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The New York Times:
THE Pentagon’s recent decision not to award the Purple Heart to veterans and soldiers suffering from post-traumatic stress has caused great controversy. Historically, the medal has gone only to those who have been physically wounded on the battlefield as a result of enemy action. But with approximately one-third of veterans dealing with symptoms of combat stress or major depression, many Americans are disappointed with the Pentagon’s decision; many more are downright appalled. As a former Marine infantry officer and Iraq war veteran, I would urge the Pentagon to consider a different solution altogether.
First, let me say that both sides of the Purple Heart debate have expressed some reasonable concerns. Those who believe that the Purple Heart should be reserved strictly for the physically wounded hold a more traditional sense of the battlefield in which wounds are bloody and undeniable. The gashes of war carry an irrevocable purity that tends to make the issue concrete and uncomplicated.
And yet there have been complications. During the 2004 presidential election, John Kerry’s Purple Hearts, awarded for his service in Vietnam, were labeled by his opponents “purple owies” because the wounds he suffered were not considered dire enough. It was a petty episode, to be sure, but it demonstrated the disparate views of this medal. In the interests of guarding the nobility of the Purple Heart, many service members, including me, have suggested that not every last physical wound merits a decoration.
When I was in Iraq, the most common wound behind the many Purple Hearts we awarded was the “perforated eardrum,” an eardrum punctured by the concussion of a nearby explosion. In the vast majority of cases, no blood was ever shed. Seldom did these marines ever miss a day of full duty. And yet they were all awarded the coveted medal.
Admittedly, I was dubious about the “recognition” of these and other lesser wounds; I felt that in a way they subverted the obvious intent of the Purple Heart — honoring soldiers who have been seriously hurt. But where to draw the line? Perhaps it should be awarded only to those who required admittance into a combat support hospital. “The Purple Heart deserves at least one night out of action,” I argued at the time. But my own commander stood fast by the rules, affirming: “A combat wound is a combat wound, no matter how small. So they get the medal.”
A year later, back at Camp Lejeune, N.C., I was making calls to the families of wounded marines — a difficult duty even when the wounds were minor. But I noticed during that time that I never once made a call to a family about a marine’s psychological wounds. I never got a casualty report for post-traumatic stress, despite the rising number of veteran suicides. Never once.
Why, I asked myself, if a combat wound is a combat wound no matter how small, shouldn’t those people suffering from the “invisible wounds” of post-traumatic stress also receive the Purple Heart? Difficulty of diagnosis is one of the central justifications the Pentagon has given, citing the concern that fakers will tarnish the medal’s image. Spilt blood cannot be faked.
But this seems an unconvincing argument not to honor those who actually do suffer from post-traumatic stress. For example, the possibility of fakers has not prevented the Department of Veterans Affairs from awarding disability payments to service members who have received a diagnosis. Why should the military itself be different?
The distinction, I suspect, lies in the deep-seated attitude toward psychological wounds. It is still difficult for many members of the military to truly believe that post-traumatic stress is, in fact, an injury and not the result of a weak or dysfunctional brain. The same culture that demands tough-mindedness also encourages skepticism toward the suggestion that the violence of war can hurt the healthiest of minds.
Still, almost all service members agree that veterans suffering from confirmed cases of post-traumatic stress should be cared for. The reality of psychological wounds is becoming harder and harder to deny. That post-traumatic stress can lead to suicide is no longer in question. That far too many of those returning from combat experience deep and long-lasting devastation is irrefutable.
So why not recognize the struggles of these many individuals with a medal? Why, for instance, if a veteran has been given a diagnosis of post-traumatic stress and awarded benefits, should he not also be awarded a Purple Heart? Sadly, as long as our military culture bears at least a quiet contempt for the psychological wounds of war, it is unlikely those veterans will ever see a Purple Heart. That is too bad, I think, because they do deserve all the honor the physically wounded receive.
But there may be another solution — perhaps a new decoration, a new medal, could be established specifically for those suffering from post-traumatic stress. It would be awarded to those whose minds and souls have been sundered by war.
I urge General Eric Shinseki, the new head of Veterans Affairs and former Army Chief of Staff, to work hand in hand with the Defense Department to bring about some form of official recognition for these wounded veterans. The current stigma of post-traumatic stress would likely prevent many soldiers from wearing the medal initially, but its mere existence would help crystallize in the American — and the American military — consciousness one of the more obscure human costs of war.
I suggest we call this medal the Black Heart. Certainly the hearts of these soldiers are black, with the terrible things they saw and did on the battlefield. Certainly the country should see these Black Hearts pinned on their chests.
Tyler E. Boudreau, a former Marine captain, is the author of “Packing Inferno: The Unmaking of a Marine.”
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