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Sunday, May 27, 2007

One Soldier's Story of Leadership and PTSD

The Seattle Times today offers an in-depth look at one soldier's story of commitment, leadership and PTSD:

By the end of his tour in Iraq, Command Sgt. Maj. Thomas Adams was crushed by memories. Too many memorial services for dead soldiers. Too many visits to the wounded in the hospital wards. Too many innocents -- men, women and children -- blown up by insurgent bombs or killed inadvertently by his Fort Lewis brigade.

Adams, the highest-ranking enlisted soldier in his brigade, started taking tranquilizers to help him sleep. In an unusual step, he shared his struggles with the homeward-bound troops.

At a dusty desert base in Kuwait, Adams went from unit to unit, telling his fellow soldiers that he was not OK and would seek counseling when he returned. He urged others to do the same. ... Since his return, Adams has shown a different kind of fortitude, emerging as a powerful advocate challenging the Army to better confront the mental wounds of war. His efforts helped expand mental-health counseling at Fort Lewis for returning soldiers -- and improve training for Iraq-bound soldiers on the emotional hardships of combat.

Click on 'Article Link' below tags for more...

Article quoted from extensively for educational purposes.

Continuing:

"I had all generals from all walks of life come down and tell us how good we are and sprinkle holy water on us," said Adams, referring to his pre-Iraq training. "But not one professional came and talked to us about what it's going to be like when we lose somebody for real." ...

A Defense Department task force, in recent draft findings, cited the mental-health threats to soldiers as "one of the most pervasive and potentially disabling" costs of war. The task force noted that 38 percent of soldiers report psychological concerns upon their return from deployment, and concluded the Army has insufficient staff and funds to adequately care for those soldiers.
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It's a challenge that was largely unforeseen by Pentagon leaders. Before 9/11, then-Defense Secretary Donald Rumsfeld embraced a vision of push-button warfare, which emphasized long-range bombers, missile-defense systems and other high-tech equipment rather than a reliance on ground troops. [I write about what is termed the 'Revolution in Military Affairs,' or RMA, in the downloadable excerpt of Moving a Nation to Care: Post-Traumatic Stress Disorder and America's Returning Troops.]

The war in Iraq brought a different reality. The Army has been caught up in grueling urban combat that grinds on for months, and troop strength depends on the ability to maintain the emotional fitness of soldiers funneled back into repeat combat tours.

The piece goes on to explain that Adams returned home with PTSD and mild brain trauma (TBI). He suffered from blurred vision, forgetfulness, and deep depression after watching news reports. Often, he'd wished he'd died on the battlefield with his soldiers.

During a yearlong tour in Mosul, Iraq, Adams' Stryker brigade was subject to 1,387 attacks by roadside bombs, 84 assaults by vehicles packed with explosives, and daily threats from mortars, small-arms fire and rocket-propelled grenades.

The brigade lost 45 soldiers; 632 were wounded. By Adams' count, the brigade killed 550 insurgents. "What I'm telling you is that there's absolute carnage out there," Adams said. "We have to be ready for the trauma of today's battlefield."

Adams left for Mosul, Iraq, in 2004 with the 1st Brigade 25th Infantry Division Stryker Brigade. He served as command sergeant major, "the key liaison between enlisted soldiers and the commander." He fought for the best equipment and care for every single one of them -- and he didn't insulate himself from the fight or from the emotional needs of his troops.

"He was in the fight every day -- an absolute lead-from-the-front kind of guy," said Sgt. 1st Class Creed McCaslin, an expert marksman who helped protect Adams. For Adams, the hardest tasks came after the battles.

Three soldiers died in his arms after a December 2004 mess-hall bombing. In an almost daily ritual, he would visit the newly wounded at the Army hospital in Mosul. Some had lost an eye; others suffered severe burns or had legs and arms mangled by explosions. Adams would award a brass brigade coin stamped with the Stryker vehicles, while Col. Robert Brown, the company commander, handed out Purple Hearts to soldiers.

Back at the trailers, Adams counseled soldiers as they grieved over a lost buddy or agonized over a civilian death. During the course of the year, Adams tallied 186 men, women and children who fell victim to what he termed "the bad shoots," when civilian vehicles approached too close to a traffic checkpoint or families got trapped inside an insurgent position under assault from American troops. "You just can't imagine what that does to a soldier," Adams said. "What do you say to a guy that just blew away a woman and a kid because the enemy hid in that room with them and they all had to die? ... I wasn't prepared and I wish I was."

Adams shared his concerns with Lt. Gen. James Dubik, who as Fort Lewis commander made several trips to Mosul. Adams talked about the shortcomings in training and the monumental readjustments the soldiers would face upon their return.

Proving that committed, responsive leadership can move military culture stereotypes and stigma better than any legislation or decree can, Adams rolled up his sleeves once more when he and his brigade returned home in 2005:

By then, Dubik had worked with Madigan Army Medical Center to develop a screening program for brigade soldiers that included computerized surveys and at least one visit scheduled with a mental-health therapist between 90 and 180 days after their return.

Adams encouraged the soldiers to consider another option. They could call a military hotline to set up off-post counseling. Away from Fort Lewis, he believed, soldiers would talk more freely with less fear that their problems would filter back to their unit and hurt their career advancement.Then he made it easier to go. Soldiers would no longer have to clear the visits with squad leaders, platoon sergeants, platoon leaders and officers. He told soldiers in his brigade that they needed to confide only in an immediate superior, who would keep their confidentiality.

Adams also sought to change combat training. Soldiers already studied "in gum-bleeding detail" how and when to kill. Adams insisted they needed to know how they might feel after the act. "At a minimum, it should be a mandatory thing that we have to do. To discuss the real-world feeling, the emotions that you will go through -- unless you are some sort of psychopath -- when you kill another human being," Adams said.

Based on the ideas of Adams and others who had served in Afghanistan, Dubik said, Fort Lewis began "psychological preparation" for all soldiers headed into combat zones. Dubik also credits Adams with helping launch a senior leaders program, which brings together officers and top enlisted soldiers, as well as their spouses, to talk about the stresses of command.

But, of course, none of this arrived in time to help Adams himself.

Please read the entire piece to learn of Adams difficulties with reintegration following his time in Mosul. In a postscript, it was reported the Adams is now serving in Afghanistan, surely leading his troops once again as skillfully and compassionately as during his tour in Iraq. The man deserves our thanks for a job well done -- on the battlefield and on the home front as well.

Talk about the power of one. Adams embodies it in every way. Stay safe, be well, come home soon. We need you (and more like you) more than you might even know.

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