THE BALTIMORE SUN

Sunday, May 25, 2008

By David Wood
(Sun Reporter)
GARMSIR, AfghanistanIn -- In the dying sunlight, the day's heat radiates from a
farm compound's baked adobe walls, which enclose Marines slumped wearily against
their rucksacks.

Here in southern Afghanistan, where the men of the 24th Marine Expeditionary
Unit are battling Taliban insurgents, life comes in a simple equation: There are
men out there who will kill you, unless you kill them first.

Out here, you've got to figure out how to handle the stress of that
exhilarating and awful equation.

Bust it or park it, use guesswork or patchwork or whatever works. Suck up the
heat, the dust, the physical exhaustion, the fear, the loss. Help is a long way
away.

For all the attention the U.S. military has recently given to mental health,
it's clear that at the source of the tension borne by Americans in combat, they
are pretty much on their own. That burden consumes strong men.

"I can't do this anymore," said a weary Gunnery Sgt. Rosendo DeLeon, 40.
"After this deployment I am done."

In these hours before nightfall, when the hunt will begin anew, there is
precious respite. Chins rest on flak vests, weapons across knees. Sodden, gritty
uniforms bind and chafe - even where the Marines have stretched duct tape across
their ribs for protection.

Momentarily safe from all but a chance mortar round, there is only the easing
of aching muscles, cool water in parched throats, a blessed movement of air across
bare scalps.

Or maybe it all comes back unbidden, in that terrible rushing dread. Tonight
could be it - the sudden, searing injury, the torn limb, the awful bleeding out,
the sickening smell of blood. You could die here. Worse, your closest buddy could.

Some close their eyes and project themselves back home. Some simply let the
stress buzz alongside. Some pop a pill. Some joke about it, belittle it.

Basically, stuff it down out of sight, hope it won't come back in all its dark
and evil power.

"Let's go, we're pushing out!" With DeLeon's cry, Marines heave themselves to
their feet, throw on rucksacks, clamp on helmets and stride into the dusk.

Deal with it later. For now, focus on the mission.

"Stoicism is necessary for their survival," says Dr. William Nash, a

psychiatrist who until this month directed the Marine Corps' combat stress
programs. But shoving stress down out of the way lasts only so long.

"Everybody," said Nash, "has a breaking point."

Hey - remember Molly and the leg? In Ramadi last year, a suicide bomber in a
car came at us, and our guys at the checkpoint got him stopped but he detonated
the bomb anyway and blew himself all over the place. We had this Iraqi dog we
called Molly?

Staff Sgt. Julian Lumm is telling the story between bursts of laughter. He is
handsome in the classic Latin manner, tall and hefty with dark, liquid eyes. He is
30 years old and is on his fifth combat deployment in five years, and he's got
Carlos Orjuela and DeLeon, the two company gunnery sergeants, remembering and
sputtering and guffawing.

So here comes Molly trotting back to where we are and she's got a piece of
this guy's leg in her mouth, and we're going, "MOLLY! BAD DOG! PUT THAT DOWN!"

Lumm collapses, helpless.

Orjuela: And Molly's going, like, What'd I do? She's lookin' so proud, ya
know, like a cat bringing you a mouse, and she keeps comin' and we're going, "NO
NO, GO AWAY, GIT THAT THING OUTTA HERE!!"

Oh, man. Lumm wipes a tear. That was hilarious, wasn't it?

When the 24th MEU went into Afghanistan in March, it took 2,500 Marines, a
hundred armored Humvees, jet fighters, about 4,000 assorted weapons - and a
psychiatrist.

Marine Maj. Ann Radford came to try to prevent Marines from being evacuated
for combat stress. But when the Marines went into action, she stayed at her
assigned place in camp.

"They are their own first line of defense," she said. In previous combat
tours, "they have learned stress management and reaction to trauma by doing it."

Trouble often begins when they got home. At the Parris Island Marine base,
where she works, Radford sees a lot of drinking and some spousal abuse. "That's
when the work begins," she said. That work may require having a Marine relive
emotional trauma, a delicate process that's best done away from combat.

But she is deployed to Afghanistan, she said, because the Department of

Defense "likes to have a psychiatrist out here." Given the political pressures at
home to care for deployed troops, "it's a box to check off."

Before a mission, DeLeon and other Marines are razzing one another about how
they'll behave if they get wounded.

"You'll be lyin' out there going, `Hey, I can't feel my legs!"' jokes Cpl.
Elvin Hendrix, "and we'll go, `Gunny, you ain't got no legs!"'

Acute stress among troops in Afghanistan is rising significantly, according to

a new mental health study by the Army. The main reason: Combat here is
intensifying. Three times as many soldiers reported being wounded in 2007 as in
2005, and those troops who killed an enemy combatant rose in that period from 13
percent to 21 percent, according to the Army surveys last October and November.

As a result, the incidence of depression, anxiety and acute stress was

"significantly higher" than in a previous Army survey in 2005. One of five
soldiers now says that acute stress causes them to work less carefully.

Most soldiers get stress management training. Two years ago, about half said
the training was not helpful. In the new survey, two-thirds said the training is
inadequate.

Training encourages junior leaders to watch for stress and take steps as
simple as telling a soldier or Marine to take a few hours off to catch up on
sleep, sending him or her to the chaplain - or assigning extra chores to chase
away boredom.

In the hours before they launch a 4 a.m. attack, Marines sprawl restlessly on
iron bunk beds. Idle chatter has died away.

In the dark, whispers:

Hey, man ... You OK? You scared?

(In a shaky voice) Nah.

Good, because you shouldn't be.

The scary thing about combat stress, a lot of Marines say, is that continued
exposure doesn't get you used to it.

It makes it worse.

"I hate the blood and gore part of this," says one of the Marines' most combat
experienced members. "I always throw up."

This is Gunner Robert Tagliabue, a warrant officer who is the senior weapons
expert for the 1st Battalion, 6th Marines, the 1,200-man infantry unit of the 24th
MEU. He's been in and out of combat since the U.S. invasion of Panama in 1989.
With the battalion, he returned from a combat tour in Iraq less than a year ago.

"I remember the first guy I killed, at near point-blank range. This was in
Desert Storm [1991], and the guy came up suddenly, and I just reacted. I thought
later, Jeez, what have I done?"

Tagliabue says he has mild post traumatic stress disorder: "I talk in my
sleep, and [my reactions to] thunderstorms are a family joke."

Late one night outside Fallujah last year, Sgt. Thomas Pizzillo, a lean, dark-
haired 22-year-old from New Jersey, was assigned with his nine-man squad to check
out an apparently abandoned house, to make sure no insurgents were hiding inside.

Peering through his night vision eyepiece, Pizzillo crept down a hallway,
swiveling into one room: empty. Another room: empty. Pulse hammering, he turned
back into the hallway and "HOLY -----!" bumped into ... something - a solid,
moving, breathing mass of ... a cow.

It's funny now. In the retelling, Pizzillo has Marines shrieking with
laughter. But the mirth is short-lived.

"Actually, it was a bad night for the platoon. Our corpsman was killed. We had
a Marine shot six times."

Combat veterans say the devotion among warriors is their best defense against
stress, their physical and emotional refuge.

Yet in war, that devotion itself is most at risk.

 For months on end, they endure knowing that a loved one could be snatched away
at virtually any moment. The stress eats away like acid at their sense of well-
being.

"The scariest thing about being out here is [the possibility of] losing
another one of my boys. ... You get so close to these guys," Pfc. Brandon Vallee,
a 19-year-old from Worcester, Mass., told a Marine interviewer. "Not too many
people understand except for the guys serving with you, guys left and right of
you."

With time, loss is harder to endure.

"It's like losing your child," said Sgt. Maj. Charlie Stanford, responsible
for all enlisted Marines in the battalion. He lost Marines last year in Ramadi,
and recently lost another in Garmsir. A balding, muscular man of 42, he's been a
Marine for more than two decades and is a martial arts enthusiast. He is not given
to introspection. But each combat death rips open a raw wound.

"It drives you to your knees," he said.

Unless you quit and go home, stress like that accumulates.

About 10 percent of Marines who've been in one or two firefights report PTSD
symptoms. Among those who've been through five or more firefights, almost 20
percent report such symptoms, according to Marine Corps data.

The others may be hiding it.

"Denial is necessary to survive," said Nash, the psychiatrist.

He added, "Stoicism is not just a cultural thing; when you are facing
adversity, you can't afford to talk about it or even be aware of how it's
affecting you.

"You will never get Marines, no matter how much you educate them, to raise
their hands and come forward to say, `I can't sleep, I have horrible nightmares.
... "'

Quitting may not be an option. Not when it means returning to a place where no
one understands what you've been through.

"I have PTSD, I get the shakes and can't sleep," a senior enlisted Marine
confided, asking not to be identified.

"I volunteered to come back out here. It's the only place I feel comfortable.

"At home, I'm a mess."

In Ramadi in 2006 and 2007, Capt. Todd Mahar and his men endured a daily
hailstorm of firefights.

On a mission to rescue a Marine patrol, his own vehicles were damaged by

roadside bombs. He led a counterattack and personally recovered the bodies of
three fallen Marines, according to his Bronze Star citation.

Mahar, since promoted to major, is a tall, barrel-chested man, revered by

younger Marines. As battalion operations officer, he plans and oversees combat
missions, a high-stress duty he handles with hard-eyed stoicism.
 But at what cost?

"There is a lot of stuff I don't want people to know about," he said privately
one day.

"Losing a Marine, the sight and smell of it, makes me sick. People don't need
to know that. I don't want my kids to know."

david.wood@baltsun.com