From The New York Times:

DEXTER, Me. — The roadside bomb that separated Sgt. Matthew Pennington from his left leg in 2006 also shattered his right leg and scorched his lungs. Those injuries he understood. But then came the ones he did not, the ones inside his head.

In the months after checking out of Walter Reed Army Medical Center, he found himself easily frustrated and, his wife said, perpetually angry. Envisioning threats in grocery stores and shopping malls, he stopped leaving his house and started drinking heavily. His marriage was near collapse when, in a fit of alcohol-fueled despair, he drove his car into a brick wall, emerging so dazed that he thought he was back in Iraq.

 “With a physical injury — three months, six months, whatever — your cuts will heal,” he said. But post-traumatic stress “is more difficult because people don’t see it.”

Like Mr. Pennington, many veterans injured in combat are finding that their invisible psychological and neurological wounds are proving more debilitating than their obvious physical ones. 

About 1,700 American service members have lost limbs in Iraq and Afghanistan, most in roadside bombings that seared skin, shattered bones and damaged internal organs as well. Most of those troops also came home with traumatic brain injuries and post-traumatic stress disorder, which in many cases were not recognized for months.

While advances in prosthetics have made it possible for many lower-limb amputees to regain full mobility, the track record for overcoming brain injuries and chronic P.T.S.D. — both capable of altering personality and hampering mental functioning — is more spotty, experts acknowledge.

“I think the limiting factor for these people going back to their lives is not having lost a limb,” said Dr. Douglas Cooper, a neuropsychologist at Brooke Army Medical Center in San Antonio. “The P.T.S.D. symptoms and post-concussive symptoms are the ones that seem to get in the way.”

For Mr. Pennington, medications seemed to worsen his depression and therapy did not ease his anxiety. He seemed headed for divorce, isolation and perhaps alcoholism. And there his story might have ended, a case study on the intransigence of war’s psychological scars. But it did not end there. 

In 2009, an unexpected opportunity landed in his e-mail inbox: a casting call, forwarded by a friend in Nashville, from an undergraduate filmmaker looking for someone to play a combat veteran who had lost a leg, had post-traumatic stress disorder and lived in Maine.

This is my life, Mr. Pennington thought. 

So on a lark, Mr. Pennington — whose last appearance on stage was in middle school and who had become nervous in crowds and, indeed, avoided most human contact — decided that fixing his life depended on performing before a camera.

“I thought acting would be so out of the normal that it would force me to deal with things,” he recalled. “I wanted my life back.”

The struggle by wounded veterans like Mr. Pennington to reclaim their lives is the unfolding next chapter in America’s wars in Iraq and Afghanistan. Since 2001, 46,000 American service members have been injured in combat, perhaps a third or more seriously. Those veterans now face years of rehabilitation at a cost of billions of dollars annually.

In the coming weeks, The New York Times will profile a few of those veterans. Their cases say much about the critical importance of high-quality health care and loving families. But as with Mr. Pennington, they also underscore the individuality of recovery, where the most effective therapies are often discovered by the veterans themselves.

Continue reading.

Labels: Afghanistan, Iraq War, post-traumatic stress disorder, PTSD, traumatic brain injury, Veterans