U.S. combat stress teams to help troops come home

BAGHDAD, Iraq -- The rocket-propelled grenade cut right through the turret of his Bradley Fighting Vehicle, spraying him with hot gas and shrapnel. That was more than three weeks ago, and Staff Sgt. Thomas Slago's physical wounds have healed.

On Saturday, though, Slago did something that the U.S. military increasingly views as an important part of an American warrior's recovery: He got to talk about it.

"I do have flashbacks. When I come up to intersections, I see rocket-propelled grenades coming at me," Slago, assigned to A Company, 3rd Battalion, 7th Infantry Regiment, said after meeting counselors to deal with the psychological side of his injuries.

Experts in post-traumatic stress warn that the flashbacks will not stop when he gets home. When it comes to dealing with combat stress and learning how to cope, the time, they say, is right now -- before the soldier returns to his family.

The U.S. Army has deployed combat stress teams to Iraq, and they are working their way through every unit to identify soldiers who need help and teach them to deal with flashbacks, nightmares and agitation that typify post-traumatic stress disorder.

Capt. Peter Johnson of San Diego is usually the first trained professional that soldiers assigned to Task Force 4-64 see when they need counseling. The 37-year-old chaplain monitors the unit for critical incidents and then talks to the troops afterward.

A critical incident can be a fierce firefight, friendly fire or the inadvertent killing of civilians. But for some soldiers, simply seeing dead bodies on the side of the road can be traumatic.

"What you're doing is looking at a single, or a series, of traumatic events," Johnson said, adding that combat stress teams usually start with a group of soldiers. "You want to have them talk about it. It's an exclusive process -- only those involved in the incident."

Of the 600 soldiers in Task Force 4-64, which includes Slago's company, Johnson has identified between five and eight soldiers with serious combat stress -- a low percentage, he says. But mass screening has not yet begun.

The combat stress team that arrived Saturday, from the 883rd Medical Company, planned to hold group sessions with every squad and use those talks to identify individual soldiers who may need counseling.

Usually a couple of soldiers from every group will need individual therapy, experts said. Even fewer will need immediate psychiatric care.

Maj. Timothy Patterson, a psychiatrist from Mansfield, Ohio, said the U.S. Army is trying to deal with combat stress more aggressively than ever, deploying counselors from his reserve unit near the front line to reach out to soldiers within days of a traumatic incident.

"We've had an extraordinary experience here, because usually you have one stress casualty for every five wounded physical casualties," Patterson said. But here, because of the low number of wounded, "these scales are blown out or proportion. Now there are more combat stress casualties than wounded."

In the years since the Gulf War, military doctors have concluded that stress is an injury and should be treated as such.

Overall, the total number of combat stress casualties is relatively low, partially due to commanders doing a better job of preparing soldiers psychologically for combat, Patterson said. But many cases will not surface until 18 to 24 months after the war.

"The number of people asking for help swelled in the months after the Gulf War," Patterson said. He hopes providing soldiers with treatment before they go home will reduce the amount of cases that surface later.

"You're going to find yourself to be a lot more serious, and your friends will notice it, too," Patterson told Pfc. Luis Livargas of Somerville, Mass. "If you are up front with them about it, it will put them at ease."

Livargas, 19, nodded his head and acknowledged he now felt closer to his fellow soldiers than to friends back home. He doesn't expect his high school friends to understand what he'd been through, but he's ready to deal with it.

"I think today's soldiers are more rounded, they're not stereotypical G.I. Joes, they have a lot more humanity and heart," Patterson said. "They are ready to talk."

Slago said the session helped him prepare for his return home to Los Angeles. He doesn't expect it to be easy.

"It's going to be a battle for me, but it'll be OK," he said. "I'm not sure if its because I'm still here or if it will go away. I hope I don't pull up to an intersection in the States and think, 'Where's the ambush going to come from?"'