NPR News

Excerpt: 'Fields Of Combat'

NPR | By Erin P. Finley

Published June 2, 2011 at 12:22 PM EDT

Derek and Laticia first started to think that Derek might have a problem after he was released from the hospital with his new prosthesis. Memory of the improvised explosive device (IED) that had taken his leg remained fresh in his mind. He says, "[I]t took me a while to get down from that. Especially driving on the road, anything that looked like trash or debris on the side ... I had nightmares."

Laticia chimes in, "For the record, we were watching TV with my cousin and they flipped it on a channel and there was two guys joking and laughing in the desert, riding in a Humvee ..."

Derek nods, remembering the incident. "Mmm-hmm ..."

She continues. "And the next second it blew up. And I turned and looked at my cousin and she turned [the TV] off and I turn and look at Derek. 'You OK?' He says, 'I'm OK.' " Later that night they were driving home, Derek behind the wheel, and, Laticia says, "[H]e's driving like a maniac down the highway." She stopped him: " 'You're going to kill us — pull over.' And he was shaking, clearly disturbed." She drove the rest of the way home.

There were other signs. His fear of crowds was so bad that he couldn't go to the grocery store, to the mall, to Six Flags with their kids. I ask how they dealt with that and Derek answers, shrugging toward Laticia, "She busted me a lot."

"Did I?" Laticia asks.

"You busted me a lot."

She nods, accepting this, then adds, "I think I would cry a lot. It was a mix of things — frustration, you don't understand. You don't really understand." Back then, she says, she tried to hear him out but found it difficult to be patient when she couldn't make sense of his problems. They fought on New Year's Eve when she wanted to go spend the holiday with her family and he wanted to stay home, dreading the party crush. Derek remembers that he was still angry when she came home. She defends herself. "You know — it was going from one lifestyle to another, and then dealing with something I couldn't even comprehend. To me it was like, my family's calling, we gotta go to my family. It's my family!"

By spring, however, they had fallen into a pattern and things seemed better. That summer they took the boys to Six Flags, and Derek was able to stay for several hours before he began shaking, unnerved by all the people. Another night that summer they tried going out to a club with some friends. Derek says, "I was not having that. Too loud. Too many people. Cannot see everything at once. There was smoke everywhere. And I felt really bad, because we don't get to go out much, with two kids. She was having a really good time, joking. She wants to dance and I'm trying to look everywhere at once. I had the racing heartbeat and I couldn't breathe, and we had to leave."

When fall came, he started college. He purposely chose one of the smaller schools in the area, thinking it would be less crowded and less likely to unnerve him. But over time, he found that he increasingly needed to get to campus a half hour early. "I would walk the perimeter of the buildings and I would walk around inside the building, just looking at everybody and making sure everybody fit and there wasn't a problem before I went to class. And that started becoming a problem, because — if I was out of one class a little late and I couldn't make it to one class without walking around? — I had a really difficult time focusing in class." One day he saw a man standing on the roof and nearly dived to the ground, thinking he was a sniper. "I knew it was crazy. I was thinking, he's either a sniper or he's going to radio ahead. And then I thought, this is San Antonio. There's not snipers on the roof, nobody's going to blow me up here. But I still had to walk around so I wouldn't be nervous in class."

Wives and family members play a key role in helping to shape veterans' experiences of illness, both through offering their own opinions about the source of the problem and in suggesting an appropriate response. Wives in particular are often the prime movers in getting veterans into treatment, and Laticia was trying. She had been telling Derek for months that he needed to go get some help. But the final straw came one day during a class on international terrorism. The professor finished the lecture early and put on a video for the class to watch. Derek says, "And it starts with the Islamic call to prayer, there's one of the jihadist group's flags with the AK-47s, and then this mosque just blew up." He was so upset by the unexpected explosion and the triggers of Iraqi sound and symbol that he fled. And that was it. As he saw it, his problems were now interfering with his ability to pursue a college degree and move ahead with his career plans, and that was unacceptable. He spoke with his vocational rehabilitation counselor about getting some help, and within a few days he had an appointment at the VA for a PTSD evaluation.

In Derek's story, there was no crisis, no single event that forced him into treatment, no immediate danger to himself or his family. Instead, there was a long, slow series of events that made it clear he had a problem, one that was not going away and one that could get in the way of fulfilling his plans for himself and his obligations to his family. This necessitated action.