Thoughts on Iraq - part 1

Greetings blog readers.... Well, I have survived three classes overlapping just as things got busy at work. As for Ed, well, he's down with the stomach flu which, based on reports from my family and Facebook friends, is making its way around the world. Fortunately, one usually does recover from the stomach flu. And if that's the worst that happens to him during his deployment, we will count ourselves incredibly lucky.

As I write this entry, two weeks shy of the five-year anniversary of the invasion of Iraq, 3,973 American soldiers have died, and 29,320 have been physically wounded. That’s according to the numbers provided by the Washington Post's Iraq Casualty count (see sidebar). And yet, the Washington Post only counts the physically wounded. They overlook the roughly 250,000 men and women returning home with mental wounds.

When Ed deployed to Iraq, one of my greatest fears was that he wouldn’t come back – mentally and emotionally – the same person he was when he left. A lost limb, we could deal with that. Losing the person that he was, that was scary. His decision to deploy with a public affairs unit was a compromise between his desire to serve and my desire to maximize the odds that he return home unscathed, both physically and mentally. Ed wasn’t thrilled about being a REMF, or FOBBIT, as they’re known now (see August 5, 2007 post), but it was the best agreement we could negotiate. Nine and a half months on, I have to laugh at my naiveté. While being a PAO is “safer” than being in the infantry, in today’s war in Iraq, there are no front lines. And no position is immune from the physical or psychological wounds that war can bring.

A recent study done by the U.S. Army Mental Health Advisory Team found that twelve percent of soldiers returning from their first tour to Iraq and Afghanistan suffer from anxiety, depression, post-combat stress and other problems. For soldiers on their third or fourth tour, the number jumps to more than 27 percent.

Exposure to traumatic combat events is a key risk factor for injuries to a soldier’s mental health. And the nature of the war in Iraq (and more and more in Afghanistan) means one does not have to be in a combat arms unit (e.g. infantry) to experience combat. For example, the soldiers in Ed’s public affairs unit are exposed to combat, directly and indirectly, on a fairly regular basis.

Although Ed's primary job is to coordinate logistics, such as the embedded reporters program, others in his unit actually produce new stories. Which means that they go out with patrols in order to file stories or take photographs. When his unit first got to Iraq, most of the violence was concentrated in Baghdad. Due to a number of factors, including the surge, Baghdad has become quieter. On the other hand, northern Iraq, particularly Mosul, which is part of his unit's geographic area, has seen a rise in violence.

Soldiers in the public affairs unit also cover memorials. They not only report on the fallen soldiers, but they also produce videos of the services. They film the memorial, interview soldiers who knew the deceased, edit the film and send a DVD to the soldier's family. According to Ed, most families truly appreciate receiving the videos, especially hearing all the nice things that the fellow service members say about their loved one.

Now, this isn’t to say that all the soldiers in Ed’s unit are coming home mentally wounded because of repeat exposure to death. Why some people develop PTSD or other mental ailments is not particularly well understood. It is simply to highlight that in this war, the risk of combat injuries, especially of the mental kind, stretches to people who have not traditionally been considered at risk. Another finding of the mental health advisory team was that 72 percent of soldiers in Iraq know somebody who has died or been seriously wounded. And repeat exposure to that sort of trauma that can wound even those, or perhaps particularly those, who are trained to counsel and help others.

What makes this worse, is how little compassion we as a society have for people with mental illness, whether it is organic or the result of a traumatic experience. I never thought I’d bring Britney Spears into the blog, but the ridicule that has surrounded her over the past few months is a prime example of how horribly we treat people with mental illness. Now, I’m not a psychiatrist and I’m not going to pretend to diagnose her. Perhaps she is just a silly girl acting out. But I will say that very few people act out so suddenly and so dramatically, and even more telling, parents rarely get custodianship of an adult child, if there is not some sort of mental illness present. And yet, instead of being treated compassionately, as someone with a broken leg or the stomach flu would be, she has been judged and ridiculed and harassed.

If it's that bad for a "regular person", imagine what it's like for soldiers, who are supposed to be strong. Many feel that there is a stigma to seeking help. Sadly, this is often with good reason, but the repercussions can be, without exaggeration, deadly. The Mental Health Advisory Team report did find that progress has been made toward reducing the fear and embarrassment that keeps soldiers from asking for help with mental health problems. In 2007, 29 percent of those surveyed in Iraq said they feared seeking treatment would hurt their careers. This is down from 34 percent in 2006. And yet, even when they do seek assistance or counseling, roughly 29 percent of soldiers in Iraq said it was difficult to get to mental health specialists for help. This is in part due to the fact that during the surge many soldiers moved off of the primary bases to combat outposts so they could be closer to the Iraqi population. Among troops at the main bases, like where Ed is, only 13 percent reported difficulty getting help.

Gary Trudeau, of Doonesbury fame, has done an amazing job chronicling the challenges vets face, particularly when they return home from combat. And yet, this is not something that will go away. The ramifications of the number of wounded, both physically and mentally, from the Iraq and Afghanistan conflicts will be with us for decades, long after he is no longer writing his strip and bringing it to our attention. But we’ll save that discussion for next week.