April 3, 2012

Anybody Listening

One of the readers of this blog sent me an article published in the Washington Post and I think is should be required reading for anyone with rational thought and an interest in this mess our government and military have created: Just a brief preview:

Link between PTSD and violent behavior is weak

By , Published: March 31

“Post-traumatic stress disorder and traumatic brain injury can increase a person’s anger and hostility and diminish his or her self-control. But the link between those disorders and outright violent behavior is weak and hard to pin down with certainty.That’s what the research suggests about the effects of post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), two medical conditions suffered by tens of thousands of U.S. soldiers who fought in the Iraq and Afghanistan wars. That research — which is both voluminous and inadequate — could play a role in the defense of Army Staff Sgt. Robert Bales, who has been charged with 17 counts of murder after a rampage in Kandahar province in southern Afghanistan.”Please read this entire article; it is getting closer to the mark, though the truth will most likely remain obscure, made opaque by the fecal smear of government/military tail wagging.  There are related articles in the Washington Post  that support the fact the SGT charged with the crime clearly had significant known  risk factors.  And it is true thousands of soldiers who have served under approximate circumstances perform without incident. Considering the numbers it is amazing all the factors have not come together more often, resulting in repeated disasters.  And yet, at the core, there is another reason, not an excuse, but an explanation that will be understood by other soldiers, but never discussed. It will be interesting to see if it will come out eventually.

In the meantime there are continuing examples of Army ineptness and simply ignoring evidence. Let me very  briefly simplify a complicated story of a dedicated soldier: today I admitted a man who spent 15 months on a mountain top in Afghanistan in 2008 to 2009, involved in live fire combat action every single day. He was injured in an explosion with a clear traumatic brain injury along with multiple orthopedic injuries; he did not leave his unit which  sustained multiple casualties. After they returned to their home base in Italy he and all members of his unit filled out a survey  held out by the Army as a method to detect those who sustained significant trauma. They all described signs and symptoms of TBI or PTSD or both, as in the case of my patient. There was no follow-up on this information by the Army. My patient did not see a mental health professional until two years later when he was briefly admitted to a local VA hospital in California because he could not sleep and was drinking in order to deal with his insomnia, nightmares and severe avoidance behaviors. Unfortunately there was no follow-up after this initial contact and finally in March of 2012 he got the attention he required and was sent all the way across the country for care.  So much for the military monitoring and surveillance system. which has proved to be a total disaster.  This soldier is unable to raise his left arm due to a shoulder injury from  the IED explosion; has internal derangement in his left hip and left knee; bilateral hearing loss; clearly has had a traumatic brain injury with loss of consciousness (never investigated with CT or MRI); and he meets all the criteria for active PTSD. He finally gets treatment because he is drinking so much he can not do his current assigned duties as a recruiter.  I like to think he has reached the place where he can finally get the evaluation and treatment he needs. He is worried he could be deployed again.  Do not smile at that notion, evidence indicates it does happen. We will try to prevent that ever happening.

 

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