PTSD — Post-Traumatic Stress Disorder

Capt. Sudip Bose arrives on the airport tarmac.

By Dr. Sudip Bose, MD, FACEP, FAAEM

Post-Traumatic Stress Disorder, or PTSD, is a complex issue. The way that being at war, fighting on the front lines or engaging in combat affects a person is different for everyone. Some combat veterans come home shattered and shaken and have a hard time moving on. Some come home seemingly ready to dive back into normal life and put the war behind them.

Make no mistake; war affects everyone subjected to it. It just depends how each person processes that experience and what kind of support they have when they get back home.

In a TED Talk, journalist Sebastian Junger, who has covered war for almost 20 years and produced a great deal of material on the subject – most of it related to Afghanistan – made what I thought was a very interesting observation, which subsequently provoked an interesting question. He said that he thought it was remarkable how many soldiers actually found themselves missing combat. Missing combat?

“How is it that someone can go through the worst experience imaginable and come home, back to their home, their family, their country, and miss the war?” he asked. How does that work? What’s it mean? We have to answer that question, because if we don’t, it’ll be impossible to bring soldiers back to a place in society where they belong. And I think it will also be impossible to stop war if we don’t understand how that mechanism works.”

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Taking Care of Our Country’s Veterans: One of Our Top National Priorities

By Dr. Sudip Bose, MD, FACEP, FAAEM

Veterans wrote a blank check on their lives when they volunteered to join the military, went to war in many cases, and risked not coming home to their families. Some never got to see their children be born because they were overseas protecting our freedom. They truly did serve our country by giving up their normal lives for a life spent on guard, on watch, ready to fight and die, if necessary to protect Americans and keep our enemies at bay.

But what many people who haven’t served in the military don’t really understand, is that after veterans stop fighting the enemy, they continue the struggle fighting against injuries or illness sustained while on active duty – either physical or mental, or both. In many instances, their battle continues.

I know, because I’ve been there. I walked that walk. I was an officer in the Army and attained the rank of major; I served as a front-line physician in the Second Battle of Fallujah and served one of the longest combat tours by a physician since World War II, for which I earned the Bronze Star. I became an emergency physician while I was in the Army, and I now serve as an emergency room physician and also have become one of America’s most experienced doctors on mass casualties, disaster care and PTSD (Post-Traumatic Stress Disorder). I also created TheBattleContinues.org, which is a 501c(3) nonprofit entity aimed to raise awareness of veterans’ issues and help veterans who have returned from war. Every penny of the money donated to TheBattleContinues.org goes directly to the benefit of veterans.

The health challenges veterans face are unique, almost entirely unlike those faced by any other demographic in America. A Washington Post / Kaiser Family Foundation poll taken in 2013 showed that more than half of the service members polled who served in Iraq and/or Afghanistan admitted to suffering a physical or mental health problem as a result of their service. More service members than ever before have survived combat wounds that would have been fatal in previous wars. It’s now our responsibility as a nation to tend to our veterans when they return from overseas and are discharged from military service. Some of the things our veterans have to deal with include:

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The Fight After the War

By Dr. Sudip Bose, MD, FACEP, FAAEM

According to the Substance Abuse and Mental Health Services Administration, 22.5 percent of American adults suffered from a mental illness in the past year. That’s almost 1 in 4 people. This means that almost all of us either know someone or are ourselves affected by a mental illness of some kind. These mental illnesses come with many different names: depression, anxiety, schizophrenia, and alcoholism to name a few. Those affected by mental illness must overcome one thing they all have in common: the stigma of the illness. They must battle that in addition to the universal challenges that anyone with an illness faces – managing symptoms, following up with a physician, keeping up with a treatment regimen.

What is stigma? It’s defined as a mark of disgrace associated with a particular circumstance, quality, or person. People can be stigmatized for many things, even such apparently benign things as race or gender. We have come up with words for these kinds of stigma – i.e., racism and sexism — and society has tried to move away from them as best it can. However, while we have come a long way in combating the stigma of mental illness, it is obvious that we still have a long way to go.

The stigma that someone experiences comes in two forms: external (from other people) and internal (from themselves). The impact of this stigma varies widely based on a person’s background, peer group, and personal identity. This means that some people can feel a greater impact of stigma than others. External stigma comes from the lack of support and understanding from others while internal stigma comes from our judgements of ourselves. Unfortunately, we all can be our own worst critics.

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An Open Letter to Presidential Candidates Hillary Clinton and Donald Trump on Veterans’ Health Care

By Dr. Sudip Bose, MD, FACEP, FAAEM

I’d like to take this opportunity before the first presidential debate to offer both candidates for office, Hillary Clinton and Donald Trump, some perspective related to our veterans’ health care.

Let me introduce myself. I served in the U.S. Army from 1995-2007 and as a front-line physician for 15 months while in Iraq. My service in war was one of the longest continuous tours of combat by a physician since World War II. I treated thousands of our troops and also provided medical care for Iraq’s deposed dictator, Saddam Hussein, after his capture. I’m founder of TheBattleContinues.org, a nonprofit charity serving injured veterans and speak on veteran health topics as well as what I call “emergency leadership.”

I’ve seen it all, from dealing with soldiers who would ultimately lose limbs from battle wounds to handling casualties of severe car accidents and shootings here in the U.S. as an emergency room physician in Odessa, Texas in the Medical Center Health System. Being an associate clinical professor of emergency medicine at the University of Illinois College of Medicine in Chicago, I’ve trained thousands of medical students using my textbook on emergency medical care that has been widely adopted at medical colleges throughout the country.

While you both have talked about taking care of our veterans, the need to continue care once they leave the service is immense. Our veterans deserve the best health care we can provide in America, and that absolutely must be a top priority.

I’d like to suggest a three-pronged approach to caring for our veterans:

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