Broken Bodies, Shattered Minds: A Medical Odyssey From Vietnam to Afghanistan

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Broken Bodies, Shattered Minds: A Medical Odyssey From Vietnam to Afghanistan Page 21

by Ronald Glasser M. D.


  The sergeant was right on both counts. But what he also understood, though he might not have been able to put it into such clear-cut and definitive comments, was that this isn’t World War II and the Norman Rockwell world of his past and ours has vanished for good, but his job remains what it has always been, to make sure his recruits, male or female, stay alive and are kept fighting. And in a way, his efforts have paid off.

  The major cause of PTSD among female personnel in the Marines used to be sexual harassment. Today it is the same as male marines, namely, combat. This fact alone can be considered a success for women in the military, an equality based not on gender but on equal dangers and shared risks. While no one seemed to be looking, our armed forces have truly become equal opportunity organizations.

  The refusal to believe or accept the fact that we routinely, and in ever-increasing numbers, send more and more of our women into harm’s way, is as much a fantasy today as was the search for Weapons of Mass Destruction. We apparently have two parallel universes running side by side, one on the ground in Iraq and Afghanistan, and the other within the media and the rest of the country. And it is the issue of women in combat that may be the most compelling of the connections between the two and potentially the most contentious. It certainly will be the most illustrative of what has gone so wrong, and in the end, will probably end up saying more about us as a country than about policy, military strategy, and even day-to-day tactics.

  It does take that poetic but real suspension of disbelief to walk down the street after ten years of wars that have sent over 300,000 women to fight in Iraq and now in ever increasing numbers to Afghanistan and see a young woman on a street corner missing an arm or walking on a prosthetic leg and automatically assume that it was because of a motorcycle accident. Perhaps America can be forgiven for not caring, but not knowing is a whole different matter.

  In truth, the country, along with the military, has had a long history of ignoring or devaluing servicewomen. Until recently, women veterans have remained unrecognized while being treated as second-class citizens, even though many took on the risks and paid the price for being in combat.

  It is not that women have not been acknowledged as warriors. There are archaeological findings from Fifth Century B.C, burial mounds in Southern Russia that Sarmatian and Scythian women did participate in wars. Up to 25 percent of military burials contain skeletons of armed Sarmatian women buried with their swords, lances, and bows. Certainly when the Sarmatian and Scythian men were away hunting or fighting, these nomadic women would have had to be able to defend themselves, their children, their animals, and their pasture grounds, not only competently but successfully.

  It may well be that the Amazonian legend in Greek mythology was inspired by these real warrior women. But a race of Amazons cutting off their right breast to be better able to use a bow and killing all men except for procreation does not exist within the range of normal human experiences. Nevertheless, there remain enough archaeological signs throughout Central Russia and Asia Minor of female warriors dressed as men to authenticate the written accounts of the Greek historian Herodotus. But we don’t have to go back to the Greeks.

  Armed women have served as loyal bodyguards throughout the history of India. In medieval Scandinavia, women who did not have the responsibility of caring for a family could take up arms and live as warriors. Joan of Arc drove the English out of France. Throughout the late Nineteenth Century, the kings of Siam had a personal battalion of 400 spear-wielding women. And in the Twentieth Century, the Soviet Union began to train and incorporate women into the light infantry and the tank corps. But we don’t have to go back to medieval France, Siam, or the Russians.

  More than 20,000 women served as nurses in the American Expeditionary Force of World War I. They were subject to courtmarshal authority, although they had no rank or military status. How many were wounded during those days of long artillery barrages or became casualties by being in ambulances carrying the wounded along back roads is impossible to discover. There is simply no official information on the number of women killed. It was not considered to be in the country’s best interest to remind Americans that their women were being killed.

  Over 400,000 women served in the military during World War II. Though these women were recognized for their contributions, any acceptance of their ability to do difficult or dangerous military work was ignored. And again, deaths and injuries were never rigorously documented or even discussed. That kind of reporting was considered at best “unseemly” and at worst counterproductive to encouraging national enthusiasm for the ongoing war effort. There were some things that you simply didn’t talk about.

  We won the war in both Europe and the Pacific and immediately began to disarm by emptying out the dozens of battlehardened divisions. In 1948, with the Cold War heating up, Congress, aware of how our military had deteriorated since 1945, reluctantly turned to an untapped source of personnel and passed the first law allowing women to serve in regular peacetime forces. Necessity is indeed the mother of invention, or more accurately, of reality. But there were restrictions written into the law stating that women could not be promoted beyond the rank of captain in the Army, Air Force, and Marine Corps, and above the rank of lieutenant in the Navy.

  We had a decidedly divided Army at the time, with most generals coming from the more conservative and traditionallyminded Southern States and most enlisted men from the North. It was the time of integration in the military and so the Pentagon, not so sure about putting blacks in positions of authority, took the worst of both these Americas—a South where the people didn’t care how close a black man got as long as he didn’t get too high, and a North that didn’t care how high a black man rose as long as he didn’t get to close, and applied both views to women.

  The Pentagon did indeed finally let women into the armed forces, but at the same time restricted how high they could get and where they could go. Women in the Navy were barred from being assigned to ships other than hospital ships and Navy Transports, as if those ships could not be torpedoed or bombed, and from all potential combat missions.

  Korea provided more combat experiences for another 120,000 women, as anyone watching the TV show MASH would understand. 10,000 service women went on to serve in Vietnam, with one reported death from enemy fire, despite the fact that during the Tet Offensive, on any number of the military bases being overrun by the Viet Cong, nurses as well as clerk-typists, female motor pool personnel, and intelligence specialists had to pick up weapons to fight beside their fellow male draftees and officers. Years later, the nurses, at least, received their own memorial at the Wall in Washington.

  What is clear is that the years following Vietnam were a bad time for the military. Those remaining in the Army and the Marines during those rebuilding years were more concerned about reviving a dispirited and broken military, while focusing on institutional resurrection, and had little or no interest in experimenting with social engineering. But the Army had no choice.

  The draft was gone and recruiting was terrible. With an attitude of “any port in a storm,” the military did what they had to do and increased the numbers of women within its ranks. The Army decided and quite correctly, if still a bit gingerly, to use women, with their better education levels, test scores, and discipline, to help it transition to an all-volunteer force. There was little doubt though, that at the time senior Pentagon leadership thought of this as a temporary measure, pending the resumption, when necessary, of a future draft to adequately fill its officer and enlisted ranks with men. But again, and presumably into the future, women were banned from combat, but combat could not be banned from these women.

  Vietnam had shown that in any future conflict there would be no clear front lines and no truly secure areas. It had also shown the dangers of not having enough troops on the ground, not sealing borders, not having an exit strategy, and not adequately training women for combat. But all these messages were to be lost on an Administration as well as a Pentagon some thi
rty years later.

  Today those dangers are replayed daily in both Iraq and Afghanistan. This is a first hand account of what happens when you pretend not to be in combat when you are:

  After searching the desert for a while, she found a burlap bag. Dig it up, someone said. She started digging and pulling until she couldn’t pull any more. It was stuck. Then she noticed the wire coming out of it. “Put it down! Put it down!” the grunts yelled as they took off running in the opposite direction. She did as she was told and scampered away. Later, an EOD technician blew it up. It caused quite an explosion. If she had pulled any harder, she and those around her would have been toast.

  That still goes on in Afghanistan. Life and death based solely on what you know and what you have been taught. Not to be trained for combat in a combat zone is a prescription for disaster.

  The first Gulf War in 1991 pointed out the craziness of the no-combat directives for women. The established Pentagon “Risk Rule” at the time was that women could not be deployed in combat units such as the infantry, armor or artillery, but could be deployed in support units.

  More than 40,000 servicewomen went to war and one out of every five women were deployed in direct support of combat units, though the distinction of combat versus support had grown decidedly fuzzier each week during that campaign, and would become more fuzzy with each subsequent war and each new deployment.

  In the early 1990s, the U.S.S. Eisenhower, a navy aircraft carrier, received its first sixty women officers and enlisted personnel. They were not to be involved in combat operations, but sink an aircraft carrier and everyone on board sinks with the ship. During those years the three service academies also had become sexually integrated, giving the services a whole new cadre of competent female officers, while then Secretary of Defense Les Aspin opened combat aviation for the first time to women. The volunteer army needed bodies and some of the best bodies, as well as the best minds, were obviously female. The Pentagon understood that much about the wars we were to fight, even if the politicians had not yet caught on. When Desert Storm II began, the whole debate of whether women should be barred from actual combat took off again.

  But operationally there was no turning back. The volunteer army had made fighting a war impossible without putting women at significant risk and our decisions to fight the kinds of wars we were actually going to have to fight were clearly forcing us to do just that.

  From 2003 to the present, you would not find women in front line infantry units or driving tanks, but changes in technology and the very nature of our new wars had irreversibly blurred the definition of “being in combat.” A number of women, like Leigh Ann Hester, who were in military police or other support roles, found themselves in vicious fire-fights and under attack by rockets and mortar as well as taking hostile fire while flying choppers across the wide expanses of Iraq and through the mountain passes of Afghanistan.

  Women currently make up over 20 percent of the 1.9 million soldiers and marines already deployed to Iraq and Afghanistan. Between 2001and 2009 over 200,000 female soldiers, marines and another 80,000 women from the National Guard and Army Reserves had been sent to the two war zones, with those numbers increasing every month. The absolute numbers and the percentages of women we have put in combat is simply astonishing, as are the risks they face.

  The numbers of servicewomen killed is now approaching 700, as compared to one death in Vietnam, while the numbers of overall casualties—shattered limbs, penetrating head wounds, ruptured spleens and shattered kidneys, tension pneumothorax, traumatic brain injuries, burns, and PTSD—is passing levels of over 30 percent of all women deployed.

  In World War II less than 0.2 percent of women in the armed forces were killed or wounded. In Iraq and now in Afghanistan, with the absolute number of troops deployed considerably less than the 13 million troops sent overseas in World War II, that number has reached 2 percent and is climbing towards 3 percent. The absolute numbers of women killed or wounded in Iraq and Afghanistan compared to the absolute numbers in World War II is more than staggering. When I ask audiences how many women do they think have been deployed to Iraq and Afghanistan since 2001, without even mentioning the fact that most are in combat, I get numbers of 500, 2,000, and the occasional 5,000. Nobody knows, because nobody has been told. The women know the risks, yet they continue to enlist.

  Despite the obvious danger, the reason women join the military does not significantly differ from the reasons men enlist. But they do have more practical reasons for joining up. Title Nine, with the new acceptance and unembarrassed appreciation of the athleticism of young women, has something to do with it. These women can be recent high school or college graduates. They may need money for school. They may be seeking a career, want to do something fulfilling, or simply are looking for a challenge. Some want to follow in their father’s footsteps, while many want to serve their country. Others want the excitement, and some just want a steady job with the world as the background. Those in the National Guard are for the most part single mothers who chose the Guard for the extra money and to do things for their neighbors, like flood control and helping out during winter blizzards. But the majority, Regular Army, Marines, or Air Force, are, in one way or another, using the military as much as a way up as a way out. But being a single mother in any of the services fighting in Iraq or Afghanistan brings a different kind of price to these wars.

  New kinds of battles, new kinds of weapons, new kinds of strategies, and new kinds of tactics always bring new kinds of casualties. And our newest wars are no exception. In this war it is orphans, not their orphans, but ours. What is not in the records are how many orphans this war has left in its wake when those increasing numbers of single mothers are killed, or so severely damaged in mind or body they can no longer function as a parent when they finally do return home. It is as much a new legacy of these wars as the neurosurgical unit and the orthopedics wards. There are no numbers yet, but when this whole dark thing is over and the true data are finally compiled, those numbers will surely be in the thousands. A whole generation of children will be cared for by grandmothers, uncles, and aunts, all wondering how did all this happen.

  Yet even today, the servicewomen sent to Iraq and Afghanistan, and in continually increasing numbers, still cannot drive tanks, but they can and do drive Humvees and trucks. And it is Humvees and trucks moving through the open deserts and along narrow mountain roads in long, exposed convoys that the Iraqis and Taliban target with mortars and small-arms fire, as well as ever more powerful IEDs that tear soldiers and marines apart. The Taliban, the Sunni Insurgents, and the Iranian-backed Shiites, along with their suicide bombers, do not make a distinction between servicemen and servicewomen, and perhaps neither should the military or our government.

  We have chosen a volunteer army and without a draft that is the military we have and the one that we use. The distinction between female or male soldiers is a hold-over from some other age, like the nostalgia for the horse and buggy versus cars. It does not fit anymore but is itself dangerous. There are few soldiers currently on active duty in our war zones who do not fully accept women warriors within their ranks as long as they can pull their own weight. The angst about women in combat may be no more than the angst of those who simply cannot accept that biology is not destiny. But if we are going to choose to go to war and then send our soldiers and marines to make the fight, we should at least make sure that those we send, if not to win, at least know enough to stay alive and not get blown apart. Whether we like it or not, or admit it or not, our women are there, lots of our women, and we do have to train them as well as our men, and that training must deal with real combat and the ability to survive.

  But nowhere is this lack of interest or concern more evident then in the VA system. Even with over 20 percent of those deployed to Iraq and Afghanistan being women and even with the vast majority being in combat, there are still no female clinics available to care for women with their different medical and surgical issues aside from the
ir wounds and PTSD. Today across America, women walk into a VA hospital and are questioned by the guards and asked by intake workers, “Where is your husband?”

  Still a good, if not necessary, beginning would be to give all the women in the military advanced infantry training. It makes no sense to put these women at risk and not give them the skills to make the fight and survive those risks. War does not give its participants time for on-the-job training. In Vietnam, new replacements were told to watch who’d been there a few months and do what they did. That was the training. If the new troops would do that, they had a chance to survive, if they didn’t most would be dead before their first week was out.

  Women have to be cross-trained in the use of all weapons, including the 50-caliber machine guns. They have to be taught how to use their radios to call for fire support, a basic and necessary military skill, but one that women are not taught or permitted to learn because it is a combat-related skill. Women should also be taught those basic skills on how to care for a gunshot wound, as well as a leg or foot or arm that is blown off. The military has to teach these women how to fight, how to call in artillery and gunships, how to use all the weapons, and stop pretending that actual combat for them is not combat at all. Indeed, it would seem that everyone who is being shot at in either Iraq or Afghanistan understands that much about the reality of bringing democracy to the undemocratic.

 

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