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Last week I had a chance to work with a new colleague. As we are both “old army” and seemingly surrounded by those cultural mysteries known as “former air force,” it seemed fate we would instantly bond. Somewhere along the way, however, things went awry. It happened when we struck up “small chat” on a large subject – PTSD.

I mentioned how painful I find it to see young men and women return from combat, often with broken bodies, but perhaps less perceptibly, with broken hearts and minds. We’ve all heard the party line that emotional troubles are nothing to be ashamed of and can readily be helped within the military – one need only ask for help. I would love to believe that is true today. But I wouldn’t have believed it during my own couple of decades “in” though I would have insisted to my soldiers I’d never hold their needs against them. And I see what neglect of such issues wrought in my husband who served in Vietnam at oh-so-tender-an-age, and the unending effects from which he still suffers today. So I continue to doubt soldiers, et al, feel free to own up to what some will perceive as weakness, and seek some mending.

The guy I was speaking to reinforced this concern, though I suspect he didn’t know it. He said, “If I may speak candidly, those who come back with PTSD were not mentally prepared to serve.” His meaning became clear, arguing good training can best prepare troops for the rigors of combat. He didn’t necessarily blame sufferers for having weak minds – though it came out that way – but rather implied their training was inferior.

I countered that training troops to kill or die is arguably the EASY part. It is surviving what you never conceived you might do, that takes immeasurable strength. When a Specialist shoots at a vehicle speeding toward a checkpoint, he is legally, ethically, and morally covered in his actions, especially as folks in the theater of operations should well know that is a reasonable expectation for a like circumstance. But when the vehicle careens to a stop and the door opens, spilling out a dying mom and her injured or dead children who were driving in terror, that combat soldier gets to live with his legal, ethical and moral decision. I went to basic training and OCS … I don’t remember any training to prepare me for taking that memory home with me or teaching me how to reconcile any psychic pain I might feel.

Add to this multiple tours in a few short years and we seem to be stretching even the most elastic of minds to a point of aneurysm. Training does not simulate your buddy being blown all over the back of you; it doesn’t capture begging a grievously wounded soldier to stop weeping so as not to give away the detachment’s position; it doesn’t mentally prepare you to view everyone as your potential adversary while treating everyone as your potential ally.

Perhaps the difference between me and my newly-acquainted coworker is – I don’t think surviving with whole mind, body and spirit takes a simple act of will. I don’t write this as some anti-war sentiment. I guess I am just venting that there are enough folks who superficially point at battered soldiers, sailors, airmen, marines and coastguardsmen and somehow characterize their pain as a product of their own making. People who do that are ignorant and without compassion in my beliefs.

Most of all, inevitably, I don’t expect, or perhaps accept them among the ranks of my “old army” pals.
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Well said. It seems that although warfare has always been here, each generation seems to come up with something in the genre the previous ones did not.

For us, it seems to be brain injury & PTSD will be our generation's contribution to the volumes of history.

With the advent and plethora of IEDs we're seeing the outcome -- our noggins weren't meant to rattle like that. I believe PTSD was coined in Vietnam era and continues to be prevalent today.

I would also disagree with your colleague, although I'm one of those cultural mysteries so perhaps that's a given :)

Training only goes so far, and none of us truly knows how we'd react in those situations until we're in them and then face the aftermath. Nobody could have trained for what they found at Auschwitz, etc.

• Jeff
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The only one I can think of from my family who didn't serve was my grandmother.
Uncle Mitch for example, was Army Air Force, then Air Force, serving from WWII up through the beginning of Nam.

I'm rather certain his 'way' was due to wartime experiences.

I remember as a kid looking through his original photos, magazines and such published post WWII when things weren't so censored. Very Graffic.

I don't think any amount or type of training can totally prepare you for someone losing half their skull in front of you, etc.

Musing: Perhaps this was some type of 'compensation mechanism' on his part. Or filling time in a quiet spot. I think as I aged, I now wait for direct questions before (I) make a comment.
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“If I may speak candidly, those who come back with PTSD were not mentally prepared to serve.”

This is exactly why the problem goes unreported. The soldier or marine thinks that if they say something they'll be viewed as unfit, less of a man, a troublemaker, or otherwise lacking what it takes. So they try to suck it up and it gets worse.

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I know the incidence of brain injury is way up, but hasn't PTSD pretty much been around a long time? I thought it was the same thing as "shell shock" that the vets from WW1 experienced in huge numbers.
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I thought it was the same thing as "shell shock" that the vets from WW1 experienced in huge numbers.

That was my understanding, too, but it came from a George Carlin sketch. Googling to check...

I think you're right but it doesn't definitively say so.
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I think, they are from a variety of physical and physchological exposures and resulting adaptations and responses.

'Shell shock', at least to me, connotes a close proximilty to an explosive concussion. Inbound/outbound.
But I understand the generalized catchall.
See also: Women: 'the vapors'.

Then again, it appears as wrt ADD/ADHD... more definitive labeling will follow.

In my youth though, none of these childhood 'diseases' were present and subsequently medicated.

I wonder, the history of 'clubs' on bases/posts consists for/as 'coping' mechanisms?
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My Dad is 86 years old. He served in Patton's army in WWII and earned two bronze stars. He was the scout in his unit. He left the army more than 60 years ago.

He is perhaps the most stable, sensible person I've ever known.

But now he is suffering from mental deterioration caused by normal pressure hydrocephalus, and he spends every night thinking he is back in some German cellar scouting the place out. He worries about the "boys" all the time, because he can't find them and thinks they are in danger. Even in the daytime it is not unusual for him to ask questions about when he will ship out. He has terrible dreams. I think that he always did, but never told anyone.

Anyway, my point is that PTSD is something that can surface at any time. The nursing home has no clue on how to handle someone who thinks he is in the middle of a war. I wish the government would, at the very least, get some solid research on this subject out to the public.
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WilliB -

My father probably followed your father up the roads into Germany. He's gone now (multiple myeloma took him 2 years ago). Your father and his units cleared the way before he got that far north, but the things he saw at Nordhausen (starving men, mass graves), scarred him forever and he took much of it to the grave with him in silence.

You might contact your local VA and see if they can help, or the local VFW. My father didn't care for the guys in his chapter of the VFW, but a friend found some help there for his mother (who was an Army nurse in the Pacific in WWII). Some of the VAs have good information on helping WWII vets.
And there have been pieces of information in the medical literature for a while now, see these links from around 2000:
PTSD in the WWII Combat Veteran. Am J Nurs. 2003 Nov;103(11):32-41.

Also, ask around and see if you can find a geriatric specialist who knows, or who knows somebody who knows, about PTSD in elderly vets. They are out there, but take a bit of finding.

good luck,
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