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The other battle: coming home
Cooling off, and soldiering on
Lt. Col. Gary Mauck, an Army chaplain, looks out a window at the moss-draped trees of this Georgia garrison and describes "as if it were yesterday" his March 17, 1969 return from the jungles of Vietnam.
"I got on the jet and in 24 hours I was at Fort Dix, and in another 24 hours I was on the plane home. There was no debriefing and no decompression," he says with a note of bitterness. Once back in rural Danville, Ill., the 25-year-old Mauck was at loose ends. "Home wasn't home anymore, because no one understood."
It wasn't until decades later, during a 1991 parade for Desert Storm veterans, that Mauck discovered what he had missed. "I marched as a National Guardsman, and up front they had a bunch of Vietnam vets. I realized that's what I should have had, a parade. I didn't. Nobody cared."
Vietnam veterans like Colonels Mauck and Campbell are powerful advocates for ensuring a better homecoming for US troops in Iraq. Above all, they want to prevent the sense of isolation and alienation that they believe contributed to the high rate (50 percent) of full or partial PTSD reported by veterans from Vietnam.
"The worst thing that can happen is people come back and feel like the Lone Ranger," says Mauck.
Since the 1970s, the understanding and treatment of postwar trauma have improved dramatically. Meanwhile, the creation in 1973 of an all-volunteer military has led to more professional, better-trained and educated, and cohesive units. All these factors point to "greater resilience, even in the face of grotesque trauma," says Dr. Litz.
After the brief 1991 Gulf War, surveys of veterans showed an increase in trauma, depression, and substance abuse compared with those who did not deploy - but the overall rates were far lower than those among Vietnam veterans. Estimates of PTSD among Gulf War veterans range from 1 to 8 percent.
Today, a new mandatory, Army-wide program aims to identify at-risk soldiers early and intervene quickly to lessen war-zone stress. It involves social workers, mental-health experts, doctors, and chaplains reaching out to troops and their families at each stage of deployment. The policy is driven by a stark reality: With today's rapid-fire deployments, easing stress on soldiers and families is crucial to retention.
While still in the theater, commanders use a new "Tip Card" to identify soldiers at risk. The card poses 14 wide-ranging questions on soldiers' alcohol use, unruly behavior, or conflicts with the chain of command during deployment, suicidal thoughts, anger, domestic violence or troubled relationships, financial difficulties, and combat experiences. Any checked item requires counseling by leaders, the chaplain, or health professionals.
During a "cooling off" period overseas, soldiers turn in equipment and may enjoy some R and R. In Kuwait, for example, troops from 1-39 Field Artillery rotated through a morale, welfare and recreation center known as the "marble palace" - complete with a pool, tennis courts, and miniature golf.
Once back home, soldiers remain on duty at the base for two to three weeks - partly as a "safety mechanism" as they adjust to a less regimented environment. During this time, they undergo physical and mental-health checks and attend "couples reintegration classes." Then, after two weeks of block leave, they return to work for more mental-health evaluations and stress-management classes.
Staff Sgt. John Dragoo is mostly mum about his wartime experiences as he files through a clinic signing papers and seeing health workers. A doctor asks him about his work clearing charred Iraqi vehicles, and explains possible exposure to depleted uranium. Sergeant Dragoo appears morose for a reason increasingly common to deployed soldiers: His wife, Sgt. 1st Class Andrea Dragoo, is still in the war zone.
"I won't really be able to enjoy things until she's home," he says, sunburned from a weekend building a deck to "keep busy."
Like the Dragoos, the growing number of dual-military couples - now more than 5 percent of the armed services - face distinct problems and advantages in deployments. Separations can be even longer, and providing for children, such as the Dragoos' 7-year-old daughter, Amanda, is challenging with both parents overseas. Still, shared experiences help the couples relate to one another. "It's always easier being married to a military spouse, because they understand what you have to do," Dragoo says.
Teams of social workers will revisit Dragoo and other returning soldiers after six weeks, 10 weeks, and four months. "We ask soldiers to go to war. Then we ask them to come back and push a button and be loving husbands and fathers again. It doesn't work that way," says Ms. Wilder. One reason for the aggressive counseling is concern that soldiers will avoid bringing up problems for fear of jeopardizing their careers in today's more professional and competitive Army.
"All of these [problems] have enormous stigma associated with them," says Dr. Engel of the deployment health center. "Some folks feel terribly threatened by going through these evaluations. They feel it's a tremendous invasion of their privacy, with implications for their future in the military."
At Fort Stewart, some soldiers decline counseling, while others, such as Sergeant Gilmartin, welcome it. "It's all right to feel depressed or anxious or unable to sleep," he says. Gilmartin has already sought help from an Army chaplain, and encourages his soldiers to do the same.
Many are. Chaplain Mauck says that often the soldiers who come to him have undergone a spiritual awakening in the war zone, strengthening their inner resources for dealing with problems.
"They've asked the tough questions," he says. "And not surprisingly, they have the answers."
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