Fighting the Terror of Battles that Rage in Soldiers’ Heads

New York Times

COLORADO SPRINGS, May 8 — The nightmares that tormented Sgt. Walter Padilla after returning home from Iraq in 2004 prompted extensive treatment by Army doctors, an honorable discharge from the military and a cocktail of medication to dull his suffering.

Still, Sergeant Padilla, 28, could not ward off memories of the people he had killed with a machine gun perched on his Bradley fighting vehicle. On April 1, according to the authorities and friends, he withdrew to the shadows of his Colorado Springs home, pressed the muzzle of his Glock pistol to his temple and squeezed the trigger.

Sergeant Padilla had been diagnosed with post-traumatic stress disorder at Fort Carson Army base here, where concerns over the treatment of returning soldiers struggling with the condition, compelled members of Congress last month to ask the Government Accountability Office to reassess the military’s mental health policies.

A letter signed by nine senators refers to “a number of upsetting allegations” at the base regarding a lack of treatment for soldiers with post-traumatic stress disorder and the stigmatization of those with the condition. On Monday, some of those senators’ staff members will visit Fort Carson to meet with soldiers, families and commanders, the fourth time this year Congressional staff members have traveled to the base.

The Army, reeling from fallout over its poor handling of outpatient soldiers at Walter Reed Army Medical Center, dispatched Brig. Gen. Michael S. Tucker to Colorado to speak with the base’s leaders and soldiers on Tuesday.

General Tucker, the deputy commander of Walter Reed, commended Fort Carson for its treatment of post-traumatic stress and said he viewed the Congressional visits as a means of highlighting the base’s programs that deal with the condition, said an Army spokesman, Paul Boyce.

But Veterans for America, an advocacy group that has lobbied the Army and Congress on behalf of returning soldiers, said the Army must do better, particularly at Fort Carson, where soldiers with the stress disorder have spoken of being punished by their commanders.

The base has 17,500 soldiers assigned to it, and about 26,000 of its soldiers have been deployed to Iraq since the war began.

“Fort Carson is overwhelmed with men and women coming home from Iraq with psychological injuries from war, and there are unit commanders here who don’t understand these medical conditions,” said Steve Robinson, director of veterans affairs for the group.

Col. John Cho, the base’s chief medical officer, said Fort Carson had treated 1,703 soldiers for post-traumatic stress disorder, or P.T.S.D., since 2003. Colonel Cho disputed the assertion that problems at Fort Carson were widespread. “We’re never going to fully eliminate the stigma associated with P.T.S.D., but the leadership at Carson has been fully supportive of getting soldiers they help they need,” he said.

The Army reports seven suicides of active duty soldiers at Fort Carson since 2004 but says it does not know if any were linked to the disorder. Sergeant Padilla was not included among the seven because he died after being discharged.

Most recently, Staff Sgt. Mark Alan Waltz, who was being treated for post-traumatic stress, was found dead in his living room on April 30. An autopsy of Sergeant Waltz, 40, is pending, but his wife, Renea, believes her husband died from a reaction to the antidepressants he was taking for stress and painkillers prescribed for a back injury. Ms. Waltz is also convinced that the psychological wounds he carried from battle played a part in his death.

Ms. Waltz said her husband was reluctant to seek treatment after returning from Iraq in 2004 because he thought a diagnosis of post-traumatic stress disorder would cost him his rank. She said the condition was eventually diagnosed and he was referred for treatment. Even then, she said, he was “picked out, scrutinized and messed with continually” by his commanding officers.

“It’s not right that our guys are going over to Iraq, doing their job, doing what they’re supposed to do, and they when they come back sick, they’re treated like garbage,” Ms. Waltz said.

Army officials at Fort Carson said Sergeant Waltz’s death was still under review and, citing privacy laws, would not comment further.

Mr. Robinson, of Veterans for America, said the group’s research indicated that since 2004, there had been at least six incidents in which Fort Carson soldiers with stress disorder have died, either from suicide or from accidents involving narcotics or medications.

In addition, the veterans group is investigating some 30 cases of Fort Carson soldiers with post-traumatic stress disorder, traumatic brain injury or personality disorders who have complained of mistreatment.

One case involves Specialist Alex Lotero, who returned from Iraq late last year suffering from anxiety attacks and nightmares after dozens of combat missions, including one in which his convoy was struck by a roadside bomb.

Specialist Lotero, a thick-muscled 20-year-old from Miami, said his superiors treated his diagnosis disdainfully, showering him with obscenities and accusing him of insubordination when he missed training for doctors’ appointments.

“They belittled my condition,” he said. “They told me I was broke, that I didn’t have anything left.”

Specialist Lotero eventually checked himself into nearby Cedar Springs Hospital for a few days and is waiting for his medical discharge request to be processed. He points to his forearm, draped in a tattoo of a machine-gun wielding, Vietnam-era soldier. The soldier’s face is ghoulish, his body gaunt and rotting. “This is how I feel right now,” he said.

In an interview, Maj. Gen. Gale S. Pollock, the acting Army surgeon general, said Fort Carson had taken “the bull by the horns” in combating the stigma associated with post-traumatic stress disorder.

General Pollock said the Army was developing initiatives to lessen that stigma and cited examples of officers publicly seeking treatment for combat stress as a means of encouraging their soldiers to follow suit.

“We have to reinforce it again and again,” she said. “I talk with patients, and many of them have looked at me through cheerful eyes and said, ‘You mean I’m not crazy?’ ”

Lt. Col. Laurel Anderson, a psychiatric nurse in charge of behavioral health at Fort Carson’s soldier readiness center, said the number of soldiers referred for mental health screenings had risen from about 12 percent of those seen at the center to 25 percent over the past year.

Colonel Anderson said soldiers sometimes refused her referrals to psychiatrists. “They don’t want anyone to know,” she said.

This year, Colonel Anderson began training officers to de-stigmatize post-traumatic stress disorder within their units. Another training session, this one for noncommissioned officers, is scheduled for Monday.

The Army is also considering sending a unit to Fort Carson and other bases to help soldiers navigate the administrative tangle of medical treatment. But Sergeant Padilla’s death showed that even when a soldier feels comfortable enough to seek treatment, that may not be enough.

Friends and family say Sergeant Padilla complained that antidepressants and painkillers were no substitute for talking with someone who understood what it was like to kill.

“He told me that the doctors weren’t helping him,” said his mother, Carmen Sierra, in a telephone interview from her home in Puerto Rico. “He told me that they couldn’t understand him, that he was still having those nightmares.”

A few months ago, Sergeant Padilla told his girlfriend, Mia Sagahon, that maybe it was time he start speaking with a doctor again. He never did.

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