Monday, January 12, 2009

No, John Bircher, you are not correct on PTSD

We're starting out with an e-mail from John E. Bircher III, the Director of Public Relations of Military Order of the Purple Heart.

Before we go further, this isn't a "a blog." It might have been one for about two to five days at the very beginning (it might not have, I was inept at that as well) but this is a site, it's a community, it's not a blog. It's not "What I wanted to write about . . ." That would be a blog. It's not a minor issue and someone in public relations might want to try to get the basics correct before e-mailing. Hint, it is as bad as spelling someone's name wrong. Bircher's taking offense at this Thursday morning entry and this is noted (in full) with his permission:

Greetings: I couldn't find any way to post a comment on your blog, so thought I’d just send an email for the "other side of the story."
Let me just start by saying, you did not quote me accurately -- yes, the quotes were right -- but you made it sound as though I did not think PTSD was a 'real injury', Nothing could be further from the truth.
As a Purple Heart recipient I do support the Pentagon's decision not to award the Purple Heart for PTSD.
I am also very sympathetic to those who suffer this terrible disorder and believe that that the Military and the VA are now finally aware of its effects and are offering treatment.
The criteria for this particular medal, however, is the suffering of physical wounds on the battlefield as the result of combat action by the enemies of the United States. There are many other kinds of injuries on the battlefield -- someone can have a leg crushed by a vehicle, you can be injured by friendly fire, you could be exposed to chemical or biological agents, you can even contract a life-long disease. After Vietnam, for example, those soldiers exposed to Agent Orange are now suffering from many diseases, including Diabetes. After the first Gulf war, many suffer from "Gulf War Syndrome." Where do you draw the line?
Moreover, PTSD is a treatable disease -- loss of a limb, or any combat wound for that matter, is a permanent physical and emotional scar. And, what about those who feign the illness just to receive VA medical treatment; or, what about a group who witnesses a battlefield trauma together, but only one or two suffer from PTSD; should they all receive the Purple Heart?
Just for the record, this is not a new phenomenon, it just has a new name. Soldiers have suffered from "Shell Shock", "Combat Fatigue", and other symptoms since the beginning of warfare.
Since its inception in 1932, this Medal honors those who have spilled their blood or given their lives in the defense of their country. Expanding that criteria only denigrates its honor and those who wear it proudly.

John E. Bircher III
Director of Public Relations
Military Order of the Purple Heart
5413 B Backlick Road
Springfield, VA 22151

[. . .]

Actually, that's not in full. I don't agree with him (to put it mildly) and I'll have a few comments but I don't want to start some "Bombard him with e-mails, faxes and phone calls!" thing. For that reason "[. . .]" indicates his contact info has been removed. A link to his group is included (twice, before the e-mail and in the e-mail).

I don't agree with a damn thing he says and he, in fact, proves the points we were making Thursday (and "we" includes more than me):

Who needs help from something so insignificant, so minor? Military Order of Purple Heart's John Bircher III 'explains,' "There were wounds there" for 'real' injuries and that to receive a Purple Heart, "Shedding blood is the objective."
That is so insulting and it backs up the culture of denial inbred in the US military when it comes to PTSD. Until it's confronted, many will not receive the treatment they need. The Pentagon's latest stunt and the remarks by so many in the article go a long way towards ensuring that PTSD is not seen as the very real war wound that it is.

He proves the culture of denial and he also falls into what Don Henley would describe as the I-got-mine! category. Yes, Bircher, you have your Purple Heart -- and apparently it devalues the honor for you if others get honored as well?

I don't give a damn (and I'd love to use stronger words) what you think about physical or mental wounds. Who cares what you did in the Dark Ages? Who the hell cares? Society's progressed. We grasp that mental wounds are as real as physical wounds.

You fail to grasp what PTSD is and you seem obsessed with this idea that there's faking going on -- FAKING! MUST STOP THE FAKING! Hate to break it to you, but if any faking exists today, it existed back then as well. So maybe someone lost 70% mobility and they managed to fake it to 80%? It really doesn't interest me but running a con is in our human natures and I'm sure it occurs with some claiming PTSD and I'm sure it has always existed within those applying for benefits through the VA. I'd also guess it is a small number today and was in the past and nothing to be alarmed over.

There are far more losses than the loss of limbs. And we're not going to create a hierarchy just because it makes you feel good. I will assume you've visited your share of hospitals (military and civilian). I will assume you've failed to grasp the very real wounds that did not involve bodily harm so I'm not sure how much your visits provided other than a smiling face.

You walked into this, I'm not going to sugar coat my response to you. Your remarks are insulting. They'll be seen as insulting by this community and probably 1/2 the drive-bys that read them. You may grab 1/2 the drive-bys in your favor. But your opinion is out of date and borders on hostility towards today's wounded.

And this attitude, this minimizing and belittling of PTSD, explains why so many today have trouble getting the help they need. This is exactly the culture we were talking about. 'We've always had it! We called it shell-shocked! You didn't lose a limb! It's not a real wound!'

Bircher got to express his opinion. A HUGE mistake. Huge. Forgetting Elaine's work on this issue (and her writing on PTSD in this community for the gina & krista round-robin), forgetting the members of this community with PTSD or with a spouse or loved one with PTSD, it was a huge mistake for Bircher to express his opinon.

I'm sure Bircher's a nice person, but he happens to be 100% wrong on this issue. I am more than fine with allowing for differences of opinion on most issues. I can say, "We just disgree." Not on this. This has to do with people's lives and people's suffering. I don't play with that, I don't high road it. The wounded are not getting the treatment they need. In some cases, that's due to the culture of denial on PTSD. In other cases, it's due to the appalling lack of funding on this issue. I've sat in on the Congressional hearings, I've heard all the crap from the military speakers about how they need to focus on this wound and that wound but PTSD is just getting too much money. Bull-f**king-s**t. PTSD is still not funded as needed, the bulk of those suffering have better chances of getting treatment outside the military health care. What does Elaine do? She doesn't have one paying patient. She hasn't in a little over three years. She goes to her office five days a week and treats veterans -- everyone of them pro bono. Elaine's far from the only psychologist across the country treating veterans at no charge. (She is the only one I know who makes zero dollars a week. But she can afford that.) And she does that because she's a wonderful person, yes. But also because there is a need for it.

So Bircher picked the wrong person to try to make his case to. It was never going to fly with me. He got his say. He can take comfort in the fact that the New York Times agrees with him -- the editorial board. That's not much to brag about considering last week's embarrassment that attempted to advocate for proper funding and training for the US census by arguing it was a . . . Democratic Party issue. Situational ethics. It'll be great to read their argument for the same things when a Republican is in the White House. (That truly was the most idiotic editorial in the world and the fact that no one critiqued it as such -- media watchdogs -- is astounding. Maybe everyone has given up reading those bad editorials?)

Last night I mentioned we'd hold Dan Rodricks' "Averting their eyes from troops' psychological scars" (Baltimore Sun) for this morning to pair it with something. The something was Bircher's comments. This is an excerpt of Rodricks' column:

The Pentagon has decided that soldiers who suffer from post-traumatic stress disorder (PTSD) do not deserve the Purple Heart. "PTSD is an anxiety disorder caused by witnessing or experiencing a traumatic event," Defense Department spokeswoman Eileen Lainez told Stars and Stripes. "It is not a wound intentionally caused by the enemy from an 'outside force or agent.'" In short, the psychological wound does not merit the same medal the nation would award for a physical one; witnessing your buddy blown apart by a 107- mm rocket is not as significant as taking shrapnel from it.
Anyone who has kept an eye on the Bush administration's conduct of the military operations in Iraq and Afghanistan -- and that's an ever-shrinking number of Americans -- would understand why the Pentagon wants nothing to do with Purple Hearts for PTSD. This isn't as much about upholding standards as it is about maintaining, in classic military style, the status quo in the face of overwhelming evidence that increasing numbers of troops are surviving combat but with severe psychological trauma.
According to RAND Corp. estimates, about 320,000 veterans of Iraq and Afghanistan sustained brain injuries by 2007, while close to that number -- about 300,000 -- reported symptoms of PTSD or major depression. (An estimated 1.8 million Americans have served in Iraq and Afghanistan.) The last thing an administration waging a long, costly and unpopular war wants is for the number of casualties from that war to run into the hundreds of thousands; that's far more Purple Hearts than budgeted. The Purple Heart ruling is in keeping with what Aaron Glantz, author of a new book on the neglect of veterans during the George W. Bush years, calls the official shortchanging of service members who were sent to fight.
"The Bush administration was never seriously interested in helping veterans," Mr. Glantz concludes in The War Comes Home. "The sorry state of care for Iraq and Afghanistan war veterans is not an accident. It's on purpose. After the invasion of Iraq in 2003, the Bush administration fought every effort to improve care for wounded and disabled veterans. At the root of that fight was its desire to hide the true costs of the war in order to boost public support." And, says Mr. Glantz, rejecting PTSD claims is one way of making sufferers not only ineligible for benefits but also fit for multiple tours of duty, something vital to an all-voluntary military challenged to reach recruitment goals.

Glantz' book is due out January 15th.

Bonnie notes Isaiah's The World Today Just Nuts "Princess Brat's Big Plan" Kat's "Kat's Korner: The really best of Janis Ian" went up yesterday.

The e-mail address for this site is

the new york times