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thedrifter
01-26-09, 09:49 AM
January 26, 2009
Op-Ed Contributor
Troubled Minds and Purple Hearts
By TYLER E. BOUDREAU

Northampton, Mass.

THE Pentagon’s recent decision not to award the Purple Heart to veterans and soldiers suffering from post-traumatic stress has caused great controversy. Historically, the medal has gone only to those who have been physically wounded on the battlefield as a result of enemy action. But with approximately one-third of veterans dealing with symptoms of combat stress or major depression, many Americans are disappointed with the Pentagon’s decision; many more are downright appalled. As a former Marine infantry officer and Iraq war veteran, I would urge the Pentagon to consider a different solution altogether.

First, let me say that both sides of the Purple Heart debate have expressed some reasonable concerns. Those who believe that the Purple Heart should be reserved strictly for the physically wounded hold a more traditional sense of the battlefield in which wounds are bloody and undeniable. The gashes of war carry an irrevocable purity that tends to make the issue concrete and uncomplicated.

And yet there have been complications. During the 2004 presidential election, John Kerry’s Purple Hearts, awarded for his service in Vietnam, were labeled by his opponents “purple owies” because the wounds he suffered were not considered dire enough. It was a petty episode, to be sure, but it demonstrated the disparate views of this medal. In the interests of guarding the nobility of the Purple Heart, many service members, including me, have suggested that not every last physical wound merits a decoration.

When I was in Iraq, the most common wound behind the many Purple Hearts we awarded was the “perforated eardrum,” an eardrum punctured by the concussion of a nearby explosion. In the vast majority of cases, no blood was ever shed. Seldom did these marines ever miss a day of full duty. And yet they were all awarded the coveted medal.

Admittedly, I was dubious about the “recognition” of these and other lesser wounds; I felt that in a way they subverted the obvious intent of the Purple Heart — honoring soldiers who have been seriously hurt. But where to draw the line? Perhaps it should be awarded only to those who required admittance into a combat support hospital. “The Purple Heart deserves at least one night out of action,” I argued at the time. But my own commander stood fast by the rules, affirming: “A combat wound is a combat wound, no matter how small. So they get the medal.”

A year later, back at Camp Lejeune, N.C., I was making calls to the families of wounded marines — a difficult duty even when the wounds were minor. But I noticed during that time that I never once made a call to a family about a marine’s psychological wounds. I never got a casualty report for post-traumatic stress, despite the rising number of veteran suicides. Never once.

Why, I asked myself, if a combat wound is a combat wound no matter how small, shouldn’t those people suffering from the “invisible wounds” of post-traumatic stress also receive the Purple Heart? Difficulty of diagnosis is one of the central justifications the Pentagon has given, citing the concern that fakers will tarnish the medal’s image. Spilt blood cannot be faked.

But this seems an unconvincing argument not to honor those who actually do suffer from post-traumatic stress. For example, the possibility of fakers has not prevented the Department of Veterans Affairs from awarding disability payments to service members who have received a diagnosis. Why should the military itself be different?

The distinction, I suspect, lies in the deep-seated attitude toward psychological wounds. It is still difficult for many members of the military to truly believe that post-traumatic stress is, in fact, an injury and not the result of a weak or dysfunctional brain. The same culture that demands tough-mindedness also encourages skepticism toward the suggestion that the violence of war can hurt the healthiest of minds.

Still, almost all service members agree that veterans suffering from confirmed cases of post-traumatic stress should be cared for. The reality of psychological wounds is becoming harder and harder to deny. That post-traumatic stress can lead to suicide is no longer in question. That far too many of those returning from combat experience deep and long-lasting devastation is irrefutable.

So why not recognize the struggles of these many individuals with a medal? Why, for instance, if a veteran has been given a diagnosis of post-traumatic stress and awarded benefits, should he not also be awarded a Purple Heart? Sadly, as long as our military culture bears at least a quiet contempt for the psychological wounds of war, it is unlikely those veterans will ever see a Purple Heart. That is too bad, I think, because they do deserve all the honor the physically wounded receive.

But there may be another solution — perhaps a new decoration, a new medal, could be established specifically for those suffering from post-traumatic stress. It would be awarded to those whose minds and souls have been sundered by war.

I urge General Eric Shinseki, the new head of Veterans Affairs and former Army Chief of Staff, to work hand in hand with the Defense Department to bring about some form of official recognition for these wounded veterans. The current stigma of post-traumatic stress would likely prevent many soldiers from wearing the medal initially, but its mere existence would help crystallize in the American — and the American military — consciousness one of the more obscure human costs of war.

I suggest we call this medal the Black Heart. Certainly the hearts of these soldiers are black, with the terrible things they saw and did on the battlefield. Certainly the country should see these Black Hearts pinned on their chests.

Tyler E. Boudreau, a former Marine captain, is the author of “Packing Inferno: The Unmaking of a Marine.”

Ellie

thedrifter
01-26-09, 10:04 AM
Local veterans disagree whether PTSD merits a Purple Heart
By JEFF FRANTZ

Daily Record/Sunday News

York Daily Record/Sunday News
Updated:01/24/2009 10:25:21 PM EST


They both had to hang up the phone.

Marty Riggins and Rick Rozell -- two Marine veterans living in York Township with post-traumatic stress disorder, two friends who have leaned on one another for more than a year -- were about to start yelling at one another.

One of them had mentioned the Pentagon's decision announced earlier this month not to award the Purple Heart, given to soldiers, sailors and Marines wounded in battle, to veterans diagnosed with PTSD.

Rozell, who served in current wars in Iraq and Afghanistan, has been rated 100 percent disabled because of PTSD, a traumatic brain injury and neuropathy. The decision, he said, was just another example of the Pentagon attempting to screw over veterans.

And he fully expected Riggins, permanently disabled, subject to the same type of nightmares, flashbacks and paranoia, to agree. The other veterans living with PTSD he had spoken with certainly had.

Except, Riggins didn't.

* * *

In announcing its decision, the Pentagon said the prestigious decoration was meant for those physically injured on the battlefield.

"The Purple Heart recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member," defense department spokeswoman Eileen Lainez said.

"PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event." It is not "a wound intentionally caused by the enemy from an outside force or agent," but is a secondary effect caused by witnessing or experiencing a traumatic event.

Lainez added that the Pentagon recognizes PTSD is real, and veterans suffering from it should receive any needed care and benefits without being stigmatized.

George Eyler, a Korean War veteran and adjutant of the York Chapter of the Military Order of the Purple Heart, said the Pentagon's decision upholds the historical standard for which the decoration has been awarded since Gen. Douglas MacArthur established it in its modern form in 1932.

"When you were wounded, you're bleeding," Eyler said. "You definitely were in combat, you were shot at, you were bleeding."

That doesn't mean PTSD should be ignored, Eyler said. After he was wounded in Korea, Eyler spent two months recovering in a hospital. The terror of combat, he said, was a daily companion for almost a decade. If PTSD was a known problem at the time, he might have been diagnosed.

"It is a serious thing but I don't think it warrants the Purple Heart," Eyler said. "I'm not saying they shouldn't be compensated for it. They should."

* * *

Rick Folkenroth is a Vietnam veteran living in Red Lion. Diagnosed with PTSD, he's active in the veteran community urging others to get the treatment they need.

The Pentagon's decision was a slap in the face, he said, and not at all surprising.

Ever since PTSD was named in 1980, the military and the Veterans Administration, now known as the Department of Veteran Affairs, have denied and downplayed the disorder, Folkenroth said.

If veterans continue to see a stigma in PTSD, Folkenroth said, they might not seek the treatment and benefits they deserve. A Purple Heart would reduce the stigma.

"It's just going to take time," Folkenroth said. "Veterans have to fight for everything we have."

* * *

Every day, Rozell feels the effects of his service: He can't hold a job, can't maintain focus, can't go out in crowds.

To him, those problems are equal to a wound that sheds blood or takes a limb.

"They can go about their life and learn to deal with it while people with PTSD always have to deal with it," Rozell said. "What about people with shrapnel? All they're going to have is a scar and they're going to get a Purple Heart for it.

"People need to understand PTSD is a disability just as if you lost a leg or something like that. And that's what irritates the hell out of me."

Veterans with Purple Hearts also qualify for a higher grade of benefits, such as waived co-pays for VA medical treatment and priority when scheduling. That also doesn't seem right to Rozell.

"I think all veterans who serve in a combat environments should have the same benefits as everyone else," Rozell said. "A Purple Heart is just a medal. That's all it is."

* * *

Riggins suffers similar problems to Rozell.

But the veteran of the first Gulf War doesn't see his friend's point.

"I feel like it would be degrading somebody else, another Marine who was wounded in combat," Riggins said. "I had a buddy who lost his leg. I wouldn't want that."

One reason cited by the Military Order of the Purple Heart in arguing against giving the Purple Heart to veterans with PTSD was the possibility that some veterans would fake symptoms to receive the decoration. Riggins agrees.

"Some people would fake it just to get the tag on their car. Just so they could wear a hat," Riggins said. "There's a lot of things in the mix."

Those coming home from these wars mentally damaged -- and those who came before them -- need outreach and care, Riggins said, not an extra medal.

"I don't know why anybody would want a Purple Heart," Riggins said. "Having PTSD, it changes your outlook on everything, but I still don't think it's the same."

-- The Associated Press contributed to this report.

jfrantz@ydr.com; 771-2062

WHAT IS PTSD?

Post-traumatic stress disorder is an anxiety disorder that can occur after a person has survived a life-threatening event, such as combat, a violent crime, a sexual assault, a natural disaster or a car crash.

PTSD can cause a person to become isolated, depressed and quick to anger. People often relive the event through flashbacks and nightmares. They struggle to sleep. Sometimes, those suffering from PTSD will report an emotional numbness.

PTSD can often lead to substance abuse problems, difficulties holding a job and relationship difficulties.

Doctors are still learning about PTSD. Two people might have different short- and long-term reactions to the same trauma, and no one is sure why.

ON THE WEB

To read more about PTSD and other issues facing local veterans and active service members, visit ydr.inyork.com/ydr/vets

Ellie