I have been approached many times and asked to “coach” someone on how they can better present themselves at a PTSD C&P exam. I even have several widgets on my site for info on PTSD exams and so forth. It is not to instruct Vets on how to cheat but to give them an idea of what they are getting into. Maple Syrup Frank sent me a link to this article and it struck a silent chord in my memory I thought I might share with all of you.
I know about PTSD. I did two years in a war zone and some of it entailed violence. It took me several years after I returned home to achieve what I call the ‘new, revised normal”. One thing that never left me was a desire to cover my six o’clock. Another was being armed all the time. I wasn’t ‘coached” on this. I’ve never applied for VA benefits in this area. It was merely a byproduct of my environment. It does lessen with time but never goes away. Wild and crazy dreams are the only residuals that afflict me other than Hueys and O-1s going over or loud bangs. Cupcake has been kicked, clobbered and almost pushed out of bed numerous times over the years in an attempt to escape from something I don’t recall in my waking moments.
Which brings us to all of those described in the article who suffered irreparable trauma from breaking their leg on the way to the chow hall at Lackland AFB in Basic Training. I’ve worked with a fellow who was stationed in Bahrain (a noncombatant country) and nowhere near the combat zones of Aftstan and Iraq. He sought to file for bent brain and was striving to milk me for something-anything- he could use to hang his hat on to get VA comp. The problem was he was far more sane than me. I could also hear that plaint in the timber of his voice that implies a less than truthful analysis of his affliction. Face it. Some of you will always aspire to feel you were in danger and will manufacture the requisite emotions to convince yourselves and others. I see it frequently. The mind is an interesting playground of emotions and some can sway your vision of reality to fit your desires.
This creates a contretemps of sorts between those legitimately afflicted and those wannabes who see the pot of gold at the end of the VA rainbow. Some of you are very well acquainted with the fears of combat. If you’ve ever had 7.62 rounds zip past your ear or a B-40 whoosh into a nearby jeep and go off, you can identify with wanting to know where ‘they’ are and keep your body oriented to the direction of the danger. Conversely, if you are thousands of miles away in Bahrain, it cannot be said that your demise is ‘imminent’ or assured. And then we have the Major Sexual Trauma victims of assault. These folks are the ones most disadvantaged by the process as they often do not seek help for the assault- especially if it’s male on male. Women Vets were equally unlikely to do anything about it in decades past as it only caused more harm and abuse. This post is not meant to address that facet of PTSD so don’t think I am marginalizing any of you. I speak today of real combat-associated PTSD. Since the number of support troops to actual combat troops is 85% to 15%, by rights the number afflicted should be much smaller as it was in Vietnam. Granted, PTSD as an affliction was not devised until 1980, but it has many other names from conflicts past. Shell shock, the Thousand Yard Stare, the uncontrollable shakes from unmitigated fear to name just a few.
I can remember sitting on a stack of body bags eating lunch one day at Lima Site Betty. We were waiting for an Air America Helio Courier to pick us up and the glad bags were in the shade. It seemed the natural place to sit out of the sun. The Pathet Lao inhabiting the bags were by now having their spiritual meals with the Phee (Laotian for spirits) in the next world and could care less. By rights, according to the DSM- IV I should be horribly afflicted with guilt for sitting on the dead Tahann (soldiers) but I’m not. Does this mean I’m inured to mental anguish? I’m sure a head shrinker would have a field day with this and try to pigeonhole it into some suppressed emotion due to explode in X number of years. Sorry. No sale. I remember it vividly and it didn’t give me erectile dysfunction for life. It stunk to high Heavens. We used to carry a little jar of Vick’s Vaporub and put a spot of it under our noses to mask the smell. If you didn’t have that, a small bandana of parachute silk and a dip into JP-4 or AVGAS would do the trick, too. The mind has a special device that blocks a lot of this out in times of stress in most of us. We take a cue from those around us and whether they are quaking in their boots, too. No one aspires to be the rock of Jello in an emergent situation so many squelch that fear of injury or death and press on.
What is it that sets some of us apart? Why is my rubber band in my noggin more resilient that that of, say, Bruce Almighty down in Georgia. Could it be the sum of the mental insults combined over time? Bruce did four tours back to back- from 1968 to 1972- a large portion of it in a dustoff chopper as a combat medic. Contrary to popular belief, that big red crosshair with a white background did not give him immunity from ground fire. If anything, it was an improved aimpoint in the smoke and haze of battle. Add in the brainf___K of bullets hitting all around you out in the open in a hot LZ and no way to defend yourself. That is the essence of bent brain. It’s the reality of the very real probability that the Golden BB is going to find you eventually. In time, it turns into a fatalistic approach to life. Why burn both ends of the candle when you can break it in two and light four ends at once? I’ve been there and done that. I don’t need to ask others about it.
Compare that to more recent Vets who ran convoy up the highway from Baghdad to Mosul. The threat of violence was tantamount to actual harm in these instances (IEDs) but it fades in comparison to five minutes of Hell or actually being hit and wounded. Seeing a fellow airman or soldier get dusted can be a predicate for bent brain but it only mobilized me to become more violent and vindictive-not fearful for my life. Somehow, over time, that emotion subsided and was replaced with sadness- and lastly- closure or something similar that ameliorates the ache.
Thus all of you who felt you were in danger, regardless of how far or near your service to the ‘front’ was, can understand that some of us who served in Southeast Asia look at those of later wars and ask what all the theatrics are about. The constant worry that bad things might have happened can never be the predicate for a lifetime of bent brain. Everyone who serves in combat brings away a different perspective of the horror. Those who didn’t often try to conjure up an alternate reality of “But what if I had been hurt? We were 80 klics from the fighting and we always were on DEFCON 2 so we could have been legitimately impacted. The fact that we weren’t does not lessen the fear of imminent bodily harm.” Alternate realities are all well and fine but they are a compendium of nothing more than “might have”, “could have”- or less. To me, a CIB or a CAR are the predicate for opening a discussion about PTSD. A Purple Heart can also be a valid conversation starter on this subject. Merely possessing an “I was there medal” somehow does not evoke the sympathy of those who were doing the shooting.
My answer to the “almost” argument isn’t simple. PTSD is something that makes your eyes get wet merely thinking about an event 40 years ago. It’s a storm inside your mind that never abates-that just subsides for periods of time. With luck, it relinquishes it’s grip eventually and let’s you resume a semblance of your earlier life. To me, PTSD is not a disease but an affliction akin to Tinnitus. You feel it, you live it and you live with it. No one else can see or hear it. But primarily, with PTSD, you had a stressor that was valid. One that jumps up and bites you on the ass at 3 AM-for eternity like a Groundhog Day movie. Try stuffing the intestines back into a friend as you light up a Marlboro Red for him and tell him it’s just a minor flesh wound. Circle a downed aircraft in Indian Country with no other air assets other than a S&W Model 19 and a CAR 15 and try to run off a well-armed cadre of Pathet Lao determined to kill your friends on the ground. That, ladies and gentlemen Vets, is the predicate for a lifelong echo of PTSD in the noggin. Why I was not irreparably impacted will always make me wonder for life. I eat no drugs to modify my persona. I wouldn’t even if they were prescribed. Granted, I am one person who legitimately should be afflicted but am not. Why, then, the plethora of those now claiming far less exposure and far more deleterious effects that preclude employment? Does the new generation of warrior being turned out by the Army have some inherent mental defect that arises about the time they separate? What separates these two generations of Warriors?
After reading the article, I cannot say that I am convinced every Vet applying for PTSD actually suffers it. Admittedly, everyone has a point where the rubber band breaks. And then there is the flip side of the coin-all the Major Mental Disorders (MDDs) such as schizophrenia, bipolar disease, depression, anxiety, et cetera. None of those can be blamed on combat or the diagnosis would be PTSD. An interesting contretemps. But that is the subject for another day.
You can bet VA will only become more selective in the future on this subject. Be prepared.