Friday, May 28, 2010

Reflections From This Memorial Day

Last Monday, I spent just about the rest of the money I had to host a large Memorial Day party. I’ve always felt that it’s an especially sad day – the memories of certain lives snuffed out by war, I try not to dwell on for most of the year – and I just wanted to bring together a bunch of veterans and civilians to have a positive celebration, no matter the cost. I needed that one day community and support, and I was glad that some of my civilian friends, who support the military but rarely get to show it, had that chance to do something tangible for me and war-weary veteran friends.

We toasted to the fallen, just like how we thought they would want us to. We reaffirmed our brotherhood and our dedication to being always faithful. And inevitably, despite our desire to not relive the pain of our experiences, the conversation turned to Mike’s dad.

Many of the Marine friends I still have today were my friends in high school. A large group of us joined together. Mike Starr, a hero of Fallujah one of our fellow Perry Hall High School alumni, wasn’t there last Monday. He hasn’t been with us since January 26, 2005 when his helicopter crashed killing all 31 on board.

I attended his funeral with all my worthless, clunking awards on my chest, which meant nothing when compared to the sacrifices he made, like his Purple Heart from battle. (At his viewing I learned that Mike was wounded in the face but refused treatment for days so he could still fight alongside his guys.) His family was there. His father hugged me over and over, thanked me profusely for my support, and stared into my soul with broken eyes. I have never seen a more devastated man. Still to this day, I’ve never been so close to such anguish. I promised to keep in touch. I never did.

One of my friends who is now a police officer, had pulled Mike’s father over to chat with him a couple weeks ago. It’s over five years later, and that friend reported to us at my party that Mike’s dad is still not doing well.

I had thought about inviting the Starr family to my Memorial Day party. I imagine that day is so lonely and dark for them. But I knew that ultimately my party would be what it turned out as: a bunch of young twenty somethings getting crunked and going wild; and while not speaking to it directly, we quietly lamented the sacrifices of our friends.

We spend a lot of time trying to assist the tens of thousands of mentally and physically wounded who have survived our nation’s wars, but what do we do for the families of those who did not return home?

I’m embarrassed to admit that I don’t have the answer. 


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Wednesday, May 26, 2010

Dario's Guest Blog for the Washington Post

From Fallujah to Chili's: A reservist goes back to work (Excerpt)

(Hello, everybody. I just wanted to share my recent guest blog for the Washington Post blog, "Impact of War." You can read the full blog by clicking here)

At the restaurant, right now is the highlight of our guests's week. Monday through Friday, for eight hours a day, they had to dress up, be polite to the boss and look busy behind something light and digital - how tough for them.

None of them carried a weapon instead of a Personal Digital Assistant. None of them listened to wind-tossed dog tags clanking against the rifle, boots and helmet memorial of a newly killed Marine. None of them picked up the body parts of both strangers and friends: a tossed salad served by suicide bombings.

It's March 2005; I've only been back home from my second tour for about four months and I'm heartbroken and poor and not mentally well. It's been over two months since my year-long orders to active duty ended. The military's finance system has yet to sign off on the thousands of dollars they owe me. So I'm forced to work when I'm barely capable of basic existence. On my days off, I'm too depressed to move. On my couch, I watch the days turn to darkness through the slits in the patio blinds; and when it's dark I'll finally rise to go get wasted.

I loved someone once. And she loved me. She wrote me daily in Iraq and drew me pictures. She scribbled hearts under her name and marked the envelopes with lipstick. We used to work at the same store. Now that I'm home again though, I've become an ugly man - filled with rage and sorrow, prone to excessive self-medication. I scared her away. I show up to a different Chili's now; it's too hard for me to face my failures...



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Friday, May 21, 2010

Coming Home: A Field Guide (Part 5: Advocacy for VA Healthcare Claims)

As was discussed in the last blog of this series, for many, getting governmental assistance for your VA Healthcare claim for PTSD (or any other injury) can be one bear of a task. The following is a brief overview of some of the different veteran’s groups who will provide advocacy for you and your goal of obtaining the proper medical care.

Not Alone
For more information about our eClinics, online counseling, and in-person treatment (offered in 11 states), visit our Programs page

The American Legion

From the website: “The American Legion was chartered and incorporated by Congress in 1919 as a patriotic veterans organization devoted to mutual helpfulness. It is the nation’s largest veteran’s service organization, committed to mentoring and sponsorship of youth programs in our communities, advocating patriotism and honor, promoting a strong national security, and continued devotion to our fellow service members and veterans.”

The American Legion maintains a dedicated staff of Department Service Officers all throughout the U.S. This job within the Legion exists for one reason only: the DSOs advocate for veterans and assist them with their claims and any other help that veterans need in transitioning home. You can find a DSO here.

I have some very good friends who work for the American Legion and I would (and have) personally recommended other veterans to them. They don’t just deal with healthcare; they help veterans find jobs or apply for educational benefits, among other things.

Veterans of Foreign Wars

The Veterans of Foreign Wars (who I briefly discussed in my last blog) despite their dwindling memberships and resources (the majority of their membership are older veterans, many of whom are passing away) still are a major national organization and they also have DSOs who will assist veterans in dealing with the VA’s bureaucracy. You can find access to those services here.

From the website: “The Veterans of Foreign Wars of the United States, with its Auxiliaries, includes 2.2 million members in approximately 8,100 Posts worldwide. Its mission is to "honor the dead by helping the living" through veterans' service, community service, national security and a strong national defense.”

The Wounded Warrior Project

An organization, which, as the name implies, seeks to assist wounded warriors, the Wounded Warrior Project has benefits counselors who are eager and willing to help out any veterans who need their assistance. You can contact them through their site, here

Your Elected Representatives

This might sound obvious to most, but military personnel are not trained to use this resource. Service members are ordered to respect whatever their chain of command is and not bypass it, but really, if no one in the VA is helping and no one is giving you the advocacy you need, why not contact your house representative or senator? The Veteran’s Affairs Department ultimately answers to them because congress signs off on their budget. No elected representative can deal with the bad press coming from refusing to help out a veteran during a time of war; and also, it would make them look good to take care of veterans, especially while the battles are still raging. Use this as a last resource, but they most definitely should help you out in starting your march towards earning your benefits.


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Wednesday, May 19, 2010

Special Report: The Divide Between Younger and Older Veterans

(This post is a small break from my field guide series to conduct a special report on the relationships between different generations of veterans. If you have any ideas for other special reports you would like to see, please send them my way.)

I’m sad to report that from my experiences and research, there seems to be a schism developing between the new generation of veterans and the older guys. As with any kind of social research, the reasons for this are not a hard science. However, I think I can understand why this may be occurring.

It upsets me that this may be the case, especially since I think that, in particular, the Vietnam guys deserve much of the praise and thanks for the sea change in how we as a nation treat our veterans today. When they returned from war, people spit on them and chastised their service; now, the words “veteran” or “just-returned-home” elicit clapping and handshakes and adulation. (Just last week, my friend, who is graduating from college ,received special recognition for being a student veteran – the audience of all civilians raucously cheered.)

The first hint I received of this possible divide occurred shortly after my second tour ended. I stayed on active duty and worked the 2004 Toys for Tots campaign. One such event took me to a Veterans of Foreign Wars Post in D.C. There were almost no veterans of my age who had become members. The post commander tried very hard to get me to join. I got the sense that he didn’t just want me -- it was that he needed me to become a member. Someone said, “If you new guys don’t join, our organization will just fade away.” But, this was still early in the wars, so it made sense to me that no younger vets had sought to join yet.

Well, I never wound up joining and all of my other veteran friends never did either. The Iraq and Afghanistan Veterans of America established dominance for having the most number of members from the new wars, and they set about landmark legislation that endeared them to hundreds of thousands of veterans of the Global War on Terror. Unfortunately, this only split the relationships between the young and old groups even more. The IAVA legislative upgrades to the GI Bill are specifically for the veterans who served on active duty after September 11, 2001. Upgrades in veteran’s benefits such as this one, no doubt anger some of the older guys – why shouldn’t they get these benefits too?

On the medical side of veteran’s benefits, the treatment is somewhat skewed to the younger guys also. Some veterans of the older conflicts still struggle with the VA bureaucracy. When a new veteran comes home however, they are considered “the highest priority” by the VA medical healthcare system, possibly building even more resentment.

The Veterans of Foreign Wars is the only major organization I could find that has camaraderie for bringing together “war-fighters of all generations” in their mission statement, yet, they are failing in that goal.

When researching this blog, I called dozens of VFW posts and other contacts within their organization, and (even though I told them I was young veteran myself, looking to explore the relationships between older vets and the new guys) they were mostly inhospitable. One man answered my introduction with this quickly delivered statement: “I don’t really know what we have to offer. The majority of the young guys are out beating their heads against the wall trying to get ahead everyday, and taking care of their families and s***, and they don’t have the time to hang out with a bunch of old f***ers.”  I add this experience to the time I was out at a VFW post in Pittsburgh for a wedding. I asked to use their bathroom while helping set up the reception hall and they seemed very upset to let me in the club area to urinate. “I’m a veteran too,” I said to the bartender and the couple guys sitting at the bar. No one cared.

At the larger level of nationwide organizations and legislative matters, there definitely seems to be a separation between the older vets and the younger vets developing. Maybe it’s nothing I’ve described here. Maybe it’s just that, despite the shared hardships of all veterans, the wars are different and too much time had passed between major wars to bring those people together. (I don’t mean to leave out here the Gulf War Vets, or the Grenada Vets, or the Lebanon or Somalia or any other small war veterans here, but the only wars on the same length and intensity of Vietnam since that war ended, are the Iraq and Afghanistan theaters of operations of today). Maybe it is just that young people today (including young veterans) have too much to do to put much participation into anything (especially, anything involving people their parent’s age). Maybe it’s just that, for my generation, the wars aren’t even over yet so there is no closure.

Despite what I’ve reported on, I am inspired by what I’ve experienced on the individual level and what you can see. In the famous photo of the “Marlboro Marine” fighting in Fallujah, Iraq, you can observe the portrait of a man who went on to develop PTSD. He’s back home now and still struggling, but some of his only friends are Vietnam veterans who, in an interview with Rolling Stone said, “They won’t let him turn out like they did.”

As the progress for the plight of veterans proceeds at a positive pace, it makes sense that those who are fighting today will become the focus. I think it would be great if my generation would be the last generation of veterans that our nation produces, but I’m not that big of dreamer. I know that will not be the case. Today, I am just happy to help out any veteran in any way I can. Someday, I hope my struggles will have become a lesson for some young kid returning his rifle to the armory and checking out for the civilian world. I will hope that his challenges are easier than mine. This is what each generation of warriors will always do for the next.


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Friday, May 14, 2010

Coming Home: A Field Guide (Part 4: Governmental Assistance for PTSD)

(My reference point for almost this entire blog is The Veteran’s PTSD Handbook by John D. Roche. If you would like more information, I would highly advise picking up that book or asking your local library to get it for you.)

Governmental assistance unfortunately, is a term that really only boils down to one organization and what that organization is willing to do for you: The Department of Veteran’s Affairs (VA). But, on the plus side, if it’s a service-related condition, their help is free. All veteran’s of the Global War on Terror (Afghanistan, Iraq, The Horn of Africa, Philippines and other places) by the way, are automatically, no expenses covered by the VA for five years after their term of active service ends. So, if you think that you might have PTSD, it would cost you nothing at all (other than the many headaches of one of the largest bureaucracies in the world) to get checked out.

Building off my previous blog post is some potentially good news for you: when accessing whether or not a former service member has PTSD, the VA uses the same standard I did, the Diagnostic and Statistic Manual of the American Psychological Association. If you were galvanized into looking into your mental health more based on what you read previously, you’re already on good footing for making your claim.

Let me mention specifically here, again, a point I brought up earlier. Plain and simple, the VA is a bureaucracy. That means they have a budget, a complex set of rules, long wait times for processing anything and they will be thorough in attempting to deny your claim. Like I said, no one necessarily planned for these protracted wars and this tremendous increase in the number of severely wounded – mentally and physically – combat veterans, and the VA has to cover its own ass by managing its numbers. It’s inhumane to think of, and maddening to know, but it is fact that many veterans will not get the treatment they deserve. This is the truth. Know your enemy and plan accordingly. But don’t give up.

PTSD is one hell of a mother to overcome, but if you can get them to agree to your treatment, the VA does have many different options for treating, like cognitive behavioral therapy, exposure therapy and others. Ideally any one of these would at very least help you on your path towards mental wellness. So why not try?  

According to the Veteran’s PTSD Handbook, here is a somewhat definitive list of the things you will need to consider or provide when processing a claim:

1.  The VA must follow all of its published rules. Follow to do so is an appealable action.

2. Each of the statutes, CFRs, and manuals are online by linking to the VA home page and search under Compensation and Pension Directives.

3. Your claim must have the following two elements to qualify for service-connected PTSD: evidence of a Stressor and medical evidence that validates it.

4. The U.S. Army Joint Environmental Support Group or the Commandant of the Marine Corps are sources of obtaining records to substantiate your claim.

5. Always have your congressional representative or senator obtain these records on your behalf.

6. If at all possible, have a non-VA health provider evaluate your condition before filing a formal claim.

7. If you’re claiming PTSD caused by combat with the enemy, support it with a list of medals and the corresponding citation that was given. Proving you were directly involved in combat will save you years of haggling with the VA.

8. PTSD-caused noncombat stressors is more difficult to pursue because you have the burden to prove the event did, in fact, occur and is responsible for your PTSD.

9. PTSD symptoms may first surface decades following the actual traumatic experience.

10. Don’t give up. It’s tough but you can appeal and get other people – both within the VA and elsewhere, like the American Legion (next post) -- to advocate on your behalf.

And here is the VA’s FAQ on PTSD and making claims.

The VA is not perfect, but it’s here for you. The organization might not be as compassionate as you might hope, but there are lots of former service members who work for the VA today who’ve made it their personal mission to help you through the system on the way to the assistance you need.

Godspeed, warrior.

Next post: Who will advocate for you if you need it?


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Wednesday, May 12, 2010

Coming Home: A Field Guide (Part 3: Understanding PTSD)

This might surprise some, but it’s only been in the last couple decades that anyone has gotten serious about studying PTSD. In fact, that very term, Post Traumatic Stress Disorder, wasn’t coined until the 1970s.

Early in America’s history, warriors that suffered from it were said to be “exhausted.” In World War I they were “shell-shocked,” and in Vietnam they wore “a thousand yard stare.” We know more about the condition today than ever, but, as mentioned previously, we also have more troops experiencing it a higher rates than ever. There’s no respite from the fighting in Iraq and Afghanistan. It’s a 24/7, completely organic arena of warfare. The troops aren’t safe in the chow hall. They aren’t safe when they sleep. And they’re certainly not safe when the step outside the wire.

The Diagnostic and Statistical Manual of the American Psychiatric Association (think of the DSM as the bible of psychology) maintains the following criteria for symptoms of PTSD:

1. Re-experiencing of the traumatic event.

2. Numbing of responsiveness to or reduced involvement in the external world.

3. Miscellaneous: memory impairment; difficulty concentrating; hyperalertness or an exaggerated startle response.

And, according to the same manual, there are three forms of PTSD:

1. Acute: the onset of symptoms within six months from the event and a duration of less than six months.

2. Chronic: a duration of symptoms for six months or more.

3. Delayed: the onset of symptoms at least six months after the trauma.

It should be noted here, that the whole caveat to diagnosing the condition is the operative word “Trauma.” What exactly constitutes trauma? And what counts as trauma? The Veteran’s Affairs Department would argue that a lot of a veteran’s experiences probably weren’t “traumatic,” but for the sake of the argument I’m just going to say that anyone who served overseas and armored themselves with bulletproof plates, helmets, first aid kits, rifles and grenades with the knowledge that they could die, should qualify to meet the criteria “traumatic.” Those realities are so far outside the normalcy of a typical American life, and therefore, by my definition, much more serious and potentially damaging to the psychology. Just the idea of knowing your mortality could cease at any second should count.

Here is another list of more specific symptoms of PTSD according to the DSM: “the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to that person’s integrity of self or others; recurrent distressing dreams of a traumatic event; intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event; efforts to avoid thoughts, feelings, or conversations associated with the trauma; difficulty falling or staying asleep; irritability or outbursts of anger.”

Does this sound like you? I think many of these symptoms can be found in almost any veteran. Are any of these debilitating your daily existence? How difficult is it for you after war to perform even the basic responsibilities of your life?

Search your soul and mind. Be honest. You might want to look into this yourself.

Next post: How to get governmental assistance if you know you are or think you are suffering from PTSD


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Thursday, May 6, 2010

Coming Home: A Field Guide (Part 2: A Personal Note on PTSD)

As I plan on focusing a lot of this section on PTSD and the other psychological conditions that can happen as a result of the reactions to war, I feel like I should speak about my own experiences with the disorder.

I never did have PTSD. Well, not that I know of anyway. And if I did, well, I was too stubborn or stupid to do anything about it. For sure, for a long time after coming home loud noises, crowded rooms and rooftops caused me anxiety (I wouldn’t even buckle up ever, just because I needed to feel like I could jump out of car quickly if I needed to). But those things have almost entirely stopped occurring. Maybe I’ve just gotten used to not thinking about war anymore (which probably sounds odd, since it is my platform as a writer to document combat and veteran’s struggles).  Well, I don’t think about my experiences anyway. Sometimes, they almost feel like a dream.

I have my moments though. A good friend of mine in my profile and biography class at Johns Hopkins brought in a piece of writing about a Marine who suffered terrible PTSD as a result of his experiences in mortuary affairs. When we talked about the paper and critiqued it as a group, my body became warm, and mind felt like it floated in boiling water. I got dizzy. I almost walked out the room. But I refused to succumb – and maybe this is not entirely true, but that’s how I know I don’t have PTSD (or if I did I’ve gotten over it): I can focus up and through self-will and desire move past any issues the trauma of war might possibly cause me.

Still, I feel the effects of PTSD almost everyday. Many of my friends who served are only fragments of the people they used to be. You can see it in their eyes and observe it in their actions. It’s like their pupils are trying to focus through a fog when they talk about their experiences: what it was like to hold in the brains of an injured comrade with a bandage; how they sometimes blow up, out of their sleep and begin punching the wall; how difficult it is just to get out of bed, let alone work some dead end job. It’s personal to me.

An old roommate of mine, one of my former best friends and also a Marine, came to live with me when he got out of the Corps. He’d get in fights for no reason at the bar, cry in his sleep and call out the name of his dead friends, and struggle to hold down any kind of work. He disappeared on me after just a couple weeks when rent was due. I hadn’t seen him in five years until last week, when I ran into him in a parking lot. I wanted to be mad, but I just couldn’t be. After about only thirty seconds into our reunion he said, “Dario, I’m still not doing well. I’m an alcoholic. I need some help.”

Well f***, what the hell am I supposed to do?

Yes, this is personal to me. I’ve seen it too many times, and though I’ve tried my best to let it go, I just can’t walk away from people like him. There are a lot of people like him. And as long as these wars continue, those numbers will continue to grow: like a parade of sorrow marching through the night among a society that refuses to awake.


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Monday, May 3, 2010

Coming Home: A Field Guide (Part 1)

(This is the first blog from my weeks-long series I will be posting as a sort of how to guide for the challenges of coming home. The series is divided up into three sections: governmental care for the veteran, how the community (friends, family and others) can help veterans, and suggestions for how veterans can focus their spirit and mind for overcoming their specific personal struggles)

To create a list of issues that veterans might face after returning from war would be impossible. Understanding even just a basic human psychology would be a difficult proposition, so one could imagine just how trivial of exercise it would be in elucidating the mind in reaction to the many traumas of war.

The Veteran’s Affairs’ own website, www.va.gov, tries to do this in their healthcare index, with what I would call a comical effect if it wasn’t such a serious issue. They only list three things under their index of health care under letter “C: Common Conditions for OEF and OIF Veterans.” And those are PTSD, depression and Military Sexual Trauma (MST). Despite my sardonic tone here, it is not my intention to excoriate the Veteran’s Affairs Administration here or anywhere else. I don’t think that their bureaucracy is intentionally evil -- I just don’t think that anyone was really prepared to deal with the numbers of injuries and issues that have resulted from these protracted wars. It’s a new situation that everyone has to try to adapt to – America has not been in two wars at once for this long, ever – and bureaucracies simply are not conducive to change. (Think here, for example, your state’s MVA, or dealing with the IRS or applying for social security benefits.)

Three main issues? Can that possibly be the case? Another organization, The Coalition for Iraq and Afghanistan Veterans – “a national non-partisan partnership of organizations committed to working with and on behalf of all military, veterans, families, survivors and providers to strengthen the existing system of care and support for all those affected by the wars in Iraq and Afghanistan” – address their thoughts on this issue on their website. “Invisible wounds” are what they consider to be some of the biggest challenges facing the current generation of war veterans: Traumatic Brain Injury (TBI); chronic pain; and again, depression and PTSD. According to their documentation, “because of improvements in evacuation techniques, body armor, and battlefield medicine, many who would have died can now be saved …many of these wounds are often accompanied by relentless physical pain, and may often be complicated by Post Traumatic Stress Disorder (PTSD) and Depression.”

Indeed, the government and the non-partisan organization seem to agree: in addition to the physical wounds, the unseen injuries of battle among the combat population group are multiplying as well.

According to www.icasualties.org , a website that catalogues the human toll of the Global War on Terror, 37,277 U.S. service members have been wounded so far (a number that will rise tomorrow) and it is likely that many of them will have negative psychological reactions to their injuries. And to mix those numbers with the data maintained by The Department of Veteran’s Affairs, National Center for PTSD , which state a probable PTSD prevalence of 14% among the 1.8 million veterans of the contemporary wars, or 252,000 veterans, you can imagine the scope of these psychological problems.

Because of the realities and challenges in even just interpreting the basic plight of our nations war veterans, I will focus much of my reporting on PTSD and the other mental conditions of combat stress; but I will also highlight, the lesser known “invisible wounds” of war, like Military Sexual Trauma, which affects veterans too.

I must admit, now that I’ve begun my research for this undertaking, I can see how the general malaise and confusion about how to approach the desire and intent of helping veterans keeps getting exacerbated by everyone it seems. Everyone wants to help. No one, it appears, quite knows how. I hope to be accurate-yet-brief in the following sections of my field guide. I hope to be compassionate and wise in helping lead other veterans (and those that care about them) in a positive direction with what I uncover.

As always feel free to offer up your own unique experiences. Help my research become much better with your true stories too.


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