According to the 13 March Augusta Chronicle, under the banner “The South’s Oldest Newspaper–Established 1785” — Secretary of Defense Leon Panetta, in response to the shooting of 16 civilians in Afghanistan, said the following: “We seem to get tested almost every other day with challenges that test our leadership and our commitment to the mission that we are involved in…war is hell.” These are, in this writer’s evaluation, one of the more pathetic response’s to this tragic event. I do not question that the soldier who may be found responsible for the massacre should suffer the consequences for his actions. There is a frenzy of speculation in the media about the causes of what happened. But instead of looking for some easy or obvious explanation, I anguish and plead for a far different perspective. Let us step back and ask: “What have WE done? Of course, what have WE done to those Afghan civilians and where is this mess headed? And, what can we do to prevent this happening again? Perhaps we can not prevent or eliminate the horrible insanity of human kind, but our obligation is to at least give it our best effort and I do not believe the US Army, as an institution has not done due diligence and must defend itself against a charge of negligence: not just for this current disaster, though it certainly is part of the fabric of neglect; but for the inablility to establish guidelines, set limits and stand up for the soldiers who have reached the limit of their perseverance; to have the integrity to say we do not have the capability for the mission we have been asked to do. At ground level, the thing speaks for itself; take this as a signal that our definition of the problem(s) is wrong, has failed and calls for new imaginative thinking that is in touch with reality. In frustration I have reacted to the manner our media have dealt with the massacre, and have written an angry letter to the Editor of the local newspaper because the headline to the above quoted article was “Suspect suffered injury to the head.” The story lead paragraph was the following: “The soldier accused of killing 16 Afghan civilians, most of them children, and burning their bodies, was trained as a sniper and recently suffered a head injury in Iraq,” said an anonymous U. S. official. The implication being that any manner of head injury (note the report did not say traumatic brain injury) may well cause a person to be violent and a mass murderer. We don’t know all the fact and may never all the factors that lead up to this disaster. But for sure, such speculation by the media is irresponsible journalism. I am waiting to see if my letter gets published; regardless I will reproduce it in this forum over the next few days. There is some measured thought in the press and I want to share one such expression, even though I do not fully agree with all of it. On 13 March, the Washington Post published a short commentary by Robert H. Scales, MG, USA, RET. He has some of the perspective, as I, of being involved in the Vietnam war. I recommend looking up the entire commentary as I will quote only the portion most pertinent to the current discussion. General Scales compared the trauma of being a soldier in Vietnam to the experience of present day soldiers and Marines saying today “My sense is that their collective, intimate exposure to the horrors of close combat was far more debilitating than what we experienced [in Vietnam]…This of course in no way justifies what happened in Kandahar. But I think if someone wants to place blame, it should be on the succession of national leaders who fail to recognize that combat units, particularly infantry, just wear out. Lord Moran concluded in his classic about combat stress in World War I, ‘Anatomy of Courage,’ that the reservoir of courage begins to empty after the first shot is fired. The horrors of intimate killing, along with other factors such as fatigue, thirst, hunger, isolation, fear of the unknown and the sight of dead and maimed comrades, all start a process of moral atrophy that cannot be reversed. Lord Moran rightfully concludes that nothing short of permanent withdrawal from the line will bring soldiers back to normalcy. …The media is trying to make some association between the terrible crime of this sergeant and the Army’s inability to treat post-traumatic stress disorder and traumatic brain injury. Perhaps the Army could have done more. But I think Lord Moran had it more right; the real institutional culprit is the decade-long exploitation and cynical overuse of one of our most precious and irreplaceable national assets: our close combat soldiers and Marines….If someone just after 9/11 would have told me that a very small Army and Marine Corps would fight a 10 year long set of close combat engagements in two wars and still remain intact, I would have called them crazy. Well, we’ve done just that haven’t we? But at what cost to the few who have borne enormously disproportionate share of emotional stress.?” Just reading and quoting this commentary, which I have read several times, evokes a deep emotional reaction in my gut and a great deal of anger. A retired Army General, even when near the mark in his commentary is going to pull his punches toward the Army. But I disagree with a fundamental point of his engaging commentary: Of course the Army could have done more and it must be held responsible as a major role player in this long, long chain of disastrous lack of vision. It begins with the corrupt recruitment of a large percentage of emotionally impaired young people who are unable to cope with the stresses of civilian life and are then often stressed beyond their capacity in combat situations. And then the Army, unable or unwilling to assess the depth of their distress, either sends them back into the fire, or abandons them to an inadequate system of care ( like the WTB system) which often makes them worse. Indeed, what have we done? More important, where do we go from here? Sometimes, you just have to laugh to keep some measure of sanity. There is a slap-stick quality about our military leadership: it is like a very tall and wide tree, full of gorillas; those on top look down and see nothing but shit-heads; and those below look up and see nothing but ass-holes. And, as an observer from ground level, I think we need to shine the light of reality on those areas where the sun don’t shine.
Clearly incensed over the initial response in the media to the horrible civilian deaths at the hands of an American soldier, I wrote the following letter to the Augusta Chronicle on 13 March: ” To the Editor: I wish to express my concern over the front page headline in the Tuesday March 13, 2012 edition of The Augusta Chronicle which stated under the banner Afghanistan Shootings: “Suspect suffered injury to head.” This scurrilous statement, true or not, leaves the distinct impression that a head injury of any type leads to criminal violence. First, the anonymous source of this unsubstantiated medical information about a head injury is violating the privacy of the suspect and is setting a precedent that is totally lacking in credibility. There is no evidence what so ever that this possible head injury is related in any way to the violent events that followed. What this information does do, in fact, is plant the message that the signature injury of the conflicts in Iraq and Afghanistan, namely traumatic brain injuries from IED blasts, leads to violence. There is no such evidence to support this statement, but your writer or editor did not check the facts about the long term effects of various types of traumatic brain injuries. But jumping to unfounded conclusions makes for interesting headlines, I guess. Even more distressing is the dishonor you bring to the thousands of soldiers and Marines who have served honorably and sustained traumatic brain injuries and who return to duty or their civilian lives without any indication they are dangerous to anyone. It seems that as the public understandably grows weary of this long period of conflict and we enter an election year, the media in particular and manipulators of political expediency raise speculation our servicemen and women with traumatic brain injury and Posttraumatic Stress Disorder are dangerous. The deaths of civilians in Afghanistan is indeed a horrible tragedy and the suspect, if guilty must answer for this crime, but this is not a reason for the media to make unfounded and sinister statements that indict our wounded warriors. I am a board certified Neurosurgeon and a Psychiatrist and I proudly served as a physician in the US military in the Vietnam era and was witness then to the same type of invective that was loaded on our veterans. It is now my honor and privilege to serve and care for, as a civilian, our soldiers. In their time of need I have their back and will protect then from unfounded accusations. Your type of reporting does them a disservice and they deserve your thanks for their honorable service. Since I would not expect an apology for your sloppy journalism, I would at least ask, please, before you publish information about this story or any story about our soldiers, check your facts. There are very well informed professionals within this community who can help you do your job properly.” For the record I signed my name, gave my address and telephone number. And, as expected this was not published. I can only speculate on why it was not published in the local newspaper where there is a huge military installation. However, the information available from ALL media sources are highly speculative and miss the mark by a mile. I get NYTimes.com via my IPhone and on March 15, 2012 this august publication reported the following statement from “a senior American official…who has been briefed on the investigation and who spoke on the condition of anonymity because the soldier has not yet been charged” (which is comparative coprology if I have even heard it). Here is what the mystery official is reported to have said: “When it all comes out, it will be a combination of stress, alcohol and domestic issues–he just snapped.” NO, no, no, it is not he JUST snapped. It is true our (meaning the psychiatric profession) ability to predict violence on an individual basis is poor, but this is not one of those instances where even the totally naive would say the risk for violence in this situation was low or unpredictable. In fact, while this soldier will rightfully be punished severely, perhaps with his life, the Army must accept a major share of the responsibility for the chain of events that lead up to this horrible tragedy; on a scale of 1 to 10, with 10 being disaster, this soldiers risk was in the range of 8, in my professional estimation. There were just far too many risk factors and they were not secret before the act. And I must say this drives a stake through the heart of the Army medical command and in particular the Army mental health service which does not carry any credibility since the Fort Hood disaster. What have we done? What have we done other than bury our heads in the sand, or more graphically in an orifice where the sun don’t shine. Clearly, in the face of overwhelming evidence, we have not stood up to the gorillas at the top of the Pentagon tree and expressed our outrage at the policies, planning and execution of the deployment and recovery of our soldiers in the wars of the last 10 years. We have learned nothing, absolutely nothing from the errors of the past. At ground level, meaning on the ground at home, well before they are listed by command for deployment, we must draw a line that commanders can not cross. For example, on my unit at this time is a soldier who was in the same unit at Fort Lewis with the soldier who committed these atrocities. My soldier, has been told he is scheduled for his 4th deployment as soon as he finishes our program. I will not give all the details of his situation for his privacy rights, but he can not and must not be deployed again. Still, commands can and do ignore the recommendations of medical specialists; I have posted such situations in this blog. I have told the soldier on my unit he will not be deployed, even if we have to go to the highest levels in the Army. There are very dedicated mental health professional swimming up stream against the stream of detritus that flows downhill from both Congressional and Army management. It is time to stop and listen for some touch of reality.
Before finishing this post, it is worthwhile to mention the man and voice that most represents the echelons above reality in the US Army in regard to policy and command about PTSD and traumatic brain injury: General Peter Chiarelli, who left the post of Army Vice Chief of Staff of the Army for retirement in January 2012. He was interviewed this morning, Sunday March 19, on NPR, as the expert on the state of mental health of soldiers and the decisions for deployment. Of course he defended the record of the Army in this regard; that is to say his policy for screening servicemen and women before and after deployments. General Chiarelli does not step up to own the problems with his initiatives that the entire Army is now operating under. His qualifications to make decisions and establish policy about the state of soldier’s mental health is non-existent. It is true that tens of thousands of soldiers have experienced multiple deployments, many in combat arms, and have served honorably without a hint of mental health dysfunction. But are we asking too much? Is the mission worth the risk? What have we done and is there a different way? Clearly General Chiarelli does not think so. I would not expect him to have all the answers. I certainly do not have all the answers. But isn’t it time we start asking more questions?