Contact: Time Measured in Seconds

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Contact. What is it? It’s a radio-call; it’s an event; it’s something you receive, not something you get to give (there are other words for that); it is what you train for. What is contact? I realized that contact means a little something different to everybody who receives it, because we all have different jobs, functions, and reactions to contact. I figured I would explain to you what contact was like for me as a lieutenant.

You are on a dismounted patrol, doing what it is you do with the Strykers not too far off nearby. And even though you have been at this racket for what seems like forever, reality intrudes in a violent way. Close-in AK fire erupts from somewhere; it echoes from the alleyways and buildings, initially throwing you off slightly.’That is close’ you think. “Audible” someone calls. You crane your neck as everyone else looks around a bit. In a second you start to mentally assess where the entirety of your patrol is – my immediate thoughts are 1) validate cognizant understanding of where all of my men are; 2) identify where that fire occurred, to and from what direction; 3) assess the situation to see if this is something that needs relayed higher, or is an isolated incident.

I grab the mic to my MBITR dismounted radio. I call what is left of my mounted platoon trailing somewhere behind us; “Blue, this is Blue One – audible, are there eyes on?”

Snap, pop. It’s not a breakfast cereal. The crackle of the rounds over your head; you expected it, you recognize it. You never forget it. Already-hurried processes now increase. I didn’t even get the rest of my radio call out, but now I am ducking and throwing myself against some courtyard wall, somewhere, on some street, in some shit town, Iraq. How the mental checklist goes as time rapidly unfolds across an eternity:

‘Shit that was close. Where did that come from?’ You look around, seeing your men sprawled out in different positions all along the street. ‘What do you see?’  There is a pop or two, someone just firing off rounds not really answering back the enemy, but sounding like they meant to.

“Contact!”

Time slows down for a second, even though you’ve been through this retarded time-machine before, each time is new. “Who has eyes on?” I yell out. All in unison there are random shouts from here and there of what people see, know, or think they know. ‘Where is Bravo section?’ I can’t immediately see them; where are they, do they have enough cover? Where are the Strykers? I crane my neck out some. I assess the situation; the men ahead of me are doing the same. We are displacing; I eye a nice patch of wall just across the alley where I would rather be.

Courage; it isn’t given a second thought, it is just what you and everyone else needs to do. “Moving!” I heave myself up and dash across the alleyway, quick like a bunny. I find a real nice ditch at the outside of someone’s courtyard. This is mine now. You own that plot of land and by hell you’ll fight for it square inch by square inch. ‘Better call this in.’ All part of the larger picture. My NCO’s are taking care of the real business, I flip the switch and radio to the tactical operations center, Rattlesnake Main.

“Rattlesnake Main, Charger Blue One – Contact, small arms fire vicinity intersection, Route’s Bell Air and Chevelle, Al Qadasiya neighborhood, dismounted and developing the situation, over.”

I have just opened the Pandora’s box of necessary evils, as I am expected to call in, yet every second of radio silence from this moment on will be met with frantic radio calls from Rattlesnake Main for situation reports. ‘Shit, where are these assholes?’ I crane my neck out near the corner; the fire erupts once more, as chips of concrete from walls, concrete block, and pavement flake around me. Self-preservation. ‘Okay – don’t do that again.’

An engine whines in the background; the Strykers approach as boots beat pavement, taking up positions on the opposite side of the street- Bravo has advanced to the sound of the gunfire. ‘I guess we need to action-on, and advance.’

“Someone get some high-ground! Alpha, on me! Bravo, covering fire!” and with that heave up, deserting this patch of land I had recently claimed via imminent domain; I want it no more. The M240 belches out a roar down the street as we advance, carbines raised to the backdrop of some neighborhood, in some town, Iraq. No one around and no one seen. Just empty windows and closed metal doors concealed a dozen buildings or more. Something stupid always pops into my head.

I think it is the stimuli of combat; must be all of the synapses firing in the brain. Inevitably I remember some random inane fact or thing I had been trying to recall last month. As I dash down the alley with the men,’oh, I had an H.R. Pufnstuf lunchbox in third grade. What ever happened to that?’

We find new patches of ground to call ours. The radio continues to echo in my ear, Rattlesnake Main repeatedly calling for a sitrep – ‘Well, give me some time to develop the damn situation, will you… My eyes dart about. I am seeing where we are; where the men are; I call to one of my Strykers and ask it to advance (it was partly doing so anyways). The .50 decides to rip into some poor bastard’s top floor. Communicate. Coordinate. Move. Shoot.

‘Do I even have time to shoot? Do I even have a shot??’  Hell, did I turn my EO Tech optic on? I check – yes, yes I did.

There is relative silence as we continue to advance. Fire echoes from down some other alleyway. We continue this leapfrog, my mind darting from the men; the situation; the reporting; the cover and concealment; the war; the invisible enemy we face.  The streets calm as the insurgents have peeled-off back into the scene. We mount a concerted counter offensive, yet never regain contact.  We question the poor few souls who came outside on this day. There is a whisper down the road we trod.

Calm returns. The patrol continues. Radio reports are relayed. And all of this a normal part of an average day.

“Spooky:” or, “The Making of the Swiss-Cheese House”

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Rimming the northern tip of Tal’Afar, along route Sante Fe, between checkpoint 101 and checkpoint 201 was a slight slope, or incline in the terrain that was steep enough that you couldn’t quite see up and over the hill. As you approached its apex, the rest of the route easily became visible; it was at that very pinnacle that there was a concrete house on the corner of a small road that jutted out nearly to the road. The entire right-hand side (or south side of the road, as it would be) was a long series of Tal’Afar neighborhood homes, but this one seemed to have been built extremely close to the road. We called it “the shoot house.” We called it that because it was abandoned, but due to its popular location almost at the top of the grade of the hill, and on the corner of that narrow street, it was the perfect place to shoot at American convoys going up and down route Sante Fe.

A very grainy photo of ‘the shoot house’ circa December, 2004

You easily could initiate a small arms ambush, or trigger an IED and then skulk away into the back alleys and courtyards of the neighborhood. And often times that is exactly what happened. It was the location of a coordinated ambush that hit my platoon one night when we were tasked with escorting an engineer company out of town; the IED and corresponding small arms fire disabled the Stryker in front of me, my lead vehicle, forcing us to drift to a halt right in the middle of ‘the kill box.’ Thankfully we had superior firepower as compared to the RPG’s and small arms of the insurgents, and my men were only lightly wounded.

But it was for this reason that when given the chance at an opportunity, our Squadron was more than happy to oblige. As a whole, the Squadron had its fill of the shoot house being used for nefarious purposes. One sunny day in Iraq, word came down that we could have use of an Air Force asset that had been relocated to the AOR for two weeks: The AC-130 Spectre gunship, or “Spooky.” As there were rules of war, we couldn’t just shoot any-old-thing around Tal’Afar, so the shoot house was put forward as one nomination for a target package. At the end of the day, the shoot house won out.

AC-130 ‘Spectre’ Gunship on display at the U.S. Air Force museum, Dayton, OH.

But, as there were laws of war and what have you, we were required to attempt to locate any legitimate owner of that home; we already knew that the shoot house and its surrounding five homes were all dilapidated and abandoned, but still had to at least make it look like we were making an effort. And then we had to ensure that no Iraqi civilians were going to be in or around the premises the night the operation was scheduled to take place. So Civil Affairs devised some IO fliers that essentially said “it is dangerous at night so don’t go near this house on Tuesday night” (or something to that effect). They also came up with some pretty cool ones in the line of “There’s a red-eyed dragon in the skies at night. Obey curfew of it might spit its fire at you.” I thought that was pretty cool, but in order for the IO to be successful, you had to show them that there was actually a dragon.

And on the night in question, Spooky did just that. It had been circling Tal’Afar all week late in the evening, or early hours of the morning, looking for blatant targets of opportunity (or if there were U.S. troops in contact). But the night had finally arrived for the show of force. I wasn’t sure how people were to see it, unless they could do so from the courtyard or roofs, once they heard the commotion and if they dared emerge from their homes.

Spooky rained-down precision fire on the shoot house, spitting red tracers from its cannons and guns. Anyone who would’ve seen that display of power surely would have given serious thought about violating curfew – even if they were just going to a neighbor’s house for tea, and not running around town planting IEDs.

After that day we stared calling it the Swiss-Cheese house. You’d get occasional activity, but no one really was able to use it as trigger or ambush points again. Funny how some stuff sticks.

“Oh, you want to go to the Housaniya neighborhood? Well, go up Sante Fe to the Swiss-Cheese house, then turn right…can’t miss it.”

The Only Thing Now is War

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Home.

It’s a foreign word. Invisible. Home; almost like it does not exist. You remember it, you may see pictures of it, receive emails from it – but in the head it is as distant and imaginary a land as any child may dream up on a rainy Saturday afternoon. Unreachable. When the ‘Groundhog Day’ effect seeps into every portion of your existence- making every day the same over, and over, and over again.

And over. Such distinct dreams and thoughts of home become clouded in the veil of uncertainty that is this place, this time. The only thing real is now. And the only thing now is war.

The war is real now. It was before but is more-so now when it is devouring you; unknowingly at first, but as each day passes you sink deeper and deeper into the mouth of the beast that is war. There is nothing else. Dream if you want, but do so on your own time .

There’s work to be done and we’ve no time for that nonsense now. You’d best erase whatever notions of the life you had once because even though there may be eleven, nine, or six months left on this tour – eleven months is an eternity. Nine months the same. And six just a tease to make you think eternity ends. Time is irrelevant here. Seasons pass, measurements taken in the form of casualties lost, detainees taken, weapons found – but though tomorrow may be your last, any day may very well be your last.

Put your humanity on the shelf; pack it away and hope if you make it out alive it still remains where you have left it. ‘Out of here’. Laughable.

There is no way out of here, once you’re in here, you sir are in for good. The ultimate double-down, playing for keeps. No sir, if you wish to survive this eternity, best erase this pretend notion of this ‘home’ you so speak of.

Treatise penned in my notebook during during lulls in the Surge. Often time men dreamed of home and loved ones to keep motivated and going. For others, accepting that life was now war, and that the only thing now is war, was the only way to keep sharp and remain sane. The desert does strange things to your mind. It is best to do what is necessary to survive. 

 

Veteran Resiliency: What Did You Get ‘Used To’?

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Earlier this week my better-half and I were walking into work and she made an offhand comment to me that made me think. “No matter how many times I see it, I just never get used to it” she said. She was referencing the armed police officers at our facility. Without going into too much detail, it being a government facility, our federal police are occasionally more armed than normal. To go from seeing a uniformed officer saying hello on Thursday to having two officers clad in body armor sporting H&K rifles on Friday is a normal occurrence.

Well, for me I suppose…

You see my better-half is Australian, and they have an entirely different society when it comes to guns, and a different culture when it comes to force protection. Without turning this into a debate on guns or cultures, I want to focus more on the comment that she made.

She just had a difficult time getting used to seeing this. I think I replied back that you would be amazed what you can get used to. I think as veterans, we have a solid and intimate understanding of that.

 

 My first night ever in Iraq, FOB Marez was mortared as I was walking to take a shower. I think I had been boots on the ground all of two hours. The whistle overhead of the passing rounds and rapid-succession Ka-Woomph! Ka-Woomph! Ka-Woomph! scared the hell out of me. It was a stark reminder that the local Mosul homeowners association had sent a welcoming committee. But after a few weeks, you begin to become acclimatized to that fact that you were getting mortared roughly four to five times per day. And inside of a few months you were so used to it, that it neither phased or bothered you. When once you were scrambling for a bunker while the guys from the unit you were sent to replace looked at you funny, now you looked at the new guys weird as you kept on walking (because you knew by the sound of the explosions the mortars were too far off to bother with).

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But what the human body and mind can become accustomed to goes far beyond growing used to being mortared. On mounted or foot patrols daily you grow accustomed to the fact that death surrounds you. At any point in time death may exercise his right to claim you, and you just accept that and move on. Accepting death is a key part of staying alive during deployment – it gives you the edge enough to be vigilant, alert, and poised – without the fear, nearsightedness, and jitters associated with constantly being afraid to die.

As soldiers we get used to being far away from home for long periods of time; we get used to long hours at work; endless hours of boredom; living in filthy conditions (or holes in the dirt); we get used to pissing in bottles; we get used to going places to get shot at when the reason why makes little or no sense.

At some point everything that has an air of absurdity about it becomes normal. Accepted. Expected.

As humans, we get used to seeing famine and starvation; we get used to living in corruption; we get used to living in a system or society where for us there is no justice; we get used to dictatorships; and we get used to seeing people executed in public to prove a point.

I guess what I am trying to say is as veterans, combat and servitude have taught us resiliency. We get used to things that an entire other generation of people could never comprehend or imagine. And with that resiliency we can prevail in our reintegration to society (and frankly make it better, I believe).

You got used to walking with death daily – you can get used to all the BS of ‘back here’, too.

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The Breaking Point: Crisis 11

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Baghdad: 14 November, 2007.  I was walking to the chow hall to grab my morning bagel and head into the tactical operations center (TOC) when I heard the low, resounding ‘ka-whoooomph’- the unmistakable sound of a VBIED or large IED. For a moment I was taken back to that day in Mosul in ’04 when the command post windows shuddered and the dust fell from the ceiling- the day a VBIED struck the 1-14 Cav patrol during RIP-TOA. Two men died that day; several lost limbs.

‘That’s a big one’ I mumbled to myself as I continued my walk but now with a faster pace. I swing through the TOC and the kid from intel asks me to help him plot a grid; Pale Horse Troop’s Mortar Platoon had struck an IED just 75 meters outside of ECP2, just outside of the Green Zone, and they wanted to see if where it was – because that couldn’t possibly be true. Report on casualties, 1 walking, 1 litter.

My thoughts immediately went to the boys in Pale – for they were the old Charger Troop of yesteryear where I grew up, did all my platoon leader time, and flew the banner under which I fought in OIF III; My brethren, my kin. Most of my men are still there.  My men.  Well, someone else’s men now – but always in my heart and mind – they will be my men.  At least their new platoon leader is a good kid.

Sergeant Major strolled into my office clad in all of his gear. He walked around the shop- only myself, my Lieutenant, and the Navy guy who loaded all of our counter-IED equipment were present. He closed the door. “Ya’ll hear about Pale Horse.” It was more of a statement than a question. We answered yes. He shook his head and turned to leave. I asked if there was any change to the status of casualties. He turned around, looked around one more time. “Ah, shit Sir you’ll hear it soon anyways. We had a KIA. The new Lieutenant got hit”.

The new Lieutenant.  His name was 2LT Pete Burks and I had dinner with him last night, and we talked about Iraq and the Iraqis.  See, he was down on the line now – when he arrived to the Squadron about a month ago he was attached to me (along with my other current Lieutenant, also new) to get a little air under his wings; get the lay of the land, try and ripen a bit in the sun.  I was now on what we call ‘special staff’ working civil-military operations.  I had two civil affairs teams attached to me, a Stryker, a Humvee, and the CBRN-Stryker platoon from our military intelligence company at my disposal (chemical, biological, radiogical and nuclear).  I was to groom these young men for the line.

I couldn’t concentrate right then. My hands were shaky, my eyes almost seem like they were having difficulty focusing. The air in there felt warmer. Shock.

He was assigned to Pale Horse two weeks ago; I hadn’t seen him since, and at dinner he came over and asked for a seat.  ‘Naturally,’ I said.  He had a platoon; he was going out in sector; he wanted some advice on how to perceive the local nationals.  He had a heartfelt sympathy towards them and the situation they were in.  “Pete” I said, “You remind me a lot of how I entered into this back in 2004.  Let me save you the burden of some mistakes: these people will lie to you, they will steal from you, they will be your friend when it suits them and then they will turn around and stab you in the back.”  Says the jaded, disgruntled, embittered Captain.

Now he was dead.  First mission, or some shit.  Literally had got the platoon from the other guy, handed off, and he was out being a leader.  And now he joins the ranks with the other guys I lost back when I was in Pale (then Charger).  Brothers in name, in service – and now in death.  Like some scene from a fucking movie.  I couldn’t help but think, the last advice I gave him seemed to dull his good and pure sense of servitude towards helping the Iraqi populous.  I shudder to think that he died with despair in his heart, perhaps not thinking exactly as fondly of being able to help them as he had, based on our conversation at dinner.  That ate at me (it still does).

At the 1000 Squadron Commander’s Sync, we sat down and listened to the commander give the staff a small speech about Pete, and it being OK to take an hour or so to talk a walk, and think about things – and that he didn’t mean to “be crass”, but “this is our job and this is what we deal with as a result of being soldiers”. Then he said it.

“Now the other Squadron’s will see that we’re in the fight, too.”  Boom.  Your beef with the infantry?? Prove scouts are just as good? Really, you are bringing this up now?? All in all, his attitude, delivery, and smug perceived sense of self-validation had me thinking to myself that deep down somewhere inside Pete’s death to him wasn’t just something that soldiers experience, nor was it a loss for him as a commander – it was more of a validation of him as a commander – that he is now on par with his peers across the Regiment in that he too was contributing to the fight.

You want that shirt? I’ll spare you the time, effort, and more importantly the lives of the guy’s you’ll get killed – Here; have my shirt. Been there, done that.  Trust me, not worth the trip.

I have little recollection of what happened next.  But the meeting ended.  I left the meeting bitter over the speech to prepare my Humvee for my noontime patrol. It had been in the boneyard for several weeks now to have the power-assist on the gunners turret, and an oil leak repaired.  We were going into a tight section of town, so we were leaving the larger Strykers behind, and taking out the civil affairs teams in their Humvee’s. We were short-manned that day, so I decided to drive myself, and I was going to take my new Lieutenant, and poach a dismount from the civil affairs folks as a gunner.  Like a good Soldier, I got my Humvee, drew my M-240B machine gun, loaded up my radios, and prepped my vehicle.

My Lieutenant commanded the vehicle from the passenger’s seat and I got a young kid named “Shue” to gun.  We went out in sector.  All during the mission pre-briefing I was flippant.  I was irate, not directing my anger and hostilities at any one person in general but clearly vocalizing to anyone who knew me that something was wrong.  On any given day I myself can handle about ten crises. There is a breaking point for many leaders and good ones tend to know where that is. For me, my capacity was ten. When you add in one more – that being the straw that breaks the camel’s back – I go from calm to enraged instantaneously. There is no middle ground; there is nothing except ‘Off’, and ‘Rage’.

On our way out of the Green Zone into sector the radio call came to go red-direct, and turn on our DUKES and Rhino systems. I was driving the Humvee – something I don’t really do as a matter of routine – but we needed to run the patrol light today (exactly what you want to do, right? Go out in sector undermanned). I reached to my right for my M4 to load it and lay it back down on the console when I was stricken with a very odd sense of panic and urgency: Where the hell is my M4?

It wasn’t there;  did I leave it in the motor pool? No- you didn’t leave it there – think, think! Did I leave it on the hood? The back deck of the Humvee?  Fuck I probably drove over it when we pulled out. Did I somehow get confused and put it in the Stryker?  Panic. Steer the wheel, go through the serpentine – weapon, weapon – I must have misplaced my weapon. I had to have driven over it and broke it. Think!!! No…You did none of those things – because you left it handing on the wall in your office. Fucking Jackass.

My Lieutenant asked me if I was OK.  “I think so.”

I was mortified. I had just exited the wire into Baghdad on a combat patrol, driving my own Humvee – and I had neglected to bring my rifle. Basic-fucking tenets of soldiering! What scared me more was that I got calm, and then said to myself ‘Well you have your pistol…’ I was OK with it – I had committed the mortal sin of a soldier – left my weapon behind, and I was OK with it. I loaded my pistol and we rolled on. I was now in a cloudy fog.

Dammit man, how the hell did you get here? You’re slipping! Do you have it in you anymore?? I like to think that I do, but come on – I left my rifle in my office. That is basic fucking pre-combat check material there. But, I had slipped. What else do I slip on, I wonder? What if we take fire, or take casualties and I need to fend back or repel an attack? With a Beretta 9mm and 15 rounds of 9-mil ball ammunition? But its ok, you’re just going to a few places in Khark, its safe there. Right?

Safe. That’s such a loose concept when you think about it. Safe. The perception of safety -that’s all we’re selling here. We’re paying in blood for perception. Pete thought that the entry-control point at the main fucking gate was safe – it’s controlled by the US Army and  the outer approach monitored by the Iraqi Police.

Safe.

And he paid for the perception of safety with his blood. His crew paid for it in their blood too as one sat in a medically induced coma in Landsthul, and another undergoes surgery on his arm and bicep. And we now know through these men’s blood that it is certainly not safe – that nothing is safe. It’s only as safe as it seems.  Look kids, the blast walls by the markets have nice Iraqi Flags painted on them – the walls near the schools have friendly images of children and doves and Iraqi Flags. The streets are clean, well sort of – there is less trash and shit all over the place but it is still a sty. The buildings are being freshly painted. Paint right up to the top floor where the rest is blown away from the fierce fight in the spring and summer.  Don’t paint that big pile of rubble that used to be a building, though’ we can bulldoze that into a pile and replace it with a soccer field. And it all looks very nice, and very safe.

But inside it isn’t.  And there I sat, in the parking lot of the Syrian Apartments, in my Humvee, (waiting the two hours for civil affairs to finish screening Iraqi security guard applicants – task one of this patrol) with my pistol, and an engine that is spurting oil out of the undercarriage, AGAIN. But its OK, it will be safe, because I have turned the engine off (because the oil only shoots our when the engine is on I’ve found – but not soon enough to prevent me from rolling out of the wire in it, without my fucking rifle).

I decided we had to cut my part of the patrol short. I had specific atmospherics to take that I could hand off to civil affairs; I gave all two of my passengers away to the other civil affairs Humvee’s, and I did a battle hand-off with the Major that led the civil affairs teams. I re-worked the route right there on the spot, and had the patrol swing back toward the center of Baghdad and drop me off so they could continue on the rest of their patrol and finish their objectives. I went back home alone – stupid, against protocol, and without any other crew (and without a rifle). It was half mile or less, but I wasn’t thinking.  Or was I thinking?

What was I trying to do here? What was I looking for? I didn’t know, but I made my way to the gate – not before driving right by the spot where that EPF had been that killed Pete, and seeing the blast-seat myself, and seeing for myself how it sat directly next to the Iraqi Police building and watch tower. No fucking way you don’t know a part of your curb is replaced with an explosively formed penetrater array – no fucking way.  More anger.

The guys at the front gate looked at me real funny as I rolled in alone. I have a feeling they wanted me to stop, or were really confused as to why one vehicle with seemingly no one in it just rolled in – but I had no time for them.

By the time I had got back and parked the Humvee in the boneyard (berating the civilian-contracted mechanics), I was spent.  I did a quick post-trip check of the vehicle, grabbed my M-240B to take back to the arms room, and locked it up. I then went to my office.

I sat down in my chair, spent. Emotionally and physically spent. Crisis number eleven had set me off, causing all of this that had drained me.  Caused me to lose it – to momentarily descend into madness and neglect the basic duties a leader performs in himself as an example to his men.  My rifle was hanging there, right where I left it. I was second-guessing myself.

When leaders second-guess themselves, people die.  I second-guessed myself once, and one of my men paid the price with his life.  I made a decision right quick to snap the fuck out of it, right then and there.  I was losing enough people – I refuse to lose any more.  I’ve got thirteen more months in this tour and I can’t handle more crisis eleven’s…

Veteran Pride: Finding Your ‘Happy Place’

“Why are you doing that?!! I thought you hated Iraq?!” my ex-wife said. I was sitting on the floor of the spare room, sorting through a cigar box that I had kept different unit crests, badges, and insignia in.  I had some of the medals I had been awarded laying out on the carpet because I had been contemplating making a shadow box from my time in active Army service. She stood there, harping over this. She wasn’t my ex back then, however.

It was early 2010 and I had been off of active duty for almost a year.  I was in my final semester of grad school at the University of Pittsburgh and enjoying my new career as a guardsman with the Pennsylvania Army National Guard. And much like I was learning about different aspects of public administration and public policy with my graduate program, I was starting to learn about coming to terms with the totality of my military service, and my two deployments in Iraq. In a way my ex-wife was right; I had a lot of negative impressions and memories from my two combat deployments and was struggling to come to terms with that meant to me, to be a recently separated veteran. I felt that as a veteran, there was some semblance of pride there but I was still struggling to feel proud.

I felt that I had made a lot of mistakes as a platoon leader – anything that results in seeing your men wounded and killed was, at the time for me, a huge failure in leadership. I had not fully grasped that in war, regardless of how much one can train or prepare, things are going to happen that are beyond your control. And as I was wrestling with these memories and demons, I was slowly learning to accept my failures and faults as a military officer. I was also learning to understand and accept that I also had been a good leader. That lesson wasn’t coming along as well as the lesson on identifying my faults and failures, however.

I stopped what I had been doing – my ex was extremely critical of me. We had not been married while I was in the military, and she was someone whom I met after I got off of active duty. In my struggles with PTSD and self-worth, I quickly attempted to compensate by getting involved in a relationship. I soon realized that it was a toxic, unhealthy relationship but I felt that for some karmatic reason, I deserved to be punished for all of my Iraq-related sins. She understood nothing of the Army or war, and in fact actually hated them both. She did not understand why we held ceremonies for our fallen comrades. There was a lot she did not understand.

“You’re such a hypocrite.”

“I mean, if you’re an Army person, you job is to get killed. So why is anyone making a big deal out of it? Why do you want to arrange you precious little medals to remind of you of something you claim to have hated?”  I kind of wanted to vomit when she said things like that. All of this was lost on her, and as we began to argue about my wanting to put together a shadow box, I felt a wave of heat roll over me and I got lightheaded. In anger, I screamed out ‘FINE’ and that she ‘was right.’  I grabbed the scissors that I had been using to cut and trim things and stabbed the shadow box right through the glass. I swept my hand across the floor, pushing all of my various accouterments into a pile to throw back into the cigar box. I tossed it into a cardboard box in the basement.  There was no pride to be found here.

Fast forward two years.

We were on the brink of divorce.  Well, I was anyways; surprise surprise, the relationship was failing because I was tired of being a verbal and physical punching bag for someone with her own emotional and inferiority issues. But, I was keeping this to myself, as I felt I needed to orchestrate a good exit strategy. Which was why I was surprised when she said to me one day after I came home from work “I think you should build a shadow box.”

We were living just outside of the beltway in DC, having moved there for my new job. She had met our immediate neighbors in the apartment complex (Miranda*, a stay at home mom with two masters degrees in forensics, who had a newborn and was married to an Army scientist, Ralph*).  Those are not their real names. They had become ‘friends’ but I could see that the neighbor woman was a hot mess, with daddy issues and body image issues of her own. When she learned my ex-wife was in the final year of earning a psychology PhD, she decided to make my ex her own personal therapist. Being unable to stand up to anyone on any issue, my ex generally saved her pent-up anger at life and others for me. Which is where this shadow box came in.

Initially, I thought that perhaps she was trying to actually build me and my wounded-soul up. So, feeling positive about this I obliged, ordered a display case and rooted through our storage cage to find my cigar box. I felt that I could start to revisit this ‘pride’ lesson that I had quit so readily, two years earlier. Well, the point of the story is that the woman and her Army scientist husband were snobs. He was a direct commission Army Captain. He worked in a laboratory and had no concept of the Army or service at all, really. His Army was drastically different to my Army.  He had stories from his direct-commission, scientist-basic course program. So imagine my surprise when she invites these two over for dinner one night. And there, on the wall by the dinner table is my recently-finished shadow box.

“Wow, are those all Mat’s?” the neighbor woman asked. Before I could say anything, my ex-wife was answering for me.

“Yes – he’s basically a war hero. Look, he has two Purple Hearts. See that there? What do you think about that, Miranda?” I was a little shocked, and the attitude at the dinner table was getting awkward. She continued “I mean, obviously he isn’t as smart as you are Ralph – you’re a scientist and he was just a foot soldier. How long have you been in the Army, again, Ralph? Two years?? Do you have a medal?” The night was awkward from there on, and after dinner the couple eventually went back next door to relieve the babysitter early.  The sense of smug self-satisfaction on my ex-wife’s face lit the room.

We got into a huge fight. She was’t proud of me, nor did she want me to feel pride in myself. She wanted to flaunt my service in Miranda and Ralph’s faces as a way to sort of ‘stick it to their up-tight and elitist asses.’ Who was she to try and claim my service to rub in someones face? Especially after she always put me down over it?

All of that made me mad for a number of reasons; she did not earn any of my awards or accolades, nor did she even comprehend (or care) about what toll those awards and service took, nor what they meant.  Yet she wanted to use them as her own way to inflate her own belittled and impoverished ego. And I was certainly NOT a war hero. I personally don’t buy into the whole “everyone who serves is a hero” tagline.  In an era where less than one-half of one percent serve their country, all service members and veterans deserve to be recognized for taking the oath and choosing to serve. But we indeed are servants, defenders of freedom and executors of foreign policy by force. Fighting and winning is our job. I earned no valor awards, and I was paid to get shot at, so consider that all part of the job – not being a hero.

Which brings me all back to the veteran pride issue.  We divorced not long after, and as I began to try to get my life back on track, I again began the process of seeking out what about my service I could, and should be proud about.  I started with the shadow box.  I spent some time really choosing what to put in it that had meaning to me, what the layout should be, and I tweaked it several times before hanging it on my wall.  It spent two years on the floor, leaning against the wall before I actually put it up there. I would look at it, at the unit patches in there, the ribbons and badges; I would try and recall what those things meant to me when I was a teenager before I enlisted, and then what they meant to me as I earned them. And I tried to think about what they meant to me now.

 

There was insane helmet-cam videos and GoPro stuff coming out of Afghanistan. I watched these videos on YouTube and I was instantly taken back to Tal’Afar and Mosul. Everything I saw in those videos I recalled from my own tour. And then these guys fought on, in the mountains, for hours. My longest two-way sustained firefight lasted about eighteen minutes, not eighteen hours against hundreds of trained and disciplined Taliban. Yet, I still stood my ground. And when the call came, I answered. I had to find pride in that.

 

I have a few very-best, close friends of mine who also served.  One served with me in the same Brigade, and another with the PA Guard (his unit being the unit I later joined when I got off of active duty). Neither of them had any type of military paraphernalia in their homes.  None.  I asked them why, because all of us from our childhoods wanted to be in the Army They both had said that they essentially wanted to forget all about their time in the Army.  And, having sort of gone through that same process and mentality myself, over time I began to question them on that.  Why? What did they see that I didn’t? And was I being vein?

When I was struggling to come to terms about my combat experiences, no one else wanted to talk about it. I had to respect that, but I didn’t understand why.  If you can’t talk to fellow combat vets about your experiences, who are you supposed to talk to? Or was my talking about it somehow making them feel lesser, or worse? I didn’t know.

 

When they visited my home, I think they saw my shadow box and it made them feel uncomfortable – not that my shadow box is anything special, nor am I some hero or super-soldier. But I had taken stuff I had collected from the various units and when I bought my first home, I made the ‘I love me’ room.  it’s modest and tasteful, but it clearly was something that they did not want for themselves.

And this was something I was finding with a lot of the veterans I encountered in my new job. People may have a photo or two of them in uniform, but by and large, people seemed to want to distance themselves from their time in service. I think that for some, they saw and did horrible things and they did not feel any sense of pride in that whatsoever.  And for others I think that they experienced the exact opposite; they did not see or experience the types of things that their buddies saw, or that they felt that they would see.  And i think that’s there the line between veteran and combat-veteran begins to get drawn for some people.  And that was the case for my two best friends, they felt that they just did not “do” what they thought they ought to have, or might encounter in Iraq or Afghanistan. It is the invisible and immeasurable line that we all try and compare ourselves to. We know other veterans had it tougher, saw more, did more, lost more.

One actually called me on evening, while he was sitting at the bar. I was on the back porch grilling dinner for my girlfriend and I.

“Dude. I’ve been thinking – I see all of these kids walking around with no combat patch, and I sort of judge them. And my therapist at the VA tells me that I can do that, but it isn’t their fault that we deployed and they didn’t.  Which makes me wonder, if I judge them, do you judge me?”

‘Judge you? What do you mean?’

“Like, I dunno. I judge these kids for never doing one tour, when here I did one but you did two. You have a Purple Heart. You did all this stuff – I must seem like a joke to you.”

I sat on the porch and silently cried. He just didn’t get it.  Though I was touched that he was trying to compare himself to me, I was more moved that he might have been ignoring his own Army experiences by comparing them to mine. We had fought in the same unit, though he ETS’d years before I did.

‘Dude – what do you mean only one tour? You were an infantry platoon leader in Mosul, in Iraq’s most dangerous city at that time in the war, and you think that people might look down on you for that?’ I think he just needed someone to explain it that way to him.

We all expected something before we deployed for that first time.  Everyone does.  I personally joined the Army because I wanted to serve and do something greater, but I also did so in order to prove things to myself. Why do I tell you all of this?

I am doing so because I want to reach those other veterans in a similar boat. As a veteran that struggled to understand and make sense of the feelings, the PTSD, and losing a sense of myself – I want to share with other veterans what I’ve learned. It has taken me over a decade of soul-searching, introspective insight, and wrestling with a lot of demons:

• Everyone’s tour is different. It doesn’t matter if you were an infantryman who never fired a shot in anger, a cook who never left the wire, or a mechanic who turned wrenches; every deployment is different. It’s all a roll of the dice. We don’t get to plan our deployments or how the insurgents are going to treat us. Some people caught months and years of pure-hell. Others had quiet, but still important deployments – this was all part of our war. You don’t get to choose what kind of deployment you get – it just is what it is. No one judges you based on what the war did or did not throw at you at the time.  And once you learn and accept that, seeing some pride in everything that you actually did experience gets a little easier.

• We all react differently to stress. We are all trained to the same standard, but regardless of your MOS, each of us react to things differently. And given that combat is a roll of the dice, we reacted to anything and everything we saw in the only way we knew how to at that time. Right, wrong, or indifferent – we can’t change our past, so we have to accept it, even if we did not like it. Acceptance makes moving on with life much easier than living in denial, or living in a perpetual state of replaying your decisions and actions.

• Look at the bigger picture. Everything you did played a part in the larger scheme. If you feel cheated, or dissatisfied with your service, those are your feelings and you earned them. No one can take that away from you, but I will offer you this aspect of it – bombs got put on target because men and women kept those jets maintained, fueled, and armed; soldiers that got their mail and packages delivered to them had their morale lifted, and it brightened their day; intelligence planned raids that took out terrorists and insurgents one at a time; radios that worked right and transmitted every time someone keyed the net kept critical information flowing. Not everyone needed to kick in a door and shoot bad guys. Enabling the part of the force that does that is every bit as important.

• Not everyone needs to be a hero. Sure, I think inside everyone wants to feel like they were a hero, or a bad-ass. But real war isn’t a Hollywood movie. It is boring, it can draw out, and the wars in Iraq and Afghanistan were very unfair and unconventional; this really weighs on the minds and souls of those who had to wage those wars because they were not easy. So, do not think that you needed to fast-rope from a Blackhawk into a target building in order to have been successful in your military service.  Think about the old block; remember where you came from, and think about your choice to serve compared to all of the kids in the neighborhood who didn’t. Think about the challenges and adversities that you saw and overcame, be it in basic training or tech-school, handling the stress of desert logistics, long nights and intense heat, time away from loved ones, or having that one really hard-ass jerk of an NCO who always picked your work apart. Try and put it in perspective of You, and what You have overcome.  Think about the totality of your service and everything that you did in those three, five, or seven years – whatever it was.

Even if you never stepped foot in theater, think about what it was that you learned from, or took from your time in service that has had a positive impact on you and your life, right now. What about it made you a better person? There is always something, and oftentimes they are the little things like being punctual; being prepared; coming up with solid plans; or a sense of being taken care of, and being responsible for taking care of others. Those little things learned from service can make little daily improvements in your post-service lives. There is pride in all of that.

So when I look back, I recognize that I am proud to have served with the Stryker Brigade. I am proud to have been in the company of some tremendous soldiers and cavalry scouts. I am proud to have rose to the challenges I faced; conversely, I am proud that I also kept my head held high, learning from when I made mistakes, and taking my ass-chewing’s when I screwed up. Most of all, I am proud to know that I did my part – my small part – and that I join a long gray line with the rest of you – Veterans.

I eventually built shadow boxes for my two best friends, and I am happy to report that, when faced with the totality of their service displayed for them in one convenient, walnut box, they both have since began to feel proud of what they had done. They hang proudly on their walls in their homes.

We are our own worst critic – sometimes it takes someone else holding up the mirror before we can truly appreciate seeing who we are, and what we were. You served – take pride in that!

Those We Left Behind

We took them in, leery and a bit skeptical at first, but we soon let them into our most inner-circles. And before long, they were part of our team. We gave them desert uniforms. When every other soldier had received level IV SAPI plates for their body armor, we took any extras and made sure they were protected, too.  We paid them what we considered peanuts but in reality was a small fortune. We forced them to choose sides during a time when doing so could (and in some cases did) cost them or their family their lives. We became their brothers, their friends, and part of their extended families. Sometimes we lured them into the false sense of hope that we would take them home with us.

And when our tour was up – we left. We went home. We kissed our wives and kids. We did our best to go on about our ‘normal’ lives. And yet, they remained.

They were the linguists.  More commonly, they were our interpreters: our ‘Terps. And for every squad, platoon, or company war-story out there is a corresponding story about a phenomenal ‘Terp. And often times, over the years when I returned from Iraq I would meet people who would be surprised that we employed Iraqi’s; they would wonder if we “felt safe with them terrorists working beside ya.” When I met these people, I kindly told them to fuck-off. They had no clue.  This was not an ‘us versus them‘ war.  I met some of the greatest folks I have known in Iraq: Iraqi citizens. They are people, just like you and me – we just had the good luck to have been born in the United States. They were born into an oppressive regime, navigated that life, and then managed to land themselves a job with U.S. and Coalition forces post-invasion.

A lot were opportunists. Some were visionaries. But they all wanted to do one thing – do their part to make Iraq better.

I spend a lot of time thinking about these guys.  Some I still keep in touch with through Facebook. Others, I don’t even know if they are alive anymore. One more forgotten casualty in Iraq’s ever-growing debacle. So, as I believe that as long as there is breath in my lungs their stories will get told, least they be forgotten – I want to honor those that we left behind. Memorial Day is to honor our fallen. Veterans Day is for us. And I want to make today unofficially “Interpreter Day.”

Faris Saleh

This is Fairs.  Faris was my first ‘Terp.  We got him when we arrived in Tal’Afar; he had been working for 3rd Brigade, 2nd ID already so when we assumed the battle-space from them, we got their ‘Terps, too.  Faris was 22, I think.  He was a Yazidi from a small town just on the backside of Mount Sinjar. He was dedicated to the American forces, as a non-Muslim Arab, ethnic Kurd from that in-between zone in northern Iraq that could have been Iraq, or could have been Kurdistan.  More simply, he was a Sinjari. To the Yazidi’s, the town of Sinjar meant something, and they defined themselves with it. In OIF III, all of our ‘Terps were from Sinjar. It said something about the character of the Yazidi people.

Faris had decent English, but needed help on some words and concepts (like a lot of interpreters). But he was a good kid. I say kid, hell he was only two or three years younger than me at the time.  But, for as much as I was charged with the burden of leading a scout platoon, Faris was right there along side of me when I hit the ground on an objective; my dismount was my right-hand man on the ground, and Faris was my left.

Faris validated his mettle on 17 February, 2005; if it wasn’t enough that he had been with me through all of our engagements and battles, on that day Faris huddled in the belly of the Stryker amid the din of battle, holding a pressure bandage across the area where my gunner’s throat had just been, while my medic worked feverishly to get an IV started and get a breathing tube past the wound and into his lungs. They both worked hard, but there was no hope. My gunner bled out almost instantly. Faris only stopped applying pressure after we had arrived at the FOB Aid Station and handed off the litter to the medical staff there.

I kept in touch with Faris for a while via email. I last heard from him sometime in 2007 when I deployed to Baghdad for the Surge.  Today, I have no idea where he is. ISIL / Daesh have done a lot of ‘cleansing’ in and around Sinjar. My only hopes are that Faris and his family managed to escape north to Kurdistan.

Thamer al Faisal 

Thamer was the cousin of one of our Troop’s ‘Terps, Hader.  He lived in the border town of Rabiah.  When we operated in Rabiah and on the Syrian border, Thamer was our trusted confidant. He was a local, so he brought an aura of legitimacy and street-cred to us. He had cronies whom he would send across the border into Syria to get us huge meals. By sending people into Syria, there was less likelihood that someone would mess with the food order – because what Americans are ordering take-out from Syria?!? Thamer had a gregarious laugh and a great sense of humor. He was a realist, and if you needed something he could procure it.  I broke my wrist-watch once during combat – I loved that watch – and in Rabiah Thamer arranged for it to be sent to Baghdad and repaired. I gave him the watch and $10 USD; two weeks later when my platoon rotated back to the border town, Thamer had my watch; the broken glass was replaced and the movement fixed.

Thamer and Fairs with a meal purchased for the platoon

Thamer did a lot of negotiating and coordinating for us when we were up on the border for extended periods. He helped us secure some furniture for our ramshackle building that we turned into a combat outpost. He also secured us Tuborg beer from Syria when we wanted to celebrate our last rotation to the Syrian border. The men really appreciated that. Indeed, Thamer was a solid dude whom I lost contact with after 2005.  I still have a 500 dinar note with his name, phone number, and email address scribbled on it. It also said “don’t spend it!”  I still have it Thamer – wherever you are.

 

Me, my hippie-hair, and General Ali 

Baghdad: The Surge.

Tasked with rebuilding central Baghdad after the clearing operations that tore it up, the U.S. Army partnered with the State Department and USAID. But, we lacked the quantity of Civil Affairs personnel to really have the impact we were looking for, so guys like me got cross-trained on ‘hearts and minds.’ And handed cash – gobs and gobs of cash. And I am a dummy, so when they told me that I would be making sure roads got paved and schools for built, I told them that I needed specialized help. That help came in the form of General Ali.

General Ali was a retired Iraqi Air Force General (which probably meant in reality, he was a major or colonel, because post-invasion everyone magically had a promotion or two when it came time to be hired by the Americans).  He had to be somewhat legit though, as he owned a house in the Green Zone that had been deeded to him by the Saddam regime in his retirement for his faithful career. He was an engineer, and he was really the one who made sure that when we farmed out contracts to pave roads and build schools, the scope of work was written appropriately. And he was the one who did quality control to make sure the work was done right, and within the scope we had set forth.

General Ali was kind. He noticed that I worked a lot, and did not have much time to eat. Every day when he arrived to my building, where I had set him up with a desk to do all of is work, he would bring me food that his wife had prepared that morning for me.  For the six moths that I had General Ali working for me I was never one to want for breakfast or lunch. He was a gentle creature, sympathetic to the American forces, but also loyal to his fellow Iraqi’s. It was this loyalty that always saw him steer clear of the local politics, yet focus on our work in a way that put the people of Iraq first. And this was evident in the projects that he helped us undertake and oversee.

I have dined at his house in the Green Zone with him and his wife numerous times. As far as I know, he still is alive and lives there.  He and I had a special bond, and he was almost grandfatherly, in a way. I hope time and life has treated him well.

“Jason”

Jason.  My brother.  My ‘Terp.  And the one guy that I know is still alive and well. He still lives in Iraq, and due to the nature of his situation – the enemies that he made, and the real threats that still exists there from ISIL / Daesh – I will keep identifying information about him redacted. Jason was smart, very street-wise, had a wicked sense of humor, and a heart of gold.

Jason was the ‘Terp that we actually gave an AK-47 to, because on the ground Jason wasn’t just another ‘Terp – he was one more rifleman. This guy was hands-down one of the best interpreters and people that I ever had the pleasure to meet in Iraq. Jason was there with me on the ground all over central Baghdad; he was also the only person who stood by my side on January 2nd, 2008. During an ambush in Yarmouk, an Iraqi Army soldier was shot in the head. We had been in narrow parts of Baghdad that day and we took our HMMWV’ instead of Strykers.  Unable to fit the litter with this Iraqi soldier inside of the HMMWV, we secured an Iraqi Police pick-up truck.

We loaded the litter into the bed of the truck. I was unwilling to leave the patient in there alone, as I was the one who had applied the pressure bandages and started the IV. Refusing to leave me, Jason climbed into the open bed of that pick-up truck.  My hands were busy squeezing IV bags into the young Jundi, and holding pressure on his head wound; my M4 was dangling to my side, attached to my body armor.  Jason was there, his AK at the ready as we drove back through Khark, Baghdad.  We were completely exposed to the world, with no armor, no counted-IED systems – nothing.  We were one juicy and ripe target. He literally had my back.

Thankfully, we got to the Combat Surgical Hospital without incident. Jason had my back every single day, and I always felt like I had his.  When we left Baghdad, I did my best to keep in touch with him. I was a sponsoring official on his application for a special dispensation visa. The State Department denied his application since he had been jailed during the Saddam regime as a political dissident.  “Moral Turpitude.” Man, did the system really screw up there.

There were a lot of others, too. Some made it to the U.S. as immigrants with special visas. I am sure they live full and productive lives here now as permanent residents.

I feel guilty to this day that Jason is still there, and I am here.  Knowing he is alive and well brings me joy, but not as much joy as if he were stateside, sharing a beer with me. But, alas. On behalf of America, I am sorry.  So until that day, I raise a frosty cold one to him – and to all of the ‘Terps that we hired, afforded protection to, and then ultimately abandoned: You have not been forgotten! Until we are reunited once more… We Thank You!

PTSD SERVICE CONNECTION FLOW CHART

There are three elements needed to establish service connection for PTSD in order to receive VA benefits. First, you must have a current diagnosis of PTSD from an expert who is competent to diagnose the disorder. Second, there must be credible supporting evidence that the claimed in-service stressor actually occurred. And third, there must be medical evidence of a causal nexus between the current symptomatology and the claimed in-service stressor. The following is a flow chart that you may use in order to determine what evidence is needed to establish service connection for a variety of situations.

In order for the VA to recognize a veteran’s PTSD in order to award service connection, the diagnosis must be provided by a qualified medical professional. Even though many veterans are treated by VA or private therapists who are not doctors or psychologists (i.e. licensed mental health social workers, licensed counselors, etc.), the VA will not accept their opinions initially diagnosing PTSD. According to the VA Clinician’s Guide (available to download on the VA website), professionals qualified to perform PTSD Compensation and Pension examinations (C&P exams) must have doctoral-level training in psychopathology, diagnostic methods, and clinical interview methods. They must have a working knowledge of the DSM-V and extensive clinical experience in diagnosing and treating veterans with PTSD. Persons with the requisite professional qualifications include board-certified psychiatrists and licensed psychologists, as well as psychiatric residents and psychology interns under the close supervision of an attending psychiatrist or psychologist.In addition, the diagnosis must conform to the diagnostic criteria in the DSM-V.

The most common reason the VA denies a claim for PTSD is because it believes that a veteran does not meet all of the diagnostic criteria in the DSM-V for PTSD. A veteran may be suffering from extreme PTSD, but if his or her symptoms do not fall neatly within the diagnostic criteria for PTSD, then for VA purposes, the veteran does not have PTSD, and service connection will be denied.

The diagnostic criteria in the DSM-V for PTSD are listed below (and may also be found on the VA website). After the stressor criterion, there are four symptom clusters: intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. The sixth criterion concerns duration of symptoms, the seventh assesses functioning, and the eighth criterion clarifies that symptoms are not attributable to a substance or co-occurring medical condition. Note that some criterions require only one symptom, while others require multiple symptoms.

CRITERION A: STRESSOR

The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: (one required)

1. Direct exposure.

2. Witnessing, in person.

3. Indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental.

4. Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders, collecting body parts; professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or pictures.

Examples: Combat participation, military sexual trauma, witnessing a roadside bomb go off a few vehicles ahead, learning that a family member was killed in a car accident, or being part of a burial crew. Note that number three above may be the most difficult way to satisfy Criterion A. For instance, if the person involved is not a “close” friend, but the veteran made a decision that put that person in a dangerous situation and the person dies, this may not be enough to satisfy Criterion A even though the veteran may be traumatized because he or she feels responsible.

CRITERION B: INTRUSION SYMPTOMS

The traumatic event is persistently re-experienced in the following way(s): (one required)

1. Recurrent, involuntary, and intrusive memories.

2. Traumatic nightmares.

3. Dissociative reactions (e.g., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness.

4. Intense or prolonged distress after exposure to traumatic reminders.

5. Marked physiologic reactivity after exposure to trauma-related stimuli.

CRITERION C: AVOIDANCE

Persistent effortful avoidance of distressing trauma-related stimuli after the event: (one required)

1. Trauma-related thoughts or feelings.

2. Trauma-related external reminders (e.g., people, places, conversations, activities, objects, or situations).

CRITERION D: NEGATIVE ALTERATIONS IN COGNITIONS AND MOOD

Negative alterations in cognitions and mood that began or worsened after the traumatic event: (two required)

1. Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol, or drugs).

2. Persistent (and often distorted) negative beliefs and expectations about oneself or the world (e.g., “I am bad,” “The world is completely dangerous”).

3. Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences.

4. Persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt, or shame).

5. Markedly diminished interest in (pre-traumatic) significant activities.

6. Feeling alienated from others (e.g., detachment or estrangement).

7. Constricted affect: persistent inability to experience positive emotions.

CRITERION E: ALTERATIONS IN AROUSAL AND REACTIVITY

Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event: (two required)

1. Irritable or aggressive behavior

2. Self-destructive or reckless behavior

3. Hypervigilance

4. Exaggerated startle response

5. Problems in concentration

6. Sleep disturbance

CRITERION F: DURATION

Persistence of symptoms (in Criteria B, C, D, and E) for more than one month.

CRITERION G: FUNCTIONAL SIGNIFICANCE

Significant symptom-related distress or functional impairment (e.g., social, occupational).

CRITERION H: EXCLUSION

Disturbance is not due to medication, substance use, or other illness.

• Specify if: With dissociative symptoms.

In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli:

1. Depersonalization: experience of being an outside observer of or detached from oneself (e.g., feeling as if “this is not happening to me” or one were in a dream).

2. Derealization: experience of unreality, distance, or distortion (e.g., “things are not real”).

• Specify if: With delayed expression.

Full diagnosis is not met until at least six months after the trauma(s), although onset of symptoms may occur immediately.

Sometimes, the VA will reject a competent diagnosis of PTSD because the diagnosis is not “clear” – this is an incorrect legal standard and an appealable issue. Instead, for this first element of service connection for PTSD, the diagnosis must detail whether it is “as likely as not” that the veteran is currently suffering from PTSD. In addition, the VA cannot reject a competent diagnosis of PTSD without providing an adequate statement of reasons or bases for its decision.

The VA must also be able to point to other medical evidence in the record to support its conclusion that the veteran is not currently suffering from PTSD, in other words VA cannot state that a veteran does not have PTSD simply because it does not believe the veteran’s doctor.

If you have a current diagnosis of PTSD from an expert who is competent to diagnose the disorder, move on to step 2.

NOTE: The DSM-V was published on May 18, 2013, but was not adopted in the Code of Federal Regulations until August 4, 2014 (79 F.R. 45093). The DSM-V will be used for all claims that were received by the VA or pending at the regional office level on August 4, 2014, but the rule change does not apply to claims that have been certified for appeal to the Board of Veterans’ Appeals or are pending before the Court of Appeals for Veterans Claims or the Court of Appeals for the Federal Circuit. Therefore, some PTSD cases will still be evaluated using the DSM-IV criteria.

This element of establishing service connection for PTSD is the stumbling block for many veterans, but even if you are doubtful that you will be able to corroborate your stressor, hope is not lost. Use the following flowchart to determine what evidence is needed for your claim.

Was the veteran diagnosed with PTSD during a period of active military service?

PTSD DIAGNOSED DURING ACTIVE MILITARY SERVICE

If a veteran is diagnosed with PTSD during a period of active military service, there is a lower burden of proof for stressor corroboration evidence. If the claimed stressor is related to that service, the stressor is consistent with the circumstances of that service, and there is no clear and convincing evidence to the contrary, the veteran’s own statements may be used to establish the occurrence of the claimed stressor.

The lower burden of proof applies to claims pending on or filed after October 29, 2008.Another important thing to note is that if a veteran is released from service because of a mental disorder that developed as a result of a highly stressful event in service, the veteran must be awarded a disability rating of not less than 50 percent and be scheduled for a reevaluation within 6 months.Coming in step 3.

Is the stressor related to fear of hostile military or terrorist activity?

PTSD RELATED TO FEAR OF HOSTILE MILITARY OR TERRORIST ACTIVITY

A veteran who is diagnosed with PTSD that is related to fear of hostile military or terrorist activity does not need to provide stressor corroboration evidence as long as a VA psychologist or psychiatrist has diagnosed the PTSD and says that the stressor is related to the veteran’s fear of hostile military or terrorist activity.

If a veteran’s stressor is adequate to support a diagnosis of PTSD, that stressor is consistent with the circumstances of the veteran’s service, and there is no clear and convincing evidence to the contrary, the veteran’s own statements may be used to establish the occurrence of the claimed stressor.

What is fear of hostile military or terrorist activity? The veteran must have experienced, witnessed, or been confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the vet or others, such as from an actual or potential improvised explosive device; vehicle-embedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran’s response to the event or circumstance must have involved a psychological or psycho-physiological state of fear, helplessness, or horror.

This lower burden of proof applies to all veterans, regardless of where they experience the fear of hostile military or terrorist activity, but it does not include sexual assault or hostile criminal actions of US military personnel directed against other US military personnel.

It also only applies to claims received on or pending after July 13, 2010. If a veteran has a previously denied PTSD claim, in order to reopen the claim under this lower burden of proof standard, he or she would need a lay statement of his or her fear of hostile military or terrorist activity and service records that show service in an area involving exposure to hostile military or terrorist activity.

It is important to note that while this lower burden of proof requires a diagnosis by a VA psychologist or psychiatrist, a diagnosis by a non-VA practitioner and a veteran’s statement describing an in-service stressor relating to a fear of hostile military or terrorist activity should be enough to trigger the VA’s duty to assist by scheduling a VA PTSD exam.Coming in step 3NOTE: If a veteran is attempting to get service connection for PTSD under this lower burden of proof standard, but the VA psychologist or psychiatrist’s opinion states that the doctor does not believe that the veteran’s PTSD is related to a fear of hostile military or terrorist activity, the veteran should attempt to gather corroborating evidence of the stressor, which another doctor can use as a basis for a medical nexus opinion under step 3.

Did the claimed stressor occur during combat?

PTSD FOR COMBAT VETERANS

Similar to veterans who were diagnosed with PTSD during service, there is a lower burden of proof for combat veterans when it comes to stressor corroboration evidence. Essentially, the VA admits that when a veteran is engaged in combat, his or her primary focus is going to be carrying out the mission, not taking notes on any and all injuries.

If a veteran’s stressor is related to combat, that stressor is consistent with the circumstances of the veteran’s service, and there is no clear and convincing evidence to the contrary, the veteran’s own statements may be used to establish the occurrence of the claimed stressor.The VA Adjudications Procedures Manual M21-1MR (available on the VA website) defines combat as “personal participation in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality.

It includes presence during such events either as a combatant, or service member performing duty in support of combatants, such as providing medical care to the wounded.”

Even a brief participation in combat triggers the lower burden of proof. But, depending on the circumstances, it is important to note that the veteran may have an additional hurdle in proving that he or she was in combat.

For some veterans, this is a simple task due to their military service records or military occupational specialty (MOS) and where or when they served. But for other veterans, it may not be obvious at first glance that they served in combat. For these veterans, the VA will look to not only military service records and MOS, but also certain military decorations, buddy statements, letters home to family or friends, copies of newspapers or regimental or divisional newsletters, photographs, or any other credible supporting evidence that can help to establish whether the veteran was in combat or not.

If a veteran contends that he was in combat action that cannot be confirmed by his or her MOS or military service records, the VA must make a finding as to the credibility of his or her statement and provide reasons for its finding of whether the veteran engaged in combat, keeping in mind the benefit of the doubt rule.

At this stage, if a veteran states that he served in combat and identifies a stressor that is not impossible to believe, and has a current diagnosis of PTSD (see step 1), then the VA must take steps to develop evidence. The VA will look for evidence of both combat service and additional evidence that the combat stressor actually took place. It is usually a good idea for the veteran to request these records as well.

Relevant service records may be found at the National Personnel Records Center, the US Army and Joint Services Records Research Center, the Marine Corps Archives and Special Collections, and the National Archives.Once it is established that the veteran served in combat, the VA must also accept lay evidence as proof that the alleged stressor happened during combat even in the absence of official records or supporting clinical evidence.

Even if the veteran does not have any other evidence that the stressor occurred other than his or her own statement, as long as there is not clear and convincing evidence to the contrary, the VA is obligated to apply the benefit of the doubt rule and accept the veteran’s own statement as proof that the stressor occurred. Coming in step 3.

Is the stressor related to an in-service personal assault or trauma, including Military Sexual Trauma (MST)?

SPECIAL RULES FOR IN-SERVICE PERSONAL ASSAULT OR TRAUMA AS STRESSOR

If a veteran suffers from PTSD as a result of an in-service personal assault or trauma such as rape, physical assault, domestic battering, robbery, mugging, stalking, or harassment, the stressor can be corroborated through alternative evidence if military records do not document that a personal assault occurred. The VA has a special obligation to assist in these cases (commonly referred to as Military Sexual Trauma or MST) and must inform the veteran that evidence other than that found in service records may be submitted.

Alternative sources for evidence may be things such as records from law enforcement, rape crisis centers, mental health counseling centers, hospitals, or physicians; pregnancy or STD tests; statements from family members, roommates, fellow service members, or clergy; a personal diary or journal; or evidence of behavior changes such as a request to transfer, deterioration in work performance, substance abuse, depression, panic attacks, or anxiety.

Unfortunately, these cases are frequently denied, partly due to the fact that VA has difficulty compensating for disabilities that are less obvious than a physical disability, and because due to the nature of MST cases it is rare for there to be a formal report or complaint in the record. The VA often must rely on the alternative evidence listed above, and typically fails to give that evidence the weight that is required. PTSD claims in general are difficult to win, but MST claims are even tougher.According to a June 2014 report from the Government Accountability Office, since 2008, there have been 29,000 veterans who have sought disability benefits for problems related to MST. PTSD is the most common disability claimed as a result of MST at 94 percent of claims, with major depressive disorder and anxiety disorder being the second and third most common.

The overall approval rating for PTSD related to MST is up from 28 percent in 2010 to roughly 50 percent in 2013, but this is still lower than the 55 percent approval rating for other forms of PTSD (Note: According to a report by the ACLU and Service Women’s Action Network, between 2008 and 2012, the award of MST-related PTSD claims was lower than the rate of other PTSD claims by between 16.5 and 29.6 percent each year).

Also of note is the wide disparity among regional offices: in some ROs as few as 14 percent of claims were approved, while other ROs approved as many as 88 percent of claims. The GAO report found that regional offices are having ongoing difficulty applying broadened MST standards and may differ wildly in their interpretations of the evidence in the claim file.

Another hurdle identified in the GAO report is the variation in the thoroughness of C&P examinations for MST claims. In fact, during the only formal training for VA examiners who are conducting MST exams, less than 5% of the one-hour certification course for PTSD examiners is devoted to MST.

This goes to show that there is still a lot of work and training that needs to be done on the VA side in regards to MST claims, which can be discouraging for many veterans. But just remember that while MST claims take time, they are not impossible to win.

The key is to get the VA to look at the stressor evidence in the right context in order to show, for example, a behavior change that corroborates the occurrence of the stressor.Coming in Step 3IF NONE OF THE ABOVE APPLIES, STRESSOR CORROBORATION IS NEEDED

If a veteran’s claim for PTSD does not fit into one of the above categories, there must be evidence that corroborates the occurrence of the stressor, meaning credible supporting evidence that the claimed in-service stressor occurred. The supporting evidence must include more than the veteran’s own testimony. Unless there is no reasonable possibility that assistance by the VA would aid in substantiating the claim, the VA must assist the veteran in developing evidence that supports the existence of a stressor.

For the veteran’s service records to corroborate the stressor, they do not need to include every detail of the event. If there is independent evidence of the occurrence of a stressful event and that evidence shows the veteran’s personal exposure to the event, that could be sufficient corroborative evidence.

In addition, credible supporting evidence can come from lay sources such as buddy statements.

An example of a situation in which a veteran would need stressor corroboration evidence is if he or she was in a bad car accident during service, the car accident was not related to combat, and the veteran was not diagnosed with PTSD until after leaving service. In this situation, the veteran would need to be able to corroborate that the car accident happened.

This may be through a police report, hospital records, statements of the other individuals involved in the accident, or other supporting evidence. Another situation in which corroboration evidence would be required is if a veteran was involved in an accident during a non-combat situation, such as an explosion or fire. Again, hospital records, notations in service records, and statements of other persons who witnessed the explosion would be helpful corroboration evidence.

It is important to note that if a veteran’s account of an event is contradicted by official records, the VA can reject the veteran’s account, but as long as the veteran produces evidence to back up his or her story, the benefit of the doubt rule still applies.

Coming in Step 3

The final step of establishing service connection for PTSD is proving a causal nexus between the current symptomatology and the claimed in-service stressor. This step requires an opinion by a medical expert. The evidence must show that the stressor was at least a contributory basis for the current symptoms. As long as there is a clear relationship between the stressor encountered in service and the current diagnosis of PTSD, a veteran whose service medical records show no evidence of a mental disorder can be entitled to service connection for PTSD, even if the PTSD develops many years after service.Note that this step can be more complicated if a veteran has more than one stressor.

For example, say a veteran was in a car accident in service in which his best friend was killed, and there are service records and hospital records backing up this stressor.  The second stressor was when the vet was in his bunk and some fellow soldiers came in the room and threw a grenade at him.  The grenade was a dummy, but the veteran did not know that, and he still has nightmares about it.

There is no independent verification of this stressor.  For the veteran to receive service connected compensation for his PTSD, the doctor would have to relate his PTSD specifically to the car accident in service because that is the only stressor with independent verification, and the second stressor does not qualify under one of the lower burden of proof situations mentioned in step 2. And remember, the VA will always send the veteran to a Compensation and Pension exam to determine if the veteran is entitled service connected disability benefits for his PTSD.

Navigating the VA Medical Process – Post Iraq Style

This is sort of a Part 2 to my last posting ; a ‘mini-how-to-get-help-guide’.   A reader asked me a few questions to which I felt naked and exposed.  I presented an issue and a concern without providing tools for help.  This is one tool to help.

            There has been a lot of bad press concerning the medical treatment of Veterans by the Veterans Administration hospitals; a point I will not dwell upon- no need to press the dead horse into glue.   Recovering from war wounds, physical or mental or both, is not a fully ‘do-it-yourself’ event, but you do have to be actively engaged. There are actions you can take to mitigate and improve your VA experience.

If you are self-medicating or feel suicidal call the Veterans Crisis Line right away:   https://www.veteranscrisisline.net/  or call:  1-800-273-8255 and Press 1.

            My personal VA medical treatment and compensation experience [2008-2012] was very good.  I have no complaints with the local VA.  No delays with my appointments, no surprise cancellations and no long wait times- either for an appointment or at the appointment.  This might be a unique experience, but I hedged my bets by being prepared:  I had copies of my medical records, I followed the VA’s procedures and I sought the assistance of the Disabled Veterans of America [ http://www.dav.org/ ] to help me with the compensation claims process.

            Below is a suggestion for beginning a VA Treatment and also Compensation claim.  I followed this plan in a similar fashion but in small pieces- which was overall less effective because I was new to the VA process.  No Need to make my mistakes.  There are two key parts to this action:  medical exam and various appointments to correct your issues; second is VA compensation for your injuries.  First determine what is wrong and then correct it and finally pay you for whatever cannot be corrected.

            1- Call your local VA hospital [for general VA help and to find your nearest VA hospital go to: http://www.va.gov/ for VA medical:   http://www.va.gov/health/ ] for an appointment.  The VA will first want to give you a general physical and then will schedule appointments with the necessary specialists: hearing, orthopedic, neurologist, combat stress; or whatever else ails you….You will need your ink:  DD-214, Line of Duty reports, ‘buddy statements’ verifying and event/injury and whatever medical records you have: sick call slips, medical treatment records, post deployment health assessments…

            2- Call the local Disabled American Veterans group to serve as you spokesperson for your VA compensation claim.  There are other service groups that can help, the DAV was my group and they were very supportive.  The DAV will mail you a packet to complete in order to submit for a disability compensation claim.  You will need plenty of paper and documentation: a copy of your DD 214; Iraq or Afghanistan[or where ever you get injured] OER/NCOER if you have two you will submit both; your CAB award document, your end of tour award- DA 638 and medical records, sick call slips for any injuries you are claiming for compensation- you may or may not have any.  A copy of your post deployment physical and health assessment will be very helpful.  No short cuts.

            3- The VA physical and appointment process might be slower than your typical civilian medical experiences- do not give up!  My overall VA claim/medical experience was very good and timely.

            4- Understanding VA Math.  Let’s say you complete the medical examinations and disability compensation process and you are listed [example]:

            Ringing in ears:       10% [Very common with veterans]

            PTSD:                         30%

            Migraines:                20% [or some other injury]

             The total is 60% disabled and therefor your compensation is 60%?  Not necessarily so; by VA math- the total disability could be rated at 50%, the VA does number rounding and injury prioritizing.  If you feel like you were underrated, there is an appeal process.

Quick review:

            – Do Not Delay.  The DAV magazine and Army Times has plenty of veterans asking for help to substantiate an injury from 20 years ago or longer.  Going to the VA is not a sign of weakness, but rather a sign of intelligence and self-preservation.

            – Be prepared: have all your paperwork in order, make copies of your medical records and if possible, have a digital copy.

            – Make an appointment with the VA upon retirement or separation from active duty.  If you are a reserve component service member, upon redeployment or an injury during training; this is an earned benefit and starts the process for medical treatment and claims.

            – Follow the VA process.  As Veterans we do not have to like it; we just have to follow it.

            – Do not miss appointments!!  The VA is a stickler about this point.  Call to cancel, but just do not blow off an appointment.  It is hard to expect the VA people to care about you if you do not care about you.

            – Arrive early.  Ten minutes early is still ten minutes late.  Upon arrival, you have to check in before you can go to your appointment.

            – No need to go this alone, contact the DAV or another Veterans support organization.

            – Be persistent.  The VA compensation process could take a while.

            – Do not be a Hero:  if you were injured on duty, you deserve treatment and or compensation.  This is not the time to ‘suck it up’ and live with a life-long debilitating injury.  If the injury is bothering you now, wait until you hit your 50’s.

            – Never give up.  This is no time to quit because the process got hard or complicated.

            Good luck- this could take a while, but it is very important to begin the VA process and complete it in order for you to be made as whole as you can be and be compensated for what cannot be fixed.

            If you are awarded 10% disability rating or more, there are certain local and state benefits you may qualify for; so it might be worth your time to ask your town and visit your state’s website.

Self Destruction- Post Iraqi Style

22 a day has not abated in years- despite whatever attempts by the government via the Veterans Administration and veteran support organizations to provide support to struggling veterans- who no long can carry on.

Even the ‘band of brothers’ is not enough.  We seem unable to help each other or ourselves.

Veterans attacking and killing law enforcement officers in Dallas and Baton Rouge.  This seems like a combo killing and ‘suicide by cop’.  Is this a new trend?

There have been numerous specials featuring returning combat vets with serious substance abuse issues, family abuse issues and finally going to jail versus going to treatment. And of course there is the 22 a day.

As I see it, there are five options, maybe there are more or maybe there can be less, but to keep it simple I am looking at “Productive”, “Non-productive”, mixed with “Self-destructive” and “Non-self-destructive”.  Somewhat self explanatory.

This maybe an over simplification, but think about it and how your life is going?  What life option are you living in?  What direction do you want your life to go?

And then there is the Fifth option.

Option 1: “Productive” and “Non-self-destructive”; actively living life, going to school or working with no self-destructive habits: risky behavior or substance abuse.   This is the best possible option.

Option 2: “Non-productive” and “Non-self-destructive”.  Already not as good as Option 1, Not actively living life, not going to school, sort of stuck in neutral.  However, at least there are no apparently self-destructive habits.  While not optimal, certainly better then the last three options.

Option 3: “Productive” and “Self-destructive”; living the ‘Dr. Jekyll and Mr. Hyde’ life.  While on the surface, living a productive life, however, self-destructive habits have developed and could over-come the individual.  Hopefully, by being productive, life seems to be worth living and the self-destructive habits can be addressed at either the VA or at work through an employees assistance program

Option 4: “Non-Productive” and “Self-destructive”.  Almost the worst situation, not living life and going down the path of  total self-destruction: risky behavior, substance abuse and maybe even developing a ‘life isn’t worth it’ attitude.   I you do not get help at this stage, Option 5 might be waiting for you.

Option 5:  Do I even need to describe this option out loud?  We all know what this final life option is: 22 a day.

So what option are you living now? and what option do you want to live?