Let me explain the title of this post before someone gets the wrong idea. There are many possible origins to the word, but during the Civil War, “Tramp” was used as slang for a soldier who marched off to war. Later, the Civil War homeless veterans camped out at our nations capital waiting for their bonus money and the word morphed into what would be considered a vagrant or squatter. Then there were the homeless veterans of WWI, WWII, Vietnam War, Korea…I think I see a trend!
The National Alliance to End Homelessness which is a public education nonprofit group, estimates that 1 in 4 homeless people in the United States is a Veteran. Veterans make up only 11 percent of the general population but 194,254 out of 744,313 homeless persons walking the street at night are veterans (2005 statistics). These numbers are based on information from the Veterans Affairs Department and the Census Bureau. The Veterans Affairs Department also identified 1,500 homeless veterans from the current wars in Afghanistan and Iraq and they predict this is only the beginning of the “surge” of homeless veterans from the current wars.
In doing my research on this issue, the root-cause always comes back to post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), the two signature wounds of the wars in Iraq and Afghanistan.
What is needed, or a better question is: what is our obligation to our veterans to ensure they don’t end up in the streets? There is a very comprehensive document that was just released by the Veterans For America (VFA). It talks about what I believe is the root-cause of homelessness among our returning veterans from Iraq and Afghanistan. To read VFA’s report “Trends in Treatment of America’s Wounded Warriors” and to download the complete report (PDF file), please click here.
Sam’s medical status:
Wednesday November 7th, 2007: Tomorrow Sam will be given a different type of stimulant. He has been receiving a form of Ritalin but it has been really hard on his digestive system. The last few days, Sam has been trying to move around and keep his eyes open but he’s been having a hard time staying awake, so maybe a change in stimulant is a good idea all around.
Even with Sam’s struggle to stay awake lately, today he scored a 20 on the CRS-R (Coma Recovery Scale-Revised)! He was a 16 on the CRS-R scale the last few weeks. The scale goes from 0 to 23, and at 23 a patient is considered to be out of a “minimally conscious state” (MCS). Once he starts talking he will surely score a 23.
In the same “cognitive function” vein, Erin told me that she was asking Sam some questions sort of out-of-the-blue as opposed to things she’s done in the past that were taught. In one example, Erin asked Sam to stroke his goatee. After thinking about it a few seconds, Sam lifted his arm up to his face and used his index finger and thumb to stroke his chin. When the physical therapist was in the room, Erin asked Sam what the comb was for. At first he didn’t do anything, but after about 30 seconds, he lifted up his head and legs (to help his momentum) and raised the comb up to his head.
Thursday November 8th, 2007: A few weeks ago, I mentioned Sam was going to get Botox treatment in his left arm since it seems to be stiff and curling up a bit. He actually didn’t get the treatment at that time because the hospital didn’t have the correct needles. But, yesterday he did get his Botox treatment. Erin said it should take affect in about 10 days or so.
Sam got his backside debride (debridement) yesterday. If they can get that portion of his body healed enough, they will be able to get him in a wheelchair.
Sam was put on a new stimulant called Amantadine yesterday. He was more awake and responsive than he has been the previous few days. Hopefully this drug won’t be so hard on his digestive system.
References:
BBC News
http://news.bbc.co.uk/2/hi/americas/7085081.stm
New York Times
http://www.nytimes.com/2007/11/08/us/08vets.html?_r=2&ref=us&oref=slogin&oref=slogin
The Cincinnati Post
http://news.cincypost.com/apps/pbcs.dll/article?AID=/20071108/NEWS01/711080359
The Kansas City Star
http://www.kansascity.com/115/story/351623.html
Jon Soltz – The Huffington Post
http://www.huffingtonpost.com/jon-soltz/yet-another-alarm-sounded_b_71708.html
NPR
http://www.npr.org/templates/story/story.php?storyId=6394180
Sgt. Samuel Nichols, USMC 
Amantadine, eh? I knew it was used for Parkinsons. This is a new one for me. I wish Sam much success with the drug change. It sounds like he really needed some modifications made. I had to chuckle: the hospital didn’t have the right size needle for the Botox? 🙂 Hmmm.
Regards the issue of homeless vets–I find this deplorable! I saw the report on NBC and cried. The homeless of all ilk have long been ‘invisible’ to our society. We fear behavior that does not fall under the definition of ‘normal’. Veterans require multidimensional assessment and therapy. Too many are falling between the ‘cracks’ of VA and/or community services because they do not receive assessment and treatment in a timely manner, sometimes not at all. Again, our fear of the ‘abnormal’. Even those victimized by PTSD and other DSM III or IV disorders can have an awareness that they are not ‘quite right’ and fear societal consequences of seeking assessment and treatment. Our veterans fall into this category. Clinicians long debated whether PTSD should be categorized ans an anxiety or dissociative disorder and decided on the former. Realistically, it should be both, as the lesser forms of PTSD are anxiety based, the more severe (such as borderline personality disorder and Complex PTSD) are dissociation based.
For many, the first reaction of seeing homeless persons, is one of revulsion. There seems to be a judgment call by many that these individuals have made a choice. Whether veterans, or not, who in their “right mind” would choose homelessness?
Our Veterans have put Country first. Now it is time for the Country to put THEM first.
It’s a bit more complicated than PTSD, but you’re right about the majority. When they come home, many bring the war back home with them. Even without developing PTSD, many come home changed. Family and friends have a hard time dealing with these changes and most, don’t want to talk about it. Employers often find it difficult to understand when National Guard soldiers try to go back to work, when most assume they will be able to pick up where they left off. Many come home to find their jobs are gone.
For a veteran with PTSD, it is all the above but much worse. They not only have to deal with the “usual” problems of return from combat back to civilian life, they also have to deal with the illness itself. They self-medicate with drugs and alcohol to kill off feelings they do not want to feel. Unable to work they are trapped in the system of the VA designed to help them but tortures them instead. No income will leave many on the streets. This is all especially hard on career soldiers enlisting right out of high school. They lack training in anything other than service simply because they wanted to be a career soldier or were planning on using their GI benefits to attend college.
We have been in back in Atlanta for a couple of days, and will be in DC again tomorrow for the reading the names at the Vietnam Memorial, and will be there on Sunday to honor our Vets; we will never forget the hard work and sacrifices of all of our Vets, and we have not forgotten to pray for Sam and Erin and all of the family. I was on the plane the other day, and I sat next to a perfect stranger, and as we talked, he told me that he was from SanJose, California, and that he was born and raised in Palo Alto… now THAT was such a confirmation from God that I just needed a little reminder of Sam. I should not be surprised that God does these things. Coincidence??? I don’t think so.
If you care about homeless veterans , I really recommend seeing the film WHEN I CAME HOME. It;s about Iraq war veterans that end up homeless in NY city after they come home. There is a trialer online at:
http://www.whenicamehome.com
Support The Vets!