.Rx for Combat Stress: Comradeship .
GARMSIR, Afghanistan—The morning after Chad Wade died, nobody wanted to walk point.
The Marines in Cpl. Wade's squad no longer had to imagine what would happen if they stepped on a buried bomb. Now they had seen it, and the fresh memory of their friend's shattered legs froze them in place.
When their squad leader, Sgt. Albert Tippett, lined them up for their next patrol, no one would pick up the metal detector used by the point man to clear a path through the mines.
It was, Sgt. Tippett knew, the moment his men would either keep fighting or succumb to fear and loss. So he handed the metal detector to the man who was hurting most: Cpl. Wade's best friend.
That moment, and those that followed, epitomize the new approach to combat stress that the Marine Corps wants to institutionalize. Faced with a wave of mental-health problems among returning troops, the Corps is training young Marines—down to corporals and sergeants—to sniff out combat stress among their peers on the front lines and tackle it directly on the field of battle.
"The closer they are to their buddies, and the company they trained and deployed with, the better chance you have of returning them to combat," says Col. David Furness, commander of 1st Marine Regiment.
After nearly a decade of war, military commanders have concluded they're in danger of losing the battle against emotional trauma. One in five troops returns home from Afghanistan and Iraq saddled with some form of mental-health issue, says Dr. Matthew Friedman, executive director of the Department of Veterans Affairs National Center for Posttraumatic Stress Disorder. Not only are lives ruined, officers say, but the military, already stretched, is also stripped of forces it wants to send back to the field.
The latest research suggests troops handle battlefield stress better, and avoid post-war problems more often, when they heal among their comrades, Dr. Friedman says. In Israeli studies, researchers tracked soldiers who suffered acute combat stress in Lebanon in the early 1980s. Those treated at the front were more likely to return to combat and to function normally in civilian society afterward, the researchers found.
Marine commanders, who 18 months ago ordered the Corps to adopt the new approach, believe it's already working. They've hired Rand Corp. to quantify its impact.
Still, some Marines call the new procedures unnecessary, arguing that good infantry leaders always look out for their men. The Marine Corps' top officers don't disagree. They just want to institutionalize such practices across the service.
Others warn that even a command from the top won't change the nature of young men at war, who are often reluctant to talk about their feelings.
"I think there's always going to be a stigma—you're talking about 18-year-old alpha males," says Lt. Col. Matthew Reid, commander of 2nd Battalion, 1st Marine Regiment.
His battalion is one of three in Afghanistan to undergo the new combat-stress training prior to shipping out for duty. Sgt. Tippett's 11-man squad—1st Squad, 1st Platoon, Echo Co.—was the first in the battalion to test the approach after losing a man in combat. Enlisted men monitor for signs of stress, intervene when possible and refer cases to higher-level care when necessary.
In Garmsir, Sgt. Tippett and his men rallied around Lance Cpl. Seth Voie, the fallen man's best friend. There was no formal therapy, no group intervention, just casual conversations. They shared stories of lost friends and gruesome moments. They let him mourn, but refused to let him wallow in "why-him?" and "what-if?" They kept him fighting.
Cpl. Wade, 22 years old, grew up in Rogers, Ark., lean and athletic with a penchant for bow hunting. An only child with an Iraq tour under his belt, he could have skipped Afghanistan. His mother told him he should make a choice he could live with when he put his head on the pillow at night. He chose to go with his friends: They'd be safer with a good radio operator, he told his mother.
Lance Cpl. Voie was a fun-loving, even goofy 23-year-old from Iola, Wis. A dog handler, he engaged in a constant battle to keep his black Lab, Zoom, off of his cot. Zoom's job was to sniff out buried bombs, but he was terrified of gunfire and was given Prozac to calm his nerves.
Cpl. Wade and Lance Cpl. Voie became buddies soon after boot camp, bonding over sports and Lil Wayne's rap music. In Garmsir, they made a hole in the wall between their hooches, leaky sleeping shelters built from sand-filled barriers, so they could talk into the night after a hard day of patrols through Taliban country.
On Dec. 1, the squad was ordered to a mud-walled compound used as an opium-processing lab. Their mission was to pick up equipment from another squad. Cpl. Wade had already been on one mission that day and didn't feel like going out again. But someone had to carry the radio. Lance Cpl. Voie wanted to join his friend and swapped for a spot.
Sgt. Tippett led the squad along a man-made ridge, or berm, flanking an irrigation ditch outside the lab. "Everyone stay on my boot-prints," he said. "Don't get out of line."
As the sergeant stepped onto a field, he heard an explosion behind him. Running back towards the opaque dust cloud, he saw Lance Cpl. Voie face down on the path. The sergeant lifted him by his flak vest and saw he was unhurt.
"Who was behind you?" Sgt. Tippett asked.
"Wade," Lance Cpl. Voie responded.
As the dust cleared, Sgt. Tippett saw Cpl. Wade's rifle lying in a deep crater. "Where's Cpl. Wade?" he yelled frantically. "Find Cpl. Wade."
Lance Cpl. Voie heard Cpl. Wade moaning, but he took an instant to realize his friend had been blown into the ditch. Cpl. Wade's face was partly submerged in waist-deep water, and he stared up when Sgt. Tippett and Lance Cpl. Voie jumped in.
As they pulled Cpl. Wade from the water, they saw that one leg was gone and the other mangled. Sgt. Tippett and another Marine tightened tourniquets to stanch the bleeding.
Cpl. Wade's eyes were open, but he didn't speak. The Marines told him that his wife, Katie, loved him and that he'd see her again soon.
When his pulse faded, one Marine tried to resuscitate him by pressing against his chest; Sgt. Tippett inserted a breathing tube in his nose. A third Marine blew into it.
Soon Cpl. Wade was breathing again, and four Marines carried him to a medevac helicopter that set down on a nearby poppy field. Sgt. Tippett put his hand on the window. "I'll see you when I get home, buddy," he said.
Lance Cpl. Voie could find no reason to be optimistic.
Back at the base, Hospitalman 3rd Class Joseph Presley, the Navy corpsman, or medic, heard the patrol radio in Cpl. Wade's "kill number," which identifies a casualty: E for Echo Co., W for Wade and the last four digits of his Social Security number. The Doc, as corpsmen are universally called, knew it might mean Cpl. Wade was just wounded, but he felt nauseated nonetheless.
As Doc Presley headed out with the reinforcements, word reached the patrol that Cpl. Wade had died.
Doc Presley, a 25-year-old Iraq veteran from Memphis, immediately sought out Lance Cpl. Voie. He found him walking aimlessly, in tears. Zoom had bolted to the base. Doc Presley had taken the new combat-stress training to heart and he didn't want Lance Cpl. Voie isolating himself, obsessing over the day's decisions and events.
"That's the quickest way for someone to start going downhill," he recalled later.
Corpsmen are central to the Marine Corps' new approach. These docs patrol with the grunts and rush in to care for the wounded. They're enlisted men, one of the guys.
Another squadmate, Cpl. Shawn Spratt, 26, from Skiatook, Okla., hunted down Lance Cpl. Voie, too. He, Lance Cpl. Voie and Cpl. Wade had gone to boot camp together.
"He's gone," Lance Cpl. Voie told Cpl. Spratt.
"Everything's going to be O.K.," Cpl. Spratt assured him. "We just have to push on the fight."
It was late by the time the patrol staggered silently to base. Sgt. Tippett went to his hooch, saw the photos of his own wife and sons, and wept.
Sgt. Tippett, 23, from Warrenton, Va., had needed to fight for acceptance in the squad. The day he reported to Camp Pendleton, he made everyone stay late cleaning the barracks on orders from his superior. The squad held that against him for months. He and his wife, Nikki, had eventually won the men over by hosting squad dinners.
Unwilling to allow his men to see him cry, he dried his eyes and went out to the bonfire, where an officer announced Cpl. Wade's death to the platoon.
Afterwards, Sgt. Tippett threw his bloody fatigues into the burn pit. That night, he lay awake, listening to his men quietly crying. In h
is own hooch, Lance Cpl. Voie replayed the moment when he saw Cpl. Wade in the water and their eyes locked.
The next morning the men balked when the sergeant lined them up for an early patrol. Sgt. Tippett worried that if he let the Marines sit this one out, the fear would overwhelm them. He was especially concerned about Lance Cpl. Voie.
Sgt. Tippett took him aside. "Nobody wants to be point man," he remembers saying. "It's time for us to step up."
Lance Cpl. Voie took the metal detector and moved to the front of the patrol. Sgt. Tippett walked behind him with a long pole to probe for mines. The others fell into line.
"You sick to your stomach?" the sergeant asked Lance Cpl. Voie.
"Yes, I am, sergeant," Lance Cpl. Voie answered. "I've never been so scared in my life."
In the days immediately following Cpl. Wade's death, Sgt. Tippett checked in frequently on Lance Cpl. Voie. He saw nerves and tears, but he didn't believe the problem so severe that it had to be passed along to the regimental psychiatric nurse. Nor did the sergeant seek the intervention of his platoon commander, Capt. Nicholas Schmitz.
The wall between officer and enlisted man can be thick, and the 28-year-old Capt. Schmitz, the only officer regularly at the base, had to watch from afar as his men struggled with Cpl. Wade's death.
The captain thought his men took heart from a series of missions later that month in which the Marines killed Taliban fighters, including two they thought had placed the bomb that killed Cpl. Wade.
During that time, one of the squad's toughest Marines, Cpl. Spratt, rallied to the aid of Lance Cpl. Voie. Military mental-health experts say soldiers recover faster from combat stress if they're accepted by their peers, just as being shunned has the opposite effect. Cpl. Spratt was known as a "man's man," in Lance Cpl. Voie's words. He had been working on the assembly line building Bluebird school buses when he enlisted.
"I always wanted to see combat," Cpl. Spratt says.
The corporal thought Lance Cpl. Voie was still in shock. Cpl. Spratt called Lance Cpl. Voie on the radio when they were apart. At the patrol base, he visited Lance Cpl. Voie's hooch, where they worried together about how Cpl. Wade's mother and wife were coping with his death.
"Keep your head—we've got to make it home for Cpl. Wade," Lance Cpl. Voie recalls Cpl. Spratt saying. "If you focus on the bad out here, it will eat you alive."
Over the next week, Doc Presley conducted a vigil of sorts, watching Lance Cpl. Voie for signs of a downward spiral. He found it a Catch-22: He wanted Lance Cpl. Voie to talk about what had happened, but didn't want him obsessing about it.
It helped that Doc Presley was on his third combat tour. He told Lance Cpl. Voie about treating—and losing—two badly wounded buddies. One had lost both legs and an arm, and died on the operating table. The other was injured so badly that there was nowhere to start.
He said he was plagued by the same questions now troubling Lance Cpl. Voie about Cpl. Wade's death: "Why was it his time? Why wasn't it my time?"
Lance Cpl. Voie prayed a lot. He was angry a lot. He slept a little. But he slowly assumed a more fatalistic approach. "I just realized if it's my time, it's my time," he says.
More than anything, he wanted to remain with the platoon. "You couldn't ask for a better family," he says. "Obviously, they're not my real family, but they're all I've got out here."
Doc Presley decided against sending him to the rear for help. "I didn't feel he was so far gone," he recalled.
During a routine patrol two months after Cpl. Wade's death, Lance Cpl. Voie returned for the first time to the spot where his best friend was fatally wounded. He wore Cpl. Wade's name patch on his flak vest. He sent Zoom bounding ahead to sniff for explosives on scrubby paths.
The Marines found one booby-trap, a yellow-wrapped trigger system just below the surface of the path. Then another. And another. All told, they found five hidden bombs near where Cpl. Wade was hit.
"That's where it detonated," Lance Cpl. Voie said, motioning towards the empty crater.
Then the ditch. "That's where he landed."
Twenty-five yards away, Lance Cpl. Voie noticed a scrap of cloth, blue and yellow plaid, caught in the dried grass.
"That there, that's part of Wade's boxers," he said.
The sight shocked him.
But he also discovered he wasn't frightened anymore
WSJ
The Marines in Cpl. Wade's squad no longer had to imagine what would happen if they stepped on a buried bomb. Now they had seen it, and the fresh memory of their friend's shattered legs froze them in place.
When their squad leader, Sgt. Albert Tippett, lined them up for their next patrol, no one would pick up the metal detector used by the point man to clear a path through the mines.
It was, Sgt. Tippett knew, the moment his men would either keep fighting or succumb to fear and loss. So he handed the metal detector to the man who was hurting most: Cpl. Wade's best friend.
That moment, and those that followed, epitomize the new approach to combat stress that the Marine Corps wants to institutionalize. Faced with a wave of mental-health problems among returning troops, the Corps is training young Marines—down to corporals and sergeants—to sniff out combat stress among their peers on the front lines and tackle it directly on the field of battle.
"The closer they are to their buddies, and the company they trained and deployed with, the better chance you have of returning them to combat," says Col. David Furness, commander of 1st Marine Regiment.
After nearly a decade of war, military commanders have concluded they're in danger of losing the battle against emotional trauma. One in five troops returns home from Afghanistan and Iraq saddled with some form of mental-health issue, says Dr. Matthew Friedman, executive director of the Department of Veterans Affairs National Center for Posttraumatic Stress Disorder. Not only are lives ruined, officers say, but the military, already stretched, is also stripped of forces it wants to send back to the field.
The latest research suggests troops handle battlefield stress better, and avoid post-war problems more often, when they heal among their comrades, Dr. Friedman says. In Israeli studies, researchers tracked soldiers who suffered acute combat stress in Lebanon in the early 1980s. Those treated at the front were more likely to return to combat and to function normally in civilian society afterward, the researchers found.
Marine commanders, who 18 months ago ordered the Corps to adopt the new approach, believe it's already working. They've hired Rand Corp. to quantify its impact.
Still, some Marines call the new procedures unnecessary, arguing that good infantry leaders always look out for their men. The Marine Corps' top officers don't disagree. They just want to institutionalize such practices across the service.
Others warn that even a command from the top won't change the nature of young men at war, who are often reluctant to talk about their feelings.
"I think there's always going to be a stigma—you're talking about 18-year-old alpha males," says Lt. Col. Matthew Reid, commander of 2nd Battalion, 1st Marine Regiment.
His battalion is one of three in Afghanistan to undergo the new combat-stress training prior to shipping out for duty. Sgt. Tippett's 11-man squad—1st Squad, 1st Platoon, Echo Co.—was the first in the battalion to test the approach after losing a man in combat. Enlisted men monitor for signs of stress, intervene when possible and refer cases to higher-level care when necessary.
In Garmsir, Sgt. Tippett and his men rallied around Lance Cpl. Seth Voie, the fallen man's best friend. There was no formal therapy, no group intervention, just casual conversations. They shared stories of lost friends and gruesome moments. They let him mourn, but refused to let him wallow in "why-him?" and "what-if?" They kept him fighting.
Cpl. Wade, 22 years old, grew up in Rogers, Ark., lean and athletic with a penchant for bow hunting. An only child with an Iraq tour under his belt, he could have skipped Afghanistan. His mother told him he should make a choice he could live with when he put his head on the pillow at night. He chose to go with his friends: They'd be safer with a good radio operator, he told his mother.
Lance Cpl. Voie was a fun-loving, even goofy 23-year-old from Iola, Wis. A dog handler, he engaged in a constant battle to keep his black Lab, Zoom, off of his cot. Zoom's job was to sniff out buried bombs, but he was terrified of gunfire and was given Prozac to calm his nerves.
Cpl. Wade and Lance Cpl. Voie became buddies soon after boot camp, bonding over sports and Lil Wayne's rap music. In Garmsir, they made a hole in the wall between their hooches, leaky sleeping shelters built from sand-filled barriers, so they could talk into the night after a hard day of patrols through Taliban country.
On Dec. 1, the squad was ordered to a mud-walled compound used as an opium-processing lab. Their mission was to pick up equipment from another squad. Cpl. Wade had already been on one mission that day and didn't feel like going out again. But someone had to carry the radio. Lance Cpl. Voie wanted to join his friend and swapped for a spot.
Sgt. Tippett led the squad along a man-made ridge, or berm, flanking an irrigation ditch outside the lab. "Everyone stay on my boot-prints," he said. "Don't get out of line."
As the sergeant stepped onto a field, he heard an explosion behind him. Running back towards the opaque dust cloud, he saw Lance Cpl. Voie face down on the path. The sergeant lifted him by his flak vest and saw he was unhurt.
"Who was behind you?" Sgt. Tippett asked.
"Wade," Lance Cpl. Voie responded.
As the dust cleared, Sgt. Tippett saw Cpl. Wade's rifle lying in a deep crater. "Where's Cpl. Wade?" he yelled frantically. "Find Cpl. Wade."
Lance Cpl. Voie heard Cpl. Wade moaning, but he took an instant to realize his friend had been blown into the ditch. Cpl. Wade's face was partly submerged in waist-deep water, and he stared up when Sgt. Tippett and Lance Cpl. Voie jumped in.
As they pulled Cpl. Wade from the water, they saw that one leg was gone and the other mangled. Sgt. Tippett and another Marine tightened tourniquets to stanch the bleeding.
Cpl. Wade's eyes were open, but he didn't speak. The Marines told him that his wife, Katie, loved him and that he'd see her again soon.
When his pulse faded, one Marine tried to resuscitate him by pressing against his chest; Sgt. Tippett inserted a breathing tube in his nose. A third Marine blew into it.
Soon Cpl. Wade was breathing again, and four Marines carried him to a medevac helicopter that set down on a nearby poppy field. Sgt. Tippett put his hand on the window. "I'll see you when I get home, buddy," he said.
Lance Cpl. Voie could find no reason to be optimistic.
Back at the base, Hospitalman 3rd Class Joseph Presley, the Navy corpsman, or medic, heard the patrol radio in Cpl. Wade's "kill number," which identifies a casualty: E for Echo Co., W for Wade and the last four digits of his Social Security number. The Doc, as corpsmen are universally called, knew it might mean Cpl. Wade was just wounded, but he felt nauseated nonetheless.
As Doc Presley headed out with the reinforcements, word reached the patrol that Cpl. Wade had died.
Doc Presley, a 25-year-old Iraq veteran from Memphis, immediately sought out Lance Cpl. Voie. He found him walking aimlessly, in tears. Zoom had bolted to the base. Doc Presley had taken the new combat-stress training to heart and he didn't want Lance Cpl. Voie isolating himself, obsessing over the day's decisions and events.
"That's the quickest way for someone to start going downhill," he recalled later.
Corpsmen are central to the Marine Corps' new approach. These docs patrol with the grunts and rush in to care for the wounded. They're enlisted men, one of the guys.
Another squadmate, Cpl. Shawn Spratt, 26, from Skiatook, Okla., hunted down Lance Cpl. Voie, too. He, Lance Cpl. Voie and Cpl. Wade had gone to boot camp together.
"He's gone," Lance Cpl. Voie told Cpl. Spratt.
"Everything's going to be O.K.," Cpl. Spratt assured him. "We just have to push on the fight."
It was late by the time the patrol staggered silently to base. Sgt. Tippett went to his hooch, saw the photos of his own wife and sons, and wept.
Sgt. Tippett, 23, from Warrenton, Va., had needed to fight for acceptance in the squad. The day he reported to Camp Pendleton, he made everyone stay late cleaning the barracks on orders from his superior. The squad held that against him for months. He and his wife, Nikki, had eventually won the men over by hosting squad dinners.
Unwilling to allow his men to see him cry, he dried his eyes and went out to the bonfire, where an officer announced Cpl. Wade's death to the platoon.
Afterwards, Sgt. Tippett threw his bloody fatigues into the burn pit. That night, he lay awake, listening to his men quietly crying. In h
is own hooch, Lance Cpl. Voie replayed the moment when he saw Cpl. Wade in the water and their eyes locked.
The next morning the men balked when the sergeant lined them up for an early patrol. Sgt. Tippett worried that if he let the Marines sit this one out, the fear would overwhelm them. He was especially concerned about Lance Cpl. Voie.
Sgt. Tippett took him aside. "Nobody wants to be point man," he remembers saying. "It's time for us to step up."
Lance Cpl. Voie took the metal detector and moved to the front of the patrol. Sgt. Tippett walked behind him with a long pole to probe for mines. The others fell into line.
"You sick to your stomach?" the sergeant asked Lance Cpl. Voie.
"Yes, I am, sergeant," Lance Cpl. Voie answered. "I've never been so scared in my life."
In the days immediately following Cpl. Wade's death, Sgt. Tippett checked in frequently on Lance Cpl. Voie. He saw nerves and tears, but he didn't believe the problem so severe that it had to be passed along to the regimental psychiatric nurse. Nor did the sergeant seek the intervention of his platoon commander, Capt. Nicholas Schmitz.
The wall between officer and enlisted man can be thick, and the 28-year-old Capt. Schmitz, the only officer regularly at the base, had to watch from afar as his men struggled with Cpl. Wade's death.
The captain thought his men took heart from a series of missions later that month in which the Marines killed Taliban fighters, including two they thought had placed the bomb that killed Cpl. Wade.
During that time, one of the squad's toughest Marines, Cpl. Spratt, rallied to the aid of Lance Cpl. Voie. Military mental-health experts say soldiers recover faster from combat stress if they're accepted by their peers, just as being shunned has the opposite effect. Cpl. Spratt was known as a "man's man," in Lance Cpl. Voie's words. He had been working on the assembly line building Bluebird school buses when he enlisted.
"I always wanted to see combat," Cpl. Spratt says.
The corporal thought Lance Cpl. Voie was still in shock. Cpl. Spratt called Lance Cpl. Voie on the radio when they were apart. At the patrol base, he visited Lance Cpl. Voie's hooch, where they worried together about how Cpl. Wade's mother and wife were coping with his death.
"Keep your head—we've got to make it home for Cpl. Wade," Lance Cpl. Voie recalls Cpl. Spratt saying. "If you focus on the bad out here, it will eat you alive."
Over the next week, Doc Presley conducted a vigil of sorts, watching Lance Cpl. Voie for signs of a downward spiral. He found it a Catch-22: He wanted Lance Cpl. Voie to talk about what had happened, but didn't want him obsessing about it.
It helped that Doc Presley was on his third combat tour. He told Lance Cpl. Voie about treating—and losing—two badly wounded buddies. One had lost both legs and an arm, and died on the operating table. The other was injured so badly that there was nowhere to start.
He said he was plagued by the same questions now troubling Lance Cpl. Voie about Cpl. Wade's death: "Why was it his time? Why wasn't it my time?"
Lance Cpl. Voie prayed a lot. He was angry a lot. He slept a little. But he slowly assumed a more fatalistic approach. "I just realized if it's my time, it's my time," he says.
More than anything, he wanted to remain with the platoon. "You couldn't ask for a better family," he says. "Obviously, they're not my real family, but they're all I've got out here."
Doc Presley decided against sending him to the rear for help. "I didn't feel he was so far gone," he recalled.
During a routine patrol two months after Cpl. Wade's death, Lance Cpl. Voie returned for the first time to the spot where his best friend was fatally wounded. He wore Cpl. Wade's name patch on his flak vest. He sent Zoom bounding ahead to sniff for explosives on scrubby paths.
The Marines found one booby-trap, a yellow-wrapped trigger system just below the surface of the path. Then another. And another. All told, they found five hidden bombs near where Cpl. Wade was hit.
"That's where it detonated," Lance Cpl. Voie said, motioning towards the empty crater.
Then the ditch. "That's where he landed."
Twenty-five yards away, Lance Cpl. Voie noticed a scrap of cloth, blue and yellow plaid, caught in the dried grass.
"That there, that's part of Wade's boxers," he said.
The sight shocked him.
But he also discovered he wasn't frightened anymore
WSJ
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