Author Archives: Susan Katz Keating

A reader emailed me privately this weekend, raising an important point.

How does PTSD relate to the civilian world? They’re the ones who make the laws and run the country. How can civilians understand that this is a real issue? – Wondering

Good points, Wondering. Thank you for raising them. The short answer is, our troops are particularly vulnerable to PTSD because of the work they do; but the syndrome  can descend on any one of us. I’ve encountered it myself in civilian life. Here’s just a sample of what it can do.

On April 16 2007, my editor at People magazine asked me to check out reports of an unusual incident in Blacksburg, Virginia. A gunman had opened fire on the Virginia Tech campus. By the end of the day. the world’s media had converged to cover the deadliest shooting spree on an American school grounds. My part: Investigate the killer.

And did I ever. I spoke to people who knew the shooter in childhood; lived in his neighborhood; and sat in his high school classrooms. After many weeks of this all-killer, all-the-time inquiry, I formed an intense image of his psyche. The image was so intense that I could not shake it – even when I wasn’t writing. The killer began to pop into my head, unbidden, at random times.  He shadowed me in the grocery store. He appeared in my rear view mirror, sitting in the back seat of my car. He lurked beneath the basement steps. One night, I dreamt that he was crouched in a secluded corner on my deck, heavily armed and waiting for mychildren to wander within range. I awoke from that dream drenched in sweat, still smelling the cordite from his discharged weapons.

Because I had written so much about combat veterans, and because of my dad and because of another personal experience, I recognized the pop-up images and dreams as symptoms of PTSD. If I had not already been immersed in the world of PTSD recovery, I might have thought I was losing my mind, or was being haunted by the ghost of the Virginia Tech shooter. Instead, I knew to reach for familiar helpful resources, and to take a break from the situation. I needed to get away from murderers for a while. I needed to replace the creepy images with laughter, good times, and the beauty of Gods’ creations. It worked. But not all sufferers have acquired this hard-earned education.

A year after the shootings, an emergency room doctor who treated the Virginia Tech victims wrote an essay for the Washington Post. She wrote that after she worked so intensely to save the lives of grotesquely wounded young people, she could not get them out of her head. She could not sleep because she kept seeing the victims’ eyes. Later, she encountered a pneumonia patient gasping for breath, and instantly sprang into trauma mode because she thought the man had been shot. She wrote that she dreads the wind (the shootings took place on a windy day). And yet, she wrote: “I don’t think I have Post Traumatic Stress Disorder.”

Oh, really?

Here’s what I think. PTSD is both subtle and overwhelming. It can sneak up on sufferers and take hold, so that even a trained physician can overlook her own compelling symptoms. In my own case, I recognized my symptoms only because I have researched the issue as a journalist, and because I personally have journeyed through that fetid corridor of Hell.

What to make of these observations?

We live in a society in which a significant sub-group is at high risk for PTSD. Our military currently is at war. Our troops are exposed to violence, trauma, and the stress of deployments (and redeployments). Many will return home with PTSD. Many already have it.

We must, must, must continue to educate our troops about the signs and symptoms of this insidious syndrome. We must continue to look for treatments that work. We must establish consistent, humane policy towards those who have PTSD. And it’s not just the troops who are vulnerable. Any one of us can develop the affliction, whether it be from a day’s exposure to violence, or in the aftermath of trauma, such as domestic violence or natural disaster.

But the troops are top priority because, Wondering, there’s a whole lot of combat going on.

Today I meant to post more on the background of how we as a society have addressed PTSD. But my inbox is now flooded with stories from vets telling me their current stories. I’ve been reading and digesting all morning, with no end in sight. The tales are enough to make you want to pick up a pitchfork and jab a few soft behinds. First choice of a target: Addle-brained bureaucrats who know what the research says, but who can’t seem to develop a consistent and humane way to address PTSD-afflicted troops.

More on this to come. Meanwhile, if you are struggling with PTSD and would like to tell me your experiences, please get in touch. I’m happy to use your name, but anonymity also guaranteed. You can leave a comment here or on my blog, or send a message vai Facebook or email. I’m at Skeating428@aol.com.

If you are reading this blog, you most likely are a veteran. So I’d like to start by saying, thank you for your service to our country. If you deployed in a war zone, welcome home.

I learned to say those words in 1982, when a PTSD-afflicted “brown water rat” taught me that the phrases resonate deeply with veterans. This was only two years after the American psychiatric community formally put a name to PTSD. At the time, certain newly validated vets – my brown water friend among them - threw themselves passionately into advocating on behalf of their fellows. Advocacy included education, and teaching the noncombat-experienced public how to talk to veterans. I will write about “Brown Water Randy” and his good work in a forthcoming post; but today, I want to highlight an even earlier time. 

Before 1980, PTSD was a mysterious, nameless malady. It was unrecognized by mainstream society. but was very much known within a secret brotherhood: The veterans themselves. One of those vets was my own father.

Dad kept his malady a secret. I learned about it by accident when I was a young teen, eavesdropping on adult conversation.

One night around 1970, I was awakened from sound sleep in the middle of the night. Somone was pounding violently on the front door. The visitor was in a desperate way. He urgently shouted for my dad to let him in, right now.

The visitor was a family friend. He was a doctor. The last time I had seen him was at his going-away party to send him off to Vietnam. The doctor had been full of good cheer at the party, determined to save young lives. At one point during the festivities, he and my dad went off to sit alone under a tree, talking in earnest. It looked as if my dad were giving advice to the younger man.

Now the doctor was freshly back from war. He had stepped directly off his flight home and immediately came to see my dad. I listened from my hiding place while the doctor, speaking in tones I never before heard from a man, blurted out a horrific story. He was on board a medevac chopper, he said, leaving a combat zone, when the enemy lobbed a grenade directly inside the rescue Huey. A young medic instantly threw himself atop the doctor, saving our friend’s life – and losing his own in the process. The doctor could not come to grips with the experience. He said he kept reliving the moment. Over and over again, the scene replayed in his head; his mind; his heart.

The doctor thought he was going cray. I thought he was, too.  I figured my dad would know just what to do. He would make some excuse to leave the room, and would secretly call in the white-coats. But Dad reacted to the story with complete calm. He listened as if this were an ordinary tale. In fact, Dad said,  this sort of thing happened all the time. Dad said that many other veterans – himself included – experienced flashbacks from war. The flashbacks were troubling, he said, but they also were perfectly normal.

This came as a surpise to me. I already had intuited that my father felt guilty for surviving war while others died. But I did not know that he sometimes returned, in his mind, to the battlefield.

Still, the revelation made sense.

My dad, a former flame-thrower operator in the Korean War, was proud of his Purple Heart, but seemed to get upset when we asked how he earned it. It wasn’t just the Purple Heart questions that bothered him. He got upset whenever we tried to talk about his war experience. Once, my mother asked point blank if Dad ever killed anyone face-to-face. My father seemed to age visibly before our eyes. His silence - and his expression - gave us our answer, and also commanded:  Do not ask this question again. Another time, during a father-daughter outing to our favorite restaurant, a man rushed up to my dad and tearfully hugged him. When I learned that my dad had saved the man’s life in battle, I asked to hear more. Instead, my cheerful father disappeared into a state of mourning.

Dad also slipped into moods in response to the sights and sounds of war. He did not like fireworks. He loved war movies, but could not watch them. The combat scenes plunged him into an unsafe place deep within his own mind.

In early1970′s-America, scores of other veterans also occasionally slipped into unseen places. They weren’t crazy, and they overwhelmingly weren’t a danger to anyone except themselves. The biggest risk most of them faced was depression and a reduced capacity to be all they could be. Many, like my dad – who actually knew about the syndrome – did not understand that the flashbacks were not the only symptom. Some sank beneath the weight of their PTSD-induced depression. All were left to find their own coping skills. It is such a frustrating irony that at a time when t.v. news crew brought daily combat  into American living rooms, and when throngs of citizens took to the streets to voice their opinions on the war, the actual combatants, the veterans themselves, were left to cope alone with their personal aftermaths.

I am happy to report that our doctor friend adjusted well enough to lead a productive post-war life. I lost track of him after my father died, but I would like to think that he became part of that informal network of veteran insiders. These were the brave souls who endured mockery, dismissal, and derision in order to state the truth: PTSD is real.

Among these men were Brown Water Randy. He suffered from PTSD, and he didn’t care who knew it. He wanted the entire country to know it. He wanted the nation to reach out to help the vets they relied on. Stop in at this blog tomorrow to learn how Randy was at the forefront of advocate-veterans who reached out to their fellows and worked to improve one life at a time.

Today starts my two-week gig as guest blogger here on the site. Before I take on my topic, I want to thank the good folks at the VA Mortgage Center for “borrowing” me from my home base. It’s an honor to be in such great company!

I’d like to use my time here to call attention to an important issue that hits home with me: Post Traumatic Stress Disorder, or PTSD. We’ve all heard a lot about PTSD, to the point where perhaps we’ve even become numb to the stories. But I assure you, people afflicted with PTSD are not numb; nor are their families. They feel the effects all too clearly. I should know. My own father walked away from the Korean War with a Purple Heart… and combat-related stress. He  never was diagnosed. In those days, we did not know about PTSD. But his symptoms tell the truth about what happened to him. Tragically, he did not survive his PTSD. I lost him more than 30 years ago; but I still feel the impact of his suffering. Now, I would like to do my part to raise awareness of PTSD, and to help other veterans and their families avoid the kind of pain my own family has endured.

Despite all the publicity today surrounding PTSD, it still is a tough issue to understand. During the two weeks to come, I will post more about this. For now, though, think of PTSD as an invisible syndrome; one without rashes or fevers or strange lumps on the body, but that makes its mark, all the same. 

A skeptical civilian recently asked me, “If it’s so real, why did it take so long to identify?” To answer that, I place PTSD within the context of another medical mystery that once surrounded our soldiers.

A couple of wars ago, our veterans returned from the combat zone complaining of strange physical symptoms and bizarre medical maladies. The vets believed their health problems were caused by exposure to a chemical in Agent Orange, a defoliant used in the Vietnam War. At first, the vets were dismissed as hypochondriacs, whiners, or worse. Eventually, though, the Veterans Administration affirmed that dioxin, the active “agent” in the herbicide, caused a plethora of biohorrors, including respiratory cancer, Hodgkin’s disease, skin cancer, and diabetes.

Agent Orange syndromes and PTSD both were pooh-poohed by the pertinent experts and bureaucracies, until overwhelming evidence proved otherwise. Significantly, people suffering from both of these syndromes had to shout long and hard before securing much needed recognition – and treatment.

The dioxin analogy doesn’t stop there. The approach to Agent Orange syndromes has been spotty and inconsistent. So, too, has our approach to PTSD.  On the one hand, we are confident that PTSD – unrecognized in my father’s day – exists, and in significant numbers. One study puts the figure at 27.8% of recent combat veterans. On the other hand, we haven’t compiled the manual on what to do about the people behind the statistics. A PTSD-afflicted vet might find him or herself helped or punished for showing symptoms.  Not the sort of set-up that encourages those who need treatment to get it.

Before I get too deeply into PTSD, I want to emphasize that not everyone who goes into combat comes out with a stress disorder. Nor does every case of PTSD turn into crime or mental illness. In fact, it’s the subtle cases that are hardest to detect, and that can, over time, evolve into something debilitating. That’s why this is such an important issue.

In the days to come, I will use this space to highlight the syndrome; to point out inconsistent policies; and to advocate for solid, reliable, humane ways of addressing PTSD.

 Our soldiers do not hesitate to give us their all. Once they become veterans, we owe them nothing less than thorough, diligent care .