Cokie Roberts and Steven V. Roberts

Healing the Invisible Scars of War

One troubled veteran blows himself up on a busy street in the nation's capital. Another former soldier kills dogs, birds and finally a Cabinet officer in an increasingly desperate plea for help from his government.

The city is London, not Washington. The time is 1931, not today. The veterans fought in France and Belgium, not Iraq and Afghanistan. They are suffering from "shell shock," not "post-traumatic stress disorder." They are fictional characters depicted in Jacqueline Winspear's novel "Among the Mad," but their stories are true.

There is nothing new about veterans coming home from war with emotional and psychological wounds. But the problem is getting worse. The Associated Press reports that 45 percent of the 1.6 million veterans of Iraq and Afghanistan have filed benefit claims for service-related injuries, up from 21 percent during the Gulf War of the early 1990s, and mental disabilities are a driving force behind that sharp increase.

Eighteen veterans commit suicide every day. Newsweek estimates that more soldiers have died by their own hand than by enemy fire, and veterans organizations blame repeated deployments to dangerous and debilitating war zones. "You just can't keep sending people into war five, six or seven times and expect that they're going to come home just fine," says Barry Jesinoski, executive director of Disabled American Veterans.

The news is not all bad. Better body armor and battlefield medicine mean that many more veterans are surviving wounds that once would have killed them. "Aggressive outreach and advocacy efforts also have brought more veterans into the system," The Associated Press reports.

But that means the system is overloaded, and many veterans who need help are not getting it -- or at least not fast enough. The Government Accountability Office says the time it takes to process disability claims has jumped by about 50 percent. It blames staff shortages, outmoded data collection and ferocious rivalries between the Pentagon and the Department of Veterans Affairs.

"We are finding it next to impossible to tear down the walls of bureaucracy," says Rep. Jeff Miller, the Florida Republican who heads the Veterans Affairs Committee.

Fortunately, private volunteer efforts are stepping into this vacuum. One of the most useful is Give an Hour, founded by clinical psychologist Barbara Van Dahlen. We were privileged to serve as hosts for the organization's first fundraising dinner recently, and we learned that it has recruited more than 6,000 mental health professionals who have donated almost 50,000 hours of free care to returning service members.

One veteran helped by Give an Hour is Jennifer Crane, who joined the military at 17 and was sent to Afghanistan three years later. Crane now works for the organization, and at the dinner -- with her heavily tattooed arms revealed by her sleeveless evening dress -- she told her story.

Three weeks into her deployment, a close friend was killed and Crane served on the funeral detail. A month later, her base was attacked by mortar shells that caused severe casualties. "The images of their injuries," she says, "including lost limbs and severe head and face trauma, will always be imprinted on my brain."

After her return to the States, Crane said, she became totally isolated and alienated, a stranger in her own country. She experienced the classic symptoms of post-traumatic stress disorder: night terrors, paranoia, hostility, depression. She used drugs, lost her home, sold her body. She was a "broken human being."

Another speaker was Justin Constantine, a Marine major whose face was shattered by a sniper's bullet in Iraq. Everyone can see his wounds, and in some ways that makes his life easier, he said. People can understand his suffering and his sacrifice. Veterans like Crane, who bear invisible scars, still encounter ignorance and prejudice.

The warrior culture can treat them as weak malingerers, says Justin Weis, a former Marine who suffers from PTSD. "It's like the lepers," he told the Dayton Daily News. "Don't touch that dude. Stay away from him." Adds Heidi Kraft, a former Navy psychologist: "This has been a long haul (for) a culture that hasn't had a lot of tolerance for anything but emotional perfection, and there needed to be a shift in the way we think about combat trauma and its treatment."

Thanks to groups like Give an Hour, that shift is slowly happening. Crane's damaged spirit should be as recognized and respected as Constantine's damaged smile.

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