Cope With The Mental-Health Effects Of A Decade At War

Рубрики: Военлит, Интервью, Северная Америка, Судьба Опубликовано: 20-10-2014

Foreign Policy's managing editor, Yochi Dreazen, has had an accomplished career as a conflict journalist and spent five years reporting from Iraq and Afghanistan. But his first book, "The Invisible Front: Love and Loss in an Era of Endless War," spends relatively little time on the battlefield.

It's about the psychological traumas of war — and what the US military is and isn't doing to assist soldiers affected by post-traumatic stress disorder and other mental-health issues.

The book tells the story of the efforts of two-star general Mark Graham and his wife, Carol, to change the Army's attitudes toward mental health after losing both of their sons in a few short months.

Jeffrey Graham, a second lieutenant in the Army, was killed by a roadside bomb attack in Iraq. His brother, Kevin, a promising Reserve Officer Training Corps cadet, killed himself months earlier, and had gone off of his antidepressants because he feared discovery of his depression would lead to the end of his military career.

The Grahams succeeded in pushing for antisuicide and mental-health reforms in the military. But the first half of 2014 saw an uptick in the military's already troubling active-duty suicide rate.

And as Dreazen explained in an exclusive interview with Business Insider, there's still a lot of work to be done.

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BI: Most Americans aren't veterans and haven’t served in Iraq or Afghanistan. Do you think the American public really has an adequate understanding of what veterans have been through and what the military as a whole has been through in the past decade-plus?

Yochi Dreazen: I don’t. I think in some ways the military doesn’t understand the civilian world and the civilian world doesn’t understand the military. I think the gap between the two is really heartbreaking and potentially kind of dangerous in the long term.

Part of it is that only 1% of the country serves. But part of it is that that 1% doesn’t live in the major cities, for the most part. It’s clustered in the South or in the Midwest. The bulk of the country that lives in cities probably will never meet somebody who serves, or, if they meet them, they won’t have them as a close friend or family member. 

So when we’re in the airport and we see somebody walk by in uniform and people thank them for their service or they applaud, that’s a wonderful thing compared to post-Vietnam, when that wasn’t the case. But paired with that is a complete lack of connection or understanding …

You have the civilian bubble, and the military bubble and oftentimes people don’t go from one to the other.  

BI: Not only does the civilian world not have an adequate idea of what the people in the military have gone through, but the military world hasn’t been able to integrate some of the attitudes of the civilian world toward certain issues like mental health. How optimistic are you that this can change?

Yochi Dreazen: I think it’s changing, but very slowly.

The military obviously is the definition of a hierarchy. You have people at the top who are talking about stigma and the importance of seeking help [for PTSD], and saying that seeking help isn’t a sign of weakness. There’s a ton of money and hundreds of millions of dollars being spent by the military on the issue.

What’s tough is that to really change something you have to have someone at the top not simply say in a general sense “go seek help, it won’t harm your career” but in a very specific sense say, “I sought help and it didn’t harm my career.”

Over the course of the book I interviewed close to a dozen generals, people I had personally known from Iraq and Afghanistan. When we were talking — off-record at first — they were telling me about how they couldn’t sleep or they had anger flashes or their family didn’t recognize them. Most of them did not use the phrase PTSD, but they were clearly talking about PTSD.

When I said to them, general so-and-so, it would be valuable for me to use that in the book, and it would really help a lot of people to know that somebody could go as far as you’ve gone with the issues you’ve wrestled with. And, with one exception, they all said no. 

So when we’re talking about how to change a culture, if the people at the top who are the people everyone else in that culture looks to. If they won’t talk about it, it won’t change. And right now they won’t talk about it.  

BI: The book concludes that the problems around PTSD are only going to get worse, and it notes that there are still tens of thousands of World War II veterans being treated for it. What can we do to make sure that the problem doesn’t substantially worsen in the future?

Yochi Dreazen: I think there are three things that can be done. They’re difficult but I think they are doable ... 

One is having people at the very top, having generals who have had this disorder talk about it so that people at the bottom can see that if they can seek help, their career will not end, they can still be promoted up, and they can still be a success in the military. I can’t overstate how important that would be.

Number two — and in some ways this is a much more practical one, but it’s gigantic — is simply to make it harder for a person to get a gun. Ninety percent of military suicides, if not higher, are with handguns. And a lot of times these are handguns that were issued to the person, but a lot of the time they were personal weapons. 

Israel had a case for a while where they noticed a giant spike of military suicides. And when the Israelis looked into it what they realized is that for decades when soldiers went home on leave they took their weapons with them. It was a safety thing, and part of the culture of the Israeli military.

So they did the logical thing, which was take those weapons away and say, if you’re leaving on a Friday, you leave your gun and your pick it up on a Monday. And the suicide rate plummeted. 

There are little things we know from the civilian world that can help. Trigger guards make it so you have to unlock a gun to be able to use it. It’s an easy thing to do. They cost about $2 to put in. Giving one to every soldier would help, but it’s not being done.

The third thing — and this is something that we as a culture can do — is that it’s very easy for us to just say that we support the troops.

The hard thing to do is to actually meet someone who’s served and try to actually talk to them. And they’ll be somewhat reluctant because they might say, you’re a civilian, you can’t understand, how could you possibly know?

But it will open up, and it will change, and it will help the people who come back and feel lonely and think the rest of the world doesn’t understand or doesn’t care about them. Even just that little human connection can make an enormous difference.

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This Intense Story Reveals How Bad Things Got In Iraq After The Insurgency Picked Up 

The following is an excerpt from The Invisible Front, Foreign Policy managing editor Yochi Dreazen's newly released book about one army general's efforts to change the military's approach to the mental health of its personnel during the wars in Iraq and Afghanistan. In this section, second lieutenant Jeffrey Graham arrives in Iraq for a combat deployment eight months after the US invasion of the country, at a time when the anti-US insurgency was intensifying.

Graham was killed in an improvised explosive device (IED) attack in Khalidiyah, Iraq, on February 19th, 2004, and was posthumously awarded the Bronze Star and the Purple Heart.

Reprinted from The Invisible Front Copyright © 2014 by Yochi Dreazen. Published by Crown Publishers, an imprint of the Crown Publishing Group, a division of Random House LLC.  

 

“Hey, LT, where are your stilts?”

It was 4:30 AM on November 24, 2003, and a young sergeant from the 1st Battalion, 34th Armor, was giving Jeff an unofficial welcome to Iraq.

Jeff’s Chinook had just landed at the Al Taqaddum air base, or TQ, a bustling facility directly across the road from Camp Manhattan that served as a staging area for the units moving toward Fallujah and Ramadi.

Jeff was barely five foot six, and his height quickly became an endless source of amusement to the men around him. He wasn’t put off by the gentle mockery. In his letters and e-mails home, Jeff proudly referred to himself as an Oompa Loompa.

Jeff’s first day in Iraq flew by in a disorienting rush. A newly arriving officer would normally be given a week or two to get to know his men, adjust to the unfamiliar terrain, and learn the ins and outs of his com­mander’s overall strategy for fighting the insurgency.

Jeff wasn’t given time for any of that. Matt Homa’s unit — 2nd Platoon, Charlie Company — had been rudderless since the young officer’s injury, and Swisher needed to get it back into the fight. Jeff led his first mission, a foot patrol through a cemetery in the nearby town of Khaldiyah, just hours after landing at TQ.

Insurgents had been sneaking into the cemetery at night to fire rocket-propelled grenades and crude mortar shells at Camp Manhattan, which was just a few hundred yards away. Jeff didn’t find any of the mili­tants, and he thought that slowly making his way around the piles of dirt that marked each individual grave was “scary as hell.” Khaldiyah itself was almost entirely deserted. It looked, Jeff thought, “like a Hollywood set of a ghost town.”

Jeff had his first meeting with Swisher on November 25, Thanksgiv­ing Day. The battalion commander wasted little time with small talk when they sat down in Swisher’s tidy office. He told Jeff that the Centuri­ons were getting hit multiple times per day and had just lost two popular lieutenants, including Jeff’s predecessor.

The unit was fighting in one of the most dangerous parts of Iraq, and Swisher wanted Jeff to know ex­actly what was waiting for him each time he left the fortified walls of Combat Outpost Killeen, the tiny base that housed his platoon.

“This is what you’re stepping into,” Swisher told him. “The enemy is aggressive right now. Get your head screwed on straight if it’s not on straight already.”

Jeff spent his first days trying to get to know Crane, his unit’s top en­listed man, and the other soldiers of his platoon. He was deeply shaken by what he found.

The men were struggling to recover from the shock of Homa’s injury and were openly fearful of getting blown up by an invis­ible IED or shot by an unseen sniper. “You’re not human if you don’t get scared, and we had reason to be scared,” Chavez, one of Jeff’s soldiers, said later.

As time went on, Chavez added, many of the men from his platoon began to question why they were in Iraq and how they could possibly win a war with no front lines or clear objectives. Soldiers were being killed and wounded virtually every day, and many of the Centurions concluded that further losses were inevitable.

“The morale here is low,” Jeff wrote on Thanksgiving Day. “Guys try, but they all think they’re going to die.”

Jeff quickly got a sense of why his men were so afraid. On Decem­ber 1, his platoon was designated as the battalion’s quick response force, or QRF, which meant they would be the first troops called in if other Cen­turions came under attack. Just after 11 a.m., Jeff’s radio suddenly crack­led to life.

A convoy of US Humvees had been surrounded by insurgents armed with machine guns and rocket-propelled grenades while the ve­hicles were passing through the rough, tense town of Habbaniyah. The Humvees were coming under fire from multiple directions, and one sol­dier, Sergeant Uday Singh, had already been seriously wounded. Take your men, Jeff was told, and get out there as fast as you can.

Jeff’s platoon jumped into their trucks and roared out of Camp Manhattan. They reached the ambush site ten minutes later, just as an army medical evacuation helicopter was setting down to pick up Singh’s motionless body. Jeff ordered his gunners to lay down covering fire for the chopper by pounding away at the unseen militants with the powerful .50-caliber machine guns mounted to the roof of each Hum­vee.

He and Mike Crane ran out to link up with some of the other men from Singh’s unit, firing their M4s as they ran. The news was grim. A bullet had ripped through the young soldier’s helmet, passing through his forehead and then out the other side. Singh never regained con­sciousness and was declared dead during the short flight to a military hospital in Fallujah.

The death hit Jeff hard. He had gone on three patrols with Singh and remembered that the young soldier always seemed to be smiling. Singh, twenty-one, had been born in India to a family with a long history of mil­itary service. His grandfather joined the nascent Indian air force in the 1930s and fought Japanese forces in Burma during World War II. Singh’s father, Preet, spent twenty-five years in the Indian army as a tank com­mander and took part in the war against Pakistan in 1971.

Uday had been accepted into the University of Illinois but chose to enlist in the army in the summer of 2000 instead of beginning college. He died just days after receiving his US citizenship.

“Tough day, tough day,” Jeff wrote in his journal that night, describ­ing a raid that ended with his soldiers arresting four Iraqis. “I thought my guys were going to kill ’em.”

The violence continued. On December 14, the day after US forces captured Saddam Hussein, an enormous car bomb demolished an Iraqi police station in Khalidiya, killing twenty Iraqi cops. Jeff had been in the station more than half a dozen times and knew some of the dead men.

Two days later he was getting ready to go to Camp Manhattan when his radio squawked. “Cobra X-ray, Apache,” a panicked voice said. “We’ve been hit.” Jeff escorted the unit medics out to the site of the blast. An IED had blown up a US Humvee, severely wounding two of the Centuri­ons inside.

Jeff watched, horrified, as one of the soldiers readjusted the blood-soaked bandages covering his head and sent half the skin on his face sloughing off, exposing the bone below.

“I finally have seen combat. War. Hell,” Jeff wrote. “It’s not pretty. I wish I wouldn’t have to see it again.” 

Jeff woke up and fell asleep to the sound of distant explosions. He began to have vivid, unsettling nightmares.

In one dream Kevin [Graham's brother, a promising Reserve Officer Training Corps cadet who committed suicide earlier that year] walked up to him at a party, visibly drunk, and began choking so badly that Jeff could see the veins of his face turn blue. In another, Kevin told his brother that he was still alive and had simply taken a nap. Jeff woke up with a start after each nightmare and couldn’t fall back asleep.

US troops continued to die, seemingly by the day.

On January 9, in­surgents shot down a Black Hawk helicopter near Fallujah, killing all nine of the soldiers aboard. On January 24 a suicide bomber in a Toyota Land Cruiser detonated his explosives outside the gates of a small American outpost, killing two soldiers instantly. A third died while he was being flown out to a military hospital.

Jeff and Mike Taylor spent the follow­ing day at the blast site, picking body parts and scraps of blackened flesh out of the crater gouged by the bomb. They wanted the families of the fallen soldiers to have something to bury, no matter how small, and they were determined not to leave the remains of a pair of American soldiers to rot in the sun.

Three days later an IED went off less than six hundred meters from Combat Outpost Killeen, killing three of the four soldiers in a passing Humvee, including a company commander and a senior non­commissioned officer (the fourth soldier soon died from his wounds).

Jeff and his men began to feel an overpowering sense of bloodlust and fury. They imposed a midnight curfew in K-Town and talked about killing any Iraqi they saw on the streets. Jeff seemed almost excited by the prospect of retribution.

“This job is tough, but losing 6 guys in 4 days . . . ,” he wrote in his journal. “It’s time for payback and all the guys are ready.”

Not all of Jeff’s time in Iraq was so grim. He retained his obsession with Kentucky basketball, unfurled a large University of Kentucky ban­ner near his bed, and was happy to talk trash with fans of other schools. He played football and video games with the soldiers from his platoon to build unit cohesion and try to keep morale as high as possible. He was quick with a joke and never seemed to take himself too seriously.

On Christmas, Colonel Swisher walked over to Jeff’s table and handed him a plastic toy that had been mailed in from a McDonald’s back home. “Here,” he told Jeff. “You forgot the toy from your Happy Meal.” Jeff was sitting with his platoon, and there was a moment of nervous silence as the soldiers waited to see how their commander would react to so public a joke about his height. There was an audible gasp of relief when Jeff took the toy, proudly placed it on the edge of his tray of food, and then burst out laughing.

Still, Iraq was changing him. It hardened and conditioned him to withstand exposure to carnage that he would have found unimaginable just months earlier.

He began sprinkling his letters home with repeated references to “hojies,” a racial epithet of sorts about Iraqis. He made ca­sual reference to letting his men rough up Iraqis, run them off the road, or even shoot them.

Like veterans of other conflicts, Jeff felt transformed by his exposure to war. The world, in a fundamental way, was beginning to feel different to him.

“Most of the time it’s like being in a dream,” he wrote in a letter to Melanie. “Neither good nor bad. Just a dream.”

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