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From Wounds, Inner Strength

At Walter Reed Army Medical Center, Eric DeSarme adjusts a prosthesis for Hilbert Caesar, who lost a leg in Iraq.
At Walter Reed Army Medical Center, Eric DeSarme adjusts a prosthesis for Hilbert Caesar, who lost a leg in Iraq. (By James A. Parcell -- The Washington Post)

Tedeschi said there can be feelings of spiritual development, improved relationships, a sense of personal strength, a better appreciation of life and new interests and priorities.

Both men stressed that growth is not necessarily a goal, nor is trauma "good." Calhoun said: "Post-traumatic growth occurs in the context of . . . suffering. We hope everybody who goes to Iraq comes back safe and sound and doesn't have any traumas to grow from."

Although scientists continue to worry about war's impact on mental health, experts say research now shows that most people exposed to combat and other traumatic events do not develop chronic mental health problems.

"It used to be thought that virtually everybody who experienced these kinds of catastrophic events would go on to develop" PTSD symptoms, said Lt. Col. Charles C. Engel Jr., a psychiatrist at Walter Reed Army Medical Center in Washington. "That was kind of a post-Vietnam War assumption. What we've learned over time is that probably, on average, really about two-thirds to three-fourths don't develop PTSD."

Friedman, of Dartmouth, said that research on the issue has not been that extensive and that the "deleterious" effects of trauma have received the most attention.

But that is changing. "The whole field, in the last four years, has shifted to a certain extent [to focus on] resilience, on human potential," he said.

Friedman said studies of World War II veterans often showed that they valued the experience, even though they had serious post-combat stress: "Yes, I've suffered," he said men would report, "but I wouldn't have given up this experience for anything in the world. . . . The things I experienced have made me a better man today."

Studies of Vietnam War POWs have shown similar sentiments. One study, in 1980, found that 61 percent of American POWS in North Vietnam believed their experience was ultimately beneficial.

Tom McNish, a former Air Force pilot who was a prisoner in North Vietnam for six years, said: "There is no question in my mind that the experience I had in Vietnam has had an overall very positive effect on my life. But I don't recommend it for anybody else. And I don't want to have to do it again."

Wounded veterans of the Iraq war say similar things. Adam Replogle, 25, of Wellington, Colo., a former Army sergeant and tank gunner who lost his left hand and the vision in his left eye in a battle in Karbala in 2004, said that he still has ups and downs but that after his experience in Iraq, not much worries him.

"Sometimes it takes people a lifetime to realize what it's all about and what's important and what's not," he said. "And you go through something like this and it grows you up a little bit and makes you realize that stuff a lot earlier in life."

Caesar, a native of Guyana who grew up in New York City, was a six-year Army veteran and a section chief in a field artillery unit in Iraq. He was in charge of a long-range, self-propelled 155mm howitzer -- a huge vehicle with treads that resembles a tank.

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