The Things They Carried by Tim O’Brien is a novel in which he depicts the effects of war on soldiers and the impact it has on their lives following their service in Vietnam. The story is told from the perspective of a post-traumatic stress disorder, or PTSD, war veteran and his first-hand experiences during the Vietnam War. O’Brien uses his fellow brothers-in-arms’ experiences to show how war affects others both mentally and physically. Before the war, there was not much light being shined upon PTSD and no one knew a whole lot about it. The Vietnam War cause many cases of PTSD and suddenly it was a huge problem that needed to be addressed. PTSD is being treated like the elephant in the room and O’Brien uses his own and his brother’s experiences to show how bad PTSD actually takes a toll on a person both mentally and physically.

In 490 B.C., there was a fight that is now called The Battle of Marathon. Herodotus described an Athenian warrior as going blind when the soldier next to him was killed. The Athenian warrior was not harmed himself, but the psychological toll on his brain was too much, causing him to go blind. According to the article I chose, this may be the earliest recollection of PTSD, or posttraumatic stress disorder. PTSD is the development of characteristic and persistent symptoms along with difficult functioning after exposure to a life-threatening experience or to an event that either involves a threat to life or serious injury. According to a study by the RAND Center for Military Health Policy Research, less than half of returning veterans that need help for PTSD get any at all, and less that one-third receive evidence-based care. There are many different ways someone with PTSD can be helped and cognitive behavioral therapy (CBT) proves to have the highest success rate for reducing symptoms and has shown to be the most effective nonpharmacological treatment path. Other ways to pharmacologically treat posttraumatic stress disorder include: antidepressants, gamma-aminobutyric acid, anticonvulsants, and a controversial form of treatment, cannabis. The article also lists ways to combine pharmacotherapy and psychotherapy and show that in some cases the combination of the two treatments work. According to the article, veterans now account for 20% of all suicides in the US. There are an estimated eighteen to twenty-two casualties caused by suicide due to PTSD in veterans. According to a study done by JAMA Psychiatry, the likelihood of suicide increases once a person leaves active military service, and that risk is further increased in veterans whose service time was less than four years. There is a huge debate on the correlation to PTSD and suicide. Others try to indicate that the higher risk of suicide is due to comorbid psychiatric conditions and not a direct link to PTSD.

The world is still in the dark when it comes to the issue of PTSD. The technology and healthcare to diagnose and treat PTSD is nowhere close to where it needs to be. From 2010 to 2012 there was a study being conducted to “examine the joint association of PTSD and combat exposure with health functioning and disability. This particular study was being conducted on twins and was focused on the long-term health on Vietnam-era veteran twins. The researchers sent subjects a general health questionnaire and the subjects were to mail it back. Upon further review, the patients were then invited to participate in another mail survey and a psychiatric telephone interview. Upon completion of the entire process, the twins were compensated $75. “Because of the size and scope of the study, all mail and telephone fieldwork was done under contract by Abt SRBI, Inc., a large survey research organization. Training for the telephone psychiatric interview was done by VA staff who were certified trainers, and the administration of the interviews was continuously monitored throughout the course of fieldwork” (Goldberg).

The study was not as large as the researchers had hoped. Out of the 10,539 twins who were alive and able to participate, 7,079, or 67%, returned the mailed survey, and 5,862 completed the psychiatric telephone interview. The data that was published for anyone to see only consisted of the 5,574 twins who completed both the mailed survey and the telephone interview. The largest category for people with PTSD were the white soldiers who were under the age of 60. Of all the branches of the military, the Army had the highest percentage of post-Vietnam PTSD with it being 61.6 %. Of everyone who had PTSD, 99.1% of positive PTSD patients were ranked at Enlisted. Only .9% of PTSD patients were officers. 

Although this study was conducted under a close eye, there were a number of limitations. The study is based on twin-pairs, who may be completely different than non-multiples; although a study conducted by Scandinavia shows that there are few health differences between adult twins and non-multiples. Another setback was the lack of record keeping in the early stages of the Vietnam war. There were about 4-5 million discharge records available in electronic format that could be used to identify twins from a total of 9 million Vietnam-war veterans. Another limitation were the actual results from the Vietnam-vets themselves. The researchers had to account for the number of vets who may have limited their answers when it came to their disability. The vets did not want their answers to affect their payments or service use from the Veteran Affairs, or VA. This could especially affect the vets with PTSD even though the participants were given explicit instructions that the responses would be used for research only and not for clinical care, which is what they were afraid of. 

Many, if not most, of the stories Tim O’Brien used in his novel consisted of his brothers-in-arms suffering from symptoms of PTSD. In “Speaking of Courage”, Norman Bowker had trouble adjusting back to his small, normal life. Lots of vets who came back from the war are so adjusted to war-like scenarios, that a normal life is not suitable for him or her. Bowker, who feels immense over the death of his comrade, Kiowa, struggles to find a way to cope with the emotional and physical trauma he endured during the duration of his tour in the Vietnam. Bowker also felt as though he was alone. He could not talk to his father, who was always busy. The only time he felt as though someone was there with him was when he finally wrote the letter O’Brien. Tim O’Brien states in one of his chapters that he made parts of the novel fictional to make it more real. By reading The Things They Carried, one could assume O’Brien himself was suffering from a mild form of PTSD as well as the characters depicted in the novel. Showing guilt in some of his chapters, O’Brien looks back at his time in Vietnam and tries to cope with everything he experienced. 

Tim O’Brien states that he uses writing as a way to deal with some of the trauma he faced as well. This was a great way to share his experiences with his readers as well as put his thoughts down to deal with them himself. Many veterans cannot find a way to deal with what they experience during war. Tim O’Brien found his own, unique way and shared it with the world.. Research for PTSD has drastically improved since the Vietnam-era. PTSD is finally being treated like the cancer that it is, and war vets now and the war vets to come need help and the support they are finally getting after years of being ignored and thrown away. 
