Traditonalists oppose Purple Heart for PTSD? What's a traditionalist?

Back in June 2008, Mark Thompson of Time wrote an article about what motivated the Pentagon to even consider granting the Purple Heart for troops diagnosed with PTSD. Although DOD has for now rejected the idea based on negative feedback from a few old fashion Veterans Service Organizations, the most resistant being the Military Order of the Purple Heart (an American Legion clone) and of course the Americanism (translated Nationalists) Legion itself.

In the spirit of keeping this idea, among others, alive as a means to attacking the STIGMA toward mental illness in our society that’s based more so on IGNORANCE than fact or medical/psychological evidence; I’m posted this article plus feedback from the Mental Health community that has to address these issues far beyond the U.S. Armed Forces. The number of such professional within all branches of military service are miniscule compared to the overall career field in American society.

Only forces that can drive or pressure both Congress, if necessary, and the Pentagon as a professional group with vested interest and that is the entire outside medical and psychological community combined with our troops and military families of the current generation. As evident from a few, not all but a few, nationalistic VSOs, [reporters are starting to call them Traditionalist as in backward thinking], Iraq and Afghanistan Vets and families cannot count on the Military Order of the Purple Heart (MOPH) or American Legion to look out for our interests went it comes to the hidden wounds of war, nor do they take serious PTSD anymore than these kind of organizations took Agent Orange or Gulf War Illness serious.

Question is, and it comes not from me but the professionals who deal with mental illness and the stigma that traditionalists place in their way, exactly what medical degrees, experience, or psychological expertise does the American Legion or especially the Military Order of the Purple Heart have that give them the arrogance to influence such decisions? How many members of the American Legion or Military Order of the Purple Heart are Board Certified Psychiatrists let alone Psychologists? That said, how many members of these VSO with a 19th century mental illness (excuse me mentality) give a hoot about PTSD. These organizations have a traditon (no pun intended) of opposing the existence of every and any illness or disease that keeps young men and women off the battlefield. History speaks for itself, the American Legion, VFW, and MOPH were the tip of the spear in denying the existence of PTSD , and Agent Orange ala Vietnam, plus Guld War Illness ala our generation of late 20th century warriors. The VFW spokesmen even takes a slap at Gulf War Illness comparing it to PTSD as unworthy side effects of WAR. Shame on them, all of them.

It is this vulnerability combined with younger troops and military families standing up alongside the vastly superior Medical and Psychological profession outside the Armed Forces and the few who place patient ethics above promotional goals that can place this decision into a debate based on factual evidence NOT ignorance and most traditonalism is based on IGNORANCE. However, just granting a medal or ribbon for PTSD only takes a baby step towards dealing with the issue of stigma associated with mental illness in our society period. No pun intended but it would be just as much a band aid as the purple hearts worn at the Republican National Convention during 2004 as the Military Order of the Purple Heart remained silent.

(If anyone can provide me a link to any official statement by the MOPH condemning the mockery of the Purple Heart at the 2004 Republican National Convention, please clarify this for me. I’m fairly good at Google searches and even checked out the MPOH magazine archive for a documented reaction and found none.)

Robert L. Hanafin

Major, U.S. Air Force-Retired

Mark Thompson of the Times wrote that the “Pentagon has diagnosed roughly 40,000 troops with post traumatic stress disorder (PTSD) since 2003, and tens of thousands of others are dealing with it on their own or ultimately will be diagnosed. With the war taking such a heavy psychological toll, as noted in Thompson’s earlier article, America’s Medicated Army, some inside the military [meaning they are not yet older VETERANS of previous wars per se] were and still continue asking if men and women who become mentally injured in the service of their country deserve the Purple Heart. To some traditionalists, [Nationalists] the idea is absurd on its face, but it is not a theoretical debate —the Pentagon did consider a change in policy that would make PTSD, in a term only the military could invent, a "qualifying wound" for the medal.”

The so-called traditionalists of the American Legion and its clone the Military Order of the Purple Heart with a mission to spread Americanism [Nationalism] have won the first round, because it is up to those inside the military TODAY to challenge old fashion ideas that belong in the 19th and early 20th century with the American Legion and MOPH.

Thompson goes on to note that the, “Army classifies PTSD as an illness, not an injury, which means it doesn’t qualify for the honor.” So technically speaking the Army has traditionally (no pun intended) taken the position of traditionalists Veterans Groups. Then, how come the idea of granting the Purple Heart even saw the light of day in the 21st century? This is a very important question for younger Veterans and Military Families need to ask themselves. Why? How many of us youngsters are seriously considering ever joining the American Legion or MOPH, maybe a few, very few, of us.

Well, readers, the idea did not come from a VETERAN; at least he wasn’t one when he promoted the idea. The idea in fact did not even come from many of the various PTSD support groups and forward thinking Veterans groups that DO take PTSD serious. It cames from someone within the military who was more qualified than any Board Member or Commander of the American Legion or MPOH.

It was an Army psychologist, John Fortunato, at Fort Bliss, Texas, who argued way back in early May 2008 that PTSD affects soldiers by physically damaging their brains, making the condition no different than conventional wounds. Soldiers with PTSD often have suffered as much "as anybody with a traumatic brain injury, as anybody with shrapnel wound," he said. Their ineligibility for a Purple Heart "says this is the wound that isn’t worthy, and it is." Advocates of the change like Fortunato believe it would [contribute to lessening the STIGMA associated with PTSD both in the military and out] help encourage soldiers with symptoms of PTSD, many of whom are afraid [due to the STIGMA that the Pentagon and our society admits exists] of being blacklisted and having their chances for promotion limited, fail to seek out the help they need. [In the long run, this is what leads to the growing number of suicides our military is experiencing during the War on Terror. Thus, just like any other wound directly or indirectly related to combat, PTSD is a killer and that cannot be debated except by those VSOs that do not take PTSD serious.]

As explained to me by a Navy Psychiatrist back during the relative Peacetime of the late 1990 after I returned from the Gulf War passionately in denial about having PTSD, is that PTSD and certain other major or minor depressive illnesses, including bi-polar, are caused by chemical changes in our brains, an imbalance if you will. In fact, this military physician (not a PhD, but an MD) went to a black board and drew me a picture of exactly how this imbalance works and what it does to our though processes. That’s why PTSD and so on is treated with medications. If there were no medical and psychological basis to PTSD, then there should be no reason to medicate patients. However, that is what I was taught as a patient, I’m no expert. This is why it is paramount that those who are within the Armed Forces itself must put aside traditionalists ideas based on ignorance and do what your profession calls for, because not all of you are going to become Colonels, Generals, or Admirals within the military medical community where the emphasis is on what it takes to get promoted not ethical patient care. If this were not the case the Walter Reed Fiasco would never have gone public.]

Though tabled for NOW, the suggestion DID garnered high-level Pentagon attention. The Mind you despite claims to the contrary, even from me, the DOD does not base all of its decisions on feedback or ignorant input from VSOs. They base their decision on how much it’s going to cost and how many ground troops are they going to lose at a time when more troops are needed for Afghanistan. The image or worth of a medal or ribbon is going to be the lowest common denominator to that decision. If awarding a medal or ribbon will cost nothing plus benefit morale of all troops that is the direction Pentagon uniformed leadership will go with the idea. However, DOD is not lead by uniformed service members, each Admiral and General reports to a civilian that’s the way of our military for now.

Although he backed off more so for political reasons and heat he would get from traditional, old fashion, VSOPs the fact remains that Defense Secretary Robert Gates felt "It’s an interesting idea," recently noted. "I think it is clearly something that needs to be looked at." The Defense Department’s awards advisory group, which previously ruled and again recently ruled that PTSD doesn’t merit a Purple Heart. That’s NOW, and the War on Terror is far from over. Robert Gates is a Republican appointee kept on for lord only knows why by the Obama Administration, if he a traditionalists himself felt it was an idea worth looking at once he was briefed, just think what a future 21st century thinking SECDEF might do who happens to not be a traditionalist by an innovative THINKER.

Shame on the Traditional Veterans Groups who ARE NOT 21st century THINKERS

Thompson doesn’t have to note, but he does that the so-called, “traditional veterans’ groups don’t want the rules loosened.”We vehemently disagree" that PTSD is a physical wound that warrants a Purple Heart, says Joseph Palagyi, the national adjutant of the Military Order of the Purple Heart, who earned the medal [during the mid-20th century] in Vietnam on June 2, 1968. "We feel that the purity of the medal must be maintained." The American Legion agrees. "Unless PTSD crosses the line and is shown to be an injury—with a direct relationship to the enemy—we support the current policy," says Phil Riley of the Legion. Michael Wysong, the director of national security issues for the Veterans of Foreign Wars, likens PTSD to the Gulf War syndrome that afflicted troops following that 1991 war. "Not to diminish the illness or effects of PTSD," he says, "but it is the VFW’s belief that awarding the Purple Heart for PTSD is not consistent with the original purpose and would denigrate the medal."

The Army surgeon general didn’t venture into this minefield when TIME offered him the opportunity. “They haven’t asked my opinion about it," Lieutenant General Eric Schoomaker said May 27, 2008 of the Pentagon panel reviewing the question. When pressed on the question—shouldn’t the Army’s top doc have an opinion on whether or not PTSD warrants a Purple Heart?— he punted. "Whether or not a medal should be awarded is not in my purview," he said. "The senior operational commander in the Army needs to decide that." It’s evidence of the sensitivity of the issue that even the army’s senior doctor suggests a second opinion.”

Conclusion: (1) The Defense Department’s awards advisory group was persuaded by a SECDEF to take a look at this twice now, so it is not going away as long as there is a War on Terror and the accountability and credibility of traditional VSOs remains questionable as qualified to make decisions on what medical and psychological wounds warrant recognition. Many of these traditionalists rate extremely low on charity watch dog organizations for failure to maintain proper management practices in fund raising. The MOPH and American Legion needs to focus more on proper and efficient management practices and less on lobbying the Pentagon on matters that concern 21st century troops and families NOT 19th and 20th century minded Veterans. (2) Media reports mention advocates of the change like Dr. Fortunato, however fails to mention who these other advocates are or exactly how prevalent the views of Dr. Fortunato are within the Armed Forces medical and psychiatric community. If it was a minor opinion by a minority of professionals, then why did Robert Gates or the DOD awards board give it any consideration at all? Depending on how many medical professionals both inside and outside the Pentagon agree with Dr. Fortunato, let me assure you the DOD will be looking at this again and hopefully not from a position based on IGNORANCE biased by traditionalism. (3) The duck and cover silence and distancing of the Army surgeon general was the most disgraceful, because it publicly shows that our Armed Forces definitely is not picking the best and brightest of the medical profession to lead those efforts during a time of WAR.

Lieutenant General Eric Schoomaker said it dumber than I ever could have, and this is what outside Medical Professionals are laughing at. On May 27, 2008. The General should have, could have said I wasn’t’ asked my opinion and left it at that. That response would have been DUMB enough, however say that, "Whether or not a medal should be awarded is not in my purview," he said. "The senior operational commander in the Army needs to decide that."

It is evident that medical leadership in our Armed Forces is subordinate (and I mean that in a negative way) to operational command and that includes issues of professional competence and expertise. Meaning that in order to get promoted, military medical personnel must compromise their own professional expertise and opinions for a second opinion from their bosses who happen to not be qualified, and who’s focus is on getting and keeping as many ground forces in combat as possible if they have PTSD or not.

http://www.time.com/time/health/article/0,8599,1812757,00.html

Robert L. Hanafin
Major, U.S. Air Force-Retired

Robert L. Hanafin

Readers are more than welcome to use the articles I’ve posted on Veterans Today, I’ve had to take a break from VT as Veterans Issues and Peace Activism Editor and staff writer due to personal medical reasons in our military family that take away too much time needed to properly express future stories or respond to readers in a timely manner.

My association with VT since its founding in 2004 has been a very rewarding experience for me.

Retired from both the Air Force and Civil Service. Went in the regular Army at 17 during Vietnam (1968), stayed in the Army Reserve to complete my eight year commitment in 1976. Served in Air Defense Artillery, and a Mechanized Infantry Division (4MID) at Fort Carson, Co. Used the GI Bill to go to college, worked full time at the VA, and non-scholarship Air Force 2-Year ROTC program for prior service military. Commissioned in the Air Force in 1977. Served as a Military Intelligence Officer from 1977 to 1994. Upon retirement I entered retail drugstore management training with Safeway Drugs Stores in California. Retail Sales Management was not my cup of tea, so I applied my former U.S. Civil Service status with the VA to get my foot in the door at the Justice Department, and later Department of the Navy retiring with disability from the Civil Service in 2000.

I’ve been with Veterans Today since the site originated. I’m now on the Editorial Board. I was also on the Editorial Board of Our Troops News Ladder another progressive leaning Veterans and Military Family news clearing house.

I remain married for over 45 years. I am both a Vietnam Era and Gulf War Veteran. I served on Okinawa and Fort Carson, Colorado during Vietnam and in the Office of the Air Force Inspector General at Norton AFB, CA during Desert Storm. I retired from the Air Force in 1994 having worked on the Air Staff and Defense Intelligence Agency at the Pentagon.