PTSD-urple Heart
WSJ reports on a move to award Purple Hearts for PTSD:
WASHINGTON — Centuries before Iraq and Afghanistan, George Washington created the Purple Heart to honor troops wounded in combat.
But with an increasing number of troops being diagnosed with post-traumatic stress disorder, the modern military is debating an idea Gen. Washington never considered — awarding one of the nation’s top military citations to veterans with psychological wounds, not just physical ones.
Defense Secretary Robert Gates offered cautious support for such a change on a trip to a military base in Texas this month.
“It’s an interesting idea,” Mr. Gates said in response to a question. “I think it is clearly something that needs to be looked at.”
The Pentagon says it isn’t formally considering a change in policy at this point, but Mr. Gates’s comments sparked a heated debate on military blogs, message boards and email lists. The dispute reflects a broader question roiling the military: Can psychological traumas, no matter how debilitating, be considered equivalent to dismembering physical wounds?
Supporters of awarding the Purple Heart to veterans with PTSD believe the move would reduce the stigma that surrounds the disorder and spur more soldiers and Marines to seek help without fear of limiting their careers.
“These guys have paid at least as high a price, some of them, as anybody with a traumatic brain injury, as anybody with a shrapnel wound,” John Fortunato, who runs a military PTSD treatment facility in Texas, told reporters recently. Absent a policy change, Dr. Fortunato told reporters, troops will mistakenly believe that PTSD is a “wound that isn’t worthy.”
I thought they already had an award for PTSD. It’s called the Combat Infantryman Badge. Everybody who was in combat gets one.*
Critics note that military PTSD cases may include people who haven’t engaged the enemy. The standard for the Purple Heart, as I understand it, is relatively simple. Blood has to be drawn, or some degree of obvious physical trauma experienced, as a result of being engaged with the enemy. Drawing the line on PTSD could be considerably more complicated, even if it is a result of combat. What the degree of impairment should be required? Along the lines of what retired LTC Bob Mackey says in the WSJ article, I’d suggest anyone who’s spent 15 minutes in a pitched firefight, had a friend killed or gone on a combat assault with the reasonable expectation of not returning could make a case. Purple Hearts all around.
Brave soldiers who fought hard can be subject to terrible post-traumatic stress, and maybe that should be honored in some way. What about cowards? I don’t mean people who break down, have to be taken out after extensive combat exposure. What if you bolt or freeze under fire, fail to carry out your duty, maybe other soldiers are killed or wounded as a result, and you later claim PTSD. Are you eligible for a Purple Heart? Do you get honors instead of a court martial?
* OK, not everyone. Maybe that’s a way to address this. A universal award that shows a soldier, sailor, airman or Marine has acquitted himself or herself honorably under fire. I believe some service branches don’t have a CIB equivalent, and within the Army, soldiers who are not in certain combat arms specialties are not eligible. Given the fluid nature of the battlefield and broad exposure of rear echelons to deadly enemy fire, maybe they should have an equivalent available to all.
Prior:
Posted by Jules Crittenden at 11:00 am on Wednesday, May 14, 2008
4 Responses to “PTSD-urple Heart”
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May 14th, 2008 at 1:56 pm
Far out, I wonder if they’ll give me one for going off the deep end after stubbing my toe. That was the worst case of PTSD that I’ve had since I found out that my dog actually didn’t like me.
I really appreciate them devaluing the Purple Heart so I could get one too. The Purple Heart was the first medal issued by this country so I guess that it’s about time it was devalued. How else can you get one if you don’t qualify under their overly stringent set of rules. Imagine, having to actually get wounded to qualify! Why Splinter John is probably turning over in his political grave right now.
May 15th, 2008 at 7:52 am
While PTSD can develop over a single highly traumatic incident, in general it’s due to repeated traumatic stress.
Combat stress also takes its toll physically. A guy I work with has a bad back (really bad…) that he got, and then exacerbated, hauling a heavy rucksack around Iraq. And he did this, at times, during contact with the enemy. You can do an xray and see that the bones in his back are clearly not right, and he has a clear progression of symptoms during his time performing patrols and combat missions.
There’s a strong parallel here. Yes, due, in part, to contact with the enemy, his body is broken. But no chunks of metal pierced him or burnt him, no explosive concussion knocked him down, there was no single incident during combat that definitively caused this injury. It was caused by the job he did and it is a continuing burden on his life. But this kind of injury, as I understand it, doesn’t qualify for the Purple Heart.
So, with all due respect to soldiers with PTSD, and I’ve seen bad PTSD, that’s just not what the Purple Heart is for. And it would seriously devalue the medal because it would open it up to injuries that would be difficult to link to specific events. Even the CAB and CIB both require specific events to occur, not just “I was in country.” (The combat patch is issued for simply being in country with a unit.)
“The Purple Heart was the first medal issued by this country so I guess that it’s about time it was devalued.”
The Medal of Honor was established in 1862, the Purple Heart not for another 70 years at least.
May 18th, 2008 at 3:27 pm
Actually, all Army Soliders not eleigible for the Combat Infantry Badge are eliglible for the Combat Action Badge, which functions more or less the same way, just for everyone but Infantry.
As it stands, if a Soldier has received a Purple Heart, a CIB or a CAB, that is accepted as evidence of “service connection” by the VA for PTSD. This proposal just reverses the cart/horse relationship with regard to the OPH.
May 18th, 2008 at 3:32 pm
PTSD and the Purple Heart
An idea was floated recently to change the regulations for the Purple Heart Medal to allow it for Post Traumatic Stress Disorder. Current regulations require a physical wound. I have deep reservations about this, not because it’s not a worthy idea, b…