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Could that man be my brother?
Melissa Gieniec had been warned he didn't look good, but this?
She remembered her brother as a man who plucked his eyebrows.
The man sitting on the bench in the baggage claim of the Anchorage airport looked like he hadn't showered or shaved in weeks. He smelled homeless.
John Shaubach served 22 years in the Army. He jumped out of planes with the 82nd Airborne Division. He led men into combat in Iraq and Afghanistan and earned a pair of Bronze Stars and a Purple Heart.
The man in front of her looked lumpy, she later
recalled. His shoulders slumped forward.
Twice, she said, she had walked past the man before she realized this was her brother.
"Hey," Shaubach said.
Gieniec
A week earlier, in the first days of April, her brother's wife, Sarha Shaubach, had called in the middle of the night and said her husband's post-traumatic stress disorder was getting worse. She no longer knew what to do when he peed in the closet or hid under their daughter's bed during the night.
While John Shaubach's case of PTSD might be severe, he is not alone among recent veterans.
Experts from the Department of Veterans Affairs estimate one in four veterans from the Iraq war will suffer some form of PTSD.
According to the VA, 75,033 veterans from Iraq and Afghanistan have received some treatment for PTSD from either a VA medical facility or a Vet Center.
Two trips to VA-run PTSD treatment centers did not help Shaubach. One -- to a center built next to a base with live-fire and helicopter exercises -- actually intensified his symptoms, Shaubach said. His seven weekly medical appointments have had no effect.
"A year ago, he wasn't like this," Gieniec said. "A year ago, he was trying to find his way. And then it just passed him by."
The next week, she took a week off from her job as a dental assistant in Springettsbury Township
She wanted to see some evidence that her brother could get better.
She's still waiting.
Twice during his Army career, a superior officer told 1st Sgt. John Shaubach, "That's a risk I'm willing to take."
His mind survived the first time.
On Dec. 23, 2003, an officer wanted Shaubach's men to drive three pieces of equipment 100 miles across an Iraqi desert, Shaubach said during a recent phone conversation.
He had been in the country since August and had already served an eight-month tour in Afghanistan.
Two days earlier, on the same road, a buried bomb had killed men from his unit.
"A chunk of metal hit the gunner's eyes so that his eyeballs and
Shaubach said he asked the officer why they needed to transport the three pieces of equipment. We need to plant sod for a ceremony, Shaubach said the officer told him. Speaking freely, Shaubach responded that was a stupid reason for a dangerous convoy.
That's when the officer gave his risk assessment.
Shaubach carried out the mission. No one was hurt on that convoy.
But before he left Iraq in April 2004, Shaubach said, he was hit in four more roadside bombings.
Then, in October 2005, he and another officer sat at his home base at Fort Richardson, Alaska. The officer asked him to do something, and Shaubach
"That's a risk I'm willing to take," the officer said.
Since returning from Iraq, he had fought nightmares and road rage. He avoided crowds. The lifelong Army man felt uneasy around other soldiers.
Those words did the rest.
Shaubach went home and collapsed. The next day, a counselor at the base told him to forget work and arranged for a 90-day stay at the National Center for Post Traumatic Stress Disorder in Palo Alto, Calif.
The trip stabilized him, Shaubach said. But he left Palo Alto without confronting what he had seen or done and without giving himself a real chance to heal.
Shaubach entered VA care in August 2006,
His wife compared the experience to a cartoon, where a character gets stretched thin or dropped from great heights for no reason.
After an endless series of meetings and evaluations, Shaubach still has no comprehensive care plan, his wife said.
On multiple occasions, Shaubach said, he was promised a primary care physician only to receive a letter of apology after months passed without one being appointed.
Three times he tested positive for a traumatic brain injury -- the signature injury of the war, and often linked to roadside bombings -- but the VA has yet to declare it a service-related injury.
During one evaluation, Shaubach said, a nurse kept calling him Ian, even after he corrected her. Another time, he asked to see his file. The first four pages were his. The rest, Shaubach said, belonged to a Navy veteran named Marty.
"I fell through the cracks," Shaubach said.
With each VA screw-up, Shaubach said, he lost hope that he would ever get the care he needed to recover.
On Jan. 3, Shaubach began an intensive two-week PTSD inpatient program in Seattle, part of the VA's Puget Sound Health Care System.
Then, on Jan. 17, he was transferred as scheduled to the PTSD program at the VA's American Lakes Medical Center, which, according to a social worker there, is separated from Fort Lewis "by a distance that is the width of a wire of a chain link fence."
Shaubach was supposed to stay at American Lakes for six weeks.
Counselors discharged him after 16 days, with a nervous system so overloaded he was on the verge of taking his own life.
While at American Lakes, Shaubach heard gun and artillery fire from the range at Fort Lewis, according to a letter written to the VA on Shaubach's behalf by Bradford Smith, a licensed clinical social worker at the center. Helicopters flew training missions overhead.
Shaubach could not handle it, as Smith wrote:
"You were not able to escape these stimuli, and you became overwhelmed with memories, associations, and a near-continuous fight or flight stress response.
"Because you were unable to use the strategy of avoiding these things, your re-experiencing and hyperarousal symptoms became intolerable and you needed to leave our program."
Those 16 days terrified Shaubach.
"As soon as I got back," he said, "I started pissing the bed every night."
It was the worst his wife had ever seen him.
"We're lucky John didn't hang himself down at Fort Lewis," she said.
Shaubach's reaction to Fort Lewis was unfortunate, said Dr. Miles McFall, the director of the PTSD program for the VA's Puget Sound Health Care System, which includes American Lakes.
American Lakes treats about 125 veterans annually, McFall said, and focuses on reintegrating patients into the community. Veterans walk across the street to an out-patient facility for group therapy.
The program likely wasn't a good fit for where Shaubach was in his recovery, McFall said.
"In 24 years I've been doing this, this is maybe the first time I've heard a veteran has found it so objectionable they need to leave," McFall said.
"That's not blaming Mr. Shaubach at all. That's just saying it's not a common problem that would lead us to do something like close the program down."
The firing range at Fort Lewis is several miles from American Lakes, McFall said. Veterans can hear gunfire, but it does not echo or shake the building.
Most times, McFall said, veterans can avoid the sounds by going inside or listening to music on headphones.
But hearing the rounds and helicopters doesn't have to be harmful to a veteran, McFall said, noting that the Department of Defense has started using virtual reality to help soldiers deal with combat trauma.
"You ask your veterans to talk about their experience in therapy, the gunshots and what that would bring up for them, and you would help them cope with that," McFall said.
"You'd find a way to regulate it so they're not overdosed, again through the headphone thing or staying indoors a little bit more, but you can't avoid life, so let's have you be outside when they're doing target practice and let's teach you some meditation methods, maybe some yoga to help you learn how to calm yourself in the face of these inevitable stressers in life."
Still, McFall said, American Lakes will need to make adjustments as it sees more veterans from Iraq and Afghanistan.
"This younger group of vets with more acute PTSD, they haven't had as much time (since they were in combat)," McFall said. "Some of these cues, like helicopters and such, might be more bothersome to them.
"We need to educate them before they come in as to what they might be exposed to and, maybe more importantly, tool ourselves up to help them cope with that."
Gieniec spent a week in Alaska with her brother in April.
For a few minutes, when they were out at the market, Gieniec saw the brother she recognized, the stoic, confident kid who graduated from Lancaster Catholic and followed his grandfather's footsteps into the Army.
But once he got home, Shaubach retreated to his garage, where he sat in a collapsible hunting chair in a corner, surrounded by the pelts of animals he once shot.
She would ask him questions. He would just stare straight ahead, Gieniec said, sometimes for 15 minutes, before answering.
When he first came home from Iraq, they would talk once or twice a week on the phone. He got divorced, then remarried, then divorced again, before meeting Sarha in 2006. He bounced from job to job.
"I lived with the hope he was OK," Gieniec said.
With each conversation in the garage, Gieniec said, it became more clear to her how sick her brother was, and how long he had been this way.
That week, she went with her brother and Sarha to his VA appointments.
Shaubach's physical therapist told her his work was worthless, Gieniec said, because Shaubach was still thrashing around at night and sleepwalking, exacerbating the problems in his back, legs, heel, elbow and shoulder. Until his physiological needs could be addressed, his body would always be in pain.
Other medical workers left her feeling hopeful.
"I would talk to Sarha and we'd be in the middle of talking to this doctor and I'd tell her, 'I think that went really well. I really feel like he heard you and he has John's concerns at hand,'" Gieniec said.
"And she said, 'We've heard this so many times before, Melissa, you walk away going, Great, they're going to do something,' and then nothing happens.'"
On Friday of that week, a brain specialist was supposed to perform the final exam that would link Shaubach's TBI to his service. Instead, Gieniec said, a muscle specialist showed up and asked to examine his leg.
That night she called her husband in Lancaster, and said she had to come home.
"There was an incredible sense of hopelessness that this was never going to end," Gieniec said. "To hear it and see it firsthand was overwhelming."
On May 8, the VA declared Shaubach homebound and 100 percent disabled.
Before that, he was 30 percent disabled but could not work.
One night at the end of April, Sarha had a choice as she went through the bills.
"Should I replace my mattress that smells like piss or should I buy my daughter the glasses she needs?" she said. "I don't think this should be retirement for someone who served in the military for 22 years."
The 100 percent disability rating came only after she began talking to senators and the military's Wounded Warrior program, she said.
Earlier this month, he was assigned a primary care physician.
She wonders why every veteran who receives a medical discharge is not given a case worker to help them through the system and explain all the benefits.
"If they say you're mentally disabled, they should treat you like that," she said.
Currently, Shaubach is in South Dakota, at the VA Black Hills Health Care System at Fort Meade.
There, the hospital backs up against a forest, Sarha Shaubach said. Her husband called home and said he and a few other veterans from the program go stomping around out there for three or four hours a day. It felt right, he told his wife.
The first week of treatment went well, she said.
But they both know doctors will soon ask him about the things that he has tried to keep hidden away.
How he reacts will tell them a lot about where Shaubach is going and how long it will take him to get there.
jfrantz@ydr.com; 771-2062
WHAT IS PTSD?
Post-traumatic stress disorder is an anxiety disorder that can occur after a person has survived a life-threatening event, such as combat, a violent crime, a sexual assault, a natural disaster or a car crash.
PTSD can cause a person to become isolated, depressed and quick to anger. People often relive the event through flashbacks and nightmares. They struggle to sleep. Sometimes, those suffering from PTSD will report an emotional numbness.
PTSD can often lead to substance abuse problems, difficulties holding a job and relationship difficulties.
Doctors are still learning about PTSD. Two people might have different short- and long-term reactions to the same trauma, and no one is sure why.
By the end of 2007, 67,525 veterans of the wars in Iraq and Afghanistan were treated for at least a preliminary diagnosis of PTSD in medical centers and clinics run by the Department of Veterans Affairs.
Including veterans who received treatment at Vet Centers around the country, that number rises to 75,033.
-- Source: The National Center for PTSD and the Department of Veterans Affairs
CONTACT US
If you are a combat veteran still recovering from your service, contact Jeff Frantz at 771-2062 or jfrantz@ydr.com.
MORE COVERAGE
Read more about PTSD and other military and veterans' issues in our special section.
Read a Feb. 13, 2008 letter to John Shaubach from his case manager, describing his employability
