The War Within: Experts Say Millions Could Seek Treatment For Post-Traumatic Stress Disorder
Forget what they say about time healing all wounds.
More than 57 years have passed since Phil Heath, 76, of Granite City, served with the Marine Corps in Korea. But he can't shake the image of the first Marine he saw die in combat.
It was April 24, 1951. Heath's company was trapped on a hill, defending it from communist attackers.
Fallen Marines covered the hillside, and stretchers were scarce. So Heath and his comrades used an old tarp to carry away the soldier's body, he said.
"But in order to put him in there, I had to pick his intestines up off the ground and put them on him," said Heath, a retired steel mill supervisor. "So his intestines were just laying open."
Neither can Heath forget the last Marine he saw die five months later.
That was Sept. 15, 1951. Promoted by then to platoon leader, Heath was fighting to survive on an outpost nicknamed "Starvation Hill." He had taken cover in a foxhole when Chinese mortar shells began raining down on his unit."And a young 18-year-old boy in my platoon had the left side of his head blown off," Heath said, his voice quavering. "I'll never get over it, you know."
'People who deserve help'
Heath is one of hundreds of thousands of aged veterans seeking help for the nightmares, flashbacks and anxiety they have battled for decades. They are spurred by a growing public awareness of post-traumatic stress disorder (PTSD) wrought by tens of thousands of Iraq and Afghanistan veterans seeking help.
And experts predict millions more World War II, Korea and Vietnam veterans will join them.
The implications for the Department of Veterans Affairs are staggering: There are 6 million World War II veterans, 4.1 million Korean War veterans and 8.1 million Vietnam-era veterans.
Vietnam veterans already receive 92 percent of the agency's PTSD care, VA figures show. The percentage of male Vietnam veterans age 65 and older is projected to increase from 26 percent of the male veteran population in 1990 to more than 40 percent by 2017, the VA estimates.
In addition to seeking VA help, these aging veterans are filing claims for disability payments for their PTSD and other injuries suffered in war.
World War II veteran Stanley Gibson, 84, of St. Louis, served in the Army's 99th Infantry Division during the Battle of the Bulge during WWII.
A light machine-gunner, Gibson spent two weeks -- from Dec. 16, 1944, to Jan. 4, 1945 -- eluding capture behind enemy lines after German tanks overwhelmed his unit.
Three years ago, Gibson, who grew up on a Southern Illinois farm, received a 100 percent disability rating from the VA -- 60 percent for frostbite on his feet, 30 percent for PTSD and 10 percent for his age.
But the $2,500 VA check he gets each month doesn't erase Gibson's troubling memories of the two German soldiers he shot dead at close range with a .45-caliber pistol when they discovered him hiding in a Belgian farm shed.
Nor does it erase memories of another German soldier Gibson shot and killed as the soldier ran away.
"I think about it quite a bit. You don't shoot a guy in the back," Gibson said. "But when you get in combat, you throw the book away."
Until a few years ago, when he began receiving treatment for PTSD, Gibson dreaded going to bed.
"I didn't like to sleep because sleep would be dreams," Gibson said. "And it's a wonder Vyrlene (his wife) would still be alive because I would have these nightmares. I mean real bad dreams about the war."
Overall, the influx of so many older veterans into the VA system is a positive trend for society, said Paula Schnurr, a psychologist and deputy executive director of the VA's National Center for PTSD in White River Junction, Vt.
"What it means is that people who deserve our help, at least some of them, are finally getting it," she said.
Schnurr began studying PTSD among World War II and Korean War veterans nearly two decades ago.
"Time heals most wounds if you look at the data, meaning that most people who get traumatized won't develop PTSD," she said. "However, all kinds of time are not equivalent."
That is especially true for the veterans who adopted a workaholic lifestyle and decided to get on with their lives once they came home, Schnurr said.
"It helped them cope," she said.
For older combat veterans, PTSD becomes a problem when one or a combination of "stressors" occur: retirement, the death of a spouse, serious illness, even attendance at a military reunion, Schnurr said.
"It's the right combination of elements lining up together," she said.
'I'm not alone'
Heath spent more than 50 years trying to forget.
Burying himself in his work at the steel mill. Earning a business management degree at Washington University. Raising four kids. Building houses as a side business.
Always keeping busy.
"They say when you come back from war, you either become an alcoholic or workaholic," Heath said. "I was a workaholic."
Then seven years ago, everything fell apart.
Heath had retired from the steel mill after a corporate buyout and found himself with a lot of time on his hands.
In July 2001, a good friend and neighbor passed away. Over the next few months, Heath lost his brother, then another good friend, then other friends and relatives.
Then his daughter, Deborah, died at age 46 after suffering a brain aneurysm.
"I lost about 10 people, and it just closed in," Heath said. "And I went to pieces."
Heath grew depressed. He stopped eating, shedding 25 pounds from his already spare frame.
"I lost interest in almost everything," he said.
With little to occupy his time, memories of Korea besieged him.
"My wife would sometimes say, 'Why do you get so angry about things?'" Heath said. "I said, 'I don't know. I guess I just have a temper.'"
Then four years ago, Heath joined a weekly support group for Korean War veterans at Jefferson Barracks VA Hospital in St. Louis County. There, he has found comfort in the group counseling and camaraderie.
"I know I'm not alone in this business," he said.
Sam Brown, 70, depends on the support group to make it from one week to the next.
Brown, a St. Louis native, lied about his age and joined the Marines at age 14 to fight communists in Korea. Boot camp was in San Diego. Brown remembers showing up in Korea ready to prove himself in battle.
"I thought I was a bad ass," Brown said. "I really did. I thought nothing was going to happen to me."
Brown nearly died on Easter Sunday 1953, after 11 months and 23 days in Korea. His platoon attacked a hill held by the Chinese. A grenade blast shredded Brown's chest, winning him a Purple Heart and sending him home.
Brown still broods about the death of his best friend, a Japanese-American named "Musaki" -- Brown never learned his first name, something he regrets -- who was killed a few months earlier while they attacked a Chinese-held hill.
"We were together nine months when he got hit," he said. "He just got too far ahead of me. I kept calling to him, 'Slow down, slow down.'"
A pair of Chinese soldiers rushed at Musaki, killing him with their bayonets, Brown said.
Brown paused for a few moments to think about his long-dead friend.
"He made me brave," he said.
Brown took immediate vengeance on the soldiers with his M1 rifle.
"And I didn't have no regret," he said. "None whatsoever. ... But they were fighting for what they believed in. They had families just like we had families. Now I care. And that's part of healing."
Back home in St. Louis, Brown finished high school, then found work as a welder and as a railroad engineer.
He blamed the break-up of his two marriages on his PTSD. Undiagnosed for years, his illness made him hard to live with, and given to rages, he said.
"And I always say I need somebody to stop this thing that's going on in my head," he said. "I just wish somebody could stop what's going on in my head. It's like my head is talking to me."
Brown could never convince his second wife his problems weren't his imagination. His two daughters are split regarding whether he suffers from PTSD, he said.
"My oldest daughter, she's like her mom. ... 'It's all in the imagination,'" Brown said.
His other daughter, 13, takes his symptoms seriously, he said.
"And sometimes I have flashbacks, and I come out of that bedroom and I've hit the floor," Brown said. "And the first thing she does is grab me. She tells me 'Everything's going to be OK, Daddy.' That's what she does."
No quick fix
Dr. Robert Anderson, director of the PTSD clinic for older veterans at Jefferson Barracks, cautioned against anyone expecting a quick or permanent fix.
"These are the things that we deal with in life, and there are limits to what we can do," said Anderson, a psychiatrist who has worked with Vietnam veterans since 1972.
The problem for many older veterans is their realization of all they lost to war. "You lost buddies. You lost your youth," Anderson said. "You lost the perspective you had before."
Today, many Vietnam veterans are coming forward for the first time to seek treatment because they realized their lives aren't working, Anderson said.
"If you're 30 you think, 'OK, I still have a lot of time and I can fix this,'" Anderson said. "If you're 45, you start to look back and say, 'It isn't getting fixed.'"
Nothing seemed to be working for Robert Hawkins, of St. Louis, until he showed up at the Jefferson Barracks clinic several years ago.
Hawkins, 64, served in a U.S. Navy Riverine squadron in 1970. Stationed aboard a heavily armed gunboat, Hawkins took part in combat patrols up and down Vietnam's treacherous waterways.
His memories of combat and the deaths of his friends haunted him ever since he returned home, stoking an explosive rage.
"I didn't understand it because I thought, 'There's nothing wrong with me. I have a good job. I have a family. There are guys much worse off than me,'" he said.
It came to a head one morning at the mortgage company he once operated in St. Louis when he tried to make some phone calls but couldn't. He has since closed the mortgage company and is on disability.
"Because I had intrusive thoughts and flashbacks all day, I couldn't pick up the hand holding a phone to make a call," he said.
After several years in the therapy group Anderson runs, Hawkins said he now understands his rage "comes from pain and unresolved anger at the pain and the loss."
"So by addressing those issues and grieving those issues, a funny thing happens: That anger goes away," he said.
Many older veterans with PTSD forge strong bonds at their VA-sponsored group sessions.
Heath and Brown first met in 2004 at the support group. Brown had already been showing up for several months when Heath dropped in.
"And there was an empty chair, so I sat by the Marine Corps flag," Heath said.
Brown grabbed the chair next to him.
"And that was it," Heath said. "We got to talking, and we found out we were former Marines. And we just took it from there."
Sometimes at group meetings, Brown said, when he's feeling low, "Phil will tell me, 'I don't want you looking down,'" Brown said. "'I want you to sit up straight.'"
Heath and Brown talk often on the phone. Their friendship helps each manage the thoughts and memories that weigh on them.
For Heath, it's the guilt he feels for coming home alive.
"When you get over there, all you want to do is survive," Heath said. "And you want your friends to survive. And you get a guilt complex when you come back. Because you had friends who were 18, 19, 20 years old, who were killed."
When night falls, Brown feels anxious -- a legacy of the night attacks he survived as an infantryman.
"So I leave the lights on every night," he said.
But light can't block the memories. One stands out.
It was 1952. Brown and his platoon were crammed in the back of a truck, part of a convoy speeding to the battle front.
Their truck passed a tiny Korean boy sitting near the road.
"Yeah, he couldn't be no more than 2 or 3 years old," Brown said, his voice catching, his face a mask of regret.
Next to the boy lay the bloated body of his mother.
"And he was just sitting there with his hands on her. And there was nothing we could do. Nothing," Brown said. "That's why wars are so horrible."
Contact reporter Mike Fitzgerald at email@example.com or 239-2533.
© 2007 Belleville News-Democrat