A war of arms, legs and minds

Michael Callahan | Boulder Weekly

Think about a time you had to deal with a difficult insurance claim, or feared recovery in the aftermath of an injury.


Now think about trying to deal with that after two, three or even four tours in a war zone while living in a fog that makes everyday life an onerous task. Many of our veterans are now facing just such a task.

With no military draft and a volunteer army fighting our battles, media that provides constant distractions from such things as the war, and a price tag for conflict that has yet to be fully assessed, a lack of awareness regarding the true costs of war has set in. For instance, many of us now believe that our soldiers are safer than in past wars because we are told that fewer than 7,000 have died on the battlefield in the past 10 years. But as our Global War on Terror forges ahead into a second decade, this supposed safety has been proven a myth for tens of thousands of our veterans.

Our nation has been programmed to view death rates as one measure of success for a mission or war. So when we hear that only 6,500 recorded deaths of U.S. personnel have occurred during a decade of war in multiple theaters — roughly the same number of dead as the 35-day Battle of Iwo Jima during World War II — it can lead one to believe that the wars in Afghanistan and Iraq represent a level of success. But the success is muted, considering that the Department of Defense claims we have nearly 47,000 wounded service members from those wars and the Veterans Administration reports that 508,152 veterans of those campaigns have been treated by the VA. Many have sustained injuries that in previous conflicts would have meant certain death. So instead of immortalization, like the iconic memory of American soldiers raising the flag during intense battle, many of today’s survivors return home to immobilization.

Americans wounded in World War II survived at a rate of 69 percent, a number that rose to around 76 percent during Vietnam. Today, the survival rate for wounded service members stands at about 91 percent. Medical technologies, better equipped and trained medics, and tactical expertise all help account for the dramatic increase in those saved in action. The flip side of such a glowing statistic is one that most of us overlook — the increasing number of wounded who survive, only to face the daunting challenge of surviving the rest of their lives dealing with their injuries.

Blast injuries are the most common injuries in Operation Enduring Freedom and Operation Iraqi Freedom, replacing the injuries from ballistic projectiles that marked the Vietnam era. In 2011, the U.S. military reported 16,554 improvised explosive device (IED) attacks, more than 45 per day. Despite improvements to vehicles and armor intended to deflect these homemade weapons, thousands of amputations have been necessary. The concussive blast that accompanies an IED often causes traumatic brain injury (TBI). An estimated 14 percent to 20 percent of our military service members have fallen victim to TBI during our most recent conflicts, while thousands more are thought to remain undiagnosed.

Being subjected to small arms fire on the way to work, knowing co-workers who died doing the same job, and having job duties that include handling human remains, it’s not hard to see how post-traumatic stress disorder (PTSD) might set in. A “hidden” ailment like TBI, PTSD can manifest itself long past the point where a gung-ho soldier steels himself for battle after getting his bell rung. The civilian rate of PTSD hovers at around 5 percent, but nearly 20 percent of our service members return from Iraq and Afghanistan with characteristics of PTSD.

Post-traumatic stress might not reveal itself until long after military duty ends, when the rigors of civilian life and re-acclimation to life outside the war zone take their toll. But many veterans don’t request outside assistance, perhaps because it goes against the fighting ethos they signed up for and acquired during their service.

“A lot of veterans say it’s easier to keep your mouth shut,” says Pamela Chapman, an Army vet who has worked with military personnel at the Colorado Vet Center in Denver as part of her graduate studies. “People have a hard time asking for help; it can be perceived as a sign of weakness. There’s a big stigma in asking for help.”

We assume our soldiers will have medical insurance coverage for their injuries, but that is not always the case. Despite what cutting-edge technology and invention provides to the battlefield, the reality of trying to navigate the world of health care benefits is its own challenge. All the talk of fast-response tactics and sweeping routs becomes moot in a society unprepared to deal with returning veterans who are truly casualties of war.

While many of us are detached from the war effort and live our lives with only the occasional media report to remind us of the conflict, the cost of the wounded veterans impacts us all because the true costs of a war doesn’t peak until decades after the conflict ends. Harvard professor Linda Bilmes and Nobel Prize laureate Joseph Stiglitz, co-authors of The Three Trillion Dollar War: The True Cost of the Iraq Conflict, note that the peak payout for medical claims from World War II didn’t happen until the 1980s, while claims from Vietnam have yet to peak. With eligible veterans of today’s conflicts applying for VA benefits at higher rates and greater severity of injuries than previous generations, the costs of helping our service men and women may prove to be the real empire breaker.

The American military has done a good job preventing soldiers from dying on the battlefield. But while saving a life at any cost is to be lauded, are we doing enough to ensure that the life forever changed by the hell of war will be properly cared for? Will those who have served our country and been injured be offered the best chance at recovering from their wounds, or should they just be happy to have survived?

“I think that a lot of people just want to get back to their lives quickly. But if you just give yourself a break, take it slowly, and realize that it will take time,” Chapman says, this self-help world will eventually provide assistance to those who need it most.

War is messy, especially for those brave men and women who fight them.

It’s time that we recognize that one the highest costs of fighting wars, at least in economic terms, is providing lifelong health care for our veterans.

Let’s hope that we have not become so detached from the wars that we wage that we forget to provide for those we send to do our fighting.

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