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How good is the U.S. military at determining who is fit for battle?

Ten years into the war in Afghanistan, and after nearly nine years of war in Iraq, we know that the defining injuries of these conflicts for our service members include traumatic brain injury and post-traumatic stress disorder. We also understand that the all-volunteer force is stretched thin and that multiple deployments to combat zones are routine.

What military physicians don’t have a good sense of, however, is how to tell whether a combat veteran is still qualified for the battlefield. And the tragedy this month in Afghanistan, where Army Staff Sgt.…  Seguir leyendo »

“Every day I was in Vietnam, I thought about home. And, every day I’ve been home, I’ve thought about Vietnam.” So said one of the millions of soldiers who fought there as I did. Change the name of the battlefield and it could have been said by one of the American servicemen coming home from Iraq or Afghanistan today. Wars are not over when the shooting stops. They live on in the lives of those who fight them. That is the curse of the soldier. He never forgets.

While the authorities say they cannot yet tell us why an Army psychiatrist would go on a shooting rampage at Fort Hood in Texas, we do know the sorts of stories he had been dealing with as he tried to help those returning from Iraq and Afghanistan readjust to life outside the war zone.…  Seguir leyendo »

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.…  Seguir leyendo »

The American troops in Iraq daily face the risk of death or injury — to themselves or their fellow soldiers — by homemade bombs and suicide attackers. So it is not surprising that post-traumatic stress disorder is a common problem among returning soldiers. But how many, exactly, are affected?

This question is key to determining how large an investment the Department of Veterans Affairs needs to make in diagnosing and treating the problem. The United States Army’s Mental Health Advisory Team, which conducted a survey of more than 1,000 soldiers and marines in September 2006, found that 17 percent suffered from P.T.S.D.…  Seguir leyendo »