Jon was later told that a canister on one of the damaged Bradleys had exploded and hit him on the head and neck. He also suffered a gunshot wound in the back. A day later he was Medevac’d out of Kuwait to Walter Reed Medical Center. “My right arm was paralyzed. I couldn’t walk. It took a long time for everything to come back, but it did. It was the mental stuff that they couldn’t fix.”

  Eight years later, happily married to Dee, Jon was still often irritable and jumpy around loud noises. He had trouble remembering things. In crowds he was guarded and anxious. “I couldn’t stand the smell of barbeque. Still can’t. It reminded me of burning flesh. It’s a sweet smell. You could smell a burning body a mile away.” “I tried to sympathize with his mental problems,” Dee says. “We didn’t know he had PTSD so it never occurred to us that he could get benefits from the Veterans Administration.”

  Then in the spring of 2004 Jon’s health started to deteriorate. He was diagnosed with diabetes in March, the same month their daughter, Veronique, was born. Dee quit her job. “I was making $9.50 an hour and it just didn’t make sense to keep on working with a new baby.” Jon continued to work but in August he had a stroke. “My health just went south. For a while we survived on savings, but the money ran out real fast. We kept getting farther and farther behind.” His recovery in the hospital was complicated by Gastroparesis, a diabetic condition that affects the nerve endings in the stomach. “I couldn’t hold anything down. You gotta eat extremely small meals and liquids. The conditions worked against each other. I needed to get strong and do physical therapy, but at the same time I was getting weaker and losing weight from the stomach allergy.”

  When Jon finally left the hospital, his health was still in jeopardy but his mental state was worse. He tried to cope with an increase in nightmares and the worst migraines he’d ever experienced. Unable to work or take care of the children, he stayed at home, depressed and angry. “No one understood what I was going through. When I’d try to explain, they treated me like crap. They’d say, ‘Go out and get a job and support your family.’ The family was living on $1,300 a month from state unemployment and $220 a month from the VA.

  An old customer urged him to apply for an increase in benefits from the VA, and in 2005 he finally did. “It must have taken ten trips to the Veterans’ Center in Philadelphia and Newark to get them to even consider me,” Jon recalls. “At first they said, my deployment was so long ago, it would take some time to get all the documents and a long time to process, and there were no guaranteees.” Once he was screened and retested Jon was classified 60 percent disabled with severe PTSD. But by then the two wars in Afghanistan and Iraq had created a two-year processing logjam before applicants began to receive benefits. It would be April 2007 before the Campaz family would see a dime. Meanwhile Jon was diagnosed with bowel cancer.

  “I think it was during Jon’s chemotherapy at the end of 2005 that we were at our lowest point, Dee says. “We almost separated. We had so little money that we sent Korey back to live with his mom. Both younger children missed their brother terribly. I just kept thinking, ‘We got to find our way through this. There’s got to be a way.’” They applied for food stamps. “We went into the office,” Jon recalls, “and the woman looked out the window and saw my 1997 Ford Explorer and said, ‘If you own that car, you make too much money for food stamps. Sell it and come back.’ She was rushin
g us out of the office. I was humiliated.”

  Jon went to a local charity center to see if he could qualify for any amount of money to tide them over, but when a representative from the center made a home visit and saw a two-year-old wide screen television and an “X” box Jon had purchased for his children during better times, she denied his request. “No one would believe that we couldn’t pay our bills. Out of desperation we got together all our jewelry, more than $2,000 worth and pawned it for $300 to pay our gas and electric bills.”

  Jon wrote his Congressman. “I said ‘I’m a disabled veteran and my family is going to get thrown out of our house.’ They wrote back that they were not a federal agency so there was nothing they could do. No one wanted to help us.” What the Congressional office did do, however, was recommend that Jon seek an independent human services agency. “Through a Google search I found the Armed Forces Foundation. One phone call later, the rent was paid. They also provided the name of other agencies such as USA Cares, which enabled us to get some of the past due bills paid to get back on track.” In early 2006 Dee got a job as a floor manager at Linens and Things, and the Campaz family received additional help from the American Legion. Somehow the family, including Korey, who had returned from his mother’s, hung on until Jon’s benefits kicked in.

  Today Jon and Dee are both going to school, Jon to get his degree in social work, and Dee to become a certified medical assistant. After a lengthy to-and-fro with the VA, Jon was finally screened for TBI and has now been certified 100 percent disabled, but that will never stop him from going after a career. “I’ve been working since I was sixteen, and I want to provide for my family. I think I’ll make a good social worker because I’ve been there. I know what it’s like to have problems no one will recognize. I know what it’s like to be on the verge of being homeless.”

  Life is still a battle. Jon takes 20 pills a day, not counting two types of insulin. He must use a sleep apnea machine, and the doctors at the VA have yet to find a remedy for his migraines. And the Campaz marriage has its ups and downs. “We’ve learned how to be more patient with each other, more supportive. The kids get us going sometimes but they’re good kids. I love my kids. We still argue but we won’t ever give up. I believe in my family. Family is everything.”

  Jon continues: “I do not blame any one for what happened to me; I chose to be a soldier and I am proud to have given it my all. As a soldier I chose to put myself in harm’s way. As J.D. Sallinger wrote in Catcher in the Rye, ‘The mark of the immature man is that he wants to die nobly for a cause, while the mark of the mature man is that he wants to live humbly for one.’ I choose to live humbly for one. My family knows that without the darkness we cannot appreciate the light.”

  MEDALS

  (Among others) Bronze Star with “V” attachment, Purple Heart.

  “In many cases these caregivers have had to sell the family home, quit their jobs, and move their families to be closer to hospitals. The result is that taking care of their disabled loved one becomes their full time occupation. They end up putting on hold their careers and lives and in some cases they are dealing with a person that does not resemble the love one before the injury. Gaining access to the limited benefits is time consuming and not at all easy.”

  —“The Challenges of the Caretakers of Disabled Veterans,” Ginny Estupinian, April 30, 2008, VeteransTransitionweblog

  18

  THE REAL STORY BEHIND YOUR STORY

  By Dr. Rick Levy

  Bill Moeller, a 58-year-old veteran of the Vietnam War, called my office for an appointment, saying I was his last hope after he had seen a TV news feature on my work. Bill had served in the First Cavalry Division, one of the most decorated units of the war. He was a hero by anyone’s standard, awarded the Bronze Star, the Vietnam Service Medal with Bronze Star, the Vietnam Campaign Medal, and the National Defense Service Medal, though he is quick to deny he did anything exceptional during the conflict.

  After Vietnam, life was torture. For 35 years he was sleepless every night, consumed by rage and a visceral fear that haunted him; he couldn’t walk down the street of his hometown without feeling like he was under attack. He suffered from flashbacks in which he relived the worst moments of his military career, like the day one of his friends was blown up beside him. And he endured chronic guilt because he couldn’t save his friend or the other members of his troop. Bill succumbed to alcoholism, a battle he waged and won. But his erratic behavior was harmful to the people he loved. His marriage and his relationship with his only child became further casualties of the Vietnam War.

  Bill succeeded in business in the years that followed. But finally, the stress of corporate America combined with the strain of undiagnosed Post-Traumatic Stress Disorder began to take a life-threatening toll. He had a pulmonary embolism, followed by a massive heart attack. He was unable to work, and would struggle just to walk, which left him winded and suffering from angina. But Bill had the heart of a lion. Armed with state-of-the-art methods from the field of mind-body medicine, we used the power of his mind to free him from the psychological and physical wounds of war, lead him to health, and help him to create the life he most wanted to live.

  Bill’s physical health problems were caused by his PTSD, but the cause of his PTSD was secreted away in his mind; therefore, one of our primary clinical goals was to find it and dismantle it, which we did.

  “Every disease begins with dis-ease”—this is an essential tenet of mind-body medicine. When reality clashes with our needs and expectations, as it had repeatedly for Bill during his time in Vietnam, disease arises in the mind in the form of grief, anger, terror and distorted thinking. Sometimes we can resolve our dis-ease while it’s happening, but for the soldier that isn’t possible. A soldier must devote all of his or her energy to survival—there is simply no time to process and deal with the constant trauma and anguish that arises 24/7.

  If we can’t resolve our dis-ease while it’s happening, we can sometimes resolve it later using psychological methods. In Bill’s case, he had never been afforded this opportunity. (The clinical methods I use in my practice today weren’t available in the late ’70s, or even the ’80s.) If we can’t find a way to resolve our dis-ease, and it persists, the subconscious mind will place it symbolically in the body in the form of illness. The subconscious mind does this not to hurt us but to communicate that there is something wrong that needs our attention.

  The bottom line from a clinical perspective is that every illness (mental or physical) has a related root in the mind: find that root and pluck it out and recovery time is reduced or eliminated. Some people find this hard to believe because they don’t realize how much of their “thinking” is going on at an unconscious level. Most of us rely only on our conscious minds (everyday thoughts and feelings) for self-insight, but the conscious mind is the smallest part of the mind. The subconscious mind—a storehouse of memory, feeling and deep self-knowledge—is almost three times the size and power of the conscious mind. Among other things, the subconscious contains a record of the experiences, feelings and thoughts of a lifetime, reaching as far back as infancy. You probably can’t remember what you were doing on New Year’s Eve when you were three, but the subconscious mind has it all tucked away in high definition with surround sound.

  For the veteran with PTSD, repeated exposure to life-threatening trauma saturates the subconscious mind with the experience of terror and helplessness to such a degree that it chronically invades the conscious mind—it creates the conscious expectation that ordinary, everyday events will be life threatening and heartbreaking, and that ‘there isn’t anything I can do about it.’

  It is easy to see how Bill’s experience in Vietnam led first to PTSD and then to heart disease. His subconscious mind was densely populated with the continual experience of tragic death, unresolved grief, guilt and helplessness. Consciously, Bill was home, living a seemingly safe existence. But subconsciously, his life was a “heart-rending” battle. In my clinical opinion,
any one of the traumatic experiences he endured in Viet Nam would cause psychological instability and physical illness in the average person. This is Bill’s story, as told in his own words…

  In April of 1970, I arrived in the Republic of South Vietnam. It was about 3:30 am when the Captain of the chartered Boeing 707 announced we would be landing soon. I looked out the window, and for as far as I could see there were fires everywhere. At first I thought they might be campfires that were keeping our troops warm, but as we got closer, I could see they were buildings and huts that were ablaze. The pilot came back on the intercom and announced he was going to circle around the airbase and land to the west using no landing lights, no cabin lights and a very steep approach—something he had to do because the airbase at Bien Hoa was under attack.

  When the door of the aircraft opened, the most acrid odor I have ever smelled assailed me. It was cordite—jet fuel used to burn human feces, backed by the smell of burning buildings and jungle rot. The sound of artillery shells exploding and the roar of fighter aircraft was deafening. We were met by an Air Force enlisted man who told us to hurry into the terminal and huddle close to the walls because the perimeter of the building was surrounded by sandbags. The humidity was so bad that by the time we got in the terminal our clothing was sticking to our bodies and the sweat was pouring off us. We were told not to worry, we would get used to it. I got used to the sweat, but I never got used to the smell or the explosions. After my return from Nam and for three decades to follow, bad smells and loud abrupt sounds would trigger uncontrollable fear and flashbacks in me.

  I was trained in Avionics at Fort Gordon Georgia for eight months before arriving in Vietnam, so I was sent to the Avionics hooch at the Cav Rear. Our shop and hooch were just behind the main hanger, and I was often on the flight line. Soon after my arrival, I was on the line taking the radios out of a Loach helicopter. Another Loach came in for a landing. The pilot taxied the bird to his respective spot, put the engine on idle, and the Crew Chief got off the aircraft to load something on board. As I was watching, I observed the Crew Chief getting too close to the tail rotor blade. I started to scream at the top of my lungs to warn him, but the noise of the engine and his flight helmet prevented him from hearing. All of a sudden he walked backwards into the tail rotor, which split his head and helmet into a million pieces. I rushed to help him, along with many others. After he was medevac’d out I returned to the safety of my hooch and cried for hours. For the first time in my life I saw someone die, needlessly.