Proud service, powerful suffering When the gunfire and bomb blasts stop, the terrifying nightmare begins for Canadian soldiers living with PTSD By: Kevin Rollason Posted: 1:11 PM CST Friday, Nov. 10, 2017 Last Modified: 3:28 PM CST Monday, Nov. 13, 2017

Hey there, time traveller!
This article was published 10/11/2017 (1964 days ago), so information in it may no longer be current.

Kelly Russell can be anywhere, doing anything, when suddenly the enemy is upon her.

Without warning, a sight or smell or sound can take the soon-to-be fully retired Master Warrant Officer back to Afghanistan or to the middle of a terrorist incident.

Russell’s enemy is no longer a terrorist or insurgents firing missiles. This enemy hides inside her.

This enemy is post-traumatic stress disorder.

And the post-traumatic stress disorder can rear its terrifying head wherever and whenever it wants, Even in a Winnipeg department store.

“You know how (in a department store) they have all the phones on shelves and alarms go off when kids hit them?” Russell says.

“I was there, and they’re making this high-pitched sound and the clerk, he’s behind the counter and he isn’t paying attention, and I said to my spouse, ‘Is he not going to do something about that?’ And she says calm down… and suddenly I flashed back.

“When I came around, the next thing I knew… I had my hands around (the clerk’s) neck. That sound was all it took to take me somewhere else.”

 

PTSD has been around as long as human beings have experienced shocking, frightening events, or someone close to them has. And it has been known by myriad terms.

European doctors in the 1600s called it “nostalgia” when they saw changes in soldiers’ personalities. After the U.S. Civil War, it was called “soldier’s heart,” because there were observed physical changes in many soldiers, including faster heart rate and elevated blood pressure. Russia was the first country in the world to designate what they called “battle shock” as a true medical condition in the early part of the 20th century.

It was known as “shell shock” in the First World War, “battle fatigue” in the Second World War — the U.S. army even adopted the official slogan, “Every man has his breaking point” — Vietnam combat reaction and post-Vietnam syndrome in and after that conflict and then finally, PTSD, formally coined by the American Psychiatric Association in 1980.

Scott Casey, president of Military Minds, which helps veterans find needed programs and services, says research has shown PTSD was not only around hundreds of years ago, but some of the effects felt by its victims may have led to particular roles in warfare.

“The Vikings had Berserkers,” Casey says. “They would throw themselves into battle willingly, killing anything, with no fear of being killed. But it was obviously PTSD, so something had happened to them sometime before.

“As long as we have had war we have had PTSD.”

The word “berserk” comes from those Viking warriors.

Research by American psychiatrist Jonathan Shay beginning in the late 1980s originally made the connection between soldiers in that berserk state and PTSD.

Shay’s research also found what may be the earliest known reference to PTSD. In part, in a soliloquy in Shakespeare’s play, Henry IV, Part 1, Lady Percy tells Henry Percy, the Earl of Northumberland and a member of the rebels against the King:

“Why hast thou lost the fresh blood in thy cheeks;

And given my treasures and my rights of thee

To thick-eyed musing and cursed melancholy?

In thy faint slumbers I by thee have watch’d,

And heard thee murmur tales of iron wars…

“… And in thy face strange motions have appear’d,

Such as we see when men restrain their breath

On some great sudden hest. O, what portents are these?

Some heavy business hath my lord in hand,

And I must know it, else he loves me not.”

 

PTSD doesn’t just afflict members of the military. It is a diagnosis that is also given to scores of people in other walks of life — police officers, first responders, prison guards, emergency-room doctors, to name a few — that have experienced first-hand serious accidents, natural disasters, and major losses of life.

People who’ve been involved in serious car crashes, victims of crime and devastated family members have been diagnosed as well.

It’s easy to diagnose an injury in the battlefield when it is physical, such as a broken bone or a shrapnel wound, but it is much more difficult to diagnose a mental illness that may manifest while the soldier is still in action. Or decades later.

One of the saddest chapters in military history before PTSD was diagnosed as a condition caused by witnessing trauma was during the First World War, Casey says.

“You were discharged or you were executed for cowardice,” he says. “That’s disturbing. They were killing our guys because they were scared. Cowardice and being afraid is only one symptom of PTSD.”

Dr. Cyd Courchesne, chief medical officer and director general, health professionals, with Veterans Affairs Canada, says that of the country’s almost 700,000 veterans, about 130,000 of them became disabled during their service and of that number, 20 per cent have been diagnosed with some type of mental-health illness.

“It means one in five have a disability for a mental-health condition, so roughly 24,000 of them,” Courchesne says. “Of those, three in four have a diagnosis of PTSD, so a little less than 20,000 of our clients. And about one-quarter of our veterans with PTSD have served in Afghanistan — so three-quarters have not. They served in other operations, including the Second World War and the Korean War.”

PTSD can strike while soldiers are serving, when they leave the military or years or even decades later.

“There is no time limit when they can come back to us for help,” she says. “You can always come back.”

There is no one-size-fits-all treatment plan for PTSD, she says.

“Services are tailored to meet all the needs… Not everyone needs the high end of services,” she says. “We treat every veteran with care, compassion and respect.”

The support Veterans Affairs can provide includes career transition, financial support, and 24/7 support phone lines. The federal government’s 2017 budget includes creating a new $17.5-million Centre of Excellence in Veterans’ Care to specialize in PTSD and other mental-health issues. Next month, Veterans Affairs, with the help of Statistics Canada, will begin reporting on veterans’ suicide rates.

Veterans Affairs also funds Operational Stress Injury Clinics across the country, including one that has been at Deer Lodge Centre in Winnipeg since 2005. The Winnipeg clinic is unique because, while most of the others in Canada help older veterans, the majority of Winnipeg’s OSIC clientele are active-duty military, young soldiers who’ve recently received medical discharges and RCMP officers.

Michael Kaan, the clinic’s manager, says because of demand — the federal government predicts an annual increase of between 12 and 15 per cent for services — Deer Lodge’s north pavilion has already undergone renovations, and $3 million worth of renovations to about 12,000 square feet on the main floor of the building are about to get underway.

The clinic, which has psychologists, nurses, social workers and physiotherapists on staff, has a current caseload of about 300, a 20 per cent increase in the last two years, Kaan says.

Pointing to a family therapy room, Kaan says, “You might come here as a veteran, but they can also bring their spouse and kids here.”

The clinic’s caseload is about 40 per cent active military, 40 per cent veterans, and 20 per cent RCMP officers, he says.

Deer Lodge CEO Kevin Scott says most people think of veterans as 95-year-old men.

“But if you are discharged from the military, you are a veteran,” he says. “It could be a 25 year old is a veteran.”

Scott says the building in which the OSIC is located was built in 1938, and was used to house veterans from the First and Second World Wars, as well as the Korean War, but as they died over the years, the number of beds declined.

“At its peak, Deer Lodge had 1,250 beds. To put that in perspective, the Health Sciences Centre has 840. But that was a long time ago… we have 95 beds now.”

Kaan says the average patient age is early 40s, but the clinic treats veterans from age 19 to 95. About 80 per cent of the patients suffer with PTSD, but most have more than one diagnosis.

“They served in Rwanda, Haiti, Bosnia, Afghanistan and the Second World War,” he says.

“Most people know when they have a problem and come in, but when we first opened they came seeking help after having it for 10 or 15 years.”

He says people are treated with both psychological and pharmacological therapies.

 

Russell spent 32 years with the Canadian Armed Forces and before that three years with the army reserve at Camp Bordon, north of Toronto. She spent about 12 years with the army before transferring to the air force.

The Winnipeg woman soon retire with a formal medical release; the reason is PTSD.

Russell, 54, has had episodes triggered by various things, but a veteran she knows who also suffers with PTSD has difficulty with the sound of a crying baby.

“He would take babies to the hospital,” she says. “Now his own baby crying can trigger him. Something that should be joyful to him, he can’t handle.”

It wasn’t always like this for Russell, who loved many aspects of her military career. She says her favourite job was the one she did the last few years — training and instructing military personnel here and in European countries how to deal with terrorism incidents. But that role came at a heavy cost.

“It was the most exciting job,” she says. “I taught NATO counterterrorism. You had to think like a terrorist, but that wasn’t a good thing for me.”

Training exercises the soldiers participated in were so realistic it seemed people really had arms blown off.

Before that, Russell was part of a surveillance crew that flew above Afghanistan in a converted 747 jet.

“You’re a huge target and, with all the equipment on board, there was no defence (systems)… there were a few times where you heard a sound — you knew you had been locked on — and you held on while the plane did manoeuvres to miss the missile.

“It was nice to hit the ground afterwards. But then you would go up again the next day and the next. You don’t think about it at the time, but it’s tough.”

Russell says she now knows that the incidents that led to her PTSD symptoms occurred throughout her career. Episodes began shortly after recruitment; basic military training teaches soldiers how to shut off feelings and obey orders without question.

“So you get very good at shutting your emotions off, but then you end up getting PTSD and your emotions all come back at once and you don’t know how to turn them off anymore,” she says.

“It’s an accumulation, but you don’t know it at the time. There were little things you never thought about or thought were meaningful at the time, but now when you talk to your psychologist you say, ‘I never thought of that.'”

As it is for most veterans — particularly those with PTSD — Remembrance Day is a bad time of year.

“It is a hard thing,” she says. “It used to be such a proud day and now it is a hard day. I haven’t gone for a while… I watch it on TV. But this is my goal. To go back to Remembrance Day (ceremonies).”

 

Russell has had four-legged help to deal with her PTSD-caused episodes. She received Spot, an Australian shepherd, from Audeamus, a not-for-profit organization that provides service dogs to veterans and first responders “traumatized in the line of duty and whose quality of life depends on them,” more than a year ago.

“(Spot) has allowed me — I know it sounds pathetic — to be able to go back in public,” she says. “To go into stores and go shopping. Spot has given me back my dignity, he has given me back my confidence and he has allowed me to realize I am important and that I am a good person.”

Russell has taken Spot with her when she has spoken to students at the University of Winnipeg and University of Saskatchewan about PTSD and service dogs; he gives her the confidence to go to places where she has particular difficulty, including airports.

She says the dog is constantly on alert to be ready to calm her down when her PTSD is triggered and her breathing becomes more rapid and her voice changes. Spot has been trained to either lean against her or put his paws on her and, as dogs do, lick her face.

Russell recalls the first night she had Spot, while staying at a relative’s place, adamant that she didn’t need a service dog, she soon discovered the benefits of having one.

“I had the worst night with flashbacks,” she says. “My sister-in-law heard me screaming and I was hunkered down in a corner with my hands around the dog’s neck. She couldn’t hear what I was saying, but the dog was pushing me and licking my face even though I had my hands around his neck.

“My eyes started blinking really fast and I grabbed him closer and yelled, ‘Spot!’ It was the first time in two years I woke up and knew where I was and knew who I was with.

“I went back the next day and said, ‘I’m keeping the dog.'”

Several times during the phone interview with Russell, when perhaps the questions are getting into areas still emotionally raw because of her PTSD, her voice suddenly goes up a notch to a higher pitch and speeds up. Then, after hearing her say a few times, “Good boy, Spot,” she becomes calm again.

Russell admits she is being triggered, but says Spot has taken charge and does what he is trained to do by getting close to her, leaning against her or putting his paws on her.

At one point during the conversation, Spot even jumps into her lap.

“He’s 53 pounds and he thinks he’s a lap dog,” she says, laughing. “He’ll even put a paw on my shoulder when I’m driving. I’ll pull over and he’ll put his head on my lap. When I calm down he jumps back into the back seat and I’ll begin driving again.

“I don’t know how he senses it sometimes.”

Russell says her family has seen the difference Spot has made in her life.

“My spouse told (Audeamus), ‘It is like night and day. I actually have her back,'” Russell says. “My mom wrote a letter saying, ‘Thank you, because it is nice to have my daughter back.'”

Russell says when she received Spot, she also received a package of dog food and supplies worth more than $500 to Cvet’s Pets, a Winnipeg-based organization that helps veterans with service dogs.

 

Veterans Affairs Canada helps, but many soldiers and former soldiers who took part in missions to Bosnia and Afghanistan have realized there were — and are — gaps in available services, so they have created organizations to fill them. And some organizations have been created by people who didn’t serve.

Chris Cvetkovic is one of them. Cvetkovic spent 10 seasons as a long-snapper with the Winnipeg Blue Bombers before retiring in 2014. He said it was during a visit to CFB Winnipeg 17 Wing a few years ago that he spoke to a firefighter and learned about how service dogs help veterans with PTSD.

“I asked, ‘What do you need?’ and they said, ‘We need supplies,” he says. “Then it turned into this.”

“This” is Cvet’s Pets, a 100 per cent volunteer-run, not-for-profit organization that gives veterans and first responders across the country who are diagnosed with PTSD and who have service dogs, free kits with everything needed to own an animal, including food, orthopedic bed, leashes, collar, grooming supplies and toys. The food comes from the Canadian Legacy Project.

Cvet’s Pets also assists spay-and-neuter initiatives and local animal shelters.

Cvetkovic says he started the organization while he was still playing football. He does it on a volunteer basis, taking no compensation.

“What veterans tell me is the dogs have a massive impact,” he says. “It’s not just them getting their lives back; they’re getting their families back.

“A dog’s love is about as pure as you can get.”

But as helpful as the service animals are, veterans currently can’t claim the money spent to keep the dog as a medical expense on their income tax returns, he says. That’s where his organization comes in.

“We have 30 players across the CFL that will help us and the Bomber alumni are 100 per cent on board helping us,” he says.

In the last year the number of veterans reaching out to the organization has gone up — he’s now getting up to 10 inquiries a month — but he knows there are more out there who could be helped.

“It’s hard to reach them,” he says. “There’s a lot of pride.”

 

Jim Lowther helped create VETS Canada in 2010 when he realized some of the people he saw living on the street and homeless were former soldiers.

“We had 12 years of peacekeeping and then we’ve had 12 years of straight-up war,” Lowther says. “Canada has a small military, so some guys have been deployed two or three times.

“That’s why we have such a large number of guys with PTSD, because we’ve had 25 years of basic fighting.”

In addition to helping homeless veterans, the organization helps veterans “in crisis,” who may have a place to live but can’t afford to buy food or pay their bills.

Lowther, a veteran himself, says when he was deployed to Bosnia it was the first time since the Korean War where Canadian soldiers were fighting and witnessing carnage.

“We were trying to put ourselves between two or three countries who were trying to kill each other and everybody in between,” he says. “And many went from Bosnia to Afghanistan. You get an adrenalin rush. Your spidey sense is going 24/7 because the threat is everywhere. But when you come home you still have it and you don’t need it here.

“That’s when the whole PTSD thing comes in.”

Lowther says Remembrance Day is often a trigger for veterans.

” We have friends who were killed; it’s a tough time,” he says. “Once you get through Remembrance Day it’s better. It’s because it brings back memories.”

VETS Canada assists people from 19 years of age to 91.

“We noticed there were so many veterans out there on the street and people didn’t know,” he says. “People were homeless. We’ve now assisted more than 2,000 homeless veterans.”

And Lowther says, just as Ottawa and Deer Lodge predict, he expects the caseload to get larger.

“We know the floodgates will open soon,” he says. “There’s so many people that have been exposed to war. We know there are still people out there who haven’t come forward who are suffering.

“A lot of the guys who went to Afghanistan were going to be lifers. This was their career. When you have to get out due to injury you feel like you lost a family and you feel like you’re an orphan. A lot of guys who get out with medical release aren’t ready for it and it doesn’t work out.”

 

Military Minds came about from Cpl. Chris Dupree connecting with veterans on Facebook. It has more than 130,000 members now.

Since its creation, it has connected veterans and others with PTSD with services, Casey says.

“A lot of these people are silent, but we do get messages that just reading the posts (online) have ‘kept me above ground,'” he says. “I’m actually compiling all of our incidents where we have intervened in suicide attempts.

“We’ve have interventions in 378 cases.”

Casey, who served in Bosnia with the Canadian Forces, says he knows what veterans go through.

“I’ve had some rough times too, and got to the cusp of committing suicide myself,” he says. “I wanted to do the right thing and help others.

“PTSD is not curable, like it goes away. PTSD is an actual chemical change in the body. You can’t change it back. But it can be managed.”

Casey says Military Minds is working to add multi-day group therapy at an out-of-town location as an option for members.

“Now you go to an office building and you speak to a clinician for 15 minutes to get to know each other, then 20 minutes of clinical and then 15 minutes of setting up the next appointment,” he says. “Our idea is to get the veterans to speak with each other in a rural setting and have talk time with a doctor. This way nobody leaves triggered.”

Casey says the program will begin next year at a lodge in Alberta.

“It’s unfortunate we even exist,” he says. “I don’t think we’ll ever eradicate suicide, but we can mitigate it.”

 

Scott Maxwell, executive director of Wounded Warriors Canada, says the organization, founded in 2006 in the wake of an incident where four soldiers and several others were injured, began by sending care packages to wounded soldiers and assisting them and their families while they recovered in hospital in Germany.

But Maxwell says Wounded Warriors decided on a “major shift” in focus in 2013.

“Our main emphasis now is with mental-health and operational-stress injuries,” he says, noting the organization not only helps veterans, but also first responders and their families.

“There’s nothing wrong with needing help, it should be expected,” he says. “We should expect people who see horrific incidents every day will need help.”

Maxwell says the symptoms of PTSD may not appear until years after they’ve experienced trauma. The average time for a Canadian Forces member who served in Bosnia to seek help was about a decade.

“That’s a significant life gap,” he says. “The transition to civilian life is a very demanding experience. People planned to have a lifelong 25-year career, and then they don’t get that. We need to make sure the programs and support elements are in place for them.

“What’s the next 25 years of your life like? We know there are thousands of people across Canada who need support. The need is staggering.”

Programs run by Veterans Affairs are good, but they are not enough, he says.

“We see ourselves as a complementary service provider,” he says. “Government will never be 100 per cent a solution.”

 

Russell says she knows that, unlike a physical injury such as a broken leg, there’s no magic treatment or pill to take for PTSD that will make it go away.

“I’ll be dealing with it for the rest of my life,” she says. “It sneaks up on you, but if you find a way to deal with it, do it.”

But now, looking back after three decades in the military and having now received psychological help, she has advice for new recruits and for others who are well into their careers.

“Talk to people. Talk to people, man,” she says.

“Now when you’re deployed, they offer to sit down after missions and talk to others. Don’t try to be tough and say you don’t need to talk to others. Sit down with your buddies.

“If you keep it to yourself, you’ll end up where I am.”

 

kevin.rollason@freepress.mb.ca