This is Chapter Two from Overcoming Post-Deployment Syndrome: A six step mission to health.

Setting the Stage

Military researchers have reported that nearly one in five of the more than two million U.S. service members who have been deployed to either Iraq or Afghanistan have returned with an array of signs and symptoms that we are now calling post-deployment syndrome (or PDS). These official, conservative estimates confirm that at least 400,000 U.S. troops have been impacted with PDS. You may have seen terms like traumatic brain injury, polytrauma, combat stress, blast injury, post-traumatic stress disorder (PTSD), post-concussive syndrome, or other names, but each of these fi ts into the spectrum of symptoms called PDS. Four hundred thousand previously healthy young men and women now live with a range of signs and symptoms that, at times, causes them to be completely disabled or to suffer so much that they even may take their own lives.

Although this number may seem staggering, as we’ll see, it’s actually just the tip of the iceberg. PDS affects not just these service members, reservists, National Guardsmen, and Veterans, but also their friends, family members, employers, communities, and even the very health care workers who are desperately trying to help them. Amazingly, despite how common this syndrome is, it still remains challenging to fully defi ne and understand. Here’s how one Iraq War Veteran who is trying to get help for his PDS describes his feelings:

I wish I was back in Iraq. People don’t understand, but it’s just what we do. I’m a marine, not a patient. I remember when I fi rst got there. I was so strong. It was intense. In Faluja we were kickin’ ass. We were total warriors. I had no idea it would be this hard when I got back. As hard as the 15 months in Iraq were they don’t compare with how hard it is to be back here. I spent eight months at Walter Reed. That was a couple of years ago now. The way I feel now . . . everything’s a pain. My back is killing me. I wonder if I’m ever gonna really walk right again. These headaches won’t let up. Everywhere I go the lights are way too bright; and I can’t stand being around people, they’re constantly staring at me. These meds just wipe me out. I don’t feel right. I just feel like sleeping, but with the meds I can’t wake up and without them I can’t get to sleep, and when I can my dreams are horrible, mostly about that kid. I can’t concentrate, and I can’t remember anything. I can barely play video games. And trying to play bass just bums me out, my hearing’s all messed up. My parents, and Jill, and those doctors: they don’t have clue. I feel better when I’m hanging with Jason and Sean. They were there. But my body feels like shit, my mind feels like shit, and my heart feels like shit. I even look like shit. How can that really be my eye? When will it all go away? I can’t get Will’s getting blown up out of my head. And now they are telling me that along with this brain injury, I’ve got PTSD, too. I wish I was back in Iraq. I gotta buck up. Fuck it.

How could such a level of suffering and angst have come out of the very mission that this Marine had exquisitely trained to be in? Where has PDS come from? The two wars that have ensued from the September 11, 2001 attacks on New York’s Twin Towers have had a whole range of unplanned effects. Some of these effects were so important as to have changed the world we once knew, some of them so utterly meaningless that it makes us question war’s sensibilities, some of them so positive that it reminds us what it means to be an American, and some of them so negative that we fear for the future. PDS is one of the unplanned, negative effects.

These two wars, designated Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF), have been the longest wars in America’s more than 240-year history. They have also been the driving force behind tremendous advances in weaponry, innovations in military tactics, an enhanced appreciation of the cultures of Iraq and Afghanistan, the development of a worldwide system of combat health care delivery, and incredible breakthroughs in medical techniques and technology. As with every major American war, OEF/OIF has helped to generate major health care initiatives in this country, including the ramping up of trauma services in the Department of Defense (DoD), the establishment of a comprehensive Polytrauma System of Care (PSC) in the Veterans Administration (VA), and an unprecedented level of cooperation between the DoD and VA, as well as the private and academic health care providers. It has aided in the development of integrated systems of trauma and rehabilitation care and an ever expanding field of research into blast injury to combat the relatively new use of improvised explosive devises (IEDs) by Iraqi and Afghani combatants. The American and worldwide public have also demonstrated a startling outpouring of community and corporate support directed toward helping America’s newest heroes. All of these activities have been the direct or indirect result of two commercial airplanes being deliberated crashed into a symbol of wealth and power in New York City, as well as the two other planes destined for the Washington, DC centers of power. These are the obvious impacts of the 9-11 terrorist attacks on America. These are the stories we all have read in newspapers and magazines, seen on television and in the movies, listened to on the radio, and perhaps heard through the grapevine. But what is the untold story of OEF/OIF? What has happened to more than 400,000 of America’s heroes who have fought our Global War on Terror? What is PDS?

The wife of our devastated Marine whose feelings were expressed previously provides some additional insights into PDS, the so-called signature injury of the OEF/OIF conflicts: