The Pentagon confirmed yesterday that it will not award the Purple Heart for combat-induced Post Traumatic Stress Disorder. Defense Department spokeswoman Eileen Lainez announced that the affliction, which even struck Achilles, is "not a qualifying Purple Heart wound.”
Technically, DoD is correct. The Purple Heart guidelines specify that the award be given to servicemembers whose injury "...requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member.” PTSD, by definition, is a "secondary effect."
However. And there is a big "however." The evidence shows unequivocally, PTSD can wreck lives. My own father was awarded the Purple Heart for wounds sustained in combat in Korea. He recovered well. But I am convinced that PTSD, for which he received no medal nor treatment, had a hand in his death.
I understand that much stigma is attached to the PTSD label. Troops remain reluctant to acknowledge symptoms. In addition, both society and the military leadership view the disorder with mixed feelings. Is PTSD an easy out for malingerers? If you have it, does it mean you're nuts? If we admit that combat is bad for the troops' mental health, does this mean we can't ever go to war? The short answer, to all three, is a resounding "no."
Nevertheless, we remain faced with the question: Should we acknowledge PTSD within the context of an award? The Pentagon has issued its ruling. But in doing so, DoD also has used code words that betray its prejudice:
"Historically, the Purple Heart has never been awarded for mental disorders or psychological conditions resulting from witnessing or experiencing traumatic combat events — for example, combat stress reaction, shell-shock, combat stress fatigue, acute stress disorder, or PTSD."
In dredging up these highlighted terms, some of which have been used in prior wars as dismissive sobriquets, this particular Pentagon commission reveals a preconceived mindset: Do you have PTSD? Get over it.
I don't pretend to know what's best in terms of a PTSD award. I never have served in combat, and I never have been faced with the question of whether to announce my injuries to the world at large. The PTSD-award decision is best left to the troops themselves. I'd very much like to see their thoughts on this matter.
This blog has addressed PTSD at length. You can view the full collection here.