11.15.2009

max cleland: the forever war of the mind

I understand that many people question the idea that the Nidal Hasan, who opened fire at Fort Hood last week, could have had PTSD, since he was never deployed. These aren't people who are freaked out over the man's name or his ethnic background. These are good people on the side of justice, who feel we're using the expression "post-traumatic" too lightly.

When I heard this, I immediately thought of my friend Dean, a former marine now living in Canada, one of the many war resisters at risk for deportation by the Harper government. I've written about Dean a few times, most recently here. Dean deployed to Iraq twice. In between those two tours, he was stationed at Landstuhl Regional Medical Center, a US military hospital in Stuttgart, Germany.

The rate of severe depression and suicide at the hospital was so high that military brass became concerned. Soldiers were assigned to act as go-betweens for patients and visiting families, and Dean was one of them. He had no medical or social work experience, and was given no training.

Many of the patients were dying. Many were burn victims, so not only were they dying, but in constant, agonizing pain. Families were flown in to say goodbye. Other patients would survive, but with permanent, life-changing disabilities, and adjustment was a long way off.

It was there - not in Iraq, but in the hospital base in Germany - where Dean developed symptoms of severe depression and PTSD. The hospital personnel told him, Don't worry, we all go through that.

This was not from fighting the war, but from seeing its aftermath, up close, all day, every day.

Max Cleland knows something about PTSD. For those not familiar with Cleland, he was a US Senator from Georgia. He is also a Vietnam War veteran, who lost both legs and one arm in that useless war.

Despite succumbing to intense pressure to vote for the Iraq War authorization, Cleland became an outspoken critic of the Cheney Administration. In his 2002 re-election campaign, Cleland's Republican opponent, Saxby Chambliss, resorted to unthinkable tactics, often politely referred to as "questioned his patriotism". Questioned his patriotism? They ran doctored photos of Cleland with Osama Bin Laden and Saddam Hussein! (Where was Saxby Chambliss while Max Cleland was being blown to bits? Gathering student deferrments.)

The campaign defeat re-triggered Cleland's depression. His life came unglued; he feared he wouldn't survive. That's how he ended up at Walter Reed Hospital, surrounded by veterans wounded in Iraq and Afghanistan. (I've blogged about the disgraceful conditions at Walter Reed several times: see here and here.) That's where the shooter was stationed, too. Here's Cleland, writing on Veterans Day, or Remembrance Day in Canada.
The Forever War of the Mind
By Max Cleland

“EVERY day I was in Vietnam, I thought about home. And, every day I’ve been home, I’ve thought about Vietnam.” So said one of the millions of soldiers who fought there as I did. Change the name of the battlefield and it could have been said by one of the American servicemen coming home from Iraq or Afghanistan today. Wars are not over when the shooting stops. They live on in the lives of those who fight them. That is the curse of the soldier. He never forgets.

While the authorities say they cannot yet tell us why an Army psychiatrist would go on a shooting rampage at Fort Hood in Texas, we do know the sorts of stories he had been dealing with as he tried to help those returning from Iraq and Afghanistan readjust to life outside the war zone. A soldier’s mind can be just as dangerous to himself, and to those around him, as wars fought on traditional battlefields.

War is haunting. Death. Pain. Blood. Dismemberment. A buddy dying in your arms. Imagine trying to get over the memory of a bomb splitting a Humvee apart beneath your feet and taking your leg with it. The first time I saw the stilled bodies of American soldiers dead on the battlefield is as stark and brutal a memory as the one of the grenade that ripped off my right arm and both legs.

No, the soldier never forgets. But neither should the rest of us.

Veterans returning today represent the first real influx of combat-wounded soldiers in a generation. They are returning to a nation unprepared for what war does to the soul. Those new veterans will need all of our help. After America’s wars, the used-up fighters are too often left to fend for themselves. Many of the hoboes in the Depression were veterans of World War I. When they came home, they were labeled shell-shocked and discharged from the Army too broken to make it during the economic cataclysm.

So it is again, with too many stories about veterans of Iraq and Afghanistan ending up unemployed and homeless. Figures from the Department of Veterans Affairs show that 131,000 of the nation’s 24 million veterans are homeless each night, and about twice that many will spend part of this year homeless.

We know of the recent failures at Walter Reed Medical Center, where soldiers were stranded in substandard barracks infested with rats while awaiting treatment. I was in Walter Reed myself at that time seeking counseling for post-traumatic stress disorder, which, ignited by a barrage of Iraq headlines and the loss of my United States Senate seat, had simply consumed me.

I never saw it coming. Forty years after I had left the battlefield, my memories of death and wounding were suddenly as fresh and present as they had been in 1968. I thought I was past that. I learned that none of us are ever past it. Were it not for the surgeons and nurses at Walter Reed, I never would have survived those first months back from Vietnam. Were it not for the counselors there today, I do not think I would have survived what I’ve come to call my second Vietnam, the one that played out entirely in my mind.

When I was wounded, post-traumatic stress disorder did not officially exist. It was recognized as a legitimate illness only in 1978, during my tenure as head of the Veterans Administration under President Jimmy Carter. Today, it is not only recognized, but the Army and the V.A. know how to treat it. I can offer no better testament than my own recovery.

Weeks before the troubles at Walter Reed became public in 2007, my counselor put it to me simply. “We are drowning in war,” she said. The problems at Walter Reed had nothing to do with the dedicated doctors and nurses there. The problems had to do with the White House and Congress and the Department of Defense. The problems had to do with money.

When we are at war, America spends billions on missiles, tanks, attack helicopters and such. But the wounded warriors who will never fight again tend to be put on the back burner.

This is inexcusable, and it comes with frightening moral costs. There are estimates that 35 percent of the soldiers who fought in Iraq will suffer post-traumatic stress disorder. I’m sure the numbers for Afghanistan are similar. Researchers have found that nearly half of those returning with the disorder have suicidal thoughts. Suicide among active-duty soldiers is on pace to hit a record total this year. More than 1.7 million soldiers have served in Iraq and Afghanistan. Imagine that some 600,000 of them will have crippling memories, trapped in a vivid and horrible past from which they can’t seem to escape.

We have a family Army today, unlike the Army seen in any generation before. We have fought these wars with the Reserves and the National Guard. Fathers, mothers, soccer coaches and teachers are the soldiers coming home. Whether they like it or not, they will bring their war experiences home to their families and communities.

In his poem “The Dead Young Soldiers,” Archibald MacLeish, whose younger brother died in World War I, has the soldiers in the poem tell us: “We leave you our deaths. Give them their meaning.” Until we help our returning soldiers get their lives back when they come home, the promise of restoring that meaning will go unfulfilled.

Max Cleland, the secretary of the American Battle Monuments Commission, was a Democratic senator from Georgia from 1997 to 2003. He is the author, with Ben Raines, of “Heart of a Patriot: How I Found the Courage to Survive Vietnam, Walter Reed and Karl Rove.”

Another note about Cleland. He was a member of the Kean Commission, the official 9/11 "investigation" (if anything ever deserves scare quotes, is that one). Cleland resigned from the Commission after becoming hopelessly frustrated with the Cheney Administration's stonewalling and cover-ups. Here's an interview with Cleland by PBS's Frank Sesno.

14 comments:

deang said...

I can understand how Nidal Hasan could be suffering from PTSD even though he didn't directly experience war himself.

After I read descriptions of modern torture methods in the early 90s, I began having a hard time being in a doctor's office. I once nearly passed out when an ophthalmologist put dilating drops in my eyes. I didn't realize what was going on, but the nurse suddenly stopped what she was doing and said, "You're turning grey." I then realized I had become light-headed because I was associating the involuntary dilation of my eyes with indescribably horrific medical tortures I'd read about from Guatemala and Chile. It took me a while to "come to" again so they could continue with the procedure.

I have a similar reaction now if I think too long about internal organs or internal physiological systems - it involuntarily brings back memories of medical tortures I read about and makes me kind of light-headed.

I can only imagine what it must be like for Hasan to hear people describe not only their own physical and psychological injuries but those they themselves have inflicted on others.

soho44 said...

Thanks for posting this. Now, here's another perspective on PTSD.

I'm a guy rape survivor with severe PTSD and dissociative disorder. After 20 years of lousy therapists, doctors, the wrong meds and more, I finally found a therapist who actually listens. He's helped a lot and there's been some clarity. But now (due to the economy), I have to move. On the other hand, I have a good network of sources that I can use in the interim.

In my case:

Nobody (other than my therapist) ever listened to me. Nobody's ever said I'm sorry you were raped. Nobody's ever put their arm around me to reassure me.

Why's that? Because they're afraid that they'll get raped too if they do? Because I'm their worst nightmare?

Yes, you can say they're uncomfortable, they don't know what to say. My answer to that is this. Set that aside and show some human decency. Would it kill you to take ten seconds and some concern?

If my current health coverage found out about my PTSD, I could be cancelled. For something that's not my fault.

I still have all the symptoms:
dissociating
flashbacks
lucid dreams
adrenlin surges
physical body memory (bruises and more)

At times I'm driving and you fight to not black out. How do you that when you're having a flashback and there's nowhere to pull over? Then you go home, lock the door and close the drapes. And then scream for another hour or two to fight to not fall apart.

Society tells a woman survivor there's help for you. But if a guy survivor asks for help, he's told you don't exist. But I have many of the same problems that she does. The response: this is just too freaking weird.

The MSM will never touch this topic (except during sweeps weeks). Then it's always little kids that were "abused" by priests. NEVER do they say raped. Why's that? Is it because telling the truth (which ideally is what the MSM is supposed to do) just can't be bothered? So instead we'll exploit the hell out of this for ratings and profit.

Sometimes it takes me twenty minutes to dial a phone number because of adrenalin surges. Sometimes you're this close to blacking out. But society says just shut up and go away.

When I've needed to call a helpline, 99% of the time I get more help from overseas than I do here. This in the "land of the greatest health care in the world."

At times I've thought about emigrating to Canada to get the proper PTSD treatment. I've been told that there are medical visa catagories avaiable. But I'll have to do more research on this.

Are trauma survivors stigmatized in Canada the way there are in the States? I've had national health care abroad before. So I know firsthand that it does work.

If millions of people here are so pissed off about no universal care, then why aren't they marching and not backing down until they get it?:

Because rioting in the streets only happens in other countries. And we don't do that kind of thing here, thanks very much.

Because they're burned out.

Because they're terrified of being jobless and homeless. (I've been homeless twice because of untreated PTSD).

Because they're cynical as hell and just don't care.

Because Obama could use this as a "national emergency" and declare martial law. That's perfectly legal under current regulations.

What does it say when a President gets the Nobel Peace Prize for doing nothing substantive? The only reason people think he's the World's Coolest President that can do no wrong is because he's not THAT OTHER GUY. There were other choices during the campaign. But that's not allowed in "American Politics."

There are no soundbites for guy survivors. No Congressional hearings. No MSM coverage at all. No disrespect to women survivors (vets or civilians). But there ARE guy rape survivors who are vets. And civilians.

And frankly, it's a huge insult to say (directly or indirectly) that because the number is so small, it's not worth talking about for more than 10 seconds.

Thanks for letting me vent.

soho44 said...

I have a PTSD blog. Here's the URL:

ptsdsurvival.blogspot.com

redsock said...

I had a similar experience at work in Toronto last summer. For a fire/evacuation drill, we had to walk down the stairs to the street. At the appointed time, everyone in the department (eight people, maybe) went down together. We are on the 15th floor. Maybe halfway down the stairwell, I started to freak out inside. I kept walking, but was sweating and had a very queasy feeling. People were making small talk, but I was quiet, focused on getting down and out.

It was clear that whatever I had read and thought about people trapped in the WTC on 9/11 was causing these panic feelings.

Which I thought was amazing, but it also felt wrong (and a bit embarrassing). Why should I be feeling that? I had no connection to what happened. I've read a lot about that day, but I was at home when it happened (although in Manhattan) and it was almost seven years ago by that time.

(By the way, is anyone able to see a plane in the sky and NOT think of it as an arrow slicing into a building?)

L-girl said...

Allan, you also worked at the World Trade Center, so you can more easily visualize the scene than people who did not.

I have a similar experience as Dean about a certain detail I learned about the Holocaust when I was a child in Hebrew School. If I hear a certain word, I am instantly nauseated, and sometimes actually vomit.

Thanks to both of you for sharing that.

As you know, I've written about how my own PTSD - from a one-time incident, now more than 25 years ago - still surfaces (see "The Tyranny of the Subconscious" on the sidebar). I find it incredibly frustrating.

I fully understand how someone in Hasan's (or Dean's) position could have PTSD.

redsock said...

If I hear a certain word, I am instantly nauseated, and sometimes actually vomit.

Is it "twoandahalfmen"?

L-girl said...

Soho44, thanks for sharing that. I've known and worked with several male survivors of rape, and my heart goes out to you for the extra levels of isolation and frustration you must deal with. I hope you find the help and community you need, because I know it's out there.

Society tells a woman survivor there's help for you.

I hope you will be careful when you say things like this. Society tells a lot of things to rape survivors, and few of them are positive unless they are the right kind of victim. I believe it's possible to talk about your own pain without holding other people's situation as comparisons.

And frankly, it's a huge insult to say (directly or indirectly) that because the number is so small, it's not worth talking about for more than 10 seconds.

Who says the number is small? That could only be said out of ignorance. The number of male survivors of sexual assault is anything but small.

L-girl said...

The MSM will never touch this topic (except during sweeps weeks).

I hope you are not looking to the MSM for comfort and validation. That would be a mistake of mammoth proportions. It took decades of activism for female rape victims to be taken seriously, and as you know, the job is only partially done.

If you want society to change, you have to join a movement to force it to change. Until/unless you are ready to join with other male victims to demand change, you will never see it. If you do, you still may not see it during your lifetime, but at least you will be working on the problem.

L-girl said...

If I hear a certain word, I am instantly nauseated, and sometimes actually vomit.

Is it "twoandahalfmen"?


ROFL

Thanks for that. :)

Also, when Allan said "I had a similar experience," Soho44's comment wasn't up yet, he was responding to DeanG.

L-girl said...

Soho44, I realize that because you don't know me, you might misinterpret my comments, above.

I'm a rape survivor and have worked in the anti-violence movement as public speaker, writer, counselor, etc.

I have the utmost empathy for what you've been through and I don't mean to suggest anything but that.

It's vitally important, though, that you don't expect anything from the mainstream world in this regard. You and other male survivors have to follow the same path women trod through the 1960s, 70s and 80s. You have to create that space for yourself - you have to shout so loud that people have no choice but to listen. And slowly, they will listen.

The whole movement has come a long way, and you can be part of that. It's incredibly healing to be a part of.

Maybe you already are, I don't mean to assume. But you sound like you're waiting for CNN to catch on. That's a complete waste of your energy, IMO.

soho44 said...

Thanks for posting your thoughts. Maybe I wsn't clear on some points. So I'll try again.

That's true that many parts of society want to fit various types of trauma survivors into neat catagories. I wasn't trying to say that all women survivors instantly get all of the help that they need all of the time. Far from it.

Instead, in my experience when the MSM talks about it, almost never do they talk about guy survivors. It's almost always about women survivors. Women vets who've been raped. The focus is on talking about their problems. And trying to get them help.

Now, does this always happen perfectly every time? Of course not. But again I go back to my other point re: guy survivors. The few times I've heard women who are ex-vets talking about guy survivors, they get maybe 10 seconds of airtime. Then that's it. Which then makes me say, how come I don't count?

Yes, the number of guy survivors isn't small. But in the MSM world, less than 3% (that are "officially reported") is small. Which then is their "justification" for ignoring it.

Of course it's bigger. My therapist tells me that 10% of the Stateside population has some form of PTSD. I work in many parts of the MSM. So no, I'm not pinning my hopes on the MSM solving all of my problems.

And re: activism, I'm about 3 steps ahead of you. I have different outlets and sources that I use to get the word out re: guy survivors.

Nothing personal, but I think it's a poor choice of words to say that maybe it won't change in our lifetime. In general terms, you can say that about a wide range of issues (everything from women's voting rights to gay marriage). But when you're a survivor and this has affected your whole life, you prefer to be optimistic. And to not feel cheated out of never having any happiness at all.

Hope I explained this clearly.

L-girl said...

I'm glad to hear you are several steps ahead of where I imagined you to be, based on your earlier comments.

You find that a poor choice of words, but that's my opinion. I said "it might not change in our lifetimes" and that's a fact - it might not.

Susan B Anthony never saw women achieve voting rights.

Women who fought the earliest battles to normalize violence against women didn't see their work gain wide traction, either.

Forget about African Americans who fought for equality in the 1940s and 50s!

Many fights take many generations. Yours may be no exception. Or you may see significant changes in your lifetime. I see it as a statement of fact, not an optimist vs pessimist thing. You do what works for you.

deang said...

I've given the impression that I think I have PTSD, but I don't really think I have it. I don't feel like my experience has been traumatic enough or insurmountable enough to qualify as PTSD. My reactions have been manageable. I can now think myself out of queasiness using logic. I just wanted to suggest that, if something as seemingly inconsequential as reading about torture could make it difficult for me to think about human physiology, it could well have been traumatizing to the point of PTSD for Hasan to have interacted for long periods of time with real people affected by war atrocities. And then to be ignored when he requested not to be sent to the Middle East, that could certainly send an already unsettled person over the edge.

L-girl said...

I don't know about anyone else, but I knew just what you meant, Dean.