Purple Hearts for PTSD?

19Sep13

This was published by BreachBangClear in two parts on September 17th and 18th.

http://www.breachbangclear.com/site/10-blog/485-should-we-award-purple-hearts-for-ptsd.html
http://www.breachbangclear.com/site/10-blog/486-should-we-award-purple-hearts-for-ptsd-part-ii.html

Yes, it’s a long essay. But some things can’t be explained in a short blurb. Especially something this close to my heart.

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SHOULD WE AWARD PURPLE HEARTS FOR PTSD?

No, we shouldn’t.

I came home from Afghanistan angry and depressed. Most of my problems came from guilt over one particular incident. Without going into too much detail, I felt that I failed to prevent another American’s death in combat. I knew that my feelings were objectively irrational. The situation had been chaotic and confusing, I was sick and suffering severe fatigue, and there was no way I could have known at the time what I found out later. But feelings don’t follow logic; even though I knew the man’s death was solely the enemy’s fault, I still blamed myself.

I had studied Post Traumatic Stress Disorder extensively between my Iraq and Afghanistan deployments. I knew I would come home with some aftereffects, which if handled correctly wouldn’t be permanent or debilitating. I also accepted my own responsibility for my mental state; I had reenlisted many times just so I could deploy, left one unit to join another that was going to Afghanistan, and volunteered for many combat missions I didn’t have to be on. I couldn’t complain about the result of what I chose to do.

I went to a VA counselor, and a civilian counselor. I talked things out. I shared my story with trusted friends. I leaned on my wife for support. My home life was affected, my work performance suffered, but I stuck to counseling until I worked through the issues. I made peace with what had happened. I’ll never forget it, and even now, four years later, I sometimes cry over it when I’m alone. I accept that I will never truly be over this incident, and to tell the truth I wouldn’t want to be. Occasional tears are my small but lasting tribute to a brave man’s life and death. But those tears don’t mean I have PTSD.

Two years ago I attended a class about PTSD. We watched videotaped interviews with PTSD victims. One was a former Special Forces sergeant named Paul Schroeder who had been awarded a Silver Star for valor but suffered from horrible PTSD after his discharge (I met him face to face a couple times). Another man on the video was a former Marine infantryman who had nearly destroyed his life with alcohol after his return from Iraq. We also listened to a speaker, a young woman who had completed two tours in Iraq.

I could relate to this woman. On one of her tours she had been a vehicle commander on a convoy escort team. I had the same job in Iraq. I experienced the same things, on the same missions, in the same places. For a couple of years after Iraq I had a startle response if someone used a camera flash near me, without warning me first (the first thing I saw when IEDs detonated near us at night was a blinding white or orange flash). I identified with the young woman, and while I didn’t come home with PTSD – no, the aforementioned startle response does not by itself equal PTSD – I understood how she could have it.

But toward the end of her talk, she said something that has come to trouble me greatly. This comment didn’t really register with me at first. As time has passed, and I’ve encountered many more instances of this, it bothers me more and more.

The young woman said her disability rating for PTSD was 30%. She was trying to get it raised, though. The reason?

“If I get it a little higher,” she laughed, “I can park in handicapped parking spaces.”

At the time, I thought it was a joke. I don’t think so anymore. In my opinion, too many veterans are jumping into the “PTSD business”, falsely claiming to have war-related emotional problems in order to receive a nice check every month, plus other little benefits, forever. This problem appears to be so widespread that many veterans of Iraq and Afghanistan are developing an automatic “This person is lying” internal response whenever we meet someone who claims to have PTSD.

This isn’t the response we should have. I’m not saying it’s “right”. But it’s hard to not feel that way after some of what we see and hear.

A sergeant, widely regarded as a malingerer, was on radio watch. A patrol near his firebase was ambushed. The patrol returned fire and pushed through the kill zone. No Americans were killed or injured, no vehicles damaged. The sergeant claimed PTSD because he listened to the ambush on the radio.

A large unit came home from a partnering/foreign military training deployment to a third world country. This country was not at war. There was no combat. Not a single soldier was in a firefight, no IED attacks occurred. Upon their return, a handful of soldiers claimed PTSD.

A Marine Iraq veteran I know well went to the VA to register for care. He saw a psychologist as part of the normal process. He told the psychologist the truth: he was never in combat, never heard a shot fired, never saw a casualty, never experienced anything more dangerous than rockets that landed far away and never hurt anyone. No nightmares, no isolation, no alcohol or drug abuse. His assessment? 30% disability for PTSD. He didn’t turn down the money.

A soldier told me that her deployment, which consisted of working 12 hour days as a supply officer, was traumatic. No, she was never in combat. But she worked crappy hours with no days off, was under constant stress from her superiors, and her marriage collapsed from the strain. “That’s PTSD,” she explained.

An Afghanistan veteran appeared on American Idol and told his story of being badly wounded in combat. He was called a hero on national TV and basked in sympathy for his terrible PTSD. Later, he was exposed as a liar who served one month in Afghanistan as a supply clerk and was never in combat (maybe I don’t have to go into much detail on this one, you might be familiar with it already).

My point is that fraudulent PTSD claims already abound, in addition to what certainly seems to be a zeal by the VA to diagnose veterans with PTSD. Those who legitimately suffer from it deserve all the help they can get. When they’re not stuck in the VA backlog, partly brought on by many vets who are gaming the system, they have access to therapy and medication. Yes, they deserve better treatment than what’s currently available. But do they need to be publicly recognized with a medal for suffering PTSD?

Recently an Afghanistan combat veteran, Army Major and author named Benjamin Tupper published an essay in the Daily Beast. Major Tupper wrote this essay as a plea on behalf of troops who came home from war physically sound, but suffer from PTSD. Tupper wants these veterans to be awarded Purple Hearts, just like those who suffer physical wounds.

In his essay , titled How The Purple Heart Can Help Heal Veterans with PTSD (http://www.thedailybeast.com/articles/2013/08/23/how-the-purple-heart-can-help-heal-veterans-with-ptsd.html), Tupper makes valid arguments, backed with personal experience. He acknowledges that veterans he has spoken to about it are almost universally against his idea, and admits he himself was opposed to it until recently. But he cites the veteran suicide rate as evidence that PTSD can be just as if not more crippling than physical wounds. He also points out that those who suffer Traumatic Brain Injuries – invisible wounds which weren’t recognized in the past – are now eligible for Purple Hearts. He argues that a veteran with PTSD is no less injured than one with physical scars, and deserves equal treatment.

For the record, I have nothing but respect for Major Tupper’s service. I don’t doubt the honesty of his opinion or his sincere desire to help traumatized veterans heal. I don’t disrespect Tupper for his views. But I can’t agree with him on this one.

One point of evidence Tupper uses to support his position is that Iraq and Afghanistan veterans are committing suicide at an alarming rate, leaving more veterans dead by their own hand than are killed in combat. On its face, that certainly does seem to suggest PTSD caused by wartime service is a crippling injury affecting masses of veterans. And nobody disputes the fact that one veteran suicide is too many.

But that statistic may not tell the whole story. Yes, the military suicide rate has risen dramatically. The civilian suicide rate has also risen to a similar level (20 per 100k vs 18 per 100k). Our Army “Resiliency” training informs us that 80% of soldiers who commit suicide have never deployed.

No, I’m not suggesting military suicides aren’t a problem. But they aren’t as simple as “being in combat makes you suicidal”. While I don’t accuse Tupper of making that simplistic argument, I do believe the general public often makes that assumption. Like everything else about the War on Terror, the reality is much more complicated than that. Suicides can result from a complex array of problems like alcoholism, drug abuse, mental problems or even PTSD from non-military causes (as Tupper acknowledges in his essay). And for those with suicidal ideations directly linked to combat, would a Purple Heart help? I don’t think so. Also, right or wrong, most soldiers who receive Purple Hearts for minor injuries are looked down upon by other veterans. This might lead you to think, as I do, that awarding a PH to a suicidal veteran might just make him feel guilty, which makes the problem worse.

My main argument against this proposal, though, is that it will create a wave of false PTSD claims. Tupper, to his credit, is aware that many veterans oppose his idea for this reason. But he offers a counterpoint: soldiers can lie to obtain other medals too. “Sadly, fakery can occur in any military award and that is why the current award system requires multiple witness statements to corroborate the award narrative. The same stringent review would be required for service members being submitted for PTSD related Purple Hearts: corroborating witness statements documenting combat exposure, as well as statements from professional mental health clinicians.”

The problem with Tupper’s proposed solution is that witness statements can’t prove or disprove feelings. Unlike awards for valor, which require witnesses to a specific action, there is no way to verify someone else’s emotions. Yes, witnesses could testify that a soldier experienced a traumatic event. They could testify to his or her behavior afterward. But they couldn’t give an insight into what that soldier is truly feeling.

In Iraq we had a soldier who was on numerous convoy escort missions as s gunner. On one mission in Baghdad his convoy was hit by multiple IEDs and small arms fire. He was wounded in the hand, but stayed on his gun. He was later given a Purple Heart and an award for valor, which we felt he legitimately earned.

But one day he got drunk on illicit liquor and passed out. He was taken to the base hospital. At the hospital he had to be restrained because he tried to fight staff members. At one point during his violent outburst, he screamed, “Have you ever been to Najaf? Then you don’t know what it’s liiiiiike!

This soldier could be viewed as suffering from the effects of PTSD. He had an alcohol problem. He had been wounded in combat. He was screaming about a dangerous place, maybe even having a flashback.

But when I had conversations with other soldiers in my unit about the drunken outburst, the response was either laughter or a dismissive shake of the head. “What the hell was he yelling about? Nothing ever happened to us in Najaf.” And the soldier in question, who by the way I still respect for his service and genuinely like as a person, was known to have an alcohol problem long before we deployed. When I asked him why he was yelling about Najaf, he laughed and said, “Man, I was just drunk. I don’t know what the hell I was saying.”

So was his behavior caused by PTSD, or just a lack of self-discipline? How can the military tell? Witness statements wouldn’t prove anything either way.

Tupper also acknowledges, “… most soldiers look down on awards given for minor injuries, arguing that doing so cheapens the Purple Heart’s significance for those who were killed or more gravely wounded.” I absolutely agree, based on my personal experience with the Army’s latest watered-down award: the Combat Action Badge. Yes, I was in combat. Yes, I earned my CAB. But some soldiers see the CAB on my uniform and think, “Huh. I bet he was on some huge FOB and a rocket landed a kilometer away. Sure, he was really in combat.”

I know they think this because I catch myself thinking the same thing when I see a CAB on a stranger’s uniform. I think this because during my Afghanistan tour a rocket landed in a living area, and the next day “CAB hunters” paced off the distance from the impact crater to their huts to find out if they were inside the rocket’s killing radius and therefore qualified for the award (even though numerous other huts blocked the shrapnel). I think this because in Iraq mortars landed near a tactical operations center, and everyone who was assigned to the TOC received CABs whether they were in the TOC at the time or not. I think this because I was there when another team had a vehicle window chipped by a rock, and one soldier wrote a report citing “damaged by gunfire” as the cause of the chipped window, then tried to use that to claim a Combat Action Badge.

I’m damn proud of my Combat Action Badge, because it means I’ve followed in the footsteps of generations of family members before me. But because of people who stretch the truth or outright lie to get it, the CAB doesn’t mean to others what it means to me. I don’t want the same thing to happen with the Purple Heart, one of our most respected awards.

When my brigade returned from Iraq, as part of our outprocessing we listened to a parade of representatives from veterans’ advocacy groups. One of those representatives urged us to submit a VA disability claim for anything that might be service connected. Ringing in the ear, sore elbows, lower back pain, headaches, anything.

One soldier asked, “But if we have a lot of problems, how many should we claim? Should we really claim every little thing?”
The representative answered, “Well, how much money do you want to get every month?”

Do I think some soldiers apply that same greedy, morally corrupt thinking to PTSD claims? You bet. The American military is a reflection of American society. If we have liars, cowards, posers and thieves in our civilian population, we’ll have some in the military. Awarding the Purple Heart for PTSD is guaranteed to produce more liars seeking an award, attention and money. Which makes it harder for real PTSD sufferers to get treatment.

In Tupper’s essay, he tells the story of a friend who was slightly wounded in Afghanistan, but almost killed himself in a drunk-driving accident, fueled by PTSD, after his return home. I don’t doubt Tupper’s story, and I wish his friend well. But I also have a friend who suffers from PTSD. My friend was horribly wounded and almost killed by a huge IED blast that killed two of his friends. He’ll never walk normally again and will struggle with memory issues the rest of his life.

Does my friend benefit if soldiers are awarded Purple Hearts for PTSD? I don’t see how. He would likely have to wait even longer to receive the services and benefits he’s entitled to, because of the mad rush of alleged PTSD patients who would mob the VA in search of a medal and a free monthly handout. If we think we have a problem with liars and posers now, wait until we start issuing Purple Hearts for how people feel.

As I said before, I don’t have PTSD. I know this, and two independent counselors confirmed it. But if the military changes its policy and awards Purple Hearts for PTSD, I could get one. All I’d have to do is go back to the VA, retell my story, add a few nightmares, claim I get scared in crowds or have withdrawn from my friends, say whatever’s necessary to meet the criteria for PTSD. No witness statements could refute what I claim to feel. And I could go home with a shiny Purple Heart, at the cost of only my integrity, on the back of a heroic American who died valiantly facing the enemy one horrible day in 2009.

I’d rather shoot myself than get a Purple Heart that way. I’d almost rather shoot myself than see others lie to get a free medal and monthly check. I’d venture a guess that even many veterans with PTSD would rather not get a Purple Heart for it. Even if I really had PTSD, I know that I could never look my horribly wounded friend in the eye and tell him about my “PTSD Purple Heart”.

Sorry, Major Tupper. Love you, brother, and I respect what you’re trying to do. But I just can’t see it.

And by the way, remember Paul Schroeder, the Special Forces sergeant suffering from PTSD who I mentioned earlier? Turned out he was never SF and never in combat. He was just another lying scumbag, holding a hand out for all the money he’d get for being a PTSD victim.

Available as an ebook on Amazon, Barnes and Noble and iTunes/iBooks. Also available in print and electronically at Tactical16.com.

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17 Responses to “Purple Hearts for PTSD?”

  1. I knew a guy who claimed PTSD from friggin boot camp. There’s no shortage of dishonorable shitbags that would line up for a free medal to go with their monthly handout.

    • Dan,

      I’ve heard several secondhand reports of people claiming PTSD from basic. I haven’t personally seen it, but I have met a soldier who said they couldn’t participate in any combat training because they’d have panic attacks. If someone like that deployed, freaked out because they heard a firefight, claimed PTSD and received a PH for it, I’d be f’kn pissed.

  2. 3 KHorn

    You are exactly right to resist this idea. The Purple Heart should be protected from being debased by too low of standards. As I’ve mentioned before, my father was a WW2 vet who fought with the 1st Division in North Africa, Sicily and Normandy. He picked up minor wounds a couple of times, such as when a grenade went off far enough away that the pieces of shrapnel that hit just penetrated the skin. He just scratched them out and poured iodine on them and never thought about it anymore and certainly never considered trying to get a PH. He did get a Purple Heart when a mortar shell fragment hit him in the head and knocked him out and gave him a concussion during the battle of Troina (kind of an amusing story on that) and his Oak Leaf Cluster during Operation Cobra in Normandy when an artillery shell fragment shattered his left leg. For Dad and his buddies, if it didn’t knock you out of the fight, you didn’t put in for a medal. His second wound ended the war for him as it took 8 months for the bones to set well enough that he didn’t have to wear a brace (he was still wearing the brace when my parents got married). He always had a slight limp and decades later the wound contributed to a need for a knee replacement, but he never put in for disability of any kind. His attitude was he could still do everything after the war that he could before, so how was he disabled? To hear people getting disability because they heard a firefight is just sick. If the WW2 and Korean vets thought that way, we’d be drowning in disability payments.

    • K,

      Your father’s generation had a much different mentality that today’s. Your father’s generation survived the Depression, and generally understood that life was tough. I think we’ve lost that today. The “Entitlement Society” pretty much believes that they’re owed something, forever. I know that doesn’t apply to all of this generation’s vets, but it’s way too common.

      And yeah, I think in a few decades we will be drowning in disability payments.

  3. 5 BobF

    Brain injury is one thing. But until there is a gizmo that can analyze and diagnose non-physical “injury” as accurately and definitively as an MRI, X-ray, or such for physical injuries, ruling out imagination, fakery, of self-caused “thought injury,” I vote no. I just can’t equate injury measured on a factually solid-evidence scale with PTSD, and until PTSD rises to that level of certitude I cannot support award based on it. Treatment? Oh hell yes.
    But award of a Purple Heart? No.

    Many years ago I had issues. Intending to make a career of service, there was no way I was going to have a mental health section in my medical records unless things got out of hand and I had to. Maybe not the smartest thing to do, but I handled it outside the fence. PTSD? I have no idea, but I don’t think so, it was just some things that needed working out. Looking back on it, it was nothing more than mentally moving back to where the rest of me was, doing a job every day in uniform. It didn’t take a lot and things worked out. Nightmare only occasionally and certain feelings for a while, but nothing that interfered with daily life. Should that merit a Purple Heart? What if nightmares were slightly more frequent? Where is the line drawn? What is the objective standard? It sure can’t be the magic stamp of PTSD because we know that is no truly objective standard.

    Treat PTSD, even if there may be a degree of fakery, because much like seat belts, the treatment is as much for the rest of us as it is for the individual. But base an award on it? No. I applaud the major’s interest, research, and thoughts. I appreciate the time he has invested in the subject — it is certainly one worth exploring. But I cannot agree with his conclusions.

    • Bob,

      Major Tupper did mention in his article that it may be possible to “see” PTSD with an MRI or other medical technology. I’m still unsure on that, though. It would have to be identifiable beyond a shadow of a doubt, just like a physical injury.

      Glad to hear you worked through your problems. Combat service leaves a mark on all of us.

  4. We’re stingey enough in handing the medal out (or not) for any number of combat-inflicted actual wounds.

    Giving it away to someone who was scared when some native kid jumps out and yells “Boo!” would be the inevitable result of such a foolish debasement of the award.

    The criteria right now work just fine. It also helps to make it a medal no one really wants to earn, which is why more than a few wounded combat vets refer to it as the “enemy marksmanship award”.

    • Aesop,

      I had an argument about what “real” PTSD is with my former company commander. He’s a great officer, and is very sympathetic to soldiers who are having problems. I made the point that “post trauma” requires “trauma” to begin with; people claiming PTSD because they heard a rocket explode a kilometer away haven’t really experienced trauma. He responded with the stock Army answer, “Everyone responds differently to trauma, and just because something didn’t bother you that doesn’t mean it wasn’t traumatic for them.” So I came back with this: a soldier in Iraq claims PTSD because he heard on the news that Selena Gomez and Justin Bieber broke up, and he just can’t handle that. So would that be a legitimate PTSD claim? I repeated his “everyone responds differently to trauma” quote right back to him. He didn’t have a good answer to that one.

  5. 9 Stuart the Viking

    I did 6 years in the Marines, and never saw any kind of combat (other than arguing with my ex-wife… I know, doesn’t count…). When I got out in ’95 we were told the same thing “Claim every little ache and pain so you can get service connected”. They even encouraged us to take the last few days before we separated and spend them in medical getting anything we could think of noted in our medical records so we could get our percent as high as possible (Hey, we had to get above a certain percent to rate a check every month, don’t we want a check every month?). Then, make sure to get a copy so they couldn’t screw you over.

    I didn’t. It just didn’t seem honorable.

    I’m with you on not giving out the Purple Heart for PTSD. Yes, PTSD exists, and people with it should be able to get help. I’m all for that. But a metal? no.

    s

    • Stuart,

      Unfortunately, not many people seem to share our view on that. I didn’t try for any disability because I’m not disabled, and whatever help is available needs to go to those who really need it. Plenty of others just see free money, and dive right in.

      By the way, when did you go to boot? I also served in the Marines for six years and got out in 95.

  6. Like the website;

    I served 6 years in the U.S. Army from 1985 to 1991, and did a tour in the first gulf war, I did have an exciting army career( For as long as it lasted). I and a lot like me will not ever claim PTSD, even if we had it, we will not talk to the VA about it. Once you talk to the VA, your name goes into NCIC and if you want to later buy a pistol…? forget it..you will not pass the expanded background check. and depending on the state that you live at, the police will come for your other firearms. I know of people that got 100% disability using the PTSD and other stuff with the claims and to me, it is a hustle for “Free” money. It shows a breakdown of morality. They say that 1 out of 2 present vets will try to claim something whereas the percentage of “older” vets are much less.

    • Mr. Garibaldi,

      I don’t believe PTSD gets reported to NCIC. There’s a lot of worry about that happening, but as far as I know there’s no provision for reporting mental health status. I know that as a cop I never saw any reference to mental health on an NCIC return. I’m familiar with one incident where a gun owner was ordered to turn over his weapons due to a mental health issue, but as far as I know that was reported and handled entirely at the local level. Although I get your worry about it.

      In regards to your last comment, I’ve also heard that present vets are claiming many more problems than previous vets did. One figure I heard was that WW2 vets who made a disability claim reported an average of two service-connected issues, while present vets have an average of seven. Don’t know if that’s true or not, but it’s believable. And I definitely agree, much of the quest for free VA handouts shows a breakdown of morality.

  7. 13 Rickey

    The main reason that the author has is stated as it will likely produce false reporting of PTSD. To this I respond, then you are willing to punish those who legitimately have combat PTSD on the grounds that some might fake it. Come on, that is a lame excuse. If that is the case, then, no purple heart should ever be given to anyone because there have been plenty of examples of those who have faked earning a purple heart who claimed to have suffered a physical wound in combat.

    • At no point did I advocate “punishing” anyone for having PTSD. What I advocate is maintaining the status quo: only awarding the PH for physical wounds. Yes, people can fake physical injuries (i.e. shooting themselves in the foot and claiming it was the enemy); however, there still has to be documentation, witness statements, etc. If we award PHs for PTSD, then we open the award to anyone self-reporting PTSD symptoms. As I discovered after publishing one of my PTSD essays, a veteran can literally get a PTSD diagnosis because they were scared once. Even if they never experienced combat, never heard a shot fired, never saw a casualty, even if they were never in actual danger themselves. According to the VA’s rules, if their trauma was fear of a military or terrorist attack they don’t even have to present corroborating evidence of the threat of an attack. I have a serious issue with awarding people a PH for simply reporting that they were scared once, with no evidence they were actually even in danger.

  8. 15 Craig Jones

    I think true combat related PTSD is worthy of the Purple Heart medal. I spent two tours in Vietnam, rec’d Combat Action Ribbon as well as other medals. I was not physically wounded, but I have suffered from PTSD for over 40 years, not knowing what it was until being diagnosed by local VA several yeas ago. Trust me when I say it leaves permanent wounds!


  1. 1 Veterans: Defeating ourselves, with the media’s help | iRON MiKE
  2. 2 Media Misunderstandings On PTSD | Vent4Vets.net

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