Occasional blogging, mostly of the long-form variety.
Showing posts with label PTSD. Show all posts
Showing posts with label PTSD. Show all posts

Wednesday, November 11, 2015

Sense and Insensibility

On Armistice Day (or Veterans Day, or Remembrance Day), it’s an especially good time to pause and reflect. Those most eager for war are rarely the ones who will fight or pay the costs. Requiring a high threshold for war is the position of basic sanity; it’s common sense. Yet saber-rattling and posturing bravado always sell well to certain crowds, and blithe imperialism will eternally be fashionable among a particular vacuous and powerful set. What’s ignored is the human experience and the inevitable suffering of people a step or two (or many) removed.

World War I, the Great War, which sadly proved not to be “the war to end all wars,” was raging 100 years ago. One of the war’s best poets was Wilfred Owen, who tragically died shortly before the war’s end. I’ve featured his poetry before, including this piece, but was reminded of it again recently:

Insensibility
By Wilfred Owen

I
Happy are men who yet before they are killed
Can let their veins run cold.
Whom no compassion fleers
Or makes their feet
Sore on the alleys cobbled with their brothers.
The front line withers. 
But they are troops who fade, not flowers, 
For poets’ tearful fooling:
Men, gaps for filling:
Losses, who might have fought
Longer; but no one bothers.

II
And some cease feeling
Even themselves or for themselves.
Dullness best solves
The tease and doubt of shelling,
And Chance’s strange arithmetic
Comes simpler than the reckoning of their shilling.
They keep no check on armies’ decimation.

III
Happy are these who lose imagination:
They have enough to carry with ammunition.
Their spirit drags no pack.
Their old wounds, save with cold, can not more ache.
Having seen all things red,
Their eyes are rid
Of the hurt of the colour of blood for ever.
And terror’s first constriction over,
Their hearts remain small-drawn.
Their senses in some scorching cautery of battle
Now long since ironed,
Can laugh among the dying, unconcerned.

IV
Happy the soldier home, with not a notion
How somewhere, every dawn, some men attack,
And many sighs are drained.
Happy the lad whose mind was never trained:
His days are worth forgetting more than not.
He sings along the march
Which we march taciturn, because of dusk,
The long, forlorn, relentless trend
From larger day to huger night.

V
We wise, who with a thought besmirch
Blood over all our soul,
How should we see our task
But through his blunt and lashless eyes?
Alive, he is not vital overmuch;
Dying, not mortal overmuch;
Nor sad, nor proud,
Nor curious at all.
He cannot tell
Old men’s placidity from his.

VI
But cursed are dullards whom no cannon stuns,
That they should be as stones.
Wretched are they, and mean
With paucity that never was simplicity.
By choice they made themselves immune
To pity and whatever moans in man
Before the last sea and the hapless stars;
Whatever mourns when many leave these shores;
Whatever shares
The eternal reciprocity of tears.


These are old and recurring themes, and this poem resonates across eras. It spoke to World War II veteran Eugene Sledge, who wrote the war memoir With the Old Breed (part of the basis for the series The Pacific and also used in the Ken Burns documentary, The War). Sledge recommended the piece to Studs Turkel during his interview for Turkel’s great, ironically titled oral history, The Good War. Remarking on the poem’s speaker, Sledge observed, "This is the only way he can cope with it mentally... and he hates to see his buddies killed."  (It’s fascinating to listen to the discussions between Sledge and Turkel because Sledge is so candid and reflective, and Turkel is so genuinely interested in other human beings.)

“Insensibility” covers a great deal of ground in a short space – it expresses a sardonic wit, explores numbness (whether voluntary or involuntary) as a survival mechanism, and ponders “Chance’s strange arithmetic,” an apt phrase for a perennial wartime fear. Insensibility isn’t the only possible response – Sophocles explored rage and madness in his 5th century BCE play, Ajax, a piece that still resonates with modern audiences, particularly those who have experienced combat. How does someone deal with such experiences? It’s not easy, and sometimes the response may indeed be post-traumatic stress disorder (the “shell shock” of an earlier era), or numbness, or rage, or depression, or fatigue, or some mix, or something else altogether.

This is an old story, but not one our country has grappled with well, especially as it plays out against actual human beings. Obviously not every veteran is a powder keg, and that’s definitely not the point of discussing this – the issue is whether we’re offering adequate help to those who need it. A set of 2014 studies bolsters past findings on PTSD and its prevalence. It can be treated, but there’s still a heavy and unfortunate stigma attached. Anthony Pike of Iraq and Afghanistan Veterans of America (IAVA) observed that “An estimated 20 percent of Iraq and Afghanistan veterans are diagnosed with PTSD or depression, and most civilians are unaware that 22 veterans take their own lives each day.”

Reportedly, the military has gotten better at addressing PTSD and similar issues over the years. But for perspective, military spending by the U.S. has often exceeded 600 billion a year in the past decade or so, and that trend looks to continue when everything is tallied. Given all that money, perhaps more could be diverted to the general mental health and well-being of servicemen and women. Perhaps more effort could be made at addressing attitudes that PTSD or other problems are due to a lack of character (or, as we’ve explored in previous posts, a lack of religious faith).

Wars of choice are unconscionable (and we’ve explored that in depth in other pieces), but especially if one supports such a war (or really any war), it’s inexcusable not to take care of that war’s veterans. That means not serving up hollow slogans or flag-waving or jingoistic platitudes and instead providing actual help, from physical health care, to mental health care, to jobs programs. (Honestly, all of that would a good idea for the whole country, too.) The vacuous, the rabid, and the dullards might not want to discuss such things – or any of the negative consequences of war – but addressing them remains a matter of basic decency and common sense.

(Cross-posted at Hullabaloo.)

Thursday, November 22, 2012

Meditation, Compassion and PTSD

Yesterday, NPR ran a good (and moving) story on the use of meditation to help veterans cope with post-traumatic stress disorder (PTSD), which afflicts roughly one in four veterans of the wars in Iraq and Afghanistan. (Given a less cheery recent post on PTSD, and the spirit of the day, this seemed especially appropriate.)

The Vietnam vets talk first. Some say they'd never even heard of PTSD until a few years ago. Now that they're getting treatment, it's like they're making up for lost time.

"The idea, of you saying, 'just like me,' that does a lot for me in a sense because I know how I'd like to be treated or how I want to feel," says John Montgomery, who has a bushy gray mustache and a tattoo of a scorpion on each forearm. "So if I'm showing that to somebody else, I find myself looking at me a little better and being satisfied with what I see."

Montgomery says he knows that what the meditation is teaching him sounds incredibly basic: Treat others the way you want to be treated; it's Human Relationships 101. And yet, it's completely at odds with the person the Vietnam War trained him to be.

"You're in a situation where you don't negotiate. You either make it or you don't," he says, "because we were taught to survive."

When he came home, Montgomery says, he had forgotten how to be a son, a parent, a friend. This lasted for decades.

John Perry, a soft-spoken Vietnam vet from Phoenix, steps in.

"It's pretty much just a self-imposed prison," he says. His story is much the same as Montgomery's.

"I didn't talk to anybody. No one would ask me any questions about it. I wouldn't answer if they did," Perry says. "So isolation has been my problem for 40 years."

Hey, whatever works. Meditation alone might not do the trick for every vet, but it's definitely helping some of them. It's also heartening to see Vietnam vets get some attention along with the younger vets. The skills and mentality necessary for surviving warfare, an unnatural environment, are often ill-suited for civilian life. Not every soldier suffers PTSD, but the transition alone can be difficult (something The Best Years of Our Lives, among other works, captures well). "Treat others the way you want to be treated" may be "Human Relationships 101," but it's one thing to know it intellectually, and quite another to know it your bones, to feel it, to live it, to grow into that understanding more deeply over a lifetime. The most moving part for me is hearing the older vets reaching out to the younger ones – they've been there, and can speak with authority… and as John Montgomery discovers, compassion.

Sunday, November 11, 2012

Only the Faithless Suffer

In past years for Armistice Day, we've looked at how denying loss can tragically lead to more loss. We've examined how eagerly a blind rage can be embraced. This year, I wanted to look at willful blindness. (It turns out that the Beltway establishment and the Religious Right are quite similar in that regard.)

The Morality of Drone Strikes

First, let's consider Joe Klein and his remarks in late October on the drone strikes Obama has authorized in Afghanistan. The drone conversation starts roughly 7:15 in and goes until about 13:00:

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Some of the key lines (emphasis added):

SCARBOROUGH: What we're doing with drones is remarkable: the fact that over the past eight years during the Bush years - when a lot of people brought up some legitimate questions about international law - my God, those lines have been completely eradicated by a drone policy that says: if you're between 17 and 30, and within a half-mile of a suspect, we can blow you up, and that's exactly what's happening . . . . They are focused on killing the bad guys, but it is indiscriminate as to other people who are around them at the same time . . . . it is something that will cause us problems in the coming years . . . .

KLEIN: I completely disagree with you. . . . It has been remarkably successful –

SCARBOROUGH: at killing people –

KLEIN: At decimating bad people, taking out a lot of bad people - and saving Americans lives as well, because our troops don't have to do this . . . You don't need pilots any more because you do it with a joystick in California.

SCARBOROUGH: This is offensive to me, though. Because you do it with a joystick in California - and it seems so antiseptic - it seems so clean - and yet you have 4-year-old girls being blown to bits because we have a policy that now says: 'you know what? Instead of trying to go in and take the risk and get the terrorists out of hiding in a Karachi suburb, we're just going to blow up everyone around them.

This is what bothers me. . . . We don't detain people any more: we kill them, and we kill everyone around them. . . . I hate to sound like a Code Pink guy here. I'm telling you this quote 'collateral damage' - it seems so clean with a joystick from California - this is going to cause the US problems in the future.

KLEIN: If it is misused, and there is a really major possibility of abuse if you have the wrong people running the government. But, the bottom line in the end is - whose 4-year-old get killed? What we're doing is limiting the possibility that 4-year-olds here will get killed by indiscriminate acts of terror.

Digby remarks:

Am I wrong or did Klein say that he thinks killing 4 year olds is legitimate because it "limits the possibility "that 4 year old American will get killed? Holy Moley. That's so far beyond the concept of self-defense he's veering into simple pathology.

Klein tends to slip up and inadvertently spill the beans about what our foreign policy elite (of which he is one) really think. Now, I would guess that he was trying to fudge here and say that it was too bad that 4 year olds got killed but "we have to fight them over there so we don't have to fight them over here." But the truth that slipped out was that he believes we are killing their 4 year olds as part of a campaign of terror. And, for him, the good news is that we can do it with a joystick in California. That's sick.

Now, I doubt very seriously that anyone's targeting 4 year olds at the moment. Even I am not that cynical. But I also don't doubt that there are people who believe that if the 4 year olds of "those people" are killed it will wear down the enemy and make them cry uncle. It sure sounds to me like Joe Klein is one of them.

Greenwald dismantles the argument, showing that Klein's formulation results in exactly the opposite of what he claims to want. I'm so repelled by the fact that anyone would blithely remark that such a "trade-off" in this situation is remotely moral that I can't get past it.

There's much more that can be said about Klein, who's very much a Beltway establishment pundit. He's currently backing Obama, but he's hardly a liberal; he seemed to make it a point of pride to "punch hippies" objecting to civil rights abuses during the Bush administration.

Ever notice how the people who say "Shit happens" are often the people doing the shitting? (Or fully supportive of it.) It's a nifty little trick, pointing to the undeniable suffering in the world, and then shrugging to suggest that their own selfish actions are somehow ordained. It conflates life's unavoidable tragedies with those that can be avoided – and ignores that working to avoid tragedies, or minimize their impact, is the entire point. The people saying such things often honestly believe in what they're saying; it's the usual cognitive dissonance for mental self-preservation. It's an attempt – conscious, unconscious, or semi-conscious – to normalize selfishness, cruelty, or just callous disregard for the horrible consequences of one's actions (and inaction).

The conceit of people such as Joe Klein is that they are making the hard choices, that they are the realists – but this is, of course, self-aggrandizing bullshit. It's also evil, not matter how fashionable it may be in certain circles. Klein doesn't make the case that killing four-year old Afghani children is necessary. (Of course it's not, and even if one ignores the grotesque immorality of it for a moment, blowback does greater harm than any such killing could possibly achieve.) Klein has posed a theoretical "tough choice" without offering any evidence that it actually exists; he thus swiftly glosses over reality to present his fantasy as a pressing, urgent actual situation. This is the same game many a torture apologist has played, whether out of sincere fear or disingenuously. As Rear Admiral John Hutson testified in 2007, "Torture is the method of choice of the lazy, the stupid, and the pseudo-tough." As we've discussed before, there is nothing "hard" or "tough" in letting someone else suffer, certainly not in the context of war, torture and abuse. That's the easy path. Klein has merely invented a shoddy rationalization to help him live with himself. He wants the answer he's invented – because it means he bears no responsibility, and he doesn't have to do anything. It's a kind of bourgeois imperialism or the usual ruling class corruption, all with the familiar pseudo-tough macho posturing of the chickenhawk. It's self-serving, willful blindness that seeks to excuse and normalize unnecessary suffering. Americans: Do not question the empire, or lose faith. Afghanis: I have made the hard choice to let you suffer.

The Conservative Mindset

We'll look at how religious conservatives in the Bush administration harmed patients suffering from PTSD, but I think a brief detour to explain the underlying mentality might help. Congressman John Shimkus (R-IL) provides a perfect example; a 2011 Blog Against Theocracy post looked at remarks Shimkus made during March 2009 hearings of the U.S. House Subcommittee on Energy and Environment:

The key remarks are:

The earth will end only when God declares its time to be over. Man will not destroy this earth. This earth will not be destroyed by a flood.

Shimkus has said plenty of other dumb things. However, these particular remarks were both dumb and theocratic, and therefore of greater concern. They're problematic – or dangerous – for at least three reasons.

One, environmental and energy policies for the United States should not be dictated by any religious text. The same goes for all public policy, but the problem is especially glaring for any policy involving science. (We'll deal with some caveats in a bit.) Shimkus was pushing a blatant violation of the separation of church and state. Passing a law that said, "You can't regulate pollution because the Bible says so" would not pass constitutional muster.

Two, Shimkus is on shaky religious grounds as well. The passage he cites only refers to what the God of the Bible will or will not do - human beings are quite capable of destroying the planet all on their own. (More specifically, human beings are quite capable of destroying humanity, but the planet would survive.) Additionally, Shimkus is picking and choosing what he wants from the Bible in his Appeal to Religious Authority. He's not asking the Food and Drug Administration to ban eating shellfish, or asking Congress to abolish a few amendments to bring back slavery, or trying to outlaw certain types of clothing, or otherwise trying to enforce many other precepts in the Bible.

Three, assuming Shimkus is sincere in his stated beliefs, his religion makes him a less reflective, less responsible human being. He has spouted beliefs that dictate that he, and other human beings, and the government of the United States of America, do not need to act responsibly when it comes to energy and the environment, because God will sweep in to save the day.

This third point is the key one for our purposes. Obviously, reflective religious people exist, but some people, such as Shimkus, use religion to shut down reflection – and absolve themselves of responsibility.

This is hardly a rare trait. While obviously not all conservatives are theocrats, and not all conservatives think this way regardless of the specific rationale, a core conservative tenet –directed at those Other People – can be expressed as:

1. Your misfortune is your own fault.

2. Therefore, I don't need to do anything to intervene.

The thing is, in reality, precept #2 actually leads to #1, not the other way around; it's a rationalization for conservatives' preferred (in)action, hierarchy, notion of the natural order, simple and comforting view of the world, and so on. Numerous studies have shown that conservatives (especially the more authoritarian conservatives) prefer a simpler world view or even black-and-white thinking, free from ambiguity or nuance. This "moral" stance justifies them doing nothing to help the fellow man or woman (just as the Gospels teach).

Denying PTSD

One of the more striking accounts about PTSD (post-traumatic stress disorder) being denied comes from "God, the Army, and PTSD" by Tara McKelvey for Boston Review in 2009. The piece looks at Faith Under Fire, a memoir by Army chaplain Roger Benimoff, who served in Iraq and suffered from PTSD. Do read the whole thing, but here's some background (emphasis added):

During the Iraq war, however, the great difficulty veterans experienced in getting psychiatric care—greater than before—was not a product of cost-cutting, but of conviction: many Bush administration officials believed that soldiers who supported the war would not face psychological problems, and if they did, they would find comfort in faith. In a resigned tone, one prominent researcher who worked for the VA, and asked that he not be identified because he was not authorized to speak to the press, explained that high-ranking officials believed that “Jesus fixes everything.” Benimoff and the others who returned with devastating psychological injuries found a faith-based bureau within the VA. At veterans’ hospitals, chaplains were conducting spirituality assessments of patients.

The story of the mistreatment of returning veterans from Iraq is well known and shocking. But the role of religious ideology in that mistreatment—how, inside the government, it was a potent tool in the betrayal of an overwhelmingly Christian Army—is much less known.

“I couldn’t stand to hear that phrase any longer—‘God was watching over me,’” Benimoff wrote.

He wasn’t watching over the good men I knew in Iraq. Faith was the center of my life yet it failed to explain why I came home and those soldiers did not. The phrase was a Christian nicety, a cliché that when put to the test didn’t fit reality.

Things had already begun to change dramatically at the VA by early 2005, shortly after Roger Benimoff left for his second deployment to Iraq. Many appointees at the agency were disturbed that so many Iraq veterans showed symptoms of post-traumatic stress disorder (PTSD). In part the concern grew from skepticism about the diagnosis itself, which some believed to be a legacy of the Vietnam-era anti-war movement. Whatever the merits of the diagnosis, it was clearly widespread and, moreover, staggeringly expensive to treat. In 2008 the RAND Corporation put a number on the problem, reporting that one in five veterans of the wars in Iraq and Afghanistan has suffered some form of mental illness, mostly PTSD and depression.

“God doesn’t like ugly,” one political appointee told Paul Sullivan, an analyst in the VA’s Veterans Benefits Administration, in a clumsy attempt to reduce the cost of caring for psychologically traumatized veterans. “You need to make the numbers lower.” Sullivan left the VA in 2006 and became head of Veterans for Common Sense, a group that filed a class-action lawsuit against the secretary of the VA for the shoddy treatment of veterans. It was dismissed in 2008 and is now being appealed.

These accounts are disturbing, especially given PTSD's potentially crippling effects and the history of PTSD treatment. Back in World War I, PTSD was called "shell shock," and many British doctors treated it as a failure of the will. (Luckily not all did. See the work of W.H.R. Rivers and the novel Regeneration. Meanwhile, Mrs. Dalloway provides a memorable portrait of a horrible doctor of the period.)

We should know better by now, but unfortunately, PTSD has too often been poorly treated in the past decade. Some of that poor treatment has been due to a macho military culture that frequently still sees PTSD as a personal failing versus an affliction, and some has been due to a Christian evangelical outlook that has essentially taken the same stance. See, for instance, Harper's, "Jesus Killed Mohammed: The crusade for a Christian military and "U.S. Attorneys Scandal–Milwaukee," The Washington Post, "A Political Debate On Stress Disorder", The Nation, "Disposable Soldiers," as well as "AP: VA Makes It's too Easy for Veterans to File Claims ... Seriously," "Blaming the Veteran: The Politics of Post Traumatic Stress Disorder," the archives at They Gave Us a Republic and my own modest archives on the subject.

This is the section of the Boston Review piece that really sticks with me (emphasis added):

Sullivan was working as an analyst at the Veterans Benefits Administration in Washington in early 2005 when he was called to a meeting with a top political appointee at the VA, Deputy Assistant Secretary for Policy Michael McLendon. McLendon, an intensely focused man in a neatly pressed suit, kept a Bible on his desk at the office. Sullivan explained to McLendon and the other attendees that the rise in benefits claims the VA was noticing was caused partly by Iraq and Afghanistan veterans who were suffering from PTSD. “That’s too many,” McLendon said, then hit his hand on the table. “They are too young” to be filing claims, and they are doing it “too soon.” He hit the table again. The claims, he said, are “costing us too much money,” and if the veterans “believed in God and country . . . they would not come home with PTSD.” At that point, he slammed his palm against the table a final time, making a loud smack. Everyone in the room fell silent.

“I was a little bit surprised,” Sullivan said, recalling the incident. “In that one comment, he appeared to be a religious fundamentalist.” For Sullivan, McLendon’s remarks reflected the views of many political appointees in the VA and revealed what was behind their efforts to reduce costs by restricting claims. The backlog of claims was immense, and veterans, often suffering extreme psychological stress, had to wait an average of five months for decisions on their requests. When I asked him years later about the meeting, McLendon laughed. Then his face darkened in anger. “Anybody who knows me knows I wouldn’t talk that way.”

Nevertheless, McLendon was open about the skepticism he felt toward the diagnosis of PTSD, calling it “a made-up term,” which has “taken on a life of its own.” As he spoke about the diagnosis, he pounded the table with the side of his hand more than ten times, hitting it so hard that the wooden surface shook. “Do I think they have a mental illness and should be stigmatized for the rest of their life?” he asked. “What gives a psychiatrist the right to do that?” Later, in an email about our conversation, he wrote:

[PTSD] is not a diagnosis based on empirical evidence, but rather . . . it is an artificial construct erected by a vote of selected psychiatrists. This does not mean that there are not problems that certain individuals do have [and] issues that need to be addressed. But rather, it means that we have created policies and programs that have not served veterans well.

He recommended several books on the subject, including The Selling of DSM, whose authors, Stuart Kirk and Herb Kutchins, show a deep mistrust about the disorder and the scientific rhetoric surrounding the diagnosis. McLendon’s outlook seems to have had a significant impact on the way veterans are treated upon their return from war.

McLendon and many of the other high-level officials at the VA shared political convictions that, along with doubts about the science of PTSD, made them less likely to push for additional psychiatric services for veterans. They believed in streamlined government and free markets, and they supported a prominent role for faith-based organizations. The secretary of the Department of Veterans Affairs, R. James Nicholson, had previously served as chairman of the Republican National Committee and as ambassador to the Vatican. McLendon’s politics closely mirror his boss’s, and under Nicholson’s watch, veterans had increasing difficulty in obtaining adequate psychological care.

When a 2006 Government Accountability Office report raised questions about whether soldiers were getting the psychiatric help they needed, an assistant secretary of defense disputed the report’s findings, pointing to the fact that soldiers were being referred to chaplains. During this time contracts for veterans’ services were increasingly parceled out to leaders of faith-based organizations rather than to secular ones, even though veterans’ advocates opposed any bias toward faith-based treatment and argued that replacing empirically proven, nonsectarian programs with faith-based ones was a mistake.

One last bit – the military handed out many copies of Rick Warren's book The Purpose Driven Life overseas, but:

As Benimoff and other soldiers eventually discovered, The Purpose Driven Life was not helpful, especially as the war’s own purpose grew less clear. Since Vietnam we have learned that PTSD tends to hit people especially hard when they fight in wars of choice.

Obviously, anyone's free to have any beliefs regarding religion (including atheism) they wish. That includes both soldiers and those treating them.

However, if your job is to help soldiers, and your religious beliefs are interfering with that – that's a serious problem. It is the moral duty of the caregiver to reach out to the person suffering, not the other way around. The line that's always stuck with me is:

...if the veterans “believed in God and country . . . they would not come home with PTSD.”

McLendon denies he said it, and perhaps other readers will find that credible; I frankly don't believe him. Everything else he says in the article, his dismissal of PTSD and the DSM, and all the other pieces linked above that point to a sort of Christian triumphalism in the military, suggest otherwise. The thinking, however unconsciously, goes something like this: If God is all-powerful, and God is just, then the good are rewarded and the wicked suffer. Ergo, if someone suffers, he must be wicked. It's their own fault if they have PTSD. It's their own fault if they're suffering. I don't need to do anything.

...if the veterans “believed in God and country . . . they would not come home with PTSD.”

When I first read that line, it stopped me cold, as if reading about a case of child molestation. If you're read or seen accounts of PTSD, and have some inkling of how devastating it can be, how it can destroy lives, break up marriages, lead to homicides and suicides – the casual, callous disregard for suffering in those words is glaring. When I read those words, I felt (and still feel, when I think about it) a deep if quiet rage, held in check by appalled shock. I want to talk to this man, question him, demand of him, How dare you?!? I want to try to slowly explain to him how horrible his actions have been, what unnecessary harm he has caused, what preventable suffering he has allowed… But I suspect he would not understand, would not let himself understand – because that's been the whole problem from the start.

These proudly Christian men thought they were godly; instead, they're Pontius Pilate.

If you send men and women to fight, die and get wounded overseas in the name of their country – especially in an unnecessary war – the absolute least you can do is to give them adequate care when they return. It is immoral to send them into a horrific situation – and then when they respond appropriately, as human beings, to that horror – to tell them that they have somehow failed, that it is their fault.

It is absolutely unconscionable for someone in this position of power to be this ignorant of the basic realities of his profession. And who let him be there in the first place? It would be like inviting a finger painter to perform major surgery on critical patients (except with a lower fatality rate). There are forms of stupidity so willful, so harmful, so cowardly, so self-righteous and blindly cruel they become a form of evil.

McLendon stepped down in 2006 because he allowed the theft of computer data, so part of this story is moot. But unfortunately, the mentality lives on and flourishes in some arenas. Like Joe Klein, like John Shimkus, Michael McLendon invented a way to wash his hands and absolve himself from responsibility. McLendon and Shimkus believe themselves to be men of God, and Joe Klein believes himself to be a wise political advisor. They are all painfully wrong, and their being wrong is not without consequence. It will be impossible to put an end to unnecessary wars and tragedies as long as men and women in power continue to convince themselves that the suffering of others is unavoidable or somehow a good, that only the faithless suffer.

Tuesday, September 07, 2010

Coming Home From War

The Iraq War isn't really over, and the war in Afghanistan certainly isn't. But some military personnel are getting to come home, if briefly, and those returns often raise significant challenges.

Back on 8/26/10, NPR's To the Point aired a good program on "The Joys and Sorrows of Coming Home" from Iraq and Afghanistan. As the blurb describes:

America's combat role in Iraq has ended, and tens of thousands of returning troops are repopulating military bases and nearby towns all over the country. But history shows that many joyous welcomes are bound to go sour with marital problems, crime and suicide likely to increase in the months to come. Are the military services and the Veterans' Administration ready to help so many people recover from wounds and shake off the mental burdens of combat? Will civilians recognize their sacrifice? Will ongoing controversy over the war itself tarnish the rewards of coming home?


On PBS tonight, one of the local stations aired the P.O.V. documentary, "The Way We Get By." It's about a group of senior citizens up in Bangor, Maine, who greet the high number of arriving and departing troops at the airport. It's picked up a few nominations and awards. As filmmaker Aron Gaudet explains:

It's really a personal story not a political one. That goes for the greeters themselves as well. They have different views on the war, but their main goal is to support the troops.


The film focuses on three of the greeters (one, Joan, is the filmmaker's mom). While we see many scenes of greeting, and hear what it means to both the troops and the greeters, there's also plenty of time spent on the greeters' lives otherwise. They face some pretty tough situations, such as cancer, or having to give away cherished pets due to cost. They've lost spouses, and in one case, a child. One of the more touching tiny moments is when Joan mentions to a departing soldier that two of her grandkids will be shipping out soon, and he smiles and reassures her they'll be fine. Joan's there to support them, and the greeters are much appreciated by the troops, for the pats on the back, the warmth, and the cell phones they hand them to call home when they get off the plane. But this soldier senses her anxiety and reaches out in turn. Later on, we see more about Joan and her grandkids. Despite the reassurances, she frets, "They're in the middle of a war, how can they be safe?" (If you follow the link above, you can see comments about the film, including some from troops who were greeted.)

In the "personal not political" aspect, this doc reminded me of The Messenger, the narrative film about a death notification detail stateside. (It's the second film I reviewed here.) If you haven't seen it yet, it's excellent, but be prepared for some gut-wrenching scenes. As Woody Harrelson's character Captain Tony Stone says, there's "no such thing as a satisfied customer."

Lastly, hearing the To the Point program made me think of Homer's homecoming in the post WWII film, The Best Years of Our Lives (1946). Homer was played by Harold Russell, and if you don't know his story, it's worth reading. Here's the opening of the film (this one never fails to get me):



(Some previous posts have covered PTSD, and then there's the War Series.)

Sunday, June 20, 2010

Traumatic Brain Injuries

NPR and ProPublica have produced a series on returning military personnel suffering from traumatic brain injuries. Sadly, these troopers often haven't been getting proper help, and these sort of injuries can become debilitating. While the military's medical system does a good job overall, hearing about TBI and PTSD not being treated adequately - if at all – is maddening. If the actual military budget amounts to close to one trillion dollars per year, there's no reason why troopers can't get decent pay and excellent medical care, especially when they received these injuries in combat.

Here's Part One and Part Two. Check out the "related links" for more. Meanwhile, Blue Girl and the rest of the crew at They Gave Us a Republic have been following stories on TBI, PTSD and veteran treatment diligently.

 

Wednesday, July 29, 2009

Heart of Darkness

I had no job training. All I know how to do is kill people.

- Kenneth Eastridge


I know the Army would like to say it is not responsible for this, that it didn’t train them to do this. But that is bullshit. They trained them to kill, then when they didn’t have enough men for the surge, they pushed these guys until they broke, then threw them away.

- Michael Needham



The Colorado Springs Gazette has run a harrowing series on military personnel returning home with Post-Traumatic Stress Disorder and committing violent crimes at an astounding rate. It centers on one unit in particular, based out of local Fort Carson. These particular soldiers become destructive and dangerous to those around them, and of course themselves. Meanwhile, the stigma and hazing about seeking PTSD treatment adds a tremendous obstacle, and PTSD treatment itself remains too scant. Even if you've heard quite a few PTSD and war stories, this series will likely hit you. This is not pretty stuff, but it's very important, and I'd recommend reading the whole thing.

"Casualties of War, Part I: The hell of war comes home"

"Casualties of War, Part II: Warning signs"

Eric Martin posts on the series in "Losing Hearts While Losing Your Mind," on what all this means for COIN (counterinsurgency) doctrine and warfare in general. Gary Farber covers it in "What Our Wars Do to Our Soldiers," and has been spreading the word on the series, so thanks to him.

The Editor's Note for the series gives a good overview:

For as long as wars have been waged, soldiers have been sent to kill or be killed. The lucky ones survive. Some return home unscathed; others are shell-shocked and emotionally scarred for life.

That’s been true forever. But something changed in Iraq. Thanks to modern medicine, transportation and gear, soldiers survived injuries that would have killed yesterday’s troops. They patrolled streets without battle lines, where smiling civilians waved one day and silently watched ambushes the next. Multiple deployments moved soldiers from war to home and back, again and again.

Most found a way to cope. But in one Fort Carson unit that took heavy casualties, men began to break. Some recall war crimes. Some came home, to Colorado Springs, and kept killing.

Those killings have prompted Fort Carson to re-examine how it treats soldiers. For the first time, the Army is demanding that commanders look for signs that a soldier is in trouble. This issue is of particular concern to the Pikes Peak region. When soldiers come home, they bring the baggage of intense, prolonged brutality.

Today, following months of interviews with soldiers and their families and the examination of medical and military records, court documents and photographs, The Gazette presents the first of a two-day report that retraces the steps of the soldiers who ended up behind bars.

A word of caution: The details of battle are graphic, and the language of soldiers is, at times, profane.


Even supposedly "good" or "necessary" wars involve death and destruction, and exact a high cost on at least some of the troopers that fight them. As the Gazette's editors note, it has been ever thus. It's reprehensible to ignore any of that. It's one of many reasons why going to war should never be considered lightly, and why every idiot or scoundrel such as Bill Kristol who blathers about the 'glories of war' should be forced to spend time with some combat veterans. Better yet, the Kristols can "debate" them on the air, or better still, be kept off the air altogether when they don't know what they're talking about or don't care about the costs. The warmongers should be challenged - and at the very least, as a nation we should be providing good mental health care and training for anyone we do send into a combat zone.

I don't want to diminish the impact of the Gazette series at all, because there's not enough being done to help prevent and treat PTSD, but there is hope. Via Balloon Juice, here's a piece from the Wall Street Journal :



It's a touching story, although Luis Carlos Montalvan's marriage broke up before he got to this point. Even with treatment, it's generally not an easy road to recovery. Regardless, best wishes to him and to everyone in his situation.

His story does point to the importance of connection and friendship (whether human or animal). However, in the Gazette series, and in the PTSD stories we covered at Blue Herald, a few trends emerged. When military personnel return home suffering from PTSD, their friends and family often don't know what's going on. More importantly, even if when they do, they just aren't equipped to help on their own, and when they seek aid for their loved one, they can't get it. The military does assist some troopers on this front, but too frequently has not been helpful or just isn't set up to respond to the pressing concerns of a trooper's family member or spouse. It's also dismaying to see that, almost 100 years since WWI, many of the same attitudes toward "shell shock" or PTSD – viewing it as a lack of courage and character – are still oppressively prevalent in military culture. Some of that is to be expected, but the brass should know better, and that attitude just has to change.

There have been studies on combat stress (featured in the book On Killing, among other places) that show that, without sufficient R&R and recuperative time, almost everyone will eventually break. The stop-loss programs and the accelerated rotations of troops in Iraq and Afghanistan don't help at all. PTSD, and an increase in it, is an natural and predictable response to that – a natural response to a highly unnatural situation. In a combat zone, many troopers (as in the Gazette series) cope by hardening. That may work in the short term and may even be necessary for sheer survival. There may be a small percentage, adrenaline junkies and lifers, for whom that approach also works in the long haul (The Hurt Locker is the latest film to delve into that). But the Gazette series follows some adrenaline junkies who still break or become dangerous to themselves, their unit, the civilian population abroad, and their community at home. Long-term, it seems that the only "cure" for prolonged exposure to such inhumane, unnatural, extreme situations is a steady dose of humanity, or doggie love, or art, or something else positive, connecting and centering. Most troopers with PTSD can't handle it on their own, and their family and friends can only do so much without greater assistance. More of the Pentagon's roughly half-trillion yearly budget needs to go to this. It's unconscionable to send anyone into a war zone without proper preparation and gear, and without a commitment to pick up the pieces afterward, as best as can be done.

The PBS special Coming Home, which featured muppets, Queen Latifah and John Mayer, did a good job of explaining the difficult situations of PTSD and war wounds to young kids (I've linked it earlier, although unfortunately only clips seem to be online). There's one section in the aired program interviewing a young girl whose PTSD father is distant, more than he himself would like – but he's still pretty numb. His daughter explains, with some anxiety, how she wants to give him something really special for his birthday - so that he'll understand that she loves him. I dare anyone to watch that section without being hit in the gut. There are human costs to warfare that go far beyond yellow ribbons, chest-thumping bravado and the more soulless types of pundit blather. Inhumanity and dehumanization are simply too easy to choose, and there is a moral obligation as a society and nation to heal those wounds where we can. We have to do better.

Wednesday, April 01, 2009

Elmo Takes on War Wounds


"Brought to you by the letters PTSD..."

On most PBS stations tonight at 8pm, the special program Coming Home: Military Families Cope with Change will air, featuring Elmo, Queen Latifah and John Mayer. You can learn more and watch a preview here. The site also provides other resources for parents.

I remember reading about this months ago, but this is really pretty cool, even by Muppet/Children's Television Workshop standards (Dave Letterman's production company is also involved). In the preview video, the injuries shown are physical, but the website does cover how to talk with a child about "invisible injuries," and two of the families depicted apparently deal with Post-Traumatic Stress Disorder and related issues. I'll be interested to see the program, which runs under 30 minutes. But I dare ya to watch the preview video without a twinge.

(I'd rather not mention it in this post, but it's the reality - the Republican numberless budget of last week predictably used classics from the Reagan and Gingrich playbooks - urging that the National Endowment for the Arts be eliminated and that PBS be de-funded. I don't care if none of it will succeed, or whether the attacks are cynical or sincere. They just shouldn't happen, and the Overton window is badly askew. I'm really, really sick of such attacks, and wish the people who actually do some good could be properly, generously funded and otherwise left alone. Regardless, here's to Elmo and the gang for doing something very worthwhile.)

(Cross-posted at Blue Herald)