The most advantageous way to glimpse into the mind of a culture is to study its art. Artists express the triumphs and downfalls of their current society with every brush stroke or word printed. A controversial issue in our culture is veterans, specifically their reintegration into society and mental health care. Many modern veterans battle with Post-traumatic stress disorder (PTSD) and don’t obtain aquadate care. This subsequently causes them to be alone on the fringe of a society they no longer understand. Our best insight into this issue is through the medium of literature. It grants us access into the minds of those impacted and supplies a necessary commentary on society’s laissez-faire approach to tackling this issue. Society needs to become more aware of the impact PTSD has on the lives of those who served and more aggressive in the fight to combat it. 

Post-traumatic stress disorder is characterized as a disorder that develops in some people who have experienced a shocking, terrifying, or traumatic event (NIMH). It is commonly experienced in victims of sexual assault, war veterans, and those who experienced childhood trauma. Some symptoms are flashbacks or mentally reliving the event, staying away from people or places that remind the victim of the event, distorted guilt, and negative thoughts about oneself or the world (NIMH). The National Institute of Mental Health also lists living through dangerous events, seeing someone get hurt or die, feeling horror or helplessness, and having no social support as being increasing risk factors for the development of PTSD. All of these are common in the war experience, putting veterans at an increased risk. In fact cases severe enough to receive compensation have rose by 79.5% between 1999 and 2004 (Frueh). That is over 67% higher than any other mental or physical disability during that time (Frueh). These together show that modern veterans are being deployed in increasing traumatic situation subsequently causing increasing cases of PTSD, with no change to the VA’s currently flawed programs.         

The term PTSD is so synonymous with veterans in our culture, that the sketch comedy show Key and Peele, they even have a sketch about soldiers singing about how they're going to get shipped off to war and get PTSD. This trend in uniform throughout the industry, with other shows such as Saturday Night Live also writing skits centered around soldiers with PTSD. However, it’s the Key and Peele sketch that supplies the most beneficial insight into the culture's view of the issue. One of the last lines of the song is “the VA won’t care for me.” The VA of department of veteran affairs, is the government branch in charge of providing treatment to veterans. These sketches clearly portray that society knows that our current programs are flawed, but there is no real movement to change it. Authors such as Tim O’Brien and research into VA programs supplies with the necessary information to fully grasp why this issue is stagnant in society.  

The text The Things They Carried by Tim O’Brien, portrays the lives of a members of a fictional platoon in the Vietnam war. While this book may be based in the 60’s and 70’s, many of its themes still resonate today. One culturally relevant passage in The Things They Carried is “Notes”, which describes the main character’s struggle to reintegrate into the town and society he once knew. The main character of this passage is Norman Bowker, a member of the platoon followed throughout the book. This story however, is set on the fourth of July in 1975, sometime after he returned from Vietnam. The passage revolves around Norman aimlessly driving around the lake in his hometown, imagining three hypothetical conversations he will never have. Those conversations are with his father, his high school girlfriend Sally, and Max, his best friend who drowned in the same lake Norman is encircling. All three conversations share an identical centerpiece, Norman’s desire to talk about the night his friend died and to finally feel like the hero he wants society to perceive him as. He attempts to portray the story of his friend dying as a heroic war story, titling it the time he almost won a silver star. He repeatedly imagines describing the excruciating details of the mortar shells hitting the mud, the think overbearing stench, and most importantly his friend slowly slipping below the mud. He reiterates these details numerous times in each imagined conversation. The other key event of this passage is Norman’s encounters with the people he passes by. In every interaction he attempts to talk to them and in every interaction is perceived as invisible. 

Norman’s struggle in “Notes” stems from his perceived alienation from society. Alone he can’t reintegrate back into society and in this passage he has no one willing to guide him. The three people Norman fantasizes having conversations with represent guidance, innocence, and acceptance. His father portrays the guidance Norman is missing. Similar to his father, people don’t understand Norman’s pain and take a hands off approach. Sally incarnates innocence because both are lost when Norman goes to war and he desires for both of them to return. Finally Max is acceptance. Norman’s one connection to society dies just before he goes to war, leaving him alone and with no outlet for for his inner trauma. O'Brien deliberately uses the 4th of July, a day representing freedom, as irony to highlight Norman’s mental and emotional imprisonment by the events in Vietnam. That imprisonment branches from Norman’s inner guilt of his friend’s death. He believes he was a coward. In his hypothetical conversation with his dad, Norman thinks “He would’ve explained to his father that none of these decorations was for uncommon valor. They were for common valor. The routine, daily stuff- just humping, just enduring- but that was worth something right? (135)” He tries to justify to himself that what he did mattered and that he didn’t let his friend die. Subsequently this is the rationale behind his fixation on this event being the silver star he almost won. He yearns to be told he was courageous to help subdue his inner demons. 

O’Brien’s initial commentary on society’s treatment of veterans with PTSD comes through the eyes of the soldier. Norman believes he is invisible to everyone he attempts to talk to. In the next passage “Notes” O’Brien writes about his fictional selfs experience writing about Norman’s suicide. In a letter he receives from Norman before he dies, O’Brien writes “The thing is,’ he wrote, ‘there’s no place to go. Not justin this lousy little town. In general. My life, I mean. It’s almost like I got killed over in Nam… Hard to describe. (150)” Norman’s lack of direction stems from his inability to talk about his experience. However, this isn’t from a lack of trying. “Want to hear about the Silver Star I almost won?’ Norman Bowker whispered, but none of the workmen looked up. (138)” Throughout the these two passages, Norman has many encounters with many different people and he is unable to successfully communicate his struggles to all of them. O’Brien adds these two passages into the middle of his war novel to help show that is there is a second war for some veterans. For some this a war that is fought one there own, since there is nobody there to listen.       

O’Brien’s last bit of analysis swings the pendulum away from the soldier, instead focusing his lens on society. O’Brien’s incorporation of the multiple encounters Norman has is to show how little society cares. While driving Norman thinks “The town could not talk, and would not listen. ‘How’d you like to hear about the war?’ he might have asked, but the place could only blink and shrug. It had no memory, therefore no guilt. (137)” O’Brien packs two major concepts into those short quote. The first is a comment on society. He claims they don’t care about  veteran’s issues, that they are just a passing thought. O’Briens second concept is the rationale to this enduring problem. He says “It had no memory, therefore no guilt. (137)” What O’Brien is inferring is that they weren’t there, they don’t know. This is very valid explanation as it’s hard to relate to what you haven’t experienced. O’Brien’s message isn’t society is neglecting those that are struggling, it’s that they don’t know the extent of the agony. 

The common theme of veterans being unable to transition back into society after returning from war is synonymous through the multiple mediums it transcends. Another ending that is reminiscent to that of Norman’s story is the end of The Hurt Locker by Kathryn Bigelow. The film follows an EOD bomb disposal team during its tour in Iraq. As the film progresses it becomes increasingly focused on the man defusing the bombs, Staff Sergeant James. As the film progresses the audience begins to realize that his initial quirks are larger issues than are made worse with every mission. This comes to the forefront when James returns home and is unable to comprehend his new life. One of the most powerful stills in the entire film is when James is grocery shopping. It’s a low angle long shot of James standing in the middle of what appears as an endless row of cereal. The cereal towers over James portraying James’ feelings of being overwhelmed and lost. James is the only person in the shot, illustrating James’ loneliness and isolation. Bigelow incorporates this scene instead of ending the film with the squads touring ending to help bring awareness, to this incredible overlooked issue. She desires her audience to comprehend all of war, and that for some it’s not just a smooth transition home. However unlike O’Brien, Bigelow chooses to end her movie with James reenlisting and not committing suicide like Norman. 

The Hurt Locker and The Thing They Carried shared my common themes dealing with PTSD and soldiers transitions back into society. The grocery scene in Bigelow’s film directly parallels that of Norman’s drive around the lake. In both the veteran is consumed by feelings of loneliness as well as generally being overwhelmed by daily routines they can’t comprehend. Norman fantasizes conversations about his medals with his Dad to finally believe he is a hero, while James’ puts himself in serious danger to save a child who ultimately didn’t need saving, to feel the same high. James’ wife refusing to talk to him about the war echos similarities to Norman’s dad refusing to talk to him.  It’s the isolation and confusion that drives both to insanity, and eventually their breaking points. The only difference is their ending are slightly different. O’Brien chooses to blatantly say Norman hung himself, Bigelow embraces a more subtly outcome. By having James’ reenlist again, she is stating that James’ is going to do this till he dies, postponing his death for another day. She having James’ walk out into the Iraqi sunset defusing bomb, she attempts to wrap James’ in the outer view of heroism and applies this as a subtle comment about society. She presents the notion that society only sees the heroism, that it doesn’t look under the surface and recognize the pain and trauma from the horrors these soldiers have experienced. This is where she detours from O'Brien's thinking. Bigelows commentary is much harsher than O’Briens 19 year prior. Bigelow’s harshness provides insight to how America’s view on this issue has become increasingly naive. In the 90’s O’Brien was stating that the reason there was no change was due to lack of knowledge of the issue. His response to spread it. Bigelow presents modern culture as knowing but refusing to accept the severity of the issue, that it can’t be as bad as people say. This transition of authors’ helps highlight the issues behind the incomprehensible lack of change.

In 2007 researchers under the direction of Christopher Frueh conducted an investigation into trends with PTSD and the VA’s programs to combat it. In his research Frueh states “An accumulating body of empirical data suggests that current Department of Veterans Affairs (VA) psychiatric disability and rehabilitation policies for combat-related posttraumatic stress disorder (PTSD) are problematic. In combination, recent administrative trends and data from epidemiological and clinical studies suggest theses policies are countertherapeutic and hinder research efforts to advance our knowledge regarding PTSD. (Frueh)” Frueh and his team discovered two major reasons for this; lack of trust between doctors and patients, and disability payments. The lack of trust between doctors and patients stems from many veterans, roughly 53% of those seeking compensation, exaggerate symptoms. This subsequently causes doctors to provide less passionate, less effective care because of doubts they have over the patient's legitimacy. This root of the problem however is the compensation since it causes some veterans to exaggerate symptoms hoping to get paid. This causes doctors to become skeptical and patients who are legitimately ill to have to exaggerate their symptoms to receive care. This continuously repeats itself causing nothing but harm in the process. According to Frueh these payments also discourage full participation in the programs. His team looked at data from other demographics of PTSD compared to veterans and found while 67% of other demographics with PTSD no longer fell on the scale by post-treatment, there was almost no change in veterans (Frueh).  The VA also has no data on clinical improvement of veterans receiving care. This coincided with data showing that veterans receiving benefits were less likely to fully commit to the process subsequently causing their symptoms to worsen.  Frueh also found that the culture of veterans also contributed to the rise in PTSD cases. “We may be instilling counterproductive social expectations that war-zone deployment will make veterans psychiatrically disabled, potentially a self-fulfilling prophecy. (Frueh)” The thought veterans are guaranteed to come back disabled, leads to the stigma that change is no important. This feeling is what has lead to the outdated and inadequate care that is making veterans worse.

PTSD in veterans and the inability to reintegrate into society it's causing, is a growing issue in society. This issue however, is not getting to proper attention it deserves. Artists continue to portray a society that maintains its laissez-faire approach to solve this problem. Throughout the last 20+ years their films,novels, and painting depict identical problems with an increasingly harsher tone in the lack of movement to solve them. Research into the VA has determined that their programs are inadequate and actually counter-therapeutic. Research also shows that many of the VA’s disability payments actually cause decreased care by creating mistrust between doctors and patients. Overall, veterans are continuing to suffer with no end in sight.
