Monday, November 2, 2009

A soldier's injuries cripple body and mind

A soldier's injuries cripple body and mind

By Jia-Rui Chong

November 2, 2009

Peter Sinclair rummaged through the closet and found what he was looking for.

His roommate, drawn to the commotion, saw Pete raise a gun to his head. Daniel Jennings managed to yank it away. He locked up all of Pete's guns.

"You can't stop me," Pete said.

Jennings and Pete had served together in Iraq from 2004 to 2005, but this was a year later and Pete was struggling.

Daniel encouraged him to lie down and left to get help once Pete seemed calmer.

"You're a good man," Pete said.

But he could not shake the images of war: dismembered children, mutilated bodies. Alone in his house, Pete called his parents. His sister Jennifer answered.

All he could do was scream, "Goodbye, goodbye, goodbye!"

He found a 7-inch knife and plunged it into his wrist.

As the blood spread across the floor, Daniel returned with an Army friend. They took the knife away and stopped the bleeding. Paramedics and police officers soon swarmed the house in Garden Grove.

As an officer in Iraq, Pete had won praise and promotions. His commander had called him "one of the finest, if not the finest young officer in the 298th Corps Support Battalion."

But Pete had come back from war with a broken body, suffering from back injuries and painful memories. Doctors, nurses, psychologists and physical therapists treated him, but few were able to help.

The wars in Iraq and Afghanistan are challenging, if not taxing, veterans medical services. So far, nearly 36,000 troops have been wounded, many returning with injuries that in previous conflicts would have killed them. Some, like Pete, endure complications from physical and emotional trauma that neither surgery nor therapy nor medication can easily resolve.

Pete was 20 when he enlisted in the Army. He thought the military would give him focus.

He served in the Persian Gulf War, and after he returned home he joined the Los Angeles Police Department and the Army Reserves. In December 2003, he was called up for another tour in Iraq. A first lieutenant, he was assigned to an ordnance company at Ft. Buchanan in Puerto Rico.

Jen wondered whether her brother could physically handle the deployment. When they were growing up in South Pasadena, Pete, who was seven years older, had been her protector. That was changing now.

He had had two operations on his lower back to repair injuries stemming from a parachute jump during Army training and a bike accident while on police patrol. Jen thought combat would make matters worse. A lawyer, she started to research medical waivers. He asked her to stop.

"I'm an officer," he told her. "How could I have been in the reserves all these years and then they need me and not go?"

Pete's unit was quickly caught up in insurgent attacks. His base at Al Taqaddum, about 45 miles west of Baghdad, was shelled as often as 56 times an hour, according to a sergeant stationed there. In Balad, north of the capital, a rocket explosion threw Pete, who was asleep, from his cot onto the floor.

"I'm happy just to be alive today," he wrote home.

During a mortar attack that same month, he dove onto the ground, landing hard on his back and shoulder.

His injuries were exacerbated by the weight of his body armor and the constant jostling in Humvees. Sometimes he experienced spasms in his lower back so severe he could not walk. Sometimes it hurt so bad he had trouble speaking.

Painkillers, muscle relaxers, ibuprofen and Valium offered relief, but Pete struggled with the realities of war. He saw a Marine torn apart by a rocket. He came across mutilated bodies hanging from a bridge. Then there was a ride through Baghdad in the fall of 2004. Soldiers had been handing out candy to children to celebrate the opening of a sewage treatment plant when a bomb went off. More than 40 people, mostly children, died; dismembered bodies littered the street. Pete's convoy rolled through the aftermath.

Two weeks later, he e-mailed his sister about his nightmares: standing in city streets surrounded by body parts and blood.

"I am pretty numb and withdrawn upstairs," he wrote.

When Jen at one point encouraged him to explore the possibility of a medical leave, he felt compelled to stay. There were guys missing arms and legs, and he was whole. "If I can get up and go on, I should," he told Jen over the phone.

In February 2005, he was promoted to captain. A few weeks later, his deployment was over. He was sent back to his unit at Ft. Buchanan. On his health assessment form, he wrote in small, shaky handwriting: "I saw a lot of dead dismembered bodies and I have nightmares often. . . . My back is in pain EVERY day."

A psychiatric evaluation noted his risk for post-traumatic stress disorder.

He called Jen in New York. She was alarmed by his weak voice, and when he didn't call the next day, she jumped on a flight to San Juan. When she got to his apartment, she barely recognized him. He was stooped and shuffled slowly.

"Oh, thank God you're here," he said.

More than a dozen medications were spread out on a table, and Pete did not know what they were for or how much he had taken.

The next day she took him for a scheduled MRI. Before Jen and Pete received the results of the test, he was ordered to begin physical therapy on the base.

"Don't do it, Peter," she said. "You don't know the stability of your spine."

During the first session, he blacked out from the pain.

Jen spent days pleading with officials at Ft. Buchanan to transfer Pete to the states, closer to his family. Eventually he was assigned to an injured soldiers unit in Sacramento, and within a week, he was cleared to return to Southern California. He found a roommate -- Jennings, who had served with him in Iraq -- to share his home.

Navigating the military medical system was challenging, and Pete's mother, Barbara, a retired professor of nursing, became his advocate when Jen had to return to New York. When the Army recommended operating on Pete's back, the family contacted a surgeon who they believed was more skilled. On May 2, 2005, the chief of orthopedic spine surgery at UCLA repaired the degenerating discs in Pete's back.

As Pete recovered from surgery, his memories from Iraq became more pronounced. He was depressed and scared. He had trouble finding psychologists in the military health insurance network who would treat him. One said that he scared her.

Pete burned through his anxiety medication, doing what he was told: taking a pill whenever he had a panic attack. A prescription that was to last a month needed refilling in 10 days. He repeatedly called Tricare, the administrator of the military insurance program, for help with appointments and prescriptions, and he grew increasingly frustrated with the system.

In February 2006, he went to see a psychiatrist at the VA hospital in Long Beach, and when he got home that day, he refused to come out of his room. He would not return calls. The next day he threatened to kill himself with the gun. Then he cut his wrist with the knife.

The Sinclairs had found an inpatient psychiatric facility near their home. Pete checked into Aurora Las Encinas Hospital in Pasadena, and his mood began to stabilize. He was eventually transferred to a VA residential program in Palo Alto that specializes in the treatment of PTSD.

After nine weeks, the Army moved him to Ft. Lewis, outside Tacoma, Wash., for a review of his status. Jen helped him get settled. Time slowed to a crawl. For nearly a year, Pete lived in motel-like rooms on the base. At first, he saw mental health specialists regularly, but the visits tapered off.

Though doctors in Palo Alto had cut down on his medications, he was back on a regimen of painkillers. He was quickly overwhelmed and on one occasion became so overmedicated that he had to be hospitalized.

When one of the commanders of his old unit, Maj. Gen. Paul E. Mock, visited Pete at Ft. Lewis, he found a disheartened man. Medications were spread over a credenza, and Mock wondered whether the Army was making the soldier well or just masking his problems. Who's taking care of Pete? he asked himself.

As Pete's review drew near, Jen assembled medical records and interviewed Army buddies. Her goal was to persuade the Army that Pete suffered from serious psychological trauma associated with his combat service and deserved a retirement benefit generous enough to live on.

The family hired Gary Myers, a private attorney, to help.

On March 14, 2007, Pete put on his desert fatigues and sat down before three members of the Physical Evaluation Board. Their responsibility was to determine whether he could return to duty, and if not, whether his medical problems were related to his time in Iraq and how he should be compensated.

Jen and Barbara settled onto a couch. Myers asked Pete to tell his story. He spoke in a labored cadence and rambled at times. He acknowledged that he should have asked to leave Iraq earlier.

"I knew I was messed up," Pete said. "But I've always been kind of stupid when it comes to ego and pride so I just said, 'Ah, you know' and shook it off."

Myers played recorded testimony from an Army psychiatrist who had treated Pete for about a month and who confirmed that Pete's condition left him "severely impaired."

As for the suicide attempt, Pete explained how hopeless he had felt. "I was rocked with an intense sense of foreboding. . . . I just didn't feel like I was getting any help at all, again. I was being let down."

When the board asked Pete for his final comments, he said he was not looking for any "extra goody."

"I was a happy man," he said. "I had a good, solid career. I was moving up. Everything was great. And now, you know, I can't even pick up a book and read it and I'm scared. I'm afraid to go outside."

The panel deliberated for about an hour and came back with a finding of severe PTSD, which previous Army hearings had refused to acknowledge. Pete was given a disability rating of 60% that helped establish his retirement pay. It was less than what the family thought he deserved.

Pete returned to Garden Grove. He worked on his house and played classical music on his grand piano.

Toward the end of 2007, he booked a trip to Australia and Indonesia, where he sent his mother a picture of himself grinning in front of a temple with a monkey on his head.

At home, he began to worry that he was addicted to the drugs the doctors had prescribed for back pain. He abruptly stopped taking morphine, oxycodone and Valium, and when he went into withdrawal, his mother persuaded him to check in to the VA hospital in Long Beach. He left after four days with a prescription for a low dosage of morphine. About a week later, his psychiatrist recommended that he resume taking Valium. By early May, Pete told his family that he was no longer taking any painkillers.

For a time he appeared to be feeling better. He had fallen in love; her name was Tracy Rougvie, a second-grade teacher. He talked about marriage. He even hinted to his mother about grandchildren.

On the night of June 11, 2008, after relaxing with Tracy in his Jacuzzi with a glass of wine, Pete went to bed and never woke up. He was 40. Toxicology tests determined the cause of death to be "acute morphine intoxication," the manner of death accidental.

Jen was furious. She thought he was off morphine. She discovered that weeks before his death, he had slipped in the shower and wrenched his back again.

The pain became unmanageable. A VA doctor on June 9 had prescribed 30 milligrams of morphine to be taken three times a day, and if the pain wasn't relieved, the dosage could be increased to 60 milligrams. Pete was also given a prescription for 30 milligrams of codeine to be taken as needed.

Jen and Barbara wondered why Pete hadn't told them, but he was expert at hiding his pain.

Barbara remembered the lunch she had with her son on Mother's Day and the family dinner when he had brought Tracy. He'd seemed jovial, more like his old self.

Tracy played back the night he died. His heart had been racing when they went to sleep, and when she asked him about it he said he was fine.

After consulting a toxicologist and medical textbooks, Jen came to the conclusion that the VA had acted irresponsibly in prescribing the latest dosage of morphine. She believed that because Pete had been off the drug for at least a month, he would be especially sensitive to its effect and should have received a lower dosage. She also knew from medical records that Pete was frequently confused over how much medication he was supposed to take.

"You might as well have given him a gun," she said.

In Barbara's mind, the Army and the VA at various stages of Pete's care miscalculated the severity of his condition. "The system is not set up to handle the problems," she said.

The doctors in charge of Pete's care said that the prescribed dosage of morphine was not particularly high.

"We did the best we could," said psychologist Richard Hanson, who cared for Pete at the VA hospital in Long Beach. "We prescribed the medications in consultation with the patient that seemed most appropriate at the time."

On one of the hottest days of last year, more than 100 mourners crammed the pews at St. James' Episcopal Church in South Pasadena. Many wore the midnight-blue uniforms of the LAPD. Men in Army green inspected the programs.

There on the cover was Peter Courtney Sinclair, dressed in his police uniform, beaming. His family wanted to remember the better days before he was sent to war again.

A friend told stories about Pete's charm and sense of adventure. His uncle praised his dedication to his country.

"Dear God, do not let Peter's sacrifice of his life go unnoticed," said Bishop J. Jon Bruno as he led the mourners in prayer. "Care for all people who are returning from military action with such great love that they have all that they need to become whole again."

Afterward, friends and family filed outside to a courtyard. Barbara cried when an Army official handed her a folded American flag. Jen doubled over in tears when an LAPD officer gave her a wooden box with an image of Pete's badge etched on the glass cover.

Pete's ashes were sealed in the church's columbarium, under the shade of a maple tree.
Copyright © 2009, The Los Angeles Times


I suffer from PTSD and have severe back pain and have since May 2000, the VA found me totally disabled in October 2002 due to cardiac problems and 100% PTSD, they did not rate my cardiac problems until June 2009 after they were forced to by an award granted by the Board of Veteran Appeals (BVA) the hearing was held 4 Feb 2009, the Judge's decision was issued on 7 April and the Regional office issued the award percentages on June 4, 2009, more than 6 1/2 years later.

I imagine the Captain should have been rated 100% by the VA for PTSD and 60% for his DDD, my back is inoperable and my local VAMC gives me percocet to control the pain, others I have hear use either methacone or morphine patches, I guess I should be grateful for the percocets.

Yes, I have tried killing myself three times in the past and I couldn't even do that right, I have suffered a stroke and 7 heart attacks and a failed triple bypass, I guess the lord isn't ready for me and the other guy doesn't want me. I must have something left unfinished to do, I have spent since 2004 doing veterans advocacy, it is one thing I can do from this power chair, I may not be the same man I was when I entered the Army in 1973, but I am still a man and I will do what I can, I hope my speaking out on PTSD encourages even one man or woman to speak up and ask for help from the VA, a Vet Center or the National Center for PTSD e mail or call If you are in crisis, please call 911, go to your nearest Emergency Room, or call 1-800-273-TALK (1-800-273-8255)

Suicide prevention website

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