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A general battles post-combat stress

HEIDELBERG, Germany — Just back from a year in Iraq, Gen. Carter Ham got into the car with his wife, Christi, and began a strangely silent, cross-country drive.

“I probably said three words,” Ham recently recalled of the trip four years ago from Washington state to Washington, D.C.

His time in Iraq, what the future held for them, the sites along the way — that was a lot not to talk about, Christi thought, for her usually communicative husband.

It was almost like he resented being home.

“I sensed a huge feeling on his part that there wasn’t a huge purpose to his being here (with her) and there were important things being done (in Iraq), and that he wasn’t part of it,” she said.

The trip provided the first of several signs that would eventually persuade Ham that what had happened during his year in Mosul in 2004 had left him a changed man — and that to recover, he needed to talk.

Now the commander of U.S. Army Europe, Ham, along with his wife, discussed his post-combat difficulties in an interview just before Christmas. It was the second interview the pair have given to a newspaper. Their willingness to speak publicly about the issue is rare in traditional military culture, but they appeared entirely comfortable.

“Frankly, it’s a little weird to me that people are making a big deal about it,” Ham said of the response to his openness. “Like lots of soldiers I needed a little help, and I got a little help.”

What Ham went through in Iraq was different than what sergeants or privates or captains or anyone on the line experience, he said, men and women whose lives are constantly at risk, who see close friends killed and maimed. “I wasn’t out on patrol on the streets at night … my exposure was episodic,” he said.

His Humvee was hit by a roadside bomb, though, and the gunner was badly injured.

But by far the most terrible, gruesome event was the suicide bombing in a mess tent under Ham’s command shortly before his tour ended. Twenty-two people, 14 of them U.S. troops, were killed in the Dec. 21, 2004, attack on the dining hall at Forward Operating Base Marez near Mosul.

It was devastating to Ham, the worst day of his life, and he said he has thought about it every day since.

But that wasn’t the only thing. It was also simply the burden of command. “It was the consequences every commander lives with: You issue orders that put soldiers in harm’s way,” Ham said, “and some end up killed.”

“How can you not be affected?” Christi asked.

Ham didn’t have post-traumatic stress disorder. His symptoms were more in line with what experts increasingly say are normal difficulties in post-combat adjustment: long silences, trouble sleeping, exaggerated emotions alternating with emotional detachment.

And he functioned well on the job.

“Work wasn’t a problem,” Christi said. “He could slice it that way.”

Ham said he noticed something was different when he first saw his dog, who’d been staying with his daughter during the deployment.

“The dog comes bounding out of the house and leaps up on me,” Ham said. “And I start bawling like a baby.”

One influential study indicated that about 20 percent of troops who’ve been deployed to Iraq and Afghanistan develop post-combat stress disorder. But the majority experience some adjustment problems, experts say. The Defense Department is trying to make it easier for all of them to seek help if they need it — if symptoms persist or make life difficult — often by just talking about their problems with a counselor or chaplain.

One way to get soldiers to open up is to remove the stigma that still exists within military culture to seek counsel and admit to what’s still seen — wrongly, the experts say — as a weakness.

“Reaching out and connecting — it’s a sign of strength,” said Brig. Gen. Loree Sutton, a psychiatrist and head of the Department of Defense’s Centers of Excellence for Psychological Health and Traumatic Brain Injury.

Sutton is at the center of an effort to get senior leaders to speak out about their post-combat issues — from the nearly universal sleep problems to feeling out of place, anxious and irritable, or self-medicating with alcohol — and so make it acceptable for everyone else.

But the Hams spoke out independently.

Would they have done so if he’d been a captain, a major, a lieutenant colonel and had not already reached the pinnacle of an Army career?

Ham said he didn’t know.

“I don’t think it would have made any difference,” his wife said. “Because he’s honest.”

Ham said he hopes his talking will encourage other soldiers to do the same.

“If it’s OK for this old soldier to talk about it publicly, it’s OK for you to talk about it privately,” he said.

He first acknowledged his problem years ago during an in-house session for senior leaders organized by Lt. Gen. James Dubik. Dubik encouraged frank disclosure at the session, something that was met with mixed enthusiasm. “Some were, ‘I’m OK. This is [BS],’ ” Ham said.

“It was the spouses who said, ‘You’re not OK; you’re different.’ ”

Ham calls his wife “the love of my life,” and he seeks her counsel often. Still, he said, “I wasn’t ready to talk to her.”

So, talk to someone else, she suggested.

“It wasn’t, ‘You need to go get help,’ ” he said. “It was more subtle than that.

“For me, the right outlet turned out to be a chaplain. To talk to someone in whom you have confidence, where you can say, without risk, ‘Here’s what I’m feeling.’ ”

Ham got numerous e-mails and phone calls after the first newspaper story about him in USA Today. It surprised him that they were uniformly positive, he said. “I thought I would get some ‘What the hell are you still doing in command?’ ”

But his most treasured response came from the guy Ham calls his hero: his son-in-law, an Army captain and Silver Star recipient wounded in an Afghanistan ambush. He sent a note thanking his father-in-law and said he had had some issues as well.


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