Tuesday, June 23, 2009

Wounded warrior Jerrod Fields, an Army sergeant featured in “Where Life Is,” screened at the GI Film Fest, panics every time July Fourth fireworks go off, though he’s been home from Iraq for four years.

“Soldier’s Heart” - the name given to that dazed stare of Civil War soldiers, ceaselessly reliving ear-piercing, nerve-wracking blasts, bloody carnage and the stench of death - afflicts between about 300,000 and 600,000 American troops (20 percent to 40 percent) returning from Middle East theaters of war. They have helped win the peace, only to be robbed of inner peace.

Skyrocketing suicide rates - up 60 percent since 2003, now exceeding killed-in-action numbers - have prompted an intense effort by top military brass to fight and win this battle of the soldier’s heart.

The biggest problem is the stigma attached to admitting mental wounds as if a sign of weakness. As an antidote, the Defense Department recently launched its Real Warriors campaign (www.realwarriors.net) communicating that it’s OK to get help - “You’re not alone.”

Abraham Lincoln, for one, suffered from depression, signaling, rather than weakness, that what’s now called post-traumatic stress disorder (PTSD) shows one’s specialness.

When asked to comment, Chairman of the Joint Chiefs of Staff Adm. Mike Mullen told me the memory of Lincoln, who preserved the Union under great duress and sought to “bind up the nation’s wounds,” highlights the need for “leaders right now” to deal with PTSD’s toll “particularly [among] those who have been in the heavy throes of combat” for so long - “our sixth year of two wars, eighth year of going to war.”

As the point person stimulating leadership to tackle this burgeoning crisis, Adm. Mullen is asking military leaders to “step forward” to get screened and get help, if necessary. “And, if they do that, others will follow, and they’ll know it’s OK.”

Adm. Mullen pointed to the corresponding need for a “mental health system that has the capacity and the wherewithal to be able to deal with the challenges” of PTSD about which “we’re just learning.”

“This,” he said “is going to be a long haul.”

We’re not short on leaders.

Gen. Peter W. Chiarelli, Army vice chief of staff, for one, said Adm. Mullen has exhibited the kind of leadership needed on PTSD by focusing on what needs to be done “institutionally” vis-a-vis “the stress issues coming out of war, the short time home, the relationship issues,” the latter responsible for the highest number of suicides.

Assisting that effort are veterans like Jay Kopelman, a retired Marine Corps lieutenant colonel who fought in the Battle of Fallujah. While encapsulating his experiences in two New York Times best-selling books, including “From Baghdad to America,” he stepped forward to get help as part of his research. He now heads the San Diego-based non-profit, Freedom Is Not Free, helping active-duty service members and vets wounded in combat, many suffering from PTSD, by providing direct financial assistance and quality of life enhancements such as the 75 percent treatment-and-cost-effective Virtual Reality Medical Center, also based in San Diego, headed by Dr. Mark Wiederhold.

Awarded an Office of Naval Research grant in 2004 “to research the utilization of virtual reality therapy for the treatment of combat related PTSD,” its evaluation is expected shortly. On Sunday, VR’s promising results were presented at “Cybertherapy 14” in Lago Maggiore, Italy, including progress made by six PTSD-afflicted warriors treated at the Medical Center in Fallujah.

Sports also play a huge role in the physical and mental healing process.

As the poignant film “Where Life Is,” screened at last month’s GI Film Festival in the District, compellingly documented, three wounded warriors - Marine Cpl. Bradley Walker (double amputee), Army Sgt. Jerrod Fields (single amputee) and retired Marine Staff Sgt. Andrew Robinson (paralyzed) - transformed their lives through competitive track and field, swimming and hand-cycling, respectively. But, as Sgt. Fields admitted, “The mental is more [difficult to heal] than the physical” given its complexity.

This very complexity points to the need for a multiplicity of approaches, private and institutional.

Initiatives like the Theater Project (www.philoctetes.com) featuring well-known actors, including Paul Giamatti and David Strathairn, performing key scenes from Sophocles’ millenniums-old PTSD-themed plays “Ajax” and “Philoctetes” for military audiences (10 since August) to expel the demons of war.

The project, said organizer Bryan Doerries, “reduces the stigma” of PTSD and “creates the conditions for conversations [afterward] that otherwise would not be possible.” Sometimes those discussions last for hours. The plays “paint a portrait of the psychological impact of war” largely depicted in code that, said Mr. Doerries, only a military audience could fully translate.

Or music therapy, reflecting what singer-songwriter Lee Greenwood told me: “Every soldier has a different taste in music … if [by playing their favorite music] you could just take the mind off the injury and whatever’s bothering them at the moment - give them a little bit of space, then you’ve got space for recovery.”

Or a Fort Bliss, Texas, chaplain’s pilot program providing relationship counseling.

Finding that space for recovery in all its dimensions and all its individuality is “a huge problem and one we’re going to have to continue to stay focused on,” Adm. Mullen said.

And in our nation, the rallying cry must be, “It’s not OK not to help.”

Mary Claire Kendall was special assistant to the assistant secretary for health in the U.S. Department of Health and Human Services from 1989 through 1993.

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