The Battle Within

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Apart from memories, a heartfelt suicide note is now the only keepsake a mother has of her son; the son whom she lost to constant recurring nightmares of the atrocities he witnessed in Afghanistan. His is by no means an isolated case. According to the US Department of Veteran Affairs, every 65 minutes a military veteran commits suicide. In 2012 more US soldiers killed themselves than died in combat. Treatment for Iraq and Afghanistan vets suffering from PTSD has cost more than 2 billion dollars so far. Multiple redeployments into war zones have not only had unprecedented financial costs for the US government but incalculable mental and emotional costs on America’s men and women in uniform and their families; a clear indication that the greatest casualties of war are seldom on the battlefield.

TIME CODE : 00:00 – 05:00

Judi:

Here’s to all the ones I love. I’m sorry I could not take it anymore. So it is time for me to go, to go to where the sun is always sunny and the grass is always green and the flowers smell like honey Levi left us a letter, my mother found it. To me it’s the most precious gift he gave me.

When my son was over there after operation Anaconda, they had to clean up land mines that were left around Bagram airbase for troops to come and they stopped to take a break, and a young Afghan girl came over and asked for a bottle of water. My son threw it to her and it hit the ground and when she stepped forward to pick the bottle of water up, she stepped on a land mine that they had missed and it killed her. My son ran and was holding her body, what was left of her, rocking her.

Narration:

Levi Derby was born in Cissna Park Illinois on May 13, 1981. He joined the army in 2001 and was deployed to Afghanistan six month later.

Judi:

I was very proud. That was something that my mother and I had encouraged him for quite some time. My father had served through World War II, my great-grandfather was the private guard to Keiser Wilhelm in Germany. Six generations or more, my family is… someone in my family has served. So I was very pleased that he had decided to serve his country.

He came home and all he had was a dead stare out of his eyes. He was like the walking dead. Anger, you could see anger in him and a coldness. The happy son that I had known, that loved life so much and loved children and animals, now would just seem like this shell of a person.

When he first came home, he was not home long when he was told that he would be shipping off to Iraq and he could not bear to go into war again. It was something he said he would never do again. He had told me when he came home that he had killed, and he would never ever kill again.

Narration:

Judy realized that her son was going AWOL and convinced him to speak to the base chaplain. Levi was not feeling capable of returning to war and agreed to an other than honorable discharge, therefore he was denied medical and mental health benefits of any kind by the army.

Judy:

He served honorably, I have it in record. I contested his discharge several times and the last time I contested it, they agreed that he had served honorably. He had went over as a TB2 and came back as an E3. He was promoted while he was there. Because of his illness that was a result from the war, I believe he should have been given a medical discharge.

Narration:

Levi was becoming more isolated, not taking care of himself or working and having recurring nightmares about his experience at war. He and his family realized that he was in need of inpatient health treatment and decided that he would go to a hospital in Kankakee. Aware of the high cost of treatment and his lack of health care coverage, when Levi and his grandmother were halfway to the hospital, he asked her to turn back.

Judy:

She drove him home, and my son had an Iraq that he had raced and he had pulled the engine out of the car about year earlier and it hung on a chain hoist.

TIME CODE : 05:00_09:53

Judy:

He asked his grandma to help him take the engine off the chain hoist and she did and She went to church. He tried again to call his counselor on the suicide hotline number and he had told her that he had gotten almost to the hospital, but not today and she said well what about tomorrow and he said, maybe, maybe tomorrow, but everything’s going to be okay and then he came over here andhe wrote his letter telling us goodbye and he went to my dad’s garage and he hung himself on the same chain hoist that my daddy had swung him on in a car tire when he was a little boy. and he had felt betrayed by our government and his family and his friends and he hung himself in my dad’s garage and mom came home from church and opened up the garage door to find my son.I think that he could still be here today had he been given the proper treatment.

Narration:

Every day, 22 veterans take their own lives. As shocking as the number is, it is actually higher if you count men and women such as Levi Derby’s. Veterans are killing themselves at more than double the rate of the civilian population with about 49,000 taking their own lives between 2005 and 2011. The question is, why has suicide become such an epidemic?

Adrian served as a Captain in the Army Infantry and spent 25 months in Afghanistan over two combat deployments. He now works as a journalist, writing investigative articles for the NY Times concerning PTSD and the high cost of war.

Adrian:

The veterans most at risk based on my experience would be those veterans that participated directly in combat operations. I don't think that's even a risk, I think that's probably a direct correlation that you participate in combat operations, there's a almost a 1 to 1 correlation that you will experience some amount of PTSD.

Narration:

One in 5 veterans of the wars in Iraq and Afghanistan has been diagnosed with Post Traumatic Stress Disorder also known as PTSD.

Yuval :

PTSD is a psychiatric disease or disorder that was defined in the early 80s, 1980s by the American Psychiatric Association, although it was known for many, many years actually.

Narration:

Dr. Yuval Neria, Director of Trauma and PTSD at the New York State Psychiatric Institute and Professor of Clinical Psychology at Columbia University Medical Center, runs one of the country’s leading trauma programs working with PTSD recovery.

Yuval:

It is comprised of a number of symptom clusters that mainly include reliving of the trauma; and here is the idea that a patient with PTSD is thinking and feeling and recalling aspects of trauma in an involuntary way again and again.

TIME CODE: 09:53 _15:08

Yuval:

The second cluster is the cluster of actually trying to be removed from the trauma. So because of the memories of the traumas and rethinking about the trauma, it activates a lot of anxiety, avoidance is a key component of PTSD, and that’s why PTSD patients tend to be removed from society, to be alone, to be lonely and to be avoidance of any reminders that can be associated with the trauma memories.

Narration:

A detailed study by the army surgeon general in 2008 found that three-quarters of young male troops saw someone seriously injured or killed, more than half were attacked or ambushed, and 88% received incoming fire. These traumatic memories tend to replay themselves over and over in these soldiers minds.

As with Levi Derby, the image of the young Afghan girl and the land mine was something he told his mother that he re-experienced on a daily basis. The constant stress of being in a war zone creates illness. These people witness things that disrupt their sense of inner security, what is right and wrong - creating tremendous inner conflict.

Adrian:

But in the military, there is the military story, and that is the story you are allowed to tell, to yourself, to your friends, to your family and to your fellow people in the infantry and whatever else. This is what happened, this is what is says on the piece of paper and that's the way it is. It's tough to live that reality out in a lot of different ways. I had ideas about what PTSD was going to be, but when it came down to it, it was a very innocuous event. They were attacking us or we were trying to help people & bad things happened but they were in the context of a greater logic. The time I was attacked and started running not forward but backwards for cover because the cover was closer to me and I didn't want to get shot. I still deal with in the present moment, now I check for locks. If I'm in a room, if I'm in a hotel room, in my apartment. I will make sure the windows are closed and the doors are locked every day. A lot of it just revolved around not drinking as much, taking myself more seriously, establishing routines, and writing and storytelling. Which is something that I hadn't made a lot of space for. But there isn't a lot of space for storytelling in the military. There's a lot of space for storytelling afterwards which is probably why so many of the best writers of the 20th century tended to be veterans of World War I, World War II and Vietnam.

US President Obama:

" Tonight I can announce over the next year 34 thousand American troops will come home from Afghanistan, this drawdown will continue, and by the end of next year our war in Afghanistan will be over".

Judi:

Number one, absolute number one when they take women and men and they send them into a combat zone or when they come back home, their immediate family needs to be brought in and they need to be given contact pointsthat they can go. They need to be given information. They need to be trained what to look for. They need to be given the help because they’re the number one help that’s going to help that person more than anybody else is their family. I believe that the soldiers need to be hooked up with veterans from other wars so that they have a safe place to go, to talk to someone else that can understand that’s seeing the elephant, as the expression goes. The family definitely needs to be involved. "They’re their first line of defense and they’re not educating them enough for them to be able to help. My personal feeling, if you’ve done once, you shouldn’t have to go back again."

TIME CODE : 05:08_20:00

Narration:

The government offers a wide array of mental health services including mental health assessments and testing, medications, psychotherapy and family therapy, and residential or inpatient care programs. However, if you are not entitled to these benefits because of an other than honorable discharge, the cost is prohibitive leaving them with little or no options as in the case of Levi Derby.

Inpatient mental health hospitalization costs an average of about $2000 per day. You need a minimum of a two week stay, ideally a 4 week stay, which costs between $14,000 and $30,000. This great expense is cost prohibitive for most American families unless the government can step in and can cover this cost.

Yuval:

I think that’s really very unfortunate. In fact, the main barrier I think for treatment currently is not so much the knowledge, the effectiveness of the treatment, there’s availability of trained clinicians – it’s really about being able to mobilize those young adults who are coming back from the wars and giving them a sense that there is hope out there. It’s so unfortunate, you know, there is a lot of funding coming from federal government and private foundations to war veteran’s treatment centers, and what you see unfortunately is that clinicians are available, treatments are available for those patients, but still patients are not coming to this treatment.

Adrian:

Right now the government is doing a pretty good job of helping, of encouraging society to help veterans with reintegration. And I'm not sure the gov't could be doing much more. I'm not even sure if that's even the role of gov't. In Vietnam, the gov't did almost nothing to help people reintegrate into society--that was a big problem . But the government and the military have a lot of programs designed to help people reintegrate. Maybe, the problem with any large bureaucracy is that people are going to fall through the cracks. I know because one of my soldiers committed suicide. And he definitely fell through the cracks. And there was nothing we could do to prevent that at the time.

Judy:

When he first came home they had him on pills to sleep, pills to deal with the nightmares, pills for the anxiety attacks. He always had a prescription for Lorazepam for the anxiety attacks. And then he doctor that was treating him, and one he said that his PTSD was so severe that he couldn’t tell for certain that he also didn’t suffer from bipolar disorder, and they started trying to treat him with medication for that and so many of the medications they tried, he ended up having an allergic reactions to them. My son also possibly had a traumatic brain injury that was never diagnosed. From the time that he had come back until the time he dies sometimes blood would trickle out of his ear and down his neck. Then I took the sheets off of his bed after his death and there was blood stains on the bed from his ears having bled while he was sleeping.

Yuval:

The efficacy of current treatment is modest, is not as great and as effective as we would like them to be. This is why there is a lot of research now on working on innovative treatments. Treatments that are informed by neuroscience research and treatments that can target directly these functional processes. Neural processes. Never the less, among the available treatments I would say that prolonged exposure is the most effective treatment. That treatment involves a gradual process in which we ask patients to recall and memorize different aspects of the traumatic experience again and again until they are comfortable with the experience, until the experience does not reactivate the remarkable anxiety that was associated with the trauma initially.

This is a way in which patients are able to gradually get to terms with what happened to them.

Bob Gebbia:

So this is why we walk tonight. To ensure that suicide doesn't continue to take the lives our love ones, our friends, our classmates, our co-workers, all the lives of those in the military and our veterans.

TIME CODE : 20:00-25:18

Chris Hedges

Hope, will only come now, when we physically defy the violence of the states. All who resist, all who are here today, keep hope alive. All who succumbed to fear, despair, and apathy become an enemy of hope. They become in their passivity agents of injustice. If the enemies of hope are finally victorious in this nation, the poison of violence will become not only the language of power but the language of opposition and those who resist here today with non-violence for the last thin line of defense between the civil society and its disintegration.

Judy:

We send them back over and over and over. No person can handle that. You see things in war that you can’t un-live it. You can’t un-remember it. It’s there with you forever, and then to make them go back multiple times is way too much. No human can handle that.

Yuval:

I think that assessment before and after deployment is key, the question is what happened with a soldier that is coming back home. The need for treatment is not only in the immediate point after redeployment. It’s really when those people are spending time at home, coming to terms with what happened to them.

Adrian:

The only way to really minimize PTSD amongst military veterans is to not go to war. War is a trauma factory, so if it's worth to us to go to war then we know that part of that calculus part of that cost, the human cost is going to be the suffering of the soldiers that go to war. And I don't know if it the most recent wars were probably worth the cost in human suffering.

Narration: According to The Department of Veteran's Affair every 65 minutes, a military veteran commits suicide. In 2012 more US soldiers killed themselves than died in combat. Treatment for Iraq and Afghanistan vets suffering from PTSD has cost more than 2 billion dollars so far.

Multiple re-deployments into war zones have not only had unprecedented financial cost for the US government, but incalculable mental and emotional costs on America's men and women in uniform and their families, a clear indication that the greatest causalities of war are seldom on the battlefield. 

   

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