Does the widespread reaction to the recent expose at Walter Reed and the neglect of some of our nation’s physically wounded Iraq veterans indicate that our nation has had a wake-up call to what the full impact of war entails -- and what is required to address it? As a Vietnam veteran with a 25-year leadership career with the VA, please forgive my skepticism. The underlying institutional problems go far beyond any benefits from sacking high-ranking officials; cosmetic cover-up and pest control treatment at one military facility; and renewed time-limited Congressional oversight that eventually dissipates.
Walter Reed characterizes one of over 30 lessons unlearned about our nation’s treatment of war casualties over many decades: Our country sends us to war. Our military uses us in war. And our country forgets us after war. This unlearned lesson is compounded by a second lesson. When our nation sends us off to war, a sacred covenant is made -- in return for going into harm’s way and putting our lives and our comrades-in-arms’ lives and health at risk, the nation promises to honor our sacrifices and provide humane and timely war-related financial benefits, health and medical/mental health services. When this sacred covenant is broken, despair, isolation, rage, and alienation cascade in turbulent waves over our war-wounded and their families.
The wounded languishing at Walter Reed reflect the plight of many veterans who have been, are, or will return to find themselves warehoused too often in sub-par facilities and inattention in the limbo of “medical hold” status at numerous military installations. Just check out medical holds at Ft. Benning, Ft. Dix, Ft. McClellan -- or elsewhere. As one mother of a severely wounded Iraq veteran said, “When he was no longer of use to the military, they forgot about him.”
These physically wounded are a fraction of a much greater number of casualties even more forgotten -- those suffering post-traumatic stress and other serious mental health problems. Various studies indicate mental health problem prevalence rates of up to 30 percent or as many as over 400,000 uniformed Americans who have been deployed to Iraq and Afghanistan to date! And this number will grow exponentially, because the acute psychiatric casualty rates of war always are much less than the longer-term casualty rates.
And then, the Department of Veterans Affairs, the object of several recent investigations, epitomizes more unlearned lessons. The head of the VA is a political appointee; thus, VA officials typically echo what the White House stance is and not necessarily act as vigorous advocates for veterans’ interests (Max Cleland was a notable exception)…another unlearned lesson. When a “new” war is being conducted, veterans of prior wars, their families and programs are pushed to the bottom of the priority list. In the midst of the emotionally charged climate to support our forces in harm’s way, perhaps this is somewhat understandable -- understandable, but absolutely not acceptable.
A related unlearned lesson: pro-military political forces are not necessarily pro-veteran; too often they consider funding for veterans’ programs to be detrimental to funding the enormous costs to sustain the DOD in (or out of) war. And veterans’ programs suffer. It was the case before and during my leadership of several VA national and regional PTSD programs, and it is the case today.
One recent example: a McClatchy Newspaper study revealed that some 100 local VA clinics provided essentially no mental health care in 2005! And this is to a veteran population that includes still as much as well over a half million veterans from the Vietnam War alone with war-related mental health problems -- the unseen or hidden casualties of war. And both physical and mental health casualties and their families are left, by and large, alone during the ensuing decades to fight the unglamorous, unbelievably courageous daily battles with lifelong, unremitting severe chronic pain, disabilities, disfigurement, impairment and/or anguish from seemingly indelible horrific war trauma memories. Research reveals that those wounded are among the highest at risk to develop PTSD -- a double whammy.
Another lesson unlearned is the collusion to not tell us all that studies since WW II consistently demonstrate a very strong linear relationship between exposure to combat and the development of mental health problems, e.g., those who encounter the heaviest combat, have extended or multiple deployments are at higher risk to develop war-related problems. This is exactly what is happening today. The costs and implications for war policies and taking care of our own now and later are enormous -- and lest we forget or not care, for tens if not hundreds of millions of Iraqis.
Furthermore, in Iraq, the increasing nastiness of and prolonged exposure to horrific combat conditions are combined with the increasing polarization and divisiveness about the war in Iraq and the growing specter of no honorable way out. These factors fuel a perfect storm of anguish and malaise that may well engulf untold legions of yet another era of wounded warriors and families.
Do not let Walter Reed be only a wake-up call; insist that our nation rallies to support the full range and duration of physical, psychological and social casualties of war and fully honors that sacred covenant that has been forged in blood and sacrifice. And yet...the experiences of innumerable Vietnam and (still counting) Iraq and Afghanistan veterans and their families keep intruding and pulling at my heart, whispering loudly to me, “You know that this, too, shall pass and if history tells us anything, it is that, once again, selective amnesia will eventually envelop yet another era of veterans and their families.
Dr. Raymond M Scurfield, recognized internationally for his expertise in war-related trauma, has written a trilogy of books about war’s impact. The most recent is "War Trauma. Lessons Unlearned From Vietnam to Iraq." He also has several writings about the impact of Hurricane Katrina. He is a professor and director of the Katrina Research Center at The University of Southern Mississippi Gulf Coast and can be contacted at firstname.lastname@example.org . More information about Scurfield is found online at: http://www.usm.edu/gc/gchealth/scurfield/index.html .