Save Our Vets News1

Posted 2/28/2005 2:08 AM
Trauma of Iraq war haunting thousands returning home
By William M. Welch, USA TODAY

MORGANTOWN, W.Va. — Jeremy Harrison sees the warning signs in the Iraq war
veterans who walk through his office door every day — flashbacks, inability to relax
or relate, restless nights and more.

Jesus Bocanegra, 23, who has been diagnosed with post-traumatic stress disorder,
visits the South Texas War Memorial.
By Robert Deutsch, USA TODAY

He recognizes them as symptoms of combat stress because he's trained to, as a counselor at the small storefront
Vet Center here run by the U.S. Department of Veterans Affairs. He recognizes them as well because he, too, has
faced readjustment in the year since he returned from Iraq, where he served as a sergeant in an engineering
company that helped capture Baghdad in 2003.

"Sometimes these sessions are helpful to me," Harrison says, taking a break from counseling some of the nation's
newest combat veterans. "Because I deal with a lot of the same problems."

As the United States nears the two-year mark in its military presence in Iraq still fighting a violent insurgency, it is also
coming to grips with one of the products of war at home: a new generation of veterans, some of them scarred in ways
seen and unseen. While military hospitals mend the physical wounds, the VA is attempting to focus its massive health
and benefits bureaucracy on the long-term needs of combat veterans after they leave military service. Some suffer
from wounds of flesh and bone, others of emotions and psyche.

These injured and disabled men and women represent the most grievously wounded group of returning combat
veterans since the Vietnam War, which officially ended in 1975. Of more than 5 million veterans treated at VA
facilities last year, from counseling centers like this one to big hospitals, 48,733 were from the fighting in Iraq and
Afghanistan.

Many of the most common wounds aren't seen until soldiers return home. Post-traumatic stress disorder, or PTSD, is
an often-debilitating mental condition that can produce a range of unwanted emotional responses to the trauma of
combat. It can emerge weeks, months or years later. If left untreated, it can severely affect the lives not only of
veterans, but their families as well.

Of the 244,054 veterans of Iraq and Afghanistan already discharged from service, 12,422 have been in VA
counseling centers for readjustment problems and symptoms associated with PTSD. Comparisons to past wars are
difficult because emotional problems were often ignored or written off as "combat fatigue" or "shell shock." PTSD
wasn't even an official diagnosis, accepted by the medical profession, until after Vietnam.

There is greater recognition of the mental-health consequences of combat now, and much research has been done
in the past 25 years. The VA has a program that attempts to address them and supports extensive research.
Harrison is one of 50 veterans of the Iraq and Afghanistan wars hired by the VA as counselors for their fellow
veterans.

'It takes you back there'

Post-traumatic stress was defined in 1980, partly based on the experiences of soldiers and victims of war. It produces
a wide range of symptoms in men and women who have experienced a traumatic event that provoked intense fear,
helplessness or horror. (Related story: Iraq injuries differ from past wars) The events are sometimes re-experienced
later through intrusive memories, nightmares, hallucinations or flashbacks, usually triggered by anything that
symbolizes or resembles the trauma. Troubled sleep, irritability, anger, poor concentration, hypervigilance and
exaggerated responses are often symptoms.

Individuals may feel depression, detachment or estrangement, guilt, intense anxiety and panic, and other negative
emotions. They often feel they have little in common with civilian peers; issues that concern friends and family seem
trivial after combat.

Harrison says they may even hit their partners during nightmares and never know it.

Many Iraq veterans have returned home to find the aftermath of combat presents them with new challenges:

• Jesus Bocanegra was an Army infantry scout for units that pursued Saddam Hussein in his hometown of Tikrit. After
he returned home to McAllen, Texas, it took him six months to find a job.

He was diagnosed with PTSD and is waiting for the VA to process his disability claim. He goes to the local Vet Center
but is unable to relate to the Vietnam-era counselors.

"I had real bad flashbacks. I couldn't control them," Bocanegra, 23, says. "I saw the murder of children, women. It was
just horrible for anyone to experience."

Bocanegra recalls calling in Apache helicopter strikes on a house by the Tigris River where he had seen crates of
enemy ammunition carried in. When the gunfire ended, there was silence.

But then children's cries and screams drifted from the destroyed home, he says. "I didn't know there were kids there,"
he says. "Those screams are the most horrible thing you can hear."

At home in the Rio Grande Valley, on the Mexico border, he says young people have no concept of what he's
experienced. His readjustment has been difficult: His friends threw a homecoming party for him, and he got arrested
for drunken driving on the way home.

"The Army is the gateway to get away from poverty here," Bocanegra says. "You go to the Army and expect to be
better off, but the best job you can get (back home) is flipping burgers. ... What am I supposed to do now? How are
you going to live?"

• Lt. Julian Goodrum, an Army reservist from Knoxville, Tenn., is being treated for PTSD with therapy and anti-anxiety
drugs at Walter Reed Army Medical Center in Washington. He checked himself into a civilian psychiatric hospital after
he was turned away from a military clinic, where he had sought attention for his mental problems at Fort Knox, Ky.
He's facing a court-martial for being AWOL while in the civilian facility.

Goodrum, 34, was a transportation platoon leader in Iraq, running convoys of supplies from Kuwait into Iraq during
the invasion. He returned to the USA in the summer of 2003 and experienced isolation, depression, an inability to
sleep and racing thoughts.

"It just accumulated until it overwhelmed me. I was having a breakdown and trying to get assistance," he says. "The
smell of diesel would trigger things for me. Loud noises, crowds, heavy traffic give me a hard time now. I have a lot of
panic. ... You feel like you're choking."

• Sean Huze, a Marine corporal awaiting discharge at Camp Lejeune, N.C., doesn't have PTSD but says everyone
who saw combat suffers from at least some combat stress. He says the unrelenting insurgent threat in Iraq gives no
opportunity to relax, and combat numbs the senses and emotions.

"There is no 'front,' " Huze says. "You go back to the rear, at the Army base in Mosul, and you go in to get your chow,
and the chow hall blows up."

Huze, 30, says the horror often isn't felt until later. "I saw a dead child, probably 3 or 4 years old, lying on the road in
Nasiriyah," he says. "It moved me less than if I saw a dead dog at the time. I didn't care. Then you come back, if you
are fortunate enough, and hold your own child, and you think of the dead child you didn't care about. ... You think
about how little you cared at the time, and that hurts."

Smells bring back the horror. "A barbecue pit — throw a steak on the grill, and it smells a lot like searing flesh," he
says. "You go to get your car worked on, and if anyone is welding, the smell of the burning metal is no different than
burning caused by rounds fired at it. It takes you back there instantly."

• Allen Walsh, an Army reservist, came back to Tucson 45 pounds lighter and with an injured wrist. He was unable to
get his old job back teaching at a truck-driving school. He started his own business instead, a mobile barbecue
service. He's been waiting nearly a year on a disability claim with the VA.

Walsh, 36, spent much of the war in Kuwait, attached to a Marine unit providing force protection and chemical
decontamination. He says he has experienced PTSD, which he attributes to the constant threat of attack and
demand for instant life-or-death decisions.

"It seemed like every day you were always pointing your weapon at somebody. It's something I have to live with," he
says.

At home, he found he couldn't sleep more than three or four hours a night. When the nightmares began, he started
smoking cigarettes. He'd find himself shaking and quick-tempered.

"Any little noise and I'd jump out of bed and run around the house with a gun," he says. "I'd wake up at night with cold
sweats."

A recent Defense Department study of combat troops returning from Iraq found that
soldiers and Marines who need counseling the most are least likely to seek it because
of the stigma of mental health care in the military.

By Robert Deutsch, USA TODAY
Jesus Bocanegra is waiting for the VA to process his disability claim.

One in six troops questioned in the study admitted to symptoms of severe depression,
PTSD or other problems. Of those, six in 10 felt their commanders would treat them
differently and fellow troops would lose confidence if they acknowledged their problems.

A report this month by the Government Accountability Office said the VA "is a world leader in PTSD treatment." But it
said the department "does not have sufficient capacity to meet the needs of new combat veterans while still providing
for veterans of past wars." It said the department hasn't met its own goals for PTSD clinical care and education, even
as it anticipates "greater numbers of veterans with PTSD seeking VA services."

Harrison, who was a school counselor and Army Reservist from Wheeling, W.Va., before being called to active duty
in January 2003, thinks cases of PTSD may be even more common than the military's one-in-six estimate.

He is on the leading edge of the effort to help these veterans back home. Harrison and other counselors invite Iraq
and Afghanistan veterans to stop in to talk. Often, that leads to counseling sessions and regular weekly group
therapy. If appropriate, they refer the veterans to VA doctors for drug therapies such as antidepressants and anti-
anxiety medications.

"First of all, I let them talk. I want to find out all their problems," he says. "Then I assure them they're not alone. It's
OK."

Fifty counselors from the latest war is a small number, considering the VA operates 206 counseling centers across
the country. Their strategy is to talk with veterans about readjustment before they have problems, or before small
problems become big ones. The VA also has staff at 136 U.S. military bases now, including five people at Walter
Reed, where many of the most grievously injured are sent.

The toughest part of helping veterans, Harrison says, is getting them to overcome fears of being
stigmatized and to step into a Vet Center. "They think they can handle the situation themselves," he says.

Vet Centers provide help for broader issues of readjustment back to civilian life, including finding a job,
alcohol and drug abuse counseling, sexual trauma counseling, spouse and family counseling, and mental
or emotional problems that fall short of PTSD.

More than 80% of the staff are veterans, and 60% served in combat zones, says Al Batres, head of the VA's
readjustment counseling service. "We're oriented toward peer counseling, and we provide a safe environment for
soldiers who have been traumatized," he says.

"A Vietnam veteran myself, it would have been so great if we'd had this kind of outreach," says Johnny Bragg,
director of the Vet Center where Harrison works. "If you can get with the guys who come back fresh ... and actually
work with their trauma and issues, hopefully over the years you won't see the long-term PTSD."

In all cases, the veteran has to be the one who wants to talk before counselors can help. "Once they
come through the door, they usually come back," Harrison says. "For them, this is the only chance to talk
to somebody, because their families don't understand, their friends don't understand. That's the big
thing. They can't talk to anyone. They can't relate to anyone."

Iraq veteran reaches out

ASSOCIATED PRESS

EBENSBURG, Pa. - Early on a Sunday morning, Jason Brosk stands in front of 40 or so camouflage-clad
Marine reservists back from their second tour of duty in Iraq. A list labeled "Tips" is projected on a large
screen behind him.
•Avoid alcohol and drug use.
•It helps to exercise.
•Eat right.
•Talk, talk, talk.
The 28-year-old with a muscular build stands casually, his khakis and striped button-down shirt making him
look more like a college jock than a former Army officer.
He tells them nightmares are common. He tells them he, too, partied too much when he returned. He tells
them that, oddly enough, although being deployed overseas is stressful, so is being a civilian.
Mr. Brosk's difficult readjustment to life back home and search for new purpose make him the perfect
outreach worker.
"The worst part was coming home," he says. "You lost a year of your time that you really can't account for.
Your reality was Iraq."
In some ways, Iraq and home would have much in common.
From Fort Campbell in Kentucky to Camp Pennsylvania in Kuwait to the battlefields of Iraq, the soldiers
waited.
Waited for orders. Waited for the enemy. Waited to go home.
Never knowing what would come next, Mr. Brosk says, had everyone on edge.
At Camp Pennsylvania, where his platoon spent nearly a month, the soldiers watched movies or played cards
when they weren't conducting drills.
Then, on the night of March 23, 2003, Mr. Brosk was awakened in his tent by an explosion and a siren. His
first thought: The Iraqis were attacking first with mortar rounds.
He grabbed his gear and helped set up a perimeter of soldiers around his section of the camp. He later
would learn that about two football fields away, an Army captain and Air Force major were killed, and more
than a dozen injured, at the hands of a fellow soldier. Sgt. Hasan Akbar was recently sentenced to death in
the grenade and rifle attack.
The experience shook the nervous soldiers.
Days later, the order would come for Mr. Brosk and his reconnaissance platoon to enter Iraq. The platoon
led into the desert a division that included about 400 vehicles. It provided surveillance for forces going into
the city of Najaf. The soldiers went on more than a dozen raids, many at schools. They found tons of
ammunition but little resistance, also the case in smaller villages.
"I'm ready to fight and we're not really fighting," Mr. Brosk says. "I was expecting kind of like a tooth-and-nail
kind of fight and that's not what's happening."
The waiting was difficult. For fun, the soldiers would bet on what day they would be sent home. He missed
home and missed color amid the sand and dust. He returned home in September 2003.
"Six hours after I was back on American soil," he says, "I went to a bar."
Discharged from active duty in November 2003, Mr. Brosk turned his attention again to civilian life. He
needed a job.
He found no job prospects at the FBI or CIA. With an accounting degree from the University of South
Carolina, he tried unsuccessfully to find work at a bank.
Mr. Brosk thought someone would see the value of the skills he learned while leading a platoon into battle
and being responsible for hundreds of thousands of dollars of military equipment. But no one seemed to, he
says.
He waited, this time for his life to start again.
He says he began drinking four or five times a week, and burning through the savings he had accumulated
while deployed. He picked a fight at a bar one night, and had trouble relating to friends and even family. He
was jumpy.
He worked briefly in construction and worked out at the gym, sometimes twice a day.
Mr. Brosk's mom, Mary Ann Brosk, saw her son, the third of four children, grow increasingly frustrated.
"When he came back, of course, we were all so caught up with being so thankful," she says. "We just lived
in that aura of happiness for several months."
Mrs. Brosk was thankful when her son heard about a job with the Department of Veterans Affairs.
"Who'd have known," she says. "If he was struggling with this all by himself, maybe he wouldn't look for help,
but it's right there."
His new job title is readjustment counseling technician.
He works out of the Greater McKeesport Vet Center, located in a suburban Pittsburgh storefront. Most of
his colleagues also are veterans.
More than 2 million veterans have visited centers nationwide since the counseling service was established
in 1979. But many veterans still don't seek help.
A study last year by Army researchers found that about one in eight soldiers who fought in Iraq reported
symptoms of post-traumatic stress disorder such as nightmares, trouble concentrating and sleeplessness.
But the study said less than half of the soldiers with problems sought help.
In March, Mr. Brosk was asked to speak at the headquarters of the 4th Marine Division's Truck Company in
Ebensburg, 90 minutes east of Pittsburgh. Leaders of the unit, which could be deployed a third time, had
noticed that some of the reservists were drinking more, withdrawing from the group, or becoming easily
agitated. The unit has lost two in battle and about 30 have been wounded.
"We kind of built a family here, and when someone withdraws from that family" everyone grows concerned,
says Travis Miller, a hospital corpsman first class. "We're trying to get a grip on it now."
Mr. Brosk talks first to the group, later to their families.
Each Marine fills out a post-traumatic stress disorder questionnaire, then meets individually with
counselors from the vet center.
Mr. Brosk waits again, this time in a large meeting room while the private sessions are taking place. But he
has found his purpose behind the closed doors.
He is taking 10-hour classes each Saturday to earn a master's degree in counseling. He hopes to have his
degree in 1½years. He also is still repaying his Army commitment as a member of the Individual Ready
Reserves until December 2007.
Until then, there's always a chance he could go back.