"A recent study of soldiers and Marines who had served in Iraq and
Afghanistan found that about 17 percent met criteria for
post-traumatic stress disorder, depression, or generalized anxiety
disorder. Of those whose responses were positive for a mental
disorder, 40 percent or fewer actually received help while on active
duty."

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/01/29/MNGMHGVCEV1.DTL&hw=Matthew+Stannard&sn=004&sc=165

THE WAR WITHIN

Matthew B. Stannard, Chronicle Staff Writer

Sunday, January 29, 2006
 

 The photo of the `Marlboro Man' in Fallujah became a symbol of the
Iraq conflict when it ran in newspapers across America in 2004. Los
Angeles Times photo, 2004, by Luis Sinco 
http://www.sfgate.com/c/pictures/2006/01/29/mn_marine_photo8.jpg
    

Pike County, Ky. -- BATTLE SCARS: The photo of the `Marlboro Man' in
Fallujah became a symbol of the Iraq conflict when it ran in
newspapers across America in 2004. Now the soldier has returned home
to Kentucky,where he battles the demons of post-traumatic stress
The photograph hit the world on Nov. 10, 2004: a close-cropped shot of
a U.S. Marine in Iraq, his face smeared with blood and dirt, a
cigarette dangling from his lips, smoke curling across weary eyes.

It was an instant icon, with Dan Rather calling it "the best war
photograph in recent years." About 100 newspapers ran the photo,
dubbing the anonymous warrior the "Marlboro Man."

The man in the photograph is James Blake Miller, now 21, and he is an
icon, although in ways Rather probably never imagined.

He's quieter now -- easier to anger. He turns to fight at the sound of
a backfire, can't look at fireworks without thinking of fire raining
down on a city. He has trouble sleeping, and when he does, his fingers
twitch on invisible triggers.

The diagnosis: post-traumatic stress disorder.

His life in Kentucky, before and after the clicking shutter, says as
much about hundreds of thousands of new American war veterans as his
famous photograph said about that one bad day in Fallujah -- a photo
Miller cannot see as an icon.

"I don't see a whole lot," he said. "I see a day I won't care to
remember, but that I'll never forget."
James Blake Miller was born in Pike County in the hills of eastern
Kentucky, where Daniel Boone is said to have walked and where
moonshine is still consumed. An average family here makes about
$24,000; the only decent-paying jobs are down at the coal mine.

Miller got his first name from his father, who got it from his and
back into family history. But folks called him Blake, the middle name
his parents heard on the television show "Dynasty."

His paternal grandfather was a Marine in '53; a heavy smoker, like
most of the men in the family, he died of cancer before he was 40. The
man Miller grew up calling "Papaw" was his grandmother's second
husband, an Army vet of Vietnam.

Sometimes, Papaw would get crying drunk and start telling the story
about the boy who came into the camp in Vietnam one night, and how
they had to shoot him. Then he would stop speaking, and look at the
little boys hanging on his every word. "You've had enough, Joe Lee,"
his wife would say then. "It's time to go to bed."

"It wasn't that he liked to drink -- that was how he dealt with it,"
Miller said.

Miller grew up in Jonancy, a tiny hamlet 20 miles from the county seat
of Pikeville. He got his first job -- washing cars at the local auto
dealership -- at age 13, about a year after he took up smoking.

Before long, he began working in a body shop, where the owner told him
the most extraordinary thing: Miller could get his auto body repair
certification for free -- just by joining the military. A Marine
recruiter offered more: insurance, housing, college money.

"I thought, 'Well, damn, that's amazing,' " Miller said. "Hell, here I
am, 18 years old -- I can have all this in the palm of my hands just
by giving them four years."

Following his grandfather's footsteps, he went infantry, and left for
boot camp in November 2002. Four months later, the war in Iraq broke out.

"Before I knew it," Miller said, "I was thrown into the mix without
even thinking about it."

Miller was assigned to the 1st Battalion, 8th Marine Regiment of the
2nd Marine Division, based in Camp Lejeune, N.C.

"Right before we got ready to leave for Iraq, I guess I was a little
nervous. I started smoking more -- I went from about a pack-and-a-half
a day to 2 1/2 packs a day," he said. "When we got to Iraq ... I was
smoking 5 1/2 packs."
For a while, Iraq didn't seem all that bad. Miller and his fellow
Marines settled into a routine in Anbar province in western Iraq,
setting up hiding places among the palms and sand, and watching for
the white pickups that insurgents would use to plant bombs and fire
mortars.

There also was time for candy and laughter with the Iraqi children who
came running to see the American troops. Miller felt like he was helping.

Then, on Nov. 5, 2004, in the middle of a sandstorm, the Marines got
the word that they might be heading for an assault on Fallujah -- at
the time, the capital of the Iraqi insurgency.

No American forces had gone inside the city in months. And now Miller
would be among the first. He had been a Marine for less than two years.

"It puts butterflies in my stomach right now," he said. "I don't know
if you can describe it. I don't think words can."

The days before the assault were an intense blur of training,
preparation and fear. But there was one bright spot, when Miller ran
into a good friend in the chow hall -- Demarkus Brown, a 22-year-old
from Virginia.

Miller met Brown in infantry school, when the smiling African American
introduced himself to the white Kentucky native with a grinning,
"What's up, cracker?"

Miller quickly realized Brown didn't mean the word seriously -- didn't
mean much of anything seriously. Brown liked to party all hours and go
dancing, then call Miller to come pick him up.

"It didn't matter what you told him or how s -- ty it was," Miller
said. "He was always the one guy who had a smile on his face."

But one thing Brown took seriously was music: He loved raves and
techno music, and Miller played bluegrass on bass and guitar. Their
styles somehow harmonized, and they became close friends.

Now they were together outside Fallujah.

The night before U.S. forces went into the city, Miller gathered with
his fellow Marines and led them by memory through a passage from the
Bible, John 14:2-3.

"In my Father's house, there are many mansions: if it were not so, I
would have told you. I leave this place and go there to prepare a
place for you, so that where I may be, you may be also."

The assault on Fallujah began Nov. 8, 2004, when U.S. planes, using a
combination of high explosives and burning white phosphorus, hammered
the city in advance of the artillery push. Miller was under fire from
the moment he stepped out of the personnel carrier.

It lasted into Nov. 9 -- the day that, for a while, would make
Miller's face the most famous in Iraq.
As Miller remembers that day, he was on a rooftop taking fire and
calling for support on his radio - a 20-pound piece of equipment that
he had to lug around along with nine extra batteries, hundreds of
extra rounds of ammunition, and a couple of cartons of cigarettes.

As insurgent bullets from a nearby building pinged off the roof, a
horrified Miller heard footsteps coming up the stairs behind him. He
raised his rifle -- and barely had time to halt when he saw it was
embedded Los Angeles Times photographer Luis Sinco.

Miller returned to his radio, guiding two tanks to his position. When
they opened fire, he said, the thunder left his body numb -- but the
building housing the attackers had collapsed. Later, he said, they
would find about 40 bodies in the rubble.

"I was never so happy in all my life to take that handset away from my
head," Miller said. "I lit up a f -- cigarette."

His ear was bleeding from the sound of the tank firing -- Miller still
can't hear out of his right ear. His nose bled from a nick he took
when his rifle scope and radio got tangled up midfire. He looked at
the sunrise and wondered how many more of those he would see.

He was vaguely aware that elsewhere on the rooftop, Sinco was taking
pictures.

At a briefing the next day, Miller's gunnery sergeant walked up to
him, grinning, and said: "Would you believe you're the most famous f
-- Marine in the Marine Corps right now? Believe it or not, your ugly
mug just went all over the U.S."

The Marines wanted to pull him out of Fallujah at that point, Miller
said, not wanting the very public poster boy to die in combat. But he
stayed.

He won't talk about the weeks that followed. He only mentions moments,
like still frames from a film. The day his column barely survived an
ambush, escaping through a broken door as bullets struck near their
feet. The morning he woke up to discover that a cat had taken up
residence in the open chest cavity of an Iraqi body nearby, consuming
it from within.

The day he discovered that Demarkus Brown had been killed.

"When we found out, I told a couple of my buddies who were close to
him, too. We just sat around, and we didn't say much at all," Miller
said. "You didn't have the heart to cry."

But it wasn't those terrible benchmarks that affected him the most,
Miller said. It was the daily chore of war: the times he had to raise
his rifle, peer through the scope and squeeze the trigger to launch a
bullet, not at a target, not at a distant white truck, but at another
human being.

"It's one thing to be shot at, and you shoot a couple rounds back,
just trying to suppress somebody else," Miller said. "It's another
thing when you see a human being shooting a round at you, knowing that
you're shooting back with the intent to kill them. You're looking
through a scope at somebody. It's totally different. You can make out
a guy's eyes."
When Miller returned to America, he brought back a big duffel bag
packed with numerous letters and gifts from those who had seen his
photo. It was only later that he discovered he'd brought home some of
the war, too.

None of the Marines talked much about the strain that war puts on
one's emotions, Miller said. The "wizards" -- military psychologists
-- gave the returning troops a briefing on the subject, but nobody
paid much attention. Even guys who were taking antidepressants to help
them sleep didn't think much about the long-term consequences.

"What the hell are those people going to do once they get out? They
ride it out until they get an honorable discharge, and then they're
never diagnosed with anything," Miller said. "How the hell are you
going to do anything for them after that? And that's how so many of
these guys are ending up on the damn streets."

Miller dismissed the early signs, too. When he and his buddies reacted
to a truck backfire by dropping into a combat stance and raising
imaginary rifles, well, that was to be expected. And when his wife,
Jessica -- the childhood sweetheart whom Miller had married in June --
told him he was tightening his arm around her neck in the night, that
was strange, but he figured it would pass. So would the nightmares he
began to have about Iraq, things that had happened, things that hadn't.

Then one day, while visiting his wife at her college dorm in
Pikeville, Miller looked out the window and clearly saw the body of an
Iraqi sprawled out on the sidewalk. He turned away.

"I said, 'Look, honey, I just got to get out of here.' I couldn't even
tell her at the time what had happened," he said. "(I thought), 'Well,
that's it. That's my little spaz I'm supposed to have that the
psychiatrists were talking about ... I'm glad I got it out of the way."

But he hadn't. Jessica, a psychology student, tried to help with a
visualization technique. But when he looked inside himself, Miller
found a kind of demonic door guarded by a twisted figure in a black
cloak. Under the cloak's hood, he spotted the snarling face of the
teufelhund, a Marine Corps icon -- the devil dog.

"So I come out again, without closing the door," he said. "After all
this happened, my nightmares started getting a lot f -- ing worse."

Finally, Miller went to a military psychiatrist, who diagnosed him
with signs of post-traumatic stress disorder. Miller thought that
meant he could not be deployed. But in early September, he joined a
group of Marines headed to police New Orleans in the wake of Hurricane
Katrina.

"I really didn't want to go. ... There was a possibility we would be
shooting people," he said. "We could be going into another (urban
warfare) environment just like Iraq, except this would actually be
U.S. citizens.

"Here we go, Fallujah 2, right here in the states."

Not long after they arrived, as Hurricane Rita bore down on them, the
Marines were packed into the amphibious assault ship Iwo Jima to wait
out the storm offshore. And one day, as Miller headed for the smoke
deck with a Marlboro, a passing sailor made a whistling sound just
like a rocket-propelled grenade.

"I don't remember grabbing him. I don't remember putting him against
the bulkhead. I don't remember getting him down on the floor. I don't
remember getting on top of him. I don't remember doing any of that s
-- ," Miller said. "That was like the last straw."

On Nov. 10, 2005 -- the Marine Corps' 230th birthday and one year to
the day after the Marlboro Man picture appeared in the Los Angeles
Times, Miller was honorably discharged after a medical review. His
military career was over.
Miller returned to eastern Kentucky, the place he had spent years
trying to escape. He wanted the familiarity and safety of the people
and land he'd known since birth.

"Maybe it made me think twice about what I had lost," he said. "What I
was really missing."

In a way, though, his family is still missing Blake Miller -- the
Miller who left Kentucky for Iraq a couple of years ago.

The man who left was easygoing, quick to laugh, happy to sit in a
relative's house and eat and smoke and talk. The man who came back is
quick to anger, they say, and is quiet. He still smiles often but does
not easily laugh.

And when he takes a seat in his adoptive grandmother's home, amid her
collection of ceramic Christ figurines, it is in a chair that faces
the door.

Mildred Childers, who owns those figurines, sees Miller's difficulties
as a crisis of faith. She still remembers Miller's call just before
the assault on Fallujah, and his terrible question: "How can people go
to church and be a Christian and kill people in Iraq?"

"He was raised where that's one of the Ten Commandments, do not kill,"
she said. "I think it's hard for a soldier to go to war and have that
embedded in them from small children up, and you go over there and
you've got to do it to stay alive."

Recently, some of his Marine buddies have been calling Miller up,
crying drunk, and remembering their war experiences. Just like Papaw
Joe Lee used to do when Miller was a boy.

"There's a lot of Vietnam vets ... they don't heal until 30, 40 years
down the road," Miller said. "People bottle it up, become angry,
easily temperamental, and hell, before you know it, these are the
people who are snapping on you."

Jessica interrupted. "You're already like that," she said.

She recalled her own first glimpse of the Marlboro Man -- an image
seen through tears of relief that he was alive, and misery at how worn
he looked.

"Some people thought it was sexy, and we thought, 'Oh, my God, he's in
the middle of a war, close to death.' We just couldn't understand how
some people could look at it like that," she said. "But I guess for
some people it was glory, like patriotism."

She looked at her quiet husband through the smoke drifting from his
right hand.

"But when it comes out and there's actually a personality behind that
picture, and that personality, he has to deal with all the war, and
all he's done, people don't want to know how hard it actually is," she
said.

"This is the dark side of the reality of war. ... People don't want to
know the Marlboro Man has PTSD."
Miller stood outside his father's home in Jonancy, looking over the
beaten mobile homes, the rows of corn, potatoes and cabbage. For a
change, he wasn't smoking - he's down to a pack-and-a-half a day.

"There ain't a goddamn thing around here," he said. "My whole life,
all I did was watch my old man bust his ass."

It was why he joined the Marines -- why part of him wishes he could go
back.

"My whole life, all I've ever known is working on cars, doing body
work, cutting grass, manual labor, you know? It was something
different," he said. "You always hear those commercials -- it's not
just a job, it's an adventure. It was, you know?"

On the other hand, Miller isn't sure he'd want to go back to combat --
nor sure he'd ever let any kid of his enlist. He has mixed feelings
about the oversize copy of the Marlboro Man picture proudly displayed
in the lobby of the Marine recruiting station in Pikeville.

Some of his relatives and friends are against the war; others see it
as a fight against terrorism.

Miller himself seems torn -- proud of the troops fighting for freedom,
but wondering whether there was a peaceful way, to find terrorists in
Iraq without invading.

There was no time for such questions in Fallujah. But now, at night,
when he can't sleep, Miller thinks of the men he saw through his rifle
scope, and wonders: Were they terrorists fighting against America? Or
men fighting to protect their homes?

"I mean, how would we feel if they came over and started something
here?" he asked. "I'm glad that I fought for my country. But looking
back on it, I wouldn't do it all over again."

It helps, sometimes, to talk about it -- last week, Miller did what he
hopes other veterans do: He had his first visit with a Veterans
Administration counselor.

"I've got my whole life ahead of me," he said. "I'm too young to lay
down and quit; too young to let anything beat me."

Down the road, Miller hopes to start a business. For now, he is
waiting for his disability benefits to kick in. Maybe then, he and
Jessica can afford the big wedding they had always wanted. She already
has her white wedding dress. He still intends to wear his Marine Corps
blues.
Veterans and stress

Post-traumatic stress disorder is an ailment resulting from exposure
to an experience involving direct or indirect threat of serious injury
or death. Symptoms include recurrent thoughts of a traumatic event,
reduced involvement in work or outside interests, hyper alertness,
anxiety and irritability.

About 317,000 veterans diagnosed with the disorder were treated at
Department of Veterans Affairs medical centers and clinics in fiscal
year 2005. Nearly 19,000 veterans of the wars in Iraq and Afghanistan
were seen for the disorder in veterans' medical centers and Vet
Centers from fiscal year 2002 to 2005.

A recent study of soldiers and Marines who had served in Iraq and
Afghanistan found that about 17 percent met criteria for
post-traumatic stress disorder, depression, or generalized anxiety
disorder. Of those whose responses were positive for a mental
disorder, 40 percent or fewer actually received help while on active duty.

For more information, contact your local veterans facility, call (877)
222-VETS or visit one of the following Web sites:

U.S. Department of Veterans Affairs National Center for Post-Traumatic
Stress Disorder: www.ncptsd.va.gov/

San Francisco Chronicle Guide for Returning Veterans:
www.sfgate.com/returningvets/

Sources: Department of Veterans Affairs, New England Journal of Medicine

E-mail Matthew B. Stannard at [EMAIL PROTECTED] 






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