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Long Island, NY families recall struggles of their Mideast war vets

Tormented by memories of what they saw and did as combat troops in Iraq, three veterans sought refuge from their post-traumatic stress disorder by living in the Lake Ronkonkoma home of one of their parents at various times in 2012.

They considered the house to be a calming oasis, according to the only one among them who is still alive.

It was a place where they could live with fellow veterans who understood how angry and fearful their war experiences had made them. How they craved substances -- legal or illegal -- that could bring them moments of peace. How estranged from friends and co-workers their PTSD had left them.

But the help provided by Tom and Donna Taylor -- he a pool builder, she a nurse, both of them determined to help their son and his friends -- was not enough to save all three men.

The deaths of veterans who have survived combat in Iraq and Afghanistan, only to struggle with emotional problems and self-inflicted harms once they are home, has raised broad alarm among mental health experts and veterans advocates. With PTSD, major depression or traumatic brain injury affecting one in five of the more than 2.5 million troops who have served in those countries, getting effective help to all who need it has remained an elusive goal, officials, veterans and advocates say.

The Taylors' son Michael, who before a fellow veteran moved in with him had harbored such uncontrollable rage that he once fired an assault rifle during a confrontation with his parents, was the first to die.

On May 31, 2012, Taylor, 30, locked himself in his bedroom, drank the equivalent of six shots of vodka, spiked a syringe into the crook of his right elbow, and fired a lethal dose of heroin into a vein, according to an autopsy report. The former Army specialist had been days short of entering an intensive inpatient PTSD program at the Northport VA Medical Center.

"When he joined the 82nd Airborne, he had found his niche," Tom Taylor said of his son, who joined the Army in 2004, and served as a sniper in Baghdad during a 14-month deployment. "But horrible things happened to him and he had to do horrible things, and he was never able to forgive himself."

Ronald Cinquemani, 33, of Port Jefferson, an Iraq War veteran and friend of their son, died three months later. Cinquemani had lived at the Taylor home in the weeks after Taylor's death, joining another combat veteran who had been a friend of Taylor and who was also battling post-combat traumatic emotions. After Taylor's death, Cinquemani had an image of St. Michael tattooed on his arm.

"They were like this," Cinquemani's sister, Carol, said of the three men, squeezing her fingers together. "But when Mike Taylor died, Ronnie was devastated."

That August, Cinquemani, also a former Army specialist, left the Taylors' home to return to an inpatient Northport PTSD program, where he stayed until Aug. 29. Two days later, another friend of Cinquemani's, Army National Guard Spc. John Barbato, died inside the PTSD program Cinquemani had just left.

Cinquemani's depression deepened. So did his craving for heroin, whose drowsy embrace provided a temporary respite from his almost-daily nightmares.

On the morning of Sept. 4, he dropped his mother off at her job. She worried when he did not pick her up that afternoon after work. She found his body slumped near a chair in her living room.

"I think that morning I looked over at him and he had the saddest eyes I've ever seen," his mother, Frances Cinquemani, said. "I've always felt guilty after he died, wondering what more I could have done."

The third veteran, who asked not to be named because he fears it would ruin his chances of finding employment again, said he sometimes feels he is hanging on by a thread.

During peacetime, young veterans are actually less likely to die than are nonveterans of their age group, thanks to the military's "healthy soldier" selection of recruits that are physically strong and mentally resilient, according to studies cited by the National Institutes of Health.

Indeed, most Iraq and Afghanistan veterans lead productive lives after returning from combat. Some veterans advocates have bristled over what have been called "wacko-vet myth" depictions of veterans who have struggled to adjust to civilian life. "We who have served and are serving refuse their pity," Gen. John Kelly, who commanded Marines in Iraq, wrote in the November edition of Veterans of Foreign Wars magazine.

But increased suicides, drunken or aggressive driving, violent confrontations and drug overdoses leave combat veterans much more likely to die than noncombatants of the same age, data show. Deaths among veterans who served in Vietnam, for example, were 17 percent higher than among veterans who served in Europe or elsewhere, according to a 1987 study of Vietnam-era veterans by the federal Centers for Disease Control and Prevention.

Although there has been less mortality research on Iraq and Afghanistan veterans, data show they and Gulf War veterans have been more likely than nonveterans to die in car crashes, said Han K. Kang, a VA epidemiologist.

Being involved in a battlefield killing increases the likelihood that a veteran who develops PTSD will attempt to harm him or herself, according to research co-authored by Dr. Charles R. Marmar, director of PTSD research at the New York University Langone Medical Center.

"The major wounds of war are invisible wounds," Marmar said. "If a returning war fighter has PTSD, depression and TBI [traumatic brain injury], they are at greater risk for these impulsive behaviors."

In the years before their deaths, both Cinquemani and Taylor had been consumed by feelings of confusion, guilt and remorse over battlefield incidents during which they killed at least one Iraqi civilian, according to writings they left behind.

Taylor described his torment in a December 2011 essay written while he was a rehab patient at the Hudson Valley Health Care System in upstate Montrose.

A young girl strapped with explosives approached a U.S. encampment while he was serving as a sniper in Baghdad in 2005. He fired a fatal burst to protect his fellow soldiers. Her death became the subject of nightmares that dogged him the rest of his life.

"This beautiful little girl haunts my dreams," Taylor wrote. "My brother was there and he wouldn't take the shot, so I took it. But this time I was sprayed with her blood and it wouldn't wipe off."

Troops can suffer "moral injury" when they are involved in "perpetrating, failing to prevent, bearing witness to, or learning about acts" that violate "core ethical or moral beliefs," according to the VA's National Center for PTSD. Individuals suffering from moral injury often display "self-handicapping behaviors," such as sabotaging relationships or harming themselves, researchers say.

Cinquemani's involvement in a gruesome shooting in mid-2005 "haunted me every day since," he recounted in an April 18, 2012, conversation with a VA psychologist, whose notes were provided to Newsday by Cinquemani's family.

He was serving as a Humvee turret gunner during a convoy along a highway leading from Tikrit, an insurgent stronghold that had been the hometown of Saddam Hussein. Bomb craters from insurgent attacks were eerie roadside reminders of what could await them, and Cinquemani anxiously waved civilian drivers to move aside.

But the driver of an onrushing car apparently did not see Cinquemani's increasingly urgent waving. Unsure of whether the driver was a threat, Cinquemani trained a barrage from the Humvee's 50-mm machine gun at the windshield.

"The children in the backseat was the worst part," Cinquemani wrote of the incident in a VA disability application. "It was sickening."

Six months later, Cinquemani, an Army reservist, returned to Long Island and tried to blend into his former suburban life.

But by their own accounts, the shooting left Cinquemani, who left active duty in 2006 with an Army Commendation Medal, and Taylor, who left in 2008, dramatically changed.

"I never spoke of it until I arrived at the PTSD unit at the Northport VA," Cinquemani wrote. "It's extremely hard to talk about and brings me to tears every time. It's affected me in civilian life as well. I've totaled two cars and have gotten into four serious accidents since I got back from Iraq. This incident changed my life forever, and I have yet to make peace with it. I'm not sure if I ever will."

Taylor, who before his military service was described by friends as loyal and outgoing, became so consumed with anger -- a potential symptom of PTSD -- that he repeatedly got into alcohol-fueled fights and road-rage incidents. A lifelong friend invited Taylor to live with him after Taylor left the service, but changed his mind after Taylor began sleeping in their living room with a gun in his lap.

Realizing how troubled their son had become, the Taylors asked him to move back in with them. But it was a decision that came at great risk to the couple.

Taylor frequently lashed out against his parents' insistence that he set rules for himself and curb his binge drinking.

During one confrontation in their Lake Ronkonkoma home, he pointed a loaded assault rifle at them, then fired a round that sliced through the kitchen window. The slug flew out into the night before embedding itself in their garage.

Taylor fled, evading his father and discarding the rifle before climbing onto the roof of a nearby school building. When his father finally was able to contact Taylor by cellphone, Taylor told him he had suffered an Iraq War flashback and had fled to the rooftop because he thought he was being attacked.

That night, Tom Taylor drove his son to seek psychological help at a local emergency room. Michael Taylor would be in and out of psychological care, most often at Veterans Affairs facilities, for the rest of his life, according to VA records.

Like Taylor, Cinquemani spent the last years of his life in a revolving door of VA PTSD and drug rehabilitation programs, including at least seven inpatient stays at Northport since July 2007, VA records show.

Both men were taking cocktails of VA-prescribed drugs. Taylor, who had a bad back and had been diagnosed with a traumatic brain injury, by November 2008 was receiving VA prescriptions for hydromorphone, diazepam, oxycodone and morphine -- highly addictive painkillers and anti-anxiety drugs, according to VA "Progress Notes" obtained by Newsday. In March 2009, he told a Northport social worker he wanted treatment for PTSD because "the meds are not working."

"I want to be myself again," he wrote in December 2011, while in an upstate VA detox program. "Drugs and PTSD run my life."

Both Cinquemani and Taylor increasingly indulged in self-medication, including alcohol and street drugs. The social worker's March 2009 notes indicated that over the previous six months, Taylor had tested positive for opiates, cocaine and marijuana, and that Taylor "did not comply with outpatient detox treatment plan."

Cinquemani, who friends and family described as a funny and emotionally generous big brother kind of guy before leaving for Iraq, at first seemed fine after coming home. He returned to his job as a Long Island Rail Road usher and bought an apartment in the complex where his mother and sister live.

But nightmares began coming with bruising frequency, leaving him perpetually sleep-deprived. Unnerved by crowds, his work at Penn Station became so anxiety inducing that he took repeated leaves of absence before resigning. He lost his apartment and the new Jeep he had purchased a month before his deployment. Cinquemani told VA officials he began getting prescription opiates from friends in 2007 to block his war anxieties. He turned to heroin in 2010 when the weaker drugs "no longer helped reduce PTSD symptoms," according to VA "Progress Notes" recorded 10 weeks before his death.

The Northport VA has received enthusiastic praise from former patients, veterans organizations and the Taylor and Cinquemani families for providing aggressive outreach and helpful services to individuals struggling with PTSD. The facility's "Unit 65," an eight-bed inpatient program, is often referred to by veterans who have used it as the gold standard for PTSD treatment.

But both the Taylors and Frances Cinquemani say their sons faced repeated delays in their effort to be treated at Unit 65. They said they were frustrated that Northport clinicians would insist that their sons first complete a drug detox program before being admitted to the unit.

Each had completed a rehab program, only to find there was no space at Unit 65, they said. Each had relapsed into drug use before they could be admitted, forcing them to start over again.

"It took him three years to get into that program," said Cinquemani, whose son was admitted to Unit 65 in May 2012, six years after he left active duty. "By that time he lost his job, he lost his co-op. It took too long."

Dr. Charlene Thomesen, who directs mental health programs there, said Northport's inpatient PTSD program has not had a waiting list, and that patients needing emergency psychological care are first stabilized in an acute care unit. "We have not had an issue with not being able to accommodate veterans in a timely manner," she wrote in an email.

Michael Taylor died waiting for admission to Unit 65.

"I went to the VA and asked if they could move him up," Tom Taylor said. "I didn't think he was going to make it."

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