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.

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