In the Walter Reed Medical Center, Ward H, the door opened. A nurse came in, glancing around nervously. She had nothing to fear though, as all the patients were still asleep. Hurriedly, she walked over to the bulletin board. It was a sad looking thing, blank, covered with cork that looked as if it were a hundred years old. Tacks lay half hazard, sticking out of the cork as is they had been left there and forgotten. With one swift motion, the nurse tacked up a piece of paper with two words on it:

Dr. Stevens

    The nurse hurried out, slamming the door behind her. The noise reverberated around the small room, shaking one older man awake.
    His head jerked up before his eyes opened. His breathing was short and shallow; sweat gleamed on his forehead. When his eyes snapped open, he jerked his head around as if looking for something. His eyes were unfocused, scanning the room as if looking for some danger that was not immediately apparent.
    Slowly, his whole body began to calm down. He stopped looking around the room, his breathing returned to normal, if a bit raspy, and his pulse seemed to return to normal. He leaned his head back and closed his eyes, as if he had just been through one of the most terrifying ordeals of his life. It was only when he opened his eyes again that he noticed the piece of paper tacked onto the board.
    He wheeled himself over to the board. There was something hollow in his movements, as if he was more machine than man. All his actions seemed delayed and droopy. He looked at the paper, scanning his eyes over it three or four times.
Slowly, he pushed a shaking hand into his pocket and withdrew an ancient looking pen. He moved it up to the piece of paper and leaning forward, put pen to paper. Underneath the doctor’s name he wrote eight letters in shaky uneven handwriting: “Good Luck.”
***
    A crack to the head brought Richard back to reality. The bus had stopped suddenly in traffic, sending him into the back of the seat in front of him. The graduate student pulled out a book from under his seat and began reading. He wouldn’t try to sleep again.
    As Richard exited the bus, he first noticed the beautiful garden and fountain in front of the hospital. From what he had read, it was the number one hospital to go to for surgeries. As he walked in, he was greeted by the antiseptic smell that is prevalent in hospitals (“US Army Hospital”, NPR). There was a cheerful bustle about the place, with smiling faced nurses running around like ants in an anthill.
    The opportunity of a lifetime, his graduate professor had said. A psychiatrist’s dream. Here he was, heading to one of the most renowned hospitals in the country, to help treat military veterans.
    Richard checked his notes again. As he scanned the notes made by the hospital staff he saw cases of anxiety disorders, post-traumatic stress syndrome, and some physical injuries. Some of the people were from the Iraq War but most were veterans of Vietnam. He had about twelve patients in all in his ward but noticed that there were over seven hundred that still needed treatment (“US Army Hospital”, NPR). If he did well at treating some of these patients, he would pass his course and receive his degree.
Richard walked up to the front desk. The woman behind it was in a starched white uniform, typing into a computer.
    “Hi, I’m…Doctor Stevens. I’m here for Ward H.”
    The woman continued typing into the computer as if she had not heard him. The silence went on for so long that Richard almost asked again.
    Suddenly the nurse looked up and spoke to him. “Follow the signs for psychological wards. H will be down the hallway on your right.” And the woman went back to typing.
    As Richard followed the signs, he walked farther and farther into the bowels of the hospital. Finally he came to the psychological ward hallway.
    It was as if he had walked into a different hospital. The lighting was dim; the paint on the walls was chipping and peeling, and an old moldy smell drifted over the area (“US Army Hospital”, NPR).  It was as if he had just discovered the hospital’s best kept secret: a run down chamber where they kept the rejects of society.
    As he began to walk down the hallway, he heard something scurry on one side of the wall and saw a pink tail slither into a hole in the plaster. Rats! There were rats in a hospital (“US Army Hospital”, NPR).  Richard gaped in horror. What had he gotten himself into?
    He walked tentatively down the long narrow hallway until he reached a wooden door with “Ward H” printed on it, in peeling lettering. Stevens stopped for a moment and examined himself from head to toe. He adjusted his tie and jacket, and ran his hand through his hair. Now he was ready. His hand found the doorknob and the door creaked open.
    The room was not what he had imagined. The walls, which were once bleached white, were now a sickly tinge of yellow and peeling. The dusty carpet on the floor was stained in
many places and many of the mattresses were falling apart (“Walter Reed”). There was a small office to his right, with a desk and chair. The room was completely barren and smelled of sickness.
     Richard’s briefcase dropped from his hand. What was this? This was unthinkable, unimaginable. It is too much for him to take in. In the twenty first century, at the height of modern medicine, how could a place like this exist?
    “Dr. Stevens, I presume?” A raspy voice came from the corner of the room. Stevens turned his head to find a man in a wheelchair sitting there. He was old, with thinning white hair and a hunched back. He wore a red sweater and dirty jeans, but was so skinny he looked like a skeleton. His left leg had been cut off at the knee, with a filthy bandage wrapped around it.
    “Yes, that’s me,” the grad student answered after getting over the shock of meeting his first patient. He was still preoccupied with the state of the ward.
    “This is Building 18,” the old man answered as he wheeled himself towards Stevens. “Or hell as it’s more commonly known (“Walter Reed”).” The old man rasped in what Richard thought must have been laughter. It was only when the patient met his eyes did Stevens know there was something wrong with him.
    The patient’s eyes were grey. But they were not the piercing grey of Richard’s girlfriend back home. Instead they were milky in color, sometimes hard to tell where the iris ended and the cornea began. They were dilated and unfocused. Even when the man looked directly at Stevens, it appeared he was looking to the side.
Richard quickly turned away, to avoid the patient’s gaze. “Where is everyone? I’m supposed to have twelve patients.”
    The patient laughed again. “It’s been three full weeks since we’ve seen a nurse or a doctor or anyone. Most of the people live in hotels not far from here. We’ve been in this ward                                            
for a couple of months now. I can’t afford a place to stay, so I stay here. It’s quieter, more peaceful…”
    “Wait, I’m sorry, you’ve been here for months?” Stevens replied shocked.
    “Several, yes. Many of us have been discharged from the hospital but now we’re stuck here until they decide what to do with us. We’ve all got mental conditions of one sort or another. The staff just gives us a bottle full of medicine and instructions and leaves. Sometimes we don’t see them for days, other times weeks. Many of the patients who were here for the first few weeks took off. Nobody knows where they went. (“Walter Reed”)” He chuckled to himself again as if he found this all very amusing.
    “I need to sit down.” Richard walked over to the desk and sat on the chair placing his briefcase beside him. As soon as he sat, a cloud of dust puffed up from the desk chair. He placed his head in his hands, massaging his temples. This entire thing was wrong. This was not how he had planned it at all. His entire strategy, his confidence, had been shot. Maybe he should just go home.
    He glanced up to see the patient staring off into space outside the office. Stevens sighed. He couldn’t leave now, not while there was a person who needed his help. He glanced down his list of patients and found the file on the old man. “Mr. Stilton, could you come in here for a moment, please?”
***
    Justin Gann looked out the window. The sun was shining, and it could just be made out through the blinds, which covered the windows of his apartment. The place was a mess. Fast food wrappers lay everywhere, the smell of an unwashed body lingered, and all sense of order seemed to have fled the apartment.
    Gann was a man of about twenty-five, dressed in a dirty undershirt and torn jeans. His face was unshaven and his hair greasy and unwashed. The apartment was sweltering but the ceiling fan had not moved.
    Gann had been sitting on the couch staring at walls for hours. Finally, when he couldn’t take it anymore, he got up. He thought he might head back to bed. Carefully, taking slow deliberate steps, he moved towards the bedroom.
    A piece of paper had fallen off his cluttered desk. He tenderly bent down to pick it up.
Immediately, he wished he hadn’t. His heart began to race and his breathing became more rapid. His body felt hot all over and butterflies began in his stomach. He dropped the paper and stumbled to the bed. The two words on the paper were still ingrained into his memory: “Dishonorable Discharge.”
Suddenly, he was back in Iraq. Explosions were everywhere; there was the metallic taste of blood in the air. Sirens sounded, screams could be heard from miles around. Everything was a blur. It was only him, fighting against an unseen enemy.
    Slowly, the Iraq image dissolved, but now he felt those same feelings of constriction, confusion, and impending doom in his own apartment. His stomach was in knots; he had lost all control over his body. His mind was racing, with horrible thoughts running through his
head: You’re going to die. You’ll never make it through this. You’re too weak, just like you were in Iraq. No one can help you.
    Gann reached for his medication bottle by his bed. His shaking hands managed to unscrew the lid, but it was empty. He had forgotten to refill it. The battle sounds were around
him now in his apartment. He knew the end was drawing near. He couldn’t take it, this feeling of sheer panic.
    Quickly he ran to the kitchen. He shuffled through drawers until he found what he was looking for: a bread knife. He hesitated for a minute and then began to slit his wrists. He had to escape the sheer horror. Slowly, a warm liquid began to drift down his arms. A tingling began in his body and then numbness. Suddenly, he was on the floor. His eyes closed, and he was at peace.
***
    There was something intimidating about Stilton. He could have been Richard’s grandfather, yet he had a hardness to him, like he had seen too much of life. Maybe it was the missing limb from his right leg. Maybe it was the eyes that never seemed to focus on you.
    “Alright, Mr. Stilton, you have been diagnosed by a previous doctor as having PTSD or Post Traumatic Stress Syndrome due to your time in Vietnam.” Richard paused for a moment. When no answer came from Stilton he tried to lead the conversation onwards. “Is that true?”
    “Yup.”
    Richard let out an audible sigh. This day had been frustrating in so many ways. He did not need a difficult patient to top it all off. “Okay Mr. Stilton. I’m going to lay it all out for you. I know that there’s no reason for you to feel comfortable talking to a kid who you’ve never seen before. But, please. I’m here to help. I’m not going to be like your other doctors. I’m going to be here for you. Frankly, I find the conditions you’re living in deplorable. I just want to help you, that’s all I’m here for. And, I understand with the neglect you’ve faced in the past, that you would not want to talk, but please…”
    The old man just continued to stare at him. He didn’t even make any reaction to let Richard know that what he’d said had registered. Richard put his head in his hands and closed his eyes.
Suddenly, the old man spoke. “It was a normal mission. We were out on a raid of a suspected training facility for Vietnamese soldiers. We didn’t realize it was a trap. There were landmines set up everywhere. My best friend was next to me one second, and in pieces the next. It was as if all the soldiers in my group were randomly exploding. Blood and limbs were flying everywhere.” His voice was haunting. It was dull drone, as if the powerful things he was saying had no meaning to him, did not affect him anymore. “People were alive one minute, then a flash of light, and explosion, and they were blown apart. Then the next thing I knew, it was me. I heard and felt something, excruciating pain, and then I woke up in a hospital.”
    He paused for a moment, as if recollecting, and then began again. “It’s as if I can’t forget it; I can’t stop myself from remembering. I see the dark night, feel the warm air, and see the explosions, the bodies being blown apart over and over again. I just can’t switch it off.”
    Richard sat there, waiting for him to continue. The old man seemed to have trouble finding his voice for a moment, and it faltered on the first syllable. But he quickly regained composure. “After he war I began drinking. I still do sometimes when things get bad. But ever since that moment, I’ve never felt like I’ve come back to the real world. I’m not affected emotionally anymore. I’m scared to sleep because I know I’ll have a flashback. I feel like I did when I was in Vietnam permanently. My sense of fear is always there, my hearing is elevated, and I feel like I’m still there. I just want to come back…”
    When it was clear Stilton was not going to say anymore, Richard cut in. “Mr. Stilton, I understand that this has been horrible for you. It might help, I think, for you to understand why this is happening to you. PTSD causes a biological change in the brain. All animals have what’s called a flight or fight instinct. When something life threatening happens, you go into this heightened sense of awareness and anxiety. However, for people with PTSD, this state stays with you even after the danger has passed. Hormones inside your body continue to increase stress if not treated properly.” Richard paused to let this sink in.
    “60% of men experience a traumatic event in their lifetime and 8% of them develop PTSD. It’s much higher for women who are victims of rape. People can develop PTSD from numerous events. People with heart attacks or cancer can develop it, as well as soldiers such as you. In fact, more than half of Vietnam veterans have PTSD. In total, 60% of war veterans have serious medical conditions and only 6% of them are physical” (“Post Traumatic Stress Disorder, Haines).
    “Looks like you did your homework,” Stilton commented wryly.
    Richard smiled and glanced at his chart. His smile quickly turned into a look of confusion when he saw what the patient’s medication was. “I’m sorry, Mr. Stilton, could I see the medication you’re on.”
    “Sure.” Stilton took a bottle out of his pocket and slowly, with shaking hands, handed it to the doctor. “Take three of these everyday.”
    It was the right type of medication: Zoloft, which was commonly used to treat PTSD. However, the amount that the patient was taking was astronomical. “Mr. Stilton, I’m afraid you’re being overmedicated, right now. We’re going to slowly, over the next couple of weeks, tail you back to one of these a day. We can’t do it immediately because that can be dangerous with this type of medication. We’ll add some cognitive behavior therapy, which is me teaching you how to control your flashbacks. However, part of the therapy will be to relive the events in Vietnam. Do you think you’re ready for this?” (“Post Traumatic Stress”)
    Stilton gave a raw smile. “Whatever you say, Doc.”
***
    Gann slowly opened his eyes to find he was back in a hospital. Immediately he shut his eyes and grunted in frustration. How many times was he going to find himself back in this place?
    The door opened and a young man walked in with a clipboard. Gann gauged him at barely out of college; however, the suit he was wearing masked his age.
    “Justin Gann?” The young man asked. Gann nodded in response, hesitant to say anything until he knew who this guy was.
    “I was on call for the psychological ward at Walter Reed when you had your…accident.”
    “It wasn’t an accident.”
    “I know.” The doctor looked at him for a moment. “Why did you do it?”
    “I just freaked you know?” Gann looked around him. “So I’m back in hell again, huh?”
    The young doctor ignored the obvious slur to the hospital. “My name is Dr. Stevens, I’m here to help you. It says in your file that you were in Iraq?”
    Immediately Gann went stiff and spoke carefully. “For a year, yes.”
    “Dishonorable discharge, I see. What did you do?”
    Immediately Gann began to feel the fluttering in his stomach. His heart started to race. He took a few deep breaths to calm down before he spoke. “Nothing. I had some…mental issues. Everything started to set me off, I couldn’t take it anymore.”
    “What do you mean set you off?” The young doctor questioned.
    “I would just lose control, you know? Everything sped up. I couldn’t think straight. It felt like dying but worse. I felt incredibly scared all the time.” He shook his head. “You know, before this war, the president said he had things set up to help soldiers with mental health problems? Bullshit. Officers punish you out there, they consider it a weakness” (“Soldiers say army”, NPR).
    “So you had another episode and that’s why you tried to kill yourself?”
    “Ya, but they just keep getting worse, you know? The meds don’t help…” He wiped away a tear. Stevens pretended he hadn’t seen.
    “Well, I’m here to help you. As soon as you’re better, we’re going to start some therapy sessions and get you on the proper medication. Sound good?”
    But before Gann could answer, a man in military garb walked into the room. “Justin Gann?” He asked in an authoritative voice.
    “Yes?”
    “I’m here to perform a physical inspection on you to see whether you are fit to return to active duty.”
    Both Gann and Stevens looked at him shock. “Who gives you the authority to do this?” Stevens finally asked.
    “It’s within the military’s jurisdiction to redeploy soldiers if they have not served their full term and are deemed physically fit.”
    “But you gave him a dishonorable discharge.”
    “Does not matter.” (“US Army Hospital”, NPR).
    Immediately Gann began to lose control. A cold sweat came over him, his heart began to race, and his breath came in short shallow gasps. He barely heard the doctor and the general arguing through the pounding in his ears. He couldn’t think. He was going to die.
***
    The resignation appeared on the nurse’s desk the next morning. It claimed “Walter Reed provides one of the worst possible systems of care to former veterans in the mental ward.” But to her, it was just another resignation.
    She put it on top of another form she had to file claiming one Justin Gann fit for active service and redeployment.
    She picked up the phone. It was time to call for another doctor.

Bibliography:
Bethune, Brian. “The Meaning of Crazy.” 2 June 2006. 16 Dec 2007.
ca/science/technology/article.jsp?content=20060605_128182_128182>.

“Ecstasy, the Peace Drug?” Tell Me More. National Public Radio. WRVO. 26 Nov 2007.

Haines, Cynthia D. “Post Traumatic Stress Disorder (PTSD).” WebMD. The Cleveland Clinic. 15 Dec 2007. .

“US Army Hospital Reported to be in Poor Shape.” All Things Considered. National Public Radio. 19 Feb 2007.

Zwerdling, Daniel. “Soldiers Say Army Ignores, Punishes Mental Anguish.” National Public Radio. 15 Dec 2007. .