The Women's War
Jim Higgins
http://www.nytimes.com/2007/03/18/magazine/18cover.html?_r=1&oref=slogin&pagewanted=print
On the morning of Monday, Jan. 9, 2006, a 21-year-old Army specialist named
Suzanne Swift went AWOL. Her unit, the 54th Military Police Company, out of
Fort Lewis, Wash., was two days away from leaving for Iraq. Swift and her
platoon had been home less than a year, having completed one 12-month tour
of duty in February 2005, and now the rumor was that they were headed to
Baghdad to run a detention center. The footlockers were packed. The
company's 130 soldiers had been granted a weekend leave in order to go where
they needed to go, to say whatever goodbyes needed saying. When they
reassembled at 7 a.m. that Monday, uniformed and standing in immaculate
rows, Specialist Swift, who during the first deployment drove a Humvee on
combat patrols near Karbala, was not among them.
Swift would later say that she had every intention of going back to Iraq.
But in the weeks leading up to the departure date, she started to feel
increasingly anxious. She was irritable, had trouble sleeping at night,
picked fights with friends, drank heavily. ''I was having a lot of little
freakouts,'' she told me when I went to visit her in Washington State last
summer. ''But I was also ready to go. I was like, 'O.K., I can do this.'''
The weekend before the deployment was to start, however, Swift drove south
to her hometown, Eugene, Ore., to visit with her mother and three younger
siblings. The decision to flee, she says, happened in a split second on
Sunday night. ''All my stuff was in the car,'' she recalls. ''My keys were
in my hand, and then I looked at my mom and said: 'I can't do this. I can't
go back there.' It wasn't some rational decision. It was a huge, crazy,
heart-pounding thing.''
For two days after she failed to report, Swift watched her cellphone light
up with calls from her commanders. They left concerned messages and a few
angry ones too. She listened to the messages but did not return the calls.
Then rather abruptly, the phone stopped ringing. The 54th MP Company had
left for Iraq. Swift says she understood then the enormity of what she'd
just done.
For the remainder of that winter, Swift hid out in the Oregon seaside town
of Brookings, staying in a friend's home, uncertain whether the Army was
looking for her. ''I got all my money out of the bank,'' she told me. ''I
never used my credit card, in case they were trying to trace me. It was
always hanging over my head.'' At her mother's urging, she drove back to
Eugene every week to see a therapist. In April of last year, she finally
moved back into her family's home. Then, on the night of June 11, a pair of
local police officers knocked on the door and found Swift inside, painting
her toenails with her 19-year-old sister. She was handcuffed, driven away
and held in the county jail for two nights before being taken back to Fort
Lewis, where military officials threatened to charge her with being absent
without leave. As Army officials pondered her fate, Swift was assigned a
room in the barracks and an undemanding desk job at Fort Lewis.
Despite the fact that military procedure for dealing with AWOL soldiers is
well established - most are promptly court-martialed and, if convicted,
reduced in rank and jailed in a military prison - Suzanne Swift's situation
raised a seemingly unusual set of issues. She told Army investigators that
the reason she did not report for deployment was that she had been sexually
harassed repeatedly by three of her supervisors throughout her military
service: beginning in Kuwait; through much of her time in Iraq; and
following her return to Fort Lewis. She claimed too to be suffering from
post-traumatic stress disorder, or PTSD, a highly debilitating condition
brought on by an abnormal amount of stress. According to the most recent
edition of The Diagnostic and Statistical Manual of Mental Disorders, used
by mental-health professionals to establish diagnostic criteria, PTSD
symptoms can include, among other things, depression, insomnia or ''feeling
constantly threatened.'' It is common for those afflicted to
''re-experience'' traumatic moments through intrusive, graphic memories and
nightmares.
Swift's stress came not just from the war and not just from the supposed
harassment, she told the investigators, but from some combination of the
two. In a written statement to investigators, Swift asserted that her
station, Camp Lima, outside Karbala, was hit by mortar attacks almost
nightly for the first two months of her deployment. She reported working
16-hour shifts, experiencing the death of a fellow company member in an
incident of friendly fire and having a close friend injured in a car
bombing. What Swift said distressed her most, however, was a situation that
involved her squad leader, the sergeant to whom she directly reported in
Iraq. She claimed that he propositioned her for sex the first day the two of
them arrived in Iraq and that she felt coerced into having a sexual
relationship with him that lasted four months - the relationship consisting,
she said, of his knocking on her door late at night and demanding
intercourse. When she finally ended this arrangement, Swift told me, the
sergeant retaliated by ordering her to do solitary forced marches from one
side of the camp to another at night in full battle gear and by humiliating
her in front of her fellow soldiers. (The sergeant could not be reached, but
according to an internal Army report, he denied any sexual contact with
Swift.)
As it often is with matters involving sex and power, the lines are a little
blurry. Swift does not say she was raped, exactly, but rather manipulated
into having sex - repeatedly - with a man who was above her in rank and
therefore responsible for her health and safety. (Some victims' advocates
use the term ''command rape'' to describe such situations.) Swift says that
the other two sergeants - one in Kuwait and one back home in Fort Lewis,
both a couple of ranks above her - made comments like ''You want to
[expletive] me, don't you?'' or when Swift asked where she was to report for
duty, responded, ''On my bed, naked.''
In the wake of several sex scandals in the 1990s, the U.S. military has
tried to become more sensitive to the presence of women, especially now that
they fill 15 percent of the ranks worldwide. There are regular mandated
workshops on preventing sexual harassment and assault. Each battalion has a
designated Equal Opportunity representative trained to field and respond to
complaints. Swift said she initially reported what she characterized as an
unwanted relationship with her squad leader in Iraq to her Equal Opportunity
representative there, who listened - she claims - but did nothing about it.
(According to the internal report, the E.O. representative told
investigators that he asked Swift if she had a complaint to make but that
she declined at the time.)
Swift made it clear that since enlisting in the Army when she was 19, she'd
grown accustomed to hearing sexually loaded remarks from fellow enlisted
soldiers. It happened ''all the time,'' she said. But coming from her
superiors, especially far away from the support systems of home and against
a backdrop of mortar attacks and the general uncertainties of war, the
overtones felt more threatening. ''You can tell another E-4 to go to hell,''
she said, referring to the rank of specialist. ''But you can't say that to
an E-5,'' she said, referring to a sergeant. ''If your sergeant tells you to
walk over a minefield, you're supposed to do it.''
I went to see Swift last July as I was immersed in a series of interviews
with women who'd gone to Iraq and come home with PTSD. I was trying to
understand how being a woman fit into both the war and the psychological
consequences of war. The story I heard over and over, the dominant narrative
really, followed similar lines to Swift's: allegations of sexual trauma,
often denied or dismissed by superiors; ensuing demotions or court-martials;
and lingering questions about what actually occurred.
Swift and I - along with her mother, Sara Rich - met at a run-down sushi
place in Tacoma, Wash., not far from Fort Lewis. Swift has blond hair, milky
skin and clear green eyes, which lend her the vague aspect of a Victorian
doll - albeit a very tough one. She curses freely, smokes Newports and, when
she's not in uniform, favors low-cut shirts that show off an elaborate
flower tattoo on her chest. ''Suzanne is not some passive little lily,''
explained her mother. ''She's a soldier.''
By midsummer of last year, the two women had settled into a ritual: once a
week Rich would pick up her daughter at the base and take her out for a
meal, and then the two would check into a nearby Holiday Inn, talking and
watching television and finally going to sleep. At 6:30 the following
morning, Swift would put on her uniform and Rich would drive her back to
Fort
Lewis in time to report for work. Rich, who is 41, is a social worker who
specializes in family therapy and operates with a certain type of mama-bear
verve. She was in frequent touch last summer with her daughter's
Chicago-based lawyers, who were then negotiating with the Army to get Swift
medically discharged for her PTSD so that she could avoid being
court-martialed and convicted for going AWOL. In the six weeks since Swift's
arrest, Rich marshaled both legal funds and public sympathy for her
daughter's defense, largely by tapping into the outrage fulminating inside
the antiwar movement. One of Rich's friends from Eugene built a Web site
devoted to Suzanne, taking both donations and online signatures for a
petition to have her released from the Army without punishment. Someone else
started selling T-shirts, tote bags and teddy bears that read ''Free
Suzanne'' and ''Suzanne's My Hero'' to benefit the cause.
At that point, the hullabaloo was doing little good. A week before I arrived
in Washington, the Army's investigation determined that Swift's charges
against two of her higher-ups, including the one Swift said demanded sex
from her, could not be substantiated because of a lack of evidence. (Both
men denied Swift's allegations. By the time the investigation began, in June
2006, her squad leader had already finished his military service, which put
him beyond the reach of punishment by the military anyway.) There was a
third sergeant against whom Swift filed a formal harassment complaint in the
spring of 2005, nearly a year before she went AWOL. In it she maintained
that immediately following her unit's return from Iraq, he began making
frequent suggestive remarks to her and at one point, during the course of a
normal workday, ''grinded'' his body against hers in an inappropriate way.
That man received a stridently worded letter of reprimand on May 25, 2005,
from a lieutenant colonel and was transferred away from Fort Lewis.
What still remained to be determined was whether Swift would be held
accountable for going AWOL or whether the Army would accept the idea that
her failure to report was, as she saw it, an instinctive act of
psychological self-preservation. Whatever the case, Swift was quickly
becoming a symbol - though of what it was hard to say. Among the antiwar
crowd, thanks in part to the fiery speeches Swift's mother was delivering at
local rallies and antiwar gatherings, she was being painted as a martyr, a
rebel and a victim all at once. Meanwhile, others deemed her a traitor, a
fraud or simply a whiny female soldier who'd been too lazy or too selfish to
return to war.
Swift herself seemed stunned by the attention. ''Look at me, a poster
child,'' she told me wryly, making it clear that she was not enjoying it.
She did not make the kind of grandiose anti-military statements her mother
did but rather seemed to be trying to shrug off what happened to her. She
told me she was having nightmares and was sometimes waylaid by fits of
hysterical crying. But she described these flatly, seeming almost unwilling
or unable to express anger or hurt. Overall, she seemed strikingly detached.
I had read enough about PTSD to know that ''emotional numbing'' is one of
the disorder's primary symptoms, but it made understanding Swift and what
she'd been through a more difficult task. ''Avoidance'' is another commonly
recognized symptom in people with PTSD, especially avoidance of those things
that bring reminders of the original trauma. If the Iraq war and the men she
encountered there and afterward traumatized Swift, then perhaps going AWOL
could be seen as a sort of meta-avoidance of all that plagued her.
That night after dinner, Swift lay on her hotel bed with her shoes kicked
off, staring blankly at the ceiling. She was thoughtful and willing to
answer questions. A few times, describing her deployment, she hovered close
to tears but then seemed promptly to swallow them. She told me that she came
home from Iraq feeling demoralized and depressed. She resumed her stateside
duties with the Army for the 11 months between deployments and in general
''just tried to deal.''
She was not, however, formally given a diagnosis of PTSD until after she
went AWOL - first by a civilian psychiatrist within days of her failure to
report for deployment and later, Swift says, through the Army's
mental-health division at Fort Lewis. (The Army could not confirm this,
citing privacy issues.) The timing raised a serious question: Was the PTSD a
legitimate disability or a hastily crafted excuse for skipping out on the
war? Nobody, perhaps not even Swift, could say for sure.
II. The 'Double Whammy'
No matter how you look at it, Iraq is a chaotic war in which an
unprecedented number of women have been exposed to high levels of stress. So
far, more than 160,000 female soldiers have been deployed to Iraq and
Afghanistan, as compared with the 7,500 who served in Vietnam and the 41,000
who were dispatched to the gulf war in the early '90s. Today one of every 10
U.S. soldiers in Iraq is female.
Despite the fact that women are generally limited to combat-support roles in
the war, they are arguably witnessing a historic amount of violence. With
its baffling sand swirl of roadside bombs and blind ambushes, its civilians
who look like insurgents and insurgents who look like civilians, the Iraq
war has virtually eliminated the distinction between combat units and
support units in the military. ''Frankly one of the most dangerous things
you can do in Iraq is drive a truck, and that's considered a combat-support
role,'' says Matthew Friedman, executive director of the National Center for
PTSD, a research-and-education program financed by the Department of
Veterans Affairs. ''You've got women that are in harm's way right up there
with the men.''
There have been few large-scale studies done on the particular psychiatric
effects of combat on female soldiers in the United States, mostly because
the sample size has heretofore been small. More than one-quarter of female
veterans of Vietnam developed PTSD at some point in their lives, according
to the National Vietnam Veterans Readjustment Survey conducted in the
mid-'80s, which included 432 women, most of whom were nurses. (The PTSD rate
for women was 4 percent below that of the men.) Two years after deployment
to the gulf war, where combat exposure was relatively low, Army data showed
that 16 percent of a sample of female soldiers studied met diagnostic
criteria for PTSD, as opposed to 8 percent of their male counterparts. The
data reflect a larger finding, supported by other research, that women are
more likely to be given diagnoses of PTSD, in some cases at twice the rate
of men.
Experts are hard pressed to account for the disparity. Is it that women have
stronger reactions to trauma? Do they do a better job of describing their
symptoms and are therefore given diagnoses more often? Or do men and women
tend to experience different types of trauma? Friedman points out that some
traumatic experiences have been shown to be more psychologically ''toxic''
than others. Rape, in particular, is thought to be the most likely to lead
to PTSD in women (and in men, in the rarer times it occurs). Participation
in combat, though, he says, is not far behind.
Much of what we know about trauma comes primarily from research on two
distinct populations - civilian women who have been raped and male combat
veterans. But taking into account the large number of women serving in
dangerous conditions in Iraq and reports suggesting that women in the
military bear a higher risk than civilian women of having been sexually
assaulted either before or during their service, it's conceivable that this
war may well generate an unfortunate new group to study - women who have
experienced sexual assault and combat, many of them before they turn 25.
A 2003 report financed by the Department of Defense revealed that nearly
one-third of a nationwide sample of female veterans seeking health care
through the V.A. said they experienced rape or attempted rape during their
service. Of that group, 37 percent said they were raped multiple times, and
14 percent reported they were gang-raped. Perhaps even more tellingly, a
small study financed by the V.A. following the gulf war suggests that rates
of both sexual harassment and assault rise during wartime. The researchers
who carried out this study also looked at the prevalence of PTSD symptoms -
including flashbacks, nightmares, emotional numbing and round-the-clock
anxiety - and found that women who endured sexual assault were more likely
to develop PTSD than those who were exposed to combat.
Patricia Resick, director of the Women's Health Sciences Division of the
National Center for PTSD at the Boston V.A. facility, says she worries that
the conflict in Iraq is leaving large numbers of women potentially
vulnerable to this ''double whammy'' of military sexual trauma and combat
exposure. ''Many of these women,'' she says, ''will have both.'' She notes
that though both men and women who join the military have been shown to have
higher rates of sexual and physical abuse in their backgrounds than the
general population, women entering the military tend to have more traumas
accumulated than men. One way to conceptualize this is to imagine that each
one of us has a psychic reservoir for holding life's traumas, but by some
indeterminate combination of genetics and socioeconomic factors, some of us
appear to have bigger reservoirs than others, making us more resilient.
Women entering the military with abuse in their backgrounds, Resick says,
''may be more likely to have that reservoir half full.''
Over the last few years, I've spoken at length with more than a dozen trauma
specialists, questioning them about the effect this war will have on the
psyches of the women who have fought in it. The prevailing answer is ''We
just don't know yet.'' The early reports for both sexes, though, are
troubling. The V.A. notes that as of last November, more than one-third of
the veterans of Iraq and Afghanistan treated at its facilities were given
diagnoses of a mental-health disorder, with PTSD being the most common. So
far, the V.A. has diagnosed possible PTSD in some 34,000 Iraq and
Afghanistan veterans; nearly 3,800 of them are women. Given that PTSD
sometimes takes years to surface in a veteran, these numbers are almost
assuredly going to grow. With regard to women, nearly every expert I
interviewed mentioned the reportedly high rates of sexual harassment and
assault in the military as a particular concern.
The Department of Defense in recent years has made policy changes designed
to address these issues. In 2005 it established a formal Sexual Assault
Prevention and Response program, and trains ''Victim Advocates'' on major
military installations. The rules have also been rewritten so that victims
are now able to report sexual assaults confidentially in ''restricted
reports'' that give them access to medical treatment and counseling without
setting off an official investigation. The results could be viewed as both
encouraging and disturbing: comparing figures from 2005, when the restricted
reporting began, to those of 2004, the number of reported assaults across
the military jumped 40 percent, to 2,374. While victims may be feeling more
empowered to report sexual assault, it appears that the number of assaults
are not diminishing.
If Suzanne Swift's why-bother approach to telling her superiors about the
harassment in Iraq initially struck me as curious, it began to make more
sense as I spoke with a number of other female Iraq veterans. There was a
pervasive sense among them that reporting a sexual crime was seldom
worthwhile. Department of Defense statistics seem to bear this out: of the
3,038 investigations of military sexual assault charges completed in 2004
and 2005, only 329 - about one-tenth - of them resulted in a court-martial
of the perpetrator. More than half were dismissed for lack of evidence or
because an offender could not be identified, and another 617 were resolved
through milder administrative punishments, like demotions, transfers and
letters of admonishment.
Unaware of the actual numbers, many of the women I talked to seemed, in any
event, to have soaked up a larger message about the male-dominated military
culture. ''Saying something was looked down upon,'' says Amorita Randall,
who served in Iraq in 2004 with the Navy, explaining why she did not report
what she says was a rape by a petty officer at a naval base on Guam shortly
before she was deployed to Iraq. ''I don't know how to explain it. You just
don't expect anything to be done about it anyway, so why even try?''
III. The Pressure of Being a Woman
Many of the women I spoke with said they felt the burden of having to
represent their sex - to defy stereotypes about women somehow being too weak
for military duty in a war zone by displaying more resiliency and showing
less emotion than they otherwise might. There appears to have been little,
too, in the way of female bonding in the war zone: most reported that they
avoided friendships with other women during the deployment, in part because
of the fact that there were fewer women to choose from and in part because
of the ridicule that came with having a close friend. ''You're one of three
things in the military - a bitch, a whore or a dyke,'' says Abbie Pickett,
who is 24 and a combat-support specialist with the Wisconsin Army National
Guard. ''As a female, you get classified pretty quickly.''
Many women mentioned being the subject of crass jokes told by male soldiers.
Some said that they used sarcasm to deflect the attention but that privately
the ridicule wore them down. Others described warding off sexual advances
again and again. ''They basically assume that because you're a girl in the
Army, you're obligated to have sex with them,'' Suzanne Swift told me at one
point.
There were women, it should be noted, who spoke of feeling at ease among the
men in their platoons, who said their male peers treated them respectfully.
Anecdotally, this seemed most common among reserve and medical units, where
the sex ratios tended to be more even. Several women credited their
commanders for establishing and enforcing a more egalitarian climate, where
sexual remarks were not tolerated.
This was not the case for Pickett, who arrived in Iraq early in 2003, having
been sexually assaulted, she said, during a humanitarian deployment to
Nicaragua less than two years earlier, when she was just 19. When I spoke to
her by phone in December, she recalled being too afraid to report the
incident, particularly given the fact that the supposed perpetrator was an
officer who ranked above her. During her 11-month stint in Iraq, stationed
mostly outside Tikrit in a company of 19 women and 140 men, Pickett claimed
her male peers thought nothing of commenting on her breast size or making
sexual jokes about her. She regularly encountered porn magazines sitting in
the latrines and in common areas. None of this behavior was particularly new
to her; it was life as she knew it in the military. Yet in a war zone the
effect seemed more corrosive. ''The real difference is that over there,
there's never a break from it,'' Pickett told me. ''At home, you can go out
with your girlfriends and get a beer and talk about the idiots who were
cracking jokes. Over there, you're a minority 24 hours a day, seven days a
week. You never get that 10 minutes to relax or even cry. Sometimes you just
need to let it all out.''
One night in the fall of 2003, Pickett recalled, her unit endured a mortar
attack. Trained as a combat lifesaver, she spent part of the night tending
to bleeding soldiers by flashlight in a field tent. Once the experience was
over, the memory kept replaying in her mind. ''For a long time, I wished I
had died that night,'' Pickett told me, adding that she returned to her home
in Wisconsin and was ''barely functioning''- unable to sleep or concentrate.
She spent days alone inside her apartment, not talking to anyone. ''I was
draining everyone around me,'' she says. A year after her deployment, a V.A.
clinician formally diagnosed PTSD, which Pickett says she thinks stems from
the stress of combat, harassment and the earlier sexual assault. If Vietnam
became notorious as a war that combined violence and sex, with Southeast
Asian brothels being the destination of choice for soldiers on temporary
leave from the war, the sexual politics of the Iraq war are, as of yet,
unclear.
Joane Nagel, a sociology professor at the University of Kansas, is studying
sex and the military as it pertains to the Iraq war. What she has found, she
told me recently, is that ''when you take young women and drop them into
that hypermasculine environment, the sex stuff just explodes. Some have
willing sex. Some get coerced into it. Women are vulnerable sexually.'' The
specter of childhood abuse in military men and women potentially adds
another layer of combustibility to gender relations. Tina Lee, a
psychiatrist at the V.A. Palo Alto Health Care System in California, works
with both male and female PTSD patients. She points out that traumatic
experiences in childhood may increase the risk of developing PTSD when
exposed to another trauma in adulthood. Experiencing childhood trauma can
also produce opposing behaviors in adult men and women. Male survivors of
childhood abuse are more likely to act aggressively and angrily, while some
women appear to lose their self-protective instincts. A female patient, she
says, once offered up an apt description of this tendency to end up in
hurtful situations, saying that her ''people picker'' had been broken.
''So you have young women joining the military who have the profile of being
victimized, who don't have boundaries sometimes,'' Lee went on to say. ''And
then you have a male population that fits a perpetrator profile. They are
mostly under 25, often developmentally adolescent, and you put them
together. What do you think will happen? The men do the damage, and the
women get damaged.''
Being sexually assaulted by a fellow soldier may prove extra-traumatic, as
it represents a breach in the hallowed code of military cohesion - a concept
that most enlistees have drilled into them from the first day of boot camp.
''It's very disconcerting to have somebody who is supposed to save your
life, who has your back, turn on you and do something like that,'' says
Susan Avila-Smith, the director of Women Organizing Women, an advocacy
program designed to help traumatized women navigate the vast V.A.
health-care and benefits system. ''You don't want to believe it's real. You
don't want to have to deal with it. The family doesn't want to deal with it.
Society doesn't want to deal with it.''
Pickett, who since returning from Iraq has become active in Iraq and
Afghanistan Veterans of America, a nonpartisan advocacy group, says she
believes that the stress of just worrying about this puts a woman in danger.
''When I joined the military, a lot of people at home said things like, 'Oh,
are you really going to be able to handle it?''' she said. ''So then you're
in Iraq, driving down Highway 1 with an M-16 in your hand. You have those
doubts people had about you in the back of your head. You're thinking 5,000
things at once, trying to be everything everybody wants you to be. And you
still have to take the crap from the men. You're 20 years old and growing
into your own body, having an actual sex drive. But you've got 30 horny guys
propositioning you and being really disgusting about it.'' She added:
''Women are set up to fail in a very real way, in an area where they could
get killed. If your mind isn't 100 percent on the battlefield, you could
die. That's the bottom line.''
IV. Flickers of a Larger Fire
Three years ago, while researching an article for this magazine on injured
soldiers who fought in Iraq, I happened to have a phone conversation with a
woman from Michigan who served as a reservist in the gulf war. Like many
people, she'd been watching coverage of the war in Iraq with concern. At the
time, I was focused on the early waves of soldiers returning home with
horrendous, debilitating injuries - the amputees, the paraplegics, the
brain-injured - but she was worried about something entirely different,
equally devastating but far less visible.
She used her own story as an example: While serving in a mostly male reserve
unit in Kuwait, she told me, she was sexually assaulted. After returning
home to Michigan, she began exhibiting symptoms of PTSD - jumpiness,
intrusive thoughts and nightmares - and promptly went to her local V.A.
hospital for help. She was then put into group therapy - which has long been
shown to be an economical and reasonably effective way of helping trauma
survivors process their experiences - but her ''group'' was made up entirely
of male Vietnam vets, some of whom were trying to work through sex crimes
they committed during military service. Others came home from war and beat
their wives. ''I freaked out,'' the female reservist told me. ''It sent me
into a complete tailspin.''
She began to drink heavily. She lost her job, moved away from her family and
toyed with the idea of suicide. Few PTSD stories are happy stories, but this
one eventually took a positive turn: a therapist at her local V.A. hospital
finally referred her to a 10-bed residential program for women with PTSD
located in Menlo Park, Calif. Desperate for help, she spent a number of
weeks there, receiving daily therapy and learning coping skills in the
company of a small group of other female veterans and a staff of mostly
female therapists. The experience, she told me, saved her life.
Following the early coverage of the Iraq war, however, she was feeling her
PTSD begin to stir again. Jessica Lynch - who, it was reported, might have
been sexually assaulted as a prisoner of war in the first weeks after the
invasion - was being celebrated as a hero. TV news reports showed female
soldiers bidding farewell to their spouses and children. All this woman in
Michigan could think about, though, was what things would look like on the
other side, whether the V.A. would know what to do with these women if they
later turned up needing help - whether, in particular, sexual-assault
victims would be retraumatized trying to find their way in a system that was
built almost entirely around the needs of men.
Thomas Berger, national chairman of Vietnam Veterans of America's
PTSD-and-substance-abuse committee, told me recently: ''I think women are
more likely to fall through the cracks. The fact is, if a woman veteran
comes in from Iraq who's been in a combat situation and has also been raped,
there are very few clinicians in the V.A. who have been trained to treat her
specific needs.''
As the Iraq war creates tens of thousands of female war veterans, surely we
will begin to know more about the impact of PTSD on the life of a military
woman. Female soldiers have flown fighter jets, commanded battalions, lost
limbs, survived stints as P.O.W.'s, killed insurgents and also come home in
flag-covered caskets. And many, too, have begun to experience the psychic
fallout of war, a concept made famous post-Vietnam by a generation of now
middle-aged men. ''We're much more willing to acknowledge what guys do in
combat - both the negative and the heroic,'' says Erin Solaro, author of the
2006 book ''Women in the Line of Fire.'' ''But as a culture, we're not yet
willing to do that for women. Female combat vets tend to be very lonely
people.''
Sexual trauma by itself or in combination with combat stands to isolate a
female vet further, says Avila-Smith, the veterans' advocate. ''If you're in
combat, you can talk about it in group therapy,'' she told me. ''You can
say, 'Yeah, I was in this battle and I saw my friends blown up,''' she says.
''But nobody raises their hand and yells out in the middle of the V.A.:
'Yeah, I was raped in the military, was anybody else? Do we have something
in common?''' Avila-Smith herself says she was sexually assaulted while
stationed in Texas in 1992 and developed PTSD as a result. For a long time,
everyday functioning was a challenge. ''For two years I had a list on my
bathroom mirror to brush my teeth, brush my hair, wash my face,'' she said
as we sat at a sunny picnic table outside a V.A. hospital in Seattle.
''Every morning it was like waking up in a new world. How did I get here?
What's going on? Why is my brain not working?''
This kind of bewilderment is something I encountered again and again,
talking to more than 30 military women who struggle with PTSD. Whether they
had just returned from Iraq or were 25 years past their service, whether
they'd been sexually assaulted, seen combat or both, most reported feeling
forgetful and unfocused, alienated from their own minds.
Keli Frasier, an Army reservist living in Clifton, Colo., who said she did
not experience sexual assault, told me that because of some combination of
anxiety and memory loss, she'd been fired from three low-wage jobs and
dropped out of college since returning from Iraq in May 2004. Like a few of
the others I met, Frasier always kept a notebook close by to jot down things
she was afraid she'd forget. ''Half the time,'' she said, sounding genuinely
confused, ''I don't understand why I lose the jobs.'' According to her
account, while driving a fuel truck in Iraq, she watched her squad leader
die in a roadside ambush and another peer have his leg blown off with a
grenade. ''In all those situations, your mind just goes on autopilot, and
you just do what you're trained to do,'' she said, sitting on a couch in a
warmly decorated trailer she and her husband own. She bounced her
8-month-old son on one knee as she talked. ''I didn't really start having
any mental issues until we got home,'' she said, adding that it was four or
five months before PTSD was diagnosed by a V.A. counselor.
Research has shown that exposure to trauma has the potential to alter brain
chemistry, affecting among other things the way memories are processed and
stored. To vastly simplify a complex bit of neurology: If the brain can't
make sense of a traumatic experience, it may be unable to process it and
experience it as a long-term memory. Traumas tend to persist as emotional -
or unconscious - memories, encoded by the amygdala, the brain's fear center.
A trauma can then resurface unexpectedly when triggered by a sensory cue.
The cerebral cortex, where rational thought takes place, is not in control.
The fear center rules; the brain is overwhelmed. Small tasks -
tooth-brushing, grocery-shopping, feeding your children - start to feel
monumental, even frightening.
''I was not scared a single day I was in Iraq; that's what baffles me
most,'' Kate Bulson, a 24-year-old former Army sergeant, told me by phone
not long ago from her home in Muskegon, Mich. She developed PTSD after
completing the first of two tours in Iraq, she said, adding that she had not
experienced sexual trauma. ''I did everything the male soldiers did: I
kicked in doors, searched people and cars, ran patrols on dangerous
highways,'' she said. ''Over there, I would hear an explosion at night and
sleep through it. Now I hear the slightest sound and I wake up.''
Just last month, The Journal of the American Medical Association published
the results of a study sponsored by the V.A., which endorsed the use of
''prolonged exposure therapy'' in treating female veterans with PTSD. The
process calls for a patient to visit and revisit traumatic memories in order
to lessen their power over the mind. ''It becomes an organized story rather
than a fragmented story,'' says Edna Foa, who directs the Center for the
Treatment and Study of Anxiety at the University of Pennsylvania and is
considered a pioneer in trauma treatment. ''They are able to put things
together. They find all kinds of new perspectives to look at what happened
to them.''
Across the V.A., there appears to be an earnest recognition of the need for
stepping up these innovative programs for veterans of both sexes.
V.A.-financed researchers are working on everything from testing a drug
normally used to treat tuberculosis on PTSD patients to developing
virtual-reality war simulations that are meant to give veterans more
emotional control over their traumatic memories. Of the some 1,400 V.A.
hospitals and clinics, currently only 27 house inpatient PTSD programs, and
of these, just 2 serve women exclusively. According to the V.A., several
more women's residential treatment programs are in the planning stages.
Despite fighting wars in two far-off countries, the Bush administration
recently announced that while it will increase V.A. health-care financing by
9 percent for 2008, it has proposed consecutive cuts of about $1.8 billion
for 2009 and 2010. Moreover, as recent revelations of poor patient care at
the military's flagship facility, Walter Reed Army Medical Center, have
demonstrated, a federal health-care system built to serve soldiers and
veterans is sagging under the load of those who fought in Iraq and
Afghanistan, a significant number of whom struggle with mental-health
issues. The V.A. currently has a reported backlog of 400,000 benefits
claims, which can in turn lead to long waits for appointments or for
approval for medications. When I met her in January, Keli Frasier, the Army
reservist, described herself as ''really having a hard time'' but had been
waiting two months to get an appointment to have an expired antidepressant
prescription renewed.
It's possible, too, that female veterans suffer from more invisibility.
Patricia Resick, at the Boston V.A. hospital, says she feels that women may
perhaps take longer than men to recognize their symptoms and find their way
into treatment. ''They're more likely to have a primary parenting role,''
she told me. ''When they get home, they're going to be trying to get back
into their families, to re-establish their relationships.'' Lee, the
psychiatrist in Palo Alto, says that in her experience, men are more likely
to have been encouraged to seek help, usually by their spouses. ''You don't
hear as much about husbands saying, 'Honey, why don't you go into
residential treatment for two months?''' she says. And those who feel shame
following a sexual trauma, Lee went on to say, may keep it hidden from their
health-care providers anyway.
The larger question is: How will this new crop of female war veterans
respond, recover or act out the traumas of their military experience? While
it is still too early to know, paying attention to small stories, usually
tucked inside local newspapers, may indicate the early flickers of a larger
fire. There is the story of Tina Priest, a 21-year-old soldier who,
according to Army investigation records, shot herself with an M-16 rifle in
Iraq last March, two weeks after filing a rape charge against a fellow
soldier and days after being given a diagnosis of ''acute stress disorder
consistent with rape trauma.'' (The Army says that a subsequent
investigation failed to substantiate the rape claim.)
There is the story of Linda Michel, a 33-year-old Navy medic who served
under stressful conditions at a U.S.-run prison near Baghdad and was given
Paxil for depression during the deployment. Returning home last October, she
struggled to fit back into her life as a suburban mother of three in a quiet
housing development outside of Albany. She shot and killed herself within
three weeks of the homecoming. Her husband, also an Iraq veteran, wondered
aloud to a reporter with The Albany Times-Union: ''Why wasn't she sent to a
facility to resolve the issues?''
More recently, there's Jessica Rich, a 24-year-old former Army reservist who
one night early last month climbed drunk into her Volkswagen Jetta and drove
south on a northbound interstate outside of Denver. She slammed head-on into
a sport-utility vehicle, killing herself and slightly injuring four others.
After a nine-month tour of Iraq in 2003 - and according to former soldiers
who'd been in group therapy with her, having been raped during her service -
PTSD was diagnosed. Her friends say she never got past those experiences.
''She was having nightmares still, up until this point - flashbacks and
anxiety and everything,'' one told The Denver Post. ''She said it was really
hard to get over because she couldn't get any help from anybody.''
V. 'What's Wrong With Me?'
Earlier this winter, hoping to understand more about PTSD and its effects, I
visited a couple of female Iraq vets who felt their postwar lives had been
shaped - if not temporarily ruined - by the ''double whammy'' of combat and
sexual stress. Both happened to live in Colorado, though each had deployed
to war through units located in other states. I met Keri Christensen one
morning at her home in a tidy subdivision outside of Denver, where she
recently relocated from Wisconsin with her husband and two daughters. She
had just taken her daughters to school, and her husband was away on a
business trip.
Christensen is 33, blue-eyed and outwardly perky, with an easy smile. By the
time she was deployed to war in 2004, she had finished 13 years of part-time
service in the Wisconsin Army National Guard as a heavy-equipment
transporter. Prior to her deployment in Iraq, she loved her role in the
military. ''Before we were married, my husband was in awe of it,'' she said,
laughing. ''He was like, 'I met this girl and she hauls tanks!''' She added
that she was good at what she did, receiving several awards over the years.
Beyond commitment to the Guard of one weekend a month and two weeks'
training each summer, Christensen spent the previous six years as a
stay-at-home mom. Her life, she said, had been a generally happy one.
But the stresses of deployment were surprisingly manifest: she agonized over
leaving her daughters, who were then 6 and 2 years old. Stationed in Kuwait,
Christensen's unit ran convoys of equipment back and forth from the port to
inside Iraq. ''It was really scary,'' she said, explaining that her convoy
had been mortared during an early mission. ''But it was like, Hey cool,
we're on a mission.'' Then one day in February 2005, Christensen was
accidentally dragged beneath a truck trailer and run over, breaking a number
of bones in her foot and injuring her knee and back. She was assigned to a
desk job in a tent in Kuwait, mostly working the night shift. It was there,
she said, that a sergeant above her in her command - a man she'd known for
10 years - began making comments about her breasts and at one point baldly
propositioned her for sex.
Something inside of her broke, she said. Christensen claims that she was
punished for even mentioning the situation to her company commanders -
written up for minor infractions; accused, she says falsely, of being
intoxicated (for which she was demoted); and reassigned for duty to an
airfield near a mortuary, where she occasionally helped load coffins of dead
soldiers onto planes bound for the U.S. (The Wisconsin Army National Guard
denied that Christensen was punished for making a sexual-harassment claim
and stated that the claim was investigated and dismissed for lack of
evidence.) Christensen says that a combination of war stress, harassment and
the reprisals that followed were so upsetting and demoralizing that she
considered suicide on several occasions. Her military records show that
during her deployment, she was given a diagnosis of depression and PTSD.
After Christensen's experiences in Kuwait, she allowed her military
enlistment to expire, which given that she was six years short of receiving
military retirement benefits, only added to her pain. ''That was my career,
and they stole it from me,'' she said, sitting on an overstuffed couch in
the family room of her home, idly fiddling with one of her children's
stuffed animals as she spoke. ''They make you feel like you're crazy. And
I'm not just the only one. There's other women out there this has happened
to. Why is the attitude always 'Just shut up and leave it alone'?''
Christensen had been home from war then for just over a year, having
returned to her life as a stay-at-home mother, yet she could not shake what
the deployment had done to her - the accident, the confusion and shame of
her sexual harassment, and then what she felt was an ignominious demotion
and marginalization after reporting the incidents. And while there are those
whose image of PTSD is still tied to Vietnam War movies - the province of
men who earned their affliction only after having their best buddies die in
their arms in a gush of blood - Christensen shares the same diagnosis. That
is to say that no matter what constituted her war experience, the aftermath
was much the same. She suffered from severe headaches and forgetfulness. ''I
feel like I'm always forgetting something,'' she said. ''I leave the house
and I don't know if I've left something on - the stove or a candle. I can't
trust my memory.'' She told me that her 8-year-old, Madison, recently had to
tell her the family's new phone number. She'd lost friends and had ''rough
spots'' with her husband. Afraid of crowds, she started grocery shopping at
6 in the morning and was having her mother buy clothes for her children.
Driving, too, made her fearful, since she felt ''foggy'' and more than once
ran a stop sign or a red light with her kids in the car. Though she went for
counseling and medical treatment at a local V.A. while living in Illinois
after she returned from Iraq, Christensen had not yet found her way to the
Denver V.A. for treatment. The thought of getting in her car and making the
20-minute drive petrified her.
Describing it, Christensen began to cry, wringing the stuffed animal in her
hands. ''What's wrong with me?'' she said, more to herself than to me. ''I
have nightmares of being trapped underneath a trailer with body parts
falling on me.'' Her body heaved with sobs as she continued: ''Once when my
kids were sleeping with me, I woke up suddenly, thinking it was an Iraqi
person, and I almost tossed my kid across the room.''
VI. 'Nothing Is Ever Clear'
Amorita Randall lives across the state from Christensen, in a small town
outside of Grand Junction. She is 27, a former naval construction worker who
served in Iraq in 2004. Over the course of several phone conversations
before visiting her in January, I grew accustomed to the way Randall
coexisted with her memories. Mostly she inched up to them. On days she was
feeling stable, she would want to talk, calling me up and abruptly jumping
into stories about her six years in the Navy, describing how she was raped
twice - the second rape supposedly taking place just a matter of weeks
before she arrived in Iraq. Her experience in Iraq, she said, included one
notable combat incident, in which her Humvee was hit by an I.E.D., killing
the soldier who was driving and leaving her with a brain injury. ''I don't
remember all of it,'' she told me when I met her in the sparsely furnished
apartment she shares with her fiance?. ''I don't know if I passed out or
what, but it was pretty gruesome.''
According to the Navy, however, no after-action report exists to back up
Randall's claims of combat exposure or injury. A Navy spokesman reports that
her commander says that his unit was never involved in combat during her
tour. And yet, while we were discussing the supposed I.E.D. attack, Randall
appeared to recall it in exacting detail - the smells, the sounds, the
impact of the explosion. As she spoke, her body seemed to seize up; her
speech became slurred as she slipped into a flashback. It was difficult to
know what had traumatized Randall: whether she had in fact been in combat or
whether she was reacting to some more generalized recollection of
powerlessness.
Either way, the effects seemed to be crippling. She lost at least one job
and was, like a number of the women I spoke to, living on monthly disability
payments from the V.A. Her fiance, an earnest construction worker named Greg
Lund, at one point discovered her hidden in a closet in the apartment they
share, curled in the fetal position, appearing frozen. ''It scared the hell
out of me,'' he said. ''I'm like, am I in over my head here?''' On another
occasion, shopping with Randall at Lowe's, he had to pull her away from a
Hispanic man she mistook for an Iraqi. ''She was going to attack him,'' Lund
said. ''She was calling him 'the enemy' and stuff like that.'' The biggest
tragedy for her was that her daughter, Anne, who is 4, was taken from her
custody by the Colorado child-welfare authorities after she was found
playing in the road unsupervised one day last June. At the time, Randall and
her daughter were living with another family in a halfway house. Randall was
inside folding laundry, believing - she said - that Anne was being watched
by older children in the other family.
There were days when Randall couldn't remember things, telling me her mind
felt fuzzy. Accordingly, when she broached a subject that was difficult, her
speech would slow down markedly and sometimes stop altogether. ''Nothing is
ever clear,'' she explained. ''Sometimes I'll just have feelings. Sometimes
I'll have pictures. Sometimes it'll be both.'' Her confusion could be both
literal and moral. She blamed herself, in part, for the rapes, saying she
felt peer pressure to drink heavily in the Navy, which made her more
vulnerable.
Randall's life story was a sad one, though according to the V.A.
psychologists I spoke with, it was not atypical. Growing up in Florida, she
said, she was physically and sexually abused by two relatives - a condition
that has been shown to make a woman more prone to suffer assault as an
adult. Eventually she landed in foster care. She told me she joined the Navy
at 20 precisely because she was raised in an environment where ''girls were
worthless.'' The stability and merit structure of the military appealed to
her. Stationed in Mississippi in early 2002, Randall said, she was raped one
night in her barracks after being at a bar with a group of servicemen. The
details are unclear to her, but Randall says she believes that someone
drugged her drink.
A couple of months later, she discovered she was pregnant. In November 2002,
she gave birth to her daughter. Less than a year later, Randall's unit was
deployed to the war, stopping first for several months on Guam. She put Anne
in the care of a cousin in Florida. The second rape happened after another
night of drinking. ''I couldn't fight him off,'' Randall says. ''I remember
there were other guys in the room too. Somebody told me they took pictures
of it and put them on the Internet.'' Randall says she has blocked out most
of the details of the second rape - something else experts say is a common
self-protective measure taken by the brain in response to violent trauma -
and that she left for Iraq ''in a daze.''
Given her low self-esteem and her tendency, as a trauma victim, to suffer
from fractured memory, someone like Randall would make an admittedly poor
witness in court. Randall claims that after returning from war, she told her
commanders about the second rape but says she was told ''not to make such a
big deal about it.'' (The Navy says it knows of no internal records
indicating that she had reported a sexual assault.) Since her daughter was
removed from her custody last summer, she had been going for weekly hourlong
therapy sessions with a civilian social worker, paid for by the V.A. She was
also taking parenting classes at a social-services agency and petitioning to
have the child returned to her care. Overall, she was feeling optimistic
that through therapy, her PTSD was beginning slowly to subside. But she also
felt it was a case of too little, too late, saying that before losing her
daughter, she was receiving what for many women is considered to be a
standard course of mental-health treatment in a V.A. system strapped for
resources - a 60-minute counseling session held every month. Randall
shrugged, describing it. ''We never got very far with anything,'' she said,
''The guy would just ask me, 'So, how are you doing?' And I'd look at him
and say, 'Well ? I guess I'm fine.'''
VII. ''It Just Kept Building Up and Building Up ... ''
The Women's Trauma Recovery Program is tucked into a small adobe-style
building on one corner of a sprawling V.A. health-care campus in Menlo Park,
Calif., about 20 miles south of San Francisco. Outside there is a sunny
courtyard, where residents often gather to smoke and talk. Inside there are
five dorm-style bedrooms, each with a pair of twin beds. The feeling is
something less than homey but something more than institutional. Next door
there is a larger and more established 45-bed program for male active-duty
soldiers and veterans with PTSD.
When I arranged to visit the women's program for a couple of days last July,
it was unclear whether any of the six female patients then in residence
would speak to me. According to Darrah Westrup, the psychologist who leads
the program, this group had only just begun its 60-to-90-day treatment
program, which was devoted both to learning coping skills and to gradually
doing exposure therapy for their traumas. For many of the patients, entry in
the program - gained through a referral from a mental-health specialist and
then a fairly intensive application process - felt like a last resort.
Privacy, too, was paramount: some of these women had isolated themselves for
years and, working with the program's therapists, were just beginning to
rebuild some confidence, Westrup said.
So it came as a surprise when, one by one, each one surfaced at Westrup's
office, ready to talk to me. (They requested that I protect their privacy by
not using their full names.) Each asked too that Westrup be present for the
interview, and I soon understood why: despite the fact that conversation
revolved mostly around the impact of living with PTSD rather than the
traumatic events that caused it, the danger of a flashback always lurked.
''Are you here?'' Westrup would ask gently when somebody appeared
momentarily glazed or her speech slowed down. ''Do you feel your feet on the
ground?''
Some of the women served in previous decades and were only now dealing fully
with their PTSD. They recognized themselves as harbingers, as cautionary
tales of how bad it could get for those of the current generation of female
soldiers if they left their PTSD untreated. And they repeated that sentiment
again and again. ''I'm only talking to you,'' one said, ''because I want
other sisters to know they're not alone.''
I met six women, two of whom served in Operation Iraqi Freedom. Most hadn't
seen combat, though three of them said they were raped by fellow soldiers
during deployments in Germany, in Japan, in Qatar. The women - Johnnie,
Kathy, Kathleen, Ann, Michelle and Sara - had served in the Army, the Navy
or the Air Force. What ran through nearly every woman's story was a sense of
things left unresolved. Nobody mentioned perpetrators being punished. Nearly
everyone expressed having gone through relentless self-questioning: ''What
if I hadn't accepted that ride?'' one wondered aloud. ''What if I hadn't
drank so much?'' asked another.
According to Patricia Resick of the National Center for PTSD, being able to
process trauma is the key to recovering from it. Those people who cannot
make sense of what happened to them are more likely to continue reliving it
through flashbacks and intrusive memories. ''It's like a record that keeps
getting stuck,'' she said. ''They can't accept that it happened because of
the implications of accepting it. It means that bad things - horrible
things, really - can happen to good people.''
The women in Menlo Park described, vividly, the aftermath of living with
unresolved military trauma: Kathy was arrested more than once for drunken
driving. Michelle tried to kill herself three times. Sara was put into a
military psychiatric hospital. Ann raised children and had a successful
career, but said that inside her home in rural Northern California, she was
often so paralyzed by fear that she hid in the closet any time the phone
rang.
The program required that the women spend time writing down their thoughts
and then analyzing them on paper, rooting out the ''distorted thinking'' -
things like feeling unworthy or guilty - and then reinterpreting them in a
more healthful way. While each woman acknowledged that the work was painful,
there seemed to be a kind of summer-camp camaraderie growing among them. Yet
there was always the notion looming that at some point they, and their
symptoms, would need to return home.
One of the two vets of the Iraq war on the V.A. campus was Kathleen, a
37-year-old Army nurse with dark hair and fair skin. She arrived at Menlo
Park courtesy of a program sponsored by the Department of Defense, in which
active-duty soldiers with severe PTSD are granted leave and financing to
pursue residential treatment through the V.A. This is part of a larger
effort across the military to find and address soldiers' mental-health
issues as quickly as possible. Kathleen was a first lieutenant and a
registered nurse based at Fort Sill, Okla. She was medevacked out of Baghdad
less than three months earlier.
Sitting in a chair in Westrup's office, dressed in a pastel T-shirt and
jeans, Kathleen knit her fingers together anxiously. Despite appearing
nervous, she seemed eager to talk. For better or worse, Kathleen's trauma
was still fresh. She was also one of the few female veterans I spoke with
who were suffering from PTSD who did not mention experiencing sexual
harassment or assault in the military, though she did allude to ''a bad
childhood.''
Speaking in a soft drawl, she described being stationed at a combat support
hospital inside Baghdad's Green Zone, working 15-hour shifts in the
intensive-care unit, often tending to burn patients who were helicoptered in
from southern Iraq. ''I expected some death,'' she said. ''I was realistic.
What I didn't expect was that we would be taking care of so many civilians,
and those civilians would be children.'' She paused to add that she had five
children of her own - all daughters, ages 9 to 18, who were back in Oklahoma
with her husband, himself an Army man who'd been deployed to Iraq twice
already.
In Baghdad, the stressors piled up quickly: helicopters kept arriving from
the south, burn patients howled, children sometimes died. Lying in bed at
night, Kathleen listened to mortars exploding and stray gunfire outside the
Green Zone. ''It just builds up and wears down on you,'' she said. ''You're
always in a heightened adrenaline rush.''
Her hands started to tremble then. She mentioned a young boy named Mohammed
who died in the Green Zone hospital early on in her time in Iraq, saying
only that she felt responsible for his death. ''I can't say more about
that,'' she said, shaking her head. She then described caring for another
young Iraqi who'd lost his legs because of complications from a gunshot
wound. She started to understand that he might not survive outside the
hospital. She described a creeping feeling of powerlessness. ''You get to a
point when you can't take care of everybody,'' Kathleen said, her voice
quavering. ''It's really tough.'' She knotted and unknotted her hands,
appearing somewhat blank.
Westrup interjected softly, ''Kathleen, are you here?''
''I'm here,'' she said. Then she continued: ''It got to a point that I was
having panic attacks all the time because we'd get a patient in, and I'd be
thinking, Oh, my God, they're not going to survive, and how can I help them
stop screaming and not be in pain? It just kept building up and building up.
...''
Then one day Kathleen's superiors barred her from visiting the young man
who'd had his legs amputated, suggesting that she was becoming too
emotional. Since the death of the boy named Mohammed, she had been taking
Paxil for depression, and about the same time, she said, an Army doctor took
her off the medication.
''I went crazy,'' she said plainly. ''I had a major panic attack. I felt
like I couldn't get enough air.'' On the night it happened, she climbed the
stairs to the hospital's rooftop, which overlooked the Green Zone. ''We sat
up there millions of times, smoking our cigarettes or just shooting the
breeze and watching the helicopters coming in and going out. It felt like a
safe place.'' But when a hospital doctor turned up on the roof, startling
her as she gasped for air, Kathleen began to cry. The doctor fetched the
senior nurse on call. Believing that Kathleen was contemplating suicide, the
nurse had her evacuated first from the roof, Kathleen said, and then from
Baghdad altogether.
When I asked if she considered suicide during her deployment, Kathleen
answered: ''Oh, several times, but I was able to contain those thoughts.
What kept me going was the thought of my children, and them not being taken
care of if I killed myself.'' She did, however, rehearse some thoughts about
what would happen if she wandered outside of the Green Zone and deliberately
into enemy fire. ''I was worried about how children of parents who commit
suicide have a higher rate of suicide themselves. I have three teenagers,
and I'm thinking, I can't do that. But if I died because of the enemy, then
that would be acceptable. They would be sad, but they could hold their heads
high and say, 'Yes, my mom served - she gave to this country.'''
Everything that happened to Kathleen - her feelings of compassion for her
Iraqi patients, the powerlessness she felt in trying to save them, the
depression, Paxil and ultimate breakdown - all very easily could have
happened to one of her male colleagues. Indeed, she told me she was not the
only soldier feeling great stress in the hospital: ''We were all facing
these struggles,'' she said. ''There were people that were breaking down
crying, nobody was sleeping well. There were a lot of nightmares.'' And yet
it was Kathleen who was helicoptered out of the war on a stretcher on April
29 last year and returned to Oklahoma, to her three-acre property, her five
girls and her husband.
Leaving Iraq and returning home to Oklahoma, Kathleen felt an instant change
in her relationship with her daughters. ''It was very difficult for me to
see them,'' she told me. ''I thought I would be excited and run to them and
tell them I loved them, but instead I was scared. I was scared for them to
hold me, to touch me. I don't know why, because I wanted to really bad. I
was afraid for them to see me shake or stutter, not being able to
communicate.'' She mentioned, with no small amount of heartbreak, that it
was hard to reconnect with one particular daughter, who has dark hair and
brown eyes, because ''she looks like she could be Iraqi.''
Two weeks after arriving in Menlo Park, she was still baffled by how
excruciating family life had become. When her 9-year-old daughter had
started shouting playfully while being chased by her 11-year-old in the yard
outside, her mind flashed instantly to Iraq. Kathleen said: ''It just goes
through me and brings me right back. I have a lot of flashbacks. And then
I'd have nightmares, afraid that they'd hear me talk in my sleep or yell
out, moaning.'' She added, ''Me and their dad have had nothing but conflict
after conflict, because he wants me to be a certain way, and I can't.'' Her
children, she said, had begun avoiding her in order not to upset her, asking
their father to drive them places, speaking quietly in her presence.
Kathleen started seeing an Army psychologist daily, something she found to
be extremely helpful. A social worker at Fort Sill introduced the idea that
she might be further helped by the women's residential program in Menlo
Park. Yet having already left her children for most of the last year,
Kathleen was resistant to going.
And then came a turning point. One day, when her husband was not around to
do the driving, she had the girls in the car on their way to somebody's team
practice, when her 13-year-old daughter tried to offer some encouragement.
''She said, 'Mama, you can get through this; it's not like you killed
anybody,''' Kathleen recalled. ''I started crying, and she goes, 'Oh, my
God, you killed somebody!' I went into another panic attack right in front
of my kids.'' She welled up at the memory, saying: ''That was enough for me.
I was like, I'm ready to go. I'm getting through this.''
So far, however, treatment had been a mixed bag for Kathleen, mostly because
she was homesick and afraid. She had, however, fostered a great deal of
empathy and respect for the other women she'd met, understanding that some
had lived with debilitating PTSD for 20 years.
''I came close to leaving here the other day,'' she told me. ''But the girls
just surrounded me. They were like, 'Don't leave.''' The women then went on
to describe how they lived before treatment - one with security cameras and
a security fence at her house, another locked away in her apartment, several
having lost their marriages and distanced themselves from their kids. ''They
said: 'You don't want this life. I would give anything to go back to when my
trauma was new and to get help with it,''' Kathleen recalled. ''And I could
see myself 20 years down the road; I would be them. And I don't want that,''
she said. ''I love these girls, but I don't want that.''
VIII. What the Future Holds
Six weeks later, I flew back to California to attend the Women's Trauma
Recovery Program graduation. It was held on a Thursday morning in a wide
recreation room on the building's ground floor. Someone had moved the
Ping-Pong table to one side and dragged a number of chairs into neat rows. A
modest buffet lunch was laid out along the room's back wall.
The residents took their seats at the front of the room, having clearly
primped for the occasion. They then read poems, held hands, made grateful
speeches to the staff and, at the end, played some pensive music on a
boombox and bowed their heads, many of them weeping. It was, of course,
impossible to know what was in store for any of them. Clearly, they had
benefited from the cohesiveness of the group, having met others who were
wrestling with the same demons.
There was one notable absence - Kathleen, who, it turned out, left treatment
not long after I met her, presumably to return home to her family and
military life in Oklahoma. Over the next few months I sent several letters
to Kathleen, hoping to speak with her, but got no response. Finally, a
couple of weeks ago, she called me, apologizing for her silence. She'd only
just received a medical discharge from the Army and felt comfortable
talking. She had mixed feelings about leaving the military, since she loved
her work as an Army nurse, but felt that the PTSD symptoms kept interfering.
She'd spent much of the fall giving vaccinations to soldiers, but after a
soldier passed out one day, causing her to panic, she realized she was a
long way from being able to handle an urgent medical crisis.
Kathleen also told me that she left Menlo Park last summer after one of her
daughters was involved in a minor car accident. ''I left treatment because
my children were more important than my needs,'' she said.
What struck me again and again, meeting and talking to female Iraq veterans
grappling with PTSD, was their isolation. So many, like Kathleen, seemed
uncertain of what to do next. It was as if their mistrust of the world had
led them to mistrust themselves. Most were on antidepressants and were
receiving some counseling through the V.A., but few had a sense that their
symptoms were going away. In Colorado, Amorita Randall was working to regain
custody of her daughter - a process that she found discouraging. ''Just
because I'm disabled doesn't mean I can't care for my daughter,'' she told
me. Recently, after months of waiting, Keli Frasier, the mother in Colorado
who had been struggling with depression, finally managed to schedule an
appointment with a V.A. psychiatrist to obtain new antidepressants. Across
the state in Denver, Keri Christensen said she was still haunted by
nightmares and unnerved by driving.
And finally, there was Suzanne Swift, who in early December was given a
summary court-martial at Fort Lewis, a hearing normally used for minor
offenses. As part of a plea bargain, she pled guilty to ''missing movement''
and being absent without leave. Her rank was reduced to private, and she
spent the next 21 days, including Christmas, in a military prison in
Washington State. The Army ruled that in order to receive an honorable
discharge, Swift was dutybound to complete her five-year enlistment, which
ends in early 2009. After finishing her stint in prison in January, Swift
says she checked herself into the inpatient psych ward at Fort Lewis's
hospital for a few days but ultimately was released back to duty. She told
me she was trying generally to ignore the PTSD but had taken to drinking a
lot in order to get by. ''I kind of liked the Army before all that stuff
happened,'' she said in early February, on the phone from her barracks at
Fort Lewis. ''I was good at my job. I did what I was supposed to do. And
then in Iraq, I got disillusioned. All of a sudden this Army you care so
much about is like, well, all you're good for is to have sex with and that's
it.'' She added, ''I really, really, really, don't want to be here.''
The Army had issued an order for Swift to be transferred to a base in
California later this spring. Swift was unhappy about the change, because it
would take her farther from her family in Oregon, but she was also
considering other plans. ''Did you know,'' she said, ''that there's some
program near San Francisco that's just for women who have PTSD?'' She paused
for a moment, surrounded by the silence in the barracks at Fort Lewis, then
said, ''I'm thinking about trying to get in there.''
--
"The king of Israel answered, "Tell him: 'One who puts on his armor should
not boast like one who takes it off."
SwampMidget
here's the real story: http://gatewaypundit.blogspot.com/2007/03/new-york-times-plays-ptsd-fool-for-iraq.html