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Writers Articles And Opinions |
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11 December 2009
By Dahr Jamail
US
Army Specialist Lateef Al-Saraji, a decorated combat
veteran, came back from the occupation of Iraq with
severe post-traumatic stress disorder (PTSD).
Saraji
joined the military because he wanted to serve his
country. He served well as a linguist and translator
working under secret clearance with military
intelligence, according to a letter of recommendation
written by his commander following his tour in Iraq,
“This letter is to inform you of my endorsement of SPC
Alsaraji’s superlative performance and vital
contributions to the command during our recent
15-month extended combat tour in Iraq.” Saraji is also
a three-year trustee with American Legion Post 42 in
Gatesville, Texas.
PTSD
is often routed in one event, but more often, with the
two ongoing occupations, it is rooted in multiple
traumatizing events. While in Iraq, Saraji was
horrified by discovering headless bodies of suspected
spies caught by the Iraqi resistance, which were
thrown in a canal near the building where he was based
“so we would see them. I still have nightmares over
the bodies in the water, all blue and foul-smelling,”
he wrote of his experience.
When
he got back to the US, it took him several months to
get an appointment with a counselor on his base, who
then referred him to an off-base psychiatrist, who
diagnosed him with severe PTSD.
In an
email to Chuck Luther, the founder and director of the
Soldier’s Advocacy Group of Disposable Warriors,”
Saraji wrote that he “felt that the Army did not care
about me and my superiors did not seem to care. On
July 1 [2009] the psychologist, Dr. Leach, wrote a
letter recommending I have 2 weeks off.”
Rather
than his commander, Sgt. First Class Duncan, follow
the recommendation of Dr. Leach, Saraji was accused of
going absent without leave and told he would not be
given the two weeks off, along with being written up.
“I got
too depressed,” Saraji wrote of his experience. “I
thought everyone would be better with me dead. I was
going to kill myself. I drank ¾ gallon of Bacardi 151,
took some pills and was going to shoot myself. I was
depressed and tired of the racism and prejudice that I
was receiving. I was talking on the phone with the
Chaplain and he heard me cock my gun.”
Luckily, very shortly thereafter three officers
appeared at his door and took him to nearby Fort Hood,
where he was admitted to a psychiatric unit for a
week. From there he was transferred to a facility in
Wichita Falls, Texas, for three weeks, where he was
jumped by five soldiers who harassed him and called
him a “towel head” and “sand nigger.” He was moved to
a different floor of that hospital, but wrote, “I was
afraid for my safety so I tried to run away from the
hospital.”
Saraji
returned to Fort Hood, only to find Sergeant Duncan
writing him up yet again. According to Saraji, when
Sergeant Duncan learned Saraji had nearly attempted
suicide, he coolly told Saraji that he should go kill
himself.
Luther, a former sergeant who served 12 years in the
military and is a veteran of two deployments to Iraq,
where he was a reconnaissance scout in the 1st Cavalry
Division, is appalled by Saraji’s treatment by his
superiors.
Saraji’s is but one of 20 other cases Luther is
working on, in hopes of avoiding yet another disaster
like the one that occurred on November 5, when Major
Nidal Hasan, suffering from a combination of secondary
trauma and dealing with major ongoing harassment for
being a Muslim, went on a shooting spree that killed
13 soldiers and wounded dozens more.
“The
ground has been laid for another crisis, another
shooting … it’s volatile here, nothing has been
resolved,” Luther told Truthout from his home in
Killeen, Texas, on the outskirts of Fort Hood. “The
average Joe on the street thinks things are resolved
here, but they are anything but resolved. We are
primed to have more soldier-on-soldier violence if
something doesn’t change right away.”
Luther
explained to Truthout that while he has had success
with the base commander at Fort Hood, Lt. Gen. Robert
Cone, addressing all the issues Luther has brought to
his attention, “these lower-down folks are doing what
they want to do anyway. I have 20 cases like his on
this base alone. Fort Hood is not good right now. It’s
only a matter of time, if they don’t fix these
problems and fix them quickly, either Duncan was about
to end up injured, or Saraji was going to injure
himself. These lower-level commanders continue to
intimidate and harass these soldiers, even soldiers
who want to be deployed. Saraji had even offered to go
back to Iraq. This is not a guy who is questionable.
When you go find these guys getting kicked out for
misconduct - you’ll find that prior to this you had
commanders pushing them, punishing them, and harassing
them, then they break.”
Dr.
Kernan Manion is a board-certified psychiatrist who
was hired last January to treat Marines returning from
the occupations who suffered from PTSD and other acute
mental problems born from their deployments. Working
for a personnel recruiting company that was contracted
by the Defense Department, NiteLines Kuhana LLC at
Camp Lejeune, the largest Marine base on the East
Coast, Manion not only quickly became all too familiar
with the horror stories soldiers were telling him
during their therapy sessions, but he became alarmed
at the military’s inability to give sufficient
treatment to returning soldiers, and even more so at
their reports of outright abuse meted out by some
commanders against lower-ranking soldiers who sought
help.
Manion
told Truthout that last April two Marines urgently
sought his help soon after the clinic opened at 7 a.m.
They told him, ‘One of these guys is liable to come
back on base [from Iraq or Afghanistan] with a loaded
weapon and open fire. ‘
This
episode is just one that is indicative of pervasive
and worsening systemic problems afflicting a military
mental health care system that is not only
overburdened, overstressed, understaffed and
ill-equipped, it is exponentially worsened by its
being administered by career military with rank, but
who are ill-trained to provide the complex psychiatric
expertise necessary to effectively treat
psychologically impaired soldiers from both
occupations.
Manion
explained to Truthout that upon returning home, troops
suffering from myriad new-onset deployment-related
mental health problems were flooding the available
resources, and when they did come they had to bear the
brunt of pervasive harassment and oftentimes outright
psychological abuse from Marine Corps superiors who
refused to acknowledge the validity, much less the
severity, of their problems.
“I saw
previously strong Marines, people who were now very
fragile, deeply weary and broken by one, two or often
more deployments, come back and be squashed by their
commanders - who told them they were “goddamn losers,”
Manion told Truthout, “I felt like I was witnessing
child abuse. These courageous and fit men go through
boot camp, and combat and the incredible duress
inherent in deployment, and then you come back and
your midlevel command says this to you, and there is a
tremendous amount of resentment that builds up there.”
According to Manion, doing psychotherapy with soldiers
returning with this type of severe complex
combat-related psychological trauma “is the
psychological equivalent of neurosurgery.”
“Yeah,
of course people need symptom relief from things like
insomnia and irritability (some of these guys have
been averaging only about two hours of sleep a night
for over a year, is it any surprise that they
self-medicate with alcohol?). But really, I find these
guys coming to me because they are in an utter state
of interpsychic chaos and turmoil, because too many
things are going on simultaneously to sort out,”
Manion explained to Truthout, “And too many powerful
emotions that simply comprise turmoil - anger,
anxiety, sadness, shame and hurt, overwhelming them.”
Manion
described what he sees happening with returning
soldiers as their being in “a state of psychic
implosion - someone that is literally having a
psychological meltdown. It’s like having your
motherboard shut down. Just like a computer
motherboard shutdown, the internal psychological
apparatus, the mechanism itself, fries, it shuts down.
There’s currently simply no terminology in the APA
[American Psychiatric Association] literature for
this. When you’re dealing with cumulative stress from
constant guardedness because of continuous exposure to
danger – multiple firefights, patrols, losses of
buddies and utter exhaustion from deployment – and
then you have family problems, and relationship
problems, and then on top of all of that you have
commanders telling you you’re nothing but a worthless
piece of shit, you simply can’t think straight
anymore, and who could be expected to. We need to name
that - this is psychological implosion - what we’re
talking about here is meltdown. When you have
overloaded circuits that are frying the fuse box, you
don’t put in a higher capacity fuse, you have to
unload the circuits.”
Manion
continued to warn his superiors of the extent and
complexity of the systemic problems, and he was deeply
worried about the possibility of these leading to
violence on the base and within surrounding
communities.
Rather
than being praised for his relentless efforts to
address these concerns, Manion was fired by the
contractor that hired him. While a spokeswoman for the
firm says it released Manion at the behest of the
Navy, the Navy preferred not to comment on the story.
Manion
told Truthout that while working at Camp Lejeune, he
was deeply concerned with the fact that he was seeing
an inordinate number of Marines grappling with
overwhelming suicidal or assaultive impulses, and
felt, like others, that this was clearly indicative of
the residua of extreme combat stress.
The
proof was already available - in 2008, according to
the Marine Corps, at least 42 Marines committed
suicide, and at least 146 others attempted to do so.
Manion,
who was already concerned about the increasing
likelihood of violence among post-deployment Marines
at Camp Lejeune, charged that medical officials at the
Deployment Health Clinic where he worked simply
refused to study and discuss violence among these
returning Marines and work on a coherent response.
Authorities at Camp Lejeune, according to Manion, did
little planning to improve the handling of troubled
Marines in most desperate need of treatment for their
PTSD.
The
national evidence was clearly apparent; those who were
not getting necessary care were killing themselves and
other soldiers in startling numbers. Manion remained
deeply committed to confronting the ongoing reported
harassment from their superiors of Marines who were
seeking mental health care.
Despite being warned to essentially stop making
trouble by the national director of the contractor he
worked for in June, Manion felt compelled to continue
with his appeals because he was not seeing the changes
necessary to prevent the already bad situation from
deteriorating further. Because of even more flagrant
offenses, on August 30 he appealed urgently to
multiple military inspectors general in a written
complaint warning of an “immediate threat of loss of
life and/or harm to service members’ selves or others”
if conditions did not improve.
Manion
complained of a “complete disregard for … implications
for patient safety and well-being” and said the
officials at Camp Lejeune had ignored “repeated overt
and emphatically stated concerns about the very safety
and overall welfare of the affected patients.”
Finally, Manion warned his superiors that the lives of
“many patients” were imminently at risk, concerning a
disruption in care that would result from a decision
that his superiors made that would prohibit him from
seeing his patients.
Four
days later, Manion, with 25 years of experience as a
psychiatrist who specializes in PTSD and traumatic
brain injury, and with an investigator from the
inspector general’s office just having arrived, was
fired on the spot by the contractor and escorted out
of his office by an armed MP.
His
warnings, like those at Fort Hood, went unheeded at
Camp Lejeune.
When
Manion heard the news of Maj. Nidal Hasan’s shooting
rampage, “I thought, ‘That could just as easily have
been right here at Camp LeJeune. We are dealing with
people who are fried, who are ready to snap.’”
Was
Manion surprised when he learned that Hasan was a
psychiatrist who had been treating traumatized
soldiers?
“Did
he snap because of all the stuff he heard?” Manion
replied. “I myself came back home some nights so
overwhelmed and even tearful at what I’d heard from
these guys. It’s possible. I wondered, ‘What was
available for him for his support?’ We had no support
structure in place for those providing treatment. I
look at the mental health care work at Camp LeJeune,
and people there and probably throughout the system
really do not understand the absolute necessity of
taking care of the treaters. I had good therapists
come into my office and break down in tears because of
the immensity of the stories they were hearing.”
Manion
holds deep concern for the future of both the soldiers
themselves as well as those who treat them.
When
asked if he thinks the military will incorporate the
changes necessary to rectify these problems, Manion
took a long, deep breath before answering.
“It
concerns me greatly. How ignorant can we be that we
can’t learn from the immediate past and the present?
How ignorant can we be that we’re still not
understanding the immensity of PTSD, of this overall
state of psychological implosion?”
The
doctor added, “If not more Fort Hoods, Camp Liberties,
soldier fratricide, spousal homicide, we’ll see it
individually in suicides, alcohol abuse, domestic
violence, family dysfunction, in formerly fine young
men coming back and saying, as I’ve heard so many
times, “I’m not cut out for society. I can’t stand
people. I can’t tolerate commotion. I need to live in
the woods.” That’s what we’re going to have. Broken,
not contributing, not functional members of society.
It infuriates me - what they are doing to these guys,
because it’s so ineptly run by a system that values
rank and power more than anything else - so we’re
stuck throwing money into a fragmented system of inept
clinics and the crisis goes on. It’s not just that
we’re going to have an immensity of people coming
back, but the system itself is thwarting their
effective treatment.”
Speaking both to the problems he saw at the Deployment
Health Center at Camp Lejeune and the effects of these
rippling into the future, Manion said, “If we’re going
to respond to the immensity of people coming back who
are broken, we need clinics run by people who know
what they are doing. From my perspective we had a
program run by folks who didn’t have the expertise
they needed to run it. They seemed to me to be turning
a blind eye to a philosophy in the Marine Corps that
treats psychological impairment or woundedness as
though you are of weak character.”
The
warnings of Luther and Manion have already proved
prophetic.
On
November 22, Killeen police reported that a
20-year-old Fort Hood soldier, Army Specialist David
Middlebrooks, was stabbed to death. The next day,
22-year-old Joshua Wyatt, another Fort Hood soldier,
was shot to death in his residence. The killers of
both soldiers are alleged to be Fort Hood soldiers as
well.
Yet killings involving Fort Hood soldiers have been
commonplace in recent years, even prior to the mass
killing on November 5. In the years leading up to that
event, soldiers from Fort Hood were involved in the
deaths of at least seven people in the previous five
years alone, several of these incidents being
soldier-on-soldier violence. Taking one of these as an
example, in September 2008, Specialist Jody Wirawan
fatally shot 1st Lt. Robert Fletcher. When Killeen
police arrived, Wirawan proceeded to commit suicide.
In addition, Luther told Truthout that at least two
soldiers at Fort Hood have attempted suicide since the
massacre on November 5.
And the killings are not limited to Fort Hood.
Less than 12 hours after Maj. Nidal Hasan’s shooting
spree, Camp Lejeune officials discovered the body of
one Marine and took into custody another Marine, Pvt.
Jonathan Law, who was accused of killing his
colleague. Law, who had served a seven-month tour in
Iraq, was also suffering from self-inflicted wounds
when arrested.
In upstate New York in the town of Leray, on the
outskirts of Fort Drum, home of the 10th Mountain
Division, between November 29 and 30, soldiers Waide
James, 20, and Diego Valbuena, 23, were murdered by
Joshua Hunter, another Fort Drum soldier, according to
Jefferson County Sheriff John Burns.
Both
victims died of multiple stab wounds.
On
September 29, after being refused any assurance that
the patients who were in his care were OK, accounted
for and being taken care of, being worried about his
patients, and five weeks before the massacre at Fort
Hood, Manion sent a letter to President Barack Obama,
as well as copies of the letter to Vice President Joe
Biden, Secretary of Defense Robert Gates, Chairman of
the Joint Chiefs of Staff Adm. Mike Mullen, ranking
member of the Senate Committee on Veterans’ Affairs
Sen. Richard Burr, and Sens. Carl Levin and John
McCain of the Senate Armed Services Committee, among
several others, including the secretary of the Navy,
and the commandant and sergeant major of the Marine
Corps.
Manion’s letter stated, “Frankly, in my more than
twenty-five years of clinical practice, I’ve never
seen such immense emotional suffering and
psychological brokenness - literally, a relentless
stream of courageous, well-trained and formerly strong
Marines deeply wounded psychologically by the
immensity of their combat experiences.”
The
letter went on to explain how he had, over the
previous six months, raised serious concerns “about
several very dangerous inadequacies of the clinic’s
[at Camp Lejeune] operations as well as recurring
incidents of significant psychological abuse (by their
commands) of Marines who were seeking our care.”
The
doctor expressed his larger concern to President Obama
that his experience at Camp Lejeune “represents a more
pervasive problem at Camp Lejeune and perhaps even
throughout the institutional culture of the military.”
Seeing
the clear potential for the impending disaster of
soldier-on-soldier violence as a result of untreated
PTSD, Manion’s letter continued with a sense of
urgency:
“Mr.
President, given what I’ve witnessed and personally
experienced, I think that, beyond the immediate
issue of my firing and my patients’ care, it’s vital
that these flaws be named and examined. Please know,
I am not a publicity seeker; I’m not pitching a
product; and I’m not trying to rise in rank, power
or compensation. I’m not even trying to restore my
employment in government service. I have no agenda
but to speak my truth on these matters and to
confront these issues so as to ensure that these men
and women receive the best of mental health
treatment services that they’re truly entitled to.”
With
President Obama’s recent announcement to send an
additional 30,000 soldiers to Afghanistan, concern for
the already immense mental health crisis is
increasing. Now, more than ever before, the US
military needs a comprehensive health plan initiative
to meet the radically different psychological
implosions that are occurring due to the occupations
of Iraq and Afghanistan.
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