I am going to address a sensitive
subject. Which is hard, because I'm not a sensitive person. So I'm
going to bury this in a lot of gallows humor, and ask that you take
it with the whole salt shaker.
PTS
I wont call it a disorder. A disorder
is defined as:
A disturbance or derangement that
affects the function of mind or body
Basically, that your mind is broken
somehow, and not working right. Except that with PTS, it is, really. The brain
has, over the endless millennia that man has walked the earth
developed this mechanism to cope with “too much bad stuff” when
it happens, compartmentalizing it away until you are in a safe place
and able to deal with it. From the days when Ugh the cave man was
trying not to become Saber-tooth kitty chow to the Romans hanging
people on trees for fun and profit, to today's modern battlefields with "point and click" killing,
this “shell shock”, battle fatigue, whatever you want to call it,
has been known by soldiers in war.
And its not just in war; we recognize
that police, EMTs and Fire-fighters max out their stress meter pretty
easily in their job. Rape victims are also recognized and treated.
What most people dont seem to understand is that its not just
danger that triggers this response. Vehicle incidents that cause
injury; death of loved ones; even childbirth is a traumatic event,
and the brain will try and protect you by blocking out and
“forgetting” the worst parts.
We even have a word for this event,
this forgetting of pain, stress, and the general unpleasantness of
life. “Nostalgia” was invented by a Medical student in the 1600s
to describe the Swiss mercenaries who were suffering a mix of
home-sickness and battle fatigue. He observed that the Mercs talked
of how great things were back home, as if anywhere was that good in
the 1600s.
Its this same sentiment that lets
Grandma (or Great Grandma for some of you young pups) talk about how
“wonderful” it was to work in a factory during WWII. 12 hour work
days; No A/C, no heat, no tools to help lift; fearing the letter
informing you your loved one was dead; having your kids raised by the
one woman on the block who didnt have to work (because her husband
was already KIA) all while living on rationed food, gas, and other
necessities only seems good in hind-sight. We have thousands of
sources telling us honestly just how bad it sucked by any reasonable
standard. Or we can just look at North Korea.
Many cultures have a similar word that
expresses this same sentiment; the remembering of the good of the
past while forgetting the bad. And we can read through history of
that soldiers have always dealt with PTS; when you see in old
writings that someone “returned funny”, that “the war soured
them” and similar such terms, you are seeing the phrases of their
times to explain what we today call a disorder.
Diagnosing
PTS has a problem in that it is “the
invisible wound”. You can see an amputated limb, from the bloody
hamburger freshly removed and still bleeding to the bandaged stump
after the medics work their mojo. You can measure healing, from the
newly stitched stump after the doctors have performed surgery to the
tanned scarred tissue that the artificial limb connects to.
You cant do that with PTS. You cant see
if a person is injured. Have they started healing? Are they healed?
You dont know without prying, and that very prying can be the trigger
for another episode if they arent ready.
Second is the fact that different
people respond differently to the events that can cause PTS, and so
have different wounds. If you shoot a man with a .45ACP, he has a
bullet hole in him. (unless he's Superman) Training, strength,
natural toughness; none of these matter. You shoot him, he gets shot,
he gets a hole in him. But with PTS... What injures one man, another
doesnt even notice. Im told my driver the night I was injured spent
quite some time in therapy for PTS over my injury. Me? It didnt
bother me at all; all my issues came from other incidents. One of the
men in my platoon (a former cook reclassed to Infantry) was
traumatized by our Section Sergeant continually joking how he wanted
to win a Purple Heart. I gather quite a few of the young'uns were. Us
old crusties laughed in public, since we were supposed to support the
incompetent moron in his stupidity. Behind the scenes, we tried to
quiet fears and keep moral up, and remind the guys how good we were
and how that would keep us safe.
But it goes to show, what one man
considers a joke, another will consider trauma.
PTS and the VA
How the VA determines if you have PTS:
(only slightly tongue in cheek)
- Have you been kicked in the nuts or punched in the bewbies?
- Do you try to avoid remembering being kicked in the nuts or punched in the bewbies?
- Do you have nightmares, even ones that dont involve being kicked in the nuts or punched in the bewbies?
- Are you very unhappy/upset/angry when reminded about the time(s) you were kicked in the nuts or punched in the bewbies?
- Do you have strong physical reaction when discussing being kicked in the nuts or punched in the bewbies? (you sweat, grip the chair, pound the table, etc)
- Do you have flashbacks of being kicked in the nuts or punched in the bewbies?
- Do you avoid people, places or things that remind you of being kicked in the nuts or punched in the bewbies?
- Do you avoid people, places or things where you are likely to be kicked in the nuts or punched in the bewbies?
- Do you thing you are a bad person? Or that you have done bad things?
- Do you blame yourself, at least partially, for being kicked in the nuts or punched in the bewbies?
- Have your interests changes since you were kicked in the nuts or punched in the bewbies?
- Do you feel disinterested or detached from others?
- Are you irritable or short-tempered?
- Do you enjoy activities others would call “risky”?
- Do you have a strong flinch reflex?
- Do you have trouble concentrating?
- Do you have trouble sleeping?
These are the 17 questions that the VA
will ask you, disguised in various forms, to see if you have PTS. If
you answer yes to 5-7 of them, you are diagnosed with mild PTS; 8-14
is moderate; any more and you are considered severe. You probably
noticed that many of these questions tend to have a positive answer,
even from completely normal, healthy people. Thats kinda my point;
outside of goths and emos, most people, especially
soldiers, are going to test mild to moderate on this scale normally.
Treatment
The VA
is big on group therapy. So, having decided that you have PTS from
being kicked in the nuts or punched in the bewbies, they send you to
the PTS group therapy session. There, you're told that your wounds
have equal merit, validity, and honor as everyone else's. Then you
look around the room: to your left is a guy, poisoned by the
chemicals democrats still
wont admit were there, who has been told the chemo didnt work, and
he's got months left. On your right is a guy missing a limb. Across
from you is a lady who was raped by one of the interpreters, who
wasnt punished because “mission dictates we need him.” Another is
a guy that had his guts turned to jelly by an AK; the body armor didn't stop
all the rounds. He's trying to cope with the fact that he “coded”
(died) three times on the operating table, and he has another surgery
in a few weeks that only has 50/50 odd of survival. And you have to
tell them that the VA sent you here because they diagnosed you PTS
because of a kick in the nuts or a punch in the bewbies. And the VA
doesnt understand why you feel out of place among these people.
Many
of the Veterans I talk to have mild PTS from their time in uniform,
no matter the hell they endured, compared to what the VA did to
“help” them.