July 13, 2008 – It should have been one of happiest days of Nick Santoro’s young life.
After two hellish combat tours in Iraq, Santoro was back at his Buckingham home just before Thanksgiving last year. He was surrounded by his loving family and many of his oldest, closest friends.
Santoro felt fine, like himself, he thought, but everyone kept asking him what was wrong. They kept telling him to cheer up. They kept telling him to smile.
Santoro was furious.
“That (angered me) so bad,” said Santoro, 23. “I had to hold myself back from just punching them in the face. These were good friends, friends I’ve had my whole life, and I was just getting so frustrated. I wanted to choke them out.
“They don’t know and I can’t hate them for that,” he said in a hushed voice, “but I don’t think a lot of people know what really happened over there.”
When Jared Baker, 24, of Plumsteadville joined the Army in July 2002, he was always the cool, level-headed friend who rarely had problems with anyone. After his combat tour in Iraq, Baker came home and started drinking a lot. Now, he gets angry all the time.
“We would just be out at a bar and some dude just looks at you the wrong way and it just sets me off,” Baker said. “I get irritable with just about everything with everybody now and it’s about nothing.”
Debbie McKee of Chalfont said, when it came to his marriage, her son Philip McKee was always the calm one. But after his 15-month combat tour of Iraq in December, he frequently loses his patience.
“He can really be short-tempered now,” she said. “The smallest things set him off.”
McKee, 29, an Army sergeant, was a tank driver and gunner in Iraq, where he was hit by seven separate improvised explosive devices, one with more than 700 pounds of explosives, Debbie McKee said.
“It’s just such a scary thing,” she said. “There’s only so many times your body can handle something like that.”
Santoro, Baker and McKee are part of a new generation of veterans returning home from war with post-traumatic stress disorder. Known as PTSD in medical and veterans’ circles, it is an anxiety disorder that can develop after a traumatic event, like an assault, a natural disaster or military combat.
ANGER, NIGHTMARES, DEPRESSION
“PTSD has been around as long as history,” said James Goss, a Vietnam veteran and director of the PTSD program at the Coatesville Veterans Affairs Medical Center in Chester County. “The good news is that it is a readily treatable disorder and it can, in fact, be cured in some cases. The bad news is that, if it goes untreated, it could become much worse.”
Previously known as shell shock or battle fatigue, PTSD was first defined in 1980, Goss said. Symptoms include irritability, extreme anger, restlessness, startled responses, social isolation, memory loss, nightmares and depression.
According to a recent report by the Rand Corp. nearly one in five veterans of the wars in Iraq and Afghanistan suffer from depression or stress disorders, including PTSD. Fewer than half of those 300,000 veterans have received care for depression or PTSD, according to the study, which was funded by the California Community Foundation.
The Department of Defense estimates more than 280,000 of the 1.65 million American soldiers who have been deployed to Iraq or Afghanistan, about 17 percent, will develop PTSD significant enough to need treatment.
Dan Fraley, Bucks County’s director of veterans affairs, said the number of Iraq war veterans seeking help from his office has skyrocketed this year. In the course of one week last month, three Iraq war veterans came into his office on separate occasions, seeking help for legal, family or drinking problems. All three have PTSD, he said.
Goss said about 40 percent of the patients who have been evaluated for PTSD treatment at the Coatesville center served in Iraq or Afghanistan. Many veterans have avoided treatment because of the stigma they think comes with mental disorder.
Santoro said when his unit returned home from Iraq, they would joke about how bad they had the disease.
“Everyone’s PTSD was so bad, we’d always laugh about it,” he said. “Our anger, our frustration, our irritability — we were so on edge that we had no other way to look at it without getting depressed about it.”
NO TURNOFF SWITCH
While they were in Iraq, Baker and Santoro said they developed severely violent tendencies. Every day was a life or death situation, they said.
“You have to be an animal there to survive,” Baker said.
“When you’re in Iraq [and] something happens, you react to it. And when you’re in Iraq, I always felt I had to react with anger,” Santoro said. “You act as strongly, quickly and intelligently as you can because you have to.”
While they were in Iraq, they had to be alert 24 hours a day, Santoro said. They went on missions in 125-degree heat, slept only three hours a day and felt like they were constantly in danger.
Now that they’re back home it’s hard to flip off that switch, they said. Both said they regularly have extreme reactions to small problems.
“If someone looked at you the wrong way in Iraq, it was a sure sign of danger,” Santoro said. “That is why when we are home and someone looks at us the wrong way, we feel threatened the same way we did over there. It’s extremely hard to turn something like that off, and most of the time it is nearly impossible.”
Shortly after he got back, Santoro’s mother called him to tell him she had just bought pizza. Santoro was excited, but when he got home and found it wasn’t the kind he wanted, he lost it.
“I got so mad and I started flipping out and cursing and I was so frustrated I wanted to start hitting things,” he said. “Why did I flip out about pizza? I felt like an idiot.”
“WHAT THE HELL DID I SIGN UP FOR?”
When Santoro graduated from Central Bucks East High School in 2003, the thought of spending the next four years in college bored him. A couple of his friends had decided to join the Marines and Santoro, who felt he needed some discipline in his life, signed up as well.
He spent three months on what was described as a humanitarian mission in Haiti, where he was shot at for the first time. Then his unit — the 3 rd Battalion, 8th Marines weapons company — spent the next eight months fighting insurgents in Fallujah, a city about 40 miles west of Baghdad. He had some close calls there with sniper attacks and IEDs, but it wasn’t until his unit got to Ramadi, the capital of Iraq’s Al Anbar province, that Santoro said things got “a lot worse.”
“If something didn’t happen in Ramadi — if you didn’t get shot at or you didn’t get blown up — that’s when you start to worry,” Santoro said. “That’s when you know something bad’s going to happen and it always did.”
Santoro was nearly killed in April 2006 when an explosion blew him 15 feet out of his Humvee.
“Everything’s a blur, but I kind of remember our doc dragging me and I was just soaked in blood from the waist down,” Santoro said. “I remember preparing myself — “I’m dead, I’m dying’ because I couldn’t feel anything.”
Baker, who joined the Army about a month after he graduated from Central Bucks East in 2002, arrived in Iraq in April 2003, shortly after the U.S. invasion in March. His unit, the Army’s 3rd Armored Calvary Regiment, was the first to take over Camp Ramadi.
Santoro and Baker weren’t in Ramadi at the same time, but they saw a lot of the same horrors.
They were hit by IEDs repeatedly and their bases came under regular fire from rocket propelled grenades and mortar rounds. They saw friends die from sniper fire or lose limbs from explosives and everyone in that violent, desert city seemed to want to kill them.
“You definitely watch movies, and movies kind of glorify [war] and then you get there and you’re like: “What the hell did I sign up for?’ ” Baker said.
Baker was on board a Chinook helicopter in November 2003 when it was hit by a surface-to-air missile. Nineteen people on board survived the attack; 16 were killed. Baker woke up six days later at Walter Reed Medical Center in Washington, D.C., with almost no memory of what happened.
“I remember the missile hitting and then … it’s just black,” Baker said.
“I’M STILL ADJUSTING”
Baker and Santoro are both in treatment for PTSD, as well as a host of physical injuries they suffered during the war. Baker said he’ll pursue a degree in business marketing at Penn State Abington in the fall. Santoro said he isn’t ready for school yet and has gone into business, at least temporarily, with his father.
Both said they have no regrets about their service in Iraq.
“I am proud of the job we did and the way my fellow Marines performed,” Santoro said. “I lost a lot of close friends in Iraq and I miss them, but they died for this country and died for you to have your freedom.”
Both said they hope to help their fellow veterans now coming home from war.
Right now, they’re just trying to deal with their lives after Iraq, a war where they saw horrors they said no one can understand unless they saw them themselves.
They still have to convince themselves that an IED isn’t buried in a pothole or inside a trash can alongside the road. Baker said every time he smells diesel gas, he has a flashback to Iraq “because that whole country smelled like diesel.” Santoro said that smell is his first memory after he awoke from his IED attack.
“I’m still adjusting,” Santoro said. “It feels like ever since Iraq I have this bad side of me. It feels like a little beast inside me. It’s something that it seems like it’s almost impossible to get rid of.”
WHAT IS PTSD?
Post-traumatic stress disorder is an anxiety disorder that can develop after you have been through a traumatic event when you fear your life or the lives of others may be in danger.
DOES IT ONLY AFFECT SOLDIERS?
No. PTSD can affect combat veterans, but anyone who experiences a traumatic event, such as victims of child abuse, sexual assault, a serious car accident, a natural disaster or anyone who lives through a terrorist attack.
WHAT ARE THE CAUSES?
People who experience a traumatic event may experience intense emotions that could create changes in their brain that may result in PTSD. The development of PTSD depends on several factors, including how long the trauma lasted, if someone close to them was killed or how much support was given after the incident.
WHAT ARE THE SYMPTOMS?
Reliving the event, avoidance, a feeling of numbness, anger, irritability, trouble sleeping or concentrating or memory loss are among the most common symptoms.
WHAT PROBLEMS CAN DEVELOP FROM IT?
Alcohol or drug abuse, shame, despair and relationship or work problems, among others.
CAN IT BE TREATED?
Yes, and in some cases it can be cured. Therapy is the most common method for treating PTSD, including one-on-one sessions with a psychologist or psychiatrist, group therapy and education that helps people with PTSD understand the disorder.
Sources: The National Center for PTSD, James Goss, director of the PTSD program at the Coatesville Veterans Affairs Medical Center, the National Institute of Mental Health