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Aftershock: The Blast That Shook Psycho Platoon

Five soldiers injured in the same 2009 bomb blast are a case study in a new epidemic among America’s troops, who are grappling with a combination of concussion and post-traumatic stress disorder.

A photo of Staff Sgt. Brock Savelkoul from his service in the military. (Katie Hayes Luke)

Updated March 13: ABC News and CNN have reported that the soldier who allegedly killed 16 Afghan civilians previously suffered a traumatic brain injury during one of his four deployments, citing unnamed Defense Department sources. As part of our extensive coverage of traumatic brain injury, ProPublica featured a unit of soldiers dubbed "Psycho Platoon" who sustained brain injuries in Iraq and had severe mental health challenges when they returned from their deployments. In another story, we also visited Fort Lewis, where the soldier accused of the killings was based. While there, we talked to soldiers about how they are assessed for brain injuries.

A version of this story was co-produced with NPR and aired on All Things Considered. (Listen here.) This story was also published as part of Amazon's Kindle Singles program, and is available for reading on that device.

MINOT, ND -- At 8:20 p.m. on Sept. 21, 2010, Iraq veteran Brock Savelkoul decided it was time to die. He lurched from his black Tacoma pickup truck, gripping a 9-mm pistol. In front of him, a half dozen law enforcement officers crouched behind patrol cars with their weapons drawn. They had surrounded him on a muddy red road after an hour-long chase that reached speeds of 105 miles per hour. Savelkoul stared at the ring of men and women before ducking into the cab of his truck. He cranked up the radio. A country song about whiskey and cigarettes wafted out across an endless sprawl of North Dakota farmland, stubbled from the recent harvest. Sleet was falling, chilling the air. Savelkoul, 29, walked slowly toward the officers. He gestured wildly with his gun. "Go ahead, shoot me! ... Please, shoot me," he yelled, his face illuminated in a chiaroscuro of blazing spotlights and the deepening darkness. "Do it. Pull it. Do I have to point my gun at you to ... do it?"

Twenty feet away, the officers shifted nervously. Some placed their fingers on the triggers of their shotguns and took aim at Savelkoul's chest. They were exhausted, on edge after the chase and long standoff. They knew only the sketchiest of details about the man in front of them, his blond hair short, his face twisted in grief and anger. Dispatchers had told them that Savelkoul had been diagnosed with post-traumatic stress disorder. They warned that he might have been drinking. Family members told police that Savelkoul had fled his home with six weapons, including a semiautomatic assault rifle and several hundred rounds of hollow point ammunition. To Megan Christopher, a trooper with the North Dakota Highway Patrol, Savelkoul's intentions seemed obvious. "Suicide by cop," she thought. "He wants to go out in a blaze of glory."

As it happened, Savelkoul's state of mind was of interest not only to the cops, but to some of the nation's top military officers and medical researchers.

More than 2 million troops have deployed to Iraq and Afghanistan since 2001. Tens of thousands have returned with a bedeviling mix of psychological and cognitive problems. For decades, doctors have recognized that soldiers can suffer lasting wounds from the sheer terror of combat, a condition referred to today as post-traumatic stress disorder. They also have come to know that blows to the head from roadside bombs -- the signature weapon in Iraq and Afghanistan -- can result in mild traumatic injuries to the brain, or concussions, that can leave soldiers unable to remember, to follow orders, to think normally.

Now it is becoming clear that soldiers like Savelkoul are coming home afflicted with both conditions, in numbers never seen before. Studies have estimated that about 20 percent of soldiers returning from Iraq and Afghanistan have suffered a mild traumatic brain injury while deployed. Of those, anywhere between 5 percent to nearly 50 percent may suffer both PTSD and lingering problems from traumatic brain injuries. It is an epidemic so new that doctors aren't even sure what to call it, let alone how best to diagnose and treat it.

Savelkoul and four of his comrades landed on the front lines of this confounding new conflict over the minds of America's soldiers when an Iraqi rocket exploded near their trailer in January 2009. By chance, a senior Army neuropsychologist was in Iraq at the time to conduct a study on the military's tools for diagnosing concussions. After learning of the attack, he persuaded Savelkoul and the others to enroll. The men became the first fully documented victims of "pure blast" concussions -- that is, mild traumatic brain injuries caused by the force of an explosion, rather than a secondary effect, such as slamming into a Humvee wall after a roadside bomb.

The concussions marked only the beginning of the men's problems. Aftershocks from the blast would ripple through each of their lives differently, mirroring the spectrum of psychic and physical outcomes that doctors have begun to catalog. Of the five men injured that night, three remain in the Army and are currently deployed to overseas war zones. One recovered quickly, though he continues to suffer occasional severe headaches. Two recuperated more gradually but complain of forgetfulness and problems concentrating. A fourth left the military, tired of the violence and still grappling with concussion symptoms.

Savelkoul struggled the most to return to the person he had been before. On that night last September, his troubles transformed from academic data point to terrifyingly real confrontation. All the Army's men, all its research, all its treatments, had failed to prevent the desperate showdown that would unfold on a deserted stretch of highway just south of the pinched hills of the Dakota badlands. Now the outcome depended on one distraught man and a half-dozen nerve-wracked police officers, trying to negotiate a battlefield of the mind that none of them -- no one in the world, really -- understood.

An Unremarkable Blast

The football-sized hole left in the 12-foot-high concrete blast wall following a rocket attack on the camp, where soldiers Junge, Hopkins, Hollingshead, Fuller and Savelkoul were unwinding after a day of patrolling. (Photo courtesy of Spc. Jared Hollingshead)In the violence of the wars in Iraq and Afghanistan, it was an unremarkable attack on an unremarkable day.

On the night of Jan. 16, 2009, several soldiers were hunched around a small television screen in a trailer at Camp Liberty, a sprawling base just outside of Baghdad. The men of Psycho platoon, Hell Raisers Battery, 1-7 Field Artillery of the famed 1st Infantry Division, the Big Red One, had arrived in Iraq from Fort Riley, Kan., in October 2008. They were on their second or third tours. After spending most of the day patrolling a nearby Iraqi village, they decided to unwind by playing "Call of Duty 4," a video game that allows players to act as U.S. Marines fighting in an unspecified Middle Eastern country. Subtitled "Modern Warfare," the game's scenes are harrowingly similar to the conflict in Iraq, with patrols down narrow streets of dun-colored buildings, sudden explosions and attacks by hidden enemies. "It sounds strange, but it's how we relaxed," said Staff Sgt. Derrick Junge, a muscular Illinois native with a shaved head and a fondness for reading Virgil, John Milton and Charles Dickens.

At about 8 p.m., the men heard the warning klaxon of the Phalanx, an antimissile system designed to destroy incoming mortar and artillery rounds by spraying bullets into the sky. The men continued playing "Call of Duty." Rocket attacks were common. The insurgents aimed so poorly that they rarely posed a danger. Seven minutes after the first warning, a second sounded. One man remembered that a fellow player, referring to the video game, called out "He's got a grenade!" Then, chaos enveloped the men.

Staff Sgt. James Hopkins, a Missouri native with a slight build, sharp face and a love of Red Vines candy, was sitting on his bed in a room next door to the rest of the men. He was talking to his wife on Skype. The blast force threw him to the floor. "It was just loud and thunderous. The living quarters actually shook. It was like if I were to stand next to the biggest Fourth of July explosion ever."

Spc. Jared Hollingshead was standing when the blast hit. The stocky Texan remembered "a bright flash of light, a very loud bang and everything goes blank after that. It was the most heart-wrenching thing you'll ever go through. It feels like your whole body clamps up. It's beyond words. It's utter terror."

Shane Fuller, then a corporal, was sitting with his back to the wall, listening to music on his laptop computer. "I just slumped over from the force of it," said Fuller, a Missourian who joined the Army after the lawnmower engine factory where he worked shut down. "All I could hear was ringing for 10 to 15 seconds."

An Iranian-made 107mm rocket had just slammed into one of the 12-foot-high concrete blast walls that protected the soldiers' housing compound, blowing a football-sized hole into the wall. Shrapnel, jagged and red hot, shredded the thin shell of the trailer, puncturing it with holes. Lights crashed down from the ceiling. Power went out. Fuller miraculously escaped physical injury, though shrapnel pierced the wall around him and ripped apart a Missouri State flag hanging above his head.

The men remember the next few minutes haphazardly, like a movie in which they duck in and out of the theater. In the dark and smoke that filled the trailer, several of them heard Savelkoul call out: "I'm hit, I'm hit!" A piece of metal from the rocket had burned his leg, making him the only soldier to suffer an external injury in the blast. Junge groped through the dark for a flashlight. Hopkins staggered out of his room to check on his men. Hollingshead grabbed his rifle. Fuller, who had blacked out, came to with blood streaming from his nose. Several ran to Savelkoul, dragging him to a nearby bunker.

Within minutes, combat medics arrived and took the men to a nearby medical clinic. They cleaned and bandaged Savelkoul's wound. They checked out Fuller but determined he had no injury. Though medics are supposed to check soldiers exposed to a blast for concussion, none of the men remembers talking about traumatic brain injury -- though all admit their memories were hazy. According to a doctor who reviewed their medical charts, none were diagnosed with concussions.

The men felt lucky. Nobody had died, nobody was seriously wounded, as far as they could tell. "I looked at it as though it wasn't a huge deal," Junge said. "You look at yourself and you say, nothing really happened to me."

By the next morning, Junge and several others went back on patrol.

As chance would have it, two weeks earlier, Lt. Col. Mike Russell -- then the Army's most senior neuropsychologist -- had landed in Iraq to begin a study of concussion at the behest of the Army's surgeon general. One of the first graduates of the neuropsychology program at Walter Reed Hospital, Russell had spent much of his career studying traumatic brain injury at Army hospitals and combat zones all over the world. He was something of an iconoclast in the military. Blunt-spoken and easily frustrated with bureaucracy, Russell decided the best way to find patients for his study was simply to hang out in military clinics, seeking blast survivors. He happened to hear about the rocket attacks at Camp Liberty and asked to examine Savelkoul and his comrades personally.

After assessing them at a field clinic on base three days after the blast, Russell concluded that five of the soldiers in the blast that night had, indeed, suffered mild traumatic brain injuries. The signs were obvious, Russell said, showing up clearly in the daylong battery of neuropsychology exams he performed. "When you work a lot with acute concussion, you actually kind of recognize even the look of a person who has been acutely concussed, which is kind of a dazed expression, a little bit unfocused, a little bit slow to respond," Russell said. "Several of them had significant gaps in their memory. And it wasn't clear how long they were unconscious. The last thing they remember is they were playing video games. The next thing they remember, they are outside the trailer in a shelter. Some minutes had actually passed where they weren't recording memories. That's post-traumatic amnesia. And that's your classic symptoms of a concussion."

For each of the men, Russell entered two diagnoses in their electronic medical records:

1. Concussion
2. Post concussive syndrome

The New Epidemic

Staff Sgt. Derrick Junge, right, was on his second tour in Iraq when he sustained a traumatic brain injury from the Jan. 16, 2009 rocket attack. (1st Lt. Mark Peek )War has always fueled innovation, helpful and horrible. Better body armor and battlefield medicine have helped soldiers survive injuries in Iraq and Afghanistan that would have proven fatal in previous conflicts. But the advances that have saved soldiers' bodies cannot protect their minds from insurgents' primary weapon, the roadside bomb. Blast waves penetrate through Humvee doors, bulletproof vests and Kevlar helmets, rattling soldiers' brains and altering cells and circuitry. Most recover quickly, but some suffer lasting damage to their cognitive abilities. At the same time, the terrifying experience of surviving such blasts haunts them, seeping out in violent nightmares and emotional outbursts.

Given the number of troops deployed, tens of thousands of soldiers, Marines, sailors and airmen may be suffering from this pernicious combination of PTSD and lasting problems from mild traumatic brain injury. They become, quite literally, different men and women than they used to be, a generation of warriors whose fight has shifted from external combat zones to invisible internal battlefields.

The issue has ignited debate in scientific and military circles, where much of the basic science remains in dispute. Are the two conditions related? If so, how? Does having a mild traumatic brain injury increase the chance of developing post-traumatic stress disorder? Or does surviving a terrifying event somehow make it more difficult for the brain to recover from a concussion? Doctors also struggle to tell the two conditions apart. PTSD and traumatic brain injury can produce similar symptoms, such as problems with memory and concentration. Yet both conditions escape detection by medical imaging devices, hindering diagnosis. Other conditions further complicate the picture. Besides PTSD and cognitive problems stemming from brain injury, soldiers also face chronic pain, missing limbs, vision, hearing and other physical problems. "It's very complicated," said Jennifer Vasterling, who has studied the issue and treated soldiers as chief of psychology at the Boston Veteran's Administration Hospital. "There are no simple scenarios."

Until recently, concussions were not even seen as particularly serious. Boxers boasted of returning to the ring after being knocked out. Soldiers in combat shook off feeling dazed and unfocused. Symptoms of concussions can include headaches, dizziness, difficulty speaking, memory troubles and sometimes balance and visions problems. Most people recover within four to six weeks. But for some, the symptoms can persist for months or even years. Civilian studies have found that between 5 percent and 15 percent of concussion victims endure long-term problems -- a condition formally known as post-concussion syndrome. Recent studies of athletes in the NFL and other sports have shown that repeated concussions can result in chronic traumatic encephalopathy, a condition associated with dementia and other Alzheimer's-like disorders.

Some researchers believe that soldiers' concussions may pose an even more complex medical challenge. Soldiers sustain their injuries in settings dramatically different from those encountered by athletes or car accident victims. Civilian concussions are typically caused by a physical blow to the head. But nobody is sure exactly how the brain is damaged in a blast concussion. Do blast waves rupture miniature blood vessels inside the brain? Does the force sever connections between neurons? Does it damage individual brain cells? Or does it simply slam the helmet into the head hard enough to injure the brain?

After the blast, soldiers face a different environment than typical concussion victims. No fans applaud as they rise from the field. Medics often can't rush them to the safety of a hospital right away. Instead, they remain on a hostile battlefield, fighting for their lives, the violence and rush of combat filling their brain with abnormal levels of chemicals such as adrenaline. Those left dazed, but not unconscious, experience a fear so fierce that it may simultaneously trigger post-traumatic stress. Paradoxically, patients who suffer severe traumatic brain injuries are less likely to develop PTSD -- perhaps because, knocked unconscious, they do not actually experience the horror unfolding around them.

"The scientific literature does not capture or mention the kind of patient that we are seeing," said Maria Mouritidas, psychology chair at Baltimore's College of Notre Dame, who worked with soldiers returning from the battlefield. "You can't compare this to a football game or a car injury. In a football game, if you go down, the game stops. On the battlefield, the game doesn't stop. Your survival depends on it."

For decades, the military has struggled to sort out the mysteries of concussions. In response to soldiers suffering head injuries during the Gulf War, the Pentagon and the Veterans Affairs joined forces to create what is today called the Defense and Veterans Brain Injury Center, a network of research and treatment clinics. But the wars in Afghanistan and Iraq dramatically expanded the need. Military doctors began noticing a wave of troops suffering brain injuries in blasts. In August 2006, the Armed Forces Epidemiological Board, responsible for monitoring health trends among troops, noted the growing number of head injuries. In a memo first disclosed by USA Today, the board warned senior Pentagon health officials that the military's medical system "lacks a system-wide approach for proper identification, management, and surveillance for individuals who sustain a TBI, in particular mild TBI/concussion."

However, it wasn't until the Walter Reed Hospital scandal of 2007 that the military dramatically increased attention to the so-called "invisible" wounds of war. The Washington Post revealed that officials at the hospital, the crown jewel of the military medical system, housed soldiers with brain damage in moldy hospital rooms, often ignoring their needs. The scandal caused an uproar in Congress and across the nation. Lawmakers passed legislation devoting more than $300 million in new research funds to brain injuries and PTSD. They ordered the military to conduct cognitive screenings of soldiers before and after deployment. President Bush created a commission headed by retired Sen. Bob Dole and former Health Secretary Donna Shalala to suggest recommendations to improve care for soldiers with PTSD and brain injury. In 2008, the Rand Corporation produced a groundbreaking report estimating that 19 percent of soldiers in Iraq and Afghanistan had suffered a probable traumatic brain injury, while another 18 percent reported symptoms of PTSD or depression. About 5 percent reported a combination.

Yet, despite the pressure and the growing numbers, the Pentagon's response was uneven, at best. ProPublica and NPR reported last year that the military continues to have problems diagnosing and treating brain-injured soldiers. The military's standard screens failed to catch as many as 40 percent of concussions, according to a study published earlier this month. Injuries weren't always noted in soldiers' medical files because of poor recordkeeping. In some cases, soldiers resisted admitting that they had sustained head traumas because of a desire to remain on the battlefield with comrades. In the command echelons, some high-ranking military officers dismissed the effects of mild traumatic brain injuries.

Col. Heidi Terrio, an Army doctor who has worked extensively with soldiers returning from the combat field, conducted a study published in the Journal of Head Trauma Rehabilitation that reported that 7.5 percent of combat soldiers returning from Iraq and Afghanistan showed three or more symptoms associated with post-concussion syndrome, with another 20 percent reporting one symptom. Terrio said her study showed that it was important to pay attention to soldiers with concussions. "Mild traumatic injury does not mean it's a mild problem," she said. "Mild doesn't necessarily mean mild consequences. One concussion may cause you to have lifelong problems. Most of the time it doesn't but it can."

Spc. Jared Hollingshead sustained his second concussion in the rocket attack on Jan. 16, 2009. Afterward, he experienced trouble wth his balance and keeping track of orders from his superiors. (Photo courtesy of Spc. Jared Hollingshead)The lack of clarity has frustrated battlefield commanders trying to navigate the debate in the middle of a war. "I don't feel comfortable on where the science is right now," said Gen. Peter Chiarelli, the vice chief of staff for the Army. "It's an extraordinarily tough nut to crack."

Chiarelli has worked relentlessly to change that, convening conferences of top neurologists and flying them to his wood-paneled office in the Pentagon's inner ring to hammer out possible treatments. He has encouraged researchers to find biomarkers to better diagnose brain injury. He envisions a system that, with enough data, could one day help commanders predict which soldiers were at greatest risk of committing suicide.

Although he acknowledges there is more work ahead, Chiarelli's temper flares at the suggestion that the Army is not trying hard enough to improve how it diagnoses and treats soldiers with brain trauma. He points to a directive issued last year that mandated rest periods for soldiers involved in blasts and thorough neurological examinations for those suffering three or more concussions. He also notes that the military has spent millions of dollars on research that has generated promising new technologies to identify and treat injuries related to PTSD and TBI.

"Our doctors are doing everything they can to come up with the best techniques possible to insure they get better at the initial diagnosis of these injuries," Chiarelli said. "But it is extremely difficult because the science is not as developed as it is with the mechanical nature of this war."

Call of Duty

Though the men of Psycho platoon returned to duty shortly after the explosion, several continued to experience aftereffects.

Hollingshead remembered stumbling across the base, unable to keep his balance on the white gravel that lined the ground between buildings. His ears rang constantly. He had difficulty keeping track of what his sergeants were telling him to do. "I just could not remember it. I'd ask three different times. It's a very unusual feeling, not being able to remember all of a sudden." Hopkins had similar trouble. "I just didn't feel right. I could barely walk a straight line," he said. "I was forgetting things, my attention span was shot, someone would be directly talking to me and I would not even really be paying attention. I couldn't recall or say back what they said to me. It was like I was paying attention but I wasn't gathering the information." Junge had splitting headaches, so he popped ibuprofen and Tylenol PM to help get to sleep.

In March, the Army held a ceremony to award the men combat action badges, given to soldiers who have attacked or been attacked by the enemy. For the wound to his leg, Savelkoul also received a Purple Heart, one of the military's most revered symbols of sacrifice, an honor dating back to George Washington. The other men, however, were turned down, even though Army regulations specifically list concussion as an injury deserving recognition. Hopkins was incensed. He began firing off appeals on behalf of himself and his men, with no success. "They don't consider [concussions] to be an injury that is going to stay with you for the long term," he said. "That's a big slap in the face."

For most of the men, some symptoms improved. Their balance got better, the headaches were not as severe -- a typical recovery from mild traumatic brain injury. But the symptoms did not go away entirely. Fuller's ears kept ringing. Hollingshead's headaches remained painful, sometimes disabling. Still, the men continued providing security details for senior commanders, patrolling villages, or protecting fuel and food convoys racing across the desert. "After we saw Dr. Russell, that was it. It was back to work," Hollingshead said. "Nobody ever came back to us to follow up."

Savelkoul was awarded another commendation, the Army Achievement Medal, for manning a gun truck and coordinating air support during a dangerous run between Baghdad and Al Hillah. That April, he was scheduled for a rest and relaxation break. He decided to go with a friend to Thailand. On March 20, he posted a message on Facebook: "on my way to Thailand !!!!" His sister, Angie, quickly wrote back: "have fun. Don't do anything stupid."

Savelkoul didn't reply.

The Farm Kid

Savelkoul grew up in North Dakota. His father was a car salesman, then a truck driver. When Savelkoul was getting ready to enter high school, the family enrolled him in a school in Glenburn, pop. 347, in far north-central North Dakota because their hometown school in Minot, pop. 36,000, was too big. Savelkoul played football and basketball for the Glenburn High Panthers. During halftime, he played trumpet in the high school band. At Christmas at his grandparents, Savelkoul and Angie, a flute player, would play mini-concerts. The family had its troubles, and Savelkoul's parents eventually divorced, but they stayed close.

Savelkoul loved hunting: deer, geese, coots. When he was 14, Savelkoul and his father Bruce drove out to the North Dakota badlands on a rainy, gray winter day. They hiked up a hill, getting soaked as they searched for game for hours. Suddenly, right in front of them, Bruce spotted a mule deer. It would be Brock's first kill. He started shaking uncontrollably as he tried to lower his rifle. Bruce gently crouched in front of him and had Brock lay the rifle across his shoulder, steadying it. Brock aimed, killing the deer with a single shot. It was a beautiful buck, its antlers tall and broad above its head. The mount, which won first place at a local trophy show in 1996, would hang on the wall of Bruce's mobile home, the first thing you see when you walked in the door. "He was a good kid, a very good kid," said Bruce, who is balding, with glasses. His pride in his son is obvious. "He was a farm kid. We had farm values -- scruples and values and respect."

After high school, Brock Savelkoul attended community college but soon dropped out. He was bored and unsure of what he wanted to do. He moved to Fargo, where he got a job with a fencing company. One day, he was on a job with an older man. He suddenly realized that he didn't want to spend the rest of his life building fences in Fargo. In February 2003, he signed up with the Army. He was assigned to Fort Riley. Six months later, Savelkoul headed to Iraq for the first of three tours.

During his tours, Savelkoul took on a number of different jobs. He was the gunner on a Humvee that patrolled the streets. He did foot patrols of villages. He took a course and began to operate Ravens, small surveillance drones used to fly above roads to make sure they were clear of bombs. Mike Krebsbach, a friend from basic training, said Savelkoul was a good, conscientious soldier. They were based in Baghdad, their quarters a palace that had once belonged to Saddam Hussein. At night, they would sit on the roof, staring over the boxy brown cityscape. Krebsbach, an atheist, would debate Brock, a Catholic, about God, life, the war. "We didn't talk much about the fear," Krebsbach said.

Two incidents seemed to affect Savelkoul, changing him. During his first tour, his unit began taking fire after turning down an alleyway. The men, novices to combat, fired back, seeking desperately to escape. All survived, but the incident shook them. "Everybody was tripping out," Krebsbach said. "We were acting like a combat infantry team, but with zero training. ... There was just a bunch of really scared soldiers."

During his second tour in 2005, Savelkoul was responsible for giving the OK after he scanned a route with the Raven and determined that there were no signs of IEDs, or improvised explosive devices. In an article for a base newsletter, he proudly told the reporter that his job saved soldiers' lives. "We're protecting them from the sky," he said. One day, however, a convoy driving down a route he had checked hit an IED. Details are unclear. Savelkoul rarely spoke of it. The bomb destroyed one of the vehicles. Several soldiers apparently died in the blast. "It blew the truck into nothing. You didn't even know it was a Humvee," said Krebsbach, who remembered seeing the vehicle after it was towed back to base. He said Savelkoul became sullen and withdrawn afterward. "It was hard to get him not to fixate" on that incident, he said.

Bruce Savelkoul remembers getting a solemn phone call from his son after the explosion.

"Dad, I'm responsible for those deaths," Brock told his father.

"No, you're not," Bruce responded, trying to console him. One of Savelkoul's commanders, who did not want to be identified because the Army had not authorized him to comment, said that he had looked into the incident and concluded that Savelkoul was not negligent in carrying out his duties.

When the rocket hit the concrete wall protecting the soldiers' quarters, Staff Sgt. James Hopkins was thrown to the floor. He has since been fighting for Purple Hearts for his men and himself. (1st Lt. Mark Peek)In any case, the Humvee deaths weighed on Savelkoul, as did the failure of a brief marriage, which ended in divorce just a few months before he left Iraq in January 2006. To Angie, his sister, he seemed different. Although some family members had suffered depression, Savelkoul had never shown any signs of mental distress. "He wasn't his normal self. He was very quiet, withdrawn," Angie said. "It's like he wasn't there."

With straight blond hair and an open, honest face, Angie is the glue of the Savelkoul family, the little sister who keeps tabs on everyone. A labor and delivery nurse married to a plumber, she juggles crazy work hours with family crises and the kids' basketball games. Through it all, she made sure to communicate with Brock regularly. When he deployed to Iraq again in October 2008, she convinced him to open a Facebook account. They exchanged messages after the Jan. 16 explosion. Brock assured her he was OK.

That was why Angie got nervous when Brock didn't respond to her messages after he left for Thailand. "You need to write, call, something," she wrote. " ... gettin worried ... "

She had reason to be. Her brother had begun to fall apart.

Falling Apart

Photos taken of Savelkoul in Thailand show him acting as soldiers often do on leave, partying in bars, surrounded by friends and women. It's impossible to know exactly what happened, but about a week after his arrival, he began sending out strange messages: "I'm under special army training in Thailand ... It's crazy!!!" read one. Nothing in his military records indicates he received any training in Thailand. Friends remember getting nonsensical text messages on their cell phones. Bruce Savelkoul said Brock called him from Thailand in the middle of the night.

"'Dad, there are guys trying to kill me, Dad, you got to help me,'" Bruce said his son told him. "He was absolutely paranoid. I was 7,000 miles away. What could we do?"

At some point, U.S. Embassy and military officials picked up Savelkoul and transported him to Tripler Army Medical Center in Honolulu. There he was placed under lockdown and diagnosed as having suffered a psychotic breakdown.

After stabilizing at Tripler, Savelkoul was transferred back to Fort Riley. He seemed to pine for Iraq. "You guys have no clue how bad I want to be there!!!! It's just not the same without you guys," he wrote in a Facebook message in May 2009 to a fellow soldier still in Iraq. Officials at Fort Riley declined to comment on what kind of treatment he received. Savelkoul's military record shows that his condition wasn't improving. In August 2009, he was hospitalized a second time. In October, the Army barred him from possessing weapons. Savelkoul was diagnosed as suffering from post-traumatic stress disorder.

Post-traumatic stress disorder has its own controversial history. Accounts of soldiers suffering mental afflictions after exposure to war's horrors date back thousands of years. In Homer's Iliad, some have speculated that Achilles' blind rage after the death of a beloved companion is an early description of post-traumatic stress. During the Civil War, men who struggled to return to normalcy after the war were described as suffering from "soldier's heart." In World War I, it was called shellshock. World War II brought the name "combat fatigue." All generally described soldiers numbed and haunted, unable to return to battle -- or normal life.

Military commanders showed little tolerance or understanding during earlier eras. Gen. George H. Patton became infamous for slapping and publicly berating a soldier suffering from combat fatigue, calling him a "coward" and ordering him back to the frontlines. Patton was later forced to apologize.

The Diagnostic and Statistical Manual of Mental Disorders, the psychiatrist's primary diagnostic tool, did not formally recognized the syndrome until 1980, after thousands of veterans returned from Vietnam suffering psychological distress. Today, the diagnosis requires that troops meet a series of criteria. They include having faced a risk of serious injury or death; recurring nightmares or memories; and problems with sleep, anger and emotional control that last beyond a month. Researchers continue to debate the criteria and what happens inside the brain to trigger the disorder. Does a sudden rush of chemicals in the brain change fundamental pathways for dealing with stress? Do genes play a role?

Despite the questions, after a 30-year push by veterans and their advocates, PTSD has gained greater acceptance than post-concussion syndrome. Commanders and soldiers are reminded to watch for signs constantly during military training. Nearly all VA and military medical facilities offer some form of counseling for PTSD. By comparison, mild traumatic brain injury is the new kid on the block. At times, researchers have seemed to divide into factions, with PTSD advocates seeking to protect their gains and TBI advocates fighting to make advances. Charles Hoge, a retired colonel who published groundbreaking research on PTSD in Iraq and Afghanistan, has expressed skepticism publicly regarding the severity of mild traumatic brain injury. In an opinion piece in the New England Journal of Medicine, Hoge worried that overdiagnosis of lingering problems from concussion will create "illusory" demands for the military's medical system. "There tends to be camps. One camp is everything is TBI and the other is nothing is TBI," said Rodney Vanderploeg, director of the brain-injury treatment program at the Tampa VA, which specializes in treating soldiers with multiple traumas. "The truth is somewhere in the middle."

Savelkoul was suffering in that middle. In November 2009, the Army made a last-ditch effort to help him, sending him to a residential mental health program at a veterans' home in Yountville, Calif., called the Pathway Home.

While now-Sgt. Shane Fuller was initially determined to be injury-free after the attack, he experienced a constant ringing in his ears and debilitating headaches from his mild traumatic brain injury even after he returned stateside. (Photo courtesy of Hillary Fuller)It is hard to imagine a more idyllic location. Surrounded by the gentle brown hills of Napa Valley, the sprawling campus of Spanish-style buildings has towering redwoods and lush green lawns. Fred Gusman, a nationally prominent expert in PTSD who recently retired from the Department of Veterans Affairs, established the program in January 2008 for Iraq and Afghanistan veterans. The intensive, six-month program is designed for the hard cases, the troops and veterans who have had an especially difficult time recovering in traditional military settings, where therapy can be haphazard and uncoordinated. At the Pathway Home, teams of doctors and clinicians strive to take a comprehensive approach to care, coordinating treatments for psychological trauma, chronic pain and other issues, such as alcoholism. Patients have encounter groups. They go fly fishing and hiking.

Savelkoul, Gusman remembered, had symptoms similar to scores of patients that have gone through his program. He suffered nightmares, severe depression, trouble sleeping, headaches. "He's not unique in what we see," Gusman said. Savelkoul struggled to adjust to the program. Sometimes he would participate. Sometimes he would withdraw, apparently not convinced that he needed help and uncertain whether he wanted to remain in the Army. "There is anger, fear and shame. A lot of people wonder why they are in this treatment and others are not. They get stuck like that," Gusman said.

After about two months in the program, Savelkoul wandered off campus -- which is not closed -- and somehow made his way to Sacramento. Bruce Savelkoul got a call a short while later. Brock told him that he was back in Baghdad, surrounded by thousands of people. At about the same time, Gusman got a call from a staff member. Savelkoul had been found in the Old Town section of the city, a tourist area near the Sacramento River. He had been drinking and was having a panic attack, they told Gusman. Gusman sent a van to pick him up and transport him to Travis Air Force Base. Eventually, Savelkoul was sent back to Fort Riley. Gusman said Savelkoul was not yet ready for his program and that the military did not aggressively pursue other treatment options: "The problem in this country is that we haven't accepted the hard reality that we can train people to be in a war. ... But we can't train somebody in how they're going to respond."

For the military, it was the last straw. Staff Sgt. Brock B. Savelkoul was honorably discharged from the Army on March 31, 2010. He had served two years, three months and four days in Iraq. His awards included the Purple Heart, the Army Commendation Medal and the Army Achievement Medal. He was placed on temporary disability due to post-traumatic stress disorder. He was ordered to be re-evaluated in six months.

Savelkoul was going home.

The Others Struggle

In September, just before Savelkoul was shipped off to California, the rest of Psycho platoon returned from Iraq. They began to split up. Junge was transferred to Fort Campbell in Kentucky. On a test he took shortly after getting back, a screen given to all soldiers to check for potential brain injury and mental health problems, Junge had filled in "Yes" for every question relating to traumatic brain injury. Positive answers are supposed to trigger an evaluation by a medical professional. But nobody at the local TBI clinic ever examined Junge.

Junge, his wife Holly and their kids moved to a modest home with two magnolia trees in the front yard in Clarksville, Tenn., a short distance from their new post. As they settled in, Holly began to notice changes. Junge would snap at the kids, something he had never done before. He started building a tree house in the front yard but never quite finished. Before joining the Army, Junge had been an air force mechanic on the B-2 stealth bomber, one of the most complicated pieces of machinery ever invented. Now he struggled to fit together the pieces of a trampoline in their backyard. Holly, a nutritionist with a soft face and brown hair, grew worried. "From day one, he was a different person," she said. "He was very irritable. He doesn't sleep well. He forgot things, little things, but kind of annoying."

One day, the couple's 10-year-old daughter asked Holly, "Why is Daddy so mean to you?" Recalling the question, Holly began to cry. "Everything was wonderful. Not that's he's not now," she said, wiping tears from her face. "But it's different."

Junge said he never considered his troubles serious enough to go see a doctor. Nobody had ever ordered him to seek counseling. He was focused on his men, he said, and getting ready to redeploy to Afghanistan. "I just don't deal with stuff like I used to," he said. "I guess you could say I used to be a different person. It kind of sucks. But it's where I'm at and you work with it the best you can."

Upon his return, Hollingshead had a mental health examination at a VA hospital in Shreveport, La. He was hoping to begin PTSD counseling, but he left the Army before treatments could begin. Hollingshead said he was simply tired of the violence and bloodshed. "I wanted to be done," he said.

He eventually moved with his wife, Lena, to be near his family in Marshall, Texas, on the far eastern edge of the state. They found a small home surrounded by piney woods. He began taking classes to learn how to become a lineman for a power company but struggled to find a job. During his time in Iraq, he had lived through two bomb blasts, the one in January 2009 and an earlier one on his first tour. Now he would wake up in the middle of the night, thrashing his arms and legs. When he went to a July 4 fireworks show, he panicked at the explosions, gripping Lena's arm so hard that it left marks. "I'm glad this military time is over," she said. "It took its toll. It took its toll."

Of the five soldiers who sustained mild traumatic brain injuries in the Jan. 16, 2009 rocket attack, Brock Savelkoul was the only one to be injured by shrapnel and be awarded the Purple Heart. (Katie Hayes Luke)Hopkins and Fuller stayed at Fort Riley. Both began to see therapists at the base's traumatic brain injury clinic. Hopkins went four times a week. He did exercises to help improve his memory. He got a handheld computer device to help him make lists. He practiced reading. His wife, Brianne, labeled the closets in their home to help him remember where to put things. At first, she said, it was frustrating. Hopkins would forget things that she had asked him to do. The couple has five kids. "Sometimes I joke about having an extra child because we have to repeat ourselves to the kids to remind them to do things." After about two months, Hopkins took a new battery of neuropsychological tests. "They pretty much cleared me at that point," Hopkins said. "They asked me how I felt, and I told them I felt pretty much 100 percent better besides the headaches and things of that nature."

Fuller had a similar experience. The ringing in his ears continued even after he got home. He got prescription-strength medication for his headaches, which came less frequently but still hit him hard. His wife, Hillary, who had known him since the 6th grade, noticed that he would start a sentence and then suddenly stop talking, as if frozen. He would forget to do small things, like button his shirt. He was irritable and angry. But slowly, she said, he improved. By the spring of 2010, about six months after his return, most things had returned to normal, she said. "I've dealt with him coming back from Iraq before without any complications. This was just a little different," she said.

"I think that had a lot to do with the rocket attack."

Seeking Help

Savelkoul returned to Minot and moved in with his father, into a 16-by-80-foot mobile home on the southern edge of town. On April 3, he posted on Facebook, referring to his profile picture. "Home!! Great to be home with family!!! Guess I should take that Army pic down and put up a civilian pic ... errr don't want to but that's what I am now." He tried to continue psychological treatments, but Minot is 271 miles from the nearest Veterans Affairs hospital. He started to make the drive several times but would get spooked when going under overpasses, often the site of insurgent attacks in Iraq. Savelkoul also sought help at a local VA clinic in Minot, but his counselor left. He tried going up to the Air Force base north of town but didn't feel like he fit in.

Savelkoul's troubles in finding treatment were not unusual. The majority of VA patients are older and served in the Vietnam War. The VA has struggled to figure out how best to adapt to the newer, younger veterans now seeking mental health counseling and therapy. The issue is especially acute in rural areas.

Savelkoul's family noticed how much he had changed. He couldn't remember birthdays, anniversaries or even the date his mother had died. On a shopping trip with Angie, he didn't recognize the house where they had grown up. He seemed uncoordinated and had trouble playing catch with his nephew. Trips to the Minot Zoo and a Minnesota Twins baseball game ended in disaster when he grew panicked at the crowds around him.

"All these people are dead. Why should I be alive? I'm lost. I'm confused," he would tell Angie.

The family felt confused, too, and unsure what to do. As a nurse, Angie was upset at all the different medications Savelkoul was taking -- antidepressants, antipsychotics, mood stabilizers, sleeping pills. "They weren't doing anything for his symptoms," Angie said. "Every doctor he'd see, they'd give him something different. ... You get that many meds, they interact with each other. They can be dangerous."

"We wanted him home because we thought he needed family," Bruce said. "He was not ready for the real world. ... We didn't know how to handle him."

On the evening of Sept. 21, Brock sent Angie and Bruce a text message. It read: "I love you guys more than anything. Never forget it. I can't do this anymore."

Bruce raced home. On the stove, Bruce found a grocery list that Brock had begun with the word "butter" at the top. After that, Brock had scrawled a note. It read: "No hope for me. Love you so much."

A licensed gun dealer, Bruce found that Brock had ripped open boxes containing guns that he planned to sell. Missing was a DPMS AR-15, an assault rifle similar to the M16 used in Iraq, two hunting rifles and three handguns. Also gone were two 30-round magazines and several hundred rounds of hollow point ammunition.

Bruce went to Brock's room and found he had destroyed his laptop computer. He also had smashed open a small, wooden case that hung next to his bed. It contained photos, mementos and awards from Iraq. He had taken out his Purple Heart.

Bruce knew he had no alternative. He called the police on his own son. "I didn't know what to do. I thought that he was gonna hate me forever, but I really had to call the cops," he said.

The hunt for Savelkoul had begun.

The Chase

At around 6:20 p.m. on Sept. 21, Savelkoul walked into a convenience store called the Kum N Go in Watford City, a small town about 120 miles west of Minot. Police records say that he pointed a rifle at one of the patrons and asked, "Do you want to die?" Then he fled the store.

He headed south down Highway 85, a narrow, two-lane road undergoing construction repairs. A Watford City police cruiser heard the call about the altercation at the Kum N Go, spotted Savelkoul headed out of the city and turned on his lights and siren.

Savelkoul gunned his Tacoma through the narrow gravel beds of the construction zone. He kept going faster and faster, 60, 70, 80, until he hit 105 miles an hour, police records say, flying down the arrow straight road, across the river, toward the North Dakota badlands.

Back home, Angie and Bruce had told a friend from the local police department about Brock's past, that he was a veteran suffering from PTSD, and heavily armed. The friend relayed the information to the police chasing Savelkoul. As the chase progressed, the friend would call Angie and Bruce to give updates. In the background, they could hear the dispatchers talk as more and more police officers were called in to stop Savelkoul.

Bruce Savelkoul realized that his son was driving toward the same area where they had stood together 15 years earlier, to shoot his prized deer. "I don't know that anybody can say why somebody wants to kill themselves," Bruce said. "But that was one of the favorite places he'd been in his life. Maybe a person wants to go to a favorite place to die. That's what I think. I think his mission that night was to die."

The chase, captured on video cameras mounted on Highway Patrol cruisers, unfolded like a movie. When a patrol car attempted to block Savelkoul's route, he pulled off the highway, bouncing through high grass, blasting through a barbed-wire fence. A few minutes later, he roared back on the highway. Finally, out of gas, he pulled over on a farm road about 15 miles from the hunting grounds where he shot the deer. Within seconds, he was surrounded by sheriff's deputies, police officers and highway patrol troopers. They began yelling: "Drop the gun, drop the gun!"

The standoff was just beginning. Over the next two hours, Savelkoul paced, smoked, brandished weapons and even shot a round into the back of his pickup. On several occasions, Savelkoul disappeared from view behind his truck. Officers worried that he was attempting to sneak through the darkness to get behind them. At perhaps the most tense moment of the standoff, he came within feet of one of the patrol cars. Raising his 9-mm handgun to his side, he begged someone to shoot. "Go ahead, shoot me!" he yelled. As the officers held their fire, he reassured them he would not shoot first. "You already ... know that I won't ... hurt, I will not ever shoot, a law enforcement agent," he said. "This gun will go to my head before it will go to you. I guarantee it."

North Dakota State Trooper Megan Christopher never stopped talking to Brock during the two-hour standoff on Sept. 21, 2010. (John W. Poole/NPR)Through it all, one officer, Megan Christopher, talked to Savelkoul nonstop, working feverishly to save his life. Christopher had joined the North Dakota Highway patrol only two years earlier. With high cheekbones and bright blue eyes, she had already made her mark, helping chase down four fugitives featured on an episode of "America's Most Wanted." In her brown trooper's hat and carefully pressed uniform, she could pass for a real life version of the cop Frances McDormand played in the movie "Fargo."

On the evening of Sept. 21, she had been sitting down to dinner when the call came in. She and her commander raced to join the chase. When Savelkoul finally ran out of gas, Christopher was one of the first on the scene.

Although she was a junior officer with no real training or experience in crisis negotiation, she was the first officer to use her patrol car megaphone to talk with Savelkoul. Savelkoul seemed to respond to Christopher, the only woman on the scene. "I tried to put myself in his shoes and empathize," she said. "I think my voice was softer and not expected."

Christopher tried anything she could think of to convince Savelkoul to surrender. When she learned his first name, she introduced herself. "Brock," she said. "My name is Megan." When Savelkoul took out a tube of Chapstick, Christopher needled him. "What kind of Chapstick was that? I need some," she said. "My lips are really dry now. I've been talking a lot." When he turned up the radio, Christopher tried to sing along. "La, la, la. It's time for Karaoke," she joked. She appealed to his past. "You sound like you're pretty proud of the medal that you have," she said, referring to his Purple Heart. "I appreciate everything that you've done for your country, for me and my country." She urged him to think of his future. "You have a lot of people who want to help you," she said. "What you're doing is not fair to anybody. And especially not to you."

With a cell phone in one hand to communicate with one of Savelkoul's friends and a microphone in the other, Christopher never stopped the chatter and never left her position crouched behind the door of her patrol car. The cold cramped her hands. The sleet soaked her uniform. Over and over, she made a simple, emotional plea: She wanted to meet Savelkoul in person, alive and well. "Brock, I'd like to meet you. Put the gun down so we can meet," she said.

Finally, at about 9:30 p.m., more than three hours after the chase began, Savelkoul aimed his gun toward the open prairie and fired a round. Then, the videotape shows, he walked toward Christopher. After she promised to give him a cell phone if he put down the gun, he placed it at his feet. Christopher walked toward him, holding the cell phone in front of her, her own weapon holstered. Her voice broke as she neared him. "I'm kinda new at this. Sorry," she said. "I think I'm going to cry."

Suddenly, Savelkoul turned toward her. Two coiled, white wires unspool through the night air. Another officer, believing that Savelkoul was turning to attack, had fired his Taser, a weapon designed to shock a person into incapacitation. Savelkoul stiffened and fell to the ground. Police officers ran toward him from all sides, their knees on his back, arms, legs. They handcuffed Savelkoul. Christopher walked toward him and knelt. She put her hand to his cheek.

"I'm Megan," she said, "I'm glad I get to meet you."

New Mission

In November 2009, Lt. Col. Mike Russell presented his initial findings involving Savelkoul and nearly 300 other soldiers at the annual meeting of the National Academy of Neuropsychology. His conclusion: The primary test the Army was using to evaluate whether soldiers had suffered concussions was "only slightly better than a coin toss." Another tool being deployed was even worse. The tests were fixable, Russell told the gathering, but the Army was still a long way from diagnosing and treating soldiers like Savelkoul and his buddies. "We did not design our health care system for mild traumatic brain injury," Russell told the audience. "There are a tremendous number of people who have concussions ... meet the diagnostic criteria for mild traumatic brain injury, that never seek professional attention."

Russell's work featured prominently in the Army's Surgeon General's testimony before Congress on problems at the military's top medical center for brain injury. The Army is working now to develop better tests. Russell has recently launched a follow-up investigation in which he hopes to re-evaluate the soldiers in his original study.

In October 2010, a few months after Congress learned of Russell's results, Staff Sgt. Derrick Junge redeployed to Afghanistan. Before he left, he visited a doctor for the first time since the January 2009 blast, discussing his troubles with short-term memory and concentration. The doctor recommended that he visit Fort Campbell's clinic for traumatic brain injury. Junge declined. "I told them to hold off. I didn't want it to keep me from deploying," he said. Last month, Junge survived another roadside explosion while on a convoy with his men in Paktika, a remote province in southern Afghanistan. He was checked by a medic, who cleared him to return to duty, said his wife, Holly. Junge, who has only occasional access to e-mail, could not be reached for details. Holly said that her husband continued to have problems with his memory. On a recent break, he suggested renewing their wedding vows. He asked her to write down his request in case he later forgot making it. "It's worrisome," she said. "I told him that as long as he doesn't forget my name and the kid's names, we're OK."

Brock Savelkoul completed the eight-week residential treatment program at the St. Cloud VA hospital. He now lives in Fargo, N.D., with his new dog Lucky and continues treatments as part of the deal to dismiss the three felony charges against him. (Katie Hayes Luke)Hollingshead is still seeking steady work. He and his wife are looking forward to the birth of their first child this summer. Memories of the blast still haunt him, he said. "We weren't missing an arm or a leg or a finger. We weren't bleeding. But the brain is just as important. If it's injured, it's injured. I'm going to have these issues for the rest of my life," he said. Hollingshead is still waiting for an appointment to see a doctor at the nearest VA hospital, which is 45 minutes away. He has already signed up to be in Russell's follow-up study. "I'd like to get an MRI and do whatever. It'll help soldiers down the line later on. What they find out in me might help somebody else later on. Anything that I can do to help the future, I'll do it."

Fuller, now a sergeant, and Hopkins have both redeployed to Iraq. Fuller, who has had a ringing in his ears since the explosion, said he is returning to the war zone convinced of the severity of even mild traumatic brain injuries. "TBI effects different people in different ways. It's critical that this is discussed. It's a serious injury, even though you can't see it," Fuller said. A few days after his arrival, he visited the trailer where the January 2009 blast had occurred. It still stands, the shrapnel holes patched with white caulking.

Prosecutors charged Savelkoul with three felonies and a misdemeanor. His sister, father and a local veterans' advocate lobbied North Dakota's governor and other officials, urging that he get treatment instead of remaining in jail. At a court hearing in October, the judge agreed to release Savelkoul on a $10,000 bond, as long as he attended a VA treatment program.

In December, Savelkoul was committed to a psychological lockdown ward at the Fargo VA hospital as he waited for an opening at the nearest VA residential treatment program. He was the only patient on the ward. His room had a single plastic chair and a single bed. There was nothing sharp. The bathroom door was a piece of foam covered in soft beige fabric. He looked hollow, bewildered and tired. He said that he could not recall details of the police standoff. But he did recall wanting to end it all.

"I was suicidal. That was the main plan," he said. "I was thinking that I was worthless, about the constant struggle I was putting my family through. Family is everything to me. Having to see them go through what they were going through for me was too much. It all came to an overwhelming point."

A private man, embarrassed over what had happened, he spoke guardedly about his experiences: the blast, the trip to Thailand, the psychological breakdowns. He said he had difficulty adjusting to civilian life. He had loved the Army and had planned to make his career there. Now, he said, he felt like a failure for being unable to stay in.

"Civilian life is so slow that it's hard. You don't have that day-to-day adrenaline. Everything that goes through your mind is, I've got to do something different. Maybe I can do something more dangerous," he said.

"Now it's my goal, or my mission, to do whatever it takes to get better for them and for myself."

Eight weeks later, on Jan. 31, Savelkoul finished residential treatment at the St. Cloud VA. As part of it, he completed a program for alcoholism and a second program to help him deal with post-traumatic stress. He and a small group of other veterans had undergone so-called "exposure therapy," remembering and reliving the events that seared them. He called it an "educated hell," a kind of boot camp for the mind to help him regain control of his emotions. "I finally got to talk about the demons and what the real demons were," he said. "We talked, we cried together and we shared intimate details that won't ever leave that room. It helped a lot."

Under a plea deal reached this month, Savelkoul will have the felony charges dropped if he meets a series of conditions, including remaining in treatment until he is cleared by a doctor. He's now back in Fargo, where he is receiving outpatient treatment from the local VA. He recently rented an apartment and bought a dog, whom he named Lucky. He wants to attend school and resume a normal life, perhaps aiding other veterans in similar situations.

One day last month, he climbed into his black Tacoma pickup—restored with $11,000 worth of repairs since the chase. He drove through minus-15 degree weather to a coffee shop a few miles from the Veterans Affairs hospital. Snow covered the ground. The sky stretched endless and blue above the city.

Savelkoul seemed more at peace, more rested, more confident of the life ahead of him. He had taken the first steps, he said, toward understanding the war in his mind. He said that the VA and the military were helping.

"They teach us how to get over there," he said. "Now they need to teach us how to get back."

this is DU poisoning..it is NOT “bedeviling”...they KNOW what it is..there is no cure -

so angry at our government for allowing this..

Tremendous journey and story - I hope and pray all involved find peace and purpose.

Mike McLaughlin

March 22, 2011, 2:20 p.m.

in 1988 our oldest son was hit by a car while he was riding a bicycle in training for a triathlon. He had a TBI and lots of other injuries. He developed PTSD while in recovery for his physical injuries. He received emergency and follow-up care at MCV, Medical College of Virginia.

His care was prompt, and excellent. He is now a productive member of society, working as a Certified Rehabilitation Counselor. Now he participates in Ultra-Triathlons.

In 1988 MCV had federal funding to help export their system to other hospitals.The methods of care that MCV used for our son should have been available for our service members for YEARS.

Gen. Chiarelli, with due respect, you are in deep denial. Medcom, DVBIC and DCoE have screwed the pooch. While Tomei figures look in line, we new about this years ago. Where are the senior medical officers responsible for the botched policies? Why is no one being fired? Why are the lack of scientific results not being investigated? Why has it taken so long cost so much and produced so little?

It is time to dig into this. 

We will be paying for this for the next 40 years.

Mr McLaughlin,
With all due respect, the PTSD suffered in wars is far more severe and different from one that’s suffered in RTA (road traffic accidents). Every case is different and whilst your son was able to respond well to therapy, other’s are not so lucky.

Barry Schmittou

March 22, 2011, 2:38 p.m.

Insurance companies are endangering numerous Psychological claimantsn the U.S. !!

In the case of Zanny verses MetLife, U.S. District Judge Richard Enslen wrote :

“Metlife and its henchmen should appreciate that such conduct may itself precipitate the suicide death of a person who has placed implicit trust in their organization. This record is an open indictment of MetLife’s practices and treatment of the mentally-ill and long-term disability benefits.

In my personal case my Psycologist wrote that MetLife caused my PTSD. Here are exact quotes from her report :

“It is my impression that three medical doctors paid by Metlife appeared to have ignored medical evidence. For example, Metlife’s paid consultant, Dr. Yanik, “evaluated” Mr. Schmittou without ever having seen him or his medical record from 2004 through 2008.

In fact, from the time he filed the claims in 2002 until the Court ordered a review in 2008, Metlife ignored both his claims for long-term disability based on vision impairments and on psychological impairments. In treatment, I have observed that the impact of such actions by Metlife has resulted in exacerbation of Mr. Schmititou’s psychological symptoms and periods of significant destabilization.

While being diagnosed with cancer was itself traumatizing, the subsequent nine-year struggle with Metlife has proved even more devastating to Mr. Schmittou. His COBRA insurance expired. He had no money for food, housing, insurance, medical treatment, or medication for four years until he received Social Security Disability benefits. His credit has been ruined. He has had to move in with his parents. He has developed desperate fears about homelessness. Understandably, his mental health deteriorated, traumatized by this threat to his life, his well-being, his sense of wholeness.

Now, in addition to his impaired vision, he has intense psychological distress, impaired concentration, impaired frustration tolerance, fitful sleep, irritability, and hypervigilance, all hallmarks of Post-traumatic Stress Disorder (PTSD). As a result, he is at greater risk for impulsive acts against himself or others.

At various times, Mr. Schmittou has informed Metlife how desperate he has become. He has begged Metlife to stop the delays and obfuscations, because they added to his stress and depression, even to the point he often wished he were dead. Currently, he is so demoralized he is not seeking treatment for suspicious skin lesions or disturbing GI symptoms.

In light of the violations Metlife has committed against Mr. Schmittou and Metlife’s awareness of the additional harm caused him, Metlife’s actions seem irresponsible, inhumane, dangerous, and reckless.”

(end of quotes)

To see many more case quotes including quotes from numerous U.S. Judges’ who wrote that doctors’ paid by Metlife have ignored brain lesions, Multiple Sclerosis, and a foot a new mother broke in five places, please go to the following website where you will also see how the DOL and DOJ refuse to enforce numerous laws :

http://www.obamaknowsdoctorscrimesendangerlives.blogspot.com

To see how identical crimes are being committed by multiple insurance companies in five different types of insurance including injured war zone contractors and injured American workers please go to :

http://www.5typesofdeadlyinsurancecompanycrimes.blogspot.com

(Bullet point one of that website is in reference to the first link listed above)

I pray someone will help soon because thousands of lives are being destroyed every year !!

Gen. Chiarelli is confusing activity with achievement.

Mike McLaughlin

March 22, 2011, 4:18 p.m.

Dr, Chaudhry states: “. . . the PTSD suffered in wars is far more severe and different from one that’s suffered in RTA (road traffic accidents). Every case is different and whilst your son was able to respond well to therapy, other’s are not so lucky.”

I agree with you Dr. I fully recognize that “battle PTSD” is significantly different, usually (but not necessarily) worse than getting run down by a Chrysler on a rural road.

My point is: Why hasn’t the DOD adopted, or at least studied, MCV’s program of 1988? It has only been known for a mere 20 years!

Barry Schmittou

March 22, 2011, 4:27 p.m.

It is very embarrassing but I am trying to share my PTSD hoping it will help others.

Every human has a breaking point !!

My PTSD was caused by three MetLife doctor’s ignoring my eye cancer.

I can’t begin to imagine how bad the soldiers in war zones PTSD makes them feel !!!!

Here are quotes from an urgent letter that my Psychologist wrote to Assistant Secretary of Labor Ms. Borzi and Metlife Senior Management on December 2nd, 2010.

“His intense emotional misery is a daily struggle. His thoughts and emotions are so troubled he describes feeling “like my brain is on fire”. I think he struggles to express the fullness of his distress. The fact that he has not sought recommended medical treatment for a variety of physical symptoms because he “doesn’t see the use” is evidence of the severity of his depression, in my opinion.”

“I have deep concern for my patient if he has to repeat the appeals process. He needs for this claim ordeal to be over.”

After receiving this, the DOL Directors’ instructed me to be sure to file the appeal.

Obviously the U.S. Government does not understand how serious PTSD is !!

The DOL is also responsible for regulating the benefits for injured war zone contractors’ and they are doing a horrendous job as evidenced in the reporting of T. Christian Miller.

I respectfully request that ProPublica will become more demanding with the U.S. Government and seek immediate resolution and recognition of the dangers of PTSD and all the other problems I have posted on the websites I listed above !!

I feel very fortunate that instead of harming the insurance company or others I have been able to internalize the anger from having no money for medical while three insurance company doctors’ ignored my eye cancer problems and other visual problems.

The internalization has destroyed my life as evidenced by how much I post on your web comments, and many times after I post I fall or nearly fall due to the extreme strain that typing causes.

God please be with everyone who has PTSD or any medical problems !! Your experience with the insurance companies and the U.S. government may be even worse than the disease you have !!

Steve Pittsley

March 22, 2011, 8:31 p.m.

This is nothing new; The same injuries have occurred , and been suffered from, since Caemen fought with clubs. Tens of thousands of soldiers suffered from it , in WW ll ( Just ask Gen. Patton )  However , there were always SO MANY calsaulties, the ” No Blood , No Foul ” rule went into place.
  Today , with the amounts of causaulties so Very Low , theses injuries are now evident. Its not likw this is anything bew, that needs New attention ..  War , is hell, we all know that ... And Injuries DO happen , there is no way to avoid them . Now, it’s time to step - up, and help these guys that gave so much for their country . The cost /  Geez, if we had WW ll now, we couldn’t afford the bandages, never mind anything else.
    Cost should never be a factor, when you are talking lives…

They are all heroes, and I hope they all get the help they need.  I agree that this will haunt us for decades.  I hope Brock and his family know how much we appreciate him, and hope he hangs in there and gets better.  I will try to make sure soldiers returning to my state of Maine, and their families are getting the help and support they need. Thanks for an excellent, eye-opening article.

Such a sad story that these young men, and women, are going through.  I know that a concussion from an incident as this is not as serious as a injury from sports, but it seems our highschool has better tools to monitor our athletes to see if they received a concussion and how severe.  If a high school can have programs like this, why is it that our military doesn’t?

I pray always for the health and well being of all our men and women serving the military.  And for all the innocient country men that will have these same problems.

Amazing piece as always. Propublica reports items you don’t normally get from mainstream media (except NPR, possibly).

“...It is an epidemic so new that doctors aren’t even sure what to call it, let alone how best to diagnose and treat it…”

Is that a joke?  ‘Cuz I’m not laughing.  It’s called WAR!  This country is obsessed with WAR.  Not real war which is ugly, crazy and kills/injures people, but good ol’ American war with great camera angles of shiny jets carrying phallic-looking missiles, and late night shots of cruise missiles rising from the deck of a Navy ship.  The camera feeds from “embedded” journalists showing cheering natives are replayed so often as to be permanently writ upon our drug addled brains. This edited, airbrushed version of war is more a recruitment film than reality.  So, is it any wonder that the Pentagon and the media in general, don’t want to spoil the fun by addressing very real outcomes of this obsession with WAR?

I was the weapons officer ( trigger woman ) on an ah-64a Apache Longbow, in the 100 hours war called Desert Storm. My crew and i blew up more Iraqi armor , trucks, and Soldiers than anyone could possibly imagine.  Route 80, between Kuwait and Iraq was a wasteland of machines and dead bodies. The things I saw , the things I did , will be with me forever . After two days, we just stopped vehicles, ordered everyone out, and blew iy up; we decided, as a crew, that we had killed enough . Other crews, well, some were animals. they killed everything; men , women , kids, goats. camels.. anything that moved .
    It was not war , but Hell, for them.. more like a Video game for us…
      The things we do , in war ... God have mercy .........

Julia Hugo Rachel

March 23, 2011, 7:55 p.m.

The Travesty here is that you have 2 groups in-fighting. PTSD vs. TBI. This in-fighting needs to STOP NOW. Some soldiers have TBI, some Soldiers have PTSD and Some soldiers have Both.

Then there is more…..some soldiers have GWI and it gets misdiagnosed as PTSD. Up to 50% of GWI cases are viral in etiology and can be treated. There are also environmental toxins involved.

My point is:
get the CORRECT DIAGNOSIS by:
A) Get the high resolution Brain Scans
B) PTSD Testing
C) Viral and Pathogen Testing

This is NOT Rocket Science….and these ARE Soldiers. STEP IT UP USA!

VLG on Valcyte Blog

Brother I understand what you been thru be at peace now god can help you.

My brother was hit severely, by a sniper round.  Blood-flow to the brain may have stopped several times, when efforts to resuscitate had to be employed.  He’s ODed on illegal drugs twice and is now in a program through the Houston VA.  What should we be looking for, in an effective program.  He’s intelligent and devious…  He knows what to say, to convince the Dr.s…

I am always surprised, in discussions about US soldiers and war, that so little is mentioned about the moral, ethical and karmic consequences of volunteering to serve in the military-industrial complex which is all about invading and occupying small countries in order to secure their natural resources for exploitation by multinational corporations.
Let’s face it, anybody who is old enough to volunteer for US military- an institution dedicated to US hegemony- is old enough to find out that these wars are illegal, immoral and horrible, and that joining the military will involve doing bad things to people in faraway lands.
There are consequences for participating in wars that are NOT about “protecting our freedoms” or “protecting us from terrorists.”
I would suggest that all soldiers renounce war and work for peace. This will help their souls, their PTSD, etc.
But if you pick up a gun to serve the Empire, you are very likely to damage yourself, and a lot of innocent foreign civilians, in the process.

Narelle Dimond

March 24, 2011, 4:10 a.m.

Having worked voluntary with PTSD sufferers from the Vietnam war. I decided to make PTSD my major in post graduate studies. I noticed that there were many variences of behaviour between 2nd World War Vetrans and Vietnam Veterans. I also noticed the differences between PTSD sufferers that were Police Officers, Doctors, Fire workers, etc. My comments are that you cannot put all PTSD sufferers into any category nor can you treat them the same.

The only common answer that comes from any PTSD is that they feel lost and seperate from humanity, almost alien. The middle east wars are producing a further variation. I am very concerned that all soldiers get warfare training at various levels but get no training on how to fit back into society when they return. The drugs given are no answer to their nightmares, nor telling them they are lucky to come back alive and to get on with their lives.Most either become drug (both medical & self inflicted)dependent or alcaholics.Most find it impossible to remain in a relationship and drift in and out of employment.

PTSD is a psychological issue that needs more investment for study, millions go to aids research, cancer, research but very little is given to this research yet the world wars and trauma’s are producing more sufferers daily, far mor than the former medical conditions. If these brave people give part of their lives to fight for justice then all justice should be given to their reabilitation when they return from these gastly wars. All countries in the world need to support and learn to understand this horrible health problem because it affects not only soldiers but all humanity at some point.

Karl,
  It’s not about “invading” unless some leader decides that’s the way to go.  In response, without the military, we would have no defenses.  Add that our (USA) current objectives are to protect innocent lives (most of our bases outside the US are a ‘show of power.’ to reduce the likelihood of war) and in response to the September 11th attacks by a militant Islamic regime/extremist-religious group (jihad).  In Iran, Iraq and Afghanistan, we are defending the weak, aiding the injured and suppressed and fighting evil.  Of note, in ALL of the Middle East, we are part of U.N. forces.  We are not alone, in the goals of peace and prosperity for the world.  Without freedom of speech, freedom of dissent, you would not even be allowed to speak in this manner.
  Jihadists believe that, not only are THEY the chosen master race, but that anyone of lesser purity is to be put to death.  You would have already been put to death, by your father, for getting caught THINKING of anything less than total annihilation of the rest of the human race.

Dan Fredrickson

March 24, 2011, 11:05 a.m.

I have a clinic that successfully treats and cures TBI and PTSD with hyperbaric oxygen. Congress just cut a bill to treat our vets with hyperbaric oxygen in the last Military Appro. Bill at the last minute because of pressure by drug companies. We have treated several Vets for free and have had outstanding results. We have been able to get these great men and women off there drugs and back to a healthy life. advancedhyperbraics.com look under the veterans section to see what’s been done so far. I’m a retired Navy diver and have been curing people with brain problems for over 30 years. When is the medical society going to catch and look to a non-drug therapy that cures the problem instead of masking the symptoms.

@JK Frusha & Steve: I am surprised that people visiting Pro Publica would be so enamored of the official cover story regarding why the US invades and occupies small countries. “In Iran, Iraq and Afghanistan, we are defending the weak, aiding the injured and suppressed and fighting evil.” This is so Orwellian and bizarre, all I can ask is, have you seen what the US military has done to the land, infrastructure and innocent civilians in the countries it invades? Have you forgotten that Bush lied about the reasons to go to war, used torture, etc.? Have you forgotten General Eisenhower’s warning about the military-industrial complex which today is the controlling force in our country? I don’t like fundamentalists of any type, be they Muslim, Christian or American is the Savior types. The USA is not spreading peace. Starting with Vietnam, continuing with Ronnie’s covert, illegal wars in Central America, and now to our hegemonistic invasions in the Middle East, it is all about money and power. These wars do not protect my freedom, or protect me from Jihadists. These wars make the world a more brutal place. Those are the facts, my friends.

Karl,
  You’re more than welcome to move.  The Russians might have a use for you.  Convert to Islam and you’d learn that converts don’t get into their heaven and should, like all infidels and unclean, less than pure-blooded should be killed.
  I believe you’ve forgotten the abandoned SCUD missiles that showed residual Ricin, Mustard Gas, Nerve Gas and other poisons, which, by definition, are weapons of mass destruction.  Disarmed and abandoned, but intent and equipment was in place.
  You haven’t seen the Terabytes of video that shows the cheering populace, because it doesn’t make for ‘good TV.’  Death and destruction is the order of the day, because it captivates the masses.
  My brother nearly died because he was over there.  He wishes he was able to go back.  Not because he likes killing, but because it IS the good fight.
  As for religious fanatics, they are everywhere.  Look around you.  Westboro is probably ready to recruit you.  Extreme fundamentalists came and attacked us, the US, first, then they started in on the rest of the world.  We took the fight back to them.  The countries that were also attacked, have joined us.  The ones that didn’t are beginning to submit to Islam, the next Communism.
  I had a friend that immigrated to the US after the war began.  His on stupidity got him killed in a motorcycle accident.  Most of what little he earned, went to his family, in Iraq, in a blown apart city.  They live and work in a city that was almost blown off the map…  THEY are some that continue to cheer the troops on, over there.

So Karl , we’ll just totally forget about the 117, 000 bodies found ( So far ) Buried in the desert by Saddam . You are right , they do not deserve justice; just forget them, and all the rest of the people who WOULD have died by the hand of the worst killer since Hitler .  Just as we should forget about his Jewish Victims.
  We should NEVER have gone to war agaimst Hitler either ; Scre w Europe, why should Ford get rich selling Tanks and Planes, and Colt make a fortune selling the military pistils.
  You know, iIm so sick of hearing about how President Bush lied, yak , yak , yak ..Roosevelt lied too; he had to, to get America to move to do the right thing ; America, unfortunately, has always had such an Isolationist attitude . Even today , we allow people to be butchered by these animalistic dictators, sitting on our hands, while the same Bleeding Hearts pretend to shake their fists in indignation .
They are the people that walk by a man , face down in blood on the subway , and do nothing.  They give a couple bucks towrads shelter , and pat each other on the back at their cocktail parties
    All safe and secure, here in America .. thousands of miles away from the real world. , they have No Idea what is happening.. At least , i HOPE they do not; for if they did, and still choose to do nothing, then All is lost .  They will wake - up , perhaps, when they are being led to the ” Showers ” ... God Bless America, God Bless the President, and God Bless those who are in need of our help, that will Nevr receive it .
    Go see the people of Iraq; ask them, are you glad Saddam is gone.. see if they do not kiss your feet
    If Blood suckers are going to make money , selling weapons for war , let them be Americans , rather than Chinese.. Let america profit , Not the Communist . Remember them .the Communist that would bury America ? they are still there .. They are still willing to bury us ; China is NOT our friend. I donot know how we will fight their 10 million plus troops, but we will have to , sooner than most people realize.
  But, I digress..  There is no way to change you, or anyone with such a convoluted view of the world ‘s mind; I know that .  But, I do know that I am right ; history proves it. Having been a part of the Greatest fighting force the World has ever known, I sleep well at night , with the knowledge they will keep us safe. You go to bed, sleeping well at night, because you send $18 every month to Sonis, the poor kid in Columbia .. .. Yeah , it IS a shame US troops couldn’t have been there , to save her parents ........... Nuff Said .

The ending statement by Savelkoul; “They teach us how to get over there,” he said. “Now they need to teach us how to get back.” is the key to dealing with PTSD. “Though we can never forget.”  We were taken from a jungle “in my war” and 24hrs later we were walking the streets at home and expected to just blend in. We consulted our chain of command and they wanted to punish us for saying anything demanding that we just fall in like everyone else.  We try but never really make it home.

If the military would set up debriefing centers where all returning combat troops were required to go after their tour for 60 to 90 days. A place where spit, polish and vigorous war training exercises are set aside for a while,  they might become reoriented troops able to cope with the abrupt change in life style, conditions, and location.  I actually brought this idea to the attention of the Army in 1970 but ultimately was punished, busted and thrown out of the Army as a result. I hope the best for this brother and understand his fight. I know he can peace through the peace maker Jesus Christ.

Edward Robinson

March 25, 2011, 8:08 p.m.

Thank you Dan Fredrickson for your continue service to military men & women and veterans with TBI & PTSD using Hyperbaric O2 Treament. As a former Navy Corpsman and diver I have studies how this treatment has worked very well and there is a better physical & mental recovery.
It is not just sad but sickening that with the recent cuts to the Military Appro.Bill that only a few veterans will have access to this “holistic” type of treatment that really works…

HBOT is unproven. Harch has been promoting this treatment for years without proving it works. So much of DCoE, DVBIC and AMEDD research is pure crap because of attraction to wonder and silly therapies. Billions have been pissed away and troops can’t even be properly screened because a cabal of self interested officers and SESs used a product called ANAM that has never worked and the Navy has proven recently does not work.

HBOT is being tested using ANAM as an end-point. It will show nothing of value.

Hey Steve,

Just a couple of questions….
1. In your little story about the things you did in Desert Storm…Did you mean highway 8?  Because Highway 80 was bombed by the navy….Highway 8 was the road that was attacked by the US Army AH-64’s…..

2.  How did you fly a Longbow in DS when that upgrade had not even been started yet? (Longbow is the name of the FCR located in the radome over the main rotor, this was not available in DS. As the FIRST production model was delivered in 1997)

Not trying to call you a liar…..If you served….Thank you….if your lying….Get some professional help….or research your lies a little better.

We were , indeed , assigned to patrol highway 80 , The Navy bombed the road ? ...I was wondering where those holes came from . . We were sent in as mop up , sweetie ... There were PLENTY of targets of opportunity, I assure you .
  and, sorry , but 87 Longbows were RUSHED into service, before they were even fully tested ...  The first in October , 1990 . You may not be able to ” Google ” that , Brainiac, as it was , indeed not let out, in case if ” Problems ’  with the systems .  sorry .. now run along, little boy , and get out your GI joes ...
      I DO know I was called back from Germany , spring , 1989 and sent to school to learn the new systems .

Hey George Bush…Brock and other young men/women from our Armed Forces want to thank you for sending them over there to Iraq for no reason at all.  I will be happy when Bush, Cheney & Rumsfeld are all hanging from the nearest street light.

WWII victims were shamed into hiding their nightmares.  Vietnam vets got rocks thrown at the bus as we were processed out in California. Now Brock says, “they teach us how to get there, but not how to get back.” I don’t believe it can be done so let’s stop teaching the first part.  Like a moth to flame, I am drawn to this drama and equally angry to read articles or comments from those without a clue.  It doesn’t help.  Forget us..help the kids…don’t start them on this death spiral.  That is unless of course everyone plans to participate so we can all understand what all of us have been through.  Promoting your agenda with a surrogate warrior is disgusting…do it yourself or shut up.

Coleman , I’m sure that no one with an arrest record as extensive as yours was ever allowed to serve a day in the Armed Forces .. ( Other than the Dirty Dozen , lol )  and James brown already has that role .

For you to even think you could speak for the Service men and women in our Armed Services is a Joke ..  Now get back on the corner and sell that Rock ...

AF veteran here. The politics of war is an enduring argument. I’m disheartened to see the derisive comments here. Until we can see that we’re all in this together, for better or for worse, nothing can or will change for ourselves or our combat wounded. Please read War and the Soul. Amazing book.
My greatest praise today goes to Christopher who used her humanity, perhaps against her training, to defuse a deadly situation. This would surely have had a different outcome in an urban setting. What saved Savelkoul’s life that day was his community.

Major Doug Rokke, Ph.D.

March 27, 2011, 1:59 p.m.

A hospital operator at Danville Illinois VA Medical center refused to connect me to help during my own personal ptsd crisis on friday night March 25, 2011 after argung and argiung some more while i am in personal ptsd crisis she connected me to the aod who i had to argue with some more until she finally connected me to an on call duty chaplian.  chaplain dixon was helping me until operator came back on to tell us to terminate the call which then happened. so i was left on my own abandoned by order of an operator who interferred with my ongoing needed crisis care for ptsd by those tasked to help us. it is entirely broken,.  there is no accountabilty. how many more vets abnd family members have been abandoned in time need. i know i hear the same story day after day.

The military has beeen slow to the call of addressing TBI and PTSD.  TBI is concidered a concussion in the eyes of leaders and soldiers you are accostum to expect themselves, their buddies and charges to tough it out, move out or rest to fight another day.  As long as the mission is accomplish.  PTSD is a mental tag that no one wants to have or condition to have and try to cope.  The civilian providers and community provides limited support or understanding at 5 million TBI’s, and still reluctant to address.  Add the 200,000 military veterans to the numbers with 5% having both PTSD and TBI .  SOMEONE NEEDS TO TAKE NOTICE.  I can understand why our troops denie a TBI,  they worry about the lable of PTSD, thus the mental tag,  being found nonf-fit for active duty released at 10% disabled and not cared for by the VA. The civilian approach is not any better.  Limited programs, funding and insurance deniels.  TBI mild or severe is long lasting pyschological and life changing effects, therapy and rehab limited and requires self care or supportive family.  America support and become aware.

Best of wishes for positive outcome for the members of this platoon.  I take offense to the label of which they are given and what it implies.

However, being both closely related to this subject and recovering victim of a nomcombatant TBI my feelings are not the issue. 

Being a healthcare provider during the initial identification, treatment and management of both TBI/PTSD prior to the current combine efforts of 2003-2007 I applaud the message being attempted.  I am happy to see this soldier getting the assistance due him.  It was not his fault for not being recognized in need of assistance. 

Being a retired vet I AM CERTAIN I too sustained many episodes of possible tbi’s that I dismissed as bumps on the head, or poor parachute landing.  Than an injury resulting in a severe TBI IN 2009, AS A CIVILIAN AND NONCOMBAT RELATED, chnged my life.

As was mention I have close ties to the subject matter of this article. One of the persons mention in this article, and I thank NPR for introducing this story and Propublica for noting Col. Terrio’s contribution and hard work.  Bringing to the forefront need of identification and care for TBI and PTSD.  She in my opinion was the initial organizer of the TBI effort along with her VA counter part, DVBIC Team, and her crew which I eventually became part of in 2006, prior to my own injury. Like an IED, sudden, unexpected and life alterating. 

Prior to injury I interviewed many of the returning troops here at our home base, which was not at FT Riley, A place I was familiar with and a former unit of assignment.  I would interview some from 1ST Inf Div on inprocessing to our post.  Thru them and others of our post,  I would learned what was to be experiencing during my own recovery, rehab and healing as described in this article.  After reading this story in its entirety, I would like to share my experiences.  With the intent and hope will be helpful in some manner.
1.  I sustained 3 severe TBIs at the same injury,  had post and pre injury amnesia, coma for 2 weeks.
2.  First problemn experienced was forgetfulness; while speaking with sister in law I had forgotten her first name.  I knew her and her husband, her parents, her kids.  I’ve known her since 1975.  When my wife and I married, but could not recall her first name.  Now I repeat it often so as not to embaress my self again.
3.  Forgetful of words, drop words, difficult recalling especially names or single events that I know I SHOULD RECALL.
4.  Yet have a FANASTIC long term memory RECALL of the past, short term is cloudy. Common in TBI’s.  Yet no 2 TBIs are the same.
5.  After 2 yrs starting to feel different, out of place.  Told I am forgetful but dont experience at time of occurence.
6. Easily frustrated and angered.  Only to be agitated.  Which is new since I am basically non-confrontational for last 35 yrs.

These are no sweat.  What worries me the possibility:
1. Alzheimers 2. Dementia 3. The other day read about tbi being consider preceptor to possible ALS-  Lou Gherig’s disease.  4.  Not to mention the typical worries of Seizures or Suicidal ideation.  5. Standoff with authorities.  5.  PTSD.

AM I JUST OVER REACTING BECAUSE I AM SO CLOSE TO THE ISSUE AND SEEING TOO MUCH INTO IT? 

I am the lucky one.  First i am alive.  I have 11 specialist being paid by the Work Comp ,  US Govt Dept of Labor at Medicare standard?  Than I have back up Tricare?????????  But the medical community is not convince those with TBI need the treatment that is recommended. 

Imagine what our soldiers go thru? 

I thought I was having signs of PTSD. 
My Physiatrist told me to have PTSD I had TO RECALL OR REMEMBER MY INJURY EVENT,  therefor I didn’t have PTSD. 

To be on the safeside when I seen my VA Provider for routine follow up.  He asked me point blank if I had seen a Psychiatrist.  Answer was no, he referred and he agrees meds for depression which I don’t RECOGNIZE and may recommend Cognitive Therapy which Tricare won’t pay for. 

Just recently , I feel like a different person than before my injury.  Wrapping up a great career and contributed meaningful care to our troops only needed 10 yrs until retirement under SSA if around.  Now disabled forced to call it quits,  but have desire to drive on.

NO WONDER OUR TROOPS FEEL CONFUSED, LOST AND FORGOTTEN.

I believe that the men and women who defend our country should have the absolute best services that we can offer.  These indidivuals give their own life so that I can type this response.  They leave family, friends and comfort to be exposed to some of the worst conditions ever and then when they come home they are treated like outcasts.  How is this okay?  I want every solider to know how much I appreciate everything you have sacraficed for my family and me.  You are in my heart the best of the best!

A LOT of these guys are just milking the system ; using it to cover the fact that they are lazy , and just DON’T want to work , or live in society . They get used to the Service, and then getbooted out, and they have to return to civilian life. They pretend injuries, to stay close to the VA , the soldiers that really made a difference.  Theywant to be counted as a Hero, not a zero ..
  So they go home, get drunk, beat their wife and kids, and blame it on PTSD . When, in fact, they would have done the same damn thing if they hadn’t been in the service.
    Slackers, hiding in the system .. And we have made the System soooo easy to exploit, they make a living off it, much like the Welfare slackers do ..
  Nuff Said .

Styeve,
  Did you conduct this research during your time in service or after you were honorably discharged?  Congratulations;  from you comments, it would likely take someone of officer status to complete such an indepth analysis.

Of course I received as an officer . I was given a Captain’s commission , just before I left . It was a nice parting gesture. Along with my Combat Ribbons, and Silver Star, just a few of the decorations I received for Honorable Service .... I came home, and Built a successful Landscape Design biz, and a Large commercial Green house. With four full - time employees, and several part - timers ( all but one are ex - Service, by the way )  It keeps me busy ... My guys are working out their demons, partially at MY expense, which I do not mind, and would never even consider a burden .  We ALL ” play in the dirt ” and bury our demons…..
    HUH ?  What ? ... oh, apology accepted ...
    Nuff Said ..

.........of course there’s those that ride the system and try to get every morsel owed them.  But I imply its not about them or their poor leadership.  Its about the suffering by the moms, dads, children, and wives who are at home trying to reason how come their love one is different now as compared to behavior prior to the deployment.  Why doesn’t his government not do what they said they would do?  Like fix them when they got broken and take care of them to repay the life long sacrifice made when injured?  Than there the non-military TBI, 5 MILLION,  ARE THEY RIDING THE SYSTEM?  To think or say these service men and women sacrificed their future and put themself in harms way only to get a free ride is obscene.  Nuf said!

Look, no one’s denying that the Vet’s need help; hell, I have days I need help as well.  I merely throw the System users out there to stir the pot.
    But, let’s face it ; war is hell, and its not just the Troops that suffer , as you say . But, it has always been that way , Hell, since troy was sacked, lol.  Probably Much earlier . Folks got by . they survived.  War was part of life, and death; it has always been . There are always casualties , and they either survuve, or not. All of this PTSD , etc. is NOT new ; nor is it something to be swept under the carpet . But , people have got to face the fact that some just will not be ” Healed ‘. I also get tired of these people griping about the Government forcing them into war, stupid wars, etc. etc. Since like August 1973, the military became all Voluntary .  You signed up , voluntary , KNOWING that there is a very real chance of fighting in a conflict Somewhere in the world. All these people that signed up to go to school ” Free ’  are finding out that itis , in fact Not Free.  Nothing was hidden from these people; they were all told, as I was, That there was a real chance of seeing Battle.
    Now, they want more than others. They deserve the VERY BEST in the way of treatments, but nothingmore than anyone who fought before them .  I know , as we become more ” Civilized ” we become softer , the average soldier becomes less and less likely to be willing to give his life for his country .  But, you go fight for a year ) some , just months or weeks ) and they think that the world owes them a living.
    Part of the Problem is these Doctors who are forever discovering ” New ” Ailments etc. Related to War . They set out to make a name for themselves, and they usually due. The proliferation of War injuries now far outanks the the weapons used ...
    I’m out of the game, and survived relatively intact ; I’ll never know the heartbreak of a lost linb, A tramatic head wound. If any of you guys in Iraq find a toe, its mine . You can keep it, i’m doing o.k. without it..
      Nuff said..

T. Miller’s Psycho Platoon story surely helped this reader develop some perspective on the TBI and PTSD on-going debate. So many previous articles were pointy fingers casting blame and creating doubt about the military having the will or inclination to find solutions. This article focused on some of the soldiers, on all levels, who are fighting hard to win the war against this evil, invasive, common enemy.  There are all kinds of heroes and Brock and his 4 buddies, who face this enemy head-on day in and day out;  General Chiarelli, who is trying to fight this enemy by empowering his troops to identify it before it does damage; and SmokeyBear-Hat Megan (I am women, hear me roar) who was the right woman in the right place at the right time to come up against this enemy all are heroes in my eyes.  From all the comments above, it looks as if Psycho Platoon is telling a needed story and creating a cause that ALL Americans can rally behind. 

Thank you, too, Daniel Zwerdling, for your accompanying story on NPR; it was a great collaboration.  The Dick Flick car chase thru the North Dakota Badlands in the middle of winter with Chick Flick Megan leading the charge complete with a happy ending is classic Youtube material.  I love it!

I am grateful that this young man will be getting the help he needs. It is sad that he had to go through all the changes in order to receive it. My son served in IOF and received the Purple Heart and I lost him 6 months after he returned home on Thanksgiving Day. Thank you for your sacrifice and may God be with you and guide you through al your troubled times.

This article is part of an ongoing investigation:
Brain Wars

Brain Wars: How the Military Is Failing Its Wounded

The military has failed to diagnose brain injuries in thousands of soldiers returning from overseas.

The Story So Far

Traumatic brain injury is considered the “signature wound” of soldiers fighting in Iraq and Afghanistan. Official military statistics show that more than 115,000 soldiers have suffered mild traumatic brain injuries since the wars began. Shock waves from roadside bombs can ripple through soldiers’ brains, causing damage that sometimes leaves no visible scars but may cause lasting mental and physical harm.

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