The scientific evidence indicates that the earlier treatment is provided, the more effective it can be in alleviating symptoms and, even, in preventing the development of full-blown illnesses. Therefore, most experts recommend that patients should go for evaluations whenever there are concerns about possible diagnoses, and that treatment should be initiated sooner rather than later, for mild-to-moderate as well as more severe conditions. However, it is important to recognize that there are, at times, differences between the experts’ opinions and the veterans’ own preferences.
One way to deal with uncertainty about whether or not an individual veteran has a mental health condition that requires treatment would be to bypass the question. Veterans could go to Vet Centers, and get counseling for issues related to readjustment. Another would be to go to a VA medical center or clinic and ask for an evaluation. Admittedly, however, some veterans prefer to wait it out to see if they bounce back on their own, and to seek help only if it is clear that they need it. For these people, it is important to recognize that getting an evaluation is only one step in a process.
Even if a provider makes a recommendation for treatment, it is still the veteran’s choice about whether to begin immediately or to continue to wait and see. Moreover, when patients and providers agree that it is time to start treatment, treatment planning provides many opportunities for veterans to provide input by indicating their preferences about different strategies.
But what happens if mild symptoms persist? Time may go on, the veteran may not bounce back, but, in spite of symptoms, suffering and impairments, there may never be a time when the veteran feels that it is right to go for an evaluation or to seek treatment. The answer may be for veterans, maybe together with family or friends, to set up a time frame when they first notice symptoms. Maybe they should decide that it would be time for an evaluation if the symptoms are still there in two months. Maybe it should be three months, or four. Regardless, it is important to pick a time and stick to it.
Some basic principles are well established. For PTSD and other mental health conditions, treatment works, and it is readily available within VA. When mental health symptoms lead to significant suffering or impairment, they should be treated. When they lead to danger to patients or others, they must be treated. Beyond these principles, decision-making is more complex, and it is VA’s role to be a resource for veterans, helping them make informed decisions that will enhance their lives.
Veterans need to recognize that VA health care is an important resource available to them, and should take advantage of it—first, by talking about a problem or concern with a provider with whom the veteran feels most comfortable. This may be a primary care provider, a Vet Center counselor, or even the veteran’s eye doctor. The door is open, now more so than ever before.
VA facilities have extended hours on evenings and/or weekends at its mental health clinics. In addition, VA has greatly enhanced its mental health care system over the last three years. As part of this effort, over 4,000 new mental health workers have been added, and services have been expanded to promote recovery-oriented, evidence-based and innovative practices.
VA is committed to providing the best mental health care to veterans, both to honor our nation’s heroes and enable them to live the most meaningful and productive lives possible.
“More than 80 percent of a sample of Air Force women deployed in Iraq and other areas around the world report suffering from persistent fatigue, fever, hair loss and difficulty concentrating, according to a University of Michigan study…. In general, Pierce and Lewandowski found that those women in the Reserve and Guard reported more symptoms than active duty personnel. Enlisted women reported more health problems than officers did.”
—“Women and War: The Toll of Deployment on Physical Health,” Science Daily, August 15, 2008
21
WHEN MOMMY COMES HOME
The Story of Army Sergeant Devore Barlowe
“They had us set up our computers in a bombed-out concrete building, and we were just settling in when they bombed the mess tent. It was awful. But then I saw a lot of things that were awful… an Iraqi soldier with one side of his body gone, wounded and dead soldiers.”
Devore Barlowe is only 38, but she walks with a cane at the pace of a woman forty years her senior. Her year long tour of duty in Iraq left her with bronchial asthma, chronic neck and back pain from slipped disks and bone chips, hearing loss in her left ear, carpel tunnel syndrome, arthritis, mild TBI and a severe case of PTSD. She is so on edge that her two young sons are reluctant to hug her without asking first if it’s okay for them to approach. From the time she enlisted in the Army in 1993 to when she was an E5 logistical supply sergeant in Mosul in 2004, up to her current status as a “drilling reservist” with 30 percent disability from the VA, she has served her country proudly and well.
Devore’s deployment to Iraq started in 2003 when she rushed out to meet the UPS deliveryman who she thought was bringing a box of books she needed to complete her semester’s courses in criminal justice through the University of Phoenix. Instead he handed her a manila envelope stating that, as a reservist, her contract with the Army had been extended and she was to report to Pennsylvania for “SRP” (Standard Readiness Program) immediately. Mother of two little boys, Devorian, age 4, and Dakie, almost 2, Devore was living in Killeen, Texas working at a correctional facility. “I was at my ten-year mark and counting down. I was going for my degree and a career. I had it all planned out. Was I stupid or what?”
Six months later she’d moved her family to Pennsylvania, put her boys in military day-care and started learning electronic purchasing at the local Wal Mart Distribution Center as part of Army Unit 318, Logistics and Communications. “They made me an E5 and gave me four MOS’s combined into one: logistics supply. After a year I asked if I could leave and they said, ‘No, Devore. We need you. Your contract has been extended through 2005. You’ve been involuntarily attached to the 818th Maintenance Company. You’re deploying to Iraq.’ I remember the next day I was having a birthday party for Dakie who was turning three on August 29th. Through the entire party I kept wondering, ‘Will I ever see my boys again?’” Two weeks later her sister Monica came and took Devorian and Dakie back home to Wilmington, Delaware, while Devore left for Washington, DC and then to Fort Bragg, North Carolina.
On December 15th the 818th flew from Fort Bragg to Iraq, via Kuwait. “It didn’t sink in until they locked us down in a bunker in preparation for boarding the plane. That was when I thought, ‘Holy s***; this is happening to me.’ When we landed in Kuwait they put us on a bus to Camp Victory, one of the US staging areas. The bus had curtains over its windows, which were kept drawn ‘for our safety.’ It was 120 degrees outside.” Even with Hardees, Baskin Robbins, Pizza Inn, and “beach” volleyball games, amenities courtesy of the American military while settling in for the long haul, Camp Victory was still a grim, hot, sandy tent-city in the desert.
“No one had prepped us for Kuwait. No one had said, ‘Don’t go into the bathrooms or showers unless you post someone at the door because women have been assaulted.’ No one told us about the heat, the sand. A Special Ops guy came over to me when we were packing up for Iraq and said, ‘What size equipment you got on, soldier? That’s falling right off you.’ I’m five feet and I was issued a Kevlar vest two sizes too big for me.” The 350 soldiers of the 818th were broken down into units and sent throughout Iraq. Devore was one of seven soldiers, four women and three men, tasked out to handle automated supply and warehousing for all of Iraq at Forward Operating Base Endurance, home of the 1st Brigade, 25th Infantry Division (Stryker Brigade Combat Team) just south of the city center of Mosul in northern Iraq. There was no way for her to “prep” for what would happen as she arrived.
The New York Times reported it this way on December 22, 2006:
“A powerful explosion killed 22 people, including 18 Americans, when it ripped through the mess tent of a large American military base in Mosul during luncht
ime on Tuesday, in one of the deadliest attacks on American forces in Iraq. The noontime blast, which also wounded 72, sprayed shrapnel into a line where American soldiers, civilian contractors and Iraqi troops were waiting to be served lunch. Pools of blood streamed out from the tent as soldiers rushed to evacuate wounded.”
Devore’s “secured base” had been the target of a major battle (for Mosul) in early November when hundreds of insurgents along with foreign fighters coming in from Syria attempted to take over the city. The fierce fighting lasted a week with hundreds killed, including four US soldiers, before the insurgents retreated to the western part of the city from where they would continue to conduct hit and run attacks for the next year. The mess tent explosion was the work of a suicide bomber. “They had us set up our computers in a bombed-out concrete building, and we were just settling in when they bombed the mess tent. It was awful. But then I saw a lot of things that were awful… an Iraqi soldier with one side of his body gone, wounded and dead soldiers.
Devore’s unit barracked and worked out of the same blown-out building. “The Army had contracted repairs of the building to local Iraqis. They were painting and plastering. There were even detainees working construction. At first there was no water because everywhere they dug they’d hit oil instead. We had no choice but to set up our computers and start ordering supplies. Those were 18-hour days. On Christmas Eve I don’t think we even noticed when someone dropped off a little Christmas tree. No one expected much in the way of morale boosting.” Telephone calls home to her boys were few and frustrating. Her youngest son was so angry at her for leaving that he refused to talk to her at all.
Mosul was “destabilized,” as the military put it, during Devore’s entire tour of duty. “We got used to the sound of helicopters coming and going and the bombs… that heavy ‘boom!’ sound. In fact, if we didn’t hear bombs, we panicked because one time, after a period of no bombs, a mortar hit the room next to the sleeping area. It shook the building so hard that we were thrown out of our beds. It took the breath right out of me. My ears were ringing. There were times when they’d say to us, ‘We’re going black.’ That meant ‘cut off all communications. One of our soldiers has died, and we’re going in to the area to get him back.’”
After the first few months, Devore started feeling the stress. “I was anxious all the time, lashing out at people, not sleeping. I remembered what my mother told me when I joined the Army in 1994. ‘It’s not going in to the Army that you need to worry about. It’s coming out. Don’t lose yourself either place.’ My uncles had fought in Vietnam, and when they came back they had a lot of issues with drugs and alcohol. My mother was afraid the same thing would happen to me.”
Devore’s mother was killed in a car accident during her daughter’s Advanced Individual Training at Fort Hood with the 1st Cavalry. Instead of telling her himself, which was his responsibility, her squad leader left her a message taped to her door to go see the Battalion Commander who assumed she already knew about the tragedy and butchered the news. Ten years later, in Mosul, she experienced mindlessness on a greater scale when she and other black female soldiers reported countless incidents of sexual harassment and racism, to deaf ears. “If you didn’t sleep with them, they said you were gay.” But there was a war going on, and harassment was not high on the list of issues to attend to.
“We were constantly hit upon, but when we’d say something to our superiors we were told, ‘They don’t mean any harm.’” Showering was a nightmare. “Once when I was showering, two soldiers pulled down the curtain and just stood there. I was petrified but I stared them down. I still get panicky every time I take a shower.” Her anxiety was compounded by breathing and back problems. When she wasn’t at her computer ordering supplies, she was outside loading and unloading heavy cartons, carrying them from trucks to the warehouse. She injured her neck and back from jumping on and off the trucks, but worse than her slipped disks was the gradual onset of bronchial asthma. The sandstorms didn’t help. “The air was always dirty. After a sandstorm you knew you had been breathing in sand because the inside of your nose was filthy.” By the summer of 2005 Devore was having serious breathing problems. When she eventually passed out one night in late July, the Army decided to medevac her home.
Devore spent the next year at Walter Reed Medical Center being treated for her spine injury, asthma and PTSD. She lived at the Malone House, on-base quarters for wounded soldiers and their families, with her sons, and then “on the economy” in an apartment in Silver Spring, Maryland. “But they didn’t increase my housing allowance so I couldn’t pay the rent.”
Her sons went back to her sister Monica in Wilmington while she continued her treatment for PTSD and began the fight for benefits. The VA was offering her disability benefits for her physical injuries but nothing for her PTSD, although her symptoms—depression, irritability, sleeplessness, hallucinations, nightmares and withdrawal—were well documented. “If I didn’t have to fight as hard as I did, my PTSD wouldn’t be as high as it is. I know the military says to suck it up and drive on, but they can’t give me my lungs back again or make me whole mentally.”
At home in Delaware, Devore works to overcome her distrust of the world around her. “I used to drive down the middle of the street, I was so anxious. No one can come up behind me without me getting jumpy. I lock all the doors. When I walk down the street, I’m analyzing every little thing. I have trouble connecting with my kids.” She cites her faith as the reason she’s managed to keep going. “That summer in Mosul I was targeted as a trouble maker. I remember that one night I was drinking heavily. I was so depressed. I was suicidal. And I prayed to God, ‘I’m putting myself in your hands to take me home.’ Three weeks later I was on American soil.”
Devore is taking vocational education classes and attends group therapy for her PTSD at the Wilmington Veterans Center. Finances continued to be an ongoing problem. The Armed Forces Foundation gave Devore some money for clothes so she could attend college. “When I got back to the civilized world from war, I didn’t know how to get back into a regular routine. I was so hyped up on adrenaline. I don’t think I’ll ever really blend back in. When I put on my military uniform for drill I feel such anxiety; no, worse, I can barely get myself to put it on. They call that a ‘trigger’ and I have a lot of them. As I said to my social worker, ‘I can’t do the things Devore used to do. I’m not the person Devore used to be. I’m making up a new person. I just hope that person is up to the task of being a mother and having a life.” Devore has become a spokesperson for the Veterans Administration, giving advice to wounded warriors like herself on how to cope with their PTSD.
MEDALS
2 National Defense Medals, Global War on Terrorism Service Medal, Iraq Campaign Medal, Army Service Ribbon, Overseas Service Ribbon, Armed Forces Reserve Medal (with “m” device), Good Conduct Medal, Army Achievement Medal.
Army Chief Warrant Officer Richard Gutteridge at his combat outpost, outside the city of Hit, Al Anbar Province, Iraq.
Michael, Suki, Aaron and Kenzie Mills.
Army National Guard Sergent Michael Mills before his “Alive Day,” June 14, 2005 outside of Tikrit, Iraq.
Army Sergeant Brent Bretz serving in Mosul, Iraq, 2004.
Brent Bretz at Kathy Pearce’s home in Mesa, Arizona. with his niece.
Brent Bretz surrounded by children in Iraq.
Brent Bretz with General Peter Schoomaker Chief of Staff of the Army, receiving his Purple Heart.
Brent Bretz meeting with his family at the airport.
Brent Bretz at Walter Reed Medical Center.
Army Sergeant Nathan Toews outside of Kabul, Afghanistan before his “Alive Day,” June 13, 2006.
The Campaz family at Disneyland—Dee, Donoven, Korey and Veronique.
Army Sergeant Devore Barlowe in Mosul, Iraq, 2005.
Devore and her son, Devorian.
The Armed Forces Foundation h as been recognized on many occasions by the White House, Department of Defense
and the Department of Veteran’s Affairs. AFF President and Executive Director Patricia Driscoll is seen h ere with President Bush and his wife Laura Bush.
Jose Pequeno, Nellie and Elizabeth Bagley, Patricia Driscoll, and Governor Deval Patrick (MA).
The Armed Forces Foundation does much to aid wounded service members suffering from PTI and PTSD, it also provides comfort and care to the families of those troops.
Former Congressman Jim Saxton (NJ) with a wounded Marine at the monthly AFF hospital dinner at Bethesda National Naval Medical Center where most of our wounded service members are treated for PTI and PTSD.
Jose Pequeno and his mother, Nellie Bagley, at the VA’s Polytrauma Rehab Center, Haley Hospital, Tampa, Florida.
Hilary Duff appears with a wounded service member at Bethesda National Naval Medical Center while partnering with The Armed Forces Foundation.
Army PFC Rob Kislow while deployed to the border between Afghanistan and Pakistan, north of Khost, before his “Alive Day,” June 10, 2005.
Rob receiving a Purple Heart for his head and arm wounds at Walter Reed Medical Center.
Rob on his motorcycle in Bethlehem, PA, after leaving Walter Reed.
Rob showing his catch on an AFF sponsored fishing tournament.
Hidden Battles on Unseen Fronts Page 14