Slipping through the cracks

VA Watchdog

Slipping through the cracks

By BRANTLEY HARGROVE,
News-Record Writer



The yellow ribbons came down and the roses wilted. The rah-rah ebbed and the flags held in the hands of a row of other proud veterans who fought other wars stopped fluttering. The “welcome home, soldier” celebrations ended. There were no more slaps on the back.

Life for everyone else went back to normal. It followed the normal rhythms of the everyday, the mundane, even the complacent or ambivalent, half a world away from the Middle East.

But the euphoria of making it home alive dissipated for Scott Carey after he returned from Iraq in the spring of 2003.

While everyone else went about the day-to-day, he tried to figure out what exactly that meant for him. The former Marine Corps combat engineer caught a bullet through both elbows and his left hip in Iraq. While he was waiting to be evacuated, a mortar detonated nearby and shrapnel pierced his back.

Life as he knew it ended before that day, though. The things he’d seen came home, too. He looked death in the face in the form of improvised explosive devices he routinely cleared. That hyper-alert awareness that evolved inside him — an adaptation in combat — became a liability in civilian life.

How does one shift from fifth gear to first, where such behavior is seen as paranoia, not caution?

It changed him, body and mind. The skinny private first class became more lineman than lean soldier in the years after his return. Wearing a camouflage UFC T-shirt and a camouflage cap covering close-cropped hair, Carey has eyes that are both melancholy and direct at times.

For six months he was a VA inpatient on a heavy regimen of anti-depressants — about 1,300 milligrams of Seroquel for his anxiety and depression, and Trazadone for sleep. He felt like he was losing sight of himself in the drugs.

After his medical discharge at the beginning of 2005, Carey didn’t want to be thought of as a pill-popper, a mental health stigma the VA and the military are trying to turn on its head. The rationale among soldiers is if you make it out alive, you can take care of yourself afterward. You should rely on your combat buddies, not some head shrinker who wasn’t there, who doesn’t understand. But his buddies scattered to the four winds to reclaim their own lives. There was no one around who understood.

He wasn’t a part of that family that gave him place and purpose. It’s a common theme among vets. Many still in the service will keep it together, vets say. That military structure girds their traumatized minds. When it’s gone, they crumble.

“When I got medically discharged, it was like ... they took me away from something I was good at.”

So he treated himself with that socially acceptable drug of choice. One that can be laughed off or shrugged off as a young man’s folly. Carey began drinking heavily. He hung out in bars, systematically diluting his memories with each drink. When a fight would break out, he’d mind his own business. But when the fight came to him and he got bumped accidentally, he’d fly into a black rage. He’d lose control and several bouncers would be pulling him off the guy. He went to the local VA clinic only once during this time. The battlefield mindset proved hard to shed.

“If you went to a shrink, it made you think you weren’t trusted anymore,” he said. “That weighs heavily on somebody out on the front line.”

Carey found other outlets for his anger.

“I’d be David going up to Goliath and taunting him,” he said.

His self-esteem suffered. Because his knees were worn out, his elbows were shot, his joints were arthritic and his back was nearly out of commission, he gained weight. He isolated himself from his family. They still don’t know the whole story, he says. He wonders if his mother could love him, knowing where he’s been and what he’s done.

He racked up three DUIs — a felony — with the last one in Spearfish, S.D. Because of his situation, he got off with three years of supervised probation.

Carey slipped through the cracks.

Because Carey was discharged, the Marines weren’t checking in on him and no one from the VA sought him out. He’s since been diagnosed with post-traumatic stress disorder. It’s a condition that is disconcertingly prevalent, particularly among those who are injured, according to the American Journal of Psychiatry.

When soldiers return from Iraq, they may go through several post-deployment health assessments, but that system is fundamentally flawed. It’s the old Revolutionary War problem. When Gen. Washington asked his soldiers if they would stay or go, you can imagine what many of the answers were. It’s the same now.

“How are you doing,” a counselor might ask? “Doin’ great,” a soldier might reply, whether that’s true or not. They say this knowing that if they admit they’re having problems, it could put them on “med hold” and delay the one thing that has sustained them through dark times — family and home.

Many military men and women will return home from Iraq or Afghanistan with their own demons. More than 15 percent of the 1.5 million men and women deployed to these countries since 2001 will return with mental problems, according to the New England Journal of Medicine. Perhaps 23 percent to 40 percent actually will seek care.

Traumatic brain injury, dubbed the signature injury of this war due to the insurgents’ fondness for IEDs, is thought to increase a soldier’s likelihood for developing PTSD. Of those who report losing consciousness due to an IED blast or some other violent injury, 43.9 percent of them will meet the criteria for PTSD, according to the New England Journal of Medicine.

Of the 2,000 veterans of this war living in Wyoming, only 846 of them are enrolled in the VA.

The resources are there. The connection isn’t. A bill sponsored by the Wyoming Select Committee on Mental Health and Substance Abuse Services will bridge the gap. In rural Wyoming, where vets may be far from the nearest VA clinic or hospital, HEA49 will reimburse them for travel. Child care and some other expenses will be covered. For the men and women who are too busy trying to get their lives back on track, it provides extra funding for two social workers whose purpose is to seek them out and get them help.

Capt. Leon Chamberlain, a mental health officer for the National Guard, is already traveling across the northern reaches of Wyoming. He and his counterpart in the southern and more populous half of the state have located 228 veterans since December. Nearly 40 percent of them needed some sort of mental health referral.

Many of them are in the Guard or the Reserve, for whom there are registries. But for men and women who were on active duty, it can be like finding a needle in a haystack. The estimate of 2,000 Iraq/Afghanistan veterans in Wyoming is conservative at best. It’s no secret there is a diverse mix streaming into the state from all corners of the nation for the plentiful jobs, particularly in the energy industry. The stigma of mental health issues will keep many away.

“Most of these people still want to stay in the Guard or the Reserve,” Chamberlain said. “They’re concerned that if they get diagnosed with a mental health issue, they can’t stay in the military, or they’ll get their security clearance yanked or lose a promotion.

“When you look at these stigmas it’s remarkable that we get any of these people to come at all.”

As the numbers indicate, many don’t.

“George,” a soldier recently returned from Iraq, calls the health assessments a “horse and pony show.” George, who spoke on condition of anonymity because he is still on active duty in the National Guard, said the military needs to check up on soldiers after deployment on a state and individual level. And according to policy, they do. They’re assessed before they leave the theater. They’re assessed when they return, then after 60 days, then 90 days, according to Maj. Shane Croft, state mobilization officer. They’re called post-deployment health reassessments.

This came as a surprise to George. An evaluation three months later was something he recommended, not something he actually experienced. He only completed a post-deployment health assessment, and that was online.

“The Wyoming National Guard has done absolutely nothing,” he said.

George has been diagnosed with PTSD since his return. He isn’t registered with the VA. The one time he did visit with a counselor, he did so with a private practice, and discreetly. He arranged to have it paid for by Military OneSource, a sort of military insurance, but a mistake occurred during billing and he ended up eating it. It’s a problem those familiar with the process concede is a product of the bureaucracy of any insurance claim, but recently returned military personnel usually lack the time and the patience.

“Am I on some medication? Yeah,” he said. “Is it documented anywhere in my medical records? No.”

Getting help on the sly may prove troublesome for vets with private insurance. Some insurance providers, including Blue Cross Blue Shield of Wyoming, won’t pay for problems that are “the result of disease or injuries due to war, civil war, insurrection, rebellion, or revolution...” according to an October 2007 study by the Wyoming Department of Health Mental Health Substance Abuse Services Division.

Reserve and National Guard troops seem to be at a disadvantage. They don’t get the kind of decompression time that the rest of the military gets. A man in the Marines, for example, could have weeks or months on base after a deployment. It gives him time to settle down and adjust. In the National Guard or Reserve, you can be in Baghdad, Iraq, on Monday and back at work in Basin, Wyo., on Friday.

And they also don’t have the benefits. Where Carey will be entitled to VA care for the rest of his life, George will have five years when he retires, recently increased from two, according to Larry Barttelbort, retired colonel and executive director of the Wyoming Veterans Commission.

Our understanding of what combat does to the human mind, and even the nomenclature itself, has evolved over the years. From shell shock to combat fatigue to PTSD.

It was 30 years before Lee Alley, president of the Wyoming Veterans Commission and a veritable Vietnam War hero, heard the acronym that defined the last several decades of his life. Alley led an Army reconnaissance unit in the Mekong Delta in 1967-68. He returned to San Francisco, then the University of Wyoming when the anti-war movement was in full swing. He heard the name “baby-killer” and began to question what he had done over there. He put away his uniform and his medals and separated himself from his service.

He isolated himself and his experience from family, an action as relevant today as it was 30 years ago despite the differences in climate and era.

“How do I sit down with my wife and mother and look at the blood on my hands,” Alley said. “I did some things and was in some situations I don’t want my family to know about.”

Though the public is more supportive of the soldiers, public opinion of the war has gone south in recent years. Regardless of whether the war is right or wrong, Carey doesn’t want his sacrifice and those of his comrades to have been in vain.

He, Carey and George are proof that there is hope for these men and women if they get help.

George still avoids loud noises and crowds whenever possible. The flashbacks are more infrequent. But life is holding together. He says if it wasn’t for his wife and his older age, he would have almost certainly become an alcoholic.

And Carey is going to school now. He started his first semester at Gillette College, studying secondary education and photography. He wants to teach history. He says his experience gives him something to say about current events.

He goes to counseling at the VA regularly. But he still goes to school early so he can get the seat where his back is against the wall. Battle-ingrained instincts still compel him to cover his back and watch the exits.

There are many others like him who are dealing with it on their own. They’re throwing themselves into work so they don’t think about it as much. They’re getting divorced and losing sleep. Some even commit suicide.

For them, the hardest part is just asking for help.

HOW TO FIND HELP

- If you or someone you know is having a hard time dealing with combat experiences, help is out there.

- Leon Chamberlain is the advocate for vets in the northern part of Wyoming, and he can find you help. He can be reached at (307) 359-2430.

- The number for the VA clinic in Gillette is 685-0676.

- The number for the VA Medical Center in Sheridan is (307) 672-3473.

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posted by Larry Scott
Founder and Editor
VA Watchdog dot Org

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