War is hell, Union General William Tecumseh Sherman famously said 14 years after the end of the bloodiest conflict in U.S. history. It is only those who have neither fired a shot nor heard the shrieks and groans of the wounded who cry aloud for blood, more vengeance, more desolation.
Clearly the U.S. Civil War is not on the reading list of psychiatrist Sally Satel, a scholar at the right-wing American Enterprise Institute (AEI). Indeed, Satel sees war less as hell than as a golden opportunity for veteran lay-abouts to milk the government by overpathologizing the psychic pain of war.
Satel, whom the AEI trots out anytime the Bush administration needs cover for cutting veteran services and benefits, says the problem for former soldiers is not Post-Traumatic Stress Disorder (PTSD). The real trouble for vets, she writes, is that once a patient receives a monthly check based on his psychiatric diagnosis, his motivation to hold a job wanes. Her solution? Don’t offer disability benefits too quickly.
The commentary makes an interesting contrast to a powerful piece in the October 2006 issue of the California Nurses Association’s magazine Registered Nurse titled The Battle at Home by Caitlin Fischer and Diana Reiss. They found that in veterans’ hospitals across the countryand in a growing number of ill-prepared, under-funded psych and primary care clinics as wellRegistered Nurses are treating soldiers and picking up the pieces of a tattered army.
According to the authors, RNs across the country have witnessed the guilt, rage, emotional numbness, and tormented flashbacks of GIs just back from Iraq and Afghanistan, as well as older vets from previous wars, whose half-century-old trauma have been triggered’ by the images of Iraq.
How many soldiers returning from Iraq and Afghanistan will eventually fall victim to PTSD is not clear, although a U.S. Defense Department study in 2006 found that one in six returnees suffer from depression or stress disorders, and 35% have sought counseling for emotional difficulties. The Veterans Administration (VA) treated 20,638 Iraq vets for PTSD in just the first quarter of 2006 and is currently processing a backlog of 400,000 cases.
Out of 700,000 soldiers who served in the 1991 Gulf War, 118,000 are suffering from chronic fatigue, headaches, muscle spasms, joint pains, anxiety, memory loss, and balance problems, and 40% receive disability pay. Gulf vets are also twice as likely to develop amyotrophic lateral sclerosis (Lou Gehrig’s Disease) and between two and three times more likely to have children with birth defects.
The Ills of War
Modern battlefields are toxic nightmares, filled with depleted uranium ammunition, exotic explosives, and deadly cluster bomblets. The soldiers are shot up with experimental vaccines that can have dangerous side effects from additives like squalene. In short, soldiers are not only under fire, they are assaulted by their own weapons systems and medical procedures.
Satel need have no worries about the VA rushing to hand out cash to veteran couch potatoes. According to Fischer and Reiss, A returning vet must wait an average of 165 days for a VA decision on initial disability benefits. An appeal can take up to three years.
Reserve and National Guard troopswho make up between 40 and 50% of the frontline troops in Iraq and Afghanistanhave a particular problem, because their military medical insurance benefits only cover conditions diagnosed in the first 100 days. PTSD sometimes takes years, even decades to kick in.
When they do complain, vets can expect that their ailments will be dismissed or their cause stonewalled.
When Gulf War vets complained about the symptoms which have come to be called Gulf War Syndrome, the Pentagon told them it was in their heads, in spite of studies by the British Medical Journal and the U.S. Center for Disease Control that showed the returnees were suffering illnesses at 12 times the rate of non-Gulf vets.
For five years after the Gulf War the Pentagon denied that any troops had been exposed to chemical weapons. It took pressure from veterans’ organizations and Sen. Donald Riegle (D-MI) to get the Pentagon to admit finally that as many as 130,000 troops (the vets say the number is higher) were exposed to chemical weapons from the destruction of the Iraqi arms depot at Khamisiyah.
Veteran organizations are currently fighting the Pentagon over its refusal to screen returning soldiers for mild brain injuries. Figures indicate that up to 10% of the troops suffer from concussions during their tours, a figure that rises to 20% for those in the front lines. Research shows that concussions can cause memory loss, headaches, sleep disturbances, and behavior problems. The Pentagon, arguing that the long-term effect of brain injuries needs more research, is unwilling to fund a screening program.
Given the wide use of roadside bombs, Traumatic brain injury is the signature injury of the war on terrorism, George Zitnay, co-founder of the Brain Injury Center, toldUSA Today. And according to researchers at Harvard and Colombia, the cost of treating those brain injuries will be $14 billion over the next 20 years.
Upwards of 20,000 Americans have been wounded in Iraq, some of those so grotesquely that medicine has invented a new term to describe thempolytrauma. An estimated 7,000 vets have severe brain and spinal injuries, and have required amputations. For the blind, brain damaged, and paralyzed, war is indeed hell.
Calculating the cost of war is tricky, but Nobel Prize winning economist Joseph Stiglitz recently calculated that the price tag for the long-term health care for Iraq War vets will exceed $2 trillion.
But the hell we bring home is only a pale reflection of the hell we leave behind.
According to a recent estimate by the British medical journal, The Lancet, upwards of 650,000 Iraqis have been killed since the invasion. Most of the country’s infrastructurealready damaged in the first Gulf War or degraded by a decade of sanctionshas essentially collapsed.
Iraq’s experience is not unique.
The Vietnam War ended more than 30 years ago, but according to the recent book, Vietnam: A Natural History, Laotians, Vietnamese, and Cambodians are still dying from it.
From 1964 to 1973, the United States dropped over 14 million tons of bombs on those three countries, including 90 million cluster munitions on tiny Laos alone. Somewhere between 30 to 40% of those fiendish devices never exploded, and, according to the British Mines Advisory Group, they have killed or maimed 12,000 Laotians since the end of the war. They continue to extract a yearly toll of 100 to 200 people, many of them children.
Traces of the 20 million gallons of Agent White, Agent Blue, and Agent Orange herbicides that the United States sprayed over Vietnam still poison the water, soil, vegetation, animals, and people of Southeast Asia, producing cancer and birth defect rates among the highest in the world.
So war is indeed hellfor those who fight it, those caught in the middle of it, and those who eventually pick up the pieces.