While it is far easier to point fingers at the VA than propose meaningful solutions, it is evident that we have a serious and growing problem on our hands.  SFTT has reported earlier that government statistics suggest that 1 in 5 Iraq and Afghanistan veterans suffers from PTSD and that the VA is swamped with demands on the limited services they are able to provide.

The question should not be limited to how quickly the VA responds to requests by veterans seeking mental-health care, but an overall evaluation of the effectiveness of the health-care or therapy that veterans actually receive from the VA.   Just because the VA is able to respond to a request for service within 24 hours is useful information, but shouldn’t the effectiveness of short and medium-term therapy and an evaluation of the overall rehabilitation of our veterans be the focus of any meaningful inquiry.

The magnitude of this problem in caring for veterans extends far beyond the treatment of PTSD as these statistics from John Kuhn, Acting National Directory, Supportive Services for Veteran Families (“SSVF”), suggests:

• Of the 26 million veterans in the United States, 13% became homeless at some point during the last year.
• Almost 1.4 million veterans live in poverty and women veterans are 3.4 times more likely to live in poverty than their civilian counterpart.
• The unemployment rate for veterans between the ages of 18-24 now approximates 30% or twice the average of their civilian counterparts.

While many good-intentioned people are well aware of the problems facing our veterans and many studies have been funded to develop solutions, it is evident that the complexity of dealing with these issues has overwhelmed the capabilities of our institutional care-providers.  Yesterday, I attended a discussion hosted by the New York State Health Foundation on some of the challenges faced in providing “Community-Based Services for Veterans and Their Families.”

This fascinating discussion brought together care-providers and charitable organizations to determine how best to provide meaningful and effective services to our veterans.   The presentations and subsequent discussion suggested that there is no clear unanimity of how best to deal with the “well-being” issues faced by veterans, but that a community-based response seemed to offer the best prospects for success.    The Rochester Veterans Outreach Center was cited as an example of what can be done to mobilize local resources to help provide a community-based support structure for returning veterans.  Indeed, many other towns and cities appear to be feeling their way to develop similar programs within their own communities.

The key catalyst for change is leadership within the community to address the needs of veterans.  Those communities which appear to have the most resilient programs are those that recognized both the unique capabilities and needs of veterans and began the lengthy process of integrating the various local services, care-givers and donors to provide veterans with social services, education and employment possibilities that would probably have been overlooked in a “top-down one-size-fits-all” federally-mandated and managed program.

Clearly, essential and varied services provided by community-based and community-supported organizations seem to offer veterans and families a milieu of  services that can be tailored to the needs and aspirations of each veteran.  Unfortunately, these organizations often lack the visibility and/or capabilities to attract funding to support their initiatives.  Furthermore, there is little in place to benchmark performance and provide a meaningful framework to replicate successful programs for other communities.

Sharing success stories and evaluating available community-based services is essential to develop a framework to guide civic organizations and funding entities to support programs that have a reasonable chance of being successful.  For its part, SFTT and its newly created medical task force can help community leaders to develop programs that can attract the necessary resources to help change the lives of our brave veterans.

We are hopeful that community leaders will emerge and bootstrap similar programs to the Veterans Outreach Center in Rochester.   The needs of our veterans are both varied and great and can be best met with inspired and dedicated local leadership supported by our Federal and State government institutions and charitable foundations.

Richard W. May

Of this group, “11% have been prescribed opioids. For veterans with PTSD, that percentage grew to 17.8%. For other psychiatric illnesses, it’s 11.7%, with a 6.5% prescription rate for veterans with no psychiatric diagnoses.

U.S. Medicine goes on to report that “veterans with PTSD also were more likely to take higher opioid doses (22.7% vs. 15.9%), two or more opioids (19.8% vs. 10.7%) and concomitant sedative-hypnotic drugs (40.7% vs. 7.6%). Receiving prescription opioids was associated with adverse clinical outcomes for all veterans, but adverse effects were most pronounced in veterans with PTSD. Those outcomes included general wounds and injuries, accidents and overdoses, violent injuries and suicide attempts. While previous studies have shown that prescription opioids are more often prescribed for patients with psychiatric disorders, this trend was even more pronounced when the patient was diagnosed with PTSD.”

Lead author Karen Seal  of a recent study published in the Journal of the American Medical Association on the medication prescribed to veterans believes that the study results are troubling. ”The message to me is to keep redoubling our efforts to really have conversations with patients about these risks, and really provide them alternatives to just taking Vicodin or oxycodone or morphine, which has become very, very common in our society.”

It is becoming clear that our military leaders are now beginning to realize that these addictive drugs may, in fact, exacerbate the problems associated with PTSD rather than treat them.   In fact,  Bob Brewin of Veterans for Common Sense reports that  “the Army Surgeon General’s office is backing away from its long-standing endorsement of prescribing troops multiple highly addictive psychotropic drugs for the treatment of post-traumatic stress disorder and early this month warned regional medical commanders against using tranquilizers such as Xanax and Valium to treat PTSD.

“An April 10 policy memo that the Army Medical Command released regarding the diagnosis and treatment of PTSD said a class of drugs known as benzodiazepines, which include Xanax and Valium, could intensify rather than reduce combat stress symptoms and lead to addiction.

“The memo, signed by Herbert Coley, civilian chief of staff of the Army Medical Command, also cautioned service clinicians against prescribing second-generation antipsychotic drugs, such as Seroquel and Risperidone, to combat PTSD. The drugs originally were developed to treat severe mental conditions such as schizophrenia and bipolar disorder. The memo questioned the efficacy of this drug class in PTSD treatment and cautioned against their use due to potential long-term health effects, which include heart disorders, muscle spasms and weight gain.”

This greater awareness of the risk of prescribed opioids only confirms indications that SFTT has received from its sources “upwards of 80% of veterans suffering from PTSD also have an addiction problem.”     These new revelations are truly frightening and place a far greater sense of urgency in treating PTSD properly unless we plan on turning our brave veterans into addicts rather than cure them.

General Batiste is the product of a military family, (the son and son-in-law of veteran career soldiers), a graduate from West Point who served for over 30 years and a two-time combat veteran who led troops in two war zones, including Iraq.  In 2005, as a two star General, he refused to accept his third star that would have promoted him to become the second-highest ranking military officer in Iraq.  Instead, he resigned in principle, in protest at the prosecution of the Iraq war.

In the tradition of SFFT founder David Hackworth, John Batiste made headlines again in 2006 when he and six other senior retired generals (Batiste was the only General who had held a high level position in the Pentagon and had commanded troops in Iraq) went public with their condemnation of the prosecution of the war in Iraq and called for the immediate firing of then Defense Secretary, Donald Rumsfeld.  It was dubbed the ‘Night of the Generals’ by the media.

In the Army, General Batiste rose from infantry officer to commanding general of the 1^st Infantry Division -the “Big Red One”- which conducted successful peace enforcement operations in Kosovo and combat operations in Iraq (Operation Iraqi Freedom II). His deployments, assignments and commands took him from Fort Benning to Bosnia (Operation Joint Endeavor), NATO, the Joint Staff at the Pentagon and the Department of Defense. His final assignment in the US Army was commanding general of the 1st Infantry Division, the “Big Red One,” from August 2002 to June 2005.  After retiring from active duty in 2005, he joined Klein Steel, a Rochester, NY company as its president.  He is a graduate of West Point, the Army War College, and the financial management MBA program at Naval Postgraduate School.

General Batiste’s support of veterans and their families includes service as a board member of the Rochester-based Veterans Outreach Center, founding president of the Rochester Regional Veterans Business Council, and a member of the board of advisors of the First Division Museum at Cantigny. As Committee Chair of SFTT’s PTSD Initiative prior to his election to Board President, he has been instrumental in focusing attention and resources towards prevention and treatment of the PTSD epidemic (on average 18 veterans every day commit suicide in the United States).

General Batiste succeeds Fred Tanne, P.C., a senior corporate partner in the New York office of Kirkland & Ellis LLP. Tanne is stepping down as President to co-chair SFTT’s critical new PTSD initiative that is working to establish diagnosis and treatment protocols, remove the stigma of PTSD that prevents many from seeking treatment, and get those most at risk into appropriate treatment. A resident of Mt. Kisco, he will continue to be available to the Foundation as a member of SFTT’s Advisory Board.

Continuing their service as SFTT Board officers, with Ms. England and General Batiste, are:

SFTT Vice Chair/Secretary Roger Charles, a Peabody award winning investigative journalist who’s been singled out for recognition for his coverage of the Oklahoma City bombings for ABC News and CBS 60 Minutes II – Abuse at Abu Ghraib – to mention just two.  At SFTT, he was also the driving force behind the May 2007 NBC Nightly News, Dateline and MSNBC investigative reports by Lisa Myers on inferior body armor.  Combined with Roger and Eilhys’ reaching out to US Senators, it resulted in a call for Congressional Hearings and further independent testing.  An Annapolis graduate, Roger Charles is a retired USMC Lt. Col. who commanded an infantry platoon in I Corps during the Vietnam War.

SFTT Board Treasurer Bob Evans, a national market manager for 3M in its Washington, DC office.  The son of a career Army Officer, Bob served as a division artillery aviation officer, artillery battery executive officer and troop commander at Fort Hood, Texas.   Bob is president of the prestigious National Order of Battlefield Commissions. It counts Audie Murphy and the late SFTT founder David Hackworth among its 1000 by invitation only members.

SFTT (www.sftt.org) is a non-partisan apolitical organization chaired by Eilhys England, a Greenwich resident who co-founded the organization with her late husband Col. David Hackworth, America’s most valor-decorated soldier.  SFTT is unique in its mission and uniquely qualified to carry out its mission to give a voice to our troops. SFTT provides a platform and voice for the brave men and women defending us on the frontlines, by educating the public and policy makers in Washington D.C. on the need to send our country’s brave warriors off and to welcome them back with the best available equipment, training and support to make it home alive in body, mind, and spirit.

For information on SFTT, visit the foundation’s website at www.sftt.org or phone 203–629-0288.

In a solid piece of investigative reporting, Australian journalist Nick Lazaredes takes another look at PTSD to see if anything has changed since his initial report in 2007. Sadly, it hasn’t; and for thousands veterans, their families and loved ones, the nightmare of our wars in Afghanistan and Iraq  continue to haunt our brave veterans.

SFTT reported earlier on some of the difficulties of treating veterans suffering from PTSD.  In fact, it would appear that many veterans abuse drugs and alcohol to cope with the trauma of PTSD.   The V.A., which is already swamped by veterans suffering from PTSD, does not appear to have the necessary resources to cope with the problem other than to prescribe drugs.  While these drugs may treat some of the symptoms of PTSD, most medical practitioners believe  that it rarely deals with the underlying trauma.  In short, we run the risk of having veterans suffering from PTSD becoming addicted to the very drugs that are used in treating them.

In fact, OxyContin often prescribed by the V.A. to deal with the symptoms of PTSD  has proven to be addictive and of questionable value in restoring our veterans to health.  Now, it has been known for sometime that OxyContin - which is manufactured by Purdue Pharma -  is an addictive drug often referred to as “Hillbilly Heroin” among other names.

OxyContin and other drugs of questionable therapeutic value are being administered by physicians to “treat” the symptoms of PTSD among our veterans.  While these drugs may be expedient at masking the symptoms of PTSD,  are we creating an even larger problem to rehabilitate our warriors?   Most of us at SFTT are convinced that this is a serious and growing problem.    SFTT feels strongly that our military and civilian leaders need to get in front of issue before it engulfs our ability to provide the proper treatment and care for our brave veterans.

We would like to thank Nick Lazaredes and SBS Australia for keeping this tragic story alive.

While SFTT will report more on Dr. Grayson’s innovative approach to treating trauma, it is evident that there is no “magic bullet” to deal with the tragic consequences of veterans suffering from PTSD.  With at least 1 in 5 veterans who have served in Iraq and Afghanistan suffering from PTSD, the ongoing cost to our society is enormous.   Unfortunately, our military court system and the V.A. are structured in such a way that many veterans suffering from PTSD may be effectively deprived of proper treatment.

In a far-reaching report summarized by Howard Altman of the Tampa Tribune, Major Evan R. Seamone, a member of the Army’s Judge Advocate General’s Corps, argues that “courts-martial function as problem-generating courts when they result in punitive discharges that preclude mentally ill offenders from obtaining Veterans Affairs treatment. Such practices create a class of individuals whose untreated conditions endanger public safety and the veteran as they grow worse over time.”     In fact, Major Seamone’s 212 page report for the Military Law Journal may be accessed by clicking on this hyperlink:   The Military Court system and PTSD.

Major Seamone’s observations are clearly “on-target” when it comes to dealing with veterans suffering from PTSD.  Many – if not most – veterans who suffer from PTSD also have a substance abuse problem.   In fact, one experienced addiction specialist suggested that “upwards of 80% of veterans suffering from PTSD also have an addiction problem.”   Unfortunately, the V.A. and our military courts tend to address PTSD and substance abuse as separate issues thereby depriving large numbers of veterans with the comprehensive treatment they deserve.   Sadly, substance abuse is a common opiate for those that suffer from combat-related trauma.

Since the mid-1990, the US judicial system has recognized the need to deal with drug-related criminal activity and have established some 2,600 Drug Treatment Courts in the United States.  Drug treatment courts are specialized community courts designed to help stop the abuse of drugs, alcohol, and related criminal activity. Non-violent offenders who have been charged with simple possession of drugs are given the option to receive treatment instead of a jail sentence.   These programs have proven to be remarkably successful for reducing the level of recidivism in our prison system.

Capitalizing on the infrastructure and success of the Drug Treatment Courts, some 50 or so Veteran Courts have sprung up across the United States to deal with veterans who have committed a crime while suffering from substance abuse.  In many cases, these troubled vets have the support of other Vets (often from the Vietnam era) who “mentor” their military colleagues through the rehabilitation process.   Judge John Schwartz,  one of the early pioneers in the Vet Court system, said that “We offer hope to these troubled veterans who have served our country so valiantly.  It’s simply common sense.”

When communities reach out to help these brave warriors, our society is enriched. From our perspective, it’s simply a matter of doing the right thing!  We owe these brave young men and women big time!

Richard W. May

While not shy to tackle issues affecting the well-being of men and women in uniform, we do try to avoid subjects which do not directly contribute to the fulfillment of our mission.   On occasion, one of our readers will submit a question or offer an opinion which causes us to scratch our collective heads and wonder at the absurdity of it all.  Found below is one of those questions.

QUOTE

After reading the headlines about the US soldier who shot up Afghanistan civilians, I couldn’t help noticing an irony. I’m not condoning or trying to mitigate the severity of what was done, but there is all this clamor to try this guy quickly and execute him, never mind his having suffered a traumatic brain injury. Yet “our” Major Hasan, who shot up Fort Hood while screaming Allahu Akbar, still hasn’t stood trial, and they are still debating whether he was insane, even with the clear evidence regarding his motive: “slay as many infidels as possible.”  So we have a guy in a war zone who had suffered a traumatic brain injury and does the unthinkable, and he must be executed immediately. But this Muslim psychiatrist who was stateside in a nice safe office all day murders 13, wounds 29 of our own guys, and they try to argue the poor lad suffered post-traumatic stress syndrome from listening to real soldiers who had actual battle experience.

UNQUOTE

Clearly, both crimes are heinous, but should our actions as a society be any different in dealing with these situations while protecting the rights of the accused.   On the surface, Major Hasan’s criminal behavior seems to be the most reprehensible – not because of the nationality of the victims – but because it appears to have been premeditated.

In the case of Sgt. Bales, I have yet to see any evidence that his actions were premeditated.  In fact, the overwhelming evidence is that he simply snapped.  If so, why is Sgt. Bales on the fast track to judgement by a military court?

I don’t know the answers to these questions, but I would certainly hope that in the case of Sgt. Bales it is not a “rush to judgement” to appease some mistaken perception of our system of values as determined by world opinion, let alone prop up the self-serving interests of the wholly corrupt Karzai regime in Afghanistan.

The article, quoted in its entirety, is a sad commentary on the current state of our ability to evaluate the readiness and mental well-being of men and women serving in harm’s way. SFTT fully concurs with Dr. Xenakis concluding paragraph: “To recover from 10 years of combat in Iraq and Afghanistan, the Army must focus not on weapons systems but on people. This may cost more, but it will prevent the fragile conclusion of a decade of war — or innocent civilians — from being harmed by one sick soldier.”

QUOTE

The U.S. military doesn’t know who is fit to fight

By Stephen N. Xenakis, Published: March 23

How good is the U.S. military at determining who is fit for battle?

Ten years into the war in Afghanistan, and after nearly nine years of war in Iraq, we know that the defining injuries of these conflicts for our service members include traumatic brain injury and post-traumatic stress disorder. We also understand that the all-volunteer force is stretched thin and that multiple deployments to combat zones are routine.

What military physicians don’t have a good sense of, however, is how to tell whether a combat veteran is still qualified for the battlefield. And the tragedy this month in Afghanistan, where Army Staff Sgt. Robert Bales, on his fourth combat tour, allegedly slaughtered 17 civilians and has been charged with murder, underscores the urgency of finding a better solution.

I have spent much of my career searching for one. As a psychiatrist who served from 1970 to 1998, I helped develop the Army’s programs in stress reduction, and I took on the issue as a retired Army brigadier general and the senior adviser to the chairman of the Joint Chiefs of Staff.

Soldiers are, of course, screened before and after deploying. But although this process involves multiple questionnaires and a review of medical records, it varies from base to base. No physiological tests are used, and soldiers may or may not see clinicians. Assessments are highly subjective and have been criticized for relying on self-reports. After all, soldiers may not be honest about their problems. If injured or unstable, they may be unable to deploy with teammates who rely on them or may face delays in going home.

Bales had been treated for mild traumatic brain injury. But the military has lagged in developing accurate, cost-effective tools to diagnose blast-induced concussions, despite growing evidence of their harm. As early as 2004, I saw that troops injured in IED explosions were foggy and dazed. My attempts to interest the Army’s senior medical leadership at that time were brushed off.

By 2007, at the height of vicious combat in Iraq, meetings arranged to jump-start physiological tools for diagnosis and treatment were buried in bureaucracy. And the severity of the problems was minimized. “Better diagnosis was not needed because there was no treatment for concussion anyway,” one consultant to the Army surgeon general commented.

That mentality prevailed until the Defense Centers of Excellence was founded in November 2007 to tackle psychological health and traumatic brain injury. Since 2009, the Defense Department has spent millions of dollars on ANAM4 — Automated Neuropsychological Assessment Metrics, Version 4 — the standard measure of brain injury for troops returning from combat. But ANAM has serious shortcomings. Developed by military researchers in the 1980s, it has been used to select pilots and astronauts, but was not intended as a diagnostic test for concussions or any other neurological disorder.

ANAM and other psychological tests are useful but not definitive. They help identify particular problems, such as dementia, in up to 80 percent of cases, but the questionnaires are subjective, even when administered by professional psychologists. Clinicians should rely on psychological tests such as ANAM to supplement examinations — not to diagnose.

Other factors complicate the psychological testing of soldiers. Psychiatrists at Washington’s Madigan Army Medical Center — located on Bales’s home base — may have changed PTSD diagnoses to save money. Meanwhile, the murky background of new recruits — some who have mental illness, have been on medication and had concussions we don’t know about — complicates assessment. Psychologists can’t always immediately identify a private’s ability to cope with training and combat. There are no good tools to discern predisposition to emotional stress or assess for a history of concussions.

Soldiers fight a battalion of stresses: life-or-death missions, colleagues killed or badly injured, chronic aches from carrying heavy loads, disturbed sleep patterns, exposure to foreign toxins, and explosions that shake the body and the brain. No tests adequately account for every issue. Questionnaires can’t distinguish between medical problems caused by IEDs, shock, drug and alcohol abuse, or diseases that affect thinking and behavior. Using surveys to evaluate men and women before and after their service doesn’t offer a clear picture of the whole person or of the circumstances leading to their injury.

What would be better than the outdated method we use? According to some, only electroencephalogram (EEG) tests, which measure brain waves, or diffusion tensor imaging, a specialized MRI, can detect specific evidence of a brain injury. EEGs are inexpensive, take less than an hour and can be done outside of hospitals. More sophisticated radiological testing is expensive and time-consuming, but can yield worthwhile information. ANAM’s subjective self-reports are no match for physiological data for diagnosing damage to the brain.

Still, some may argue that the cost of definitive screening is prohibitive. That is a red herring. Refitting and rebuilding the Army in the 21st century requires knowing whether warriors are fit. There’s not much room for cost-benefit analysis. Commanders have a responsibility to identify at-risk soldiers. They can’t pass the buck to generic medical screening with limited utility.

To recover from 10 years of combat in Iraq and Afghanistan, the Army must focus not on weapons systems but on people. This may cost more, but it will prevent the fragile conclusion of a decade of war — or innocent civilians — from being harmed by one sick soldier.

snxenakis@hotmail.com

Stephen N. Xenakis, a retired Army brigadier general, is a psychiatrist and founder of the Center for Translational Medicine.

UNQUOTE

Regardless of one’s position on the war in Afghanistan, it is clear that many brave young men and women have served under dangerous and very difficult conditions with remarkable courage.  In many cases, service members have had multiple rotations in a war zone where the US has had a military presence for over 10 years.

The shocking story of Army Staff Sergeant Robert Bales who allegedly murdered 16 Afghan civilians,  has caused great distress within the ranks of active duty personnel.   We reported earlier that senior military officers have tried to calm service members claiming that the situation is “under control,”  but clearly the situation is not under control.

Staff Sergeant Bales’ attorney, John Henry Browne, claims that he questions the evidence and suggests that Sgt Bales is being using as a scapegoat by the US military.  In other words, Attorney Browne may prosecute the conduct of the military in Afghanistan to defend his client.   Whether he will succeed or not is a matter of conjecture, but clearly Attorney Browne can certainly question the obvious shortcomings of the Chain of Command.

How is possible that a warrior as troubled as Staff Sergeant Bales received the “green light” for deployment?

Who in Staff Sergeant Bales immediate chain of command is accountable for his actions?  If so, what sort of disciplinary action can be expected and how far will it go up the chain of command?

Are veterans properly screened for PTSD and other ailments prior to deployment to war zones?

Who is responsible for such testing procedures and what percentage of combatants are deemed ineligible for deployment?

Of those veterans deemed ineligible for further deployments, what percentage are remanded into the care of physicians?

Did Staff Sergeant Bales receive counseling for his apparent financial problems and anger management issues?  What sort of follow-up occurred prior to his deployment?

Will any senior officer stand up and say under oath “We let this brave warrior down?”

Will any senior officer stand up and say under oath “Our screening and counseling services are defective and we are placing young men and women in situations which can be harmful to themselves and others?”

Only time will tell how the military chain of command will react as Sgt. Bales goes to trial.    Nevertheless, I doubt very seriously whether anyone in his immediate chain of command is prepared to say “I’ve got your back!” or “I’ve let you down!”      The chain of command is about responsibility – not hypocrisy!

Richard W. May

P.S.  Please let me know if you have any idea why the Washington Times pulled their article entitled:  Troops Stressed to Breaking Point

From a Blogger named Universal

I can’t sleep, can’t feel
Anything.
Time passes in chunks now –
A month passes for me
Like someone else’s day.

Zombies don’t have rhythms;
I go wherever my trance
Takes me.
Today I panic in a store,
Where danger doesn’t lurk.

Maybe if I stay awake, there
Won’t be any nightmares tonight.
But I can’t go without rest forever.
It’s over, finished. So why am I
Sweating? Why am I still afraid?

Today I saw most of my family
For the first time in a year.
Nothing felt real; everybody was a
Stranger I am supposed to know.
“Dissociation,” I think a doctor said.

No bumps, no bruises. No broken limbs.
But my mind is shattered, along with my
Soul.
I don’t know how to tell you that, don’t
Know how to put the genie back in the bottle.

When my emotions got shut off, I didn’t get to
choose which ones I wanted to keep;
They all left; they are all gone.
And it feels like there is an invisible hand
Keeping me frozen on my bed.

I used to care about how I looked, but now
All I can think about is what I saw, what I
Experienced; nothing seems to matter beyond
That. I will do anything — anything at all –
To keep from repeating that time.

I think more now, talk less. Months of numbness
Are followed by a week of depression and tears.
I am weak, frail, imperfect.
Broken.
My identity then irrevocably altered.

Do I want help, you ask.
How are you going to help me?
You weren’t there; you don’t know
What I saw, what I did.
What was done to me.

How does one ‘undo’ a scorched mind?
Deep within me a voice mumbles ‘help;’
But you’ll never hear that. All you will
See is my distant, fixed stare and my
Clenched jaw. I can’t take the chance.

How long will it be before you
Give up on me? I know it’s coming;
I’m resigned to my fate. Resigned to a
Lot of things, actually. Here, in my bunker,
In Hell.

Just remember, “You are not Alone!”  There are many who care deeply about the fate of our brave warriors who suffer from PTSD and each of us in his or her own way is trying to reach out to connect.  Give us a chance.

Earlier, SFTT reported that Gen. David M. Rodriguez the commanding general of U.S. Army Forces Command, reportedly said that “he’s confident in the Army’s ability to screen and treat these signature medical conditions (“PTSD” and “TBI”) from the last decade of war in Iraq and Afghanistan – ‘we’re not perfect,’  but getting better.”   Gen. Rodriguez knows this not to be the case, so why the “happy talk?”

Sadly, we have seen this picture far too many times as senior officials within our military try to blind the American public (and perhaps themselves) to a serious and growing problem within the ranks of men and women who are strung out with repetitive deployments and suffering from a host of other medical and psychological ailments.   Claiming that the situation is under control and having it under control are two different situations entirely.

Witness this incredible article entitled “Opinion: Soldier accused of shooting rampage:  Not PTSD alone”  in which a former Army doctor, Dr. Harry Croft asserts that there were other contributing factors that caused a decorated Army Staff Sergeant to murder 16 Afghan civilians.  Now I do not wish to question Dr. Croft’s credentials, but for him to assert that there were “other contributing factors” is akin to saying that if the Staff Sergeant hadn’t been carrying a loaded weapon while on guard duty, this situation wouldn’t have happened.   Maybe he was bullied in elementary school as a child or reacted negatively to a soft drink.  Indeed, there are any number of contributing factors which could have triggered this event, but I doubt very seriously whether anyone in the chain of command will step up and say I made a terrible mistake redeploying this troubled young man a fourth time to Afghanistan.

More frightening is the implication by Dr. Croft that PTSD alone is not responsible for his erratic behavior.  On the basis of 7,000 patients he claims to have treated, not one of them murdered 16 civilians.   Boy, that is a relief!  What Dr. Croft is asking us to believe  is that there were other more compelling reasons which caused this Staff Sergeant to go on this murderous rampage.   By engaging in this “happy talk” masquerading as clinical experience, Dr. Croft is essentially laying out the position that PTSD cannot be used as an excuse or primary reason for criminal behavior.

Many have long suspected that senior officials within our military are not fully convinced of the deadly consequences of PTSD if left untreated.   Dr. Croft has deftly contributed to reinforce their position. I trust he did so unwittingly, since the lives of many other brave warriors hang in the balance until we come to grips with the problems of properly treating PTSD.