December 16, 2004
The Unseen Casualties
The New York Times is running a story this morning on the unseen American GI casualties which are beginning to, and are anticipated to, overwhelm our Veteran’s health care system. They are the psychologically wounded. The article is entitled, A Flood of Troubled Soldiers Is in the Offing, Experts Predict. These stories struck home with me, since my last 2 years of duty in the Army from 1973 to 1975, were spent working as a psychiatric technician in a military hospital at Ft. Sam Houston, Texas.
In general, there are two schools of thought regarding public awareness of our GI casualties. One school, to which the Bush Administration subscribes, says it is injurious to our war effort, to our armed forces in harms way, and to our continued public support of war endeavors, to make too public the nature and reality of our soldiers casualties. The other school says, in a civilian democracy, to hide casualties of war from public view is to encourage militarism and war as a solution without regard for the real human costs to our nation, and without exhausting all other alternatives, first.
That is a political debate that will never be resolved with unanimity in a civilian democracy. But, for those who do witness first hand the casualties of war, it is difficult to resist falling into the Dove side of the debate. And for those who have lost loved ones in war, it is difficult to resist moving to the Hawk side of the debate. Loss must be justified. To justify losing a loved one in war, one must accept the arguments for the necessity of that war. If the war was not justified, then the loss was a waste, and that is not acceptable.
While working at Chambers Pavilion at Ft. Sam, we had a patient traumatized by his military experience. I will call him John. There is little doubt John brought psychological baggage with him into the service that predisposed him to being traumatized by his military experience. But, the fact remains, something happened to him in the military that did not happen to him in civilian life. I did not know this patient well personally; he was not assigned to me on my shifts. Though he was on my ward, and I had played cards with him and chatted with him about unimportant matters. There was really no reason for me to remember him at all, except for one incident. He jumped from a 3rd or 4th floor window, and lived.
I came on duty one afternoon and his suicide attempt was all the buzz. Everyone was obsessed with wanting to know the details and who was at fault for allowing it to happen. I too wanted to know if he was on suicide watch, meaning a technician like myself was responsible for absolutely never, ever, taking their eyes off that patient and their activity. Where did it happen, how did it happen, what were the nature of his injuries? Needless to say, his injuries were massive and severe. Shattered pelvis, ribs, shoulder, skull, legs, but, he was rushed to surgery and was still alive after it.
Then, the horror of it sank in. A number of us were responsible for these soldiers' well being during the Viet Nam war; these soldiers who had returned psychologically scarred, abberated, conflicted, and tormented by what they had witnessed others do to human beings, and in some cases by what they themselves had done which they could not live with in their minds. Then began our own grieving. For us psychiatrists, psychologists, and psychiatric nursing staff charged with their care and restoration, we now had a loss of our own to contend with. I was deeply affected by the incident.
I had pulled a number of suicide watch duties at Chambers. Upon occasion, I would be blowing my nose, or chatting with another patient or staff member, only for a few seconds, and return my gaze to find my patient gone from view. It happened to all of us on suicide watch duty from time to time. The thought that entered my mind was, "Oh shit, I could lose stripes over this, where the hell did he go?" I ran immediately to find my patient, usually found in the bathroom or in the recreation room. I remember once feeling annoyed that the patient would do that to me.
But after John jumped, I had bouts of tears for sometime after. I could not help but think it could have been me assigned to John, it could have been me who had to carry the burden of having failed to serve and protect my fellow soldier and patient. It could have been me who allowed his death or massive injuries to occur. I also could not shut out the immense pain and anguish and despair that John carried with him out that window. I could not help but wonder what his experience was during the Viet Nam war that drove him to such extreme measures as to take his own life. I also remember thinking how intensely grateful I was that it was not me who had experienced what he had. I don't know what happened to John. After a few days, it was a verboten topic at the hospital. Bad for morale, you know.
Many Americans will view our returning psychological victims of the Iraq war as wimps, girlie boys, who just couldn't take it, didn't have what it takes. It is America; we are all free to think what we wish. But, I would suggest to all who read this article, that it is incumbent upon us as civilians to open our hearts and compassion for the casualties of the Iraq war whom we directed to go fight there.
I would suggest that it is the ultimate insult to our troops to hide their suffering from our eyes and our wallets. I would suggest, that if we wish to retain our own humanity, that we encourage our Congress and our President to find some money in the failed star wars defense system, or some money from those pork barrel projects to observe why birds are eating sunflower seeds in North Dakota, and spend it on providing the absolute best possible care and treatment of our returning wounded for as long as they require it. And I would suggest to readers here, that a tortured mind is no less painful than a body torn and ripped by racing projectiles.
Posted by David R. Remer at December 16, 2004 10:09 AMI think people who think soldiers with PTSD are wimps or girly men should be sat down and shown photos and videos of actual war wounds. There is something horrifying about them that makes me glad that I’ve never been in combat. There is something fundamentally insane about seeing people turned to hamburger in front of you. We’re not used to seeing human beings taken apart into meat, guts, and brains. We’d like to think of human beings in one piece, and alive as they typically are.
The most injurious thing to a war effort is not the truth. That can always be put in context. People can always be reassured about the necessities of the horrors of war, as long as they are truly necessities.
The error of the Bush Administration has been to send us to war on pretexts that came out false. In military matters, physical force is not all that wins battles, campaigns, and wars. there has to be something there that steels people’s resolves that allows them to move past the horrors and fight the battles. That something is not achieved by removal of bad news, because always sets people up for nasty, morale destroying shocks. No, that something is achieved by waging the war with an aim that makes the fight necessary.
For many, the Iraq war is a defense of our borders. However, that point is artificially imposed, because there’s no evidence Iraq was ever a threat the way we imagined it. The terrorists settled in to do their dirty work after we got there and destroyed the systems of law enforcement that kept them out.
For many, the notion that this has been a war worth fighting has eroded away. This is a war we fight from desperation rather than inspiration. We cannot lose and not increase the threat to our interests and shores.
Bush has compounded his error by not admitting it. Because of that, we are stuck in the position of having to resolve our mistakes without admitting them. Unfortunately, that means that legitimate solutions are denied to us, because they would represent an open admission of error by the people in charge of this war. Such cowardice is hardly inspiring. It inspires distrust in the motives and direction of the war.
I voted and advocated for Kerry in part because I believed he was the only candidate that could restore some kind of moral force to this war. He is the only one who could do what needed to be done without losing political capital in the process.
As long as we are not honest with ourselves about this war, we cannot prosecute it with both competence and wholehearted support. Only when we admit the worst about it, can we move past that to the kind of action that speaks well of us.
Posted by: Stephen Daugherty at December 16, 2004 11:33 AMDavid,
My experience with our V.A system was in 89’-90’. This may have been an isolated incident at the hospital in Phoenix.
I was repairing a nurse call system and saw four of the floors including the psyc wards. The conditions were appalling, and in some areas the smell was overwhelming.
I have never served in the military, but I have visited other hospitals both as a visitor and as a patient, I have never seen such as I saw at that V.A. Basicly it seemed as the worst of any Dickens novel.
How can we treat our service men and women this way? How can we make promises to them that we apparently don’t keep?
What I saw was worse than any county hospital I have ever been to.
Really EXCELLENT article, David. I share your concerns about our troops and would like to see the very best care be given to them. I also agree that what these casualties of war are going through now and will go through in the future, as a result of their wartime experiences, is something that American’s should not be kept from looking at or hearing about.
Btw, nice response, Stephen.
Posted by: Adrienne at December 16, 2004 01:34 PM“How can we treat our service men and women this way?”
Morally, I couldn’t even begin to guess Rocky.
Money is a big reason though. What do you think budget cuts effect the most?
Not the top secret programs or hot shots pay. It affects the common soldier and his benefits and working environment.
As stated above, people who use names such as wimp usually have never been in combat. I have.
The things you do and see change you forever. It’s weird though, how it effects people in different ways.
John, with all respect and love, could not handle it and deserved all the help he could get. We have let him and thousands others down. It tears me up inside.
Lets not disgrace ourselves with partisan bickering on this one. It is a problem that crosses party lines and all are at fault.
At least we haven’t been seeing the “baby killer” signs yet. This would just add to these guys mental problems. Hope that never happens.
Posted by: kctim at December 16, 2004 01:40 PMTim, when I protested the Viet Nam war, I was never protesting against the troops. I was protesting against the government that put them in harms way. I never understood the protesters that harassed the troops.
Rocky, I have not visited a VA hospital since the ‘80’s. I have read upon occasion articles indicating that the horrid conditions of the VA hospitals in the 80’s have been very much improved.
I have also read articles indicating that many are still not up to the standards we would expect, especially in the area of staffing.
Adrienne, Thank you very much for the praise.
kctim, it is important for the best care to be provided that public light be shed on this very important topic. I was very impressed with the NY Times bringing this issue to light.
Rocky, me neither. On Belle Isle in Detroit, we handed the troops flowers, most of the troops got a positive kick out of it and winked or smiled. We cared about the troops and didn’t want to see them go, and didn’t want to see them come home any different than they way they left. It wasn’t all that magnanimous, many of us protesters were in line to follow. Self-interest was a definite part of the motivation in addition to caring about our brothers.
Posted by: David R. Remer at December 16, 2004 02:13 PMRocky and David
I was not trying to imply that all protesters did that in any way.
Everyone who protests wars have their reasons and I believe it is well within their right to do so.
It is a much needed tool.
I also was not coming at any way of partisanship. I was simply thinking about how bad, mentally, it must have been to see signs that said that. I am sure/hope those signs were in the minority.
“kctim, it is important for the best care to be provided that public light be shed on this very important topic. I was very impressed with the NY Times bringing this issue to light.”
- I totally agree David. I just hope it doesn’t become a partisan issue and diminish what is happening.
Republicans and liberals must work TOGETHER on this and not make it political, or else nothing will get done.
I am sorry if I did not make myself very clear on things. This post brought back alot of things for me and my emotions probably got the best of me. I should have waited awhile before posting. I apologize to all.
A much needed and APPRECIATED post David, thanks.
Tim H.
KC Mo.
USAF Vet
kctim, you are right, the baby killer sign carriers were a minority, in my experience, but, they were a very vocal lot and got a lot of press, SDS comes to mind (Students for Democratic Society). I was acquainted with two of them (not SDS, but sign carriers) back in ‘69. They were on student deferments and were attacking the gung ho GI’s who bragged about their gook killing deeds. They actually sympathized with most GI’s who were just trying to do their job and come home. Had they experienced Nam themselves, however, I think they would have regarded the gook killing braggards as casualties of that war, as well.
The injustice in the minds of many protestors in the ‘60’s largely centered around the idea that it was not their war. Most Americans of all parties, it seems to me, agree that Iraq is our war, we chose it, and our volunteer Army chose to serve us. So, unlike the Viet Nam War, the Iraq war I think has the vast majority of civilians supporting their effort and wishing only the best for them.
We need to translate those sentiments into action however, with calls and letters to our Congress to insure that those sentiments are fully realized and not just used as political cover for money and attention spent elsewhere.
Posted by: David R Remer at December 16, 2004 04:13 PMVery well written David.
It’s not a subject some people want to talk about, but we have to. Our veterans, no matter what war, have been through horrors we can only imagine. We need to make sure they get the support they deserve.
Thank you, TheTraveler. We do in deed.
Posted by: David R. Remer at December 16, 2004 05:40 PM
