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U.S. Army Medical Department photo

A plea to deal with soldiers’ invisible wounds

COMMENTARY | May 03, 2010

House veterans affairs chairman Filner, citing suicides, says he will push for more psychological aid for veterans but that the VA and Pentagon bureaucracies are stuck in an old ‘never’ mindset.

By George C. Wilson

Inspired by what he considers reliable studies that conclude far more Vietnam War veterans committed suicide than the 58,000- plus killed on the battlefield, House Veterans Affairs Chair­man Bob Filner (D-CA) will try to impose a new ethic on the nation by specifying in the next Afghan War bill that 15 percent of the money go for treating its veterans.
Filner told CongressDaily that “suicides to me are the ultimate symptom of the deeper thing: We are not evaluating or treating kids properly” after they leave the battlefield. “We’ve got to solve the problem” before veterans of the wars in Iraq and Afghanistan take the same grim way out of their misery by killing themselves, as did Vietnam vets in alarming numbers.
The chairman cited a book by author Penny Coleman, “Flashback: Post Traumatic Stress Disorder, Suicide and the Lessons of War,” and conversations with health profes­sionals as among his sources for saying sui­cides of Vietnam War vets have exceeded battle deaths.
“We have to fight for every cent to treat these kids” who suffer from invisible wounds like PTSD and brain damage after coming out of combat, he said. It should be a given from the get-go that “when you send kids to war, you’ve got to treat them when they come back. It’s part of the cost. Build it in. It’s revolutionary, by the way, to add a surcharge for the veteran” when Congress authorizes and appropriates money for the nation’s wars. He said he will attempt to add a veterans’ surcharge to the next Defense supplemental appropriations bill expected to come before the House “in a couple of weeks.
“If you don’t have PTSD” after being in combat in Iraq, Afghani­stan or both, “I worry about you because that means you’re a ro­bot.” Filner said. “How can anybody who gets a kid killed not have issues afterward? Your buddy was here, and he was killed. He was here because you brought him here. So you may have this guilt. Or you may feel that everybody is out to get you. You have to assume that if you’re in Iraq, right? Otherwise you won’t survive.
“But when you come home and still feel everybody is out to get you, you’re considered paranoid; crazy. I want the public to be aware” of such invisible wounds inflicted on the bat­tlefield “but I also want it to know it’s heal­able. It’s like a broken arm. You don’t refuse to hire somebody because he had a broken arm, right? I don’t want someone to say” of a veteran treated for invisible wounds: “‘He’s crazy. I can’t hire him. He’ll kill somebody.’ We have real employment problems with these kids when they get out” of the service, Filner said.
Because military men and women in uniform are stigmatized if they seek professional help for the demons in their minds that can make committing suicide an inviting exit, Filner wants health spe­cialists to evaluate everyone after he or she comes out of a battle zone to determine if they suffer from brain damage or other invis­ible wounds.
While he admits the evaluations and possible treatment would be enormously expensive and hard to provide, given the limited num­ber of available and competent health professionals, the chairman argues that there is “an epidemic” of invisible wounds that must be combated. “It’s a ticking time bomb,” said Filner of the military’s coming healthcare crisis.
His panel’s jurisdiction extends only to the Veterans Affairs Department, not the Pentagon. But to be effective, evaluation and treatment of invisible wounds inflicted on the brain and psyche by the enemy’s weapon of choice in Iraq and Afghanistan — Impro­vised Explosive Devices — must begin while the soldier, sailor, airman or Marine is still in uniform as well as after he or she leaves the military.
Thus, Filner’s surcharge amendment, if it goes forward this election year, would almost certainly include evaluation and treatment money for the Defense Department as well as the VA. “Neither bureaucracy wants to do it,” Filner said of those two agencies. “They don’t want to know. We can’t afford not to do it,” he contended.
He said it is a political boon for the Democratic Party to be seen as coming to the aid of war veterans. “We usually don’t have the vet­erans. Let’s be the party for veterans and we win those votes, right?”
Filner said in his three-and-a-half years as chairman he has con­vinced his colleagues to increase the VA budget significantly. But he complained that he finds himself continually swimming upstream against the bureaucracies in the VA and Pentagon.
Bureaucrats at both places are captive of a mind set that reminds him of racism.
They contend they are dedicated to doing all they can to help the troops and veterans but exhibit the old “never” attitude when it comes to chang­ing their mindset. Filner vowed to keep up fighting the bureaucracies to help veterans, saying one thing former Alaska GOP Gov. Sarah Palin got right was declaring that only dead fish go with the flow.
This column first appeared in National Observer’s CongressDaily.

Treating the Invisible
Posted by Ted Johnson
05/22/2010, 02:51 PM

As someone with a mild-to-moderate traumatic brain injury, there are two things I'd share. First, for those of us who survive the first year, mortality rates are still 7 times higher then the general population, and life expectancies are 4-5 years shorter. The stats for people with more severe brain injuries aren't nearly as good.

Second, the stigma associated with being "brain-damaged" increases social isolation, which is presumed to be a factor in the high morbidity and mortality rates.

Ironically, my experience has been that doctors are so afraid to stigmatize the patient that they downplay or ignore conditions, with the result that care is delayed or never given. One of the most perverse examples was a counsellor who brought me to her office visa the service elevator and a back corridor do I would not be stigmatized by people seeing me go to her office.

I wanted to go through the front door, but it wasn't allowed because it might somehow stigmatize other patients. I'll argue that it's not just that we need to better diagnose the condition; we have to think about how we treat people, because making them as invisible as their injurues just doesn't do it.

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