Any reporters researching the increasingly critical story of suicides among American troops who have served in Iraq are likely to suffer from a near-crippling bout of cognitive dissonance, a kind of temporal disconnect between the tragedy unfolding for some of our soldiers and the business-as-usual tempo of a nation largely unaware.

You may also find yourself inhabiting a very sad place where a young soldier strolls away from a telephone booth in Baghdad, pulls out a gun and fires a bullet into his own head; a world where, for one Iraq vet, a motel room in Tennessee becomes a place not for celebrating his safe homecoming but the perfect secret venue for swallowing drain-clearing chemicals.

For me, a Vietnam veteran and former post traumatic stress disorder counselor, research at the Vietnam Veterans of American Foundation on soldier suicides is triggering something akin to déjà vu. We see tip-of-the-iceberg indicators that portend a post-Iraq psychiatric disaster for some returning soldiers, one that the country is ill-prepared to deal with and one that the Pentagon appears to be spinning like a top.

The army reports that 21 soldiers in Iraq and Kuwait have killed themselves since the beginning of Operation Iraqi Freedom but this number will increase as suspicious non-combat deaths that have already occurred and might be suicides await classification by the army's Criminal Investigation Division (CID). We have learned from a Pentagon source that the CID may not rule on these deaths until after the operation is over. Even the number of 21 is well above the average Army rate.

The army's peculiar calculus also excludes suicides that occur outside the "theater," that is, soldiers who served in Iraq or Kuwait but kill themselves once they get home. The media is toting these up ad hoc. United Press International discovered two at Walter Reed Army Medical Center and The Sun of Baltimore recently reported on one that occurred in a Shoney's Inn. But most of these tragedies will unfold anonymously since family members are often reluctant to speak publicly about a subject they consider taboo.

Now, over the next few weeks, as more troops rotate home, and the anniversary of the U.S. invasion of Iraq approaches, the Pentagon faces the prospect of a potentially unwieldy public becoming more "casualty sensitive," something war planners have been conscious of since Vietnam brought the human or "blood" cost of conflict into America's living rooms.

This looming milestone may explain a bizarre episode a few weeks ago when various Pentagon spokespeople began driving the suicide number down, to 18 or even 17, only to officially re-affirm a higher number later.

Also hard to know are the reasons that soldiers are killing themselves. There is some evidence that the anti-malarial drug Lariam may be playing a role, but history tells us that the relentless stress and sheer bloodiness of this deployment will also be a factor. Last July, following a "spike" in suicides, Iraq forces commander General Ricardo Sanchez requested help from the Army surgeon general, and a 12-member "mental health advisory team" was quickly dispatched. That team's much-anticipated report was reportedly finished months ago but its release keeps being postponed. The press should investigate why.

Experts both on suicide and epidemiology, including the Centers for Disease Control in Atlanta, tell us that a cluster of suicides in a specific population, in this case the army, represents the thin edge of a numeric wedge. A report by UPI on Feb. 19 from the army's hospital in Landstuhl, Germany, offers a chilling glimpse at the size of the trouble heading for the military's already over-taxed and unprepared medical system. It said that about 1,000 soldiers have already been evacuated to Landstuhl for psychiatric reasons.

The UPI story by award-winner Mark Benjamin also exposed what may be the Pentagon's internal mantra on an issue so explosive it could seriously downgrade the American public's support for this war. When asked how many soldiers the hospital has treated following actual suicide attempts, Col. Rhonda Cornum, commander of the hospital, wouldn't give a number, saying only, "This is a sensitive thing that some people might not want you to know, I guess."

Wayne Smith is special assistant to the president of the Vietnam Veterans of America Foundation in Washington, an organization that, in 1997, shared the Nobel Peace Prize. Smith was a combat medic in Vietnam and longtime therapist in the Veterans Administration's Vietnam Veterans Readjustment Counseling Program.

© 2004 VNU eMedia Inc.

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