Little Relief on Ward 53

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By Anne Hull and Dana Priest
Washington Post Staff Writers
Monday, June 18, 2007

On the military plane that crossed the ocean at night, the wounded lay in stretchers stacked three high. The drone of engines was broken by the occasional sound of moaning. Sedated and sleeping, Pfc. Joshua Calloway was at the top of one stack last September. Unlike the others around him, Calloway was handcuffed to his stretcher.

When the 20-year-old infantry soldier woke up, he was on the locked-down psychiatric ward at Walter Reed Army Medical Center. A nurse handed him pajamas and a robe, but they reminded him of the flowing clothes worn by Iraqi men. He told the nurse, "I don't want to look like a freakin' Haj." He wanted his uniform. Request denied. Shoelaces and belts were prohibited.

Calloway felt naked without his M-4, his constant companion during his tour south of Baghdad with the 101st Airborne Division. The year-long deployment claimed the lives of 50 soldiers in his brigade. Two committed suicide. Calloway, blue-eyed and lantern-jawed, lasted nine months -- until the afternoon he watched his sergeant step on a pressure-plate bomb in the road. The young soldier's knees buckled and he vomited in the reeds before he was ordered to help collect body parts. A few days later he was sent to the combat-stress trailers, where he was given antidepressants and rest, but after a week he was still twitching and sleepless. The Army decided that his war was over.

Every month, 20 to 40 soldiers are evacuated from Iraq because of mental problems, according to the Army. Most are sent to Walter Reed along with other war-wounded. For amputees, the nation's top Army hospital offers state-of-the-art prosthetics and physical rehab programs, and soon, a new $10 million amputee center with a rappelling wall and virtual reality center.

Nothing so gleaming exists for soldiers with diagnoses of post-traumatic stress disorder, who in the Army alone outnumber all of the war's amputees by 43 to 1. The Army has no PTSD center at Walter Reed, and its psychiatric treatment is weak compared with the best PTSD programs the government offers. Instead of receiving focused attention, soldiers with combat-stress disorders are mixed in with psych patients who have issues ranging from schizophrenia to marital strife.

Even though Walter Reed maintains the largest psychiatric department in the Army, it lacks enough psychiatrists and clinicians to properly treat the growing number of soldiers returning with combat stress. Earlier this year, the head of psychiatry sent out an "SOS" memo desperately seeking more clinical help.

Individual therapy with a trained clinician, a key element in recovery from PTSD, is infrequent, and targeted group therapy is offered only twice a week.

Young Pfc. Calloway was put in robes that first night. His dreams were infected by corpses. He tasted blood in his mouth. He was paranoid and jumpy. He couldn't stop the movie inside his head of Sgt. Matthew Vosbein stepping on the bomb. His memory was shot. His insides burned.

Calloway's mother came to Walter Reed from Ohio and told the psychiatrist everything she knew about her son. Sitting in the office for the interview, Calloway jiggled his leg and put his head in his hands as he described his tour in Iraq. His mental history was probed and more notes were taken. The trivia of his life -- a beagle named Zoe, a job during high school at a Meijer superstore, a love of World War II history -- competed with what he had become.

"I can't remember who I was before I went into the Army," he said later. "Put me in a war for a year, my brain becomes a certain way. My brain is a big, black ball of crap with this brick wall in front of it."

After a week in the lockdown unit, Calloway was stabilized. They gave him back his shoelaces and belt. On the 10th day, he was released and turned over to outpatient psychiatry for treatment. And Calloway, a casualty without a scratch, began the longest season of his young life.

Inside Walter Reed

The Washington Post began following Calloway after he was brought to Walter Reed last fall with an initial diagnosis of acute stress disorder. He had all the signs of PTSD, but it would be the hospital's job to treat him and then decide whether he met the Army's strict guidelines for a PTSD diagnosis -- which required a certain level of chronic impairment -- and whether he could ever return to duty.


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© 2007 The Washington Post Company

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