T
Thaddeus Stevens
Guest
Town is not alone. A six-month investigation has uncovered multiple cases in which
soldiers wounded in Iraq are suspiciously diagnosed as having a personality disorder,
then prevented from collecting benefits. The conditions of their discharge have
infuriated many in the military community, including the injured soldiers and their
families, veterans' rights groups, even military officials required to process these
dismissals.
They say the military is purposely misdiagnosing soldiers like Town and that it's doing
so for one reason: to cheat them out of a lifetime of disability and medical benefits,
thereby saving billions in expenses.
http://www.thenation.com/doc/20070409/kors
How Specialist Town Lost His Benefits
by JOSHUA KORS
[from the April 9, 2007 issue]
Jon Town has spent the last few years fighting two battles, one against his body, the
other against the US Army. Both began in October 2004 in Ramadi, Iraq. He was standing
in the doorway of his battalion's headquarters when a 107-millimeter rocket struck two
feet above his head. The impact punched a piano-sized hole in the concrete facade,
sparked a huge fireball and tossed the 25-year-old Army specialist to the floor, where
he lay blacked out among the rubble.
"The next thing I remember is waking up on the ground." Men from his unit had gathered
around his body and were screaming his name. "They started shaking me. But I was numb
all over," he says. "And it's weird because... because for a few minutes you feel like
you're not really there. I could see them, but I couldn't hear them. I couldn't hear
anything. I started shaking because I thought I was dead."
Eventually the rocket shrapnel was removed from Town's neck and his ears stopped leaking
blood. But his hearing never really recovered, and in many ways, neither has his life. A
soldier honored twelve times during his seven years in uniform, Town has spent the last
three struggling with deafness, memory failure and depression. By September 2006 he and
the Army agreed he was no longer combat-ready.
But instead of sending Town to a medical board and discharging him because of his
injuries, doctors at Fort Carson, Colorado, did something strange: They claimed Town's
wounds were actually caused by a "personality disorder." Town was then booted from the
Army and told that under a personality disorder discharge, he would never receive
disability or medical benefits.
Town is not alone. A six-month investigation has uncovered multiple cases in which
soldiers wounded in Iraq are suspiciously diagnosed as having a personality disorder,
then prevented from collecting benefits. The conditions of their discharge have
infuriated many in the military community, including the injured soldiers and their
families, veterans' rights groups, even military officials required to process these
dismissals.
They say the military is purposely misdiagnosing soldiers like Town and that it's doing
so for one reason: to cheat them out of a lifetime of disability and medical benefits,
thereby saving billions in expenses.
The Fine Print
In the Army's separations manual it's called Regulation 635-200, Chapter 5-13:
"Separation Because of Personality Disorder." It's an alluring choice for a
cash-strapped military because enacting it is quick and cheap. The Department of
Veterans Affairs doesn't have to provide medical care to soldiers dismissed with
personality disorder. That's because under Chapter 5-13, personality disorder is a
pre-existing condition. The VA is only required to treat wounds sustained during service.
Soldiers discharged under 5-13 can't collect disability pay either. To receive those
benefits, a soldier must be evaluated by a medical board, which must confirm that he is
wounded and that his wounds stem from combat. The process takes several months, in
contrast with a 5-13 discharge, which can be wrapped up in a few days.
If a soldier dismissed under 5-13 hasn't served out his contract, he has to give back a
slice of his re-enlistment bonus as well. That amount is often larger than the soldier's
final paycheck. As a result, on the day of their discharge, many injured vets learn that
they owe the Army several thousand dollars.
One military official says doctors at his base are doing more than withholding this
information from wounded soldiers; they're actually telling them the opposite: that if
they go along with a 5-13, they'll get to keep their bonus and receive disability and
medical benefits. The official, who demanded anonymity, handles discharge papers at a
prominent Army facility. He says the soldiers he works with know they don't have a
personality disorder. "But the doctors are telling them, this will get you out quicker,
and the VA will take care of you. To stay out of Iraq, a soldier will take that in a
heartbeat. What they don't realize is, those things are lies. The soldiers, they don't
read the fine print," he says. "They don't know to ask for a med board. They're taking
the word of the doctors. Then they sit down with me and find out what a 5-13 really
means--they're shocked."
Russell Terry, founder of the Iraq War Veterans Organization (IWVO), says he's watched
this scenario play itself out many times. For more than a year, his veterans' rights
group has been receiving calls from distraught soldiers discharged under Chapter 5-13.
Most, he says, say their military doctors pushed the personality disorder diagnosis,
strained to prove that their problems existed before their service in Iraq and refused
to acknowledge evidence of posttraumatic stress disorder (PTSD), traumatic brain injury
and physical traumas, which would allow them to collect disability and medical benefits.
"These soldiers are coming home from Iraq with all kinds of problems," Terry says. "They
go to the VA for treatment, and they're turned away. They're told, 'No, you have a
pre-existing condition, something from childhood.'" That leap in logic boils Terry's
blood. "Everybody receives a psychological screening when they join the military. What I
want to know is, if all these soldiers really did have a severe pre-existing condition,
how did they get into the military in the first place?"
Terry says that trying to reverse a 5-13 discharge is a frustrating process. A soldier
has to claw through a thicket of paperwork, appeals panels and backstage political
dealing, and even with the guidance of an experienced advocate, few are successful. "The
5-13," he says, "it's like a scarlet letter you can't get taken off."
In the last six years the Army has diagnosed and discharged more than 5,600 soldiers
because of personality disorder, according to the Defense Department. And the numbers
keep rising: 805 cases in 2001, 980 cases in 2003, 1,086 from January to November 2006.
"It's getting worse and worse every day," says the official who handles discharge
papers. "At my office the numbers started out normal. Now it's up to three or four
soldiers each day. It's like, suddenly everybody has a personality disorder."
The reason is simple, he says. "They're saving a buck. And they're saving the VA money
too. It's all about money."
Exactly how much money is difficult to calculate. Defense Department records show that
across the entire armed forces, more than 22,500 soldiers have been dismissed due to
personality disorder in the last six years. How much those soldiers would have collected
in disability pay would have been determined by a medical board, which evaluates just
how disabled a veteran is. A completely disabled soldier receives about $44,000 a year.
In a recent study on the cost of veterans' benefits for the Iraq and Afghanistan wars,
Harvard professor Linda Bilmes estimates an average disability payout of $8,890 per year
and a future life expectancy of forty years for soldiers returning from service.
Using those figures, by discharging soldiers under Chapter 5-13, the military could be
saving upwards of $8 billion in disability pay. Add to that savings the cost of medical
care over the soldiers' lifetimes. Bilmes estimates that each year the VA spends an
average of $5,000 in medical care per veteran. Applying those numbers, by discharging
22,500 soldiers because of personality disorder, the military saves $4.5 billion in
medical care over their lifetimes.
Town says Fort Carson psychologist Mark Wexler assured him that he would receive
disability benefits, VA medical care and that he'd get to keep his bonus--good news he
discussed with Christian Fields and Brandon Murray, two soldiers in his unit at Fort
Carson. "We talked about it many times," Murray says. "Jon said the doctor there
promised him benefits, and he was happy about it. Who wouldn't be?" Town shared that
excitement with his wife, Kristy, shortly after his appointment with Wexler. "He said
that Wexler had explained to him that he'd get to keep his benefits," Kristy says, "that
the doctor had looked into it, and it was all coming with the chapter he was getting."
In fact, Town would not get disability pay or receive long-term VA medical care. And he
would have to give back the bulk of his $15,000 bonus. Returning that money meant Town
would leave Fort Carson less than empty-handed: He now owed the Army more than $3,000.
"We had this on our heads the whole way, driving home to Ohio," says Town. Wexler made
him promises, he says, about what would happen if he went along with the diagnosis. "The
final day, we find out, none of it was true. It was a total shock. I felt like I'd been
betrayed by the Army."
Wexler denies discussing benefits with Town. In a statement, the psychologist writes, "I
have never discussed benefits with my patients as that is not my area of expertise. The
only thing I said to Spc. Town was that the Chapter 5-13 is an honorable discharge.... I
assure you, after over 15 years in my position, both as active duty and now civilian, I
don't presume to know all the details about benefits and therefore do not discuss them
with my patients."
Wexler's boss, Col. Steven Knorr, chief of the Department of Behavioral Health at Evans
Army Hospital, declined to speak about Town's case. When asked if doctors at Fort Carson
were assuring patients set for a 5-13 discharge that they'll receive disability benefits
and keep their bonuses, Knorr said, "I don't believe they're doing that."
Not the Man He Used to Be
Interviews with soldiers diagnosed with personality disorder suggest that the military
is using the psychological condition as a catch-all diagnosis, encompassing symptoms as
diverse as deafness, headaches and schizophrenic delusions. That flies in the face of
the Army's own regulations.
According to those regulations, to be classified a personality disorder, a soldier's
symptoms had to exist before he joined the military. And they have to match the
"personality disorder" described in the Diagnostic and Statistical Manual of Mental
Disorders, the national standard for psychiatric diagnosis. Town's case provides a clear
window into how these personality disorder diagnoses are being used because even a
cursory examination of his case casts grave doubt as to whether he fits either criterion.
Town's wife, for one, laughs in disbelief at the idea that her husband was suffering
from hearing loss before he headed to Iraq. But since returning, she says, he can't
watch TV unless the volume is full-blast, can't use the phone unless its volume is set
to high. Medical papers from Fort Carson list Town as having no health problems before
serving in Iraq; after, a Fort Carson audiologist documents "functional (non-organic)
hearing loss." Town says his right ear, his "good" ear, has lost 50 percent of its
hearing; his left is still essentially useless.
He is more disturbed by how his memory has eroded. Since the rocket blast, he has
struggled to retain new information. "Like, I'll be driving places, and then I totally
forget where I'm going," he says. "Numbers, names, dates--unless I knew them before, I
pretty much don't remember." When Town returned to his desk job at Fort Carson, he found
himself straining to recall the Army's regulations. "People were like, 'What are you,
dumb?' And I'm like, 'No, I'm probably smarter than you. I just can't remember stuff,'"
he says, his melancholy suddenly replaced by anger. "They don't understand--I got hit by
a rocket."
Those bursts of rage mark the biggest change, says Kristy Town. She says the man she
married four years ago was "a real goofball. He'd do funny voices and faces--a great Jim
Carrey imitation. When the kids would get a boo-boo, he'd fall on the ground and pretend
he got a boo-boo too." Now, she says, "his emotions are all over the place. He'll get so
angry at things, and it's not toward anybody. It's toward himself. He blames himself for
everything." He has a hard time sleeping and doesn't spend as much time as he used to
with the kids. "They get rowdy when they play, and he just has to be alone. It's almost
like his nerves can't handle it."
Kristy begins to cry, pauses, before forcing herself to continue. She's been watching
him when he's alone, she says. "He kind of... zones out, almost like he's in a daze."
In May 2006 Town tried to electrocute himself, dropping his wife's hair dryer into the
bathtub. The dryer short-circuited before it could electrify the water. Fort Carson
officials put Town in an off-post hospital that specializes in suicidal depression. Town
had been promoted to corporal after returning from Iraq; he was stripped of that rank
and reduced back to specialist. "When he came back, I tried to be the same," Kristy
says. "He just can't. He's definitely not the man he used to be."
Town says his dreams have changed too. They keep taking him back to Ramadi, to the death
of a good friend who'd been too near an explosion, taken too much shrapnel to the face.
In his dreams Town returns there night after night to soak up the blood.
He stops his description for a rare moment of levity. "Sleep didn't use to be like
that," he says. "I used to sleep just fine."
How the Army determined then that Town's behavioral problems existed before his military
service is unclear. Wexler, the Fort Carson psychologist who made the diagnosis, didn't
interview any of Town's family or friends. It's unclear whether he even questioned
Town's fellow soldiers in 2-17 Field Artillery, men like Fields, Murray and Michael
Forbus, who could have testified to his stability and award-winning performance before
the October 2004 rocket attack. As Forbus puts it, before the attack Town was "one of
the best in our unit"; after, "the son of a gun was deaf in one ear. He seemed lost and
disoriented. It just took the life out of him."
Town finds his diagnosis especially strange because the Diagnostic Manual appears to
preclude cases like his. It says that a pattern of erratic behavior cannot be labeled a
"personality disorder" if it's from a head injury. The specialist asserts that his
hearing loss, headaches and anger all began with the rocket attack that knocked him
unconscious.
Wexler did not reply to repeated requests seeking comment on Town's diagnosis. But Col.
Knorr of Fort Carson's Evans hospital says he's confident his doctors are properly
diagnosing personality disorder. The colonel says there is a simple explanation as to
why in so many cases the lifelong condition of personality disorder isn't apparent until
after serving in Iraq. Traumatic experiences, Knorr says, can trigger a condition that
has lain dormant for years. "They may have done fine in high school and before, but it
comes out during the stress of service."
"I've never heard of that occurring," says Keith Armstrong, a clinical professor with
the Department of Psychiatry at the University of California, San Francisco. Armstrong
has been counseling traumatized veterans for more than twenty years at the San Francisco
VA; most recently he is the co-author of Courage After Fire: Coping Strategies for
Troops Returning From Iraq and Afghanistan and Their Families. "Personality disorder is
a diagnosis I'm very cautious about," he says. "My question would be, has PTSD been
ruled out? It seems to me that if it walks like a duck, looks like a duck, let's see if
it's a duck before other factors are implicated."
Knorr admits that in most cases, before making a diagnosis, his doctors only interview
the soldier. But he adds that interviewing family members, untrained to recognize signs
of personality disorder, would be of limited value. "The soldier's perception and their
parents' perception is that they were fine. But maybe they didn't or weren't able to see
that wasn't the case."
Armstrong takes a very different approach. He says family is a "crucial part" of the
diagnosis and treatment of soldiers returning from war. The professor sees parents and
wives as so important, he encourages his soldiers to invite their families into the
counseling sessions. "They bring in particular information that can be helpful," he
says. "By not taking advantage of their knowledge and support, I think we're doing
soldiers a disservice."
Knorr would not discuss the specifics of Town's case. He did note, however, that his
department treats thousands of soldiers each year and says within that population, there
are bound to be a small fraction of misdiagnosed cases and dissatisfied soldiers. He
adds that the soldiers he's seen diagnosed and discharged with personality disorder are
"usually quite pleased."
The Army holds soldiers' medical records and contact information strictly confidential.
But The Nation was able to locate a half-dozen soldiers from bases across the country
who were diagnosed with personality disorder. All of them rejected that diagnosis. Most
said military doctors tried to force the diagnosis upon them and turned a blind eye to
symptoms of PTSD and physical injury.
One such veteran, Richard Dykstra, went to the hospital at Fort Stewart, Georgia,
complaining of flashbacks, anger and stomach pains. The doctor there diagnosed
personality disorder. Dykstra thinks the symptoms actually stem from PTSD and a
bilateral hernia he suffered in Iraq. "When I told her my symptoms, she said, 'Oh, it
looks like you've been reading up on PTSD.' Then she basically said I was making it all
up," he says.
In her report on Dykstra, Col. Ana Parodi, head of Behavioral Health at Fort Stewart's
Winn Army Hospital, writes that the soldier gives a clear description of PTSD symptoms
but lays them out with such detail, it's "as if he had memorized the criteria." She
concludes that Dykstra has personality disorder, not PTSD, though her report also notes
that Dykstra has had "no previous psychiatric history" and that she confirmed the
validity of his symptoms with the soldier's wife.
Parodi is currently on leave and could not be reached for comment. Speaking for Fort
Stewart, Public Affairs Officer Lieut. Col. Randy Martin says that the Army's diagnosis
procedures "have been developed over time, and they are accepted as being fair." Martin
said he could not address Dykstra's case specifically because his files have been moved
to a storage facility in St. Louis.
William Wooldridge had a similar fight with the Army. The specialist was hauling
missiles and tank ammunition outside Baghdad when, he says, a man standing at the side
of the road grabbed hold of a young girl and pushed her in front of his truck. "The
little girl," Wooldridge says, his voice suddenly quiet, "she looked like one of my
daughters."
When he returned to Fort Polk, Louisiana, Wooldridge told his doctor that he was now
hearing voices and seeing visions, hallucinations of a mangled girl who would ask him
why he had killed her. His doctor told him he had personality disorder. "When I heard
that, I flew off the handle because I said, 'Hey, that ain't me. Before I went over
there, I was a happy-go-lucky kind of guy.'" Wooldridge says his psychologist, Capt.
Patrick Brady of Baynes-Jones Army Community Hospital, saw him for thirty minutes before
making his diagnosis. Soon after, Wooldridge was discharged from Fort Polk under Chapter
5-13.
He began to fight that discharge immediately, without success. Then in March 2005,
eighteen months after Wooldridge's dismissal, his psychiatrist at the Memphis VA filed
papers rejecting Brady's diagnosis and asserting that Wooldridge suffered from PTSD so
severe, it made him "totally disabled." Weeks later the Army Discharge Review Board
voided Wooldridge's 5-13 dismissal, but the eighteen months he'd spent lingering without
benefits had already taken its toll.
"They put me out on the street to rot, and if I had left things like they were, there
would have been no way I could have survived. I would have had to take myself out or had
someone do it for me," he says. The way they use personality disorder to diagnose and
discharge, he says, "it's like a mental rape. That's the only way I can describe it."
Captain Brady has since left Fort Polk and is now on staff at Fort Wainwright, Alaska;
recently he deployed to Iraq and was unavailable for comment. In a statement, Maj. Byron
Strother, chief of the Department of Behavioral Health at Baynes-Jones hospital, writes
that allegations that soldiers at Fort Polk are being misdiagnosed "are not true."
Strother says diagnoses at his hospital are made "only after careful consideration of
all relevant clinical observation, direct examination [and] appropriate testing."
If there are dissatisfied soldiers, says Knorr, the Fort Carson official, "I'll bet not
a single one of them has been diagnosed with conditions that are clear-cut and makes
them medically unfit, like schizophrenia."
Linda Mosier disputes that. When her son Chris left for Iraq in 2004, he was a "normal
kid," she says, who'd call her long-
soldiers wounded in Iraq are suspiciously diagnosed as having a personality disorder,
then prevented from collecting benefits. The conditions of their discharge have
infuriated many in the military community, including the injured soldiers and their
families, veterans' rights groups, even military officials required to process these
dismissals.
They say the military is purposely misdiagnosing soldiers like Town and that it's doing
so for one reason: to cheat them out of a lifetime of disability and medical benefits,
thereby saving billions in expenses.
http://www.thenation.com/doc/20070409/kors
How Specialist Town Lost His Benefits
by JOSHUA KORS
[from the April 9, 2007 issue]
Jon Town has spent the last few years fighting two battles, one against his body, the
other against the US Army. Both began in October 2004 in Ramadi, Iraq. He was standing
in the doorway of his battalion's headquarters when a 107-millimeter rocket struck two
feet above his head. The impact punched a piano-sized hole in the concrete facade,
sparked a huge fireball and tossed the 25-year-old Army specialist to the floor, where
he lay blacked out among the rubble.
"The next thing I remember is waking up on the ground." Men from his unit had gathered
around his body and were screaming his name. "They started shaking me. But I was numb
all over," he says. "And it's weird because... because for a few minutes you feel like
you're not really there. I could see them, but I couldn't hear them. I couldn't hear
anything. I started shaking because I thought I was dead."
Eventually the rocket shrapnel was removed from Town's neck and his ears stopped leaking
blood. But his hearing never really recovered, and in many ways, neither has his life. A
soldier honored twelve times during his seven years in uniform, Town has spent the last
three struggling with deafness, memory failure and depression. By September 2006 he and
the Army agreed he was no longer combat-ready.
But instead of sending Town to a medical board and discharging him because of his
injuries, doctors at Fort Carson, Colorado, did something strange: They claimed Town's
wounds were actually caused by a "personality disorder." Town was then booted from the
Army and told that under a personality disorder discharge, he would never receive
disability or medical benefits.
Town is not alone. A six-month investigation has uncovered multiple cases in which
soldiers wounded in Iraq are suspiciously diagnosed as having a personality disorder,
then prevented from collecting benefits. The conditions of their discharge have
infuriated many in the military community, including the injured soldiers and their
families, veterans' rights groups, even military officials required to process these
dismissals.
They say the military is purposely misdiagnosing soldiers like Town and that it's doing
so for one reason: to cheat them out of a lifetime of disability and medical benefits,
thereby saving billions in expenses.
The Fine Print
In the Army's separations manual it's called Regulation 635-200, Chapter 5-13:
"Separation Because of Personality Disorder." It's an alluring choice for a
cash-strapped military because enacting it is quick and cheap. The Department of
Veterans Affairs doesn't have to provide medical care to soldiers dismissed with
personality disorder. That's because under Chapter 5-13, personality disorder is a
pre-existing condition. The VA is only required to treat wounds sustained during service.
Soldiers discharged under 5-13 can't collect disability pay either. To receive those
benefits, a soldier must be evaluated by a medical board, which must confirm that he is
wounded and that his wounds stem from combat. The process takes several months, in
contrast with a 5-13 discharge, which can be wrapped up in a few days.
If a soldier dismissed under 5-13 hasn't served out his contract, he has to give back a
slice of his re-enlistment bonus as well. That amount is often larger than the soldier's
final paycheck. As a result, on the day of their discharge, many injured vets learn that
they owe the Army several thousand dollars.
One military official says doctors at his base are doing more than withholding this
information from wounded soldiers; they're actually telling them the opposite: that if
they go along with a 5-13, they'll get to keep their bonus and receive disability and
medical benefits. The official, who demanded anonymity, handles discharge papers at a
prominent Army facility. He says the soldiers he works with know they don't have a
personality disorder. "But the doctors are telling them, this will get you out quicker,
and the VA will take care of you. To stay out of Iraq, a soldier will take that in a
heartbeat. What they don't realize is, those things are lies. The soldiers, they don't
read the fine print," he says. "They don't know to ask for a med board. They're taking
the word of the doctors. Then they sit down with me and find out what a 5-13 really
means--they're shocked."
Russell Terry, founder of the Iraq War Veterans Organization (IWVO), says he's watched
this scenario play itself out many times. For more than a year, his veterans' rights
group has been receiving calls from distraught soldiers discharged under Chapter 5-13.
Most, he says, say their military doctors pushed the personality disorder diagnosis,
strained to prove that their problems existed before their service in Iraq and refused
to acknowledge evidence of posttraumatic stress disorder (PTSD), traumatic brain injury
and physical traumas, which would allow them to collect disability and medical benefits.
"These soldiers are coming home from Iraq with all kinds of problems," Terry says. "They
go to the VA for treatment, and they're turned away. They're told, 'No, you have a
pre-existing condition, something from childhood.'" That leap in logic boils Terry's
blood. "Everybody receives a psychological screening when they join the military. What I
want to know is, if all these soldiers really did have a severe pre-existing condition,
how did they get into the military in the first place?"
Terry says that trying to reverse a 5-13 discharge is a frustrating process. A soldier
has to claw through a thicket of paperwork, appeals panels and backstage political
dealing, and even with the guidance of an experienced advocate, few are successful. "The
5-13," he says, "it's like a scarlet letter you can't get taken off."
In the last six years the Army has diagnosed and discharged more than 5,600 soldiers
because of personality disorder, according to the Defense Department. And the numbers
keep rising: 805 cases in 2001, 980 cases in 2003, 1,086 from January to November 2006.
"It's getting worse and worse every day," says the official who handles discharge
papers. "At my office the numbers started out normal. Now it's up to three or four
soldiers each day. It's like, suddenly everybody has a personality disorder."
The reason is simple, he says. "They're saving a buck. And they're saving the VA money
too. It's all about money."
Exactly how much money is difficult to calculate. Defense Department records show that
across the entire armed forces, more than 22,500 soldiers have been dismissed due to
personality disorder in the last six years. How much those soldiers would have collected
in disability pay would have been determined by a medical board, which evaluates just
how disabled a veteran is. A completely disabled soldier receives about $44,000 a year.
In a recent study on the cost of veterans' benefits for the Iraq and Afghanistan wars,
Harvard professor Linda Bilmes estimates an average disability payout of $8,890 per year
and a future life expectancy of forty years for soldiers returning from service.
Using those figures, by discharging soldiers under Chapter 5-13, the military could be
saving upwards of $8 billion in disability pay. Add to that savings the cost of medical
care over the soldiers' lifetimes. Bilmes estimates that each year the VA spends an
average of $5,000 in medical care per veteran. Applying those numbers, by discharging
22,500 soldiers because of personality disorder, the military saves $4.5 billion in
medical care over their lifetimes.
Town says Fort Carson psychologist Mark Wexler assured him that he would receive
disability benefits, VA medical care and that he'd get to keep his bonus--good news he
discussed with Christian Fields and Brandon Murray, two soldiers in his unit at Fort
Carson. "We talked about it many times," Murray says. "Jon said the doctor there
promised him benefits, and he was happy about it. Who wouldn't be?" Town shared that
excitement with his wife, Kristy, shortly after his appointment with Wexler. "He said
that Wexler had explained to him that he'd get to keep his benefits," Kristy says, "that
the doctor had looked into it, and it was all coming with the chapter he was getting."
In fact, Town would not get disability pay or receive long-term VA medical care. And he
would have to give back the bulk of his $15,000 bonus. Returning that money meant Town
would leave Fort Carson less than empty-handed: He now owed the Army more than $3,000.
"We had this on our heads the whole way, driving home to Ohio," says Town. Wexler made
him promises, he says, about what would happen if he went along with the diagnosis. "The
final day, we find out, none of it was true. It was a total shock. I felt like I'd been
betrayed by the Army."
Wexler denies discussing benefits with Town. In a statement, the psychologist writes, "I
have never discussed benefits with my patients as that is not my area of expertise. The
only thing I said to Spc. Town was that the Chapter 5-13 is an honorable discharge.... I
assure you, after over 15 years in my position, both as active duty and now civilian, I
don't presume to know all the details about benefits and therefore do not discuss them
with my patients."
Wexler's boss, Col. Steven Knorr, chief of the Department of Behavioral Health at Evans
Army Hospital, declined to speak about Town's case. When asked if doctors at Fort Carson
were assuring patients set for a 5-13 discharge that they'll receive disability benefits
and keep their bonuses, Knorr said, "I don't believe they're doing that."
Not the Man He Used to Be
Interviews with soldiers diagnosed with personality disorder suggest that the military
is using the psychological condition as a catch-all diagnosis, encompassing symptoms as
diverse as deafness, headaches and schizophrenic delusions. That flies in the face of
the Army's own regulations.
According to those regulations, to be classified a personality disorder, a soldier's
symptoms had to exist before he joined the military. And they have to match the
"personality disorder" described in the Diagnostic and Statistical Manual of Mental
Disorders, the national standard for psychiatric diagnosis. Town's case provides a clear
window into how these personality disorder diagnoses are being used because even a
cursory examination of his case casts grave doubt as to whether he fits either criterion.
Town's wife, for one, laughs in disbelief at the idea that her husband was suffering
from hearing loss before he headed to Iraq. But since returning, she says, he can't
watch TV unless the volume is full-blast, can't use the phone unless its volume is set
to high. Medical papers from Fort Carson list Town as having no health problems before
serving in Iraq; after, a Fort Carson audiologist documents "functional (non-organic)
hearing loss." Town says his right ear, his "good" ear, has lost 50 percent of its
hearing; his left is still essentially useless.
He is more disturbed by how his memory has eroded. Since the rocket blast, he has
struggled to retain new information. "Like, I'll be driving places, and then I totally
forget where I'm going," he says. "Numbers, names, dates--unless I knew them before, I
pretty much don't remember." When Town returned to his desk job at Fort Carson, he found
himself straining to recall the Army's regulations. "People were like, 'What are you,
dumb?' And I'm like, 'No, I'm probably smarter than you. I just can't remember stuff,'"
he says, his melancholy suddenly replaced by anger. "They don't understand--I got hit by
a rocket."
Those bursts of rage mark the biggest change, says Kristy Town. She says the man she
married four years ago was "a real goofball. He'd do funny voices and faces--a great Jim
Carrey imitation. When the kids would get a boo-boo, he'd fall on the ground and pretend
he got a boo-boo too." Now, she says, "his emotions are all over the place. He'll get so
angry at things, and it's not toward anybody. It's toward himself. He blames himself for
everything." He has a hard time sleeping and doesn't spend as much time as he used to
with the kids. "They get rowdy when they play, and he just has to be alone. It's almost
like his nerves can't handle it."
Kristy begins to cry, pauses, before forcing herself to continue. She's been watching
him when he's alone, she says. "He kind of... zones out, almost like he's in a daze."
In May 2006 Town tried to electrocute himself, dropping his wife's hair dryer into the
bathtub. The dryer short-circuited before it could electrify the water. Fort Carson
officials put Town in an off-post hospital that specializes in suicidal depression. Town
had been promoted to corporal after returning from Iraq; he was stripped of that rank
and reduced back to specialist. "When he came back, I tried to be the same," Kristy
says. "He just can't. He's definitely not the man he used to be."
Town says his dreams have changed too. They keep taking him back to Ramadi, to the death
of a good friend who'd been too near an explosion, taken too much shrapnel to the face.
In his dreams Town returns there night after night to soak up the blood.
He stops his description for a rare moment of levity. "Sleep didn't use to be like
that," he says. "I used to sleep just fine."
How the Army determined then that Town's behavioral problems existed before his military
service is unclear. Wexler, the Fort Carson psychologist who made the diagnosis, didn't
interview any of Town's family or friends. It's unclear whether he even questioned
Town's fellow soldiers in 2-17 Field Artillery, men like Fields, Murray and Michael
Forbus, who could have testified to his stability and award-winning performance before
the October 2004 rocket attack. As Forbus puts it, before the attack Town was "one of
the best in our unit"; after, "the son of a gun was deaf in one ear. He seemed lost and
disoriented. It just took the life out of him."
Town finds his diagnosis especially strange because the Diagnostic Manual appears to
preclude cases like his. It says that a pattern of erratic behavior cannot be labeled a
"personality disorder" if it's from a head injury. The specialist asserts that his
hearing loss, headaches and anger all began with the rocket attack that knocked him
unconscious.
Wexler did not reply to repeated requests seeking comment on Town's diagnosis. But Col.
Knorr of Fort Carson's Evans hospital says he's confident his doctors are properly
diagnosing personality disorder. The colonel says there is a simple explanation as to
why in so many cases the lifelong condition of personality disorder isn't apparent until
after serving in Iraq. Traumatic experiences, Knorr says, can trigger a condition that
has lain dormant for years. "They may have done fine in high school and before, but it
comes out during the stress of service."
"I've never heard of that occurring," says Keith Armstrong, a clinical professor with
the Department of Psychiatry at the University of California, San Francisco. Armstrong
has been counseling traumatized veterans for more than twenty years at the San Francisco
VA; most recently he is the co-author of Courage After Fire: Coping Strategies for
Troops Returning From Iraq and Afghanistan and Their Families. "Personality disorder is
a diagnosis I'm very cautious about," he says. "My question would be, has PTSD been
ruled out? It seems to me that if it walks like a duck, looks like a duck, let's see if
it's a duck before other factors are implicated."
Knorr admits that in most cases, before making a diagnosis, his doctors only interview
the soldier. But he adds that interviewing family members, untrained to recognize signs
of personality disorder, would be of limited value. "The soldier's perception and their
parents' perception is that they were fine. But maybe they didn't or weren't able to see
that wasn't the case."
Armstrong takes a very different approach. He says family is a "crucial part" of the
diagnosis and treatment of soldiers returning from war. The professor sees parents and
wives as so important, he encourages his soldiers to invite their families into the
counseling sessions. "They bring in particular information that can be helpful," he
says. "By not taking advantage of their knowledge and support, I think we're doing
soldiers a disservice."
Knorr would not discuss the specifics of Town's case. He did note, however, that his
department treats thousands of soldiers each year and says within that population, there
are bound to be a small fraction of misdiagnosed cases and dissatisfied soldiers. He
adds that the soldiers he's seen diagnosed and discharged with personality disorder are
"usually quite pleased."
The Army holds soldiers' medical records and contact information strictly confidential.
But The Nation was able to locate a half-dozen soldiers from bases across the country
who were diagnosed with personality disorder. All of them rejected that diagnosis. Most
said military doctors tried to force the diagnosis upon them and turned a blind eye to
symptoms of PTSD and physical injury.
One such veteran, Richard Dykstra, went to the hospital at Fort Stewart, Georgia,
complaining of flashbacks, anger and stomach pains. The doctor there diagnosed
personality disorder. Dykstra thinks the symptoms actually stem from PTSD and a
bilateral hernia he suffered in Iraq. "When I told her my symptoms, she said, 'Oh, it
looks like you've been reading up on PTSD.' Then she basically said I was making it all
up," he says.
In her report on Dykstra, Col. Ana Parodi, head of Behavioral Health at Fort Stewart's
Winn Army Hospital, writes that the soldier gives a clear description of PTSD symptoms
but lays them out with such detail, it's "as if he had memorized the criteria." She
concludes that Dykstra has personality disorder, not PTSD, though her report also notes
that Dykstra has had "no previous psychiatric history" and that she confirmed the
validity of his symptoms with the soldier's wife.
Parodi is currently on leave and could not be reached for comment. Speaking for Fort
Stewart, Public Affairs Officer Lieut. Col. Randy Martin says that the Army's diagnosis
procedures "have been developed over time, and they are accepted as being fair." Martin
said he could not address Dykstra's case specifically because his files have been moved
to a storage facility in St. Louis.
William Wooldridge had a similar fight with the Army. The specialist was hauling
missiles and tank ammunition outside Baghdad when, he says, a man standing at the side
of the road grabbed hold of a young girl and pushed her in front of his truck. "The
little girl," Wooldridge says, his voice suddenly quiet, "she looked like one of my
daughters."
When he returned to Fort Polk, Louisiana, Wooldridge told his doctor that he was now
hearing voices and seeing visions, hallucinations of a mangled girl who would ask him
why he had killed her. His doctor told him he had personality disorder. "When I heard
that, I flew off the handle because I said, 'Hey, that ain't me. Before I went over
there, I was a happy-go-lucky kind of guy.'" Wooldridge says his psychologist, Capt.
Patrick Brady of Baynes-Jones Army Community Hospital, saw him for thirty minutes before
making his diagnosis. Soon after, Wooldridge was discharged from Fort Polk under Chapter
5-13.
He began to fight that discharge immediately, without success. Then in March 2005,
eighteen months after Wooldridge's dismissal, his psychiatrist at the Memphis VA filed
papers rejecting Brady's diagnosis and asserting that Wooldridge suffered from PTSD so
severe, it made him "totally disabled." Weeks later the Army Discharge Review Board
voided Wooldridge's 5-13 dismissal, but the eighteen months he'd spent lingering without
benefits had already taken its toll.
"They put me out on the street to rot, and if I had left things like they were, there
would have been no way I could have survived. I would have had to take myself out or had
someone do it for me," he says. The way they use personality disorder to diagnose and
discharge, he says, "it's like a mental rape. That's the only way I can describe it."
Captain Brady has since left Fort Polk and is now on staff at Fort Wainwright, Alaska;
recently he deployed to Iraq and was unavailable for comment. In a statement, Maj. Byron
Strother, chief of the Department of Behavioral Health at Baynes-Jones hospital, writes
that allegations that soldiers at Fort Polk are being misdiagnosed "are not true."
Strother says diagnoses at his hospital are made "only after careful consideration of
all relevant clinical observation, direct examination [and] appropriate testing."
If there are dissatisfied soldiers, says Knorr, the Fort Carson official, "I'll bet not
a single one of them has been diagnosed with conditions that are clear-cut and makes
them medically unfit, like schizophrenia."
Linda Mosier disputes that. When her son Chris left for Iraq in 2004, he was a "normal
kid," she says, who'd call her long-
