Vocabulary > War > Soldiers > Veterans

Preston Parham, 89, is a survivor of the attack on Pearl Harbor.

He was aboard the light cruiser St. Louis.

Bill Tiernan/Associated Press/The Virginian-Pilot

Boston Globe > Pearl Harbor 70th anniversary December 7, 2011

Some 100 survivors of the attack on Pearl Harbor will gather in Hawaii today 70 years
after the day which drew the US into World War II.
The Japanese air and naval strike on the American military base claimed nearly 2,400 lives,
destroyed over 160 aircraft and beached, damaged or destroyed over 20 ships.
President Franklin D. called it " a date which will live in infamy"
when he addressed the Congress the next day asking to declare war with Japan.
http://www.boston.com/bigpicture/2011/12/pearl_harbor_70th_anniversary.html

Steve Breen

The San Diego Union-Tribune

Cagle

4 November 2010

veteran

http://www.defense.gov/news/newsarticle.aspx
http://atwar.blogs.nytimes.com/2012/03/07/for-veterans-with-post-traumatic-stress-pain-killers-carry-risks/
http://www.nytimes.com/2011/02/06/us/06vets.html
http://www.telegraph.co.uk/news/newstopics/britainatwar/5299500/
D-Day-dodgers-prepare-for-attention.html
http://www.independent.co.uk/life-style/health-and-families/health-news/
soldiers-struggle-to-cope-with-postafghanistan-life-2130781.html
http://www.cagle.msnbc.com/news/VeteransDay10/main.asp
http://www.cagle.msnbc.com/news/Veterans10/main.asp
http://www.nytimes.com/2010/09/30/us/30hood.html
http://www.guardian.co.uk/uk/2010/jul/09/sangin-injured-soldier-afghanistan
http://www.timesonline.co.uk/tol/news/uk/article6537430.ece
http://www.guardian.co.uk/uk/2009/jun/19/briton-becomes-worlds-oldest-man
http://www.independent.co.uk/news/uk/home-news/first-world-war-veteran-dies-1331602.html
http://www.guardian.co.uk/world/gallery/2008/nov/11/firstworldwar?picture=339561563
http://www.independent.co.uk/news/uk/home-news/
armistice-90-years-on-all-those-pals-of-mine-should-be-here-1012492.html
http://www.independent.co.uk/news/the-past-seven-days-in-photographs-806086.html
http://www.guardian.co.uk/military/story/0,,2250052,00.html
http://observer.guardian.co.uk/uk_news/story/0,,2031200,00.html
http://www.guardian.co.uk/g2/story/0,,589567,00.html
http://www.guardian.co.uk/world/1999/nov/11/firstworldwar.uk1

veteran        USA

http://topics.nytimes.com/top/reference/timestopics/subjects/v/veterans/index.html
http://www.loc.gov/vets/

http://www.nytimes.com/2012/04/15/opinion/sunday/kristof-a-veterans-death-the-nations-shame.html
http://www.nytimes.com/2012/03/25/us/recent-california-suicides-highlight-failures-of-veterans-support-system.html
http://www.nytimes.com/2012/04/15/opinion/good-night-ryan.html
http://www.cnas.org/files/documents/publications/CNAS_LosingTheBattle_HarrellBerglass.pdf http://opinionator.blogs.nytimes.com/2011/11/09/checkpoints-a-u-s-veteran-in-baghdad/
http://www.nytimes.com/2011/09/04/world/middleeast/04iraq.html
http://www.nytimes.com/2011/08/16/us/16brown.html
http://www.nytimes.com/2009/11/08/opinion/08alexander.html
http://www.nytimes.com/2009/07/17/health/views/17vets.html
http://www.nytimes.com/2008/04/22/us/22suicide.html
http://www.reuters.com/article/domesticNews/idUSN1839368020080420
http://www.usatoday.com/news/nation/2006-12-07-veteran-obituary_x.htm

Opinion | Op-Docs

Good Night, Ryan

A filmmaker explores the fate of Specialist Ryan Yurchison,

who returned from Iraq with P.T.S.D.

and, after seeking help at the local V.A. hospital,

died of a drug overdose in a possible suicide.
http://video.nytimes.com/video/2012/04/14/opinion/100000001488983/good-night-ryan.html

Related
http://www.nytimes.com/2012/04/15/opinion/good-night-ryan.html

veteran > suicide        USA

http://www.nytimes.com/2012/04/15/opinion/sunday/kristof-a-veterans-death-the-nations-shame.html
http://www.nytimes.com/2012/03/25/us/recent-california-suicides-highlight-failures-of-veterans-support-system.html
http://www.nytimes.com/2012/04/15/opinion/good-night-ryan.html
http://www.cnas.org/files/documents/publications/CNAS_LosingTheBattle_HarrellBerglass.pdf
 

The New York Times > Home Fires

Home Fires features the writing of men and women
who have returned from wartime service in the United States military.
The project originated in 2007 with a series of personal accounts
from five veterans of the Iraq war
on their return to American life.
It now includes dispatches from veterans of wars past and present.

http://opinionator.blogs.nytimes.com/category/home-fires/

Veterans Day        2010
http://www.boston.com/bigpicture/2010/11/veterans_day_2010.html

Veteran's Day > Cagle cartoons        USA        2009-2010
http://www.cagle.msnbc.com/news/Veterans10/main.asp
http://www.cagle.msnbc.com/news/VeteransDay10/main.asp
http://www.cagle.msnbc.com/news/VeteransDay09/main.asp

Vietnam War veterans
http://www.nytimes.com/2010/11/11/us/11vets.html
http://www.nytimes.com/2009/10/13/us/politics/13vets.html

Veterans Affairs        USA
http://www.nytimes.com/2010/07/08/us/08vets.html
http://www.usatoday.com/news/washington/2006-05-24-agencies-data_x.htm

Veterans Affairs Department        USA

http://topics.nytimes.com/top/reference/timestopics/organizations/v/veterans_affairs_department/index.html

http://www.nytimes.com/2012/04/19/us/veterans-affairs-dept-to-increase-mental-health-staffing.html

World War II veterans > Carl E. Clark        USA
http://www.nytimes.com/2009/12/04/us/04sfmetro.html 

D-Day 65 years on: World War II veterans return to Normandy        2009

http://www.independent.co.uk/news/world/europe/
the-dday-commemorations-the-living-and-dead-comrades-again-1698752.html
http://www.guardian.co.uk/world/2009/jun/07/d-day-normandy-veterans-barack-obama
http://www.telegraph.co.uk/news/uknews/5452891/Paratroopers-Normandy-jump-start-D-Day-commemorations.html
http://www.nytimes.com/2009/06/06/world/europe/06iht-troops.html
http://www.guardian.co.uk/world/gallery/2009/jun/05/second-world-war-france?picture=348440306
http://www.telegraph.co.uk/news/picturegalleries/worldnews/5452840/
D-Day-65-years-on-World-War-II-veterans-return-to-Normandy.html

James Bruce Morehead        1916-2012

((...) on April 25, 1942, over Darwin, Australia.
Leading a squadron of eight P-40 Warhawks
— unwieldy, frustratingly slow fighter planes that were vastly outpaced by Japanese aircraft —
Lieutenant Morehead faced down, outthought and outmaneuvered
a winged armada of about 30 Japanese bombers,
guarded by a fleet of Japanese fighter planes.

http://www.nytimes.com/2012/03/20/us/james-morehead-world-war-ii-flying-ace-dies-at-95.html

Lynn Davis Compton        1921-2011

“Band of Brothers”
told the story of the 140 men and 7 officers of Easy Company.
As commander of its second platoon,
Mr. Compton parachuted into Normandy early on D-Day, June 6, 1944,
fighting at Brécourt Manor and Carentan,
and later in Holland and at the siege of Bastogne.
He received a Silver Star, a Purple Heart and, along with his unit,
the Presidential Unit Citation for heroism in the face of an enemy
during the Battle of the Bulge.

http://www.nytimes.com/2012/02/29/us/buck-compton-decorated-veteran-dies-at-90.html

Claude Choules / Last British veteran of WW1 refuses to mark Remembrance Day        2010

The last surviving British veteran of the First World War
will not mark Remembrance Day today
because he wants to forget the horrors of war, his family has said.
http://www.telegraph.co.uk/news/worldnews/australiaandthepacific/australia/8124932/
Last-British-veteran-of-WW1-refuses-to-mark-Remembrance-Day.html

Henry Allingham        1896-2009

British first world war veteran dies at 113       

Born in 1896,
Henry Allingham was the world's oldest man
and one of the last surviving first world war servicemen

http://www.guardian.co.uk/uk/2009/jul/18/henry-allingham-oldest-man-dies

Harry John Patch        1898-2009

the last surviving British veteran of the first world war’s western front

http://www.guardian.co.uk/commentisfree/2009/aug/01/first-world-war-harry-patch
http://www.guardian.co.uk/world/2009/jul/25/harry-patch-obituary
http://www.guardian.co.uk/world/2009/jul/26/world-war-one-veteran-harry-patch-dies-aged-111
http://www.guardian.co.uk/uk/gallery/2009/jul/26/harry-patch
http://www.guardian.co.uk/theguardian/cartoon/2009/jul/26/gordon-brown-harry-patch-remembrance
http://www.guardian.co.uk/books/2008/nov/05/poetry-andrewmotion
http://www.independent.co.uk/news/uk/this-britain/
happy-birthday-harry-patch-last-veteran-of-the-trenches-turns-111-1704823.html
http://www.guardian.co.uk/world/gallery/2008/nov/11/firstworldwar?picture=339561561
http://www.timesonline.co.uk/tol/news/uk/article2746763.ece

mental health problems

http://www.independent.co.uk/life-style/health-and-families/
health-news/soldiers-struggle-to-cope-with-postafghanistan-life-2130781.html

post-traumatic stress disorder        PSTD

http://www.nytimes.com/2012/04/26/opinion/kristof-veterans-and-brain-disease.html
http://atwar.blogs.nytimes.com/2012/03/07/for-veterans-with-post-traumatic-stress-pain-killers-carry-risks/
http://www.nytimes.com/2012/01/11/us/post-traumatic-stress-disorder-may-cause-erratic-driving.html
http://www.nytimes.com/2009/07/17/health/views/17vets.html
http://www.nytimes.com/2009/01/08/us/08purple.html
http://www.usatoday.com/news/health/2008-10-26-PTSD-main_N.htm
http://www.reuters.com/article/newsOne/idUSN2736842620080527

pain killers

http://atwar.blogs.nytimes.com/2012/03/07/for-veterans-with-post-traumatic-stress-pain-killers-carry-risks/

Steve Breen

The San Diego Union-Tribune

Cagle

November 11, 2010

L: Uncle Sam = USA

A Veteran’s Death, the Nation’s Shame

April 14, 2012
The New York Times
By NICHOLAS D. KRISTOF

HERE’S a window into a tragedy within the American military: For every soldier killed on the battlefield this year, about 25 veterans are dying by their own hands.

An American soldier dies every day and a half, on average, in Iraq or Afghanistan. Veterans kill themselves at a rate of one every 80 minutes. More than 6,500 veteran suicides are logged every year — more than the total number of soldiers killed in Afghanistan and Iraq combined since those wars began.

These unnoticed killing fields are places like New Middletown, Ohio, where Cheryl DeBow raised two sons, Michael and Ryan Yurchison, and saw them depart for Iraq. Michael, then 22, signed up soon after the 9/11 attacks.

“I can’t just sit back and do nothing,” he told his mom. Two years later, Ryan followed his beloved older brother to the Army.

When Michael was discharged, DeBow picked him up at the airport — and was staggered. “When he got off the plane and I picked him up, it was like he was an empty shell,” she told me. “His body was shaking.” Michael began drinking and abusing drugs, his mother says, and he terrified her by buying the same kind of gun he had carried in Iraq. “He said he slept with his gun over there, and he needed it here,” she recalls.

Then Ryan returned home in 2007, and he too began to show signs of severe strain. He couldn’t sleep, abused drugs and alcohol, and suffered extreme jitters.

“He was so anxious, he couldn’t stand to sit next to you and hear you breathe,” DeBow remembers. A talented filmmaker, Ryan turned the lens on himself to record heartbreaking video of his own sleeplessness, his own irrational behavior — even his own mock suicide.

One reason for veteran suicides (and crimes, which get far more attention) may be post-traumatic stress disorder, along with a related condition, traumatic brain injury. Ryan suffered a concussion in an explosion in Iraq, and Michael finally had traumatic brain injury diagnosed two months ago.

Estimates of post-traumatic stress disorder and traumatic brain injury vary widely, but a ballpark figure is that the problems afflict at least one in five veterans from Afghanistan and Iraq. One study found that by their third or fourth tours in Iraq or Afghanistan, more than one-quarter of soldiers had such mental health problems.

Preliminary figures suggest that being a veteran now roughly doubles one’s risk of suicide. For young men ages 17 to 24, being a veteran almost quadruples the risk of suicide, according to a study in The American Journal of Public Health.

Michael and Ryan, like so many other veterans, sought help from the Department of Veterans Affairs. Eric Shinseki, the secretary of veterans affairs, declined to speak to me, but the most common view among those I interviewed was that the V.A. has improved but still doesn’t do nearly enough about the suicide problem.

“It’s an epidemic that is not being addressed fully,” said Bob Filner, a Democratic congressman from San Diego and the senior Democrat on the House Veterans Affairs Committee. “We could be doing so much more.”

To its credit, the V.A. has established a suicide hotline and appointed suicide-prevention coordinators. It is also chipping away at a warrior culture in which mental health concerns are considered sissy. Still, veterans routinely slip through the cracks. Last year, the United States Court of Appeals in San Francisco excoriated the V.A. for “unchecked incompetence” in dealing with veterans’ mental health.

Patrick Bellon, head of Veterans for Common Sense, which filed the suit in that case, says the V.A. has genuinely improved but is still struggling. “There are going to be one million new veterans in the next five years,” he said. “They’re already having trouble coping with the population they have now, so I don’t know what they’re going to do.”

Last month, the V.A.’s own inspector general reported on a 26-year-old veteran who was found wandering naked through traffic in California. The police tried to get care for him, but a V.A. hospital reportedly said it couldn’t accept him until morning. The young man didn’t go in, and after a series of other missed opportunities to get treatment, he stepped in front of a train and killed himself.

Likewise, neither Michael nor Ryan received much help from V.A. hospitals. In early 2010, Ryan began to talk more about suicide, and DeBow rushed him to emergency rooms and pleaded with the V.A. for help. She says she was told that an inpatient treatment program had a six-month waiting list. (The V.A. says it has no record of a request for hospitalization for Ryan.)

“Ryan was hurting, saying he was going to end it all, stuff like that,” recalls his best friend, Steve Schaeffer, who served with him in Iraq and says he has likewise struggled with the V.A. to get mental health services. “Getting an appointment is like pulling teeth,” he said. “You get an appointment in six weeks when you need it today.”

While Ryan was waiting for a spot in the addiction program, in May 2010, he died of a drug overdose. It was listed as an accidental death, but family and friends are convinced it was suicide.

The heartbreak of Ryan’s death added to his brother’s despair, but DeBow says Michael is now making slow progress. “He is able to get out of bed most mornings,” she told me. “That is a huge improvement.” Michael asked not to be interviewed: he wants to look forward, not back.

As for DeBow, every day is a struggle. She sent two strong, healthy men to serve her country, and now her family has been hollowed in ways that aren’t as tidy, as honored, or as easy to explain as when the battle wounds are physical. I wanted to make sure that her family would be comfortable with the spotlight this article would bring, so I asked her why she was speaking out.

“When Ryan joined the Army, he was willing to sacrifice his life for his country,” she said. “And he did, just in a different way, without the glory. He would want it this way.”

“My home has been a nightmare,” DeBow added through tears, recounting how three of Ryan’s friends in the military have killed themselves since their return. “You hear my story, but it’s happening everywhere.”

We refurbish tanks after time in combat, but don’t much help men and women exorcise the demons of war. Presidents commit troops to distant battlefields, but don’t commit enough dollars to veterans’ services afterward. We enlist soldiers to protect us, but when they come home we don’t protect them.

“Things need to change,” DeBow said, and her voice broke as she added: “These are guys who went through so much. If anybody deserves help, it’s them.”

    A Veteran’s Death, the Nation’s Shame, NYT, 14.4.2012,
    http://www.nytimes.com/2012/04/15/opinion/sunday/kristof-a-veterans-death-the-nations-shame.html

Buck Compton, Decorated Veteran, Dies at 90

February 28, 2012
The New York Times
By BRUCE WEBER

Lynn D. Compton, a lawyer and later a judge who was best known for leading the prosecution of Sirhan B. Sirhan for the assassination of Robert F. Kennedy — that is, until more than 20 years later when his heroism during World War II was made public in “Band of Brothers,” the best-selling book by Stephen E. Ambrose and the subsequent HBO miniseries, died on Saturday at his home in Burlington, Wash. He was 90.

His death was announced by his family.

Mr. Compton, who was known as Buck, was a deputy district attorney for Los Angeles County in California for nearly 20 years and a specialist in major felony cases. In 1969, as chief deputy district attorney, he won a conviction in the Sirhan case for murder in the first degree, scornfully dismissing the defense’s contention that Mr. Sirhan, who is still in prison, had been psychologically unstable and thus incapable of premeditating the June 1968 shooting of Senator Kennedy at the Ambassador Hotel in Los Angeles. Kennedy had just won California’s Democratic presidential primary.

“I say throw them all out in one big bag,” Mr. Compton said in his summation, referring to the claims of the psychologists and psychiatrists who testified for the defense. “I say reject all the tests. I think it would be a frightening thing for justice in this state to decide a case of this magnitude on whether he” — Mr. Sirhan — “saw clowns playing patty-cake or kicking each other in the shins in an ink blot test.”

He went on: “I’ve heard that Charles Dickens wrote in a book that ‘the law is an ass.’ I think the law became an ass when it let the psychiatrist get his hand on it.”

During the trial, Mr. Compton was described in news media reports as a decorated war veteran, but the tale of his bravery, along with that of his “brothers” in the Army’s E Company — also known as Easy Company — in the 506th Parachute Infantry Regiment, part of the 101st Airborne Division, was not revealed in detail until Mr. Ambrose’s book was published to popular acclaim in 1992.

“Band of Brothers” told the story of the 140 men and 7 officers of Easy Company. As commander of its second platoon, Mr. Compton parachuted into Normandy early on D-Day, June 6, 1944, fighting at Brécourt Manor and Carentan, and later in Holland and at the siege of Bastogne. He received a Silver Star, a Purple Heart and, along with his unit, the Presidential Unit Citation for heroism in the face of an enemy during the Battle of the Bulge.

The book was adapted for a 10-part miniseries on HBO, first shown in 2001, with Tom Hanks and Steven Spielberg lending their celebrity clout as executive producers. Mr. Compton’s role was played by Neal McDonough.

He was born Lynn Davis Compton in Los Angeles on Dec. 31, 1921, but as a boy gave himself the nickname Buck because he thought Lynn was a name better suited to a girl. His father, Robey, was an escrow clerk; his mother, Ethel, worked for movie studios, and young Lynn got work as an extra in films. During the shooting of “Modern Times,” he somehow angered the star, Charlie Chaplin, who threw him off the picture.

An athlete, Mr. Compton competed both in baseball and football at the University of California, Los Angeles, where he played in the Rose Bowl and where he overlapped with Jackie Robinson in both sports. He completed the ROTC program at U.C.L.A., and was commissioned as a second lieutenant.

After the war, Mr. Compton joined the Los Angeles Police Department and attended Loyola Law School. He was admitted to the California bar in 1949 and joined the district attorney’s office in 1951.

In 1970, Mr. Compton was appointed to the California Courts of Appeal as an associate justice by Gov. Ronald Reagan. There he earned a reputation as one of the state’s most conservative jurists, retiring in the early 1990s. His memoir, “Call of Duty: My Life Before, During and After the Band of Brothers,” written with Marcus Brotherton, was published in 2008.

Mr. Compton’s first marriage ended in divorce. His wife, the former Donna Newman, whom he married in 1947, died in 1994. He is survived by their daughters, Tracy and Syndee, and four grandchildren.

    Buck Compton, Decorated Veteran, Dies at 90, NYT, 28.2.2012,
    http://www.nytimes.com/2012/02/29/us/buck-compton-decorated-veteran-dies-at-90.html

For Soldier Disfigured in War, a Way to Return to the World

January 30, 2012
The New York Times
By JAMES DAO

Specialist Joey Paulk awoke from a coma in a Texas hospital three weeks after he was burned nearly to death in Afghanistan. Wrapped in bandages from head almost to toe, he immediately saw his girlfriend and mother, and felt comforted. Then he glanced at his hands, two balls of white gauze, and realized that he had no fingers.

So it began: the shock of recognition. Next came what burn doctors call “the mirror test.” As he was shuffling through a hallway at Brooke Army Medical Center in San Antonio, he passed a large mirror that he had turned away from before. This time he steeled himself and looked.

His swollen lower lip hung below his gums. His left lower eyelid drooped hound dog-like, revealing a scarlet crescent of raw tissue. His nostrils were squeezed shut, his chin had virtually disappeared and the top half of one ear was gone. Skin grafts crisscrossed his face like lines on a map, and silver medicine coated his scars, making him look like something out of a Terminator film.

“This is who I am now,” he told himself.

Every severe injury is disfiguring in its own way, but there is something uniquely devastating about having one’s face burned beyond recognition. Many burn victims do not just gain lifelong scars, they also lose noses and ears, fingers and hands. The very shape of their faces is sometimes altered, forged anew in heat and flame.

More than 900 American service members have been severely burned in Iraq or Afghanistan since 2001, typically from roadside bombs, the military says. Almost all receive extraordinary emergency care and rehabilitation at Brooke. But many will never have their faces restored.

Mr. Paulk, though, has come close. After leaving Texas, and the Army, in 2009, his mouth and eye still deformed, he returned home to California and became something of a recluse, hiding beneath hooded sweatshirts, baseball caps and dark glasses when he went out, if he went out at all.

But he found his way to a program at U.C.L.A. Medical Center called Operation Mend that provides cosmetic surgery for severely burned veterans at no cost — and the operations fundamentally realigned his face, restoring not just the semblance of his former visage, but also a healthy chunk of his self-confidence.

He is venturing out again, to bars, beaches and ball games. On Veterans Day last year, Mr. Paulk, 26, rode in the lead car of the New York City parade, his head bared for tens of thousands to see.

“The burns on a soldier’s face are huge: It’s your military uniform and you can’t take it off,” he said. “The surgery changed so much on my face that it completely changed my whole outlook on life.”

The story of Mr. Paulk’s cosmetic and emotional revival says much about the ways private philanthropy can complement the overtaxed military and veterans health care systems. Now in its fifth year, Operation Mend has provided free cosmetic surgery to more than 50 badly burned veterans of the current wars. The program estimates it spends $500,000 on each of its patients.

But the story also underscores the difficulties of bringing private care into the military world. Though Operation Mend’s founder envisioned the program as a model for public-private cooperation in treating wounded soldiers, it remains one of only a few such ventures, which include Center for the Intrepid rehabilitation centers and Fisher Houses for military families.

Part of the problem, said Gen. Peter W. Chiarelli, the outgoing Army vice chief of staff who has embraced Operation Mend, is that many military doctors remain uncomfortable referring patients out of their system, which they view as a protective cocoon for troops and their families. But that attitude is changing, said General Chiarelli, who is pushing for a private program similar to Operation Mend for treating traumatic brain injuries and post-traumatic stress disorder. “Our problems are so big, we have to reach out beyond ourselves,” he said.

Mr. Paulk, who grew up and still lives in the town of Vista in northern San Diego County, joined the Army a year out of high school in 2004, thinking it might help him get a job in law enforcement.

On his first deployment, with a military police unit in eastern Afghanistan in 2007, he was in a Humvee when it struck a buried mine that ignited the fuel tank and instantly killed his team leader. Mr. Paulk regained consciousness 20 feet from the truck, engulfed in flames.

In searing pain yet shivering with cold in the 90-degree heat, an odd question popped into Mr. Paulk’s head as he waited to be evacuated: Do I still have hair? Yes, another soldier said; his Kevlar helmet had saved it. “Maybe,” Mr. Paulk told himself, “the burns aren’t so bad, and I’ll still look like me.”

But it was not to be. By the time he awoke in San Antonio from a medically induced coma, he had already undergone numerous operations and skin grafts to patch his charred face, arms and legs. With his mother’s permission, a surgeon had removed all his fingers, which had been burned black and to the bone and were all but certain to become infected. He had lost 50 pounds in barely four weeks.

Over many months, his body accepted the vast majority of his skin grafts and he regained strength. But the one attempt by a surgeon to replace scar tissue on his face had failed, Mr. Paulk felt. After nearly 30 operations in 18 months, he began to resign himself to his appearance, and prepared to return to Vista, suffering from what his doctors called “surgery fatigue.”

“Everyone has a limit,” said Dr. Ivan Renz, the director of the burn unit at Brooke who Mr. Paulk says saved his life. “You get to a point where you go: ‘hold it, I’ve got to go through anesthesia again?’ ”

But before he left Brooke in December 2008, Mr. Paulk met a representative from Operation Mend who urged him to visit U.C.L.A. He took her card, skeptical that anyone could make him look good again.

The program had its origins in late 2006 when a wealthy philanthropist, Ronald A. Katz, was watching a Lou Dobbs interview with a badly burned Marine named Aaron Mankin. Charmed by the Marine but appalled at the extent of his wounds, Mr. Katz’s late wife, Maddie, poked him in the ribs and practically issued an order: “You have to do something!”

The military already had a state-of-the-art burn center at Brooke. But while the center offered reconstructive surgery, its focus was on saving lives and getting the wounded back on their feet. The Department of Veterans Affairs did not provide reconstructive surgery unless it was deemed medically necessary to restore, promote or preserve health — criteria that did not seem to include making someone look better.

During the coming year, Mr. Katz enlisted the support of U.C.L.A. and a respected reconstructive surgeon on its faculty, Dr. Timothy Miller, a Vietnam veteran. One of Mr. Katz’s daughters-in-law began assembling volunteer “buddy families” to meet patients at the airport, entertain them and accompany their families to the hospital. He met with General Chiarelli and began to slowly win over the doctors at Brooke.

Mr. Paulk remained a tough sell. But the smaller indignities of his injuries made him relent when an Operation Mend representative called again. He could not open his mouth wide enough to eat a hamburger. Could Dr. Miller fix that? And what about his misshapen lips, which made it impossible for him to pronounce his own name? Dr. Miller pledged to have Mr. Paulk whistling and eating double cheeseburgers again.

With the first surgery, Dr. Miller removed scar tissue, raising the eye lid and lower lip. With second and third operations, he improved the alignment of Mr. Paulk’s eyes and lips by replacing scars with healthy tissue. A fourth surgery implanted silicone to add definition to his chin.

At a recent checkup in Dr. Miller’s office, Mr. Paulk admired his new profile in the mirror. “From a distance, you can’t tell I was injured,” he said.

There are still uncomfortable moments. Some drunks taunted him about his looks at a baseball game, nearly starting a brawl. And Mr. Paulk admits to moments of self-consciousness about his hands. When, for instance, a little girl gawked at him at U.C.L.A. recently, he reflexively tucked his palms under his armpits.

But he has also learned how to function: to put on socks, pull up zippers and tie shoes. He can send texts and drive. He can’t play his beloved baseball, and video games remain a challenge, but he manages to catch a football and spike a volleyball with his palms.

And he looks remarkably comfortable holding a drink at a party.

“Sometimes I’ll hold my cup against my body so I can talk with my hands, and I’ll maneuver and pick it up and everyone thinks it’s so intriguing,” he said. “But I’m just doing what I’m doing to survive.”

    For Soldier Disfigured in War, a Way to Return to the World, NYT, 30.1.2012,
    http://www.nytimes.com/2012/01/31/us/for-soldier-disfigured-in-afghanistan-a-way-to-return-to-the-world.html

Back From War, Fear and Danger Fill Driver’s Seat

January 10, 2012
The New York Times
By JAMES DAO

PALO ALTO, Calif. — Before going to war, Susan Max loved tooling around Northern California in her maroon Mustang. A combat tour in Iraq changed all that.

Back in the States, Ms. Max, an Army reservist, found herself avoiding cramped parking lots without obvious escape routes. She straddled the middle line, as if bombs might be buried in the curbs. Gray sport-utility vehicles came to remind her of the unarmored vehicles she rode nervously through Baghdad in 2007, a record year for American fatalities in Iraq.

“I used to like driving,” Ms. Max, 63, said. “Now my family doesn’t feel safe driving with me.”

For thousands of combat veterans, driving has become an ordeal. Once their problems were viewed mainly as a form of road rage or thrill seeking. But increasingly, erratic driving by returning troops is being identified as a symptom of traumatic brain injury or post-traumatic stress disorder, or P.T.S.D. — and coming under greater scrutiny amid concerns about higher accident rates among veterans.

The insurance industry has taken notice. In a review of driving records for tens of thousands of troops before and after deployments, USAA, a leading insurer of active-duty troops, discovered that auto accidents in which the service members were at fault went up by 13 percent after deployments. Accidents were particularly common in the six months after an overseas tour, according to the review, which covered the years 2007-2010.

The company is now working with researchers, the armed services and insurance industry groups to expand research and education on the issue. The Army says that fatal accidents — which rose early in the wars — have declined in recent years, in part from improved education. Still, 48 soldiers died in vehicle accidents while off duty last year, the highest total in three years, Army statistics show.

The Pentagon and Department of Veterans Affairs are also supporting several new studies into potential links between deployment and dangerously aggressive or overly defensive driving. The Veterans Affairs health center in Albany last year started a seven-session program to help veterans identify how war experiences might trigger negative reactions during driving. And researchers in Palo Alto are developing therapies — which they hope to translate into iPhone apps — for people with P.T.S.D. who are frequently angry or anxious behind the wheel.

“I can’t talk with somebody who is a returned service member without them telling me about driving issues,” said Erica Stern , an associate professor of occupational therapy at the University of Minnesota, who is conducting a national study of driving problems in people with brain injuries or P.T.S.D. for the Pentagon.

Though bad driving among combat veterans is not new — research has found that Vietnam and Persian Gulf war veterans were more likely to die in motor vehicle accidents than nondeployed veterans — experts say Iraq and Afghanistan veterans are unique, for one major reason: their combat experiences were frequently defined by dangers on the road, particularly from roadside bombs.

“There is no accepted treatment for this,” said Dr. Steven H. Woodward , a clinical psychologist with the Veterans Affairs Palo Alto Health Care System who is leading a study of potential therapies for veterans with P.T.S.D.-related driving problems. “It’s a new phenomenon.”

Though there has been some research into road rage among veterans, therapists and psychologists have only recently begun to view traumatic brain injuries and P.T.S.D. as factors in prolonging driving problems, probably by causing people to perceive threats where none exist — such as in tunnels, overpasses, construction crews or roadside debris.

“In an ambiguous situation, they are more likely to see hostile intent,” said Eric Kuhn , a psychologist with the Palo Alto Veterans Affairs Health Care System, who has studied driving problems. He said his research found that veterans who report more severe P.T.S.D. symptoms also tend to report being more aggressive drivers.

Experts note that driving problems are not always the result of the disorder. In some cases, returning troops may be reflexively applying driving techniques taught in Iraq during the height of the insurgency — for example, speeding up at intersections to avoid gunfire or scanning the roadside for danger instead of watching the road ahead.

In a study of Minnesota National Guard soldiers who returned from Iraq in 2007, Dr. Stern and fellow researchers found that a quarter reported driving through a stop sign and nearly a third said they had been told they drove dangerously in the months immediately after their tours. Both results were higher than the answers reported by National Guard cadets who had not been deployed.

Though driving problems seemed to decrease the longer the troops were home, they did not always vanish. Dr. Stern found that many Guard members remained anxious about certain roadway situations, including night driving or passing unexpected things.

“Those are things they associated with threats they saw in combat,” she said.

Ms. Max, a grandmother of four, was deployed at the age of 60 to Iraq, where one of her jobs was to carry large sums of cash to Iraqi reconstruction projects outside fortified American bases. She said she learned to be hypervigilant on those trips.

Upon returning to California, she struggled with P.T.S.D. and took time off from her nursing job. She also noticed feeling nervous for the first time in her life about driving — a major problem because she had to drive to visit patients.

“My whole driving behavior changed,” she said. “I live in a state of anxiety when I’m driving.”

Ms. Max recently participated in a clinical trial to develop and test therapies, such as deep breathing, that might overcome such anxieties. In a Pontiac Bonneville sedan outfitted with equipment to track the driver’s visual focus, heart rate and breathing, as well as to measure changes in the speed and direction of the car, the researchers take patients onto highways and observe their reactions to traffic hazards, real and imagined.

On a recent spin through the hills of Palo Alto, Ms. Max drove while Dr. Woodward monitored her heart rate and breathing on a laptop in the back seat. In front, Marc Samuels, a driving rehabilitation specialist who offers one of the only programs for P.T.S.D.-related driving problems in the nation, directed her along a preplanned route, prepared to grab the wheel if anything went awry.

Ms. Max mostly drove fine, but was startled slightly when passing a construction site and then again when two cars momentarily boxed her in. Finally, when her stress level spiked in a small parking lot, Mr. Samuels told her to stop the car and regain her composure.

Ms. Max said that the clinics had made her more aware of the things that made her nervous, a first step to conquering them. But she says she does not expect to ever feel truly comfortable driving again and has no plans to replace her beloved Mustang, which she sold just before her deployment.

“Why get a hot car?” she said. “I’m not going to enjoy it.”

    Back From War, Fear and Danger Fill Driver’s Seat, NYT, 10.1.2012,
    http://www.nytimes.com/2012/01/11/us/post-traumatic-stress-disorder-may-cause-erratic-driving.html

WWII in Color: NY Vet's Rare Footage Made Into DVD

November 10, 2011
The New York Times
By THE ASSOCIATED PRESS

POUGHKEEPSIE, N.Y. (AP) — Edwin Fitchett, home movie camera in hand, had no plans to get close-ups of his boss that rainy, steamy day in the Philippines 65 years ago. He just wanted to capture the commotion of the Independence Day celebration in Manila.

But the boss was Gen. Douglas MacArthur, supreme commander of Allied forces in the Pacific, and when Fitchett, a junior officer who was off duty, found himself within arm's length of one of the world's most recognizable figures, he took advantage.

With his khaki uniform helping him blend in with the military photographers in the crowd, the 24-year-old second lieutenant eased his way into the throng of press cameramen covering the festivities on July 4, 1946, the day independence was declared. He trained his Kodak Model K on the American general who two years earlier had carried out his famous vow to return to the Philippines.

"I felt a little queasy about it," Fitchett recalled recently in the den of his home in Poughkeepsie, in New York's Hudson Valley. "He could have banished me off to the moon if he wanted to."

Instead, he captured rare color footage of a hatless MacArthur, sans his signature corncob pipe and aviator sunglasses, chatting with newly elected Filipino president Manuel Roxas and other officials as Filipinos celebrate their first day of independence from the United States. The scenes are among the highlights of "Ed Fitchett's Army Memories, 1945-1946," a 71-minute DVD Fitchett produced from the home movies he filmed while serving in the Pacific at the end of World War II.

Much of his DVD resembles a 1940s movie travelogue rather than a wartime newsreel: young, shirtless American soldiers toss a football on a sunny beach; friendly locals wave from a dugout canoe gliding in front of a jungle waterfall; merchants peddle their goods on crowded streets.

But the aftermath of the just-concluded war also fills many scenes, from battle-damaged government buildings in a devastated Manila to sunken Japanese ships dotting a harbor in Formosa (now Taiwan). Stored for the past 65 years in the basement of Fitchett's house, the footage offers a GI's view of street and country life in the Philippines and Japan not usually seen in official military films from World War II.

"Not many people were interested" in seeing his Pacific movies once he returned from the war, said the 89-year-old retired dairy company executive.

"There was so much war news that most people had enough of it by this point," Fitchett said. "My stuff didn't impress them much."

Because the U.S. military prohibited troops from having unauthorized cameras in a war zone, such home movie-style films are uncommon, said Seth Paridon, manager of research services National World War II Museum in New Orleans.

"Overseas home movies from World War II are rare, period," he said.

Black-and-white newsreels of the Filipino Independence Day ceremonies exist, said Nick Cullather, associate professor of history at Indiana University, but Fitchett's film is the only color footage of the event he has seen. The film includes a brief glimpse of the U.S. flag being lowered during the ceremony while the Filipino flag is being raised, an image that appears on the Philippines' 100-peso bill.

"It was very well-shot, very professionally done," said Cullather, author of a 1994 book on U.S-Philippines relations during the war years.

Fitchett got his first movie camera at 15 and recorded family trips and holiday gatherings. He continued his hobby when he entered Cornell University in 1940, filming college and fraternity life on the Ivy League campus in Ithaca, N.Y. He enlisted in the Army in September 1942 but remained stateside until July 1945, when his artillery battalion was shipped to the Pacific. His unit was training for the pending invasion of Japan when the war ended just weeks after they arrived in the Philippines.

With U.S. military censorship restrictions lifted, Fitchett had his camera sent from home, along with any rolls of Kodak color film his parents could find. Soon he was taking the camera along on sightseeing trips to Manila and the Philippines countryside, often in the battalion's flimsy two-seater planes used as aerial spotters.

From the air, he filmed battle damage in Manila Bay, the city of Manila and on the battered island of Corregidor. On the nearby Bataan peninsula, scene of the infamous Death March in 1942, Fitchett's buddies used the beaches as a landing strip and spent a day swimming, tossing a football and visiting a fishing village.

His film also includes footage from a Japanese POW camp Fitchett commanded after the surrender. The prisoners included hundreds of Formosans and Koreans conscripted into the Japanese military as soldiers and laborers. The footage shows the POWs in their camp and later aboard the U.S.S. John L. Sullivan, which transported them back home.

A longtime supporter of a travel and adventure film series at the Vassar Brothers Institute in Poughkeepsie, Fitchett hadn't given much thought to his footage until one a speaker at the series told him they may have some historical importance. So this year, Fitchett had the films edited and transferred to DVD, adding music, sound effects and his own narration. He's selling them to cover his costs.

Fitchett plans a public screening of the film at the institute on Dec. 14.

___

Online:

http://www.FitchettFilm.com

    WWII in Color: NY Vet's Rare Footage Made Into DVD, NYT, 10.11.2011,
    http://www.nytimes.com/aponline/2011/11/10/us/AP-US-WWII-Veteran-Film-.html

Looking After the Soldier, Back Home and Damaged

September 27, 2011
The New York Times
By CATRIN EINHORN

RAY CITY, Ga.— April and Tom Marcum were high school sweethearts who married after graduation. For years, she recalls, he was a doting husband who would leave love notes for her to discover on the computer or in her purse. Now the closest thing to notes that they exchange are the reminders she set up on his cellphone that direct him to take his medicine four times a day.

He usually ignores them, and she ends up having to make him do it.

Since Mr. Marcum came back in 2008 from two tours in Iraq with a traumatic brain injury and post-traumatic stress disorder, his wife has quit her job as a teacher to care for him. She has watched their life savings drain away. And she has had to adjust to an entirely new relationship with her husband, who faces a range of debilitating problems including short-term memory loss and difficulties with impulse control and anger.

“The biggest loss is the loss of the man I married,” Ms. Marcum said, describing her husband now as disconnected on the best days, violent on the worst ones. “His body’s here, but his mind is not here anymore. I see glimpses of him, but he’s not who he was.”

Ms. Marcum has joined a growing community of spouses, parents and partners who, confronted with damaged loved ones returning from war who can no longer do for themselves, drop most everything in their own lives to care for them. Jobs, hobbies, friends, even parental obligations to young children fall by the wayside. Families go through savings and older parents dip into retirement funds.

Even as they grieve over a family member’s injuries, they struggle to adjust to new daily routines and reconfigured relationships.

The new lives take a searing toll. Many of the caregivers report feeling anxious, depressed or exhausted. They gain weight and experience health problems. On their now frequent trips to the pharmacy, they increasingly have to pick up prescriptions for themselves as well.

While taking comfort that their loved ones came home at all, they question whether they can endure the potential strain of years, or even decades, of care.

“I’ve packed my bags, I’ve called my parents and said I’m coming home,” said Andrea Sawyer, whose husband has been suicidal since returning from Iraq with post-traumatic stress disorder. “But I don’t. I haven’t ever physically walked out of the house.”

Those attending to the most severely wounded must help their spouses or adult children with the most basic daily functions. Others, like Ms. Marcum, act as safety monitors, keeping loved ones from putting themselves in danger. They drive them to endless medical appointments and administer complicated medication regimens.

One of the most frustrating aspects of life now, they say, is the bureaucracy they face at the Department of Defense and the Department of Veterans Affairs, from problems with the scheduling of medical appointments to being bounced around among different branches of the system, forcing them to become navigators and advocates for their loved ones.

A variety of care services are offered to the severely injured. But many family members do not want their loved ones in nursing homes and find home health services often unsatisfactory or unavailable.

Despite Ms. Marcum’s cheerful manner and easy laugh, she has started taking antidepressants and an anti-anxiety medication when needed. She has developed hypertension, takes steroids for a bronchial ailment that may be stress related, and wears braces to relieve a jaw problem.

“I just saw all of my dreams kind of vanishing,” she said.

Over the past few years, advocacy organizations like the Wounded Warrior Project lobbied Congress to pass a law providing direct financial compensation and other benefits to family caregivers of service members. In 2010 they succeeded, and by mid-September, the veterans agency had approved 1,222 applications, with average monthly stipends of $1,600 to $1,800. Caregivers can also receive health insurance and counseling.

“We know it doesn’t replace full lost income,” said Deborah Amdur, who oversees caregiver support for the agency. “It’s really a recognition of the kinds of sacrifices that are being made.”

While families express deep gratitude for the help, questions remain about who will qualify and how compensation is determined, advocates for veterans say. Furthermore, the law applies only to caregivers of service members injured in the line of duty on or after Sept. 11, 2001, eliminating help for thousands who served in earlier conflicts.

And the emotional strain is still palpable as families struggle to adjust to what many call their “new normal.”

In a reversal of the classic situation in which adult children help out ailing parents, a substantial number of the caregivers of post- Sept. 11 service members are parents caring for their adult children.

Rosie Babin, 51, was managing an accounting office when a bullet tore through her son Alan’s abdomen in 2003. She and her husband rushed to Walter Reed Army Medical Center and stayed at his side when Alan, then 22, arrived from Iraq. He lost 90 percent of his stomach and part of his pancreas. His kidneys shut down and he had a stroke, leaving him with brain damage. He eventually underwent more than 70 operations and spent two years in hospitals, his mother said.

Ms. Babin fought efforts by the military to put her son in a nursing home, insisting that he go into a rehabilitation facility instead, and then managed to care for him at home.

But since her son’s injuries, her doctor has put her on blood pressure medication and sleeping pills. Now, while deeply grateful for her son’s remarkable recovery — he gets around in a wheelchair and has regained some speech — she sadly remembers the days when she looked forward to travel and dance lessons with her husband. Instead, she helps Alan get in and out of bed, use the bathroom and shower.

“I felt like I went from this high-energy, force-to-be-reckoned-with businesswoman,” she said, “to a casualty of war. And I was working furiously at not feeling like a victim of war.”

Research on the caregivers of service members from the post-Sept. 11 era is just beginning, said Joan M. Griffin, a research investigator with the Minneapolis V.A. Health Care System who is leading one such study. (The V.A. estimates that 3,000 families will benefit from the new caregiver program; 92 percent of the caregivers approved so far are women.)

What makes the population of patients receiving care different, Ms. Griffin said, is their relative youth. “The V.A. has not had a significant influx of patients of this age group since Vietnam,” she said, with a result that caregivers are looking at a “long horizon of providing care.” And one in five returning service members, a previous study found, report symptoms of post-traumatic stress disorder or major depression.

Ms. Griffin’s research shows that many family members spend more than 40 hours a week providing care. Half feel that they do not have a choice.

“They feel stuck,” Ms. Griffin said.

Some walk away.

For Ms. Marcum, 37 — who has an 18-year marriage and two sons, ages 14 and 11, with Tom, 36 — there was never a question of leaving. “I’m his wife and it’s my job, whether he’s hurt or not, to make sure he’s O.K.,” she said.

When she first asked for a leave of absence from work to care for him, she expected it would be for just a few weeks, while doctors got to the bottom of the migraines keeping him in bed for days on end. When he was up, he often seemed confused and sometimes slurred his speech. After 12 years in the Air Force, where he worked as a weapons specialist, he was suddenly having trouble taking a phone message or driving home from the base.

Mr. Marcum, who endured several mortar attacks in Iraq, one of which knocked him unconscious, eventually was given diagnoses of traumatic brain injury and post-traumatic stress disorder.

“My wife, I would imagine, probably felt as if she was a single parent for a while,” said Mr. Marcum, who is now medically retired from the Air Force. “She had to raise two boys. And now at times she probably thinks that she’s raising three boys,” he added with a laugh.

Ms. Marcum has found relief at a weekend retreat for military wives in her situation, and on a private Facebook page where caregivers vent, offer emotional support and swap practical advice. Participants say online communities like these are often more supportive than their extended families, who sometimes retreat in the face of such overwhelming change.

Financially, at least, things are looking up for the Marcum family. Ms. Marcum was awarded the highest tier of coverage through the veterans agency’s new caregiver program, giving her a monthly stipend of $1,837. Physical, occupational and speech therapy have all helped Mr. Marcum improve, but she worries that his progress has plateaued.

“We kind of have been in the same spot for a while,” Ms. Marcum said.

As proud as she is of her husband’s service, Ms. Marcum feels guilty that neither of them now works, and hopes that one day she will again hold down a job, while continuing to care for him. She pictures herself working somewhere relaxed, like a Hallmark store, where she could chat with people and help them with cards and gifts. It would be an escape, she said, from the stress at home.

    Looking After the Soldier, Back Home and Damaged, NYT, 27.9.2011,
    http://www.nytimes.com/2011/09/28/us/looking-after-the-soldier-back-home-and-damaged.html

Discharged for Being Gay, Veterans Seek to Re-enlist

September 4, 2011
The New York Times
By JAMES DAO

They lived shadow lives in the military, afraid that disclosure of their sexuality would ruin carefully plotted careers. Many were deeply humiliated by drawn-out investigations and unceremonious discharges.

Yet despite their bitter partings with the armed forces, many gay men and lesbians who were discharged under the “don’t ask, don’t tell” policy say they want to rejoin the service, drawn by a life they miss or stable pay and benefits they could not find in civilian life.

By some estimates, hundreds of gay men and lesbians among the more than 13,000 who were discharged under the policy have contacted recruiters or advocacy groups saying they want to re-enlist after the policy is repealed on Sept. 20.

Bleu Copas is one. He had been in the Army for just three years when someone sent an anonymous e-mail to his commanders telling them he was gay. After he was discharged in 2006 under “don’t ask, don’t tell,” the military’s ban on openly gay troops, “It took away all my value as a person,” he recalled.

Michael Almy is another. When the Air Force began its investigation into whether he was gay, it suspended his security clearance and relieved him of his command. On his final day in service in 2006, police officers escorted him to the gate. “It left kind of a bitter taste,” he said.

Though the Pentagon says it will welcome their applications, former service members discharged for homosexuality will not be granted special treatment. They will have to pass physical fitness tests and prove that they have skills the armed services need right now. Some will have aged to the point that they will need waivers to get back in.

Even if they pass those hurdles, there is no guarantee that they will go back to their former jobs or ranks. And because the armed services are beginning to shrink, some will be rejected because there are no available slots.

People discharged under “don’t ask, don’t tell” who wish to return to service “will be evaluated according to the same criteria and requirements applicable to all others seeking re-entry into the military,” said Eileen Lainez, a Pentagon spokeswoman. “The services will continue to base accessions of prior-service members on the needs of the service and the skills and qualifications of the applicants.”

To be eligible for re-enlistment, former service members cannot have been discharged under “other than honorable conditions,” Ms. Lainez said. The majority of people released under the policy since 1993 — a significant number of them highly trained intelligence analysts and linguists — received honorable discharges.

As with all people who join the military, the reasons for wanting to rejoin vary widely. Some say they want to finish what they started, but on their own terms. Others point to the steady pay, good health care and retirement benefits. Still others talk idealistically about a desire to serve and be part of an enterprise larger than themselves.

“It’s a hunger,” said Mr. Copas, who now works with homeless veterans in Knoxville, Tenn. “It doesn’t necessarily make sense. It’s the idea of faith, like an obligation to family.”

Jase Daniels was actually discharged twice. Because of a clerical error, the Navy failed to note on his records that the reason for his first discharge in 2005 was homosexuality. So the following year, when his services as a linguist were needed, the Pentagon recalled him.

“I wanted to go back so bad, I was jumping up and down,” he said. “The military was my life.”

He was open about his sexual orientation while deployed to Kuwait for a year, he says. But a profile of him in Stars and Stripes led to a new investigation, and he was discharged a second time upon coming home in 2007.

Now 29, Mr. Daniels says that in the years since, “I’ve had no direction in my life.” He wants to become an officer and learn Arabic, saying he is confident he will be accepted because he has already served as an openly gay man.

“No one cared that I was gay,” he said of his year in Kuwait. “What mattered was I did a good job.”

The issue of rank could discourage many from rejoining. Because there are fixed numbers of jobs or ratings in each of the armed services, some people might have to accept lower ranks to re-enlist. And those allowed to keep their former ranks will still find themselves lagging their onetime peers.

“I’ve been out six years, so my peers are way ahead of me in the promotion structure,” said Jarrod Chlapowski, 29, a Korean linguist who left the Army voluntarily in 2005 as a specialist because he hated keeping his sexual orientation a secret. He is now thinking about rejoining.

“It’s going to be a different Army than the one I left,” he said. “And that’s a little intimidating.”

Mr. Almy, 41, Mr. Daniels and another former service member have filed a lawsuit asserting that they were unconstitutionally discharged and should be reinstated, presumably at their former ranks. A former major, Mr. Almy, who was deployed at least four times to the Middle East, was among the highest-ranking members removed under the ban.

But even advocates for gay and lesbian troops say it might not be practical for the military to adopt a blanket policy of allowing all service members discharged under “don’t ask, don’t tell” to return to their previous ranks.

“You have to think long and hard from a policy perspective whether you want to put somebody who’s been out 5 or 10 years back into the same billet just because an injustice was done,” said Alexander Nicholson, executive director of Servicemembers United, a gay rights advocacy group. Mr. Nicholson, 30, who was discharged in 2002, is considering going to law school and trying to become an officer.

For Mr. Copas, who is 35, age could be a factor in whether he gets back in. An Arabic linguist during his first enlistment, he is thinking of learning Dari or Pashto so he can go to Afghanistan. He also is a musician and has a master’s degree in counseling.

But the Army may consider him too old and demand that he get a waiver. Even as he searches the Web for potential Army jobs, he worries that he will jump through many hoops only to be rejected again.

“It almost feels like I’m getting back in bed with a bad lover,” he said. “I’m still dying to serve. But I don’t know how realistic it is.”

    Discharged for Being Gay, Veterans Seek to Re-enlist, NYT, 4.9.2011,
    http://www.nytimes.com/2011/09/05/us/05reenlist.html

Wounded Iraqi Veterans Face a New Battle

September 3, 2011
The New York Times
By TIM ARANGO and YASIR GHAZI

BAGHDAD — It is hard to say which is a worse indignity to the thousands of Iraqi soldiers and police officers who have suffered crippling injuries fighting alongside the Americans in a war that continues today: receiving subpar medical care from the government they fought to preserve, or a new law that could slash their already paltry benefits.

“We are defending the Iraqi people,” said Ali Mohammad Heaal, who was a police trainee when he lost his left arm in a car bomb attack in 2005 and now works at a nongovernmental organization that advocates on behalf of wounded members of Iraq’s security forces. “Right now, we feel humiliated.”

Mr. Heaal’s organization, the Lanterns of Mercy, is trying to overturn the new law, passed in July by Parliament, that raises the salaries of active-duty soldiers and police officers but reduces government payments to those who have been wounded, including those who have lost limbs and have been unable to obtain prosthetics to enable them to work again. The law could be put into effect as soon as this month.

His efforts appear to be paying dividends, as some members of Parliament now say they never intended to reduce compensation for war veterans and plan to consider amending the legislation. Even in Iraq, it seems, politicians are finding that there are risks to laws that appear to abandon veterans.

“We are studying it,” said Abbas al-Bayati, a lawmaker and a member of the security committee. “If we find there are problems, we are ready to modify it in a way that keeps the level of compensation for their sacrifices.”

As it is written now, the law would also reduce lump-sum payments to those who were severely wounded and rescind a provision from a previous law that awarded land to victims — even though many have not received any property.

Mr. Bayati said that the intention of the law was to raise salaries for active-duty soldiers and police officers, and that he was unaware of the provisions that reduced compensation for veterans. “This is an unintentional mistake, and we will address it through amendment as soon as possible,” he said.

Another lawmaker, Najiha Abdulamir, a member of a parliamentary commission for wounded veterans, said that if Parliament did not change the law, then veterans should “demonstrate and demand their rights.”

The controversy comes as the American military prepares to withdraw, leaving the fighting to Iraq’s soldiers and police officers, who continue to take casualties from insurgent attacks almost daily, and who face those dangers without the comfort of knowing that their country will care for them and honor their sacrifices if they are hurt.

The new law that will reduce veterans’ benefits has Iraq’s wounded feeling dishonored and ignored. Many recall Saddam Hussein’s time, when those who sacrificed to preserve a dictator’s power were rewarded with land and money. “If you compare now to the previous regime, it would have been better,” Mr. Heaal said. “And they call this a democracy.”

Many joined Iraq’s new army after it was reconstituted in 2005 for a mix of motives, economic and patriotic.

“There were no opportunities for work in 2003,” said Ali Jasim, 39, who fought alongside American soldiers and Marines before losing a leg in 2005 when he was struck by a roadside bomb while securing polling sites for a national referendum that year on Iraq’s new constitution. “I also felt I needed to protect my country.”

He and his sister, and their children, are squatters in a ramshackle and boxlike home constructed of concrete blocks in a poor Shiite neighborhood that is a maze of dirt alleys.

On a recent afternoon, Mr. Jasim was spending his day as he always does: lying on the floor, his head propped up on a pillow, sweltering from the lack of air-conditioning and surrounded by his children. Like many men in his position, he is experiencing a severe economic hardship that, with the passage of the new law, could get worse.

After his injury, Mr. Jasim continued to receive his full pay — which had included a combat bonus and allowances for food — of $700 a month. It was then reduced to $450 when the government stopped paying the extra danger pay. Under the new law, he said, his pay will fall to $200.

Mr. Heaal, the former police trainee, was forced to sell his house to pay for medical treatment after being wounded. He receives $530 a month, and he could see his compensation fall to under $200 a month.

The law has added a new layer of resentment toward politicians who operate in a sphere of corruption and favoritism, and who are widely seen as out of touch with most of the Iraqi people.

“I joined the police to protect my country in a time when you were afraid of going outside the Green Zone,” said Falah Hassan Abed, who was displaced from his home because he could not work after losing his right leg in 2005, directing his rage at lawmakers. “I was face to face with the ruthless killers, the terrorists. In return, I just want to live in dignity, me and my family, and not be forced to beg to feed my family. I want to feel that there is someone who is grateful for what I did and what I lost.”

In some ways the thousands of casualties among Iraq’s army and police are the forgotten victims of the war, overshadowed in many accounts of the conflict’s toll by the numbers of American troops and Iraqi civilians who have been killed or wounded. Those numbers are familiar and easily referenced: close to 5,000 American military personnel killed, and nearly 100,000 Iraqi civilians killed, according to some accounts. Among Iraq’s security forces, more than 10,000 have been killed, according to the Iraq Index compiled by the Brookings Institution, and while there is no precise estimate for the number wounded, that figure is certainly in the tens of thousands.

A further grievance for these soldiers and police officers is the knowledge that the American soldiers and Marines who fought with them returned home to a country that may not have supported the war, but supported them. They have glimpsed television images of American presidents visiting the wounded in military hospitals.

“Here in Iraq, we don’t have any officials visiting us,” Mr. Heaal said. “And now they are punishing us with this new law.”

 

Duraid Adnan contributed reporting.

    Wounded Iraqi Veterans Face a New Battle, NYT, 3.9.2011,
    http://www.nytimes.com/2011/09/04/world/middleeast/04iraq.html

The Wrong Way to Help Veterans

August 19, 2011
The New York Times
By SALLY L. SATEL

Washington

IF all goes according to plan, by the end of the year, 10,000 American soldiers in Afghanistan will be home with their families — and their memories. As many as 20 percent of them will suffer from post-traumatic stress disorder, anxiety or depression, while suicide rates have reached tragic new highs among veterans. In response, the Department of Veterans Affairs has greatly expanded its mental health services and made veterans well aware that disability benefits are available.

It seems only logical that a veteran who thinks he has a long-lasting impairment as a result of military service would file a disability claim. The problem is that the system allows him to receive these benefits for a condition without ever having been properly treated for it. As a result, a system intended to speed up entitlements for veterans could end up hurting them.

Currently, for a disability determination, Veterans Affairs requires the claimant to go through a psychiatric exam, also known as a “comp and pension.” But the session typically lasts just 90 minutes and does not provide enough information for an examiner to make a firm decision about a veteran’s future function — that is, whether he or she will continue to be sick in a way that impairs the ability to work, and thus require compensation.

After all, gauging the prognosis of mental injury in the wake of war is not as straightforward as assessing a lost limb. What’s more, it is very difficult to predict the pace and extent of a patient’s progress when the odds of success also depend heavily on nonmedical factors: the veteran’s own expectations for recovery, availability of family and social support, and the intimate meaning the patient makes of his or her distress, wartime hardships and sacrifice. And there is an even more delicate risk: awarding disability status prematurely can actually complicate a veteran’s path to recovery.

Consider a real-life case, a young soldier returning from Afghanistan, whom I’ll call Joe. He is 23 years old and suffers from classic P.T.S.D. He is plagued by bloody nightmares. When awake, he can barely concentrate, twitches with anxiety and feels emotionally detached from everything and everybody. He fears he’ll never be able to hold a job, have a family or fully function in society. He applies for “total” disability compensation for P.T.S.D., about $2,600 a month. The only humane thing to do, it would seem, is to grant the poor man those benefits.

But it’s more complicated than that. In fact, total disability is probably the last thing Joe needs, because it will confirm his fears that he will remain deeply impaired for years, if not for life.

While a sad verdict for anyone, it is especially awful for someone so young. Imagine telling someone with a spinal injury that he’ll never walk again — before he has had surgery and physical therapy.

This isn’t a problem unique to veterans. Anyone who is unwittingly encouraged to see himself as seriously and chronically disabled risks fulfilling that prophecy. “Why should I bother with treatment?” he might think. Once someone is caught in such a downward spiral of invalidism, it can be hard to reverse course.

It’s not just a matter of self-doubt. Such premature decisions create dependency, leading a capable veteran to fear losing the financial safety net if he leaves the disability rolls to take a job that ends up demanding too much.

Of course, some veterans will remain so irretrievably wounded by their war experiences that they are not likely to ever participate in the competitive workplace, and generous support is due them. But it borders on malpractice to allow young veterans to surrender to psychological wounds without first urging them to pursue recovery.

Instead, Veterans Affairs should adopt a treatment-first approach. The sequence would begin with treatment, move to rehabilitation and then, if necessary, assess a patient for disability status, should meaningful functional deficits persist.

At the same time, veterans too fragile for employment while in intensive therapy and rehabilitation — which, for some, could last up to a year — should receive financial support. Not disability payments, mind you, with their specter of permanent debilitation; call it a “recovery benefit” — as generous as total disability, but temporary.

With some exceptions, it is both realistic and important to instill the expectation in veterans that they will get better and find a comfortable and productive niche within the community and family. The road home from war is already an arduous one — the mental health system shouldn’t make it any longer than it already is.

 

Sally L. Satel, a scholar at the American Enterprise Institute and a lecturer in psychiatry at the Yale School of Medicine, is co-author of “The Health Disparities Myth: Diagnosing the Treatment Gap.”

    The Wrong Way to Help Veterans, 19.8.2011,
    http://www.nytimes.com/2011/08/20/opinion/the-wrong-way-to-help-veterans.html

Albert Brown, Survivor of Bataan March, Dies at 105

August 15, 2011
The New York Times
By DENNIS HEVESI

Albert Brown, the oldest American survivor of the Bataan Death March, in which as many as 11,000 soldiers died at the hands of the Japanese in the Philippines in 1942, and perhaps the oldest American veteran of World War II, died Sunday in Nashville, Ill. He was 105 and lived in Pinckneyville, Ill.

His death was confirmed by Kevin Moore, co-author with Don Morrow of “Forsaken Heroes of the Pacific War: One Man’s True Story” (2011), a biography of Mr. Brown.

In 2007, Mr. Brown was acknowledged by other members of the veterans organization American Defenders of Bataan and Corregidor as the oldest living survivor of the six-day death march. The American War Library in Gardena, Calif., lists Mr. Brown as the nation’s oldest World War II veteran, but that could not be confirmed.

Mr. Brown, then an Army captain, was among the approximately 76,000 Americans and Filipinos forced to march 66 miles on the Bataan peninsula starting on April 10, 1942.

The Japanese had invaded the Philippines two weeks after the bombing of Pearl Harbor. American and Filipino forces were overmatched and retreated into the mountainous jungles of Bataan. After four months of intense fighting — their ranks reduced by hunger and disease and with no reinforcements in sight — they surrendered.

With many already close to death, they were forced to trudge toward a prisoner-of-war camp during a torrid time of year with little food or water. Those who stopped were killed. Japanese soldiers fractured skulls with rifle butts and cut off heads. Prisoners who tried to help fallen comrades were bludgeoned or stabbed. “One 18-year-old I knew, he fell down,” Mr. Brown said in the book. “A guard came along and put a gun to his head, pulled the trigger and walked away.”

The nightmare was hardly over when the survivors arrived at the camp, or at the other camps in Japan to which many, including Captain Brown, were later taken. In three years in captivity Captain Brown was regularly beaten; thrown down stairs, seriously injuring his back; and struck in the neck by a rifle butt, causing a fracture. Though nearly 6 feet, he weighed 90 pounds when he was freed after the Japanese surrender.

Albert Neir Brown was born in North Platte, Neb., on Oct. 26, 1905, to Albert and Ida Fonda Brown. His father was a railroad engineer; his mother was an aunt of the actor Henry Fonda.

Young Albert was in the R.O.T.C. in high school and at Creighton University, from which he graduated in 1927 with a dentistry degree. A decade later, at 32, he was called into the Army.

Mr. Brown is survived by a daughter, Peggy Doughty; a son, Graham; 12 grandchildren; 28 great-grandchildren; and 19 great-great-grandchildren. His wife of 58 years, the former Helen Johnson, died in 1985.

Promoted to major, Mr. Brown spent two years in an Army hospital after the war. He later moved to Los Angeles, where he bought property and rented apartments. War injuries prevented his working as a dentist.

He moved to Illinois in 1998 to live with his daughter.

In the P.O.W. camps, Mr. Brown said: “We were listed in groups of 10. If one escaped out of the 10, they eliminated the rest of them, killed them. So, at night, just before roll call, you tried to find out if your 10 were still there.”

    Albert Brown, Survivor of Bataan March, Dies at 105, NYT, 15.8.2011,
    http://www.nytimes.com/2011/08/16/us/16brown.html

Helping Veterans Trade Their Swords for Plows

February 5, 2011
The New York Times
By PATRICIA LEIGH BROWN

VALLEY CENTER, Calif. — On an organic farm here in avocado country, a group of young Marines, veterans and Army reservists listened intently to an old hand from the front lines.

“Think of it in military terms,” he told the young recruits, some just back from Iraq or Afghanistan. “It’s a matter of survival, an uphill battle. You have to think everything is against you and hope to stay alive.”

The battle in question was not the typical ground assault, but organic farming — how to identify beneficial insects, for instance, or to prevent stray frogs from clogging an irrigation system. It was Day 2 of a novel boot camp for veterans and active-duty military personnel, including Marines from nearby Camp Pendleton, who might be interested in new careers as farmers.

“In the military, grunts are the guys who get dirty, do the work and are generally underappreciated,” said Colin Archipley, a decorated Marine Corps infantry sergeant turned organic farmer, who developed the program with his wife, Karen, after his three tours in Iraq. “I think farmers are the same.”

At their farm, called Archi’s Acres, the sound of crickets and croaking frogs communes with the drone of choppers. The syllabus, approved by Camp Pendleton’s transition assistance program, includes hands-on planting and irrigating, lectures about “high-value niche markets” and production of a business plan that is assessed by food professionals and business professors.

Along with Combat Boots to Cowboy Boots, a new program for veterans at the University of Nebraska’s College of Technical Agriculture, and farming fellowships for wounded soldiers, the six-week course offered here is part of a nascent “veteran-centric” farming movement. Its goal is to bring the energy of young soldiers re-entering civilian life to the aging farm population of rural America. Half of all farmers are likely to retire in the next decade, according to the Agriculture Department.

“The military is not for the faint of heart, and farming isn’t either,” said Michael O’Gorman, an organic farmer who founded the nonprofit Farmer-Veteran Coalition, which supports sustainable-agriculture training. “There are eight times as many farmers over age 65 as under. There is a tremendous need for young farmers, and a big wave of young people inspired to go into the service who are coming home.”

About 45 percent of the military comes from rural communities, compared with one-sixth of the total population, according to the Carsey Institute at the University of New Hampshire. In 2009, the Agriculture Department began offering low-interest loans in its campaign to add 100,000 farmers to the nation’s ranks each year.

Among them will probably be Sgt. Matt Holzmann, 33, a Marine at Camp Pendleton who spent seven months in Afghanistan. He did counterinsurgency work and tried to introduce aquaponics, a self-replenishing agricultural system, to rural villages.

His zeal for aquaponics led him to the farming class. “It’s a national security issue,” he said the other day outside a garage-turned-classroom filled with boxes of Dr. Earth Kelp Meal. “The more responsibly we use water and energy, the greater it is for our country.”

Mr. O’Gorman, a pacifist and a pioneer of the baby-lettuce business, started the coalition after his son joined the Coast Guard. The group recently received a grant from the Bob Woodruff Foundation, co-founded by the ABC News journalist who was wounded in Iraq, to provide farming fellowships for wounded young veterans.

“Beginning farming has become the cause du jour among young people with college degrees and trust funds,” Mr. O’Gorman said at the farm, where there were stacks of Mother Earth News magazines in the bathroom and a batch of fresh kale in the sink. “My gut sense is a lot of them won’t be farming five years from now. But these vets will.”

Mr. Archipley’s own journey into organic farming was somewhat serendipitous. He joined the Marines in response to the Sept. 11 terrorist attacks and married between his second and third tours in Iraq. The couple bought three acres of avocado orchards north of San Diego.

Mr. Archipley, whose looks bring to mind a surfer dude, found pleasure tending his grove after leaving the Marines and eventually secured a loan from the Agriculture Department to build a greenhouse. His farm now sells organic produce to Whole Foods Markets in San Diego and Los Angeles.

In 2007, the couple started training veterans informally, financing the effort themselves. The new course, administered through MiraCosta College, costs $4,500, with Camp Pendleton offering assistance for active-duty Marines.

Farming offers veterans a chance to decompress, Mr. Archipley said, but, more important, provides a sense of purpose. “It allows them to be physically active, be part of a unit,” he said. “It gives them a mission statement — a responsibility to the consumer eating their food.”

Even in this idyllic setting, it can be a challenging process. Mike Nelson Hanes, now 34, enlisted in the Marines at 18. In 1994, six days into his basic training in South Carolina, his drill instructor committed suicide with an M-16 rifle in front of 59 recruits.

“He blew his head off,” Mr. Hanes said. “That was right from the get-go, at age 18.”

In Baghdad, Mr. Hanes served as a .50-caliber machine gunner atop a Humvee. “I was the one they were trying to kill,” he said. He returned home with post-traumatic stress disorder, depression and a traumatic brain injury. He was homeless for over a year, managing nevertheless to get a degree in environmental social services.

“Being outside was my comfort zone — still is,” he said. Two years ago, he stumbled upon the Archipleys’ “Veterans for Sustainable Agriculture” booth at an Earth Day festival in Balboa Park in San Diego. Mr. Hanes still struggles but is gaining ground.

“One thing I’ve noticed about agriculture is that you become a creator rather than a destroyer,” he said amid ornamental eucalyptus shrubs.

John Maki, Camp Pendleton’s transition assistance program specialist, said the life experiences of young veterans equip them for demanding work. “For a comparable age, you won’t find people who have had as much responsibility,” he said. “They’ve been tasked with making life-and-death decisions.”

Weldon Sleight, dean of the University of Nebraska’s College of Technical Agriculture, which has six enrolled veterans, said discipline — a mainstay of the armed forces — was critically important in agriculture. “A lot of these rural vets have this wonderful knowledge base about agriculture,” he added. “But we’ve told them for years there’s no future in it.”

In Central Florida, Adam Burke, who left farming to join the military, came full circle, designing a wheelchair-accessible farm in which his signature “red, white and blueberries” grow in containers on elevated beds.

Mr. Burke, a Purple Heart recipient who suffered a traumatic brain injury in Iraq, recently opened a second farm. “Squeezing a ball in physical therapy gets monotonous,” he said. “And you don’t get the mist from the sprinklers or a cool breeze in a psychologist’s office.”

Matthew McCue, 29, formerly Sergeant McCue, runs Shooting Star CSA outside San Francisco with his partner, Lily Schneider, delivering boxes of organic produce directly to consumers.

He recalled how orchard farmers in Iraq pridefully shared their pomegranates, tomatoes and melons.

“You learn how to face death,” he said of his service in Iraq. But in farming, he learned, “There was life all around.”

    Helping Veterans Trade Their Swords for Plows, NYT, 5.2.2011,
    http://www.nytimes.com/2011/02/06/us/06vets.html

Vets’ Mental Health Diagnoses Rising

July 17, 2009
The New York Times
By JAMES DAO

A new study has found that more than one-third of Iraq and Afghanistan war veterans who enrolled in the veterans health system after 2001 received a diagnosis of a mental health problem, most often post-traumatic stress disorder or depression.

The study by researchers at the San Francisco Department of Veterans Affairs Medical Center and the University of California, San Francisco, also found that the number of veterans found to have mental health problems rose steadily the longer they were out of the service.

The study, released Thursday, was based on the department health records of 289,328 veterans involved in the two wars who used the veterans health system for the first time from April 1, 2002, to April 1, 2008.

The researchers found that 37 percent of those people received mental health diagnoses. Of those, the diagnosis for 22 percent was post-traumatic stress disorder, or PTSD, for 17 percent it was depression and for 7 percent it was alcohol abuse. One-third of the people with mental health diagnoses had three or more problems, the study found.

The increase in diagnoses accelerated after the invasion of Iraq in 2003, the researchers found. Among the group of veterans who enrolled in veterans health services during the first three months of 2004, 14.6 percent received mental health diagnoses after one year. But after four years, the number had nearly doubled, to 27.5 percent.

The study’s principal author, Dr. Karen H. Seal, attributed the rising number of diagnoses to several factors: repeat deployments; the perilous and confusing nature of war in Iraq and Afghanistan, where there are no defined front lines; growing public awareness of PTSD; unsteady public support for the wars; and reduced troop morale.

Dr. Seal said the study also underscored that it can take years for PTSD to develop. “The longer we can work with a veteran in the system, the more likely there will be more diagnoses over time,” said Dr. Seal, who is co-director of the mental health clinic for Iraq and Afghanistan veterans at the San Francisco veterans medical center.

The new report joins a growing body of research showing that the prolonged conflicts, where many troops experience long and repeat deployments, are taking an accumulating psychological toll.

A telephone survey by the RAND Corporation last year of 1,965 people who had been deployed to Iraq or Afghanistan found that 14 percent screened positive for PTSD and 14 percent for major depression. Those rates are considerably higher than for the general public.

“The study provides more insight as to just how stressed our force and families are after years of war and multiple deployments,” said René A. Campos, deputy director of government relations for the Military Officers Association of America. “Our troops and families need more time at home — more dwell time, fewer and less frequent deployments.”

The study was posted Thursday on the Web site of The American Journal of Public Health.

Dr. Seal cautioned that, unlike the RAND study, the results from her research could not be extrapolated to the roughly 1.6 million veterans who have served in Iraq or Afghanistan because about 60 percent of them were not receiving health care through the veterans system.

But she noted that the number of Iraq and Afghanistan war veterans receiving care through the veterans system was at a historic high, 40 percent, potentially making the study’s results more universal.

The study also found that veterans older than 40 with the National Guard or the Reserves were more likely to develop PTSD and substance abuse disorders than those under 25. A possible reason, Dr. Seal said, is that older reservists go to war from established civilian lives, with families and full-time jobs, making combat trauma potentially more difficult to absorb.

“It’s the disparity between their lives at home, which they are settled in, and suddenly, without much training, being dropped into this situation,” she said.

In contrast, the study found that among active-duty troops, veterans under 25 were more likely to develop PTSD and substance abuse problems than those over 40, possibly because those younger troops were more likely to have been involved in front-line combat, Dr. Seal said.

    Vets’ Mental Health Diagnoses Rising, NYT, 17.7.2009,
    http://www.nytimes.com/2009/07/17/health/views/17vets.html

Talking Veterans Down From Despair

April 22, 2008
The New York Times
By PATRICIA COHEN

CANANDAIGUA, N.Y. — Nancy Nosewicz was busy fielding calls at the new national veterans hot line on a recent afternoon when someone from the Department of Veterans Affairs in Topeka, Kan., phoned. He had a 55-year-old Army veteran from the Northwest on the line who had called to complain about his benefits, but now the guy, drunk and crying, was talking about not wanting to live. Could Ms. Nosewicz pick up?

In a slurred voice, heavy from weeping, the veteran, named Robert, told her that he was homeless and wanted to “just lay down in the river and never get up.”

Ms. Nosewicz, a social worker, listened. Then in a voice firm and comforting like a big sister, she said: “We don’t want you to either. Today we’re not thinking about the alcohol or the housing, Robert. Today it’s about keeping you safe.”

She gave an assistant Robert’s phone number to find his address and alert local police to stand by. The chain of care resembled a relay race, with one runner trying not let go of the baton until the next runner had it in hand.

The veterans hot line is part of a specialized effort by the Department of Veterans Affairs to reduce suicide by enabling counselors, for the first time, to instantly check a veteran’s medical records and then combine emergency response with local follow-up services. It comes after years of criticism that the department has been neglecting tens of thousands of wounded service men and women who have returned from war zones in Iraq and Afghanistan.

On Monday, a class action suit brought by veterans groups opened in San Francisco charging a “systemwide breakdown,” citing long delays in receiving disability benefits and flaws in the way discharged soldiers at risk for suicide had been treated. Kerri J. Childress, a department spokeswoman, said Monday that there were an average of 18 suicides a day among America’s 25 million veterans and that more than a fifth were committed by men and women being treated by Veterans Affairs.

Up and running since August, the hot line tries to respond to at least some of those in crisis. Over eight months, it has received more than 37,200 calls and made more than 720 rescues — sending out, from a narrow office here in upstate New York, emergency responders all over the country to find someone on a bridge, with a gun in his hand, with a stomach full of pills.

Paul Sullivan, the director of Veterans for Common Sense, one of the groups involved in the lawsuit, said of the department: “I’m pleased they’re responding. However, much more needs to be done so vets aren’t turned away from health care and don’t have to wait for benefits.”

Mr. Sullivan says suicidal patients have not been able to get care promptly; he cited the case of Jonathan Schulze, who was turned away twice from a Veterans Affairs hospital before he killed himself in January 2007.

“More than 600,000 veterans are waiting, on average, more than six months for disability benefits,” said Mr. Sullivan, who worked at the department monitoring benefits.

Experts agree that veterans are more likely, perhaps twice as much, to commit suicide as people who have never served in the military. Meanwhile, a study released last week by the RAND Corporation estimates that roughly one in five veterans of Iraq and Afghanistan has symptoms of post-traumatic stress disorder, which heightens the risk of suicide.

Yet whatever larger failings may exist, the staff of social workers, addiction specialists and nurses who keep the hot line running — 24 hours a day, seven days a week — can count at least some victories by the end of each shift.

Unique about this hot line, said Janet Kemp, the national suicide prevention coordinator with the department, is that now the counselors have medical information at their fingertips, which they use to connect vets with counseling near their homes. The model evolved from a new research program on suicide prevention paid for by the department.

“For years people thought that asking questions about suicide put the thought in people’s mind, but now we know that’s not true,” said Dr. Kemp, who travels throughout the country training V.A. staff.

The department is spending about $3 million to start and operate the hot line during its first year, said a spokesman, Daniel Ryan, and another $2.9 million on a mental health research center at the sprawling red-brick V.A. Medical Center in Canandaigua. Referring to the hot line’s relay model, Kerry Knox, the director of the new research center, said, “You don’t want them to fall through the cracks.”

With Robert, for example — whose last name was not provided for confidentiality — Ms. Nosewicz gradually nudged him to agree to be taken to a hospital and to give his name and Social Security number so she could check his file and put him in contact with the department’s suicide prevention coordinator in his area.

Meanwhile, Denise Slocum, a health assistant, relayed questions from the local police dispatcher. “The police are asking if you’re near an elementary school,” asked Ms. Nosewicz, who then nodded her head at Ms. Slocum.

“No, no, no — no handcuffs,” Ms. Nosewicz reassured Robert. “You’re going to go to the hospital.”

“Do you have a tissue to blow your nose? Then use your sleeve.”

“When they come in, you put them on the phone with me, and I’ll tell them to treat you with respect.”

Twenty minutes later, Ms. Slocum called the police again to confirm that Robert had been taken to a hospital. Ms. Nosewicz alerted the prevention coordinator. One is at each of the department’s 156 health centers.

Robert’s name was added to a board near the doorway so that the staff could follow up to ensure a local counselor actually met with him.

Of course, sometimes a crack is unavoidable.

“He’s going to do it. He’s really going to do it,” said Terri Rose, a counselor who was working the noon-to-midnight shift. She was wiping her red-rimmed eyes. A caller from Texas, who said he was 65 and a helicopter gunner in Vietnam, said he had a suicide pact with his friend, but the friend had gone off and killed himself. Now he, too, was ready to die, saying he had even found a coffin for $150, said Ms. Rose, who is an Air Force veteran herself. The veteran hung up and had stopped answering her calls.

Sometimes veterans have a lot of trouble asking for help, said Jacalyn O’Loughlin, a counselor. “They keep saying, ‘I’m sorry, I’m sorry, I’m sorry,’ ” Ms. O’Loughlin said. “Especially marines. They feel they’re weak if they reach out.”

Mr. Ryan said about half the calls to the hot line — 1-800-273-TALK (8255) — were from veterans, split fairly evenly between Vietnam and Iraq. Family members and friends also frequently call. About 30 percent of the veterans are women.

A couple of months ago, Ms. O’Loughlin said, a distraught woman called from Oregon who was driving to the woods and then threatened to “walk and walk and walk and never come back.” Ms. O’Loughlin rang the tiny silver bell on her desk to signal the health technician. The health tech checked the area code and phoned the closest Veterans Affairs health center.

“And lo and behold, that suicide prevention coordinator knew her just by her first name,” Ms. O’Loughlin said. The tech called the police and the coordinator called the woman’s husband, getting the car’s make and model. Ms. O’Loughlin kept her on the line; when she hung up, Ms. O’Loughlin called her back. “This went on for hours,” she said. “I could hear her getting out of the car. I could hear the rustling from the leaves.”

Meanwhile, the police and her husband were driving up and down roads. They spotted the car, dashed through the trees and found her. She had a bottle of pills in her hand but had not yet swallowed them.

Sometimes, the victories are smaller but no less satisfying. That morning, Ms. Nosewicz spoke to a veteran whose house was destroyed by Hurricane Katrina; he had been relocated to a different state.

“He called crying because he can’t find a job, saying ‘my teeth are so rotten and my mouth stinks,’ ” Ms. Nosewicz said.

Dental referrals are not exactly part of the job description, but Ms. Nosewicz tried dental schools in his area until she found a school to do the work. “He was crying on the phone,” she recalled, “and said, ‘Thanks so much. Thanks so much.’ ”

All in all not a bad day’s work, Ms. Nosewicz said, as she got ready to leave. “Three rescues, four consults and one set of teeth.”
 

An earlier version of this article referred incorrectly

to the Department of Veterans Affairs, known as the V.A.,

by its former name, the Veterans Administration.

    Talking Veterans Down From Despair, NYT, 22.4.2008,
    http://www.nytimes.com/2008/04/22/us/22suicide.html

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