The smell of blood pooled around a dead soldier. A mother’s scream as she cradled her wounded child. The screech of a mortar round that killed a close friend.
They are Spc. Tyler Peters’ souvenirs of war.
Peters, of Spencer, went to Iraq in 2003 with an Iowa Army National Guard unit that hauled medical supplies, food and ammunition to combat zones. He came home about 17 months ago from a yearlong tour and brought with him the fear and anguish of the battlefield.
It turned a laid-back 22-year-old soldier into a confused, sometimes angry and profoundly sad civilian.
“You’re not some crazy war vet,” Peters said. “You have an illness. It is from the war, and it is real.”
Government doctors call it post-traumatic stress disorder, a condition that until the Vietnam generation was often dismissed as battle fatigue. It is now widely accepted among doctors and military leaders as a medical disorder.
A study last year in the New England Journal of Medicine concluded that 20 percent of all soldiers who serve in Iraq and Afghanistan — the total, estimated at 1.1 million, includes repeat deployments — will develop varying degrees of post-traumatic stress. That compares with about 15 percent of the 3 million who fought in the 11-year Vietnam War, which ended in 1975.
Dr. Steven Hagemoser, a psychologist who works with post-traumatic stress patients at the Veterans Affairs hospitals in Des Moines and Knoxville, said he and his colleagues are braced for a flood of patients from the war on terror. Meanwhile, more than 200,000 American veterans, most of them from Vietnam, already receive federal disability payments for post-traumatic stress.
About a fourth of U.S. veterans who visited government hospitals for treatment between October 2003 and February 2005 were told they have mental disorders. Post-traumatic stress disorder was diagnosed in 10 percent of them. Military experts say the urban warfare and frequent terror attacks that dominate duty in Iraq and Afghanistan trigger the panic attacks, violent mood swings, chronic anxiety and depression.
‘I really had no control over what I was doing’
Peters has experienced them all. Fury and despair alternately consumed his days, which usually gave way to nightmarish sleep. He has quit a half-dozen jobs since he got back.
He wept at a fireworks show July 4 and had a fight with a former girlfriend that resulted in an assault charge. Peters violated a judge’s order to stay away from her. He spent 30 days in jail.
“I’m not proud of that, but it wasn’t me. I had this anger in me and certain things would just set me off,” he said. “I really had no control over what I was doing. It’s like I’d black out and realize later what I had done.”
The blackouts Peters describes are real, Hagemoser said. Veterans who have grown accustomed to constant danger often feel threatened, and when they do, they sometimes panic and respond as they would in combat: withdraw and hide, or attack. They often don’t realize what they’re doing.
“That person has an instant response to a very real fear,” Hagemoser said.
Doctors encourage veterans to look at the symptoms as treatable, not embarrassing. Prescription drugs, counseling and support groups have helped many reassemble their lives. But without help, post-traumatic stress can worsen.
For many, the diagnosis came years after the war ended. In fact, the American Psychiatric Association didn’t officially recognize post-traumatic stress disorder until the 1980s. Treatment programs were either untested or absent altogether.
War memories remain fresh, decades later
The fear of being labeled “crazy” fostered a stigma that kept untold thousands of others from treatment.
Terrance Rigby was among them. He left Vietnam 38 years ago, but the bloodshed he saw as an 18-year-old combat paratrooper haunted him for decades. It took him 25 years to get help.
“There were many days of mass casualties,” the Bettendorf man said, recalling the way he hauled wounded comrades away from firefights. “You’d pull a guy out and find he’s missing a limb, or you’d have to push his intestines back into his stomach. Those are the characteristics of an ugly beast.
“You don’t forget any of it. It doesn’t simply go away one day.”
Doctors say people have suffered post-traumatic stress after house fires and car accidents. The disorder struck New Yorkers after the terror attacks of Sept. 11, 2001.
But the rate among combat veterans is nearly twice that of the general population.
Some veterans suffer few, if any, ill effects
Yet some walk away from combat seemingly unscathed. Mental-health experts aren’t sure why.
Army Maj. Jeff Gabby of Urbandale, who returned from a tour in Iraq 17 months ago, said he’s adjusted to life at home without severe problems, although “it’s been a challenge.”
“We had people firing into our base every day,” he said. “They may just drive up or run up next to you at any point and blow themselves up, take you with them. I don’t think you just come back and forget stuff or get used to it.”
Kelly Alsbury of Spirit Lake saw the worst of war and quickly resumed a normal life when he returned from battle. Alsbury got back this summer from a mission in Afghanistan, where he lost friends in combat, saw a bomb explode next to his Humvee, and escaped enemy fire.
“The Taliban, they would kill us any chance they got,” said Alsbury, a National Guard infantryman. “And that is hard to live with, and it is hard to just come home and put that all aside, but you have to move on. That’s what I’m doing. I think I’m doing fine.”
Alsbury, in fact, has considered a second tour.
Guard contingent unlike Vietnam era
Alsbury and others in the military say that today’s all-volunteer armed forces are the best-trained soldiers in the world and that, unlike the Vietnam era, none of them were drafted off the street and rushed into combat.
But others note that a large portion of the United States’ active military is composed of part-time soldiers. Author John Crawford, a former member of the Florida National Guard who served in Iraq, writes that many Guard members signed up for weekend duty and extra money but got “very much more than they bargained for.”
Up to 80 percent of the Iowa Guard’s 9,600 members have been on duty at times since the war in Iraq started. Men and women who were teachers and lawyers one month became battle-ready warriors the next. Katina Mack, director of the Des Moines Vet Center, which provides free counseling, said such abrupt life changes can tax even the most well-prepared.
“Some, they have very deep mental wounds, and they will need medical help,” she said.
More than 1,900 U.S. soldiers have died since the war in Iraq started; more than 14,000 have been wounded.
Treatment helps Peters get back on track
After a year of depression and rage, and after his arrest, Peters sought treatment. Counseling at the VA clinic and Vet Center in Sioux Falls, S.D., and medication for depression and anxiety have helped.
Now he gets through most days without major problems. He works at a fast-food restaurant in Spencer and studies auto-body repair. He has rekindled friendships. His parents, older brother and two stepsisters have stood by him.
“He’s been through a hell of an ordeal,” said Peters’ father, Ron. “There were many days he had his mother and me so worried. We didn’t know what to do.
“This was a softhearted kid, a Boy Scout, a kid who had a lot of friends, who got along with most everybody. He liked working on cars and watching stock-car racing,” Peters’ father added. “He came back, he didn’t care about those things, he didn’t get along with people. But he knew he wasn’t crazy. He knew something was wrong, and he wanted to get help and get better.”
Doctors say the U.S. Department of Veterans Affairs (VA) system is equipped to handle the stigma and the disorder.
“That mental scarring is permanent, and real. But at the same time, the person can learn to live with that,” Hagemoser said. “There is life after PTSD.”
Tyler Peters agrees.
Vivid flashbacks of war’s horror linger
Even now, though, he struggles. Flashbacks to war are so powerful, he said, he can’t imagine they’ll ever go away.
“There are nights, I’m trying to sleep and I can’t because all I smell is blood. It’s everywhere. You see the dead, including the innocent civilians just laying there in blood,” he said.
Other memories he doesn’t want to let go, including that of Spc. Josh Knowles of Sheffield. Knowles’ truck was behind Peters’ on a February day when it was struck with a mortar round. Sheffield was killed.
“The people left behind are the real heroes. The American public, I think, knows that,” said Peters, who stayed in the Guard. “I think they mostly support us. But there are some who don’t want to really deal with the problems we might have when we get home. I say to them: ‘Don’t degrade us, don’t call us crazy. Stay behind us. We are making a difference.’
“I’ve been asked if I’d do it all again, knowing what I know now. Absolutely, I would. . . . People just have to know that it wasn’t easy.”