Sunday, 15 August 2010

A Tale Of PTSD

This was a chapter about PTSD that never made print in my book `Watching Men Burn` so I thought I would publish it here.

It’s a glorious summers day, you have the weekend off from a hard spell in the office, Its Saturday, you drive the family down to your local pizza hut, your children are laughing and asking you for ice-cream, looking in to your wife’s eyes you think what a lucky man I am, squeezing her outstretched hand you mouth “I love you”
That’s the last thing you can recall before waking up in intensive care three weeks later. Sat around your hospital bed are your brothers and sisters who have tears streaming down their faces, they can’t bring themselves to tell you the awful truth. On the same Saturday as you were munching your first piece of deep pan pizza a young 23 year old soldier Paul was sat in a bar alone getting very drunk and starting to cry in to his beer, he was recalling the horrors of his posting to Iraq with his Regiment. At a VCP in Basra his patrol stopped a small white Hyundai van and his best mate jock checked the drivers paperwork, as jock took the paperwork the insurgent detonated himself, in a blinding flash of white heat, jock and four British soldiers all under the age of 30 were incinerated. Paul was relatively lucky, he was hit by flying shrapnel suffered minor cuts and bruises and concussion.  His tour of duty was almost over so his Commanding Officer sent him back to the UK on early leave, his Sergeant Major told him to get pissed and forget about it, he was lucky. Paul left his local pub that Saturday afternoon and staggered home and went up to his bedroom, he pulled up the floorboards and took out his prize possession that he had smuggled back from Iraq, an AK74 assault rifle. Paul wasn’t the brightest of kids at school but he new that this weapon was developed in 1974 it had a calibre of 5.45mm it had a magazine capacity of 30 rounds, its loaded weight was 3,600g and its killing range was 1,350m.

Paul wasn’t 1,350m away when he sprayed his local pizza hut with 30 rounds of lethal ammunition killing 12 men woman and children. That sad Saturday afternoon the war in Iraq had found its way into the lives of innocent people because Paul had untreated PTSD.

The story I have just told you above is fiction. Unfortunately the above tale of Paul has happened around the world and will happen again. The point I am trying to make is the Government have a duty of care to our armed forces who have been in combat, but they also have a duty of care to the civilian population. I have tried putting myself in a civilian’s position when they hear of court cases involving servicemen who are suing the MOD because of stress. I would probably think the same thing, “Nobody forced them to join up.” “Its their job.” “My Granddad was in WW11 he’s not crying for compensation and he fought the Germans for 5 years.”  Why is it ok for a policeman to suffer stress when he witnesses a colleague gunned down in the street, or a fire-fighter to have emotional problems when he finds a small child burnt to a cinder in a wardrobe, they are not called wimps, they too were not forced to join up, but it seems that it’s ok for them to have normal emotional responses. If the Government want unemotional killing machines perhaps they should start to build androids to fight wars?  Here are some facts about PTSD.
Post traumatic Stress Disorder, or PTSD, is a psychiatric disorder that can occur following the experience or witnessing of life-threatening events such as military combat like the Falklands War, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the person's daily life.

PTSD is marked by clear biological changes as well as psychological symptoms. PTSD is complicated by the fact that it frequently occurs in conjunction with related disorders such as depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health. The disorder is also associated with impairment of the person's ability to function in social or family life, including occupational instability, marital problems and divorces two up to now in my case, family discord, and difficulties in parenting.

PTSD is not a new disorder. There are written accounts of similar symptoms that go back to ancient times, and there is clear documentation in the historical medical literature starting with the Civil War, when a PTSD-like disorder was known as "Da Costa's Syndrome." There are particularly good descriptions of posttraumatic stress symptoms in the medical literature on combat veterans of World War II and on Holocaust survivors. Careful research and documentation of PTSD began in earnest after the Vietnam War. The National Vietnam Veterans Readjustment Study estimated in 1988 that the prevalence of PTSD in that group was 15.2% at that time and that 30% had experienced the disorder at some point since returning from Vietnam.

PTSD has subsequently been observed in all veteran populations that have been studied, including World War II, Korean conflict, and Persian Gulf, Falklands War, Bosnia, Northern Ireland, and in United Nations peacekeeping forces deployed to other war zones around the world. There are remarkably similar findings of PTSD in military veterans in other countries PTSD is not only a problem for veterans, however. Although there are unique cultural- and gender-based aspects of the disorder, it occurs in men and women, adults and children, Western and non-Western cultural groups, and all socio-economic strata. A national study of American civilians conducted in 1995 estimated that the lifetime prevalence of PTSD was 5% in men and 10% in women.

Most people who are exposed to a traumatic, stressful event experience some of the symptoms of PTSD in the days and weeks following exposure. Available data suggest that about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these individuals develop a chronic form that persists throughout their lifetimes, unfortunately I seem to be on of these 30%.
The course of chronic PTSD usually involves periods of symptom increase followed by remission or decrease, although some individuals may experience symptoms that are unremitting and severe. Some older veterans, who report a lifetime of only mild symptoms, experience significant increases in symptoms following retirement, severe medical illness in themselves or their spouses, or reminders of their military service (such as reunions or media broadcasts of the anniversaries of war events). I sure that the 25th anniversary of the Falklands War will be very painful to many British veterans with PTSD.
The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect, and childhood physical abuse. The most traumatic events for women are rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse About 30 percent of the men and women who have spent time in war zones experience PTSD. An additional 20 to 25 percent have had partial PTSD at some point in their lives. More than half of all male Vietnam veterans and almost half of all female Vietnam veterans have experienced "clinically serious stress reaction symptoms.
PTSD also significantly impacts psychosocial functioning, independent of co morbid conditions. For instance, Vietnam veterans with PTSD were found to have profound and pervasive problems in their daily lives. These included problems in family and other interpersonal relationships, problems with employment, and involvement with the criminal justice system. Obviously many studies on PTSD were done on Vietnam veterans but it’s the same condition that affects British veterans
Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, and discomfort in other parts of the body are common in people with PTSD. Often, medical doctors treat the symptoms without being aware that they stem from PTSD. Often, At present the War Pensions in the UK refuse to accept that these other medical complaints that I suffer from are linked to PTSD and continue to ignore the findings of many experts in the field purely to keep your disability percentage down in my opinion.
The story above about Paul is fictional but the one below is very real.
Life for Gulf veteran who shot fiancée
Martin Wainwright
Thursday April 20, 2000
An army doctor and former SAS trooper who machine-gunned his fiancée to death in a pub car park started a life jail sentence yesterday after a judge dismissed his Gulf war syndrome defence as spurious.
Thomas Shanks, a consultant anaesthetist and holder of the Military Medal, reverted fatally into a calculating killer, a jury at Sheffield crown court decided, after nurse Vicky Fletcher jilted him for another man.
But his conviction for murder - instead of manslaughter which he had admitted on grounds of personality changes caused by Gulf war service as a captain in the Royal Army Medical Corps - was by a 10-2 majority verdict and came after a previous trial ended in deadlock.
Shanks, 49, showed little emotion at the verdict and sentence.
The family of Ms Fletcher, who was 26 years younger than Shanks and previously brought assault charges against him, welcomed the fact that "justice has at last been done." The shaven-headed doctor told police that he could not bear the thought of Ms Fletcher with another man, the court heard.
On the night of May 7, 1998, knowing she was drinking with her new partner at a pub near the hospital in Pontefract, West Yorkshire, at which he and Ms Fletcher worked, he cleaned and loaded the AK47 and put it into the boot of his car with a baseball bat, axe and knife. After confronting the nurse at one pub and scuffling with David Griffin, the 47-year-old who had taken his place, he tailed them to the Lamplighters pub in Castleford.
He told the court that what followed was unreal and "like being in a video", but witnesses described his behaviour as cool and controlled.
Shanks went briefly on the run but gave himself up near Glasgow after phoning his former wife, Julie, who had been placed under police guard with their nine-year-old daughter Jodie.
Shanks was one of nine children of a labourer who died of an epileptic fit. After his mother took to drink, Shanks ran away, and joined the army at 17.
The SAS changed everything - evidence from an anonymous colonel described him as exceptionally brave and honest - and on discharge he took O and A levels and qualified as a doctor at Birmingham University. But the court heard there had always been a darker side to him, including an incident when he head-butted a policeman after being arrested for drunken driving.
Problems grew after he was stabbed by skinheads in Birmingham during medical training, and became pronounced on his return from call-up as a RAMC doctor in the Gulf, the court heard.
Ray Bristow, a warrant officer who served with Shanks in the Gulf, said he had visited the doctor in prison and was convinced Gulf war syndrome had affected him.

Guardian Unlimited © Guardian Newspapers Limited 2005

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Now time for that stiff upper lip and a cup of strong tea.