Jim Hayman: As I wrote in a recent blog, one of the major characters in my last thriller, The Chill of Night, was a young woman named Abby Quinn who was suffering from schizophrenia. I don’t know whether or not I’m particularly drawn to characters with mental health issues but, as it turns out, one of the key characters in my new novel (which I recently finished writing and is now with editors) is a young former marine, a scout-sniper who served in the battles of Fallujah and Ramadi in the Iraq war. His name is Harlan Savage and he is the younger brother of my ongoing heroine and McCabe’s partner, Portland Police Detective Maggie Savage. Maggie and Harlan’s father is Washington County Sheriff John Savage.
Like many other Iraq and Afghanistan veterans, Harlan suffers from Post Traumatic Stress Disorder (PTSD). In the book, the possibility that Harlan may have been involved in the murder of his ex-girlfriend and perhaps of another young woman draws Maggie back to her childhood home in Machias to help Maine State Police detectives investigate the case.
As with Abby, many of the chapters of the new book (tentatively titled Darkness First) are written from Harlan’s Point of View. This required me do to a little basic research into PTSD and it’s effect on the minds of returning veterans. Now that I’ve finished the book some frightening new information seems to be emerging.
As Nicolas Kristof wrote in a series of recent pieces in the New York Times, American Iraq and Afghanistan veterans “kill themselves at a rate of one every 80 minutes. More than 6,500 veteran suicides are logged every year — more than the total number of soldiers killed in Afghanistan and Iraq combined since those wars began.” And it’s not just the suicide rate among returning vets that is disturbing. Large numbers of them have been involved in murders, particularly of loved ones, and other crimes. Even larger numbers have been diagnosed as clinically depressed and frequently engage in excessive drinking and other drug abuse.
In writing the book, I treated Harlan’s PTSD, as most doctors do, as largely a psychological condition, a mental illness brought on by the trauma of war and exacerbated by coming home to a country reeling from high unemployment and severe recession.
However, in a follow-up piece published by the Times last Wednesday, April 25th, Kristof suggests something even more disturbing might be afoot. He cites research conducted by a team headed by neuropathologist Dr. Bennet Omalu at the Brain Injury Research Institute in Morgantown, West Virginia. Dr. Omalu hypothesized in a paper published in 2011 that what we call PTSD, at least among combat veterans, may be caused by traumatic brain injury, a condition called chronic traumatic encephalopathy or CTE.
Kristof writes “The finding of C.T.E. may help answer a puzzle. Returning Vietnam veterans did not have sharply elevated suicide rates as Iraq and Afghan veterans do today. One obvious difference is that Afghan and Iraq veterans are much more likely to have been exposed to blasts, whose shock waves send the brain crashing into the skull.
‘Imagine a squishy, gelatinous material, surrounded by fluid, and then surrounded by a hard skull,’ explained Robert A. Stern, a C.T.E. expert at Boston University School of Medicine. ‘The brain is going to move, jiggle around inside the skull. A helmet cannot do anything about that.’ ”
Dr. Omalu was the researcher who first found signs of CTE in professional football players and other athletes who had sustained repeated concussive blows to the head. In 2011, he conducted an autopsy on a twenty-seven year old ex-marine who had committed suicide and found signs of similar brain damage.
In athletes, CTE has been shown to lead to degenerative memory loss, diminished thinking ability and in many cases to dementia. If the hypothesis that explosive shock waves has had the same effect on the brains of returning combat veterans proves correct, the future challenges facing medical professionals at the VA and other mental health facilities will be daunting indeed. Here, as on other critical areas, I believe we as a country must resist the cost-cutting (and tax-cutting) frenzy going on in Washington and devote whatever resources are needed to finding whatever answers may exist.