Playboy has been doing some excellent reporting recently. Here’s an excerpt from a giant piece they’ve done on Post-Traumatic Stress Disorder.
Given the inevitability of psychological scarring in intense, prolonged conflicts, it is odd that the two bureaucracies most responsible for the mental health of American troops — the Department of Veterans Affairs and the Department of Defense — have taken steps to downplay the psychological toll of the war. According to sources I spoke to in the Pentagon and former officials in the VA, DOD and VA doctors are being pressured to limit diagnoses of PTSD in order to save the military money and manpower. The DOD’s official medical policy toward PTSD was recently amended to include new criteria making it a virtual certainty that many soldiers who exhibit symptoms of the disease will not be diagnosed. And the VA itself has been quietly working to arrive at new, stricter formulations of PTSD — contradicting those of the American Psychiatric Association — that would allow the agency to diagnose far fewer cases.
“Some people would argue that it’s malicious and intentional, but to me it’s a reflection of the military mind-set,” says Steve Robinson, a 20-year veteran of the Special Forces who recently became a full-time policy advocate. “The Department of Defense is not a health care provider. It couldn’t do the right thing if it wanted to because of how much money it would cost and how many doctors it would take. It’s a matter of capacity. The number of people seeking care versus the number of doctors available to provide that care nationwide across the whole armed services is out of whack.”
At the same time, politics may play a part in the underallocation of resources to PTSD patients. The soldier has tremendous symbolic power in American politics. Healthy, happy soldiers bespeak a just war. Look at how the Greatest Generation exemplifies the nobility of World War II. The converse is also true: A ruined soldier bespeaks a ruinous war. In the mid-1970s the image of the shell-shocked vet wandering the streets like a character out of The Deer Hunter or Taxi Driver had a lot to do with discrediting the Vietnam war as a failed enterprise. This lesson has not been lost on a loose alliance of neoconservative psychiatrists and fiscal conservatives who are lobbying behind the scenes to limit the number of PTSD cases the government diagnoses, treats and compensates.
To this group it’s essential that Iraq not be seen as Vietnam redux. Soldiers like Burgoyne who have been scorched by their combat experiences are therefore an embarrassment. Like the amputees and flag-draped coffins the administration hides from public view, such soldiers are antithetical to the hawkish goal of mitigating the costs of the conflict. The critical difference, of course, is that mental illness isn’t always obvious and is therefore easier to sweep under the rug. As one congressional staffer put it, “It’s much easier to deny the reality of mental illness than it is to deny the spinal cord injury of some guy sitting in a wheelchair.”
Burgoyne was supposed to be evacuated from Kuwait because he was a threat to himself and to others. Instead, he was sent home with his unit. Two days after his release from Fort Benning he stabbed a fellow soldier 32 times. He’s doing twenty years in prison.
