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Column: Fireworks and PTSD
Katherine Richardson (ANVIL).jpg
Katherine Richardson
George Richardson
Columnist Katherine Richardson’s husband, George, treats Vietnamese children while serving as a Navy medic during the Vietnam War. The children’s mothers would call him “boxsee,” meaning doctor. George Richardson suffered from what is now known as PTSD, often triggered by New Year’s Eve and July 4th fireworks. (Provided by Katherine Richardson)

All in all, this was a very quiet Fourth of July at my house. For many years, fireworks would be popping all around us from daylight until midnight. Firecrackers popped at intervals from the nearby park and up and down our street. Families on our street and surrounding blocks really put on quite a spectacular show which soared above our houses and lit the night sky. When the city of Sumter held a fireworks display at Dillon Park, we could see the upper reaches of the fireworks from the second floor windows of our tall Victorian style house. That’s about as close as my husband wanted to get to the explosions, which were meant to be joyous in celebration of America’s Independence Day. To him, they were sudden jolts of terror and memories of a place in his past which vividly came back to life in his mind.

For 33 years, I watched as my late husband, George, struggled to get through New Year’s Eve and the Fourth of July. George served in the Navy during the Vietnam War as a hospital corpsman. In civilian language, he served as a Navy medic with the Marines on the ground in Vietnam. Very few of his 13 months of duty were spent in “the rear” where it was relatively safe. Most of his tour was spent out in the midst of the fighting, following Marines through the jungles where, at any second, one could step on a land mine or become the target of the invisible enemies’ guns. They were ambushed in those jungles and once were barricaded in the ruins of an old French factory as they fought a fierce ground battle with no air support.

George’s job was to doctor the wounded men and comfort the dying ones whom he could not save. He was the one who put their remains in body bags to be sent home to their loved ones for burial. Once, all he could send home was one boot and a dog tag. There were some good moments, like when he could treat the local children for simple ailments. The children and the Vietnamese mothers called him “boxsee” -- doctor. Too many stories to tell -- but they played over and over in his mind when the fireworks rang out around our neighborhood.

When George came home from Vietnam, his thoughts were haunted by those boys and men he could not save. A family friend, Dr. Lee Large, wrote George in October of 1968: “Your Dad told me about your first experiences with battle casualties, and he tried to describe how dismally you felt. No one can adequately describe it, however; nor can one can really appreciate it unless he has been through precisely the same thing -- and how vivid those memories from years ago become …”

George had “Post Traumatic Stress Syndrome” before they had a term for it in the post-Vietnam days. He suffered with it for the rest of his life, though he bravely managed to overcome most of its symptoms and live a somewhat normal existence. Until the holiday fireworks started…

Historically, the condition we now know as PTSD was recognized as a product of battle in some soldiers, but misunderstood as cowardice and homesickness. During the late 1600s, Swiss doctors recognized symptoms of the condition as they manifested in a rapid heartbeat, insomnia, and confusion. They linked it to homesickness, calling it “nostalgia.” It was thought to be a mental condition rather than a condition of the brain and central nervous system. During the American Revolution, “nostalgia” remained the term for the condition. By the time of the Civil War, doctors and commanders noticed severe trembling in some soldiers and the term “irritable heart” began to be applied. That war also produced the discovery of dazed, disconnected soldiers wandering away from their comrades and unable to care for themselves. By the Spanish American War, the symptoms collectively began to be linked to mental illness and was called “shell shock.”

World War I brought the realization that the condition was really a mental breakdown caused by “the war to end all wars.” Seventy thousand American soldiers were discharged due to “mental breakdown” during that war. On the other side, the Germans called it “bewilderment.” Scientists were beginning to think that the symptoms resulted from brain damage due to bombardments and proximity of explosions.

The condition, of course, persisted into World War II when it was labeled “combat exhaustion” or “combat fatigue.” Sufferers of the condition were thought to be weaklings and cowards. Lt. Gen. George Patton urged the Army to court martial those soldiers he considered to be “yellow bellies” and cowards. By 1947, two scientists finally began to associate the symptoms displayed throughout the suffering ex-soldiers as “persistent, chronic and war-induced neurosis.” Kardiner and Spiegel’s paper, “War Stress and Neurotic Illness,” was apparently not noticed by the military establishment, but researchers were following this condition more closely than ever before and asking questions regarding earlier diagnoses. In 1950, a study of 200 World War II soldiers with symptoms of what we now know as PTSD found that the men had chronic illness 10 years after the war.

As the scientists continued to research the condition, they found that prolonged stress actually changes the chemical balances in the brain and eventually produces shrinkage to the hippocampus, the memory storage area of the brain. Many people with symptoms of PTSD suffer from “hippocampal shrinkage.”

Some 480,000 Vietnam War veterans, including women, came home from that conflict with full blown symptoms of PTSD, including anxiety, flashbacks, insomnia, nightmares, and diminished cognitive skills. Another 350,000 more veterans displayed partial symptoms. My husband, George, had partial symptoms, but was not one of those counted. No one from the Navy ever followed up on his health after the war.

In 1980, Post Traumatic Stress Disorder was officially recognized as a mental health condition, but it took many more years before it was widely known in popular media as a mental disorder and called such by many war veterans. The identification of PTSD vindicates hundreds of years of veterans who gave their best for their country and lived to come home afterward -- but bore the stress of battle for the rest of their lives.