Thank you for this thoughful and passionate piece. I have not yet read the book but I shall, it clearly raises many profound questions. For instance, how in detail are policies on minimal casulaties defined? for much of the world US war policy has held this as a key element since Vietnam.

Leaving politics aside PP is as much about death and disability as about anything else. Both things happen in life. Either PP is relevant in all spheres or it must re-examine its bases, but I think its bases are strong - on the road to narrow victory.

Kathryn as ever makes cogent, thoughtful and constructive points. I know that many found the ‘Future Selves’ exercise problematic but I wonder if it does not have a place here?

Best aye
Angus

So today, the public is more open to thinking about veterans as heros of the hour — but that tendency is tenuous, given that stories of misbehavior sell more newspapers than stories of quiet ongoing achievement.

So I’d ask veterans to tell stories about the best things they did, the hardest things they achieved, and the contributions, large and small, that they observed the American presence making to the Iraqi people. There are many of us who hear only the downsides, never the upsides of our presence there. What do we have to feel proud of? Make it real for us. Keep it real for yourselves.

First, I think we should shy away from the word “unprecedented” because it is neither true nor helpful. Read The English Patient. I’d say explore the horrors of earlier wars, but I don’t think that’s a good use of time!

The reason it is not helpful is it cuts these veterans off from others who have found ways to live with debilitating and often degenerative illness. Man is born to trouble as the sparks fly upwards, and that has ALWAYS been the case. But man can also be very ingenious about how to manage.

Let me illustrate with examples from my circle of friends. One 25-year-old man with cerebral palsy has no functional hands or legs, is fed through a stomach tube, and can’t talk - but laughs a lot. Another 21-year-old man died this summer with Friedrich’s Ataxia after losing his ability to walk and the strength in his hands by inches from the time he was about 10. He was an accomplished graphic artist. Another 23-year-old man has Muscular Dystrophy. He made his first unsupervised friends in his late teens when he became able to play games over the Internet. Up until then, his disability meant he was under constant adult supervision - not conducive to close relationships with peers.

So some ideas from these friends:

Companion dogs - for example, see http://www.caninecompanions.org/national/facts_faqs.html . The young man with cerebral palsy has a companion dog who is his bridge to contact with people outside the family, as well as giving him big sloppy kisses that make him laugh. People come up to pet the dog and then stop to talk. These same people would probably walk by with averted eyes otherwise. Companion dogs are thoroughly trained and require a real commitment from the person and often family, but they can be a source of great comfort and company.

Make virtual contacts with others. Human relationships matter and can be hard for disabled veterans to manage in person. My friend with Muscular Dystrophy uses virtual forms of human contact — in his case gaming. He very much appreciates the evolving technologies since things keep getting easier as the strength in his hands declines. For those who aren’t into games, there are Blogs, MySpace, and online discussions like this one. Computer companies have invested a lot in “accessibility” enhancements for software. For example, if a person can’t type well, there are trainable voice readers that can ‘take dictation.’

Find a hero — in a story or reality — who has struggled with a similar disability and somehow won through to a strong life. My friend with Friedrich’s Ataxia used Steven Hawkings for his hero and received considerable comfort from remembering that someone so disabled could still contribute so splendidly. That appealed to him because he had a similar kind of brain, so could picture himself making contributions in the same vein. Physical exercise of whatever form is still possible can also be important. So how about a hero such as the man who joined a fund-raising bike ride from Seattle to Portland in his un-motorized wheel chair, pushing all the way — and kept up.

So I guess I’m suggesting that we search among people - many of them quietly getting through difficult lives - who can provide examples of ways to find meaning in very circumscribed lives.

Kathryn

If you can’t heal the injuries so that the pain is diminished, I’d advocate some type of tried and true cognitive therapy for pain management with antidepressant drugs combo. I’ve heard that Interpersonal therapy is a good one with those dealing with grief and loneliness problems.

Again, I find value in Michael Frisch’s CASIO approach…yeah it may seem like a drop in the bucket, but really ever since I’ve heard of CASIO I use it every day and I think there is something there even for disabled vets, since they are people first and foremost.

Yet there should be a lobbyist group advocating for the disabled Vet’s mental health…that’s a systemic improvement that would really make a difference. Maybe this organization could fund posipsych coaches to go to the vets in the hospitals and provide morale boosting, something like Patch Adams for the veterans. There’d be plenty of work for our awesome pp coaches.

I know the comments section isn’t a place for partisan politics, but ultimately the veteran issue is a political one that needs in part, a political solution to create or improve the existing support organizations to involve more PP.