As troops return, many bring home psychological scars

By RAQUEL RUTLEDGE, Milwaukee Journal Sentinel
WTMJ-TV and JSOnline.com
Updated: 12:32 a.m. ET March 02, 2004

March 2, 2004 - When Alyssa Kopp closes her eyes at night, the children creep into her sleep.

Sad and desperate, they approach her convoy, rocket-propelled grenade launchers slung over their small shoulders.

"You never know if they're going to shoot you or want to trade" their weapons for food, says Kopp, a 28-year-old Army reservist who spent months in the Middle East desert with the 814th Military Police Company based in Chicago.

The nightmares are almost always the same since Kopp came back to her Pewaukee home in December.

They always include the children.

 ***

 Abelardo Diaz doesn't sleep much since his return from Iraq in November. The Milwaukeean wakes up every hour and a half. Diaz figures that's normal considering he sometimes worked 27 straight hours delivering ammunition with the 685th Transportation Company out of Hobart, Ind.

 "We were getting bombed every day. We had to don our (chemical) gear seven or eight times a day. We were getting attacked by Scuds. I was sleeping on top

of ammunition or whatever I could find," said Diaz, 25. "We didn't do much sleeping during the whole war."

 ***

 Now, as the one-year anniversary of the war in Iraq approaches, troops are trickling home. And like all soldiers who've seen combat, they're coming home changed.

 Some return with obvious wounds of war: a wheelchair, prosthetic foot, maybe half an arm. But for others, the injuries remain invisible, tucked in a corner of the brain where images of violence and panic are imprinted on their memories.

Like those whose wounds are exposed, they, too, may suffer flashbacks, disturbing dreams, depression and anxiety. They may use alcohol or drugs to help forget.

Exposure to violence in Iraq exceeds that of any of the nation's conflicts since Vietnam. As this generation of soldiers leaves the battlefield for better days, they too will be left to cope with hidden scars from serving their country.

Just how severe and widespread the emotional wounds will be is difficult to predict, experts say. After all, it's early.

"Every war is unique," said Army Col. Thomas Burke, the Pentagon's program director for mental health policy. "These deployments are longer. The combat operations are different.

"Whatever (post-traumatic stress disorder) we're going to see may not have made a significant appearance yet. It can be delayed from a month to years."

Yet, already, of the roughly 90 GIs who've returned to southeastern Wisconsin from Iraq and sought services from the Department of Veterans Affairs, nearly a quarter are being seen for mental health concerns. Some have already been diagnosed with post-traumatic stress disorder.

Nationally, the Pentagon reports that 10% of troops evacuated from the war zone to a hospital in Germany were being treated for psychological reasons. And questions have surfaced about the suicide rate among returnees.

'A wake-up call'

Veterans advocate Wayne Smith calls the data alarming.

"This is the wake-up call for America not to repeat what happened in Vietnam," said Smith, special assistant to the president of the Vietnam Veterans of America Foundation. "We think it's enormously clear that there is a mental health issue with soldiers returning from Iraq."

 The Department of Defense isn't alarmed. Emotional battle wounds always have been an outcome of war. During the Civil War, it was called nostalgia. In World War I, it was shell shock and later, after Vietnam, it became known as post-traumatic stress disorder. In fact, some 30% of Vietnam veterans may have suffered from the disorder, Burke said.

 And as of 2001, nearly 150,000 veterans had service-related post-tramatic stress disorder, according to numbers released by the VA.

***

 Staff Sgt. Georg Pogany, an Army interrogator, was diagnosed with the disorder since his return from Iraq in October.

Images of an Iraqi man's mangled body haunt his sleep. He has recurring nightmares that he's on a convoy with no weapon. He's anxious and depressed.

 "Seeing this person who was shot and killed was pretty gruesome," Pogany said.

The 32-year-old Fort Carson, Colo., soldier says the military has not handled his situation well. In fact, the Army charged him with cowardice. The move drew worldwide media attention, and charges eventually were dropped. But Pogany says the military's macho mind-set views normal, human reaction to horror as mental weakness and is not prepared to deal with it.

"My commander told me I was a (expletive) coward," Pogany said.

Pogany is undergoing intensive counseling for post-tramatic stress disorder and says he sought help outside of the military because of the stigma.

 Military reacts to problem

Meanwhile, the VA and Department of Defense say they are better prepared than ever to handle mental health issues.

The VA points to a beefed-up outreach program and better benefits. The VA now offers two years of free health care to military personnel who recently served in a combat zone. In the past, veterans had to prove that a medical problem was connected to their military service. In addition, each veteran is assigned a case worker who can coordinate complete care.

The VA also cites an increasing budget for mental health. The VA expects to spend $2.5 million on seriously mentally ill veterans next year compared with $1.5 million in 1995.

The Defense Department says it, too, is on top of the problem. About 130 mental health workers are integrated with the troops in Iraq, said Burke, the Pentagon's mental health policy director. Combat stress control units are now a permanent structure within the Army.

"We're trying to educate the chain of command that they're soldiers even if they do have mental health issues," Burke said. "Stigma is a difficult one. It's something we work on all the time."

The Defense Department implemented a health screening for all returning veterans after several soldiers at Fort Bragg, N.C., killed their wives and themselves after returning from Afghanistan. The questionnaire is designed to pinpoint potential mental health problems. The VA has a similar mental health screen activated system-wide this month targeting at-risk veterans.

 In July, in response to an increasing number of suicides, the Army surgeon general's office sent a team to Iraq to investigate mental health issues. That report is scheduled to be released next week, Army spokesman Lt. Col. Kevin Curry said.

But veterans advocate Greg Jacobs says more needs to be done and that the budget numbers are deceiving.

"I definitely see some shortcomings," said Jacobs, who works for the Wisconsin Department of Workforce Development helping veterans with disabilities. "It sounds like we're getting more money, but there are more hands reaching into the same pot of money."

Saying no to therapy

Green Bay native Danny Roberts says the military constantly offers him mental health care that he doesn't want. Roberts, 27, was transporting food and water to front-line troops when he stepped on an explosive. He lost his left foot and has undergone several surgeries on his right foot. He spent five months using a wheelchair and saw his friends riddled with bullets.

But Roberts, a member of the 890th Transportation Company based in Hobart, Ind., said he doesn't have nightmares, sleeps fine and is pretty much the same person he was before he was deployed.

 "I came to peace with it pretty easily," he said of the experience. "I think about it every day when I put on my prosthetic foot, but it's not something I dwell on."

 Roberts says counselors from Walter Reed Army Medical Center in Washington, D.C., call him about once a week to see whether he wants to talk to a therapist about his experience.

 ***

 For Kopp, it's the children she can't seem to shake. At least not yet. Images of them swarming her vehicle still appear in her dreams.

"We were told we couldn't stop for them," she said. "You know they got run over. I might have even . . ." Her voice trails off.

But for now, sleeping pills at least help her sleep.

In the daylight, she adjusts to being alone and unarmed.

"I'm used to wandering around in full battle rattle, with two weapons, a gas mask and everything," she says. "Now I'm walking around with nothing, and I'm like 'Oh my God, I'm not armed.'

 "It takes a bit to realize you're safe and don't have to look over your shoulder."

She and doctors say her symptoms are completely normal.

"I work at the VA hospital. I see people with (post-traumatic stress disorder)," she says. "That's not me."

http://www.msnbc.msn.com/id/4425468/