In our firm we are confirmed believers in the benefit of canine companions. Our paralegal, Jayne, and her dog, Magic, recently completed their therapy dog certification and are well on their way to helping brighten up the days of nursing home residents in their area. Therapy dogs provide many services throughout our country. They visit hospitals, nursing homes and even participate in local libraries helping children develop reading skills. Dogs are all about unconditional love and compassion, a trait which benefits humans in many ways.
Now, therapy dogs are finding their way to Iraq to help soldier’s with the stress of war. The Veteran’s Administration has approved the use of canine officers to help our soldiers in coping with the trials and tribulations of deployment.
America’s VetDogs has served the needs of veterans since 1946. Originally providing service dogs for soldiers who are blind or visually impaired, they have expanded to meet the needs of many returning vets with a variety of services, free of charge. America’s VetDogs is a subsidiary of the non-profit Guide Dog Foundation for the Blind.
In recent years, we have become more aware of the tremendous role therapy dogs can take in relieving stress in traumatic situations. Therapy dogs were on site on 911 providing a respite to distressed rescue workers and now, they are making their way to Iraq where their very presence eases the lives of the soldiers fortunate enough to enjoy their benefits.
PTSD has become a major problem for returning soldiers and what better way to circumvent the devastation to soldier’s lives than a visit by a K-9 officer? Whether it’s just a moment to bond with a dog or lighten the day with a game of fetch, the mental health benefits of interactions with canines is well-known. Dogs come pre-loaded with all the love, understanding and joy required to offset the dangers of war-time. Dogs are ready confidants and infinite optimists without agendas.
We often talk about troop morale. But with an ongoing deployment such as the one in Iraq, it is hard not to suffer from stress. Stress is not only situational but includes concerns about what is going on at home and separation from loved ones. A therapy dog brings with it a touch of home and a moment to forget the rigors of deployment. Many soldiers have befriended the stray dogs of Iraq and Operation Baghdad Pups endeavors to bring canine companions back to the states to reunite with their veteran buddies. VetDogs has acknowledged this need by deploying canines.
Though some have questioned the effectiveness of deploying trained therapy dogs, their success has been proven through their work with veterans across the United States. These highly trained canines can serve their country in many ways whether serving overseas or assigned to military hospitals in the USA. Regardless of where they are called into service they will provide a completely non-judgmental ear which will allow soldiers to combat the emotional difficulties of deployment.
http://www.vetdogs.org/
Operation Baghdad Pups
Purple Heart won’t be awarded for PTSD
Date: 1/8/2009
By PAULINE JELINEK
Associated Press Writer
WASHINGTON (AP) — The Pentagon on Thursday sought to assure troops that it takes post-traumatic stress seriously despite the recent decision not to award the Purple Heart to those with the disorder.
An advisory committee concluded that troops coming home from the wars with combat stress cases collectively known as post-traumatic stress disorder will not qualify for the prestigious medal awarded to service members wounded in action.
“I don’t think anybody should assume that that decision is in any way reflective on how seriously we take the problem of PTSD,” Defense Department press secretary Geoff Morrell said. He noted that the military is budgeting money for research, development, treatment and preventive measures.
“Just because an awards committee believes this particular injury does not qualify for this award does not in any way reflect that we don’t take this problem seriously and aren’t committed to doing everything we possibly can toward preventing it, toward treating it, toward taking care of those who are suffering with it,” he told a Pentagon press conference.
Troops with post-traumatic stress can have flashbacks of their time at war, nightmares, sleeplessness and other debilitating symptoms.
Nearly 20 percent of military service members who have returned from Iraq and Afghanistan — 300,000 in all — are estimated to have symptoms of PTSD or major depression, according to a study last year by the RAND Corp. research organization.
Though full-blown symptoms may not surface immediately, doctors say symptoms can be lessened and controlled with early treatment and that most people can return to their duties.
The Pentagon decided in November that troops with the disorder cannot be awarded the Purple Heart, but the decision was not known until it appeared Monday on the Web site of Stars and Stripes newspaper.
“The Purple Heart recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member,” Defense Department Eileen Lainez said of the decision. “PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event.” It is not “a wound intentionally caused by the enemy from an outside force or agent,” but is a secondary effect caused by witnessing or experiencing a traumatic event.
Veterans diagnosed with PTSD “still warrant appropriate medical care and disability compensation, Lainez said, and the department “is working hard to encourage service members and their families to seek care for PTSD by reducing the stigma and urging them to seek professional care.”
___
On the Net:
Defense Department: http://www.defenselink.mil/
Copyright 2009 The Associated Press.
By PAULINE JELINEK
Associated Press Writer
WASHINGTON (AP) — The Pentagon on Thursday sought to assure troops that it takes post-traumatic stress seriously despite the recent decision not to award the Purple Heart to those with the disorder.
An advisory committee concluded that troops coming home from the wars with combat stress cases collectively known as post-traumatic stress disorder will not qualify for the prestigious medal awarded to service members wounded in action.
“I don’t think anybody should assume that that decision is in any way reflective on how seriously we take the problem of PTSD,” Defense Department press secretary Geoff Morrell said. He noted that the military is budgeting money for research, development, treatment and preventive measures.
“Just because an awards committee believes this particular injury does not qualify for this award does not in any way reflect that we don’t take this problem seriously and aren’t committed to doing everything we possibly can toward preventing it, toward treating it, toward taking care of those who are suffering with it,” he told a Pentagon press conference.
Troops with post-traumatic stress can have flashbacks of their time at war, nightmares, sleeplessness and other debilitating symptoms.
Nearly 20 percent of military service members who have returned from Iraq and Afghanistan — 300,000 in all — are estimated to have symptoms of PTSD or major depression, according to a study last year by the RAND Corp. research organization.
Though full-blown symptoms may not surface immediately, doctors say symptoms can be lessened and controlled with early treatment and that most people can return to their duties.
The Pentagon decided in November that troops with the disorder cannot be awarded the Purple Heart, but the decision was not known until it appeared Monday on the Web site of Stars and Stripes newspaper.
“The Purple Heart recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member,” Defense Department Eileen Lainez said of the decision. “PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event.” It is not “a wound intentionally caused by the enemy from an outside force or agent,” but is a secondary effect caused by witnessing or experiencing a traumatic event.
Veterans diagnosed with PTSD “still warrant appropriate medical care and disability compensation, Lainez said, and the department “is working hard to encourage service members and their families to seek care for PTSD by reducing the stigma and urging them to seek professional care.”
___
On the Net:
Defense Department: http://www.defenselink.mil/
Copyright 2009 The Associated Press.
Iraq Long Haul PART VII: Homecoming, struggles and new beginnings
Date: 8/9/2008 12:01 AM
BC-The Long Haul VII,1st Ld-Writethru/1869
Eds: Minor edits, adds detailed Multimedia note. MULTIMEDIA: An interactive, including video, battle recreation and audio slideshows, exploring personal stories from a unit of the Minnesota National Guard during their 22 months tour of duty in Iraq will be available in the _national/long_haul folder by noon Saturday, Aug. 2.
PART VII: Homecoming, struggles and new beginnings
By SHARON COHEN
EDITOR’S NOTE — Homecoming at last, with troops and families reunited, though struggles remain. Conclusion of a seven-part series on the longest deployment of the Iraq war.
By SHARON COHEN
AP National Writer
The chartered plane loaded with soldiers descended slowly in the summer sky as Sgt. John Kriesel watched eagerly on the tarmac, clutching a walking cane. He had been waiting for this reunion for more than seven months.
Kriesel hadn’t seen his “guys” since he lost his legs in a roadside bombing in Iraq. Now, finally, on this bright July day at Volk Field in Wisconsin, the soldiers who served with him — several of whom he had known since high school — were home after a 22-month tour of duty, including 16 months in Iraq.
And he was there to welcome them.
Wearing shorts, sunglasses and bright yellow running shoes and standing firmly with his prosthetic legs, Kriesel beamed as a long line of soldiers formed, snaking from the plane’s steps across the tarmac.
One by one, Kriesel greeted them with hugs, hand shakes, smiles and jokes.
One soldier carried his battered M-4 weapon that survived the IED attack. “Is that my rifle?” Kriesel exclaimed, touching it again.
“You look good!” another friend said. “You look better than me.”
“No, I don’t,” Kriesel replied. “YOU look good. You got legs, bro.”
Staff Sgt. Tim Nelson, who was Kriesel’s roommate in Iraq and squad leader, jumped ahead in line and the two men embraced, holding each other tightly. Nelson was in the Humvee seat behind him when it ran over an IED.
Nelson flew with Kriesel to the military hospital in Balad, Iraq, and held his hand when Kriesel’s survival was in doubt.
“Good to see you, dude,” Kriesel said to Nelson. “I heard you yelling and I wasn’t going to let go.”
Staff Sgt. Todd Everson was also there. He was one of Kriesel’s rescuers, binding his left leg in a tourniquet.
“I’d be dead without you,” Kriesel said.
The next day, as Kriesel watched the soldiers’ formation at Fort McCoy, they surprised him by shouting, whistling, waving — and pointing to the place he had always stood.
Kriesel walked over and took his regular spot at the formation, and his battalion commander pinned the Combat Infantryman Badge and the Bronze Star on his chest.
For Kriesel and others who were part of the 1st Brigade Combat Team/34th Infantry Division, the summer of 2007 was a time of reunions and readjustment. Most had been gone nearly two years; their children had grown, their parents had aged, the world they left behind was different — and so were they.
When Janelle Johnson ran off the bus at Camp Ripley in Little Falls, Minn., she was amazed to see how big her two daughters looked. Emily, who’d been just 6 months old when she left, didn’t want to come to her mother or pose for a family photo and when the little girl relented, she clung to her father.
A general watching the scene put a comforting hand on Janelle’s shoulder.
“It’ll get better,” he whispered. “It’s going to be a long haul.”
And it has gotten better. Over the last year, while continuing to work for the Guard, Janelle has settled back into motherhood, reading bedtime stories to her girls and celebrating birthdays with them, not missing them anymore.
Seth and Alicia Goehring, who got married by proxy, are expanding their family. They’re expecting their second child in August, a girl they’ll name Audrey Florence.
Others have picked up where they left off.
Dr. Joe Burns went back to the emergency room of a Fargo, N.D., hospital, though he probably will return to Iraq next year.
Cassandra Houston entered a nursing program in college — something she postponed when she went to Iraq. Seeing so many needy people in Iraq inspired her. She wants to work for a humanitarian organization.
She had to adjust, too, to changes at home. During her 22-month absence, her son, Josh, turned 16, got his driver’s license and his first car. He proudly picked her up in the dented 1997 Sunfire to take her home.
Chad Malmberg came home to glory.
On Sept. 22, 2007, hundreds of friends, family and dignitaries gathered to watch him receive the Silver Star for his bravery during a January firefight.
Malmberg “deliberately and courageously exposed himself to enemy fire in order to prevent the enemy from assaulting through the kill zone and overwhelming his convoy,” the citation read. “His selfless actions prevented the enemy from turning the tide of the battle and undoubtedly saved the lives of his soldiers.”
The medal now hangs on the wall. And the hero has gone on with life. He finished Minnesota State University at Mankato with a 3.4 average and will enter the St. Paul, Minn., police academy in September. For now, he works for the department, issuing parking tickets.
In his first few days this spring, he was cussed out a half-dozen times.
It didn’t upset him. He has been in tighter spots.
___
For Dathan Gazelka, it wasn’t easy to put aside military rigor when he returned home and went to rejoin his wife, Mandy, in the real estate business.
He hated wearing a coat and tie, wasn’t sure what to say, and didn’t like Mandy being the boss.
He likes clear rules. Yes or no. Not maybe — or, I’ll think about it overnight.
He had an unorthodox sales pitch to prospective home buyers: “Listen, we’re going to look at three houses today and you’re going to buy one of them.”
Made perfect sense to him. Mandy, of course, found herself doing damage control.
And so, when the National Guard invited him to return to his job as a recruiter, Dathan (and Mandy) quickly accepted.
And he has a second job now: being a father. Mandy gave birth to Nyah last July.
J.R. Salzman was relieved to be back in Wisconsin after nine months at Walter Reed Army Medical Center.
His wife, Josie, was happy to be back in her own bed, sitting on her own couch, watching her own TV. But she worried, too. When they traveled to a Minnesota veterans hospital, she noticed that her husband — who had lost his lower right arm — was the youngest patient by far. She wondered whether the government would be there helping them for the next 50 years.
Both Salzmans enrolled quickly at the University of Wisconsin-Stout.
But college life wasn’t easy for J.R., who had stopped taking medicine that made him groggy. He couldn’t sleep more than three or four hours a night.
His memory failed him often. He missed classes because he couldn’t remember his schedule. He had trouble focusing. Then one day, while researching a paper he read a report about traumatic brain injury.
He reviewed the symptoms — confusion, anxiety, memory problems — and realized he had every one of them. Then he discovered from his Walter Reed records there was something he had been unaware of: He had minor traumatic brain injury. Bingo. It all made sense.
As the months passed, Salzman improved. His memory got better. And he took a big step toward returning to his old life.
It happened last summer when he and Josie visited Lumberjack Days in Stillwater, Minn. — trailed by an ESPN crew chronicling his recovery.
“You’re going to log roll,” Josie told him. “You’re done putting it off.”
She tied his tennis shoes and watched.
Wearing his prosthetic arm, he stepped onto the log. First tentatively, then more confidently, he took a few steps. He rolled for a few seconds, stopped, then rolled some more, getting into the rhythm.
He smiled broadly.
J.R. Salzman had to relearn how to tie his shoes, to write his name. But log rolling? It came back naturally.
Just like he never was away.
___
In the year since he arrived home, Col. David Elicerio has traveled to several states, advising Guard units, telling them what to expect when they are deployed to Iraq.
In May, the colonel was on hand for the unveiling of a “Fallen Heroes” memorial to Minnesota soldiers who died. A sculpture of a helmet, a rifle and combat boots stands atop a granite slab inscribed with their names.
Elicerio also carries his own personal memorial: a chain with replicas of 21 dog tags, each bearing the name of a 1st Brigade soldier who died in Iraq.
Every time a soldier in his command was lost, Elicerio wrote the family a letter, vowing to remember their sacrifice. In a small way, he feels those tags are holding up his end of the bargain.
One bears the name of Staff Sgt. Joshua Hanson.
Nearly two years have passed since his death but for his parents, Robert and Kathy, there still are days when they feel he might call or walk into the room.
Their home is filled with memories of Josh. Outside, there’s a bench a friend made, with “Remember Sanchez,” his nickname, carved in it. His old room remains the way it was when he left it. The stuffed bass he caught as a boy, the Minnesota Twins 1987 World Champion baseball pennant, the taekwondo belts.
His military medals rest on a corner table in the dining room, illuminated with a prayer candle.
On Aug. 30, the second anniversary of Josh’s death, a picnic shelter at Maplewood State Park, where Robert Hanson is a ranger, will be dedicated in Josh’s honor. Much of the work on the shelter was done by Josh’s Guard friends.
It will have a polished black granite marker inscribed with the words: “YOU WILL NOT BE FORGOTTEN.”
___
John Kriesel knows how close he came to death. He’s determined to savor every minute of life.
In December, he, Katie and the boys moved into a wheelchair-accessible house — built by a construction company for cost and paid for with two fundraisers.
Kriesel is taking broadcasting classes at a local college. He interns at a sports radio station, where he’s on the air one morning a week.
This fall, he’ll start a marketing job with the Guard, working with sports teams, the media and businesses.
In the mirror, he can still see the faint scars of war etched on his 26-year-old face. And sometimes, he has tingly phantom sensations as if his feet were still there. He realizes, of course, he’ll never have the feel of walking on freshly cut grass or a plush carpet. He does not dwell on the past or his injuries
He is a grateful man. Every night, he kisses his two sons as they go to sleep. Every morning, he hops in his wheelchair, showers and puts on his prosthetic legs.
There’s no time to waste. He’s got lots of plans. Even for next summer. That’s when he hopes to start running again.
___
NOTE: The story of 1st Brigade Combat Team/34th Infantry Division of the Minnesota National Guard and its tour in Iraq was reconstructed from scores of interviews with more than 20 soldiers and members of their families. Most quotations are as remembered by the speakers. In addition, the series draws upon numerous official documents, including after-action reports; videos of news conferences; correspondence provided by the families (including e-mails and letters); television coverage of the unit’s return; personal journals and blog postings.
Copyright 2008 The Associated Press.
BC-The Long Haul VII,1st Ld-Writethru/1869
Eds: Minor edits, adds detailed Multimedia note. MULTIMEDIA: An interactive, including video, battle recreation and audio slideshows, exploring personal stories from a unit of the Minnesota National Guard during their 22 months tour of duty in Iraq will be available in the _national/long_haul folder by noon Saturday, Aug. 2.
PART VII: Homecoming, struggles and new beginnings
By SHARON COHEN
EDITOR’S NOTE — Homecoming at last, with troops and families reunited, though struggles remain. Conclusion of a seven-part series on the longest deployment of the Iraq war.
By SHARON COHEN
AP National Writer
The chartered plane loaded with soldiers descended slowly in the summer sky as Sgt. John Kriesel watched eagerly on the tarmac, clutching a walking cane. He had been waiting for this reunion for more than seven months.
Kriesel hadn’t seen his “guys” since he lost his legs in a roadside bombing in Iraq. Now, finally, on this bright July day at Volk Field in Wisconsin, the soldiers who served with him — several of whom he had known since high school — were home after a 22-month tour of duty, including 16 months in Iraq.
And he was there to welcome them.
Wearing shorts, sunglasses and bright yellow running shoes and standing firmly with his prosthetic legs, Kriesel beamed as a long line of soldiers formed, snaking from the plane’s steps across the tarmac.
One by one, Kriesel greeted them with hugs, hand shakes, smiles and jokes.
One soldier carried his battered M-4 weapon that survived the IED attack. “Is that my rifle?” Kriesel exclaimed, touching it again.
“You look good!” another friend said. “You look better than me.”
“No, I don’t,” Kriesel replied. “YOU look good. You got legs, bro.”
Staff Sgt. Tim Nelson, who was Kriesel’s roommate in Iraq and squad leader, jumped ahead in line and the two men embraced, holding each other tightly. Nelson was in the Humvee seat behind him when it ran over an IED.
Nelson flew with Kriesel to the military hospital in Balad, Iraq, and held his hand when Kriesel’s survival was in doubt.
“Good to see you, dude,” Kriesel said to Nelson. “I heard you yelling and I wasn’t going to let go.”
Staff Sgt. Todd Everson was also there. He was one of Kriesel’s rescuers, binding his left leg in a tourniquet.
“I’d be dead without you,” Kriesel said.
The next day, as Kriesel watched the soldiers’ formation at Fort McCoy, they surprised him by shouting, whistling, waving — and pointing to the place he had always stood.
Kriesel walked over and took his regular spot at the formation, and his battalion commander pinned the Combat Infantryman Badge and the Bronze Star on his chest.
For Kriesel and others who were part of the 1st Brigade Combat Team/34th Infantry Division, the summer of 2007 was a time of reunions and readjustment. Most had been gone nearly two years; their children had grown, their parents had aged, the world they left behind was different — and so were they.
When Janelle Johnson ran off the bus at Camp Ripley in Little Falls, Minn., she was amazed to see how big her two daughters looked. Emily, who’d been just 6 months old when she left, didn’t want to come to her mother or pose for a family photo and when the little girl relented, she clung to her father.
A general watching the scene put a comforting hand on Janelle’s shoulder.
“It’ll get better,” he whispered. “It’s going to be a long haul.”
And it has gotten better. Over the last year, while continuing to work for the Guard, Janelle has settled back into motherhood, reading bedtime stories to her girls and celebrating birthdays with them, not missing them anymore.
Seth and Alicia Goehring, who got married by proxy, are expanding their family. They’re expecting their second child in August, a girl they’ll name Audrey Florence.
Others have picked up where they left off.
Dr. Joe Burns went back to the emergency room of a Fargo, N.D., hospital, though he probably will return to Iraq next year.
Cassandra Houston entered a nursing program in college — something she postponed when she went to Iraq. Seeing so many needy people in Iraq inspired her. She wants to work for a humanitarian organization.
She had to adjust, too, to changes at home. During her 22-month absence, her son, Josh, turned 16, got his driver’s license and his first car. He proudly picked her up in the dented 1997 Sunfire to take her home.
Chad Malmberg came home to glory.
On Sept. 22, 2007, hundreds of friends, family and dignitaries gathered to watch him receive the Silver Star for his bravery during a January firefight.
Malmberg “deliberately and courageously exposed himself to enemy fire in order to prevent the enemy from assaulting through the kill zone and overwhelming his convoy,” the citation read. “His selfless actions prevented the enemy from turning the tide of the battle and undoubtedly saved the lives of his soldiers.”
The medal now hangs on the wall. And the hero has gone on with life. He finished Minnesota State University at Mankato with a 3.4 average and will enter the St. Paul, Minn., police academy in September. For now, he works for the department, issuing parking tickets.
In his first few days this spring, he was cussed out a half-dozen times.
It didn’t upset him. He has been in tighter spots.
___
For Dathan Gazelka, it wasn’t easy to put aside military rigor when he returned home and went to rejoin his wife, Mandy, in the real estate business.
He hated wearing a coat and tie, wasn’t sure what to say, and didn’t like Mandy being the boss.
He likes clear rules. Yes or no. Not maybe — or, I’ll think about it overnight.
He had an unorthodox sales pitch to prospective home buyers: “Listen, we’re going to look at three houses today and you’re going to buy one of them.”
Made perfect sense to him. Mandy, of course, found herself doing damage control.
And so, when the National Guard invited him to return to his job as a recruiter, Dathan (and Mandy) quickly accepted.
And he has a second job now: being a father. Mandy gave birth to Nyah last July.
J.R. Salzman was relieved to be back in Wisconsin after nine months at Walter Reed Army Medical Center.
His wife, Josie, was happy to be back in her own bed, sitting on her own couch, watching her own TV. But she worried, too. When they traveled to a Minnesota veterans hospital, she noticed that her husband — who had lost his lower right arm — was the youngest patient by far. She wondered whether the government would be there helping them for the next 50 years.
Both Salzmans enrolled quickly at the University of Wisconsin-Stout.
But college life wasn’t easy for J.R., who had stopped taking medicine that made him groggy. He couldn’t sleep more than three or four hours a night.
His memory failed him often. He missed classes because he couldn’t remember his schedule. He had trouble focusing. Then one day, while researching a paper he read a report about traumatic brain injury.
He reviewed the symptoms — confusion, anxiety, memory problems — and realized he had every one of them. Then he discovered from his Walter Reed records there was something he had been unaware of: He had minor traumatic brain injury. Bingo. It all made sense.
As the months passed, Salzman improved. His memory got better. And he took a big step toward returning to his old life.
It happened last summer when he and Josie visited Lumberjack Days in Stillwater, Minn. — trailed by an ESPN crew chronicling his recovery.
“You’re going to log roll,” Josie told him. “You’re done putting it off.”
She tied his tennis shoes and watched.
Wearing his prosthetic arm, he stepped onto the log. First tentatively, then more confidently, he took a few steps. He rolled for a few seconds, stopped, then rolled some more, getting into the rhythm.
He smiled broadly.
J.R. Salzman had to relearn how to tie his shoes, to write his name. But log rolling? It came back naturally.
Just like he never was away.
___
In the year since he arrived home, Col. David Elicerio has traveled to several states, advising Guard units, telling them what to expect when they are deployed to Iraq.
In May, the colonel was on hand for the unveiling of a “Fallen Heroes” memorial to Minnesota soldiers who died. A sculpture of a helmet, a rifle and combat boots stands atop a granite slab inscribed with their names.
Elicerio also carries his own personal memorial: a chain with replicas of 21 dog tags, each bearing the name of a 1st Brigade soldier who died in Iraq.
Every time a soldier in his command was lost, Elicerio wrote the family a letter, vowing to remember their sacrifice. In a small way, he feels those tags are holding up his end of the bargain.
One bears the name of Staff Sgt. Joshua Hanson.
Nearly two years have passed since his death but for his parents, Robert and Kathy, there still are days when they feel he might call or walk into the room.
Their home is filled with memories of Josh. Outside, there’s a bench a friend made, with “Remember Sanchez,” his nickname, carved in it. His old room remains the way it was when he left it. The stuffed bass he caught as a boy, the Minnesota Twins 1987 World Champion baseball pennant, the taekwondo belts.
His military medals rest on a corner table in the dining room, illuminated with a prayer candle.
On Aug. 30, the second anniversary of Josh’s death, a picnic shelter at Maplewood State Park, where Robert Hanson is a ranger, will be dedicated in Josh’s honor. Much of the work on the shelter was done by Josh’s Guard friends.
It will have a polished black granite marker inscribed with the words: “YOU WILL NOT BE FORGOTTEN.”
___
John Kriesel knows how close he came to death. He’s determined to savor every minute of life.
In December, he, Katie and the boys moved into a wheelchair-accessible house — built by a construction company for cost and paid for with two fundraisers.
Kriesel is taking broadcasting classes at a local college. He interns at a sports radio station, where he’s on the air one morning a week.
This fall, he’ll start a marketing job with the Guard, working with sports teams, the media and businesses.
In the mirror, he can still see the faint scars of war etched on his 26-year-old face. And sometimes, he has tingly phantom sensations as if his feet were still there. He realizes, of course, he’ll never have the feel of walking on freshly cut grass or a plush carpet. He does not dwell on the past or his injuries
He is a grateful man. Every night, he kisses his two sons as they go to sleep. Every morning, he hops in his wheelchair, showers and puts on his prosthetic legs.
There’s no time to waste. He’s got lots of plans. Even for next summer. That’s when he hopes to start running again.
___
NOTE: The story of 1st Brigade Combat Team/34th Infantry Division of the Minnesota National Guard and its tour in Iraq was reconstructed from scores of interviews with more than 20 soldiers and members of their families. Most quotations are as remembered by the speakers. In addition, the series draws upon numerous official documents, including after-action reports; videos of news conferences; correspondence provided by the families (including e-mails and letters); television coverage of the unit’s return; personal journals and blog postings.
Copyright 2008 The Associated Press.
Vietnam Remains Our Biggest Military Health Issue
As we shift our focus of this blog to the emotional side of the synergistic neuropsychiatric disability that faces combat vets, I want to put the context of current soldier suicides and PTSD into perspective. This series of blogs began with my reaction to this news:
“The Associated Press announced that active duty military suicides hit its highest level on record in 2007, 119 soldiers dead. See the AP story at: http://hosted.ap.org/dynamic/stories/M/MILITARY_SUICIDES?SITE=CADIU&SECTION;=HOME&TEMPLATE;=DEFAULT “
My first reaction to that number when I read it was that there was something wrong with the record books, because I had remembered reading a number of references over the years about suicide in Vietnam veterans with numbers as high as 250,000 people. Well, the reason 119 is a “record” is the Pentagon didn’t start recording soldier suicides until around 1980 and that number is for active duty soldiers and doesn’t include vets.
Still, the overwhelming question that seems to being missed in the political debate and news coverage of 2008 is what about the Vietnam vets? As tragic as the Iraq and Afghanistan Wars have been, their footprint of death, disability and psychosis has yet to reach 10% of the magnitude of that of Vietnam. While Vietnam is now more than 30 years in our rear view mirrors, the primary group of soldiers it affected are from 55 to 70 years old. That is a serious public and military health issue for at least another generation.
$500 million dollars for TBI research for blast injuries in the so-called War on Terror is great – but what about Vietnam? The discovery of brain injury and brain damage in Iraq by the politicos and news media is truly wonderful. But Iraq is not the first war with blast injuries, not the first war where our soldiers suffered brain injury, not the first war where the soldier who returned home is a brittle, vulnerable shadow of the vibrant young man who left.
John McCain makes great political hay out of his Vietnam heroism as a prisoner of war. But how can McCain make those claims without looking back and recognizing that the United States mental health obligations to its Vets reaches back to Vietnam, Korea and even World War II survivors?
The issue of the brain injury disability and mental health of older Vets has countless sub-issues, but the most important for this blog is that brain injury and brain damage were not even considered in what we today call mild to moderate brain injury during Vietnam. Prior to 1990, there was little belief in the medical community that a brain injury that involved less than a five minute loss of consciousness was significant. Now we recognize, and have highly sophisticated neuroimaging and neuropsychological methodologies to confirm, that brain damage can occur without a loss of consciousness.
We often hear that our modern medical interventions result in more people surviving brain injury, because soldiers who would have died in Iraq or Afghanistan are now saved because of the rapid evac and treatment. That is true, but what is implicitly missing in such a statement is the clear fact that almost no one with a mild to moderate brain injury would die from it, regardless of whether they got prompt treatment. The realities of combat in Vietnam, and all wars that preceded it, is that a soldier on the front lines who gets knocked out, dazed or confused – is not likely to die from such injuries, unless he is killed by his inability to respond to the immediacy of the combat demands at the time.
Thus, there are probably far more vets with mild brain injuries in the Vietnam era than in the current generation of soldier and vets, but there are no medical records to document that they suffered such injuries. A soldier with a short-term confusion in that combat was likely expected to shrug it off and go back to fighting. Making matters worse, the complete catastrophe that is the Vietnam military health records makes it almost a certainty that documentation of brain injury is just not there. Further, the brain damage suffered in Vietnam is considerably broader than just brain injury because of the prevalence of Cerebral Malaria, which may have caused brain damage to hundreds of thousands of U.S. soldiers in Vietnam. See http://www.va.gov/OCA/testimony/hvac/16JY98NV.asp
Without the documentation of brain damage, what came out of Vietnam were hundreds of thousands of soldiers with clear cut neuropsychiatric symptoms in search of a diagnosis. The result: PTSD. PTSD is a Vietnam era syndrome of severe emotional problems, that are tied to some type of extreme emotional stressor, such as combat. But as with most “syndromes” the purity of its diagnostic criteria is lacking. The resulting over inclusive use of it in differential diagnosis of any emotional or neuropsychiatric symptom is staggering. At its threshold criteria, it requires life-threatening terror.
See http://en.wikipedia.org/wiki/PTSD which states the threshold requirement that “the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.” The second (A2) requires that “the person’s response involved intense fear, helplessness, or horror.”
This sounds like combat, it does not sound like a rear end automobile collision. While some automobile or other accidents involve prolonged moments of terror, most do not. They are over within a few moments of beginning. I have experienced both kinds but my memory of the truly terrorizing accidents (and yes, I did have that realization that my life was about to end both times) ended abruptly at the moment of collision. Relatively few people who suffer concussions have clear enough memory of the event to be exposed to a pure PTSD terror. What most relate is a moment of surprise that an accident is about to happen and then a gap in memory.
In contrast – combat, rape, fires – involve prolonged exposure to truly terrorizing events. This is the type stressor that can actually make a hard wire change to the way the brain processes information. This is the type of stressor that can create haunting memories. This is the type of stressor that can create nightmares. Yet PTSD should never become a catchall for all emotional reactions to life changing events. The category for stressor has as its blue print combat. When there is no elongated exposure to terror, the focus should be on normal human emotional responses, not a psychiatric catchall.
Next Brain Injury is not New to Iraq
Brain Damage Not Malingering
Yesterday’s blog about my frustrations with the refusal of the Wikipedia editor to add my two cents on the interaction between organic injury and emotional problems is symptomatic of a problem that is persuasive throughout neuropsychology: the insurance companies and their alter ego, the defense bar, are polluting the science of brain injury. The toxic words in this equation are malingering, conversion disorder and somatoform disorder. Huge sums of money are being funneled into what is being passed off as neuropsychological research from the insurance industry. The goal: to create peer reviewed literature that says that those with mild brain injury symptomotology are either faking their symptoms or are having an emotional reaction to what they experienced.
This topic is one worthy of several blogs. But essentially, more effort is being put into effort testing research, than almost all of the research that is going into the rest of the field brain injury. And the insurance industry has made it so profitable for neuropsychologists to work on the defense side of forensic cases, that neuropsychologists who went into the field with some sense of a calling, have convinced themselves that the doctrines of malingering, conversion disorder and malingering are real.
What does that have to do with a PTSD issue discussed in Wikipedia? It is a mild version of the same equation. The defense bar has what is correctly identified as a dog bite defense to brain injury cases. A dog bite defense is a multi-layered basis of denial, that each time something is proven, then retreat to the next defense.
You weren’t bitten by a dog; if you were, it wasn’t my dog; it you were bitten by my dog, it was your fault the dog bit you; if it was my dog’s fault you weren’t hurt.
Well in brain injury cases the dog bite defense is this:
There are no deficits, the plaintiff is normal; if there are deficits, then the plaintiff is malingering those deficits; if the plaintiff isn’t malingering, then the deficits are being caused by emotional problems, that the plaintiff had before the injury; if the plaintiff’s deficits didn’t exist before the injury, they are still just an exaggerated case of a somatoform or conversion disorder that a normal person wouldn’t have. If none of those other things don’t work, then call it PTSD (post traumatic stress disorder.)
If you work for the defense, NEVER, NEVER, NEVER, admit that the plaintiff had any permanent organic (meaning actual physical) damage or injury to the brain.
The ways in which these “research” studies are structured, they evaluate the plaintiff’s effort. They claim that their research validates that they can tell whether someone is malingering. That is just so much lying with statistics. No study can possibly tell that. It is impossible to tell what is in the mind of an individual. Neuropsychologists are not mind readers. In a court of law, they are most often not even allowed to comment on the credibility of a plaintiff. When you strip the cover off this claim, what they are really saying is that their super secret methodology (that no plaintiff could ever guess at) is telling them that a plaintiff didn’t give consistent “best effort” throughout the test.
I will blog on this particular topic more in the coming days, but such logic is incredibly flawed for a myriad of reasons. But one simple issue invalidates all effort testing claims: no person with brain damage could be expected to give consistent “best effort” over any battery of tests that last for hours and hours. Every single symptom of brain injury, makes it virtually impossible to maintain consistent effort for hours upon hours. I will later itemize how many of those symptoms effect consistent effort, but one common denominator has such a profound impact on effort that it alone makes effort testing a fraud: FATIGUE. Virtually everyone with brain damage, has fatigue. Fatigue makes you work slower, and progressively slower, the longer you are tested. Fatigue makes you make more mistakes. If you are working progressively slower and with progressively more mistakes, you will not be able to give consistent “best effort.”
Our next blog will examine these effort testing issues in more depth.
This topic is one worthy of several blogs. But essentially, more effort is being put into effort testing research, than almost all of the research that is going into the rest of the field brain injury. And the insurance industry has made it so profitable for neuropsychologists to work on the defense side of forensic cases, that neuropsychologists who went into the field with some sense of a calling, have convinced themselves that the doctrines of malingering, conversion disorder and malingering are real.
What does that have to do with a PTSD issue discussed in Wikipedia? It is a mild version of the same equation. The defense bar has what is correctly identified as a dog bite defense to brain injury cases. A dog bite defense is a multi-layered basis of denial, that each time something is proven, then retreat to the next defense.
You weren’t bitten by a dog; if you were, it wasn’t my dog; it you were bitten by my dog, it was your fault the dog bit you; if it was my dog’s fault you weren’t hurt.
Well in brain injury cases the dog bite defense is this:
There are no deficits, the plaintiff is normal; if there are deficits, then the plaintiff is malingering those deficits; if the plaintiff isn’t malingering, then the deficits are being caused by emotional problems, that the plaintiff had before the injury; if the plaintiff’s deficits didn’t exist before the injury, they are still just an exaggerated case of a somatoform or conversion disorder that a normal person wouldn’t have. If none of those other things don’t work, then call it PTSD (post traumatic stress disorder.)
If you work for the defense, NEVER, NEVER, NEVER, admit that the plaintiff had any permanent organic (meaning actual physical) damage or injury to the brain.
The ways in which these “research” studies are structured, they evaluate the plaintiff’s effort. They claim that their research validates that they can tell whether someone is malingering. That is just so much lying with statistics. No study can possibly tell that. It is impossible to tell what is in the mind of an individual. Neuropsychologists are not mind readers. In a court of law, they are most often not even allowed to comment on the credibility of a plaintiff. When you strip the cover off this claim, what they are really saying is that their super secret methodology (that no plaintiff could ever guess at) is telling them that a plaintiff didn’t give consistent “best effort” throughout the test.
I will blog on this particular topic more in the coming days, but such logic is incredibly flawed for a myriad of reasons. But one simple issue invalidates all effort testing claims: no person with brain damage could be expected to give consistent “best effort” over any battery of tests that last for hours and hours. Every single symptom of brain injury, makes it virtually impossible to maintain consistent effort for hours upon hours. I will later itemize how many of those symptoms effect consistent effort, but one common denominator has such a profound impact on effort that it alone makes effort testing a fraud: FATIGUE. Virtually everyone with brain damage, has fatigue. Fatigue makes you work slower, and progressively slower, the longer you are tested. Fatigue makes you make more mistakes. If you are working progressively slower and with progressively more mistakes, you will not be able to give consistent “best effort.”
Our next blog will examine these effort testing issues in more depth.