Aug. 3, 2006 | Most people think a soldier’s deployment to Iraq ends when he or she returns home.
But University of Arkansas for Medical Sciences (UAMS) surgeon Anne Mancino, M.D., who spent six months in Iraq, will tell you it ends sometime later, when the soldier and family have come to grips with changes caused by the deployment.
Mancino, a colonel in the U.S. Army Reserve, stressed the importance of support programs to help both soldiers and their families during her presentation, “Half of My Heart is in Iraq: The Effect of War on Soldiers and Their Families.”
“Soldiers have varied experiences during the war and varied reactions based on their backgrounds and support systems but every experience influences them in some way, and will impact their family and communities,” said Mancino, an associate professor of surgery in the UAMS College of Medicine and chief of general surgery in the Central Arkansas Veterans Healthcare System.
“The actual mobilization period is very stressful, but the reintegration back into the community and their families can also be very difficult,” she said.
A standing-room only audience of teachers and mental health professionals saw Mancino’s presentation July 11at UAMS during the “Psychological Trauma of War: Impact on Families, Schools and Communities” conference. The workshop was sponsored by the Partners in Behavioral Health Sciences program in the UAMS Department of Psychiatry, the Veterans Administration’s South Central Mental Illness Research, Education & Clinical Center (MIRECC) and a Science Education and Partnership Award from the National Center for Research Resources.
“Many workshop participants said they benefited from the ability to interact and better understand the experiences and feelings of our military personnel and their families,” said course director JoAnn Kirchner, M.D., associate professor of psychiatry in the UAMS College of Medicine and associate director of clinical care for the South Central MIRECC. “Personally, I feel that the main benefit was the relationships that emerged around this workshop between UAMS, VA, school, Air Force and Guard personnel. This type of collaboration is critical in order for our community to address the needs of our military population.”
Mancino was in Tikrit, Iraq, from January to June 2005 as part of the Reserve’s 228th Combat Support Hospital unit. She and her fellow soldiers experienced all aspects of the war in Iraq, from being shot at to becoming close to Iraqi citizens and fellow soldiers to dealing with the threat of roadside bombs. She also worked long hours treating the wounded.
Mancino presented a slide show featuring photos of depicted life in Iraq – the camaraderie among the soldiers at the base and positive interactions with Iraqi civilians but also the hard work and difficult conditions they faced.
Soldiers are trained on how to handle the scenes of death and destructions they may face in a war zone, she said. They also received support for dealing with the long-term separation from family during the deployment.
But the stress can still occur like when one sees, as one slide showed, a sign on the back of a military vehicle that stated in English and Arabic: “Caution. Stay 100 Meters Back or You Will Be Shot.” Or when the base loses power just as Mancino is in the middle of surgery and must continue under battery-powered lighting until emergency generators restore power after about 10 minutes. Or when Mancino is aboard a helicopter that comes under rocket attack (the two rockets missed).
Soldiers cope with these stresses differently. Fellow soldiers become a surrogate family, she said, as they are sharing a common experience under intense conditions. She said letters and communications from home really do make a difference for a soldier’s mental state. She spoke of passing around to other soldiers the pictures her daughter sent her.
After returning home, some avoid reminders of their time in Iraq, she said, while others remain connected through communications with friends or military support activities here.
Returning soldiers often feel a dual obligation to a unit with members still in Iraq and to the family that has missed them, she said. There’s “survivor guilt” over other soldiers killed or wounded. The soldier’s role during the deployment might feel more fulfilling than the job to which they return.
The soldier also must realize that their family went on with life while they were gone. Perhaps most importantly for both soldiers and their families is to realize that the deployment experience has changed them. This is where support programs can help with the reintegration back into civilian life, she said, by helping both sides understand those changes.
“I am different,” Mancino said. “It took some months before I could talk about some of my experiences – even to husband.”
She said she is reminded of the war regularly, sometimes when she doesn’t expect it. At one point, she realized she was becoming sensitive to traffic close to her car – a response born of seeing suicide car bombers firsthand.
Some time after she returned home to her husband and 5-year-old daughter, her husband presented her with the sticker he’d carried during her deployment that read “Half of My Heart is in Iraq.” “He said he didn’t need it anymore,” Mancino said. “But then I realized that I still did because I still have friends who are there.”
The workshop also featured presentations “Effects of War on Children and Families,” by Michelle Sherman, Ph.D., a clinical psychologist and director of the Family Mental Health Program at the Oklahoma City VA Medical Center and “Readjustment and Transition Services,” by U.S. Air Force Maj. Patrick Pohle.
“One of our workshop attendees reminded us that the idea and need for this workshop began as soon as the Arkansas Guard and Reserves started sending its members to Afghanistan and Iraq in 2002-2003,” said Chris Rule, Department of Psychiatry project coordinator. “This participant said a former workshop attendee – and schoolteacher colleague of his – was killed in combat shortly after that, but the impetus to pull it all together really started last year with more requests from our participants.”
Now Rule and Kirchner will evaluate the comments for the workshop and use that feedback to improve future workshops. Rule noted that the workshop was attended by VA staff from Oklahoma City and Houston and that both sites are considering similar programs in the summer 2007.