Traumatized war veterans are a public health issue.
That’s one conclusion to draw from the story of former corpsman Rocky Allen.
I first saw Allen in a federal court room shackled and looking too scrawny for his jail-issue brown T-shirt. I had heard a lot about him before covering the February 2016 hearing on charges of tampering with a consumer product and obtaining a controlled substance by deceit.
Weeks earlier, authorities had disclosed that someone saw Allen, at the time a surgery technician, take a syringe filled with painkillers from an operating room at Denver’s Swedish Medical Center. The hospital fired him. Given that he had tested positive for the AIDS virus, the hospital also set about notifying thousands of patients who underwent surgery in its main operating room that Allen's employment during the last months of 2015 may have put their health at risk.
There have been no reports so far that any of the patients in the operating rooms where Allen worked have contracted HIV. I can only imagine the fear he spread. I can only imagine the horrors he experienced in Afghanistan and brought home in his mind.
In the years before coming to Colorado, Allen was once found passed out at a Phoenix hospital and then failed a drug test; was discovered hunting for syringes filled with drugs at another Arizona hospital; and took a syringe filled with painkiller from an operating room in California. He managed to get new jobs because the hospitals did not share information about him among one another.
During the court hearing in Denver, Allen’s attorney described his client as a Navy veteran who suffered from post-traumatic stress disorder, or PTSD.
The Denver Post reported that Allen volunteered for deployment to Afghanistan in 2010 and was so eager to serve that he signed up for a second tour before he had even started his first six-month stint at an emergency military hospital in Kandahar. He started using drugs and instead of continuing his service, he ended up facing a court-martial for stealing painkillers.
“What many don’t understand is that we see hundreds of service members come through those (operating room) doors mangled and torn apart,” he testified during his 2011 court-martial, according to transcripts the Post obtained from the military. “I never had a patient die on my operating table until I came here (Afghanistan). Your honor, to have the number go from zero to 14 in less than six months is a numbing experience, and it will forever be imprinted in my mind.”
Under a plea agreement that ended the court-martial, Allen served two months in confinement and received a one-step reduction in rank. About six months later, he received a general discharge.
Allen testified during his court-martial that he was receiving counseling and was optimistic it would help him overcome depression and PTSD. He had little optimism left by the time I saw him as a civilian facing federal charges. As a civilian, he pleaded guilty and was sentenced to 6 ½ years in federal prison. He got another year on a contempt of court charge when he was late reporting to prison. All before he reached 30 years old.
The fall-out from Allen’s war was unusually spectacular and far-reaching. But many relatives and friends of other veterans know PTSD cannot be isolated. PTSD, sometimes called the signature medical issue of the post-9/11 wars, can affect families and communities unpredictably, and brutally.
The federal Department of Health and Human Services Substance Abuse and Mental Health Services Administration, or SAMHSA, estimates that 18.5 percent of fighters returning from Iraq or Afghanistan have PTSD or depression. SAMHSA adds half of those returnees who need mental health treatment seek it and only slightly more than half who receive treatment receive adequate care.
Raising awareness is crucial. I know I began to see the world differently after research for my book on veterans revealed how much I did not know about PTSD and other brain disorders. PTSD, I have learned, doesn’t just affect men and women on battlefields. With the onset of the coronavirus pandemic, how many health care workers will be affected, as Allen was, by seeing deaths in numbers for which their previous experiences did not prepare them? As I cruise through Denver traffic these days, I find myself wondering whether an angry driver was honking because I was slow to turn, or because he was a Vietnam vet who never got treatment for PTSD. When I interviewed inner city teens for an article about gangs, I asked myself how the trauma they were seeing on their neighborhood streets would affect them later in life.
The experts have even more questions, and agonizingly few answers. Try scannng the multiple Web pages listing National Institutes of Health-funded research into PTSD. Among the questions studies seek to answer:
• What drugs work, and why?
• Can yoga help?
• Could a dose of hydrocortisone soon after trauma is experienced help prevent PTSD surfacing later?
• How does psychotherapy physically change the brain, and is it effective when delivered online?
• Can anesthesia drugs be used to control emotional reaction during treatment?
• What are the factors that shield most people from experiencing PTSD after a shock?
• How does experiencing trauma early in life affect an adult’s ability to recover from a shock?
• What are the consequences of repeated trauma?
That last question is particularly significant for veterans of Iraq and Afghanistan like Allen. Researchers already suspect repeated deployments increase the risk of PTSD. In the war on terror, America has turned again and again to the same small pool of volunteers and professional soldiers, more so than in previous wars.
“Many more post-9/11 veterans (44 percent) than pre-9/11 veterans (25 percent) say that their readjustment to civilian life has been difficult,” Pew Research Center interviewers found in 2011 when they surveyed 712 veterans of the war on terror. “Also, a greater share of post-9/11 veterans than pre-9/11 veterans report that they are carrying psychological and emotional scars arising from their time in the military. Some 37 percent of all post-9/11 veterans (and 49 percent of post-9/11 veterans who served in a combat zone) say they have suffered from post-traumatic stress. Among pre-9/11 veterans, the comparable figures are 16 percent for all and 32 percent for those who saw combat.”
Public health issues, as we have seen with the coronavirus pandemic, require all of us to respond. Learning about what veterans face could spur some of us to seek support for our own PTSD, or for loved ones who are suffering, whether the cause is a foreign war or domestic abuse. It might lead others to come up with innovative ways to get help to those in need.
Awareness can lead to what I like to call an empathy dividend that might have changed the postwar trajectory for Allen.