Post-traumatic tightrope

Popular wisdom holds that our country hosts an all-volunteer military. That isn’t quite accurate. It is better described as a recruited one. It took convincing to get most of our men and women out of their designer duds and into combat fatigues — particularly since our occupation of Iraq turned out to be a monster wholly other than the extended ticker-tape parade it was first billed as.

For Jose Rivera, however, the decision to enlist was easy. He’d already traveled the world with his Army father as the “brat” behind the brass. He rushed to enlist as soon as he graduated high school in 1999. It was time to see the world through his own eyes and on the Army’s dime. It was also time to get the hell out of 1,400-population Irvington, Kentucky, an army town on the backside of Fort Knox.

“Yeah, I definitely wanted to get out of Kentucky,” said Rivera, with a chuckle. “I wanted to go to Germany.”

When his three years at Fort Hood in Killeen were up, Rivera signed on for another round. In 2002, under the steady drumbeat of war with Iraq, his Deutschland dreams were realized. It lasted three months. Then he was cleaning his weapon in the Kuwait desert, preparing for a march on Baghdad as a tank mechanic with the First Armored Division.

He understood the risks of combat, but never suspected that the nation that had sheltered his family all these years would turn on him after he was hit with a grenade and started displaying signs of a serious mental disorder.

Today, he knows better. And he knows he’s not the only one.

For U.S. veterans the greatest sacrifices have always been those of life and limb, with the fallen attaining instant hero status in their respective small-town papers. Those who return physically altered by missing limbs or disfiguring scars are solemnly welcomed home and quickly forgotten. But it is too often the “lucky ones,” those who return in one discernible piece, who turn out to be the most fractured of all. It’s the lesson and bitter legacy driven home by Vietnam.

Elsa resident Jose Maria Vasquez came home to the Valley after his tour in the Southeast Asian jungle only to seal himself up in his house. Eventually he would go back to work. After work he would drink. Some nights he would sleep, but never well.

His anger was a whirlwind that never settled down, his mind on constant alert for what could only be described as the ghosts of the Viet Cong and fallen comrades. The only times he managed to chase away the ghosts were when he gathered at a 10-acre abandoned gravel pit with fellow vets. There they recreated a complete base camp, with tents for Army, Navy, Air Force, and Marines. They practiced night maneuvers. It was the only therapy these vets received, isolated from the public as “baby killers” and even by fellow vets who looked down on them for their “emotionality.”

Even Korean War and World War II vets ostracized this new batch of returning warriors. In 1976, the diagnosis of Post Traumatic Stress Disorder didn’t exist, says Ray Parrish, a Chicago-based therapist with Vietnam Veterans Against the War and a Vietnam veteran himself.

“Thirty-five years ago Vietnam veterans were being called crybabies,” Parrish says. “Members of the Legion and the VFW were refusing to allow us to join their posts because we were just a bunch of crybabies. Now it’s just the opposite.”

It was 1999 when someone suggested to Vasquez he might have the disorder, saying, “Hey man, you have PTSD.” Vasquez’s response was: “Fuck you, too.”

The gravel-pit group eventually christened itself America’s Last Patrol and began to attend the funerals of fellow veterans. They visited grieving families of POWs to offer comfort. Today, of the original 12 ALP members, seven have committed suicide.

“For 30 years I didn’t smile. I gave my family hell,” Vasquez says, his body taut across the table at LuLu’s Bakery and Cafe. Even with the support of two fellow veterans sitting with him, he has a hard time explaining what the war had made him, the unquenchable rage and debilitating fear.

“Let me put it to you this way,” he says at last. “When I die, bury me face down, so the whole United States can kiss my ass.” That’s it.

Eventually, Vasquez went to Kansas for in-
patient treatment at a premier PTSD center. When he came home, his daughter didn’t recognize him. “What did you do with my father?” she asked.

Weslaco resident Lydia Caballero served in the Navy at the close of the Vietnam conflict. She wasn’t part of America’s Last Patrol, though she frequently attended the memorial and graveside salutes. She stood out. She was typically the one holding a self-made sign. One read: “33 Percent of the Homeless in the U.S. are Veterans.” She, too, learned of PTSD and, in her case, the ravaging effects of Agent Orange, from a fellow veteran.

Placido Salazar, now a state veterans-affairs officer with American GI Forum of Texas, taught Caballero the truth about Agent Orange use in Vietnam. It helped explain the loss of her breasts to cancer and the decades of dizziness that ended in a paralyzing fall.

For all their anger with the government, the group is committed to serving returning Iraq and Afghanistan veterans. Says Salazar, “It’s going to happen with another generation, with these men and women, if it’s not stopped now.”

Consider Jose Rivera’s story a foreshadowing of what is to come.

Entering Iraq in the spring of 2003 was like walking into an open oven. The mosquitoes, impervious to the 120-degree temps, effortlessly chewed into the heels of hands and into the toughest knuckles. The smell of burning oil was everywhere.

After the initial march on Baghdad, Rivera’s First Armored Division, Battalion 237, spread across the capital. Rivera was assigned to guard the Ministry of Oil.

Things were quiet, in his own words a “cake walk.” Then in the summer of 2003 U.S. troops killed Saddam’s sons Uday and Qusay. All that night Iraqis celebrated.

“All you could see was tracers in the sky,”
Rivera recalled. “There were gunshots everywhere. You could hear the bullets dropping from the sky.”

Soon after, however, reports began to circulate about small-arms fire and mortar attacks. Suicide bombings followed, including a nighttime explosion at the Iraqi Police station a few buildings away from where Rivera bunked. Almost overnight the welcoming Iraqis were transformed in the minds of the troops. Everyone was now a suspect, a potential enemy.

Tensions between companies and between officers and the enlisted flared, too. Errand-runners who before had been able to dart between posts, collecting or distributing supplies, began to run into resistance. Each company became more protective of its own and less inclined to help others.

“I thought we were both wearing the same uniform, you know? That’s when the realization sunk in we were in a dog-eat-dog world,” Rivera said. The toll it started taking on Rivera’s psyche was his most well-kept secret. He was unraveling silently under the stress, and increasingly entertaining thoughts of turning his gun on himself.

Rivera’s outfit had run into small-arms fire before, but the first casualty came when the convoy drove into heavy traffic and stalled beneath an overpass, a known “hot zone.” The crew immediately surrounded the Humvees to secure their locked-in position. They expected the worst, but it turned almost comical when the crowds above offered only a rain of trash. Just as Rivera started to let down his guard something heavy dropped in front of him. There was a flash. Grenade shrapnel shredded his hands, cracked through a knuckle, and pierced his arm and leg. He ran to the commander’s vehicle and climbed in. “Where’s your weapon?” the commander barked. “Where’s your weapon?”

His rifle had to be retrieved by a fellow soldier. Explaining from his Cedar Park apartment: “All the Army crap they teach you just went out of my head.”

The grenade attack got the young soldier back to Germany. It wasn’t the way he had envisioned it, from a hospital bed at the Heidelburg Army Hospital with daily physical therapy. It took months for him to convince the doctor to remove remaining shrapnel from the back of his hand.

Germany did offer another benefit. For the first time he was able to see a psychiatrist. The soldier’s shame unraveled as he described his frequent crying spells, the suicidal thoughts, sleeplessness, and recurring panic attacks — things he never dreamed of sharing while in Iraq. The doctor diagnosed him with PTSD. He was put on rounds of Prozac, Xanex, Clozapine, Wellbutrin, and other psychoactive meds, and redeployed with his unit in January 2006 to Talifar in northern Iraq. This second tour of duty in the less-volatile north should have been a quieter assignment. It would prove anything but.

Vietnam vets like Placido Salazar say they are already seeing the bureaucratic failures and broken promises that portend unnecessary suffering for this generation of veterans. A string of recent federal reports, likely to make the recruiter’s job a bit trickier, spell out the challenge facing returning soldiers.

For starters, there is the epidemic of homelessness — more than one in four living on the street is former military.

An exploding suicide rate: a 26-year high of 120 self-inflicted veteran deaths per week.

On top of it all are the horrendous tales of wounded veterans forced to pay back part or all of their $10,000 sign-on bonuses when they are physically unable to finish their tours of duty.

Even more disturbing are the increasing reports that the military may be intentionally misdiagnosing wounded veterans with PTSD and head traumas and discharging them with “pre-existing” mental disorders — diagnoses that limit their access to military health care.

“I don’t think we have even started to see the tip of the iceberg,” said Ignacio Leiya, vice president of service operations for the American GI Forum’s National Veterans Outreach Program in San Antonio. “In a few more years we’ll start seeing the full effect of what has been going on in Iraq.”

At the Audie L. Murphy Memorial Veterans Hospital, Dr. Tom Brown, assistant professor in the Department of Psychiatry, introduces PTSD with a cinema reference. He mentions the Pentagon-approved Black Hawk Down (“Oh, that was a great movie,” the PR flack accompanying me gushes), retelling a scene in which an unexploded missile lodges in the chest of a U.S. soldier. “As you can imagine, `seeing` stuff like that can really mess you up.”

No shit.

But the “new military” is reversing its long-held stigma about mental disorders among its troops, Brown says. “They’re trying to say, ‘No. We’re not going to kick you out right away. You just have to let us know what’s going on.’”

It can be tough identifying PTSD cases and the war’s growing “signature injury” —
Traumatic Brain Injury, a plague caused by the prevalence of homemade bombs. After all, “A mental illness doesn’t present to us like a broken leg,” Brown says. Still, thousands of brain injuries and psychologically damaged troops go undiagnosed and uncompensated.

Parrish has a more critical assessment of the military and the VA’s performance.

“There’s so much, let’s say, bureaucracy involved in all of these situations that so many of the veterans just feel hopeless. Basically we’re running into similar problems nationwide,” Parrish said. He calls the personality-disorder discharges a scam.

“The doctors are being motivated by the command to not give out PTSD diagnosis and put them in the medical-board situation,” Parrish said. “It just so happens then these doctors, whenever they give out a misdiagnosed personality disorder, they are getting patted on the backs by the command for saving the budget.”

Here’s the rub: A personality discharge means the veteran had a mental disorder before joining up. Since it is considered “pre-existing” the soldier doesn’t qualify for benefits when he or she comes home.

Currently it is estimated that more than 22,000 veterans have been discharged with personality-disorder diagnoses in the past six years. This, in turn, may have saved the Department of Defense billions in health-related claims.

U.S. Representative Phil Hare of Illinois has called on the Pentagon to put an end to such discharges until a full independent investigation into several wrongful discharges have been carried out. Hare aide Tim Schlittner said the Pentagon has been hopelessly “delusional” on the issue and has not responded. However, several U.S. senators, including presidential candidate Barack Obama, have attached an amendment to the Defense Authorization Bill now being hashed out on Capitol Hill that would launch an investigation into the practice by the U.S. Government Accounting Office.

Dr. Marvin Abney spent 30 years working for the VA before retiring recently into private practice here in San Antonio. He says that whether or not a soldier is ultimately found to have a personality disorder should not detract from combat injuries, including PTSD.

“A person can have a personality disorder but they may also have PTSD … they’re still suffering from war-related injuries,” Abney said.

But what happens when a veteran has no mental-health history, aces the military’s own in-take screenings, only later — after being injured in combat — is labeled with a personality
disorder and discharged sans benefits? It’s becoming a more common story.

For Rivera, Talifar proved just as bad as Baghdad’s hot zones. For starters, his sergeant ordered him to harass a fellow soldier the commander had signaled out as a dimwit. “He wanted me to make him cry,” said Rivera. “I started getting on him for stupid mistakes and getting on him and pushing him and thought, ‘I’m not any better than him,’ and that it was wrong.”

When Rivera refused to be the Sarge’s bulldog he found himself faced with extra duty. The tank mechanic was given jobs working on Humvees — jobs he says required two or three mechanics. Then there were extra cleaning duties, the execution of which never pleased his commanding officer. He ended up cleaning and inventorying warehouses multiple times by himself. During this period he stopped taking his prescribed meds, which he said made him feel like a zombie. As one might expect, his condition worsened. He began to think that the harassment was related to his mental-health complaints. All the while, his suicidal thoughts, panic attacks, and paranoia were escalating.

Rivera became convinced his superior wanted him dead or was going to “do something.” Making matters worse, he was reassigned to another section of camp and lost contact with the chaplain, the only person he had been able to talk to about his condition.

He started locking the door to his trailer. He’d avoid going to public areas like the PX or the computer room. “I’d go to the chow hall as quick as I could and come back. I wouldn’t use the phones.”

It was only when his father, who still had influential Army contacts, began making phone calls on his behalf that Rivera got shipped to Mosul for another mental screening. The 15-minute interview involved what Rivera said were “coercive” questions intended to elicit specific answers. Still, he went along with it. It got him back to Germany, but the diagnosis that followed now read “personality disorder.”

It took another couple weeks for the commander at his unit’s rear detachment at the Ray Barracks in Freiburg to approve a doctor’s appointment in Hanau, where the psychiatrist questioned why Rivera was accepting the new diagnosis when his real condition was PTSD. However, the doctor agreed the new diagnosis would expedite his separation from the service. That was good enough for Rivera.

It would take another month to get out of Germany. While Rivera waited, he says it was one thing after another, as officers seemed bent on getting him to slip up and lose his honorable discharge. If he was supposed to be in one place, another officer said he was to be elsewhere. If he was working one job, another would give him different duties.

“They had so many other soldiers going through the same shit, and they were giving dishonorable discharges and bad chapters,” Rivera recalled. “I knew I had to be on guard.”

As in Talifar, Rivera said the officers were trying to get him to crack, to act out, so they could write him up.

“On the Army’s side of the house, once they find out you’re going through `PTSD` they definitely try to mess the soldiers up, you know, isolate them and try to give them a bad-conduct discharge or something other than honorable so they don’t receive benefits,” Rivera said. “I saw it. I saw other soldiers get it that way. I know their chain of command, that’s how they work, that’s how they’re told to do things.”

One of the most extreme cases was exposed in The Nation earlier this year and since featured on several news shows. Jon Town had seven years of service in the U.S. Army and numerous commendations before he was wounded in a rocket attack and later booted on a personality-disorder discharge with no benefits.

Rivera says his Purple Heart and family connections allowed him to get out with an honorable discharge on a personality diagnosis. His separation papers cite the diagnosis code JFX. In a rarity, he was also able to get 80-percent disability despite the personality-disorder diagnosis. Now he is coaching other soldiers on their way out of the service how to avoid the pitfalls of a personality-disorder discharge.

So while we have learned a lot since Vietnam, in many ways little has changed. Our veterans still must rely on each other to protect them from a leadership, which under increasing financial pressure, too often fails them.

One active-duty soldier with two years combat experience in the sands of Iraq said his diagnosis of PTSD was also changed at the last minute. But thanks to conversations with Rivera, this soldier, who asked that his name not be used, is now preparing to go before the Medical Review Board to fight for an honorable discharge and Army benefits.

“They tried to trip me up,” he said. “But luckily I caught it … luckily I talked to Jose.” •


What is PTSD?

According to the National Institute of Mental Health, PTSD is “an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.”

Symptoms of PTSD, which in some cases can take years to manifest, range from emotional numbness toward loved ones, loss of interest, irritability, aggression, nightmares, and flashbacks, wherein someone “may lose touch with reality and believe that the traumatic incident is happening all over again.”

VA officials say about 19,000 Operation Iraqi Freedom and Operation Enduring Freedom veterans were seen for PTSD-related symptoms between fiscal 2002 and 2005.



So, you made it home, but you still need to run the gauntlet at the VA? Don’t be discouraged, but be aware the agency is faced with a backlog of about 600,000 cases, thanks to five years of funding shortfalls.
Average waiting times in the VA disability benefits system:

177 days at the Regional Office

751 days at the Board of Veterans Appeals

240 days at the Court of Appeals for Veterans Claims



GI Rights Hotline
(800) 394-9544

VA Suicide Hotline
(800) 273-TALK (8255)

Vet Center: Readjustment Counseling
(210) 472-4025

Iraq and Afghanistan Veterans of America
(212) 982-9699

Iraq Veterans Against the War
(215) 241-7123

Texas Rio Grande Legal Aid
(888) 988-9996

National Coalition for Homeless Veterans
(888) 233-8582