Military updating tactics on trauma

Military updating tactics on trauma

By Kate Wiltrout
The Virginian-Pilot
© November 5, 2009
After more than eight years of war, most Americans know that PTSD stands for post-traumatic stress disorder.

Now, say military and medical experts, as well as warriors whose minds were scarred by combat, it's time to learn some new acronyms.

The second day of a two-day conference on building resilient warriors wrapped up Wednesday in Norfolk with a suggestion that the "D" be dropped from PTSD. It's normal to be stressed out by trauma, one combat veteran explained, so why label it a disorder?

His suggestion was endorsed by one of the highest-ranking men in the military - Adm. Mike Mullen, chairman of the Joint Chiefs of Staff.

Addressing the conference by speakerphone, Mullen told the 400 attendees that he now uses the term "combat stress" instead of PTSD. He changed his vocabulary, he said, after a service member told him the word "disorder" creates a stigma for sufferers - even as the military is encouraging troubled troops to ask for help.

The conference was sponsored by the Defense Centers of Excellence For Psychological Health & Traumatic Brain Injury. A Department of Defense entity with an unwieldy name, the organization aims to be a one-stop shop for professionals and military personnel battling back from brain injuries and combat trauma.

Headed by Army Brig. Gen. Loree Sutton, it was born out of the controversy surrounding Walter Reed Army Medical Center in 2007. Early that year, The Washington Post revealed that the hospital was unprepared to deal with the long-term needs of combat-wounded troops.

The controversy generated attention from the top brass - and more than $1 billion in funding. Sutton, a psychiatrist with 28 years in uniform, said the Walter Reed scandal was both a tragedy and a blessing in disguise.

"We were laboring under a civilian HMO business model that did not fit the needs of our warriors and their families," she said to thunderous applause, adding that the news reports reignited a "fire in the belly" to solve the problem.

Now, Sutton said, the military has extensive resources and is creating a range of programs to address the long-term effects of concussive injuries common in combat, as well as lingering psychological effects.

She's less concerned, initially, about what the condition is called - is it traumatic stress injury or combat stress trauma?

"From the standpoint of a troop and his or her loved ones," she said, "they just want to get better."

Sutton said her organization is helping to establish standards of care for injuries across the military so that, say, an Army private or a Navy SEAL get the same treatment if they're on foot within 50 meters of a blast.

That treatment might be as simple as a day of rest, she said, to let the brain recover from the concussive force.

The standards must rest on science-based evidence, she said - not a misguided idea of strength.

"That suck-it-up mentality is no longer working," she said.

Senior leaders such as Mullen fully support the idea that a warrior's mind, body and spirit must be healthy and aligned, Sutton said. Young troops who grew up watching TV shows such as "Frasier" and "The Sopranos" seem to accept the idea that getting counseling doesn't mean someone is weak. It's the military's "middle managers" who need to embrace it, she said.

Navy SEALs, Sutton said, have a great phrase for paying attention to psychological health: They call it getting a "neck-up check up."

Kate Wiltrout, (757) 446-2629, kate.wiltrout@pilotonline.com

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I am glad the Chairman of the Joint Chiefs understands that the stress caused by traumatic events is not a "disorder" rather it is a normal reaction to a unnatural event, the scenes of combat, explosions, the fear of death, etc. The stigmatism to soldiers that raise their hand and say I need help has been a career ender for decades rather than a simple trip to a psychiatrist, the soldiers get labeled as unstable and can't be trusted, since they just can't "suck it up" "man up" or whatever else idiotic terms people higher in the chain of command determine to be appropriate.

Many soldiers have always felt the restraint of asking for help knowing that doing so, would stop promotions, get them harassed by the chain of command, instead they turned to self medicating either with alcohol or drugs to treat themselves. One only has to go back to the Vietnam war where many soldiers were thrown out on Personality Disorders after returning from Vietnam, which denied them veterans benefits and even treatment at VA Medical centers since they recieved a bad discharge, yet the Army primarily returned to this same tactic at Fort Carson as reported by NPR in the past few years.

I feel that if thetroops can get treatment earlier in their lives they may not end up totally disabled by the symptoms of Post Traumatic Stress, they may always have some symptoms but it might not prevent them from being able to keep a family together, hold a job or a professional position, etc, like many WW2 Korean and Vietnam veterans have been largely ignored by society over they years.

Like Colin Powell stated, "you broke it, you own it" this should also apply to the men and women that serve this nation in uniform. It is already supposed to according to the "PROMISE" made when our men and women enlist in the military, if you are killed or hurt by your service the nation will care for you and your spuse and children, it doesn't day we will kick them to the curb and ignore them.

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House chairman calls delayed payment to veterans 'an insult'

House chairman calls delayed payment to veterans 'an insult'

By Michael O'Brien - 11/11/09 02:40 PM ET
Delays in disability benefit payments are "an insult" to military veterans, the chairman of the House Veterans Affairs Committee said Wednesday.

Committee Chairman Bob Filner (D-Calif.) urged the federal government to cut through red tape in deploying benefits.

"People have died before they've gotten their benefits or they've lost their houses because they didn't have a check coming in," Filner said during an interview on Federal News Radio. "What I would like to do is just cut through all [the] red tape."

The chairman said that the government's slowness to respond to claims from disabled veterans is "an insult."

Filner called on the Department of Veterans Affairs to process claims as quickly as the IRS handles tax returns, guaranteeing a three-week turnaround in benefits payments.

"Why don't we do the same thing with our veterans?" Filner asked. "We send out a check as soon as we get their application, and audit it whenever we ... as much time as we have to take. But at least recognize that the soldiers that deserve compensation, we ought to get it to them quickly."

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Yes the sytem they use now can leave veterans waiting years for their first payment, which leads to divorce, homes lost and vehicles repossesed there is no rational basis for this, the VA now treats all claims as being fraudulent and making the veterans prove they are entitled to the benefits and "benefit of the doubt" the VA applies it, they doubt the veteran ever tells them the truth, and make the veterans wait for a BVA Judge to decide their claim, my claim was filed in Nov 2002, the BVA Judge awarded my claim on April 7, 2009. The local VARO sent the award letter with the percentages and back pay on 4 June 2009, simply shocking to say the least.

My BVA claims award on April 7, 2009, the hearing was held on Feb 4, 2009

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A painful lesson in the health risks of modern warfare

A painful lesson in the health risks of modern warfare

By David K. Winnett Jr.

Posted: 11/09/2009 08:46:54 PM PST





By David K. Winnett Jr.

The tools of modern warfare are vastly more effective now than in previous wars. They are more precise and infinitely more lethal, and some pose great risk to those who employ them. Case in point is depleted uranium - or DU.

DU is a byproduct of enriched uranium, a highly radioactive substance. Since 1991, the United States has used DU in the manufacture of protective armor plating for tanks and armored combat vehicles, as well as heavy armor-piercing ammunition. We not only shield our combat vehicles with DU, we also fire DU-coated ammunition at enemy vehicles, with quite deadly effect.

Since the use of DU began, a heated debate has continued over the long-term health risks. Upon impact, DU is vaporized. The resulting microparticulate is distributed throughout very large areas of the battlefield. If ingested, there is a risk of kidney, liver, heart or brain damage. The Department of Defense's own studies have demonstrated genetic, reproductive and neurological damage in rodents exposed to DU. If ingested, DU can remain in the human body for a lifetime, wreaking havoc on internal organs and the central nervous system.

DU was first used in combat during the 1991 Persian Gulf War. Now, thousands of veterans of that war suffer from permanent, life-altering chronic illnesses. Is this mere coincidence? After the war, Veterans Affairs saw a huge increase in disability claims submitted by Gulf War veterans. Yet no one was

able to identify a cause. Many veterans were deemed to be experiencing psychosomatic illness, the VA blaming the complaints on post-traumatic stress disorder. Most were told, "It's all in your head."

For 15 years I have lived with intermittent bouts of blurry vision, sore muscles often accompanied by uncontrolled twitching of major muscle groups, hand tremors and frequent bouts of extremely debilitating fatigue. I have been diagnosed with fibromyalgia, neuro-myalgias and chronic fatigue. I have an unexplained scar on my right kidney and an enlarged liver, yet I am not overweight, have never been a smoker and my alcohol intake has always been moderate.

DU is not the only suspected cause of Gulf War illnesses. Other possibilities include exposures to low levels of sarin gas accidentally released into the atmosphere during the demolition of seized Iraqi ordnance, multiple vaccinations, non-FDA approved anti-nerve agent pills, smoke from burning oil wells and heavy use of pesticides. Regardless of the cause, let's use these experiences to reduce the chances of future battlefield exposures, and to work toward improving the quality of life for those permanently afflicted by battlefield hazards.

In 1994, a law authorized the VA to grant "presumption of service connection" for certain symptoms associated with the Gulf War. Qualifying symptoms for compensation include: fatigue, rashes, muscle pain, joint pain, neurological symptoms, respiratory symptoms, sleep disturbances, gastrointestinal symptoms and cardiovascular symptoms. When these symptoms cannot be attributed to a known illness, they are to be considered "undiagnosed illnesses," and presumed to be the result of exposures in the war.

The law begins, "The Secretary may pay compensation ." The problem lies in the word "may." VA centers across the country are permitted to interpret the law as they see fit. They "may" award compensation, or they may not. The majority of Gulf War-related disability claims are denied. Approval rates also differ from one VA region to another.

Fewer than 4,000 of the 670,000 Americans who served in the Gulf War have been awarded the disability rating prescribed in the law. Yet the VA's own "Research Advisory Committee on Gulf War Illnesses" reported last year that one in four veterans are sick. Using VA's numbers, that's 167,500 sick veterans. Tens of thousands have been rated with post-traumatic stress disorder, yet less than 4,000 veterans, including myself, have been awarded the "undiagnosed" rating.

The ground war lasted 100 hours. The number of post-traumatic stress ratings far exceeds what would be expected for such short duration. Instead of being referred to neurology or the infectious diseases department in the VA, these veterans have been directed to psychiatry. Many more have given up hope that they will ever obtain assistance from the government that sent them to war. Some have taken their own lives.

Far too many have been unjustly denied medical and disability benefits. For that reason alone, the law should be amended. The word "may" should be changed to "shall." Those who served in the Persian Gulf War are heroes, one and all. This disenfranchisement of so many courageous American veterans must end immediately.

Regardless of the cause of Gulf War illnesses, Americans should demand that their elected representatives continue to provide annual funding for Gulf War illness research through the Congressionally Directed Medical Research Programs, and to hold the secretary of Veterans Affairs accountable for fairly and consistently administering disability claims submitted by Persian Gulf War veterans.

A free nation has a moral obligation to ensure that its injured or ill veterans are made whole again to the fullest extent possible through a compassionate system of disability compensation and proper medical treatment, no matter the cost.

David K. Winnett Jr. is a retired Marine Corps captain and the chairman of funding development for the National Gulf War Resource Center (www.NGWRC.org). He lives in Torrance.



David K. Winnett, Jr.

Captain, USMC (Ret.)

Fleet Services Manager

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Two VA Employees Slain, One Wounded during Shooting

VA Suffers Losses and Offers Help at Ft. Hood

Two VA Employees Slain, One Wounded during Shooting

WASHINGTON (Nov. 10, 2009) -- In the midst of providing mental health
services and other support to the Ft. Hood community following the
recent shooting, the Department of Veterans Affairs (VA) learned about
its own losses from the violence. Two VA employees, both serving on
active duty with their Army Reserve units, were among the slain. A
third VA health care worker on reserve duty was seriously wounded.



"Speaking for the entire VA family, I offer heart-felt condolences to
the families of these dedicated VA employees," said Secretary of
Veterans Affairs Eric K. Shinseki. "They devoted their working lives to
care for our Veterans, and they died in uniform, preparing to safeguard
our Nation's freedom."



Russell G. Seager, Ph.D., a 51-year old nurse practitioner at the
Clement J. Zablocki VA Medical Center in Milwaukee was killed in the
deadly attack. He was a captain in the reserves. In his VA duties, he
led a mental health team treating a wide variety of Veteran patients,
from the youngest combat Veterans just back from deployments to Iraq and
Afghanistan, to World War II Veterans dealing with depression.



Seager signed up for the Army Reserve four years ago. This would have
been his first overseas deployment. Seager was motivated to prevent the
mental health problems of young combat soldiers from occurring in the
first place. He was to be assigned to a Combat Stress Control unit to
watch for warning signs, such as anger and insubordination, among
front-line soldiers.



Seager, who was also a well-respected teacher at Bryant and Stratton
College in Milwaukee, leaves behind a wife and son.



VA's other fatality was Juanita L. Warman, 55, a nurse practitioner at
VA's medical center in Perry Point, Md. She was a lieutenant colonel in
the Maryland National Guard, with two daughters and six grandchildren.
Herself the daughter of a career Air Force member, she held a masters
degree from the University of Pittsburgh.



Warman volunteered for "Beyond the Yellow Ribbon," a program to help
members of the Maryland National Guard readjust after returning from
overseas deployments. She provided mental health counseling and helped
develop a program about the myths and realities of post-traumatic stress
disorder. She was preparing for deployment to Iraq at the time of her
death.



Dorothy Carskadon, 47, a captain in the reserves and a social worker and
team leader at the VA Vet Center in Madison, Wis., was wounded in the
gunfire that brought Ft. Hood activities to a halt. She is currently in
stable condition in the intensive care unit at the Darnall Army Medical
Center at Ft. Hood.



As a VA team leader, Carskadon oversees other social workers in
providing individual and group counseling for combat Veterans
experiencing difficulty readjusting to the civilian community following
military service. A new Army officer, Carskadon was preparing for her
first deployment.



On an average day, more than 850 VA employees don uniforms to serve
military commitments in Reserve and National Guard units across the
country and overseas.



VA has been responding to the Ft. Hood tragedy since shortly after the
sound of gunfire was replaced by the sirens of emergency responders.



Through official agreements and the shared sense of mission to care for
military members and Veterans in the central Texas region, VA has
provided clinical supplies, including pharmaceuticals, and sent mental
health teams from nearby facilities as well as four fully staffed,
portable Vet Centers to aid in counseling military members and families.




Teams of physicians, nurses and other clinical and support personnel
were placed on stand-by for possible deployment to Ft. Hood or to
receive additional patients following the shooting.



VA operates several clinical and benefits processing locations on Ft.
Hood and routinely has about 18 employees working on the post. Initial
actions included confirming the safety and security of those employees.



VA continues to coordinate with the Department of Defense on providing
care and support to all those affected by the tragedy.
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This release from the VA show the committment of many of the VA employees and their dedication to the nation, besides helping the nations veterans.

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VA pays to settle lawsuit over Michigan vet's suicide

VA pays to settle lawsuit over Michigan vet's suicide

DETROIT — The federal government has agreed to pay nearly $220,000 to settle a lawsuit over the suicide of a U.S. Marine from Michigan.


Randen Harvey's family had accused the Department of Veterans Affairs of failing to keep him in a hospital or commit him to a mental-health facility.


The 24-year-old Harvey served two tours in Iraq. He died of a drug overdose at his father's home in Farmington Hills in 2006.


Thomas Campbell, a lawyer for Harvey's estate, says the lawsuit was settled last week, a few days before trial in federal court.


A message seeking comment was left with the U.S. attorney's office, which represented the VA. Harvey grew up in Mio and Farmington Hills.

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Lawmakers see 'wake-up' call in shootings

Lawmakers see 'wake-up' call in shootings
By Jordy Yager - 11/08/09 12:59 PM ET


Defense Appropriations Chairman Rep. John Murtha (D-Penn.) said he had visited the medical processing center at Fort Hood, Texas, that was the scene of the sporadic shooting earlier this week and could see how it would be vulnerable to attack.

“I was out at Fort Hood at that very location maybe six months ago and people were lined up and bunched up and I can see how it would be a target, and I can see how that many people could be hurt by one person,” Murtha told The Hill, adding that “it’s easy to criticize the element of what might have happened and I just think we don’t know enough about it.”



Murtha is one of a handful of House lawmakers who are looking at the killing spree that left 13 people dead and wounded at least 38 others to see if there were warning signs that could have prevented Major Malik Nadal Hasan’s attack.


Hasan's rampage has led to questions about whether the psychiatrist, who objected to an impending deployment, acted out of a stress-related disorder or due to extremist views reportedly expressed to others.

“There should’ve been red lights,” said Rep. Eliot Engle (D-N.Y.) in an interview. “Someone should have spoken to him. It’s amazing that nobody could see that he would be a menace to himself and to others. Look, it’s easy to point fingers after a tragedy. But I think it’s a call to wake up.”

Engle, whose district includes the Bronx, referenced the terrorist attacks of Sept. 11, 2001, and how afterwards Americans became more vigilant about spotting suspicious behavior.

“We’re not going to be able to weed out everyone who does something bad, but we should be able to have some bells that go off. It makes us all more aware,” said Engle, a member of the Foreign Affairs Committee.

The Chairman of the Veterans Affairs committee, Rep. Bob Filner (D-Calif.), said that he hopes Congress can use the Fort Hood shootings to spur itself to action in fixing the broken veterans health system.

“These folks are under tremendous stress: the soldiers, doctors, everybody,” he told The Hill. “And we have not dealt with it properly as a nation…Something is going on besides just this one guy. Everybody is at a breaking point. You can’t do a war like this without the proper mental health resources and we just don’t have them.”

“People don’t understand the breaking point here. You’ve got hundreds of thousands of young people and they come home and they murder each other or their spouses. It’s horrible and we’ve refused to look it square in the eye, and this incident shows it, but I think we knew it long before this.”

Rep. Zoe Lofgren, a member of the Homeland Security Committee, stopped short of requesting a congressional investigation but said that the body would try to get to the bottom of Hasan’s motivations.

“We will get all of the information,” she said. “We have to be patient and find out.”

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VA'S NEW PATERNALISM: THE FATHER-FIGURE WE DIDN'T WANT

VA'S NEW PATERNALISM: THE FATHER-FIGURE WE DIDN'T WANT

VA attorneys don't want veterans to have attorneys. But, Veterans' Advocate Jim Strickland punches holes in their claim of a "New Paternalism" at the VA.



Veterans' Advocate Jim Strickland provides regular columns for VA Watchdog dot Org. If you would like to contact Jim about his columns, you can email him here... The archive of Jim's articles is here... To find an answer to a specific VA benefits question, use the VA Watchdog search engine... click here... And, be sure to use Jim's: "A to Z GUIDE OF VETERANS DISABILITY COMPENSATION BENEFITS" click here... JIm's series for new vets, "Welcome Home," is also featured on Military.com. And, you can follow Jim on TWITTER here ...

In their treatise "Effects of Representation by Attorneys in Cases before VA: The 'New Paternalism'" Department of Veterans Affairs (DVA) lawyers Reiss and Tenner presume that the DVA consistently practices at every level to be non-adversarial and to always give every veteran the benefit of the doubt.

(The paper by Reiss and Tenner is available here for viewing or download.)

"Paternalism" isn't a particularly positive noun. No matter the spin Reiss and Tenner would apply to it, the definition is generally along the lines of, "a system under which an authority undertakes to supply needs or regulate conduct of those under its control in matters affecting them as individuals as well as in their relations to authority and to each other".(1)

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Please follow the link at the top of the and visit VA Watchdog.org and read the entire article Jim wrote, it is eye-opening about the "non-adversarial" compensation claims process. It is relelvant when you are attempting to get benefits that are do you, in relation to your military service, and the government using a building full of lawyers to deny claims, that veterans should have their own lawyer, that speaks and comprehends legalese, which almost none of us veterans are proficient it, we believed them when we enlisted or were drafter to keep the "PROMISE" they lied about providing life long medical care for military retirees and their dependents, and in the 80s we got Tricare which retirees have to pay for and can only be seen at a military hospital is usually on a case by case basis and the availability of medical personnel.

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The Forever War of the Mind

The Forever War of the Mind

Op-Ed Contributor
The Forever War of the Mind
MAX CLELAND
Published: November 6, 2009

“EVERY day I was in Vietnam, I thought about home. And, every day I’ve been home, I’ve thought about Vietnam.” So said one of the millions of soldiers who fought there as I did. Change the name of the battlefield and it could have been said by one of the American servicemen coming home from Iraq or Afghanistan today. Wars are not over when the shooting stops. They live on in the lives of those who fight them. That is the curse of the soldier. He never forgets.

While the authorities say they cannot yet tell us why an Army psychiatrist would go on a shooting rampage at Fort Hood in Texas, we do know the sorts of stories he had been dealing with as he tried to help those returning from Iraq and Afghanistan readjust to life outside the war zone. A soldier’s mind can be just as dangerous to himself, and to those around him, as wars fought on traditional battlefields.

War is haunting. Death. Pain. Blood. Dismemberment. A buddy dying in your arms. Imagine trying to get over the memory of a bomb splitting a Humvee apart beneath your feet and taking your leg with it. The first time I saw the stilled bodies of American soldiers dead on the battlefield is as stark and brutal a memory as the one of the grenade that ripped off my right arm and both legs.

No, the soldier never forgets. But neither should the rest of us.

Veterans returning today represent the first real influx of combat-wounded soldiers in a generation. They are returning to a nation unprepared for what war does to the soul. Those new veterans will need all of our help. After America’s wars, the used-up fighters are too often left to fend for themselves. Many of the hoboes in the Depression were veterans of World War I. When they came home, they were labeled shell-shocked and discharged from the Army too broken to make it during the economic cataclysm.

So it is again, with too many stories about veterans of Iraq and Afghanistan ending up unemployed and homeless. Figures from the Department of Veterans Affairs show that 131,000 of the nation’s 24 million veterans are homeless each night, and about twice that many will spend part of this year homeless.

We know of the recent failures at Walter Reed Medical Center, where soldiers were stranded in substandard barracks infested with rats while awaiting treatment. I was in Walter Reed myself at that time seeking counseling for post-traumatic stress disorder, which, ignited by a barrage of Iraq headlines and the loss of my United States Senate seat, had simply consumed me.

I never saw it coming. Forty years after I had left the battlefield, my memories of death and wounding were suddenly as fresh and present as they had been in 1968. I thought I was past that. I learned that none of us are ever past it. Were it not for the surgeons and nurses at Walter Reed, I never would have survived those first months back from Vietnam. Were it not for the counselors there today, I do not think I would have survived what I’ve come to call my second Vietnam, the one that played out entirely in my mind.

When I was wounded, post-traumatic stress disorder did not officially exist. It was recognized as a legitimate illness only in 1978, during my tenure as head of the Veterans Administration under President Jimmy Carter. Today, it is not only recognized, but the Army and the V.A. know how to treat it. I can offer no better testament than my own recovery.

Weeks before the troubles at Walter Reed became public in 2007, my counselor put it to me simply. “We are drowning in war,” she said. The problems at Walter Reed had nothing to do with the dedicated doctors and nurses there. The problems had to do with the White House and Congress and the Department of Defense. The problems had to do with money.

When we are at war, America spends billions on missiles, tanks, attack helicopters and such. But the wounded warriors who will never fight again tend to be put on the back burner.

This is inexcusable, and it comes with frightening moral costs. There are estimates that 35 percent of the soldiers who fought in Iraq will suffer post-traumatic stress disorder. I’m sure the numbers for Afghanistan are similar. Researchers have found that nearly half of those returning with the disorder have suicidal thoughts. Suicide among active-duty soldiers is on pace to hit a record total this year. More than 1.7 million soldiers have served in Iraq and Afghanistan. Imagine that some 600,000 of them will have crippling memories, trapped in a vivid and horrible past from which they can’t seem to escape.

We have a family Army today, unlike the Army seen in any generation before. We have fought these wars with the Reserves and the National Guard. Fathers, mothers, soccer coaches and teachers are the soldiers coming home. Whether they like it or not, they will bring their war experiences home to their families and communities.

In his poem “The Dead Young Soldiers,” Archibald MacLeish, whose younger brother died in World War I, has the soldiers in the poem tell us:“We leave you our deaths. Give them their meaning.” Until we help our returning soldiers get their lives back when they come home, the promise of restoring that meaning will go unfulfilled.

Max Cleland, the secretary of the American Battle Monuments Commission, was a Democratic senator from Georgia from 1997 to 2003. He is the author, with Ben Raines, of “Heart of a Patriot: How I Found the Courage to Survive Vietnam, Walter Reed and Karl Rove.”

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Many veterans are able to find ways to cope with their PTSD symptoms, they become workaholics, alcoholics, drug abusers, they find a way to substitute their war memories with other issues, while they have never came to terms with their war experience, my step father was in the 8th Army Air Corp based in England, he flew many bombing missions, he was there when they used to send the bomber crews home after 25 missions, then it was raised to 30, then 35 he was in the same group as the ship the Memphis Belle, he liked the men, he had little use for the officers, he called them "prima donna's" Dale also felt the same way about General of the Army Douglas MacArthur when he was sent to the Pacific Dale was offered the radio operatos slot on the "Bataan" General MacArthurs personal airplane, Dale was a highly decorated Tech Sergeant/E7, General MacArthur was known for picking soldiers known for Valor for his assistants.

Dale refused the assignment, which sent him to Tinian Island where he flew many fire bombing mission of Japan. Just as much as he despised the fire bombing of Dresden he hated the flights over Japan, they left him with nightmares that never stopped in his lifetime, he could see the women and children running thru the streets on fire, melting clothes around them, as he called it the most gruesome way to die. He like many other Air Force bomber flight members hated the flak, they never knew when it would knock them out of the air, and either leave them dead or as a POW. Dale's birthday General Eisenhower made special due to weather, June 6, 1944 Dale turned 32 and he spent it bombing German targets as all other flyable aircraft did, nothing was not used if it was flyable. For the rest of his life Dale spent the day getting totally wasted from the moment he woke up, he always took the day off from work at the Postal Service where he became a clerk after he retired from the Air Force, like many others of the WW2 era.

PTSD is a lifelong problem some days are better than others........

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