My Injured Brain … My Wounded Heart

By Jayne Davis, DCoE Strategic Communications

Loss and recovery are common themes for individuals with traumatic brain injury (TBI). In my interview with Army Sgt. Mike Ortiz, he revealed his loss and his hope. This is his story.

It’ll be two years this June since I sustained a mild traumatic brain injury while serving in Iraq … since I worked as an Army mechanic … since I felt wholly myself—funny, athletic, outgoing and caring … since my wife said goodbye.

I’m stationed at Fort Bliss, Texas, but hope to find a job as a mechanic closer to where my two-year-old son lives. The Army says I’m fit for duty now (some days I’m still not sure) except for the weight gain from my long rehab. I’ll fix that, but I don’t see my wife and me fixing things. My behavior after the injury was just too hard on her. But, I want to be there for my son.

During my two tours in Iraq, I drove a wrecker, recovering blown-up vehicles and parts. One day, I was in a convoy on unfamiliar roads. In a convoy, you have to keep certain intervals for safety and we kept falling behind, so we punched it. What we didn’t see ahead was a hole in the road made by an improvised explosive device three feet deep and four feet wide—we hit it at 65mph. I tried to bounce with the seat, but there was so much force my head hit the roof like a projectile. When they asked me if I was ok, I said yes. Truth was my back was killing me—I didn’t even think about my head.

My back hurts … why are you talking about my head?

When I returned to the states, I saw a doctor for my back and related the story. He asked me a bunch of questions: did you develop a stutter? (I had); how many times did you hit your head? (twice); did you have anger issues that weren’t there before? (yes). I was getting frustrated because I didn’t know why he was asking those questions. I was there for my back, not my head.

When the doctor said I probably had a brain injury, I denied it. I later learned that denial and short-term memory loss are symptoms of TBI. I checked into the Jump Start program at William Beaumont Army Medical Center, Texas, which offers speech, physical and occupational therapy to service members with traumatic brain injuries and posttraumatic stress disorder. I did well. Then my wife left.

I didn’t want to tell my son: ‘Daddy got kicked out of the Army’

After that, I was constantly late for work, got into trouble, didn’t shave and didn’t care. Nearly seven years in the Army and I never got in trouble once. Now, I was in danger of being kicked out—what would I tell my son?

With encouragement from Army Staff Sgt. Victor Medina, I entered Mentis Neuro Rehabilitation and spent six months in cognitive and behavioral therapy. That was my turning point. The therapists helped me to understand that I had to take care of myself before I could take care of others.

I don’t blame her for leaving

Depression, anger, denial, problems sleeping, concentrating, memory loss—my wife dealt with all of this without the benefit of understanding traumatic brain injuries. She thought I was lazy, uncaring and belligerent when I didn’t bring things she asked for from the store or brought the wrong item home. I felt dumb because I couldn’t remember simple things. Little stuff, but it piled up.

I believe the real mistake was not involving her in my therapy from the beginning. If my story could serve a purpose, it would be to raise awareness of the impact a traumatic brain injury can have on partners and families; how incorporating them into the healing process from the beginning can help everyone understand and cope with the symptoms. Doing so just might save a marriage … and keep a family intact.

Support for families can be found with these resources:

■DCoE Outreach Center (866-966-1020)

■Veterans Affairs Caregiver Support (855-260-3274)

■Family TBI Resources

■BrainLine.org

■Traumaticbraininjuryatoz.org

New York State Police Officers

Editor's Note: One of the author is former servicemember

March 20, 2008 (San Dimas, CA) Police-Writers.com is a website that lists state and local police officers who have written books. The website added three police officers from three different New York State law enforcement agencies.

Peter S. Griffin enlisted in the U.S. Army on 13 March 1964 and was honorably discharged on 10 March 1967. After discharge Peter Griffin attended the Police Academy at Syracuse, New York and served as a Police Officer for the Oswego Police Department (New York) for over ten years. Peter Griffin is the author of When You Hear The Bugle Call: Battling PTSD and the Unraveling of the American Conscience.

According to the book description of When You Hear The Bugle Call: Battling PTSD and the Unraveling of the American Conscience, it “is a compelling, poignant and straightforward presentation of sickness and healing, righteousness opposing wrong doing, and the eventual triumph of the human spirit despite overwhelming obstacles and barriers. This very personal account of war and its aftermath was written to benefit combat veterans agonized by severe and chronic Post Traumatic Stress Disorder (PTSD), composed by one who is living the nightmare, one of their own, a fellow warrior. In the broader scope, this account is meant to help them, and their friends and loved ones to better understand this overwhelming psychological, involuntary, and innate response to continual, life threatening situations.”

Inspector Norman Denny, New York State Police (ret.), is the author of Manual for Police of New York State. According to the book description, “The most complete, accurate and timely information available for law enforcement in New York State. A compilation of a broad range of information sources vital to success.”

William Tolhurst began his law enforcement career in 1962 and quickly became a leader in the field of training and dog handling. He served as president of the North American Search Dog Network, and previously served three terms as the president of the National Police Bloodhound Association. Throughout his long career as a special deputy with the Niagara County Sheriff's Department, William Tolhurst has met every challenge. His expertise has been used throughout the United States, Canada and Australia. Every trail backed by his bloodhound testimony has resulted in conviction.

William Tolhurst is the author of Manhunters!: Hounds of the Big T and The Police Textbook for Dog Handlers.

Police-Writers.com now hosts 879 police officers (representing 385 police departments) and their 1843 police books in 32 categories, there are also listings of United States federal law enforcement employees turned authors, international police officers who have written books and civilian police personnel who have written books.

Army Releases Suicide Data, Promotes Prevention Programs

By Sgt. Sara Wood, USA
American Forces Press Service

Aug. 16, 2007 - Though its number of suicides increased in 2006, the Army's suicide rate still is lower than the rate for the same age and gender group in the overall U.S. population, according to a report the service released today. The Army Suicide Event Report, which tracks suicide attempts and completions and the factors involved, showed that in 2006 there were 99 suicides within the Army, 30 of which occurred in Iraq or Afghanistan. This is an increase from 87 suicides in 2005 and 67 in 2004.

According to the report, the Army's suicide rate for 2006 was 17.3 suicides per 100,000 soldiers. This compares to the overall U.S. population rate, for the same age and gender group, of roughly 19 suicides per 100,000 people.

"The loss of any member of the Army family is a tragedy, and the Army has made prevention of suicide a top priority," Army Col. Dennis W. Dingle, director of the Army's Human Resources Policy Directorate, told reporters at a media roundtable today. Dingle noted that the number of confirmed suicides in the Army has been rising since 2003, and leaders are emphasizing suicide prevention and education programs to counter that trend.

"Our message to you today is that the Army recognizes this issue and is taking deliberate steps to mitigate those risks that may contribute to suicidal behavior," Dingle said. "Our prevention efforts do help our soldiers and their families deal with the challenges they face every day."

A majority of suicides in 2006 involved firearms, the report says, and the most common contributing factors were failed personal relationships and occupational, legal and financial problems. The report did not find a direct relationship between increased deployments and suicides, Dingle said.

Army officials do recognize that increased deployments put strain on soldiers and on their relationships, so deployment frequency and length was closely examined in this report, Army Col. Elspeth C. Ritchie, behavioral health psychiatry consultant to the U.S. Army surgeon general, said at the roundtable. While the data has not shown a correlation between those factors and suicides, other studies, such as the Mental Health Assessment Team, have found that longer and more frequent deployments have increased the rates of post-traumatic stress disorder, anxiety and depression, she said.

"We have not yet seen an increase in suicides in multiple deployers or those who have been there longer; we may over time," Ritchie said. "We're certainly looking for that and certainly wanting to do everything we can if we do see that as an issue to mitigate any of those factors there. ... The senior Army leadership is paying very, very close attention to these issues."

This report is one of many ways the Army is working to gather information and improve its suicide prevention and training, Ritchie said. The Army is focused not only on preventing suicide, but also on increasing awareness about mental health issues and decreasing the stigma associated with seeking mental health care, she said.

In mid-July, the Army began a new training program for post-traumatic stress disorder, brain injuries and stress. This training will be given to every soldier -- active-duty, National Guard and Army Reserve -- within 90 days, Ritchie said. The Army also is taking the data gathered in this report and others and integrating it into their suicide prevention and training program, she said. For example, the Army's suicide prevention has historically focused on young men, but lessons learned recently have caused them to expand the program to focus on women and older men as well.

The Army also is working on hiring 250 more mental health professionals, and all the Army's medical personnel are being trained in recognizing post-traumatic stress disorder, brain injuries and suicide risk, Ritchie said. In addition, the Army is instituting programs to reduce the stigma associated with seeking mental health care, she said.

"We need to make sure that all our soldiers know that it's OK to come in and get help, and we're there to offer it for you," Ritchie said. "I think it is very important for everybody to recognize how difficult a completed suicide is on the soldier's family, on the soldier's unit, on the friends, on the whole system, and the pain and hurt of a suicide lasts for years."

It's difficult to know how effective a suicide prevention program is, Dingle said. However, Army leaders have taken a great deal of feedback from soldiers in the field about what solutions would work for them, and have integrated it into their training programs, he said.

"We continue to adapt the program to get to training and awareness training and intervention techniques that will help our soldiers deal with those stressors that could ultimately lead to suicide," he said.

The feedback from the new training programs has been positive, Ritchie said. She said she has taught some classes herself and has been surprised at how willing soldiers are to open up and talk about their experiences. The Army will be able to track the effectiveness of the programs by monitoring the increase in referrals to behavioral health services, she said. The first data collection for this evaluation will be around Sept. 1.

Army to Launch Traumatic Brain Injury, PTSD Education Program

By John J. Kruzel
American Forces Press Service

July 17, 2007 – Within 90 days, all soldiers will receive information to help them identify symptoms of post-traumatic stress disorder and mild traumatic brain injury, and they will be urged to seek treatment if necessary, Army officials told reporters at the Pentagon today. Mental health care professionals will brief Army Secretary Pete Geren on the new program at the Pentagon tomorrow. And by Oct. 18, the same educational supplement will have been presented to platoon-sized groups of active-duty, reserve and National Guard soldiers throughout the force.

"The mild traumatic brain injury and the post-traumatic stress disorders -- they're real," said Army Lt. Gen. James Campbell, director of the Army staff. "They impact soldiers and impact those soldiers' families. And as a result of that, that impacts the readiness of our great Army."

During his 37-year career, Campbell said he recalls only two other instances when the Army mandated such extensive "chain training" programs.

According to subject matter experts, mild traumatic brain injury is an affliction that's become a signature injury of the war on terror, often resulting from soldiers' proximity to roadside bombs, mortars and other explosions. Symptoms are similar to those resulting from a concussion, from slower reaction times to emotional and cognitive problems.

PTSD often occurs from a feeling of helplessness at the time of a severely traumatic event. It manifests itself in three clusters of symptoms: intrusive re-experiencing of the event, numbness or disassociation, and hypervigilance, or the feeling that one is constantly "on edge."

Traumatic brain injury, which ranges from mild to moderate and severe cases, requires an "injury event," while PTSD can occur from cumulative effects of combat or extended deployments.

During two 30-minute multimedia presentations that make up the program, soldiers will learn to identify basic symptoms in themselves and other soldiers. Afterwards, health professionals will answer troops' questions. The Army also has produced a video to make soldiers' family members more sensitive to possible warning signs and treatment options.

Campbell said the program's main objective is to reverse the tendency in military culture to attach a stigma to mental health care.

"I'm not naive. There is a huge culture issue here, and it is this: that those leaders or soldiers who seek help could be perceived ... as being weak," he said. "The whole thrust behind this program is that if you are, in fact, someone who needs help, that desire to get that help is not perceived as a weakness but rather as a strength, as a personal courage to do it."

Anticipating greater demand on its medical system, the Army is actively recruiting health care practitioners, hoping to gain 270 professionals. Currently, some soldiers wait up to one month before receiving treatment; the Army is seeking to reduce that amount of time.

"The sooner the intervention is made, the easier it is to treat," said Army Dr. (Col.) Elspeth Cameron Ritchie, director of Army's Proponency Office for Behavioral Health. "We don't want another Vietnam. We don't want people with chronic symptoms who first present (them) 15, 20, 25 years later when it's really hard to get rid of the symptoms.

"We want to take care of them and help the person right away," she added.

Soldiers and their families will be able to learn more about the program at www.army.mil. Also, the Wounded Soldier and Family Hotline can be reached at 1-800-984-8523, or via email at wsfsupport@conus.army.mil.

Guide Offers Post-Traumatic Stress Disorder Resources

By Donna Miles
American Forces Press Service

June 15, 2007 – After watching her own son return home from combat with post-traumatic stress disorder, an Army mom wants to share the lessons she learned -- and resources she found -- with others who find themselves faced with the same challenges. Emily Afuola said she'll never forget the emotions that tugged at her and her family when they learned that Pvt. Matthew Afuola had been diagnosed with PTSD during his deployment to Afghanistan with the 10th Mountain Division.

"When families find out about this, they're scared and worried. They're in a state of shock and a state of panic," she said.

Afuola sought out every resource she could find to get answers and allay her and her families' concerns. "Initially, it was very, very hard," she said. "But I found that people were out there who wanted to help."

Afuola recognized that other families are confronting the same circumstances and wanted to share what she learned. She joined together with several other members of Blue Star Mothers of America, Inc., to produce a 17-page "Guide to Post Traumatic Stress Disorder" to help them.

"We knew that other families are going through the same thing we did, and we're hoping that through this, they won't have to walk the same path," she said.

The guide offers basic, easy-to-understand information about what causes PTSD and symptoms to look for, as well as advice for getting treatment. It recognizes the effect a servicemember's PTSD has on family members, and the role they can play in helping their loved one deal with the affliction.

One of the guide's most valuable resources is an extensive list of places to turn to for help.

Afuola emphasized that the guide wasn't compiled by mental health professionals and isn't designed to replace the services they offer. "We just realized a need for something like this, and wanted to help make things a little easier for the people affected," she said.

Initially, the Blue Star Mothers had planned to roll out the guide during the group's annual convention in August. But so many people were seeking the information, Afuola said, organizers decided to publish it as quickly as possible. "We realized that there was a need to do something now, not to wait," she said.

Afuola said she's hopeful the guide will help reduce uncertainty surrounding PTSD and encourage more people who have it, or whose loved ones have it, to step forward. "We want to change some of the stigma so people can come forward without fear of retribution," she said.

The guide is available online at the Blue Star Mothers Web site, www.bluestarmothers.org. Afuola also includes her e-mail and phone number in hope that servicemembers or families in crisis will contact her directly.

The message she hopes servicemembers and their families take away from the guide is simple, she said. "There is hope, and people out here who care about you," she said. "We want them to know that even when they can't stand up for themselves, we will stand up for them."

Blue Star Mothers Inc. is a non-partisan, non-political organization committed to supporting servicemembers and their families. It is a partner in the Defense Department's America Supports You program that showcases initiatives groups, companies and individuals nationwide are undertaking to support America's men and women in uniform and their families.

Post Traumatic Stress in Law Enforcement

Editor's Note: The PTSD issues seem relevent to the military.

Police-Writers.com is a website dedicated to researching and listing state and local police officers who have written books. The website now hosts 560 police officers (representing 234 police departments) and their 1179 books in six categories. The website also researches and lists separately, federal law enforcement writers, civilian police personnel and international law enforcement officers. The website added a new international police writer from Australia, Esther Mckay.

Esther McKay served in the New South Wales (NSW) Police Force (Australia) for seventeen years, attaining the rank of Detective (technical) Senior Constable. She worked in Forensic Services for fifteen years, specializing in crime-scene examination and vehicle identification. She has a Diploma of Applied Science in Forensic Investigation (NSW Police) and was awarded the National Medal of service in 2001. Esther Mckay retired in 2001 after becoming medically unfit with Post Traumatic Stress Disorder (PTSD).

Esther Mckay is the president of the Police Post Trauma Support group; and, a strong advocate for improving the mental health conditions for both active and retired law enforcement officials. She is the author of the Australian bestseller Crime Scene.

Esther Mckay said of Crime Scene, “it is an autobiographical account of my work as a Crime Scene Examiner and the gradual onset of PTSD due to the constant exposure to trauma. Day after day my life was consumed by killings, distress and gruesome sites, each one adding another piece to an ever-growing mosaic that seemed to be made up of bloodied disposable gloves, plastic bags and human waste.”

According to the book description, “When Esther McKay, an idealistic young constable with the NSW police, entered the tough, male-dominated world of forensic investigation; she was determined to hold her own. She soon found herself at deeply confronting crime scenes, often working alone and without supervision. After years of long, lonely, exhausting days and nights, and following a particularly harrowing high-profile case involving the disappearance of two young boys, Esther had a break-down and was diagnosed with post-traumatic stress disorder. This is Esther's story. Powerful, moving and unforgettable, Crime Scene takes us inside the life of a forensic investigator, and reveals as never before the extraordinary demands and dangers of forensic work.”

The New South Wales (NSW) Police Force was established by the Police Regulation Act 1862, which was replaced by the Police Regulation Act 1899. In June 1987, the NSW Police Force (operations) and the NSW Police Department (policy and administrative support) were combined.

The NSW Police Force is Australia's oldest and largest police organization and one of the biggest in the English speaking world. It has 17,000 employees, including more than 13,300 police officers. The police officers serve a population of seven million in the state of New South Wales, an 801,600 square kilometer area comparable in size to Texas, and double the combined geographic areas of England, Scotland and Wales. The New South Wales Police Force operates on land, sea and from the air; and, provides community based policing from more than 500 police stations to a wide range of ethnic communities speaking more than 30 languages.