Thursday, September 27, 2012

Army Surgeon Shares PTSD Struggles to Help Others

By Lisa Daniel
American Forces Press Service

WASHINGTON, Sept. 27, 2012 – As the Army conducts a worldwide stand-down today to draw attention to preventing suicide within the force, those who have survived attempts to take their own lives may take notice. One is Dr. Tara Dixon.

Army leaders and military officials, overall, say there are multiple reasons why service members commit or attempt suicide. Some are combat-related, but at least half are not. Many involve personal problems with love, money and the law, some that simmered for years before they even entered the military. The problems are complicated by each person’s coping abilities, or resilience, and other factors, they say.

Dixon’s story is less complicated; it is the story of one soldier’s struggle with post-traumatic stress disorder that eventually left her feeling so hopeless that death seemed the only way out.

Dixon, 38, of Georgia, was in her medical residency to become a trauma surgeon when she enlisted in the Army Reserve in 2004 after hearing that the military needed surgeons in the wars in Iraq and Afghanistan. She deployed as a trauma and critical-care surgeon to Iraq with forward-deployed units in 2008 and 2010 -- “me and some guys in a tent,” she said as part of a Sept. 13 panel discussion at the annual Warrior-Family Symposium, sponsored by the Military Officers Association of America and the National Defense Industrial Association.

“We got bombed routinely,” she said. “This was not a Geneva Convention war. We had to take the big red cross off the top of our tent because that’s where [insurgents] aimed.”

Dixon described the stress of treating “the guy I had breakfast with that morning” for critical injuries, and of having to make split-second decisions about whether to amputate a limb or risk transporting a soldier hours away to a Baghdad hospital. Then there were the abused Iraqi children brought in as decoys for insurgent attacks on the unit and the female soldiers who needed treatment for sexual assaults -- crimes she was legally bound not to report at the victims’ request, she said.

Dixon said she coped with the stress through the only outlet she had: running, sometimes 80 miles each week.

Still, she said, “It messes with your mind a bit.” And even though she felt the strain of post-traumatic stress from her first deployment, she soon returned for a second one.

Dixon returned to the United States in the fall of 2010, but the war was still with her. Among the many problems, she said, was returning as a reservist to a city without a military base and no means of support. “I was very much an outcast, and I felt very much alone,” she said.

She described the frustration and embarrassment of post-traumatic stress, of dropping her bags and running to pick up patients at the sound of a helicopter, only to realize she was at her local grocery store.

“It was very embarrassing and frustrating to me that I was nervous in crowds, that helicopters bothered me,” she said. “When you get back to a normal place, somehow your body and your brain don’t shut off” from the survival instincts of war.

“If we didn’t hit the ground when we were in Iraq, if we didn’t duck when someone shoots at us, we would be dead,” she said.

Even when she was fully aware of being thousands of miles from the war, Dixon said, she couldn’t stop from reacting instinctively. “If someone drops the communion plate in church and you hit the ground, that one part of your brain knows you’re in church, but you’re still going to react,” she said.

Dixon said she sought counseling, but her problems seemed only to get worse. Six months after returning from Iraq, she tried to end her life with an overdose of pills.

“I felt lost,” she said. “I was without hope.”

After struggling to find an inpatient facility through TRICARE and the Department of Veterans Affairs, Dixon said her family found a private treatment center where she would spend the next nine months recovering from PTSD. “They gave me my life back,” she said. “They gave me hope back.”

Today, Dixon says she is much improved. She has learned to understand PTSD as “a normal reaction to an abnormal situation.” And she has learned important tactics in treating flashbacks, skills known as “dissociation” and “reorienting.”

“In treatment, they teach you to look around,” she said in an interview with American Forces Press Service from Ocala, Fla. “Here in Florida there are big, beautiful oak trees. There are no oak trees or anything lush in Iraq.” Similarly, she said, “If you hit the ground and you look around and see Starbucks, you know you’re not in Iraq.”

Dixon is processing out of the reserves, and is using some of her medical skills as a veterans service liaison for The Refuge -- A Healing Place, in Florida, where she works with veterans and their families and helps them find treatment. She gets lots of calls for help, she said, including Vietnam War veterans who still struggle with flashbacks and nightmares and even a World War II veteran whose post-traumatic stress surfaced more than 60 years after he left the battlefield.

“Sometimes it helps knowing others have been through the same thing,” she said.

Dixon said she hopes her work will prevent the 9/11 generation of war fighters to not repeat the hard times so many Vietnam War veterans have had with post-traumatic stress.

As for her own struggles, Dixon said, “I’d like to say it’s curable and it’s done and it’s fine,” but she said she doesn’t know when she might stop reacting to things like fireworks.
“I know it’s a lot better,” she said.

Dixon is proud of her work in combat. “I never lost a coalition force in two tours,” she said. But the PTSD has made her career as a surgeon uncertain.

“I really enjoyed what I did,” she said. “It’s something I was very good at. That part is sad to let go. We’ll just have to see how time progresses.”

Navy Sets Course for Path to Chief Petty Officer

From Navy Personnel Command Public Affairs

MILLINGTON, Tenn. (NNS) -- The Navy announced guidance for the administration of the Cycle 218 Chief Petty Officer Advancement Examination and the Fiscal Year 2014 Active Chief Petty Officers (CPO) Selection Board via Navy message Sept. 26.

NAVADMIN 294/12 pertains to first class petty officers from the Full Time Support (FTS) and active component communities. Navy Selected Reserve (SELRES) exam dates and selection board information will be announced in a separate message.

The Navy will administer exams to active component and FTS Sailors Jan. 17, 2013.

Exam ordering timelines, eligibility criteria, deadlines for commands to confirm eligibility lists, waiver application procedures and special requirements are contained in the NAVADMIN. The message also outlines procedures and deadlines for submitting correspondence to the selection board.

Sailors should review their Official Military Personnel File (OMPF) for accuracy at

According to the message, the selection board will review the OMPF and performance summary record (PSR) parts I, II and III of all candidates as well as any items submitted by candidates. Each eligible candidate is responsible for ensuring their OMPF is correct and up-to-date with the latest evaluations, awards and other appropriate information.

Candidates may submit a letter to the board to provide any new information or missing information that is not currently in their OMPF.

Letters to the selection board for FTS CPO eligible candidates must be received by the Navy Personnel Command (NPC) customer service center by April 22, 2013. The FTS Selection Board is scheduled to convene May 13, 2013.

Letters to the selection board for active component CPO Selection Board eligible candidates must be received at NPC customer service center by May 28, 2013. The active component selection board is scheduled to convene June 17, 2013 and is the largest selection board held at NPC.

Letters to the board may be mailed or submitted electronically. Submission procedures and mailing addresses are outlined in the NAVADMIN. Communication to the board must originate from individual candidates; correspondence from the command or from any source other than the candidate to the president of the board will not be accepted or considered.

Additional information regarding this cycle will be posted at the NPC website under "Boards" at For more information read NAVADMIN 294/12 and visit the NPC website.

 For more news from Navy Personnel Command, visit

Mid-Atlantic Region Raises Awareness for Domestic Violence

By David Todd, Navy Region Mid-Atlantic Public Affairs

NORFOLK, Va. (NNS) -- The Navy is observing Domestic Violence Awareness Month in October as a way to inform the Navy's Total Force about domestic violence prevention, how to identify the warning signs and how to report abuse.

Domestic violence goes beyond physical abuse and affects all age groups and social classes - both male and female. It can include emotional, physical and/or sexual abuse.

"Preventing domestic violence is a Navy-wide effort that depends on the commitment of everyone," said Rear Adm. Tim Alexander, commander, Navy Region Mid-Atlantic. "I am confident we can reduce incidents of domestic violence by making sure our service members, civilians and their families receive the support they need, and that we hold offenders accountable. Domestic violence degrades readiness and we should never tolerate it."

As part of an effort to combat and prevent domestic violence, Alexander signed a proclamation, Sept. 25, declaring October as Domestic Violence Awareness Month in the Mid-Atlantic region. In signing, Alexander urged individuals to learn about the warning signs and how to identify domestic abuse.

"Oftentimes, victims don't want to come forward because they are afraid," he said. "We have an obligation to know what to look for and to become actively involved when it occurs."
Alexander stressed that help and support are available for those who are victims of domestic abuse.

"There is no shame in seeking help when someone is in an abusive relationship," he said. "Never hesitate to reach out to your Fleet and Family Support Center, or a Navy chaplain. There are programs and services in place now that can help victims and help us increase our prevention efforts."

There are two reporting options available for victims of domestic abuse: restricted and unrestricted. Restricted reports do not involve military chain of command or law enforcement. Unrestricted reports, however, will include an investigation by command and/or law enforcement. In both cases, victims can receive a full range of advocacy, medical and counseling services.

If you are a victim of domestic violence, speak with a counselor or victim advocate at your local Fleet and Family Support Center, a healthcare provider at a military treatment facility, or a Navy chaplain about the options that are available to you. You may also contact the National Domestic Violence Hotline at (800) 799-SAFE, or visit for more information.

The Family Advocacy Program (FAP) is available to support families in the U.S. and overseas. FAP staff members are professionally trained, respond appropriately to incidents of abuse and neglect, support victims, and offer prevention and treatment services. An important part of the program is a collaboration among FAP staff, military units, law enforcement, medical and legal personnel, family service centers, chaplains and civilian agencies. This coordinated community effort is essential for success in preventing and responding to abusive behavior within military families.
 To find a Fleet and Family Support Center near you, or to inquire about the services that are available, visit

For more news from Commander, Navy Region Mid Atlantic, visit

Carter Visits F-16 International Training School

By Air Force Lt. Col. Christine Rhodes
162nd Fighter Wing Public Affairs

TUSCON, Ariz., Sept. 27, 2012 – Deputy Defense Secretary Ashton B. Carter visited the 162nd Fighter Wing at Tucson International Airport here yesterday to learn about international F-16 Fighting Falcon aircraft pilot training.

The Arizona Air National Guard was one of several stops Carter made throughout the Tucson area.

"It was very good for our airmen to see a senior Department of Defense leader visit our installation," said Air Force Col. Mick McGuire, 162nd Fighter Wing commander. "Dr. Carter left with a strong understanding of our mission and the impact of our global training success."

Carter and his staff met with students and exchange pilots from Iraq, Singapore, Japan, Denmark, Poland, South Korea, Norway and the Netherlands.

Air Guardsmen here train more than 70 international student pilots per year, offering several training programs that range from initial F-16 training to qualify new pilots to an advanced weapons course, officials said.

The 162nd is the "face of the USAF to the world" providing the best-trained coalition warfighting partners for the U.S. Air Force, officials said. The wing has trained pilots from 28 countries that fly the F-16, while developing strategic partnerships and building strong international relationships based on performance, friendship and trust.

Dr. Woodson Says Have The Courage to Intervene for Suicide Prevention

By Dr. Jonathan Woodson, Assistant Secretary of Defense for Health Affairs

September is Suicide Prevention Awareness Month.  The Military Health System has an important role to play in educating the military community and the civilian communities where we live on how to recognize the signs of suicide risk, where to access care and treatment, and how to intervene.

 I don't need to recite the statistics for you. All of you follow the news, and know that action is required to address the incidence of suicide among our Service members and Veterans. Both the Department of Defense and the Department of Veterans Affairs are united in our approach and our outreach.  Earlier this summer  Secretaries Panetta and Shinseki joined our most senior military officers, our top enlisted leaders, and mental health experts for our annual DoD-VA Suicide Prevention Conference where the focus was on getting back to basics.

There are a few important points that have emerged from our research and our experts in the field.  First and foremost, there is no one-size-fits-all solution to eliminate suicide. This is a complex issue with many contributing causes. Yet, there are actions that we can and are taking to ensure everyone is more aware of what can be done.

Leaders, family members, friends and coworkers...the entire military community...MUST be engaged in identifying and helping those at risk.  Many suicidal acts are impulsive. When we can intervene to assist an individual in crisis, we can often prevent the suicide from occurring.

Step one is to get them help. We have made great strides in reducing the perceived stigma of seeking mental health care, but this is just the beginning.  Getting help is a sign of strength, not weakness. It takes more than the medical community to deliver this message, but I am very encouraged by the active engagement in this message from our line leaders, and - more importantly - from our senior enlisted leaders who have such a tremendous influence over our young men and women.

We also better understand how to build up our abilities to manage difficult life challenges, and bounce back from adversity. Each of the Services has introduced resilience training to provide leaders, individuals and family members with the skills to prepare for and manage personal and organizational stressors.

I'm proud too of the role that TRICARE has played in expanding access to critically needed services. Our networks serve an important role in supplementing our direct care system.  For our brothers and sisters in the National Guard and Reserves, who often live far from their units and military installations, this network is a lifeline. As a longtime member of the Army Reserve, I can personally attest to the importance of these services to men and women who live in every state in the nation.

The National Suicide Prevention Hotline (1-800-273-TALK),, and other resources are readily available.  We need to regularly communicate their value and easy accessibility to our friends and families in need and maybe even more importantly, to those close to someone who may be in need.

Bottom line: The key is recognizing others at risk and in crisis and not being afraid to step in.  Our job as military health care providers, paraprofessionals, and members of the DoD community at large is to have the courage to intervene.

So, we have messaged that there is no shame in seeking help, but how do you overcome the shame and anger you may be met with by taking someone by the hand and doing everything in your power to get them to help if they haven't asked for it?  You run the risk of being wrong and then what?  How can our medical community become a force multiplier in educating the larger community about where to find help for someone else and how do you coax a person on the edge to get help? These are the questions we must continue to address in order to save our comrades, our families, our neighbors, and fellow humans.

Suicide prevention will be a prolonged effort. Awareness and perseverance matter. We can do more, and we are doing more to strengthen our team. To be better prepared, check out our suicide prevention awareness information and resources at  Become the light of hope for someone by helping others learn where to go for help so as a larger DoD family, we can take care of each other!