topic here

The Reckoning
At the 10-year mark, the wounds and collective
scar tissue of today’s wars amount to a national
pathology. America, and those who volunteered
to defend it, could take a generation to heal.
By James Kitfield
22 sep tem ber 10, 2 011 nationa l jou r na l
 The odyssey begins: Soldiers in Afghanistan
evacuate a comrade who stepped on a land mine.

23
national security
T
he troops come home from
war much the way they left,
largely invisible to a dis-
tracted nation. Returning
units are typically met at an
airfield by buses that shut-
tle them to a gated military
base. On a parade ground, a commander re-
minds the assembled, some of the more than
2.3 million service members deployed during
the past decade of war, of all that they accom-
plished. He recalls the brothers in arms who
didn’t make it back and the memories that
unite those who did. The shared hardships,
the moments of terror and elation, the con-
stant joking that held the awfulness at bay.
The unbearable melancholy that descends at
the playing of “Taps.”
The commander dismisses the forma-
tion, and the troops realize that the ties that
bound their lives together are breaking. The
married service members run into the open
arms of their families, husbands holding ba-
bies they’ve never met, uniformed women
hugging young children they can hardly rec-
ognize. Even before the smiles and tears sub-
side, spouses sense the vast gulf that now lies
between them and wonder how to get across.
Single troopers head for the barracks, crack-
ing wise but often wishing that they, too, had
family to welcome them home. And, inevita-
bly, there are the stragglers—young soldiers
shuffling and chain-smoking, unsure of where
to go or what to do next. Having come of age
on distant battlefields, they are suddenly lost
in America.
Even Col. David Sutherland, a decorated
commander who served in Iraq, was shocked
by the dizzying sense of alienation he felt on
reentry. “Never in the history of our Repub-
lic have so few been asked to do so much for
so long. And yet, when soldiers return home,
they feel acutely this disconnect between the
military and a civilian society that doesn’t
even seem to be at war,” says Sutherland, the
Joint Staff’s special assistant in charge of the
Warrior and Family Support program. “We
fall into the same trap of our fathers from
World War II or Vietnam, which is to keep the
memories of those sacred moments on the
battlefield to ourselves. That’s how they be-
come secrets, and secrets are not healthy.”
Tens of thousands of other troops return
home on the aeromedical-evacuation flights
that land routinely at Andrews Air Force Base
24
in Maryland or Travis Air Force Base in Cali-
fornia, where the buses waiting to meet them
bear large red crosses. The critically wound-
ed emerge from the massive C-17 transports
first, nearly invisible beneath bandages, a
jungle of medical equipment strapped to
their gurneys. Next out are the less-dire cas-
es, carried on stretchers. Finally, the am-
bulatory patients shuffle single file to the
waiting buses. In the past decade, Air Mobil-
ity Command has flown more than 35,600
aeromedical-evacuation sorties, transport-
ing more than 177,000 wounded or ill service
members home.
Staff Sgt. Dan Nevins was one of those pa-
tients who landed on the tarmac at Andrews
in 2005 clinging to life. Having already lost
one leg, he fought through 18 months and 30
surgeries at Walter Reed Army Medical Cen-
ter trying in vain to save the other. “In retro-
spect, finally letting go of my other leg and
getting on with my life was the best decision
I ever made,” says Nevins, who now works for
the nonprofit Wounded Warrior Project help-
ing other injured veterans try to get on with
their lives.
Thousands of other troopers have re-
turned home in flag-draped coffins at Do-
ver Air Force Base in Delaware. Last month,
President Obama and other senior officials
traveled to Dover to honor the 30 American
troops killed in Afghanistan on Aug. 6 after
their helicopter was shot down, the worst
single-day loss of the long Afghan war. Their
Marching Home
Hundreds of thousands of veterans of Afghanistan
and Iraq have or will soon rejoin the civilian world.
Veterans of Iraq and Afghanistan leaving
active duty (estimated)
350,000
300,000
250,000
200,000
150,000
100,000
50,000
0
’02 ’04 ’06 ’08 ’10 ’12 ’14 ’16 ’18 ’20 ’22
Source: Veterans Affairs
names joined the honor roll of more than
6,000 fallen service members from Iraq and
Afghanistan. The deafening silence of the
dead continues to send shock waves through
a landscape of grief inhabited by their fami-
lies and comrades—the collateral wounded of
these wars.
“A death in the military is unlike any oth-
er loss in our society, because there are so
many complicating factors,” says Bonnie Car-
roll, founder and president of the Tragedy
Assistance Program for Survivors, or TAPS,
which reaches out to grieving military fami-
lies with “peer professionals” who have social
work degrees and have also lost loved ones in
the military. Because deaths often happen on
long combat deployments, Carroll says, griev-
ing spouses sometimes trick themselves into
thinking that a missing service member will
still walk through the front door someday.
Other times, the manner of death is so trau-
matic that families receive multiple sets of
remains. “When a death is so horrific in na-
ture, and the spouse hears about it repeatedly
in the media or third-party accounts, they can
create a memory that leads to their own post-
traumatic stress disorder.”
THE PATHOLOGY OF WAR
Every war leaves its imprint on those who
fight it and on the national psyche. At the 10-
year mark, the wounds and mental scar tissue
from Afghanistan and Iraq have amassed into
something like a pathology unique to these
conflicts—one that will afflict this country
for a generation.
Due largely to advances in combat medi-
cine, rapid aeromedical evacuation, and body
armor, the wars have proven to be the least
lethal in modern U.S. history. According to
Dr. Ronald Glasser, a Vietnam-era Army sur-
geon and the author of the recent book, Bro-
ken Bodies, Shattered Minds: A Medical Odyssey
photo: (pre vious page) ap/Rodrigo Abd
from Vietnam to Afghanistan, for every battle-
field death, 16 service members survived their
wounds. The ratio in Vietnam, he said, was
2.4 wounded for every death. In the Civil War,
the ratio was less than 1-to-1, with few soldiers
surviving battlefield wounds.
In his book, Glasser warns that the na-
tion will face a moral and economic reckon-
ing in caring for so many wounded veterans.
“Because of body armor there have been rela-
tively few of the penetrating chest wounds or
abdominal injuries that caused so many battle
sep tem ber 10, 2 011 nationa l jou r na l

deaths in past wars,” he tells National Journal.
“But no one was really prepared for the num-
ber of seriously wounded survivors.” Accord-
ing to the Pentagon, 168,000 service mem-
bers wounded or injured in these wars are
graded “60 percent disabled” or higher, and
the VA faces a 492,000-case backlog of dis-
ability claims. More than 508,000 veterans of
today’s wars have already been treated at VA
hospitals and clinics. The Congressional Bud-
get Office estimates that the medical costs as-
sociated with today’s veterans could come to
$40 billion to $55 billion over the next decade.
Just as the current wars have dragged on,
with tactics and geography shifting over the
years, the pathology of these wounds has also
mutated over time. Early on in Afghanistan,
for instance, small arms caused many inju-
ries. A few years into the fighting in Iraq—as
insurgent bombs got bigger and the armor
on U.S. military vehicles got thicker—troops
absorbed blast waves through their seats,
causing a spike in spinal-cord injuries, con-
cussions, and brain trauma. Over the last
18 months in Afghanistan, the profile has
changed again.
“As Afghanistan has turned primarily into
photo: ap/Eric Gay
a war of dismounted infantry, our polytrauma
wards have seen a huge influx of troopers with
really massive injuries from absorbing blasts
while on foot patrol, including multiple am-
putations, really severe brain injury, and the
emotional wounds that go with all of that,”
nationa l jou r na l sep tem ber 10, 2 011
same risk. “When a lot of us
Vietnam veterans returned
from war, it took us a decade
or even two before we would
even talk about what hap-
pened, and we bottled up a
lot of anger and hurt,” says
Tom Mitchell, a state director
for U.S. Vets, a nonprofit that
works to get homeless veter-
ans off the streets. “A lot of us
are determined not to let that
happen with this new genera-
tion of combat veterans from
Iraq and Afghanistan.”
THE VOLUNTEERS
Today’s wars are the first ex-
tended conflicts to be fought
A deep bench: As a share of soldiers injured, more not by draftees but by a rela-
wounded soldiers survive now than ever before. tively small cohort of volun-
teers. That partly explains
says Dr. Shane McNamee, the chief of physical why the pathologies specific to this war
medicine and rehabilitation at the VA’s Poly- have been so hard to predict. Like previous
trauma Rehabilitation Center in Richmond, generations, however, today’s veterans gen-
Va. “In the past five years, I can’t tell you how erally keep the toxic aftereffects of war to
many times we have regeared to tailor our themselves; they are simply too painful to ad-
care delivery to subsequent waves of service mit or confront.
members with different kinds of wounds.” The small size of the all-volunteer force,
But improvised explosive devices, the en- for instance, has necessitated multiple com-
emy weapon of choice in both conflicts, have bat deployments with inadequate breaks in
caused their signature wounds, creating more between, which mental-health experts be-
than 1,300 amputees, numerous burn victims, lieve greatly increases the propensity for
and unknown numbers who suffer from trau- PTSD and its effects: depression, drug abuse,
matic brain injury. According to the advoca- failed marriages, and emotional distress. The
cy group Veterans for Common Sense, more Defense Department’s Task Force on Mental
than 190,000 troops have suffered a con- Health found in 2007 that 38 percent of all
cussion or brain injury. There is also grow- active-duty service members have reported
ing evidence of links between TBI and post- psychological symptoms after their tours. In
traumatic stress disorder. “They both injure some months this year, the suicide rate for
similar areas of the brain and exhibit simi- active-duty service members has exceeded
lar symptoms,” says McNamee. “The lines combat deaths, and in April, the VA’s suicide-
between them are pretty gray.” According prevention hotline received more than 14,000
to a 2008 Rand survey, one in five veterans calls—the most ever recorded in a single
of these wars—some 300,000 people—are month. Dr. Robert Petzel, the VA undersecre-
suffering either from major depression or tary of health, says that doctors have become
PTSD, while 320,000 have suffered concus- expert at recognizing and treating PTSD. “It’s
sions or TBI. probably true that multiple combat deploy-
Those growing numbers are significant. By ments increase the likelihood of PTSD,” he
allowing the Vietnam War—and the physical warns, “though we don’t have adequate re-
and emotional trauma it caused—to recede search to prove that yet.”
from our national consciousness, America Today’s all-volunteer force is also old-
inherited an epidemic of veterans suffering er than its draft-era counterpart, with more
from the attendant ills of PTSD. Today, the married service members and a larger num-
post-9/11 generation of volunteers faces the ber of uniformed women (14.6 percent of
25
National Security

the active-duty total). More than 220,000

women have served in Iraq and Afghani-
stan, meaning that they’ve borne a higher
share of the burden than in past wars. After
9/11, the military divorce rate climbed from
2.6 percent per year in 2001 to 3.6 percent
in 2010. And 7.8 percent of women in the mili-
tary divorced in 2010. (Because the military
does not track overall divorce rates, count as
divorced those service members who remarry
in a given year, or follow up on the divorce rate
of military personnel a year or two after they
leave service, many experts believe the Penta-
gon underestimates the actual rate of military
divorce.) “Overall divorce rates in the military
could climb to as high as 80 percent for first
marriages, which would mean that service in
the military is becoming a precursor for di- Faster than ever: A medevac team
vorce,” says Leticia Dreiling, a Houston Vets in Kandahar (above); in Marja (below).
Center marriage and family therapist.
According to the VA, about one in five fe-
male veterans, or 20 percent, have also test-
ed positive for posttraumatic stress related to
“military sexual trauma,” a catch-all category
that includes everything from sexual harass-
ment to rape. “I actually think the military
sexual trauma among women is much higher
than the official figures, because we find that
a lot of women service members feel guilty
even talking about it,” says Judith Broder, a
clinical psychologist who started The Soldiers
Project, which offers free mental-health coun-
seling to returning veterans. “Women veter-
ans often feel like it’s a betrayal of their unit
to speak about sexual trauma, so they tend to
carry that wound a long time in silence, which
increases the likelihood that it will develop
into combat-stress disorder.” Women are also
the fastest growing subset of the homeless-
veteran population in America, according
to Broder. Some land on the streets with
their children. and others that are invisible until symptoms logging duty in a faraway and unfamiliar land.

As a percentage of the overall deployed
force, the National Guard and Reserves have
also shouldered more of the burden in Af-
ghanistan and Iraq than in wars past. Yet as
citizen-soldiers, reservists are less prepared
for the stresses of a long combat tour. Indeed,
the Task Force on Mental Health found that
49 percent of National Guardsmen report-
ed experiencing psychological troubles after
their deployments.
With the wars now winding down, the
Pentagon estimates that as many as 1 mil-
lion service members are likely to leave active
duty in the next five years. They will enter a
struggling economy where the jobless rate for
young (ages 18 to 24) male veterans of Iraq
and Afghanistan was 21.9 percent last year,
and where veterans make up an estimated 20
percent of the homeless population. Many ex-
perts believe that the nation is simply unpre-
pared for that approaching army of suffering.
“There are combat wounds you can see,
develop long after service members return
home, and we’re seeing an increase in virtu-
ally all of the metrics that track them,” says
clinical psychologist Barbara Van Dahlen, the
founder and president of the nonprofit Give
an Hour, which connects veterans to a net-
work of 6,000 mental-health professionals for
free treatment.
Despite improvements in the military and
VA health care systems—and the cooperation
of nearly 5,000 nonprofits that serve military
personnel—Van Dahlen sees a population at
severe risk. “We should have learned from
Vietnam, because all you have to do is study
the homeless population today to understand
that an awful lot of those veterans never re-
ally made it all the way home,” she says. “If we
don’t get ahead of the challenge, we will risk
losing this generation of veterans.”
THE ODYSSEY
The odyssey begins on a day like any other,
photos: (top to bot tom) get t y/afp/PETER PARK S; get t y/Scot t Ol son
Dan Nevin’s began in Iraq in a Humvee that
was bouncing down a dusty road outside the
Sunni-insurgent stronghold of Falluja. With-
out warning, his vehicle struck a roadside
bomb. In an instant, Nov. 10, 2004, became
the day that changed his life forever. By the
time Nevin arrived at the U.S. military hos-
pital in Landstuhl, Germany, 12 hours later,
he had already lost one leg. Eventually, he lost
the other to a bone infection.
In 2004 and 2005, the insurgencies that
would eventually drive Iraq to the brink of civ-
il war grew; correspondingly, the number of
critically wounded service members pouring
into the military medical system spiked. Nev-
in had to wait a week to get space on one of the
crowded medical flights from Germany, and
when he arrived at Walter Reed Army Medi-
cal Center, the staff was nearly overwhelmed.
The care “was absolutely world-class,” he
says. But the caregivers “just couldn’t handle
all of the wounded. Those guys worked day

26 sep tem ber 10, 2 011 nationa l jou r na l

 and night, but it was a constant battle to get
appointments if you needed a modification to
your prosthetic leg. And when you did get an
appointment, you could wait hours.”
Leaders of the military health care system
were also beginning to realize the complex-
ity of providing life-saving and rehabilitative
care for so many severely wounded troops.
Nevin’s Reserve activation had forced him to
take a major pay cut from his job selling phar-
maceuticals in California. Because his wife
couldn’t afford to leave her own job, he could
only see her one weekend every six weeks or
so, putting more strain on their marriage. Yet
compared to some of the younger active-duty
patients who were told they were too injured
to continue serving—meaning forced separa-
tion from the only job and culture they had
known as adults—he felt lucky. “As a reserv-
ist, I had a college degree, a good job, and a
supportive family to go home to,” Nevin says.
“Some of those young kids joined the mili-
tary right out of high school, however, and
they didn’t have any of that to fall back on.
So they found every excuse imaginable not to
be released from Walter Reed. I thought they
were crazy at the time, but later I realized that
those young guys barely into their 20s were
paralyzed with fear about what came next.”
By 2007, the problems at Walter Reed ex-
ploded into a full-blown scandal when The
Washington Post published a series of articles
detailing neglect, overworked case managers,
and shoddy infrastructure. The commander
of Walter Reed and the secretary of the Army
resigned. But the scandal helped show the
Pentagon and VA that their understaffed and
stovepiped medical facilities were still unpre-
pared for the wounded and maimed patients
often transitioning back and forth between
their systems. For the Army, the result was the
creation of the Warrior Transition Command.
From the beginning, its mission was to pro-
tect subsequent waves of returning wounded
soldiers from the paralyzing fears that haunt-
ed young troopers at Walter Reed—the no-
tion that the military was abandoning them at
their moment of greatest need.
Lt. Col. Danny Dudek, who now works for
the Warrior Transition Command, realized
how precarious he felt when his own odys-
sey began in 2007. While traveling north of
Baghdad just three months earlier, a penetrat-
ing explosive hit his armored Stryker fight-
ing vehicle. The blast killed the soldier next to
him and caused a spinal-cord injury in Dudek
that left him paralyzed below the knee. With-
in days, he had been through surgery at Wal-
ter Reed; within a few months, he was sent
to the VA hospital in Seattle to recover near
his family. The care was excellent, but Dudek
felt bereft of the camaraderie and support
structures that he had come to depend on in
his unit and somewhat lost in the VA bureau-
cracy. “We overlooked all the other stuff that
goes into being a soldier, like being able to rely

The care was excellent, but Dudek felt bereft of the

camaraderie and support structures that he had come to
depend on—and somewhat lost in the VA bureaucracy.
photo: ap/army times /Rick Koz ak

Injurious: Soldiers who survive IED attacks

suffer a particular set of medical problems.
National Security
on strong leadership, showing up for forma-
tion, knowing that our families are taken care
of,” Dudek says. “I think the Army realized
that we can’t just treat wounded soldiers like
patients. We need to continue to treat them
like soldiers, too.”
That epiphany led to the establishment in
2007 of 29 community-based Warrior Tran-
sition Units for all soldiers whose care re-
quires at least six months of complex medi-
cal treatment. The units blend the efforts of
a primary-care doctor, a nurse case manager,
and a squad leader. Soldiers help shape their
own comprehensive transition plans, which
include career and employment goals; Soldier
and Family Assistance Centers aid their fam-
ily members.
Still, the challenges are so complex that
even this well-intentioned program initially
went awry in some places. Media investiga-
tions of various units showed conflicts be-
tween the medical and military staff, over-
crowding, and an overreliance on medication.
An Army Inspector General’s report issued
in January estimated that up to a third of all
soldiers in Warrior Transition Units last year
were overmedicated, hooked on drugs, or
abusing illegal substances.
The Army has investigated the charges but
hasn’t backed away from the concept. “We
did have some inexperienced leaders in War-
rior Transition Units who didn’t fully under-
stand the complexity of tailoring a treatment
regime to each soldier, and some soldiers do
feel that military drills get in the way of their
recovery,” says Dudek, who commanded a
transition unit in Seattle. “There were also
some conflicts between nurse case manag-
ers and squad leaders. But with good leader-
ship, that organizational friction usually gets
quickly resolved.” He adds that “the last thing
we need to do is come back wounded and just
‘take a knee.’ What I told my soldiers is that
you have to fight to overcome the pain, the ap-
athy, and the fear of an uncertain future. And
for me and a lot of them, it is the hardest fight
of our lives.”
FALLING THROUGH THE CRACKS
When Lance Cpl. Nancy Schiliro was medi-
cally discharged from the Marine Corps in
2005 after losing an eye in a mortar attack in
Iraq, there was no long counseling session or
transition unit. They hadn’t been created yet.
One day she was living in the 24/7 bubble of
life as a Marine—being told what to do, where
to go, when to eat, and who to hang out with—
and the next day she was home and that bub-
ble had burst. The whole experience was
so disorienting that, for six months, Schil-
iro didn’t even realize that she was suffering
from PTSD. “I wasn’t sleeping. I jumped at
loud noises. I basically stayed to myself and
stopped interacting with people. I just wasn’t
28
me,” she says. Finally, her brother’s father-in-
law, himself a former Marine, called a friend at
a local veterans’ center, who reached out. “It’s
taken me awhile to learn how to manage my
disease, and it’s gotten better,” she says. “But
I don’t think I’ll ever be totally cured.”
Cases like Schiliro—veterans who need
care but fall into the gap between military
medical treatment and VA follow-on care—
have driven reforms designed to make the
transition more seamless. The Pentagon and
the VA established a Joint Executive Council
that issued 26 initiatives to standardize treat-
ment and evaluation systems. For instance,
military treatment facilities today typically
don’t release a wounded service member un-
til he or she has scheduled appointments in
the Veterans Health Administration system.
If requested, one of a hundred VA “transi-
tion patient advocates” will even travel with
service members as they move from ma-
jor military hospitals to VA hospitals closer
to home. Anticipating demand, the VA also
hired 7,000 mental-health officials in re-
cent years, expanded suicide-prevention ho-
tlines, and established caregiver programs
The road back: A Marine
exercises at Walter Reed
Army Medical Center in 2007.
that provide stipends and travel allowances
for family members who care for seriously
wounded veterans. “The departments of De-
fense and Veterans Affairs have gone from a
relatively low-level of interaction in 2001 to
a degree of cooperation that is historically
unprecedented,” says Petzel, the VA health
undersecretary.
For all of those advances, however, ma-
jor problems persist. Despite the move to a
joint disability evaluation process designed to
streamline claims procedures, some veterans
are still waiting up to 400 days for a decision
on whether they will receive payments and at
what levels, and a backlog of nearly 500,000
late claims have gone beyond the 125-day
standard at the VA. Until disability payments
begin, easing some of their financial burdens,
wounded veterans are susceptible to alcohol
or drug abuse—or worse—to alleviate their
suffering. “I know that VA and DOD have big
challenges,” Senate Veterans’ Affairs Com-
mittee Chairwoman Patty Murray, D-Wash.,
said at a hearing earlier this year. “But service
members and veterans continue to take their
own lives at an alarming rate. Wait times for
benefits continue to drag on for an
average of a year or far more.”
Another sign of trouble: Despite
aggressive outreach, only about half
of the Iraq and Afghanistan vets
have even registered with the VA,
meaning there is a vast at-risk pop-
ulation. “A chief lesson of Vietnam
was that we need to get new veter-
ans help as early as possible, before
their lives spiral into crisis,” says
Fern Taylor, supervisor of a clinic
for returning veterans at a VA hos-
pital in Houston. “Too often, our
first contact with a veteran is in the
emergency room, through the crim-
inal-justice system, or on our sui-
cide-prevention hotline.”
Kathy Molitor, the suicide-pre-
vention coordinator at a VA post-
deployment clinic in Houston, has
no doubt that many vets need help.
In 2007, the VA’s suicide hotline re-
ceived 9, 400 calls, she says, and the
next year, it jumped to 67,400. In
2009, it reached 119,000, and last
year it was up to 135,000. Just listen-
ing to the calls for help can induce
photo: get t y images /Ale x Wong
secondary traumatic stress: I feel like
an animal, unfit for civilized society.…
My husband only wants to hang out
and drink and do drugs with his bud-
dies.… I can’t talk to my wife because
she might be infected with my disease.…
My husband barks orders at our chil-
dren like they were soldiers.… After
watching my buddy blown to bits, I’m
angry all the time.… Why does Daddy
sep tem ber 10, 2 011 nationa l jou r na l
 The haunting: A homeless
veteran in Massachusetts.

want to go back to war? … Our son is constantly

cleaning his gun in his room alone, and we can’t
get him to stop.… I’m not/she’s not/he’s not the
same person anymore …
The essential message that Molitor and the
other hotline therapists try to convey to call-
ers is simple: War is hazardous to your men-
tal health. “It’s really no surprise that these
veterans have posttraumatic stress, because
these are hard issues for humans to deal with
on top of all of life’s other stresses and diffi-
culties,” she says. “On the phone, we try and
let them know that these are normal reactions
to what are really abnormal experiences.”

BROTHERS UNDER THE BRIDGE

On a recent sweltering day, Oskar Gonzalez-
Yetzirah of the nonprofit U.S. Vets trolled
beneath one of Houston’s countless highway
overpasses, offering bottles of water to the
ragged men and women gathered there. He
had a simple question for any takers. He tries to coax the vets into government fingers and disappear onto the streets again.
“You a vet?” or nonprofit assistance systems. U.S. Vets As a former Marine who served in Iraq,
U.S. Vets is one of roughly 5,000 non- has a 72-bed facility in downtown Houston, Gonzalez-Yetzirah himself has also strug-
profits nationwide that aid military person- but it is overbooked by 30 spaces. Gonzalez- gled with PTSD and readjustment issues. In
nel and veterans. In a sense, they are Ameri- Yetzirah and his boss would have to work the his first job back—waiting tables—he almost
ca’s catchers in the rye—the last line of help phones to find an open slot at another shel- clocked his boss, a pimply 18-year-old, for or-
for veterans poised on the precipice of a cliff. ter. He knows that many veterans who suffer dering him around. That might have landed
The veterans whom Gonzalez-Yetzirah finds from PTSD would rather sleep outside than him in the Harris County Jail, where he runs
under the overpass have already hit rock bot- subject their frayed nerves to the chaos of a group-therapy sessions for the 400 to 600
tom, joining some 3,500 homeless veterans homeless shelter. He also knows from experi- jailed vets being held there on any given day.
in Houston and 150,000 nationwide. Almost ence that if red tape keeps him from logging He now sees a new wave of vets approaching
all are jobless; many are substance abusers the veterans into the system before night- the precipice, just one similar outburst away
or mentally ill. fall, they will almost surely slip through his from joining their brothers in jail or under the
bridge. “I run into a lot of [recently returned]
veterans in my work who are not homeless
yet, but they are at the stage of running from
Battle-Scarred place to place, sleeping on a buddy’s couch,
Veterans of the wars in Iraq and Afghanistan survived wounds that in earlier wars would have been fatal. living paycheck to paycheck and barely mak-
But the physical and psychological injuries wreaked by roadside bombs—the wars’ signature weapons—are ing ends meet,” Gonzalez-Yetzirah says.
growing and not yet fully understood. Many are married to young wives who have
little education and are caring for babies, even
Iraq and Afghanistan wounded in action by Iraq and Afghanistan veterans treated each
cause, Oct. 2001-Aug. 2011 year by Veterans Health Administration as the veterans struggle against their PTSD to
hold down jobs. They tend to follow a pattern,
Rocket-propelled he says: Soon, their families will break apart
grenade (1,733) Other (503) 500,000
and the vets will end up on the streets. “I’ve
Artillery
400,000
seen that enough times to understand how it
3,388
happens. I just don’t understand how we as a
Gunshot 300,000 country can allow those people who fought
4,506
for our freedoms to stay homeless.”
TOTAL: 200,000
45,170
Like previous generations of veterans be-
Not 5,483 29,557 Explosive fore them, the post-9/11 volunteers are com-
reported device 100,000
ing home from war burdened by wounds and
0 sorrows. Only this time it’s not too late to help
2005 2006 2007 2008 2009 2010 2011
them carry that weight.
The soldiers sent to fight on our behalf are
Annual new cases of posttraumatic stress disorder (all services)
not victims; they don’t want our pity, and they
photo: ap/Ste ven Senne

Deployed to Iraq
20,000 have much to contribute and even to teach us.
or Afghanistan
15,000 But combat veterans struggling to regain a
10,000
Not deployed sense of normalcy in everyday life need and
5,000
deserve the same assurances at home that
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 their buddies gave them on faraway battle-
fields: They need to know that someone has
Sources: Armed Forces Health Surveillance Center; Defense Manpower Data Center; CBO
their back. n

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