EDITOR’S NOTE: This is the first in a three-day series about post-traumatic stress disorder. Today’s story looks at one man’s descent into a living hell with PTSD that his family says began as a civilian deployed to Iraq and ended in an Arizona cemetery. Monday’s story visits a group of South Korea-based troops who meet to deal with their issues. On Tuesday, Stripes explores the different types of care available to those suffering from the disorder across the Pacific.

In 2004, William Blair e-mailed his wife Noriko a picture of himself in an Iraqi jail cell.

Noriko knew he wasn’t a prisoner, but she knew little else about his job with the Defense Intelligence Agency.

When he returned from Iraq a year later after a second deployment, Noriko Blair realized that William wasn’t the same witty, calm, peaceful man she had married. But she did not know how badly he had been wounded.

After 38 years of serving his country as a retired active-duty soldier and a Defense Department civilian, Blair died in July 2006.

Death didn’t come from a bullet or a mortar round. It came from the anguish brought on by post-traumatic stress disorder and the heart attack that struck after alcohol abuse broke his body, his family said.

Blair’s death could have been prevented, said his son, his wife and a former colleague who served with him in some of the world’s toughest places.

They say he might have lived had the DIA given him psychological screening before redeployment or offered help when he returned in January 2005.

They wonder how far it would have progressed if Yokosuka Naval Hospital had diagnosed and treated him earlier, or if they had additional PTSD training then.

Though he was already very ill, they ask what would have happened had a Veterans Administration hospital in Washington not turned him away because he got PTSD as a civilian and not while serving as a soldier, as a VA spokeswoman confirmed.

They’ll never know if Blair’s heart could have been restarted; he was transferred without Noriko’s knowledge from a civilian hospital to a medical center in Arizona, where he suffered a heart attack and later died. No one could tell Noriko how long he lay unattended after his heart stopped.

The first battles

“My father’s agency, the government or anyone else is not really to blame for doing anything directly to him,” says Scott Blair, William’s son and a former soldier whose spouse is an Air Force linguist at Osan Air Base, South Korea. “The problem was that there was just no foresight to create any standardized way of dealing with people in his situation. It almost seemed like his agency just took the policy of ignoring it, with the idea that it would go away on its own or that he could handle everything by himself.

“Quite honestly, in his condition, he wasn’t able to take care of anything on his own.”

As of Wednesday, the DIA had not responded to numerous Stripes queries spanning more than a week regarding PTSD programs and screening.

Before his Iraq deployments, Scott knew his father as a man who could land on his feet in tough situations. He picked up new languages just by walking foreign streets.

Blair joined the Army during the Vietnam War in the late 1960s and was sent to Japan as a Russian linguist in an intelligence post.

He met and married Noriko in Japan. He could not retain his security clearance level while married to a foreign national at the time, so Blair became an interrogator and spent most of his career in Cold War Germany.

Blair later served as noncommissioned officer in charge of the interrogation advanced individual training school at Fort Huachuca, Ariz.

After seven years as an Army civilian, in 1995 he joined the DIA and an exclusive new circle formed that year within its ranks: the Defense Humint (human intelligence) Service.

“Bill was a very capable man. He had a lot of experience and he really knew his trade,” said a former colleague who knew and worked with William Blair overseas for several years. He said he requested anonymity during the phone interview because he fears retribution.

Two months before “shock and awe” officially kicked off the 2003 war in Iraq, Blair and other DIA agents landed with Special Forces soldiers in Northern Iraq’s semi-autonomous Kurdistan.

The details are sketchy, but Scott Blair says his father set up detention centers with local Peshmerga forces.

When he returned around June 2003 he seemed normal, Scott and Noriko said.

It wasn’t until he found out he would be redeployed in 2004 that they noticed changes.

However, his former colleague says Blair may have kept up a good front for his family in 2003.

“In public if you didn’t know him, he looked just fine,” his colleague said. “I think the drinking maybe started when he was deployed the first time. It continued when he came back.”

Before returning in 2004, neither Blair nor anyone he knew received psychological screening through the DIA, his colleague said.

Blair called Noriko weekly from Iraq, trying to reassure her that things were OK.

One day, he told her about what was probably a mortar attack on a shower trailer. Blair knew the men inside. One died instantly, the other was badly injured.

“I think that made him really freak out,” Noriko said by phone from her home in Arizona. “I knew that was a big thing for him, but he said it was nothing to worry about.”

Returning home

Noriko flew from Japan to Scott’s Maryland home in January 2005 to welcome her husband back from his deployment. He had lost so much weight she could feel his bones through his jacket.

They went straight to the commissary and she let him push the cart.

“In the middle of store he stopped. He said, ‘I can’t move anymore.’ ”

When they returned to his duty station at Japan’s Yokosuka Naval Base in February, Blair froze again in fear at a festival.

Aversion to large crowds is a common symptom of PTSD, but Noriko didn’t know enough yet to make that distinction.

His symptoms worsened for the next few months. He asked Noriko to cut up his fruit in child-sized bites so he could eat it with a spoon.

He sat by the computer in his room, crying and watching a patriotic video clip repeatedly.

He drank when he woke up and kept drinking, averaging full bottles of liquor daily.

“One day I had to tell him, ‘Listen, this is too much. It’s not going to solve any problems. You better go to a doctor,’ ” Noriko said.

Blair tried getting help through the DIA first, but without success.

“I’ll use Bill’s quote from the HR people,” his colleague said. “It was ‘Gee, you’re a little messed up from what you did. Quit. Don’t let the door hit your ass on the way out.’ That was a summary of their official response.

“They had a plan for sending us, but they did not have a plan for what to do with us and what to do when and if we came back. To my knowledge the issue was so far removed from senior leadership … it wasn’t even on their radar scope.”

In summer 2005, Blair went to a Navy doctor at Yokosuka. The doctor recognized his alcoholism but not the underlying PTSD, Noriko said.

Blair didn’t volunteer much information that could have helped the doctor because he feared he would disclose top-secret information.

“He knew because of his job he couldn’t talk to just anybody about his problems,” Noriko said.

And few doctors at Yokosuka or elsewhere in the Pacific theater had any specialized training in spotting and treating PTSD at the time.

In September 2006, Cmdr. Mark Russell, a psychologist at Marine Corps Air Station Iwakuni, told a medical conference at Yokosuka that 90 percent of the 133 providers he surveyed in the Pacific had no PTSD training. In March 2007, Russell and a team from Veterans Affairs trained 41 Yokosuka care providers on PTSD treatment.

In fall 2005, Blair’s only options were trips to an Alcoholics Anonymous group and a stint at the Navy’s inpatient alcohol program in San Diego, where he continued to drink while the PTSD was ignored, Scott Blair said.

Noriko went to Blair’s Yokosuka doctor and told him about her husband’s mental state. He got an appointment in November to see a psychiatrist, then another in December, Noriko said. The psychiatrist then deployed to Iraq, she said.

Hope dashed in the U.S.

Scott Blair says Yokosuka doctors tried to be supportive, but told Blair there was little more they could do.

William Blair began taking initiative on his own. He did Internet research and found a doctor at a Washington state VA hospital with PTSD expertise.

After a thinly veiled threat about going to his congressman about the DIA’s lack of medical support, his former colleague says, the agency agreed to transfer him stateside.

He was almost ready to move to Washington for his new assignment near the hospital when he got the news: he was ineligible for PTSD treatment at the hospital there because he contracted it as a Defense Department civilian and not while on active duty.

That is the VA’s policy, Josephine Schuda, VA spokeswoman in Washington, D.C., said in an e-mail.

“Military retirees are not eligible for VA treatment for injuries or illnesses they suffered working as civilian for any organization, military or non-military, which is the determination that evidently was made by VA claim adjudicators,” Schuda said.

Blair’s mindset kept him from even considering civilian help after working with sensitive intelligence for most of his professional life, Noriko said.

That conviction firmed in his deteriorated mental state, which Scott compared to that of a child.

Blair made it to a DIA post at Fort Huachuca in May 2006, where he never actually worked. He was able to seek treatment at the VA hospital in Tucson because of a reciprocal hospital agreement, as long as he listed the Huachuca hospital as his primary care provider through insurance.

By then, Blair suffered pain throughout his body. His brittle bones couldn’t take the stress and his organs were failing.

Even in Tucson, Blair never received much help with his PTSD, Noriko said.

“They saw him as just one of the drunk men who could not control alcohol,” she said.

The last days

Scott Blair said his father went to the VA hospital with Noriko on July 10 believing he had an appointment. He was so sick that they wouldn’t let him go, but they didn’t have any available beds.

They referred Blair to St. Joseph’s Hospital. They took his possessions and told Noriko to go home and wait for their call.

The next morning, St. Joseph’s called back. When she arrived they told her he had been transferred, but claimed they could not tell her where because of the Health Insurance Portability and Accountability Act’s Privacy Rule, Noriko said.

A DIA employee arrived on the scene and found out that Blair had been admitted to the Palo Verde Mental Health Services, an adjunct of Tucson Medical Center.

Noriko called Palo Verde at noon and was first told he wasn’t there. After she insisted, the employee asked someone and found out he was coming but hadn’t arrived yet.

She called again an hour later and was told he was fine.

A few hours later, a Tucson Medical Center representative called and told her they came to Palo Verde on an emergency call.

“They told me how they found him on the floor unconscious,” Noriko said. “They didn’t know how long he had been on the floor.”

When asked by Stripes about Blair’s condition, Tucson Medical Center and Palo Verde declined to comment, citing privacy concerns.

He was transferred to Tucson Medical Center’s emergency room and placed on life support, but doctors said it was too late to save him.

William Blair was buried at Fort Huachuca National Cemetery. They said they would recognize Blair’s Vietnam-era active duty service on his gravestone. Scott asked if they would include his Iraq service.

“They said they would look into it and get back to me,” Scott said. “They never did.”

The Defense Department now requires PTSD lectures and training in various facets throughout the services. Scott Blair hopes that they’ll think about civilians and contractors who serve their country as well.

In his last days, Noriko says that William Blair hoped that others wouldn’t be resigned to his fate.

“He said, ‘Maybe it’s not my time,’ ” Noriko recalls. “But for future young soldiers and young civilians injured, maybe it will be their time to get treatment without a problem. He always was thinking about the other people. He cared about them.”