Vets have a problem that no parades or VA funding can solve

By Patrick Mondaca

Special to The Washington Post

In 2003, I went to Baghdad as a military police sergeant with the U.S. Army. I came home a different man.

Instead of traffic, I see blocked convoys and kill zones. Instead of crowded subways and train platforms, I see hundreds of potential casualties hemmed in by machine-gun fire from superior advantages of height and terrain. On rooftops and window ledges and on the steeples of cathedrals, I see places of concealment for snipers. On our city sidewalks, I see the anxious faces of commuters running late. They are counting minutes. I am counting dead and wounded.

I have adjustment disorder, defined by the Department of Veterans Affairs as “occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress.”

Adjustment disorder is a strange diagnosis. It implies that the veteran is “adjusting” but that he or she is also having temporary difficulty doing so. It is a quasi-acknowledgment of a problem, but not a condition given the same priority as post-traumatic stress disorder. It also unjustly absolves the government for the mental wounds sustained at war.

Because PTSD can be so disabling, the government offers veterans diagnosed with the disorder varied treatment options and compensation. But to receive such a diagnosis requires a specific traumatic incident. “At a minimum,” VA states, “the veteran must provide the following: a stressor that can be documented; the location where the incident took place; the approximate date (within a two-month period) of the incident; and the unit of assignment at the time the stressful event occurred.”

The Union of Concerned Scientists has found evidence of Army and VA doctors being pressured to diagnose struggling veterans with adjustment disorder instead of PTSD. In a 2008 report of the issue, the group suggested that the aim of the pressure was cutting the cost of long-term, expensive health care.

It’s true — I do not have PTSD in the way it is traditionally defined. I did not suffer a trauma — that is, a specific occurrence of trauma, during my combat deployment. I bore witness to gruesome things in Baghdad, but to observe traumatic events is not necessarily to be traumatized by those specific events.

A soldier, however, may be traumatized by the entire wartime experience — by remaining in a continuous state of hyper-alertness and adrenaline. This theater of war rewires and reconditions the minds of returning soldiers.

I have sustained an adjustment of my person, of my sense of self, of my relationships and of what would have been my common surroundings in any peacetime society. My perception and understanding of the world have been altered: A house dog can be conditioned and trained to fight another dog to the death. A civilian can be conditioned to do harm to his fellow man — to maim, to wound and to kill. This is less a trauma than it is a casualty of war. It is a detachment from the rest of society — an inability of the soldier to come home completely.

Throughout the 2016 election, politicians treated the veteran vote as though it could be earned with empty promises of vast overhauls and additional funding. But my concern is not just about money and promises. They could pour all the resources in the world into VA without addressing the real issue at hand.

The problem is the rest of society. We’re ill- prepared to reintegrate our soldiers back into the “tribe,” as Sebastian Junger explains in his latest book. We don’t recognize the detachment a soldier feels when he or she returns to those who have not also “borne the battle.”

Our society is focused on PTSD and the identification of specific occasions of trauma and its treatment. But I am less injured than I am displaced. I will never belong, mostly because I have been something that most of my fellow citizens have not been and cannot be: a soldier.

I do not feel shame or guilt for my part in the war. If anyone should feel guilt, it should be you. You should feel ashamed for hiding behind my brothers and sisters in arms — for asking us to do the things that you would not; for cheering us on for doing the bad things in the bad places; for shaking our bloodied hands and thanking us for our “service”; and for parading us around and buying us shots of whiskey on Veterans Day.

The village has chosen us to do its dirty work, but the village doesn’t quite know how to bring us back.

We need more substantial strategies to integrate our soldiers back into society beyond hollow celebrations.

Patrick Mondaca of the greater New York area served in Iraq with the U.S. Army in 2003 as a military police sergeant.