Monday, January 9, 2012

Post-traumatic living, the reality in war and peace

By The Legendary Jim Parks

It ain't the job that gets to you, hoss. It's what you do after you throw down with that six-gun that counts. It's what you do after you do what you do – that's the getaway. - Old-time Cowtown newsman Jim Thompson, author of The Getaway

Waco – Somebody asked Red Adair what the most challenging, frightening, stressful part of his profession as a “hell fighter” - the man who puts out oil and gas well fires – could be.

He didn't even blink.

Getting from the airport to the fire, said Red. Usually, the company man met you and put the crew in the carry-all – that's what they called an SUV before the soccer moms became the market – and from there, he was in a big hurry to get the outfit to the fire – pronto.

This business of driving a dozer with spray nozzles gushing water to cool the air, maneuvering one crane with a dynamite charge dangling from its hook while another hand like Boots, Coots or Charlie Tolar worked the well cap into position – piece of cake.

Ka-boom! Dynamite eats up all the air. Fire goes out. Cap the well, shut off the fuel. Fire is extinguished. Nothing to it.

It was riding out across the Oklahoma prairie or the blazing sands of the Libyan Sahara that most got on Adair's nerves.

That company man had a blow torch trained on his butt that was at least as hot as the derrick-melting blow-out Adair was there to extinguish. Somebody at a mahogany or teak desk in Houston was applying the heat to his hide via phone, fax, telex or radio.


Ditto the returning veteran of wars fought on foreign grounds of Uncle Sam's choosing. This ever ready ramrod with a rifle has got himself a case of the ass. El supremo, garden variety. Believe it.

He's been gone – fighting in the war under conditions he cannot explain in polite society, certainly not to wife, mother, or children – and he is trained as a stoic warrior, led by professionals at the profession of arms, and a proven practitioner of the kind of skills it takes to survive this form of total man-made hell.

What's more, he's good at it, a complete pro. The very fact of his life is all the proof he needs to offer.

He's alive. All the way live, as a matter of fact – pulse, respiration, reactions and all vital signs are a go.

According to the “Iraq War Clinician Guide” published by the Department of Veterans Affairs, integral to the discussion of “veterans recently evacuated due to combat or war stress who are brought to the VA for mental health care,” is that many, if not most “will not be seeking mental health treatment.”

Though they were “evacuated from the war zone for mental health or medical reasons,” they are “perhaps reluctant to acknowledge their emotional distress and almost certainly reluctant to consider themselves as having a mental health disorder” such as post traumatic stress (PTSD).


That's putting it mildly.

There is that career that's at stake. One does not wish to stigmatize his performance. There is the future to consider. What's more, front-line psychiatrists are prone to minimize the obvious. The emphasis is on getting the trooper back in shape to rejoin his unit.

Once evacuated, the treatment plan shifts gears. Shrinks at stateside VA hospitals and Army or Naval health care facilities don't do business that way.

The “emphasis on diagnosis as an organizing principle of mental health care is common in VA. Patients are given DSM-IV diagnoses, and diagnoses drive treatment.” In the war zone, “pathologization of combat stress reactions is strenuously avoided.”

Hey, give the guy a break. He's a normal man reacting to the stress of an abnormal situation, one in which violent death comes with the flick of finger, the beat of the heart, the blink of the eye. When it comes, it's fiery, loud, piercing flesh and shattering perceptions with devastating effect.

You're looking at a survivor.

But it's in the little things, in the kind of ordinary behavior so easy to behold, that the tell-tale symptoms occur.

Let's take driving a motor vehicle through civilian traffic.

It's hard for a Devil Dog or a Trooper to downshift his gears and start going with the flow of soccer moms and delivery drivers, commuters moving at the speed of a civilian world on home town streets. This cat has been keyed-up, convoying under arms and trying like hell to dodge the ubiquitous improvised explosive device (IED) or booby trap made out his own government's unexploded ordnance.

Consider the experience of Mary Duty, a Blue Star Mother of Caleb Duty, U.S. Marine out of the 3/2 with two tours Iraq in his service book. Together, they are organizing the Moonlight Music Festival that will take place over the Memorial Day weekend at the Meridian Bosque Bottoms Campgrounds, site of the National Barbecue Cook-off Championship, at the corner of S.H. 22 and Hwy 6.

“One of the craziest things we do, in my opinion, is let guys go back to driving without class on how their combat experience affects civilian driving. Caleb had three wrecks after his first deployment. Wow.”

There is a power point presentation available that deals with that aspect of post traumatic behavior, as well. Government work, by the book, for the book, and with the book - for the benefit of the people of the book, as their enemy the Islamic jihadist calls them, our soldiers, sailors and Marines.

Anyway, it's true.

There are other symptoms that are equally true:

- An overall interference with social functioning
- chronic high rates of job turnover
- alcohol and drug abuse
- extreme irritability and a tendency toward quick anger

Look deeply into any of these propositions and use your imagination. What is the net net, the end result – every time. Misery. Total, abject misery. Hey, folks, let's let these old boys up off the ground. Anybody deserves a break, it's our fighting men.

What to do?

“In treatment of chronic PTSD, veterans often report that perhaps their most valued experience was the opportunity to connect in friendship and support with other vets. This is unlikely to be different for returning Iraq War soldiers, who may benefit greatly from connection both with each other and with veterans of other conflicts. Fortunately, this is a real strength of VA and Vet Center professionals, who routinely and skillfully bring veterans together.”

Other treatment modes include:

- Offer practical help with specific problems
- Attend to the broad needs of the person
- Education about post-traumatic stress reactions
- Training in coping skills
- Exposure therapy through simple discussion of painful memories
- Cognitive restructuring

Meet me in the botoms, y'all. Bring me my running shoes.

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