Aug 7, 2010

Another casualty of war, another suicide; Will no one blame the war?

- Another soldier’s suicide underscores the VA’s enormous challenge: Keeping veterans alive, as the U.S. Army last week in a maddeningly obtuse report blames "high risk behavior" of troops at home and "erosion of adherence to existing Army policies and standards." ... "[Iraq war veteran Iraq war veteran Kortney Jensen] was never the same person after he came home,” said father-in-law, Grant Becherini. “It was a different Kort that came back. The real Kort died over there." Not according to the Army. -
By Matthew D. LaPlante The Salt Lake Tribune

The demons would always be there. Just over his shoulder, just within earshot, just close enough to remind him that his life would never be what it was.

They would keep him from sleeping. They would befuddle him in the midst of simple tasks. And, on occasion, they would entreat him to end it all.

But Kortney Jensen was a fighter. He had endured two tours of duty in Iraq, survived more than 75 roadside bomb detonations and was twice awarded the Purple Heart.

And in this new fight, he was well armed. He had the unconditional support of his family. He was plugged into mental health treatment at the Veterans Affairs hospital in Salt Lake City. And he was looking forward to the future: a friend’s wedding, a vacation with his mother and the birth of his second daughter.

With all of that to live for and more, the 27-year-old Army veteran had made it through some very dark days. He’d beaten back the demons.

But he could not destroy them.

‘We are getting better’ » Since 2001, the U.S. Department of Defense has acknowledged the deaths of more than 5,600 military members in Iraq and Afghanistan ­— a grim, flag-draped tally that has contributed to a significant loss of support for two once-popular wars.

But the count is incomplete. The Department of Veterans Affairs believes that more than 6,000 veterans — including many who have served in the nation’s ongoing conflicts — will commit suicide this year. VA officials say many of these deaths are as much a consequence of combat as those resulting immediately from bombs or bullets.

In the long run, the National Institute of Mental Health has estimated, suicide will eclipse roadside bombings as the leading cause of death among those who have fought in Iraq and Afghanistan.

Yet it could be worse. The VA has endured years of criticism for being slow to react to the suicide crisis; some have even suggested that its behemoth bureaucracy has aggravated the mental health woes of those it was serving. But in recent years, veterans advocates have become more laudatory of the VA’s network of anti-suicide programs. Counselors working 24-7 at VA suicide hot lines have been credited with preventing thousands of deaths. And studies have shown that young veterans being treated by the VA are less likely to commit suicide than those who are not receiving services.

“I do feel like we are getting better,” said Dan Murchie, a counselor who works in a clinic for veterans of the wars in Iraq and Afghanistan at the VA hospital in Salt Lake City. “I think we’re starting to get a reputation as the team that can get things done, the team that can cut through the bull — the red tape — and help them get what they need to get better.”

One irony: Improvements in the way Murchie’s team works to prevent suicide have often come as a result of evaluating where they might have failed veterans like Jensen, who shot himself in the garage of a friend’s home on July 31.

“Right off, I ask: ‘Do I know this guy? When was the last time my team had interaction with him? What more could we have done?’  ” Murchie said.

Those were the same questions Murchie asked following the 2007 suicide of Iraq war veteran Jason Ermer.

Ermer’s mother said the Army abandoned her son, forcing him out of the service after he returned from combat with symptoms of post-traumatic stress. She believes that the care he received from the VA was inconsistent at best ­­— and dehumanizing at worst.

“He was heartbroken,” Rosa Ermer said in 2009. “He went over to Iraq, he served his country with pride, and then they took everything away from him. They knew he had problems and they didn’t take care of him.” Murchie ­— who made the call to police that led to the discovery of the Ermer’s soldier’s body — said he will always question whether he could have done more to save the soldier. All he can do now, though, is learn from the past and move forward.

But sometimes, he said, the answer is that “we did the best we could ... and that’s the most frustrating thing of all.”

‘He’d want to go, too’ » Jensen was working on a ranch in Idaho when he heard about the Sept. 11 terrorist attacks. Soon he was in a soldier’s uniform. And it wasn’t too long after that he was called into the fight.

His posting with the 3rd Infantry Division wasn’t a glamorous job, but someone needed to lay asphalt to replace roads being destroyed by insurgent bombs near Balad, in northern Iraq.

“We were too embarrassed to tell people what we did,” Jensen’s friend, Josh Hansen, recalled. “We were trained as combat engineers. We went over there to blow stuff up, but all we were doing was fixing things that other people had blown up.”

Mortars dropped onto the base every day, exploding this way and that. Sometimes the bombs were deadly, but mostly the blasts were a nuisance. Sometimes when the alarms sounded Jensen and Hansen would race to the mess hall, hoping to make it through the doors before the base was locked down for safety. Say what you will about Army food, they found it better to be locked in than locked out.

“We really became very close during that year,” Hansen remembered.

So close that, when Hansen decided to volunteer for a return trip to Iraq, Jensen was right at his heels.

“I purposefully didn’t tell Kortney about it, because I knew that if I told him he’d want to go, too, and I had so much love for him that I just didn’t want to see him go back there,” Hansen said. “So I waited until just five days before I was supposed to leave. I figured he wouldn’t be able to get orders that fast.”

He was wrong.

‘These disorders can ebb and flow’: Post-traumatic stress disorder is an exasperatingly inequitable disease.

For some, the experiences that Jensen had during his first tour in Iraq — dodging mortar attacks on base and rolling “outside the wire” on bomb-laden roads — could be enough to trigger a lifetime of anxiety, fear and hyper-vigilance. Other soldiers weather such experiences with relative ease, suffering only when repeatedly exposed to great levels of violence over a long period of time. And still others appear to be immune altogether.

Treatment results for those who suffer from PTSD are also uneven.

“Some people just don’t respond to treatment,” said Jennifer Romesser, a neuropsychologist at the Salt Lake VA. “The vast majority of people do well — they see significant recovery — but these disorders can ebb and flow over time.”

Nearly 10,000 veterans are being treated for PTSD at the Salt Lake VA. Complicating matters for many of those individuals, and particularly for veterans of the wars in Iraq and Afghanistan, is an injury that is fast becoming the trademark wound of the anti-insurgent warfare era: traumatic brain injury caused by the concussive, brain-rattling force of improvised bomb blasts.

Researchers have a great deal of information on brain injuries related to civilian accidents — falls, car crashes, sports injuries and industrial explosions. The worst of those injuries are thought to be similar in nature to what soldiers suffer in roadside bomb blasts. What is less certain, however, is what happens when brain injuries are combined with psychological wounds.

“Brain injuries could certainly contribute and exasperate the difficulties and symptoms of PTSD,” Romesser said.

One troubling symptom inherent to both conditions: impulsivity, or the inclination to engage in dangerous, deadly or even suicidal behavior without forethought. And veterans, Romesser noted, often have the means to act quickly upon suicidal impulses.

“In some cases, when they come home, they are never comfortable being disarmed,” Romesser said. “So they keep a weapon near them at all times. It’s deeply ingrained in them, but it can also be a risk factor.”

More than half of veterans’ suicides involve a firearm.

‘We were saving lives’ » Jensen’s second tour of duty began in the fall of 2007. This time, instead of building roads, he was responsible for clearing them. Night after night, his team of bomb hunters from the 321st Engineers of Boise, Idaho, set off in heavily armored vehicles in search of the hidden killers buried under the roads of Iraq’s volatile Anbar Province.

“We were pretty damn good at it,” said fellow soldier Chris Koeppel. “Kort was a huge part of that. He was a quick thinker. He was always right up front when things were going down.”

Jensen, a sergeant, and his team took pride in finding more bombs than anyone else — even though the way they found many was when their vehicles were rocked by explosions. “Better that we find them that way than for others who had less armor,” Koeppel said. “We were saving lives.”

In late July of 2007, a massive bomb detonated under Jensen’s vehicle, violently slamming the soldier against the inside walls of the machine.

Against his pleas, Jensen was evacuated from Iraq, first to a hospital in Germany, and later to Brooke Army Medical Center in San Antonio, Texas. There, he convalesced with military members who had been badly burned and lost limbs in roadside bomb blasts, the very sort of explosions his team had worked so hard to prevent.

“He felt like they deserved to be there a lot more than he did,” said Jensen’s wife, Laura. “He felt like his injuries were nothing compared to anyone else’s.”

The military and the VA disagreed. So did Jensen’s mother. “His body hurt all over,” said Mary Heiner. “His head, his neck, his spine. All of him hurt. He couldn’t sleep. He had night terrors. He couldn’t concentrate. He was just struggling so much.”

“He was never the same person after he came home,” said Jensen’s father-in-law, Grant Becherini. “It was a different Kort that came back. The real Kort died over there.”

Ultimately, the VA would rate Jensen completely disabled. It was not a badge he wore with pride, but he struggled to build a new life for himself. He took up trapping. He joined a veterans’ motorcycle club. And he sought and received counseling at the VA.Slowly, family members said, Jensen seemed to have climbed out from the darkness. “He was always talking about the future,” Laura Jensen said. “All the time we talked about things we were going to do. We talked about the baby we were about to have.”

No one knows why Jensen ultimately decided to take his life. He didn’t tell anyone he was considering suicide. He didn’t leave a note.

No one is to blame » Andrew Wittwer knows he can’t save them all.

The case manager has worked at the Salt Lake VA for eight years, a period coinciding with an onslaught of new patients from the wars in Iraq and Afghanistan.

Early on, he concedes, the VA wasn’t up to the challenge. But over time, he believes, the system has gotten much better at keeping veterans from falling through the cracks.

But sometimes, he said, veterans won’t take advantage of all the services they are offered. And other times, he lamented, those services aren’t enough to combat the problems they face.

Nine veterans who were enrolled in the Salt Lake VA have killed themselves since October, officials reported.

“It’s heartbreaking,” Wittwer said. “There are challenges that I just can’t solve for them. There are things that are out of my control. ... All I can do is try to catch every possible scenario I can.”

The VA will conduct investigations into Jensen’s suicide in search of anything that could have been done to prevent his death.

But at least among Jensen’s family, the consensus is that the VA did all it could. “Sometimes things just happen,” Heiner said. “And no one is to blame.”

But if, in the process of investigating her son’s death, the VA comes upon something it could have done to save her boy’s life, Heiner said she would not be angry, but hopeful. “Whatever we can do now to save other people, we should,” she said. “That is the only good that comes from something like this.”

No comments:

Post a Comment