Tim O’Brien is a veteran of the Vietnam War and is the author of such novels as The Things They Carried and Going After Cacciato. In his novels, O’Brien talks about in great depth of the horrors of the Vietnam War. Soldiers returning home from Vietnam had a hard time adapting to civilian life. Some veterans thought they were fighting in the war while at home. Many were later diagnosed with post-traumatic stress disorder (PTSD). Even today, a majority of PTSD cases handled by the Veteran’s Administration (VA) are from Vietnam veterans. What are PTSD and its symptoms and effects on the human body? Only recently are ways to prevent PTSD and viable treatments have been discovered to combat the illness. Clearly, what happens to veterans with PTSD once they have separated from active duty implies a need for care. How many Vietnam veterans suffered from PTSD and committed suicide is a topic that O’Brien’s work explores. More Vietnam veterans suffer from PTSD than any other war veterans per capita.
What is post-traumatic stress disorder (PTSD) and how did it get diagnosed? Before the Vietnam War, PTSD had been called many different things. Following World War II, veterans that developed PTSD was known as battle fatigue or gross stress reaction. For World War I veterans who developed PTSD, it was known as combat fatigue or shell shock. Then there were the Civil War soldiers that developed PTSD, which was known at the time as soldier’s heart (The History of PTSD, par 5). There are two types of PTSD, acute and chronic. The acute type can happen after a trauma and the chronic happens over a period of time. The sad part about PTSD it was recognized as an emotional disorder, there were those who thought of it as simply a cowardice or personal weakness (Wellness Directory of Minnesota, par 4).
This form of emotional disorder did not receive official recognition from the American Psychiatric Association (APA) until early 1980. At this time, the APA officially added PTSD to its Diagnostic Manual of Mental Disorders (DSM) (Wellness Directory of Minnesota, par 5). It wasn’t until the end of the Vietnam War that brought PTSD to light. This is when doctors began to diagnose PTSD as post-Vietnam syndrome. Since then, the public has become educated on PTSD thanks in part to films and movies about the Vietnam War, such as, Apocalypse Now, the Deer Hunter, and Born on the Forth of July. Another excellent book by Tim O’Brien, In the Woods by the Lake, is about a Vietnam veteran that suffers from Post-Traumatic Stress Disorder.
During Vietnam, symptoms for Post Traumatic Stress Disorder are different in each veteran and not every veteran suffers from PTSD. There are those veterans relive a traumatic event or events from Vietnam through nightmares and flashbacks. In the book The Things They Carried by O’Brien, the platoon had to deal with the untimely and brutal death of Ted Lavender. Then there are those veterans that make themselves numb to repress the horrors of the Vietnam battlefields only to have those memories resurface some years down the road triggered by an emotional event. There are many Vietnam Veterans who become paranoid. Sadly, for many of the veterans who served in the Vietnam War, the war has never really ended. More than one third of the Vietnam Veterans were diagnosed from suffering from PTSD following their release from jail.
According to a 1990 study, 30 percent of the Vietnam veterans had post-traumatic stress disorder and the condition can get better with time with the number decreasing to 15 percent. A study done by National Vietnam Veterans Readjustment Survey (NVVRS) showed the 15.2 of all male veterans and 8.1 of women who served in Vietnam were diagnosed with post-traumatic stress disorder. At least half of the male Vietnam veterans suffering from PTSD have been arrested or jailed at least once, with 34.2 percent reoccurring, and 11.5 percent committing felonies. A 2004 VA statistic showed that 161,000 veterans were still receiving a compensation disability for PTSD. Another major VA study showed that at some point after their return home from Vietnam, 31 percent of the men and 27 of the women who had served developed PTSD (Grady 9).
As O’Brien describes the horrors of the Vietnam War in his novels, the next question we must ask is there a way to prevent post-traumatic stress disorder? There is no real prevention for PTSD at this time. The reason for this is simple; you cannot predict when a traumatic event can and/or will happen. These types of event happen randomly. In the book, O’Brien describes the horrific death of Curt Lemon who dies from stepping on rigged motor round. These types of booby traps today are called improvised explosive devices, or IED’s. There is no way you could have predicted Lemon’s death. How does one train for or prepare for death in boot camp or infantry training school? Even when I was in Marine Corps boot camp and then Infantry Training School at Camp Pendleton, no one ever trained or instructed the new recruits or students on post-traumatic stress disorder and how to prevent it. We were taught very simply that as an infantryman, better known as a grunt, you were expandable. Your life expectancy during combat was to be short. Another way it was described is the cost of doing business.
Research is ongoing, but there have been some experimental studies done where certain types of blood pressure medicines when administered immediately following a traumatic event and then taken regularly there after, might help in lowering the severity of the symptoms. But once again, how can one predict when that event will happen and when and what type of blood pressure medicine one might need to have on their person.
Currently, the Army is looking to make their soldiers more resistant to PTSD before sending them off to combat. 10th Mountain Division doctors are looking at taking a treatment called cognitive processing therapy and making into a preventative measure. This type of therapy has been used on individuals suffering from PTSD for roughly ten years. This is a 12-session therapy where individuals go back over thoroughly go through the traumatic event and their thoughts and feelings. The Army’s goal is to prevent PTSD, but if they cannot prevent the disorder, then they key is early treatment and therapy.
The Navy is also looking at an off the wall type of treatment for post-traumatic stress disorder called. Eye-movement desensitization and reprocessing, or EMDR. The easiest way to describe EMDR is eye-movement therapy. This type of therapy is not a typical, over the shelf, in every medical book therapy. It has received the Pentagon endorsement for treating PTSD and the Veterans Administration uses it in a limited manner.
What other types of treatments are available for those suffering from PTSD? Not only are there treatments for PTSD patients, but the individuals associated with that person such as a spouse, partner, or family member. It has been debated that chronic PTSD can be treated but not cured. Partners, spouses, and family members must have understand, patience, and love when dealing with a PTSD patient. One of the first things you have to learn as a non-patient is that you did not cause the individuals PTSD and also you can not cure it. You need to support the PTSD patient and guide them down the correct path of healing. Symptom Management, Anger Management, and rap sessions are ways the PTSD patient help in the healing process, as well as, the practice of bio-feed back, Tai-Chi, and relaxation (Wellness Directory of Minnesota, par 90).
What happens to the service member once they have separated, also know as being discharged, from the military? It is then up to the veteran to register and obtain treatment from the Veteran’s Administration. I was discharged or separated from the U.S. Marine Corp in March of 1988. While on active duty, I sustained a major injury to my right shoulder. During boot camp, I tripped and while falling I put my arms out to catch my fall. When I landed I dislocated my right shoulder. To make a long story short, I decided not to let the Navy doctors operate on my shoulder. I could explain why but that would be a research paper in itself. I explained to the doctor about my shoulder injury during my discharge physical and he noted the injury on my discharge paperwork. To make matters worse, he listed the wrong shoulder as being injured. The Navy doctor told me to follow up with the VA. That was it. I was given no guidance on how, when, where to go to the VA to seek further treatment. I was handed the medical paper work and told to be on my way.
The Veterans Administration struggles to provide treatment for post-traumatic stress disorder. The VA had estimated by 1998, those veterans suffering from PTSD symptoms were estimated to be 479,000. The annual budget for treating the seriously mentally ill had increased from $2.16 billion to $2.4 billion. But when that budget was readjusted for the inflation of medical costs, services and salaries, it fell $630 million less then the 1996 amount of $2.16 billion. Veterans seeking services from the VA during this time period had risen 11%. Also during the same time period, staffing from the serious mentally ill had decreased by 31%. The drug and alcohol treatments which are one of the most important for those veterans seeking help with PTSD had fallen by 54%. The number of older veterans seeking some form of mental health treatment has risen in recent years due to the Iraq and Afghan wars being shown on television which has triggered their stress (Barton A1).
Experts still can not agree on how many Vietnam veterans that have committed suicide. The Center for Disease Control estimates the suicides among veterans ranges from 9,000 to 100,000. There is no consensus on these numbers or how they are counted by researchers. There are two books, Facing the Wall by Duncan Spencer and Unwinding the Vietnam War: From War Into Peace by Reese Williams had estimated more than 60,000 Vietnam Veterans had committed suicide by the early 1980’s.
A study done in 1990 headed by Dr. Daniel Pollack, along with four other researchers for the Center of Disease Control, estimates that less than 9,000 Vietnam Veterans committed suicide from their discharge to early 1980. A study done in 1979 by psychologist from Denver by the name of Tomas Williams, had concluded the more than 58,000 Vietnam Veterans had committed suicide. The study done of the less than 9,000 Vietnam Veterans who committed suicide is or could be in error. The reason being is numbers were not compiled from the entire Vietnam Veterans population but were compiled from cause of death on the death certificates. Dr. Pollack stated that even with these variations, the number of suicides committed by Vietnam Veterans would not exceed 60,000 (Keating A1).
Finally, we have failed the men and women who served in the armed forces during the Vietnam War that suffer from PTSD to provide them with the necessary treatments. This is an illness that has been around for a very long time. Just because it was known by other names, it still should have been researched much more extensively. Vietnam was a war that was the start of a different type of warfare. No longer did sides just line up and shoot and kill each other, now there was the air campaign, gorilla warfare (Special Forces), children that did the killings, and the numbers game played by the politicians on how many enemy were killed during missions. The atrocities that O’Brien details in his novels are what to what is now called Post-Traumatic Stress Disorder.
Another thing that really bothers me is what veteran has to go though to get the necessary needed treatments offered by the Veteran’s Administration. The red tape, the bureaucracy, and the hoops that you are required to jump through are just asinine. I do not mean this in a bad way, but Senator Ted Kennedy is receiving first class, state of the art, top notch care for his brain tumor. Is Senator Kennedy a better person than those who have served their country by joining the military? I think not! If the Government is good enough to send these men and women into combat, then they should be good enough to provide them with the necessary medical and mental care following their enlistment.
I remember when I filed my claim with the VA for my shoulder injury while on active duty to receive some form of compensation was a very long and drawn out process. It should not be this way. Being a shoulder injury, one would think that the VA would send you to an orthopedic surgeon to write an evaluation of your injury to submit to the VA for a determination of compensation. Oh no, that did not happen. Instead the VA sends me to one of their contract doctors in Rancho Cucamonga. This said doctor was located in a strip mall operating an urgent care. Not only that, he was from Russia. This is an example of why the VA needs overhaul itself.