PTSD

By Charles Bloeser

The former soldier grimaced for just an instant as he lowered himself into a Spartan metal chair opposite mine in this cramped space we shared. A chair like the one he’d lowered himself into for his monitored telephone call with his wife. Their relationship described in Hebrew scriptures as one in which they cling to each other, becoming “one flesh.” Separated here for legitimate security reasons by a thick sheet of glass.  Those of us in “the biz” prefer to call that kind of visit a “no contact visit.” It just sounds a little better than “no human touch.”

Once he was seated, Henry and I greeted each other with mutual respect, but the veteran’s words were narrow and thin. He wore a state court detainee’s bright orange coveralls. But he couldn’t fill them out.

I glanced again at the booking photograph from six months earlier.  And I looked back at this veteran. These couldn’t be the same person. They mustn’t be the same person.

Henry confirmed the basic facts that his wife had given me out in the lobby. He said he’d been arrested before. For the same thing. Henry told me it wasn’t that way before he was sent to Vietnam.

I assured him that I’d get in touch with the D.A. to jump start his legal process. And I suggested that he might want to visit with an attorney who specializes in 42 U.S.C. §1983 suits, a type of litigation used to seek redress for violations of a detainee’s or an inmate’s constitutional rights while incarcerated. This is the type of case that by federal statute would give Henry’s lawyer a way to get paid if they win. And at the time I met Henry, state and federal law had already begun to make sure that a Section 1983 suit would survive Henry’s death and perhaps provide financial support for his widow.

Before I talked to the D.A., I told Henry, I wanted to check on his medical status.  I pulled a legal pad from my brief bag and handwrote the authorizations to release information that I would need to find out what the hell was going on. Henry labored to lift his arm, and each time he signed his name it took a while. For documents that required a notary to witness a detainee’s signature, you could usually find one among the jailers on shift.

I started by getting in touch with a nurse who worked on the jail’s medical floor.  She told me that jail staff had put Henry on her floor but that for four months she had tried in vain to get Henry transferred to a hospital.  “What’s wrong with him?” I asked.

“I don’t know for sure, but that weight loss isn’t a good sign.”

Henry had authorized me to get his medical records, and for a day or two jail staff gave me the run around.  But I kept calling and made sure that jail administration understood that if they didn’t get Henry to a hospital soon, they could count on another lawsuit.  Three days after his wife begged me to check on Henry, I went to visit him again.  Henry was gone.

The jail had finally transferred him to a local hospital, where, by contract, detainees deemed worthy of hospital medical care received it under the watch of Sheriff’s deputies.  But when I got there to see Henry, I learned he wasn’t there either.

Medical staff at hospital ran some long overdue tests. When the county’s bean counters learned the veteran had terminal cancer, Henry was promptly moved to the Veterans Administration hospital where he would soon die.  A criminal assault charge against him had finally shown up, and an assistant D.A. I hadn’t met dismissed the case against the soldier that morning.

What could I do for her Henry now that he was about to enter an eternity I had been raised to believe exists but which I knew nothing about? Ask about his faith and if he had a favorite pastor?  A priest? A rabbi? Make sure the hospital chaplain had been to see him? Whatever might be waiting for Henry was something far beyond the knowledge and expertise of this “attorney and counselor.”

I sat wordlessly next to Henry’s hospital bed and tried to see this man who was fading away inside an outsized hospital gown as the combat infantryman he was. But it was hard. I knew so little about this soldier I’d been asked to just check on. I learned early on that he had served in the U.S. Army and was honorably discharged.

Henry was one of 1,857,304 men inducted through the selective service system into the U.S. armed forces during the ten years designated as the Vietnam War.[i] That this man from the American Midwest was never the same after Vietnam was beyond question.

But I knew none of the specifics which Henry may have shared with the other vets who sometimes attended group downstairs in the VA hospital. I don’t think I ever saw Henry’s service record. Documents that I would have asked his wife for had it proved necessary to file for a writ of habeas corpus, I never saw.

For a lawyer whose life is all about asking questions, it seemed immoral to ask Henry anything more than what I had to know to help the man. This wounded husband and father had barely enough breath left to answer questions from medical staff. Henry now seemed to me like a man being washed down a drain, bit by bit, ever more rapidly falling away until there’s nothing left to see.

But as his days ran out, this Army veteran who had done what his country asked of him seemed to exude a measure of peace. And if it wasn’t peace that I saw, then perhaps it was the confidence that nothing he might encounter in a life hereafter could be nearly as bad as what he lived through in Vietnam. Recently departed British Historian Ben Shephard writes in his seminal work on the psychological price of war that “[i]t is futile to quantify the scale of atrocities in Vietnam, though historians have tried. We do better to heed the words of the most eloquent apologist for what went on there. Philip Caputo was the sensitive, bookish son of a middle-class Chicago household who came to find himself facing court martial for the cold-blooded murder of two innocent Vietnamese civilians. ‘The aspect of the Vietnam War which distinguished it from other American conflicts,” Caputo wrote, was ‘its absolute savagery. I mean the savagery that prompted so many American fighting men – the good solid kids from Iowa farms – to kill civilians and prisoners.’”[ii]

“Why are you so scared?” Henry’s words and his aim were as true as his fast-approaching death.

“I don’t know.”

Henry wanted his story told.  “They can’t be doin’ this to th’ other folks they lock up,” he wheezed.  So during a return visit he had me photograph him as he stepped ever closer to whatever lay beyond.  I took several photos, had them enlarged, and carried them, along with a blown-up copy of Henry’s booking sheet with the veteran’s puffy faced booking photo, to the county commissioners.

Doing justice to Henry’s story, doing right by a wounded warrior’s death-bed mission to force others to do right, weighed heavy on me. One of the most important things I already did for every client I could was to tell his or her story. To introduce a living, breathing fellow human being to a court that possesses the power to judge and impose life-altering sentences. To urge that court to see the person standing next to me or seated with me at the defense table or shackled to a dozen others dressed in identical coveralls and stuffed in a courtroom’s jury box, as more. As more than just a number on a case file. As more than the next defendant on the court’s docket. But as the statistics cited by Andrew Cohen, whose 2013 article in The Atlantic I quote from in the part I’s third endnote scream out, that can be damned hard to do in America’s state courts if the State isn’t trying to kill your client.[iii]

You do the best you can, though, because you swore you would and because the outcome of a criminal case – regardless of whether a client goes to prison – frequently inflicts significant consequences on the lives and fortunes of not just your client but also your client’s family. A criminal conviction, the criminal record that follows it, and any collateral consequences from the conviction, e.g., loss of professional license, reduction in amount of VA disability compensation, termination of VA pension payments, deportation, denial of access to public housing and federal student aid, etc., can hurt and even destroy families.

The story of a combat veteran left to die on the medical floor of a modern, urban jail had to be told well-enough to encourage the kind of changes needed to save lives then and to save lives yet to come. And Henry trusted me to do that. He had no one else.

I don’t remember what I told the county commissioners that day. And it wasn’t important for them to remember my words anyway. If these elected officials who are charged with the responsibility for the County’s jail remembered the images of a dying veteran and in those images remembered well the story that Henry tasked me to deliver to them, then Henry is the one who should get credit.

He’s the wounded warrior who’s responsible for any good that came from a story that he should never have been forced to write. He’s the combat veteran who tried to save the men of his platoon on the other side of the planet. He’s the American soldier who insisted that by his death here at home, others jailed – no matter the reason – must not be left to rot and to die.

From Henry’s arrest more than a half-year earlier until his death in a VA hospital, the law never stopped assuming that Henry was innocent.

 

 

 Combat stress in America

Common law courts in the United States have decreed that persons like Henry – who are jailed before they’ve been convicted of a crime – and those imprisoned pursuant to a criminal conviction, have a right to “adequate” medical treatment while held. That right is, according to American courts, based in the Eighth and Fourteenth Amendments to the United States’ written constitution. At least in theory, state and federal legislative and regulatory law abide by the courts’ decisions. They also determine what steps a detainee or inmate must follow in order to get a shot at having these rights enforced.

This right to treatment applies to those persons who suffer from shell shock aka combat stress aka PTSD. It also applies to persons who suffer from PTSD despite the fact that they’ve not personally been in combat.

Scholars have looked hard for answers to a question repeated in a 2014 article in New Republic:^[iv] “The U.K. Understands How to Treat PTSD. Why Does the U.S. Lag Behind?”

London-based researchers from King’s College and the Western Education Centre found some possible reasons for these differences during their analysis of studies from several countries that examined veterans returning from Iraq and Afghanistan deployments, as well as some from the Gulf War:

“US and UK forces deployed are demographically different from each other. US forces tend to be younger, of lower rank, and contain more reservists, who are to have increased vulnerability to post-deployment mental health problems in both countries. The US forces have a lower leader to enlisted soldier ratio, which may be a meaningful factor as good leadership appears to be protective of mental health.”[v]

Differences among research methodologies employed in the studies they examined are among other reasons cited for reported differences.

More than twenty suicides per day among active-duty military, national guard troops, reservists, and separated veterans from U.S. Armed Forces[vi] prompt experts to ask, “how did we get the data we’re using to find solutions?”

The author of A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century, British historian Ben Shephard argues that PTSD’s inclusion in the psychiatric communities’ diagnostic bible led to an ‘objectivication’ of the condition, in the sense that symptoms, diagnostic questionnaires and psychometric devices has been ‘standardised’. The whole process has become ‘all ‘objective’, taken out of the clinician’s hands.’[vii]

One resulting threat to acquiring good data and to effectively treating those who suffer from combat stress is, one psychiatrist told this researcher, a “lack of nuance” in what, exactly, we say that PTSD is.

Decades of medical practice have allowed the physician to see the signs of trauma in a broad range of patients who’ve served in the military and those who haven’t. In patients who’ve been in combat and those who have not. And while he does not suggest that a survivor of domestic violence has no claim to the label or resources associated with a PTSD diagnosis, there is, he agrees, a clinically meaningful difference between the kind of trauma that person suffers and the nature of the trauma experienced by members of the armed forces who must decide again and again which of the identically dressed men, women, and children in a dust-soaked, IED-laced town square can and might kill you or those you’ve sworn to protect.

 

This is the second instalment of a two-part article that relates these events in Henry’s life. The first part is available here

 

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Charles Bloeser is the creator of combatresearchandprose.com, a new open-source applied research initiative that will continue to contribute to bridging the gap in experience, knowledge, and understanding that divides those who’ve never served under arms from those who have. He’s the civilian son and grandson of veterans and a lawyer who’s spent most years arguing criminal and constitutional issues in America’s state and federal trial and appellate courts. Among his published research are works re Libyan-supported Jihadi terrorism in the Western Hemisphere, civilian-military law enforcement relations in the U.S., and the demands that an increasingly complex national security environment make for special operations forces. His research agenda includes national security/defense/veterans issues, with special attention to those facing challenges from combat stress/PTSD/TBI etc.

 

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Notes 

 

[i] Selective Service System. www.sss.gov. Data accessed May 9, 2018.

 

[ii] Ben Shephard. A War of Nerves: soldiers and psychiatrists in the twentieth century 371. Harvard University Press (Cambridge, Massachusetts 2001) (quoting Philip Caputo, A Rumor of War (London, 1978), pp. xvi-xvii.): “The evil was inherent not in the men – except in the sense that the devil dwells in all of us – but in the circumstances under which they had to live and fight. The conflict in Vietnam combined the two most bitter kinds of warfare, civil war and revolution, to which was added the ferocity of jungle war. Twenty years of terrorism and fratricide had obliterated most reference points from the country’s moral map long before we arrived. . .. The marines in our brigade were not innately cruel, but on landing at Da Nang they learned rather quickly that Vietnam was not a place where a man could expect much mercy if, say, he was taken prisoner. And men who do not expect to receive mercy eventually lose their inclination to grant it.” Id.

 

[iii] Death-penalty law in the United States guarantees a defendant the right during the sentencing phase of a capital trial (“stage 2”) to tell his/her story in the form of “mitigating evidence” that jurors may take into account as they decide whether to sentence to death a defendant they’ve found guilty.

 

[iv] Sarah Sloat. “The U.K. Understands How To Treat PTSD. Why Does the U.S. Lag Behind?” New Republic. February 28, 2014.

 

[v] Elizabeth J. F. Hunt, Simon Wessely, Norman Jones, Roberto J. Rona, and Neil Greenberg. PTSD in The Military: Prevalence, Pathophysiology, Treatment: the mental health of the UK Armed Forces: where facts meet fiction. European Journal of Psychotraumatology 2014 (2014) 5: 23617. http://dx.doi.org/10.3402/ejpt.v5.23617

Among additional resources is Kimberly A. Hepner, Carol P. Roth, Elizabeth M. Sloss, Susan M. Paddock, Praise O. Iyiewuare, Martha J. Timmer, and Harold Alan Pincus, Final Report on Quality of Care for PTSD and Depression in the Military Health System. RAND National Defense Research Institute 2017.

 

[vi] In June 2018, the U.S. Veterans Administration released its newest National Suicide Data Report. VA Press Secretary Curt Cashour explained that this new report reflects greater precision in reporting the VA’s suicide data for U.S. veterans. “The report shows the total is 20.6 suicides every day. Of those, 16.8 were veterans and 3.8 were active-duty service members, guardsmen and reservists.

 

[vii] A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century at 385. Harvard

University Press 2001. [author notes in chapter 27, fn. 3 that, “I have stolen the phrase

‘Chinese menu’ from G. E. Vaillant, ‘The disadvantages of DSM-III outweigh its advantages’, AJP 141 (1984), p. 543.]

 

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Image Source:  https://commons.wikimedia.org/wiki/File:US-Army-troops-taking-break-while-on-patrol-in-Vietnam-War.jpg

By Charles Bloeser

Henry[i] was a veteran who nearly died from combat injuries in Vietnam.  In his dreams, his platoon mates repeatedly kicked him and struck him, screaming at Henry that it was his fault that they were dead. His fault that their children were now orphans. When it all became too much for him, Henry exploded like the hand grenades he’d counted on to keep his platoon alive.

The last time Henry exploded led to another arrest for domestic violence.  He’d again been booked into the county jail. Taken in through the concealed sally port of an uninspired structure in a city whose architects knew better. Just a stack of a dozen oversized orange Lego blocks with box windows that were easily missed by the person on the street with bad eyesight. Orange Lego blocks of all the same size and shape.

Same size. Same shape. Same cellular structure devoid of human senses and lacking a soul. Really not that different from the way a lot of folks think of the men and women inside. Veteran or not. No different from any other county inmate wearing orange coveralls and shackled one to another, waiting in line each morning to board the bus that will carry them to the county courthouse and another court appearance in an elegant structure built around a cattle yard. Words about justice or some such thing carved in stone high across its facade.

But not Henry.

“Are you a lawyer?”[ii]

The woman who asked the question was African American and appeared to be in her early 50s.  She was slightly overweight and wore a simple beige dress and flat soled shoes that had begun to fray.  Her purse had slipped off the fashion cycle years ago and was well-worn, its contents pushing hard against something its manufacturer had tried to pass off as leather.

“Yes, ma’am, but I’m very busy right now.”

“D’ya think ya could take just a few minutes to talk with my Henry?”

“’afternoon’s gettin’ on, ma’am, and the federal courthouse is quite a hike.”

“My Henry’s been ‘ere six months and he still ain’t got no lawyer.”

Six months?  Shit.  The constitution guarantees the folks shackled inside this jail a lawyer if they can’t afford one themselves.

The U.S. Supreme Court said so. ‘back in 1963. In a case that arrived at 1 First Street NE by handwritten letter from a state inmate with an eighth-grade education. The letter’s author, Clarence Earl Gideon, was serving a five-year sentence after defending himself and losing at trial; the judge presiding over his trial determined that Florida state law did not give him the authority to grant Mr. Gideon’s request for an attorney.[iii]

This woman’s Henry had fallen through the cracks.

“What’s he in for?” I said.

“They say he hit me.  But he didn’ mean it, mister.  He’s sick, real sick.”[iv]

Most of the violent crimes inflicted on folks we’ve shared our lives with are often hard to punish and prevent, especially if a case lives or dies on the testimony of the victim. I learned as an assistant district attorney fresh from law school and the bar exam that the State’s effort to enforce the rule of law in this arena would often fail right out of the gate. State legislatures tried to improve a State’s chances of “delivering justice” to these perps by emphasizing that it’s the State – not the victim – who decides whether to prosecute these crimes. But that technicality mattered little to the victims whose rights we sought to vindicate. Frequently, a woman who had finally managed to report her latest beating would by the time she signed her name swearing to the facts that she just wrote, decided that she couldn’t go through with it.

And both the DA’s office and the victim we hoped to help knew why: the devil we might know only on paper was the devil she knew personally all too well. And a prosecutor’s or victim-witness coordinator’s claim that “we’ll keep you safe” was aspirational, at best. Other than when the WITSEC folks said those words to one of my federal clients with a price on his head, they were just that. A few words that we all very much hoped would prove true.

But for this combat veteran’s wife, Henry was never the kind of man who could be distilled into simple words like “defendant” and “perpetrator and “abuser.” There was no black and white in being struck by a man she knew had always loved her but whose best efforts to get relief from the symptoms of war had proved little more than the American version of a snipe hunt.[v]

No good v. evil. No right v. wrong. No criminal defendant and victim.

What this woman knew all too well was that her husband was still paying what Columbia University Mailman School of Public Health Professor Emerita Dr. Jeanne Stellman calls the “lifelong cost of war.” A man who did what his country asked of him and who now suffered in silence like a lot of other veterans.[vi]

For Henry and far too many veterans wounded in wars visible and wars concealed, the lifelong cost of war includes a criminal record to make their lives and those of their families even harder than they already are. As explained in a 2013 Daily Beast article titled “From PTSD to Prison: why veterans become criminals,” “[a]fter Vietnam, the number of inmates with prior military service [in U.S. armed forces] rose steadily until reaching a peak in 1985, when more than one in five was a veteran. By 1988, more than half of all Vietnam veterans diagnosed with PTSD reported that they had been arrested; more than one third reported they had been arrested multiple times.”[vii]

“We can’t ‘fford no lawyer, let alone bond. Henry’s not goin’ anywhere anyway. He’s dyin’ here. Please, Mr. Lawyer, will you check up on ‘im?’”

I went back through security and down a long hall to a compact office shielded by glass. I asked for a copy of Henry’s booking sheet. Ever-rotating young, poorly-paid, scared-by-their-shadow detention officers shared tightly clustered desks with those who knew what they were doing.

Henry’s booking sheet from six months earlier included a booking photo and basic identifying information, along with the offense name and statutory citation for the law the arresting officer was recommending Henry be prosecuted for.

I asked the officer at the desk to have Henry brought down to one of the locking attorney meeting booths. Allegedly soundproofed metal and glass chambers not much larger than a traditional London telephone box and with none of the elegance. None of us who met clients in these spaces had cause to claim that they were bigger on the inside than the outside.

I studied a client file while waiting to meet the veteran in the booking photograph, a pudgy, middle-aged, African-American man with short cropped hair on a balding head.

But that was not the man the jailer brought me.

Yes, this was the Henry whose wife asked me to check on him. The Vietnam veteran she said had been here six months without a lawyer. The man she told me was real sick and didn’t mean to hit her. The wounded warrior she said was dying inside this oblivious stack of orange Legos from which no guttural cry, no anguished scream could escape.

The Henry I met that day could barely hold his own weight. What little I could see of Henry’s skin hung loosely. His face hollowing out.

 

 

This is the first instalment of a two-part article that relates these events in Henry’s life. The other part is available here.

 

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Charles Bloeser is the creator of combatresearchandprose.com, a new open-source applied research initiative that will continue to contribute to bridging the gap in experience, knowledge, and understanding that divides those who’ve never served under arms from those who have. He’s the civilian son and grandson of veterans and a lawyer who’s spent most years arguing criminal and constitutional issues in America’s state and federal trial and appellate courts. Among his published research are works re Libyan-supported Jihadi terrorism in the Western Hemisphere, civilian-military law enforcement relations in the U.S., and the demands that an increasingly complex national security environment make for special operations forces. His research agenda includes national security/defense/veterans issues, with special attention to those facing challenges from combat stress/PTSD/TBI etc.

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Notes:

[i] “Henry” is a pseudonym for a now deceased Vietnam veteran who was introduced to me and whose brief relationship with me was, as best I can confirm, the same way that I report it here, except for minor nonessential details and limited artistic license. Having over the years lost independent recollection of certain events, though, I’ve used as an accuracy check other writings that I made about these matters much closer in time to the events which I report here.

By sins of commission or omission, “Henry” had been left to rot and die on the medical floor of a midwestern city’s urban jail. Because informal persuasion got Henry transferred from the jail to hospital in mere days, there was no need for me to file a petition for writ of habeas corpus or anything else in either the local state court or in the U.S. district court. There was no need for me to enter my appearance or show up in court for him. Henry knew about Section 1983 litigation. Henry’s wife told me up front that the couple didn’t have money for a lawyer, and I quickly came to believe that it would be immoral for me to charge them a fee.

Almost nothing I did for Henry fits the technical definition of “practicing law.” Still, my brief relationship with the combat-wounded soldier remains among those experiences that most remind me that it’s a sobering privilege to list among the items in my skill set the tools and lenses of a lawyer.

 

[ii] The events that are reported in this essay occurred during the years that the author practiced law in Oklahoma, prior to his return to Tennessee.

 

[iii] Clarence Earl Gideon v. Louie L. Wainwright, Director, Division of Corrections, 372 U.S. 335 (1963) gave the Supreme Court an opportunity to answer the question of whether the right to counsel found in the Sixth Amendment to the United States Constitution also applies to defendants facing felony charges in state courts. Subsequent developments in the law extends this Sixth Amendment right to counsel to state criminal defendants who face any possible imprisonment. “Reason and reflection,” Justice Hugo Black wrote for a unanimous court, “require us to recognize that, in our adversary system of criminal justice, any person haled into court, who is too poor to hire a lawyer, cannot be assured a fair trial unless counsel is provided to him.”

The idea that criminal defendants are entitled to legal counsel was a no-brainer for the second president of the United States. “Though he struggled at times with the lawyer’s challenging charge, [John] Adams kept his hand to the plow. He did not let go even when appointed to represent British soldiers who had killed five Bostonians after a shouting, cursing crowd ‘pelted the despised redcoats with snowballs, chunks of ice, oyster shells and stones.’ Adams represented those who threatened the very liberty he loved, ‘firm in the belief, as he said, that no man in a free country should be denied the right to counsel and a fair trial.'” Charles Bloeser, Confessions of an American Lawyer, 74 Oklahoma Bar Journal 608 (2003)(quoting David McCullough, John Adams 66 (2001)).

Well, that’s the way it’s supposed to work: “. . . Today, there is a vast gulf between the broad premise of the [Gideon v. Wainwright] ruling and the grim practice of legal representation for the nation’s poorest litigants. Yes, you have the right to a court-appointed lawyer today – – the right to a lawyer who almost certainly is vastly underpaid and grossly overworked; a lawyer who, according to a Brennan Center for Justice report published [in 2012], often spends less than six minutes per case at hearings where clients plead guilty and are sentenced. With this lawyer – often just a “potted plant” – by your side, you’ve earned the dubious honor of hearing the judge you will face declare that this arrangement is sufficient to secure your rights to a fair trial.” Andrew Cohen. “How Americans Lost the Right to Counsel, 50 Years After Gideon.” The Atlantic (March 13, 2013).

 

[iv]“Although PTSD can arise after a variety of traumatic events, war trauma made a substantial contribution to the current conceptualization of PTSD. While the terminology for PTSD only appeared in the psychiatric classification system in 1980, knowledge of battle-related psychological problems goes back to antiquity. Mythical Greek heroes Ajax and Hercules both succumbed to their emotional wounds, not injuries of combat. In 1688, Swiss physician Johannes Hofer wrote about an unusual grouping of symptoms in Swiss mercenaries fighting in France or Italy, which he termed nostalgia. Irritable heart, also called soldier’s heart or Da Costa’s syndrome, was described in soldiers of the American Civil War by Jacob Mendes Da Costa, an American physician. . ..” Dr. Angelica Staniloiu and Anthony Feinstein. “Post-Traumatic Stress Disorder (PTSD) in Canada.” The Canadian Encyclopedia (2017). https://www.thecanadianencyclopedia.ca/en/article/post-traumatic-stress-disorder-ptsd-in-canada/  accessed March 18, 2018.

 

[v]Thefreedictionary.com: “snipe hunt”: an elaborate practical joke in which the unsuspecting victim hunts a [non-existent] snipe and is typically left in the dark holding a bag and waiting for the snipe to run into it; “in the South a snipe hunt is practically a rite of passage.” But see, Joe Smith. “The Snipe Hunt: Myth and Reality.” Cool Green Science at blog.nature.org. January 14, 2014.

 

[vi] “’Our data show a lifelong cost of war,” said [Columbia University Mailman School of Public Health Professor Emerita Dr. Jeanne] Stellman who estimates the actual figures may be higher. “One of the hallmarks of PTSD is withdrawal and avoidance. Countless numbers of people have spent their lives suffering and don’t know how or why to seek help.”

 

“. . . From 1997 to 2005, mental health – service use among veterans of the Persian Gulf era has greatly increased, especially in the last five years and among younger veterans. Veterans from early service eras surprised researchers with a fivefold increase in use, especially among Vietnam vets with PTSD. The system is straining at the seams, the researchers observed. The increased demand seems to be met by fewer visits per veteran.” Carol Cruzan Morton. “PTSD: The Suffering Continues for Vets.” Harvard Medical School (news) March 21, 2008. https://hms.harvard.edu/news/ptsd-suffering-continues-vets-3-21-08  accessed April 12, 2018 (citing a then recent report on trends in VA treatment of PTSD published in the journal Health Affairs).

 

[vii] Matthew Wolfe. “From PTSD to Prison: why veterans become criminals.” thedailybeast.com (July 28, 2013). This article also examines the inner workings of one of the many veterans’ courts established in the U.S. and a vet-dedicated correctional environment being tested in the state of Virginia.

 

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Image Source: https://www.history.com/topics/vietnam-war/vietnam-war-history/pictures/vietnam-war/two-us-soldiers-helping-wounded-third-2