Veterans for Common Sense

November 14, 2007 – Demond Mullins spent a year in Iraq with the National Guard. When he came back, he felt alienated and angry at what he had seen and done in the war. Now Mullins has found a degree of peace in higher learning.

“Academia … that’s where I’m at,” the City University of New York grad student says. “Right now, school, books — Weber, Marx, Durkheim — that’s my medication.”

That’s his medication now. But if it’s true that there are seven stages of grief, it’s fair to say that Mullins is going through several stages of adjusting to his new life.

His military transport plane brought him back in the fall of 2005. When he arrived at New Jerseys’ Fort Dix, there were no bands waiting to welcome him home, Mullins says.

What waited instead was a pair of white-painted school buses. Those buses would carry the surviving members of his National Guard unit back toward civilian life.

Mullins, who grew up in Brooklyn, spent a year as a clothing model. He was ambitious enough to join the National Guard to pay for college.

That was the life Iraq interrupted.

Ignoring the Awkward Questions

And when he tried to resume it, Mullins’ old friends kept asking questions, like “What was it like when you shot someone?”

“I don’t know,” he says. “My experiences are not pornography for my friends or for anyone else. I use the word pornography because I feel like it is just the … exploitation of my personal experiences for someone else’s entertainment.”

Mullins says he either ignored the question “or I would just say, ‘You know, I don’t want to talk about things like that’ or just say, ‘I didn’t shoot anybody or whatever.'”

‘Stressed Out and on the Edge’

He says he’s not sure if he did shoot and kill anybody, though he knows exactly what he did at close range.

“I dehumanized people,” Mullins says. “I don’t even know how many raids I did while I was there. But during raids you’re throwing them up against the wall, you’re tying their hands behind their back, you’re dragging them out of the bed. You’re dehumanizing them in front of their wives and their kids and, you know, the women are crying and the children are crying and you’re just like, whatever. Put a bag over their head or blindfold, drag them into the Humvee.

“Certain exhibitions of violence on my part that were probably unnecessary — were definitely unnecessary. But I was really stressed out and on edge at the time and I conducted myself … like that.”

When he returned from Iraq, Mullins says he felt angry at himself. He broke up with his girlfriend. He spent days in his apartment.

“Staring at the wall. Not eating. I lost about 15 to 20 pounds,” he says. “My friends still look at me and like, ‘What happened to you?'”

Mullins says he was depressed to the point of being suicidal. Two of his friends have died since their return from Iraq, including one who shot himself in the face, Mullins says.

“To me, that would be the only way that I was capable of doing it because it was fast and it was a tool that I was very familiar with,” he says.

Mullins got counseling from the Department of Veterans Affairs. He didn’t like it and didn’t want to take medication.

He managed to resume college, get a degree and move on to graduate school.

Speaking Out Against the War

Along the way, Mullins focused his anger. He spoke out against the war at marches and rallies.

He appeared in an anti-war documentary called The Ground Truth.

“When I first started anti-war activism, it was because I felt guilty,” Mullins says. “Because I’d meet people, especially a lot of civilians on the street, and they say, ‘Oh, thank you for your service. Thank you for protecting America.’ Like, what are you talking about? I wasn’t protecting America. I was protecting myself and my buddy, you know?”

After Mullins participated in the film, he felt less of a need to speak out.

And by this semester at graduate school, most of his fellow students and at least one of his professors had no idea of his background.

“I had no idea he was a veteran,” says sociology professor John Torpey. “It’s just not something you would have ever known. He seemed a little sheepish about people knowing it.”

Learning and Understanding

Mullins, who knows so much about war from personal experience, comes to class and speaks about social and political theories of war. Recently, he was leading a class discussion — learning by teaching.

Mullins says he can apply the principles he’s learning to the situations he experienced in Iraq.

“I can understand the chaos that is society, the chaos that is life through a theory,” he says. “In some way, I look at my experiences in Iraq and I can understand them through theory.”

Mullins says he has gone through degrees of change since the documentary was filmed.

“When I came back from Iraq, I was just like, anti-war, anti-establishment and anti-myself,” he says. “But it’s time for me to move more in the direction of where my interests are going.”

Is he feeling less alienated?

“I’m feeling more like I’m understanding this country, this society. And I don’t want to scream against it. Right now, I’d just like to study it.”

There was a time when Mullins was screaming against his own life. For now, at least, he seems to be studying that, too.

November 14, 2007 – The stress and depression caused by combat in Iraq often don’t appear until a few months after a soldier has returned home, researchers reported today.

Six months after their deployment ended, the number of soldiers referred for mental health care was nearly three times as high as when they first returned, and the number reporting relationship problems with their families and others had quadrupled, according to results from a new screening tool used by the military to assess the troops’ mental health.

Overall, about 20{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of active-duty Army soldiers and more than 40{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of National Guardsmen and reservists were referred for care or had sought care on their own, a military team reported in the Journal of the American Medical Assn.

Psychologists hope that catching problems early and getting soldiers into treatment will prevent the type of long-term mental health problems that afflicted many soldiers who fought in Vietnam, said Dr. Charles S. Milliken of the Walter Reed Army Institute of Research, who led the study.

“We know from civilian studies and others . . . that if you can get to these problems earlier, the chances of effectively treating them are much better,” he said.

The incidence of mental health problems during the Vietnam War was about the same as that of the current war, he noted. But studies have shown that as many as 10{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of Vietnam vets still suffer chronic and disabling symptoms.

The trends reported by Milliken and his colleagues are similar to those seen in smaller studies of returning Iraqi veterans, but some experts cautioned that the absolute numbers of troubled soldiers may be artificially high because of the nature of the questionnaires used.

Psychologist Richard J. McNally of Harvard University noted that he and Dutch colleagues published a study on Dutch soldiers earlier this year using a similar questionnaire. The questionnaire showed that about 20{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of the professional soldiers suffered symptoms of depression and post-traumatic stress disorder (PTSD).

But when the subjects underwent clinical interviews, they found, only about 4{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} actually suffered the disorders.

Milliken conceded that the large numbers did not represent clinical diagnoses.

“We have intentionally set the bar pretty low,” he said. “We’re hoping to find early symptoms and intervene before they can become full-fledged clinical diagnoses.”

The study reflects an increased emphasis by the military on catching incipient mental health problems when veterans return from combat duty. Beginning in May 2003, the Department of Defense began administering the Post-Deployment Health Assessment to all returning soldiers.

Milliken, Dr. Charles W. Hoge of Walter Reed and their colleagues reported in March 2006 on the first results from the survey. They found that about one in eight soldiers suffered from PTSD or other disorders, but they speculated that the number would grow as the soldiers began re-integrating into society.

A small preliminary assessment confirmed that speculation, and the Army initiated a second survey six months after the soldiers’ return.

The new report details the outcome for the first 88,235 soldiers who took both surveys.

Of those, 4.4{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} were referred for mental health care in the first screening, and an additional 11.7{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} were referred during the second screening.

Three-quarters of those who later received mental health care had not been referred for care, but sought it out themselves. Overall, 20.3{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of active-duty personnel and 42.2{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of reservists and guardsmen surveyed underwent some form of treatment.

The results were not surprising, said Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America. The initial screening was performed while the troops were on the way home, and soldiers may have minimized symptoms for fear that admitting to an illness would delay their reunions with their families.

There is also a well-known “honeymoon period” after return that persists until their experiences begin to sink in.

The higher rates among reservists and guardsmen are also not surprising, Rieckhoff said. A stigma is still associated with mental health problems, and career soldiers may be less likely to admit to them.

But the reservists may be more likely to suffer problems because they are dropped back into society without having the fellowship of a community of others who shared their experiences.

“You can literally be in Baghdad one week and Brooklyn the next,” he said. “That’s a pretty tough shift.”

The quadrupling of those reporting interpersonal conflicts also was understandable, experts said. Despite the wide availability of telephone calls and Internet connections in this war, the soldiers were still isolated from their family and friends at the time of the first assessment, so few conflicts would be expected.

But after six months of close contact with friends and family, frictions would be much more likely.

One surprising finding of the new study was the lack of correlation between treatment and improvement in symptoms. More than half of those identified as having problems in the original study “improved without treatment,” and many of those who received treatment did not improve, Milliken said.

November 13, 2007 – Federal agents investigating the Sept. 16 episode in which Blackwater security personnel shot and killed 17 Iraqi civilians have found that at least 14 of the shootings were unjustified and violated deadly-force rules in effect for security contractors in Iraq, according to civilian and military officials briefed on the case.

The F.B.I. investigation into the shootings in Baghdad is still under way, but the findings, which indicate that the company’s employees recklessly used lethal force, are already under review by the Justice Department.

Prosecutors have yet to decide whether to seek indictments, and some officials have expressed pessimism that adequate criminal laws exist to enable them to charge any Blackwater employee with criminal wrongdoing. Spokesmen for the Justice Department and the F.B.I. declined to discuss the matter.

The case could be one of the first thorny issues to be decided by Michael B. Mukasey, who was sworn in as attorney general last week. He may be faced with a decision to turn down a prosecution on legal grounds at a time when a furor has erupted in Congress about the administration’s failure to hold security contractors accountable for their misdeeds.

Representative David E. Price, a North Carolina Democrat who has sponsored legislation to extend American criminal law to contractors serving overseas, said the Justice Department must hold someone accountable for the shootings.

“Just because there are deficiencies in the law, and there certainly are,” Mr. Price said, “that can’t serve as an excuse for criminal actions like this to be unpunished. I hope the new attorney general makes this case a top priority. He needs to announce to the American people and the world that we uphold the rule of law and we intend to pursue this.”

Investigators have concluded that as many as five of the company’s guards opened fire during the shootings, at least some with automatic weapons. Investigators have focused on one guard, identified as “turret gunner No. 3,” who fired a large number of rounds and was responsible for several fatalities.

Investigators found no evidence to support assertions by Blackwater employees that they were fired upon by Iraqi civilians. That finding sharply contradicts initial assertions by Blackwater officials, who said that company employees fired in self-defense and that three company vehicles were damaged by gunfire.

Government officials said the shooting occurred when security guards fired in response to gunfire by other members of their unit in the mistaken belief that they were under attack. One official said, “I wouldn’t call it a massacre, but to say it was unwarranted is an understatement.”

Among the 17 killings, three may have been justified under rules that allow lethal force to be used in response to an imminent threat, the F.B.I. agents have concluded. They concluded that Blackwater guards might have perceived a threat when they opened fire on a white Kia sedan that moved toward Nisour Square after traffic had been stopped for a Blackwater convoy of four armored vehicles.

Two people were killed in the car, Ahmed Haithem Ahmed and his mother, Mohassin, a physician. Relatives said they were on a family errand and posed no threat to the Blackwater convoy.

Investigators said Blackwater guards might have felt endangered by a third, and unidentified, Iraqi who was killed nearby. But the investigators determined that the subsequent shootings of 14 Iraqis, some of whom were shot while fleeing the scene, were unprovoked.

Under the firearms policy governing all State Department employees and contractors, lethal force may be used “only in response to an imminent threat of deadly force or serious physical injury against the individual, those under the protection of the individual or other individuals.”

A separate military review of the Sept. 16 shootings concluded that all of the killings were unjustified and potentially criminal. One of the military investigators said the F.B.I. was being generous to Blackwater in characterizing any of the killings as justifiable.

Anne E. Tyrrell, a Blackwater spokeswoman, said she would have no comment until the F.B.I. released its findings.

Although investigators are confident of their overall findings, they have been frustrated by problems with evidence that hampered their inquiry. Investigators who arrived more than two weeks after the shooting could not reconstruct the crime scene, a routine step in shooting inquiries in the United States.

Even the total number of fatalities remains uncertain because of the difficulty of piecing together what happened in a chaotic half-hour in a busy square. Moreover, investigators could not rely on videotapes or photographs of the scene, because they were unsure whether bodies or vehicles might have been moved.

Bodies of a number of victims could not be recovered. Metal shell casings recovered from the intersection could not be definitively tied to the shootings because, as one official described it, “The city is littered with brass.”

In addition, investigators did not have access to statements taken from Blackwater employees, who had given statements to State Department investigators on the condition that their statements would not be used in any criminal investigation like the one being conducted by the F.B.I.

An earlier case involving Blackwater points to the difficulty the Department of Justice may be facing in deciding whether and how to bring charges in relation to the Sept. 16 shootings. A Blackwater guard, Andrew J. Moonen, is the sole suspect in the shooting on Dec. 24 of a bodyguard to an Iraqi vice president.

Investigators have statements by witnesses, forensic evidence, the weapon involved and a detailed chronology of the events drawn up by military personnel and contractor employees.

But nearly 11 months later, no charges have been brought, and officials said a number of theories had been debated among prosecutors in Washington and Seattle without a resolution of how to proceed in the case.

Mr. Moonen’s lawyer, Stewart P. Riley of Seattle, said he had had no discussions about the case with federal prosecutors.

Some lawmakers and legal scholars said the Sept. 16 case dramatized the need to clarify the law governing private armed contractors in a war zone. Workers under contract to the Defense Department are subject to the Military Extraterritorial Jurisdiction Act, or MEJA, but many, including top State Department officials, contend that the law does not apply to companies like Blackwater that work under contract to other government agencies, including the State Department.

Representative Price’s bill would extend the MEJA legislation to all contractors operating in war zones. The bill passed the house 389 to 30 last month and is now before the Senate.

He said it cannot be applied retroactively to the Sept. 16 case, but he said that the guards who killed the Iraqis must be brought to justice, under the War Crimes Act or some other law.

Paul von Zielbauer contributed reporting from Camp Pendleton, Calif.

In a November 9, 2007, VA court filing related to our VCS class action lawsuit against VA, attorneys for VA revealed that nearly 264,000 Iraq and Afghanistan war veterans were alread treated in VA hospitals and clinics through the end of October 2007. 

Last week, House Veterans’ Affairs Committee Chairman Bob Filer issued a statement where he said VA expects to treat 300,000 Iraq and Afghanistan war veteans in 2008.

Senators Lead Effort on Behalf of Estimated 175,000 Affected Gulf War Veterans

November 9, 2007 – Washington, DC – U.S. Senators Robert C. Byrd, D- West Virginia , and Bernie Senders, I- Vermont , applauded the Senate’s passage of a $10,000,000 investment in research to combat Gulf War Illness. Byrd and Sanders led the effort to include the funding in the Fiscal Year 2008 Department of Defense appropriations legislation, which cleared the Senate on November 8th.

“As recent research has further demonstrated, an alarming number of Gulf War veterans continue to suffer serious ailments as a result of exposure to toxic materials during the Persian Gulf War,” said Byrd. “It is our moral responsibility to help those who are suffering as a result of illnesses contracted while serving our nation.  We can and must do more to find treatments and cures for these serious ailments.”

“Over 175,000 veterans are still suffering from a poorly understood set of illnesses related to their service in the first Gulf War,” said Sanders. “After years of denial and resistance from the Defense Department and the VA, we are finally beginning to see some promising research that could help our ill service members. This research funding means that we are keeping faith with those who so honorably served our country and who deserve real treatment and a government that lives up to its promise to care for those that wear our uniform.”

The complex of symptoms commonly known as “Gulf War Illnesses (GWI)” – widespread pain, cognitive impairment, and persistent fatigue in conjunction with diverse other symptoms and abnormalities – are
associated with service in the Southwest Asia theater of operations in the early 1990s during the Persian Gulf War. Byrd and Sanders’ efforts are consistent with the Pentagon’s historical commitment to finding treatments and cures for the estimated 175,000 Gulf War veterans affected — roughly a fourth of those who served.

The provision authorizes $10 million in funding for Gulf War Illnesses research to be conducted by the US Army Medical Research and Materiel Command’s Congressionally Directed Medical Research Program (CDMRP)
(http://cdmrp.army.mil/aboutus.htm)., which last year initiated a promising pilot program to identify treatments and diagnostic tests for Gulf War illnesses.

The following Veterans Service Organizations support the Byrd/Sanders provision:

*       American Legion
*       Veterans of Foreign Wars
*       Disabled American Veterans
*       Paralyzed Veterans of America
*       Vietnam Veterans of America
*       AMVETS
*       Veterans of Modern Warfare

Gulf War Illness Facts

*       Three new studies recently released by a team from Boston University, VA, and the Army have added to the compelling body of recent research showing that these illnesses are serious neurological conditions resulting from toxic exposures during the war.

*       Ill veterans with five or more symptoms showed a loss of brain mass in MRI scans of areas related to learning and memory, and also performed significantly worse on objective learning and memory tests.

*       Veterans exposed to low levels of nerve gas following the destruction of a major Iraqi arms depot at Khamisiyah , Iraq , showed a loss of brain white matter and poor performance on motor coordination
tests equivalent to aging 20 years.

*       Previous studies have shown that Gulf War veterans have double the rate of ALS found in other veterans, and that veterans potentially exposed at Kamisiyah have double the expected rate of brain cancer deaths.

*       Current and future American military forces, as well as civilians, are also at risk of similar exposures and will benefit from the research supported through this funding.

November 12, 2007 – Presidential contender John Edwards is introducing a $400 million plan Monday to help veterans with post-traumatic stress disorder, including those recently returned from combat in Iraq and Afghanistan.

Under Edwards’ plan, veterans could seek counseling for post-traumatic stress disorder outside the Veterans Health Administration system; the number of counselors would increase; and family members would be employed to identify cases of PTSD.

Edwards, a North Carolina Democrat, was scheduled to introduce the five-point plan during a speech at New Hampshire’s Plymouth State University.

“I strongly believe we must restore the sacred contract we have with our veterans and their families, and that we must begin by reforming our system for treating PTSD. We also must act to remove the stigma from this disorder,” Edwards said in prepared remarks his campaign provided to The Associated Press. “Warriors should never be ashamed to deal with the personal consequences of war.”

Edwards said that despite his opposition to how the war has been waged, the enlisted men and women deserve the nation’s support when they complete their service.

“We must stand by those who stand by us. When our service men and women sacrifice so much to defend our freedom and secure peace around the world, we have a moral obligation to take care of them and their families,” he said.

A recent study of Veterans Affairs records showed that the number veterans with PTSD increased by almost 20,000 during the last fiscal year – a nearly 70 percent jump.

Edwards said the Bush administration’s extension of tours to 15 months has only exacerbated the situation, and he promised to increase the time given to service members between deployment. A Defense Department study earlier this year showed that inadequate time stateside led to higher rates of PTSD or aggravated mental stress from service in the field.

Edwards’ campaign said there are too few trained counselors in the networks available to veterans. As such, they avoid seeking care because of the wait or the stigma. Instead, Edwards said he would increase counseling and training for counselors and allow veterans to seek treatment outside of the existing system.

The VA currently has a backlog of as many as 600,000 claims, increasing delays for initial treatment by up to six months, according to the campaign. Edwards pledged the entire backlog would be eliminated by Memorial Day 2009 – four months after he might take office – and would cut the processing time by half.

Edwards’ plan also would provide a comprehensive medical examination, which would be part of a “Homefront Redeployment Plan” provided to every veteran. Edwards said veterans don’t receive their first examinations for months or years after leaving the service, making it more difficult to determine whether an injury is service-related or not.

The Edwards campaign said the government could pay for the program through closing tax loopholes and more efficient tax collection.

November 11, 2007 –

To care for him who shall have borne the battle and for his widow, and his orphan.

If those words seem vaguely familiar, if somewhat out of fashion, it is because they form the motto of the Department of Veterans Affairs (VA). The words are a direct quote from President Abraham Lincoln’s second inaugural address in March of 1865.

The first part of the quote begins “With malice toward none, with charity for all, with firmness in the right as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation’s wounds…” It was near the end of the Civil War and Lincoln wanted to reconcile the country. He knew tens of thousands of veterans would be coming home, many in need of help. Many veterans of that horrible war would not be coming home, leaving widows and orphans to fend for themselves.

Although the words were spoken when veterans were almost exclusively men, the mission of the VA to care for veterans – male and female – is important and increasingly complex.

This Veterans Day we honor all those who have served and are serving our country in the military. Their duty has helped us keep the flame of liberty lit for the entire world to see.

In exchange, our country promises soldiers services and benefits after their tours are finished. A special commitment is extended to those returning with physical and emotional wounds.

Sadly, those promises often have fallen short in execution. There have been too many scandals involving the care veterans were, or more importantly, were not receiving in facilities that would not meet minimum standards in the private sector.

Soldiers needing medical or psychological treatment are bounced between the Department of Defense and the VA, often getting wrong or conflicting advice about benefits. The medical record databases of the two agencies can’t communicate causing delays and denials of legitimate benefit claims.

Veterans from wars as far back as Vietnam still struggle with problems that have not been adequately addressed by the VA such as the effects of exposure to the defoliant Agent Orange and the lingering tragedy of post-traumatic stress syndrome. Recent veterans of service in Afghanistan and Iraq complain of bureaucratic delays and denials of service.

President Bush has nominated a retired lieutenant general and physician to head the VA. Dr. James B. Peake is also an executive with a company – QTC Management – that receives most of its revenue from federal veterans programs, including one contract that could be worth $1 billion according to the Los Angeles Times. Anthony J. Principi is chairman of QTC and its former president. He also served as secretary of the VA until his resignation in early 2005.

Asking another executive of the same company that is profiting from the VA’s outsourcing to head the struggling agency doesn’t inspire confidence in an objective reform.

Why are we bringing up the VA’s dirty laundry on Veterans Day – a day we should be saying thanks to those who served and are serving?

It is right and proper to say thank you and honor our veterans on this special day. However, our words would mean more if they were backed by action in demanding our government through the Department of Defense and Veterans Administration keep our promises:

•Clean up those hospital and medical facilities that have fallen into disrepair.

•Fully fund those programs that we promised to the veterans.

•End the bureaucratic ping-pong that delays or prevents timely and proper care of our veterans.

A bill implementing some of the recommendations resulting from the horrible conditions at Walter Reed Army Hospital is working its way through Congress. It’s a start, but the problem is much larger that repairing buildings.

Thank you, veterans, for your past and present service. Our hope is that this time next year we can report significant progress in making good on our promises to you.

November 1, 2007 – Dr. James Peake, the retired Army general whom President Bush recently nominated to head the Department of Veterans Affairs, has a long and distinguished career. Among other things, he ran the Army’s medical system until a few years ago, serving as Army surgeon general. But as people begin to review Peake’s record, he’s getting mixed reviews.

A retired Army general who worked closely with Peake in the Army’s medical command has mixed feelings about the nomination. The general sat in meetings with Peake, and he brainstormed with him.

The general requested anonymity because he still works with the Army. “Jim doesn’t take easily to criticism, and when I tell you honestly what I think of him, I could lose my job,” he said.

Peake is the third man who Bush says will finally make things right for vets.

Since President Bush took office, two secretaries of Veterans Affairs have come and gone. Both men promised to make sweeping changes in the veterans’ medical system, which just about everybody agrees is broken and overwhelmed. Both of them failed.

The Good

First, here’s the positive side. The retired general said that Peake is “very bright, very dedicated and works extremely hard.” And, the retired general says Peake dives into solving problems.

All of which are great attributes for the job. President Bush said pretty much the same thing when he introduced Peake at a press conference on Tuesday, saying, “He will apply his decades of expertise in combat medicine and health care management to improve the veterans’ health system. He will insist on the highest level of care for every American veteran.”

The retired general also said that Peake is conscientious and will try to do the right thing. He said Peake loves micromanaging details.

The Bad

But the former colleague said Peake bogs down in details. He said the VA medical system is such a mess that it’s going to take someone with sweeping vision to overhaul it — and Peake doesn’t have that vision. In fact, the former colleague and some veterans’ advocates say that Peake’s myopia might have helped cause the crisis that soldiers faced when they came home from the war with serious mental health problems.

“That is clearly a failure,” said Gary Myers, a former Army lawyer, now in private practice, who works on military cases.

Myers says it’s important to remember that Peake was running the Army’s medical system when the U.S. invaded Afghanistan, and he kept running it until 18 months after the U.S. invaded Iraq. By late 2003, Army researchers were telling Peake that large numbers of troops were having serious mental health problems, including post-traumatic stress disorder. An Army study, later published in the New England Journal of Medicine, warned that soldiers were reporting “important barriers to receiving mental health services.”

Everyone from the press to a presidential commission found that when soldiers came back to America, the military’s medical centers were overwhelmed. There was a huge shortage of mental health specialists. Soldiers couldn’t get the treatment they needed, even when their lives were falling apart. So Myers wants senators to ask Peake at his confirmation hearings “why there wasn’t an urgent effort to increase the number of mental health care providers in anticipation of the arrival of these young men and women,” Myers said.

And of course, mental health wasn’t the only problem. Some journalists were reporting back in 2003 that soldiers who came home with physical injuries were having a terrible time getting treatment, and were languishing in squalid barracks. Peake was in charge then, too.

NPR asked Peake for an interview, but a spokesman at the White House press office said he won’t talk publicly until he testifies at his confirmation hearings.

November 12, 2007 – A soldier with the Army National Guard says his convoy was hit by a bomb in Iraq. He says he is now battling the VA for help with medical care.

Specialist John Colley says shrapnel from the explosion left him with a traumatic brain injury.

“I knew I was very lucky, especially after I saw the vehicle,” said Colley. “There was a very large piece of shrapnel that ripped right underneath my seat and was stuck in the frame of the vehicle.”

Colley says he luck ran out when he returned home. He says the U.S. Department of Veterans Affairs has yet to perform several standard evaluations to determine the treatment he needs. Colley says he constantly fills out forms and makes calls to figure out what to do to get help, but no one will tell him anything.

“There’s really nobody that I have found yet that has all of the answers,” Colley said. “There’s no one place you can go to that says ‘look, I need to evaluate your situation.”

Eyewitness News Everywhere tried to contact the U.S. Department of Veterans Affairs several times Monday. No one at the Washington, D.C. Public Affairs office returned our calls.

Colley says dealing with his injury and government bureaucracy has put a strain on John’s marriage and his daughters. He says wanting to get better for them keeps him fighting for the benefits he is supposed to receive.

November 10, 2007 – Daniel Bozorgnia was honorably discharged from the Army in 2006 after his convoy blew up in Iraq. The blast slammed him to the ground, but adrenaline kept him going until days later, when the back pain became unbearable. Though offered a desk job, he wanted out if he couldn’t be on the front lines.

A flag signed by soldiers who served in Iraq with Daniel Bozorgnia hangs in Mr. Bozorgnia’s Grand Prairie home. He was happy to be home in Grand Prairie with his wife and two daughters, but that’s when the nightmares began. The former squad leader would fall asleep and find himself back in Iraq – wounded, stranded and dying.

The tension spilled into his daytime routine. “When you go into crowded areas, people come up to you. You push ’em back,” he said. “People back here don’t respect your bubble. You can hear them breathing.”

With his frustration boiling into rage and his marriage at risk, he went to the Dallas Veterans Affairs hospital and was diagnosed with post-traumatic stress disorder. Now he’s getting help.

Mr. Bozorgnia, 29, blends into North Texas suburbia on one level: He’s a family man you might see at the grocery store or run into at a school event. He’s also part of a growing population of war veterans who have returned to find that adjusting to civilian life is a battle in itself.

It’s not just about recovering from their injuries, but adjusting to regular life after the stress of war. They struggle to keep their families together, find work, pay mortgages, secure disability pay, recover from war wounds and relieve post-combat stress. Yet services for them are largely uncoordinated, sluggish and confusing. And many are in poor shape to slog through the system.

“You see us and we’re not full people when we come back,” said Orlando Castaneda, an Army combat veteran from Arlington. “When we come back, we are fragments of human beings, mentally and physically. We’ve been in the thick of it.”

The Pentagon and the Department of Veterans Affairs have acknowledged their failure to prepare for the large number of casualties that came with the prolonged insurgency after the U.S. invaded Iraq in 2003.

Now, after a string of damning reports and stinging congressional hearings, there is a rush to help these wounded warriors. A massive mobilization across the Defense and Veterans Affairs departments – with crucial assistance from veteran advocacy groups and nonprofit organization – is under way to help veterans transition from combat to civilian life.

The result is a cornucopia of services that remains extraordinarily difficult to navigate, even with perseverance and the help of others who know how to work the system.

There’s a hesitancy to talk about these personal struggles, especially among former war fighters trained to guard emotions. But those interviewed said they want outsiders to understand the frustrating complexity of returning to civilian life and to encourage fellow veterans to keep pushing.

“A lot of guys, for whatever reason, are just not connected,” said Robert Lee Aiken III, a Marine veteran and Purple Heart winner who has worked his way through the system. “They don’t know. They’re not willing. They’re not able. They don’t have support.”

‘Every case is different’

Tamara Uhrich is a caseworker for the Army’s Wounded Warrior Program. Most of the clients who come into her Dallas office are men younger than 30 without a lot of education and no easily transferable skills. They enlisted for education and other opportunities, some hoping to make the Army a career. They typically were deployed two or three times before getting wounded.

“Every case is different,” she said. “I have yet to meet anyone with the same circumstances.”

An office wall map displays a thumb tack in each place she has a client. In a cabinet, she has color-coded files for each one. The green folders mean traumatic brain injury. The reds are for post-traumatic stress disorder (PTSD). The blue means an amputee. The manila files indicate disfigurements.

Better medical technology, improved treatment techniques and beefed-up armament means soldiers survive wounds that would have killed them in past wars. Using a narrow definition, the Defense Department reports that more than 28,000 troops have been wounded in Iraq, while just over 3,100 died from combat wounds.

Those numbers mean the wounded-to-killed ratio is around 9 to 1. As a point of comparison, 3.2 service members were wounded for every fatality in Vietnam; 2.3 were wounded for every one killed in World War II, according to a VA figures.

Caring for the nation’s wounded warriors will have a lasting effect on the economy, both in direct outlays for disability entitlements and in lost productivity from disabled young people.

Harvard researcher Linda Bilmes estimated in a January report that disability compensation benefits and medical care for Iraq and Afghanistan veterans will probably cost the federal government $350 billion to $700 billion over the next 40 years.

Yet many Americans feel somewhat removed from the war.

“The war is so separated from everybody,” said Mrs. Uhrich, herself an Army veteran. “Unless you know somebody in the war or work for a veteran agency, you’re so detached. You don’t really experience it.”

Others can’t turn off the experience. Among her client, the red files – for those with PTSD – are the most challenging cases to manage.

Mental challenges

Deeply rooted survival instincts kick in when fighters enter a combat zone. But it’s not so easy to turn off that hyper-vigilance. After a while, the euphoria of coming back can give way to depression and feelings of inadequacy.

The most common ailments afflicting returning service members are brain-related – either physical damage (traumatic brain injury) or lingering mental trauma (post-traumatic stress disorder).

“Being over there, I got this heightened sense of security,” Mr. Bozorgnia said. “I had a couple really close calls, but I didn’t realize how close they were until I got back because the adrenaline is running.”

Memories of dying friends torment him. He’s haunted by an 8-year-old boy who threw a grenade at his convoy. Almost anything can trigger flashbacks, he said, from honking horns on the road to crowds in the bookstore.

“I feel like I didn’t give the ultimate sacrifice, and that bothers me,” he said. “It just really eats at you. I try not to think of that stuff. I try to think of the good times, but it’s hard.”

More than 48,000 veterans from Iraq and Afghanistan have been diagnosed with PTSD, according to a Veterans Affairs spokeswoman. VA psychologist Patricia Jackley said her Dallas-based unit has enrolled more than 300 patients from the wars in Iraq and Afghanistan.

“War affects people. It [the problem] may not present in the first month. It may be a year or five years down the road,” Dr. Jackley said. “We like to say we’re the Motel 6 of mental health. We’ll leave the light on for them.”

The Army has started post-deployment check-ins to try to reduce the stigma of asking for help for mental problems. As of October, every soldier in the Army should have received some training about identifying and treating PTSD, said Lt. Gen. James Campbell, who pushed the effort at the Pentagon as director of staff for the Army.

“In conflicts past, we’ve given less attention to the wounds that are not so visible,” Gen. Campbell said.

He warned that the emphasis will result in higher numbers of veterans diagnosed for mental problems. “The normal response would be that’s bad news because the numbers are going up,” he said. “But it means now we can address it.”

Mr. Bozorgnia said his weekly VA sessions are invaluable. Doctors increased his PTSD meds, which gave him the stability needed to start classes at Tarrant County College. But complications from back surgery in October forced him to drop out for this semester. His goal is to get a degree in business and architecture and start his own business.

He has an American flag on the wall in his living room with the names of men he served with. He wears a silver bracelet with the names of three fallen friends. A tattoo on his left arm says “Psalm 91:11-13,” the soldier’s prayer: For he will command his angels concerning you to guard you in all your ways …

Employment is another huge challenge for this new crop of war veterans. Many return home to face what should be their most productive work years, yet some lack the skills or stability to move into new lines of work.

A helpless feeling

Yolanda Jones, a supply sergeant who was stationed in Iraq, has had trouble holding a job since returning to Texas in March 2005. She came back with hand, hip and ankle injuries and with a broken spirit. “Every person has a breaking point,” she said, “and I never knew mine until I got there.”

On her first Thanksgiving back, still waiting for disability benefits and feeling hopeless, she tried to kill herself by swallowing a half-dozen sleeping pills. It didn’t work, but it helped her realize that life was worth living.

Still, she struggles daily to deal with her PTSD.

A former paraprofessional who worked in a clinic before she was deployed after 11 years in the Army Reserves, she hopes to become a mental health counselor specializing in treating combat veterans.

She completed nine credit hours at Dallas Baptist University but decided the school wasn’t right for her and dropped out. After stints in a probation department, at a women’s shelter and at an answering service, she enrolled at Texas Woman’s University. She singles out four professors for being helpful and flexible about her VA appointments – keeping her on track to graduate next December.

“I’m staying above water,” she said. “All this is temporary. I have good days and bad days. I take it one day at a time.”

She lives in Grand Prairie with her 18-year-old daughter, Synthia, a college student. She also has a son in college.

Money is tight, she said, and there have been a few times she couldn’t pay all her bills. Faced with losing her car, she got help from the Veterans of Foreign Wars military assistance program.

The Texas VFW’s assistance program provides one-time financial help in emergency situations to buy groceries, pay utility bills, pay the rent or otherwise help make ends meet. In the last three months, it helped 127 families statewide; it receives about 10 applications a day.

“Who better to take care of the war vets today than the war vets from yesterday,” said Dan West, who directs the Texas program.

A grueling ordeal

Mr. Castaneda, the Arlington veteran, earned $7.50 an hour working 11- and 12-hour days at the State Fair of Texas. On weekends, he works at the Traders Village flea market in Grand Prairie. He can’t drive because of his medication, so his wife, Annette, takes him to work and VA appointments.

A corporal in the Army, he came back from Iraq to face the same financial, physical and emotional stresses that many returning warriors confront – and then, a month after leaving the Army in August 2006, he received a deportation notice.

He said his father brought him to South Texas from San Luis Potosi, Mexico, when he was 3. As a child, he played with GI Joes and dreamed of enlisting.

He said his work permit lapsed when he was in Iraq and he didn’t apply for citizenship until after he was discharged.

With three kids and a wife, the 26-year-old lived for almost a year under the specter of moving to a country where he knows no one. “My hands were tied with a piece of paper,” he said.

He tried to work directly with immigration officials and sought help from the Army, but he said he was told he should have dealt with it before he got out. In August, after someone alerted the Spanish-language media, immigration officials issued a work permit. He’s trying to become a U.S. citizen.

The ordeal left a bitter taste in his mouth, especially because he fought for his adopted country. “I was so close to giving up,” he said.

Mr. Castaneda’s situation stabilized some when Ricky Cadenhead, a patient advocate at the VA hospital, took on his case. He helped Mr. Castaneda find the right doctors, made sure the family had food when money was tight and worked through contacts to keep the family’s water and electricity from being turned off. Another VA caseworker helped arrange for the job at Fair Park.

“This is a team effort, and there’s no way to win without the team,” said Mr. Cadenhead, himself a veteran.

Mr. Castaneda said he wants to enroll at the Dallas Art Institute or open his own studio someday. But he is generally discouraged.

“There are so few people who really do care,” he said. “The little bit of people who show real concern is really what makes it work.”

PROVIDING LOCAL ASSISTANCE

While the federal government has mobilized to fix myriad problems with veterans services, nonprofit and volunteer groups in North Texas are working to fill in the gaps. Among those efforts:

Veteran advocates: Groups like AMVETS, Paralyzed Veterans of America, the American Legion and the Veterans of Foreign Wars have advocates who help veterans navigate bureaucracy. “The VA is like going into a huge city without a road map,” said Joe Chenelly of AMVETS. “We are the road map for them.”

Support grants: The Dallas Foundation has awarded $1.6 million in grants so far this year to 11 programs that serve veterans of the wars in Iraq and Afghanistan. The aim is to help provide services such as mental health care, child care and emergency assistance. To see what the money is supporting, go to triadfund.org and click on the map.

Transportation: The Metroplex Military Charitable Trust used grant money to buy three vans so volunteers can take injured veterans to appointments at the Dallas VA’s poly-trauma unit. The volunteers, a group of Marines who served in Vietnam, trained with VA doctors and learned to use global positioning devices and Blackberries to pick up patients who use wheelchairs.

Mental health: Mental Health America and the Dallas chapter of the American Red Cross are using grant money to offer free mental health care to at least 700 veterans and their families in a 12-county area over the next two years.

Family support: United We Serve, based in Plano, is hosting retreats for military families who need encouragement during and after deployments.