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The Baltimore Sun7. BREAKING POINTAs fighting in AfghanistanIn intensifies, Marines battle as ever-present enemy:combat stressDate: Sunday, May 25, 2008Section: IdeasEdition: FinalPage: 15ADateline: GARMSIR, AfghanistanInSource: Sun reporterByline: David WoodIllustration: Photo(s)Graph Source: 1. & 2. David Guttenfeler : Associated Press3. - 5. David Wood : Sun photographerCaption: 1. Marines from the 24th Marine Expeditionary Unit return fire on Talibanpositions near the town of Garmsir in Afghanistan earlier this month.2. Marines of the 24th Marine Expeditionary Unit take refuge from a sandstorm inAfghanistan's Helmand province.3. Lance Cpl. Bandon Vallee, 19, from Worcester, Mass., checks the unit'sweaponry.4. & 5. Gunner Robert Tagliabue (left) can't tolerate thunderstorms, and Sgt.Thomas Pizzillo once had a disturbing encounter in the dark. GARMSIR, AfghanistanIn -- In the dying sunlight, the day's heat radiates from afarm compound's baked adobe walls, which enclose Marines slumped wearily againsttheir rucksacks.Here in southern Afghanistan, where the men of the 24th Marine ExpeditionaryUnit are battling Taliban insurgents, life comes in a simple equation: There aremen out there who will kill you, unless you kill them first.Out here, you've got to figure out how to handle the stress of thatexhilarating and awful equation.Bust it or park it, use guesswork or patchwork or whatever works. Suck up theheat, the dust, the physical exhaustion, the fear, the loss. Help is a long wayaway.For all the attention the U.S. military has recently given to mental health,it's clear that at the source of the tension borne by Americans in combat, theyare pretty much on their own. That burden consumes strong men."I can't do this anymore," said a weary Gunnery Sgt. Rosendo DeLeon, 40."After this deployment I am done."In these hours before nightfall, when the hunt will begin anew, there isprecious respite. Chins rest on flak vests, weapons across knees. Sodden, grittyuniforms bind and chafe - even where the Marines have stretched duct tape acrosstheir ribs for protection.Momentarily safe from all but a chance mortar round, there is only the easingof aching muscles, cool water in parched throats, a blessed movement of air acrossbare scalps.Or maybe it all comes back unbidden, in that terrible rushing dread. Tonightcould be it - the sudden, searing injury, the torn limb, the awful bleeding out,
 
the sickening smell of blood. You could die here. Worse, your closest buddy could.Some close their eyes and project themselves back home. Some simply let thestress buzz alongside. Some pop a pill. Some joke about it, belittle it.Basically, stuff it down out of sight, hope it won't come back in all its darkand evil power."Let's go, we're pushing out!" With DeLeon's cry, Marines heave themselves totheir feet, throw on rucksacks, clamp on helmets and stride into the dusk.Deal with it later. For now, focus on the mission."Stoicism is necessary for their survival," says Dr. William Nash, apsychiatrist who until this month directed the Marine Corps' combat stressprograms. But shoving stress down out of the way lasts only so long."Everybody," said Nash, "has a breaking point."Hey - remember Molly and the leg? In Ramadi last year, a suicide bomber in acar came at us, and our guys at the checkpoint got him stopped but he detonatedthe bomb anyway and blew himself all over the place. We had this Iraqi dog wecalled Molly?Staff Sgt. Julian Lumm is telling the story between bursts of laughter. He ishandsome in the classic Latin manner, tall and hefty with dark, liquid eyes. He is30 years old and is on his fifth combat deployment in five years, and he's gotCarlos Orjuela and DeLeon, the two company gunnery sergeants, remembering andsputtering and guffawing.So here comes Molly trotting back to where we are and she's got a piece ofthis guy's leg in her mouth, and we're going, "MOLLY! BAD DOG! PUT THAT DOWN!"Lumm collapses, helpless.Orjuela: And Molly's going, like, What'd I do? She's lookin' so proud, yaknow, like a cat bringing you a mouse, and she keeps comin' and we're going, "NONO, GO AWAY, GIT THAT THING OUTTA HERE!!"Oh, man. Lumm wipes a tear. That was hilarious, wasn't it?When the 24th MEU went into Afghanistan in March, it took 2,500 Marines, ahundred armored Humvees, jet fighters, about 4,000 assorted weapons - and apsychiatrist.Marine Maj. Ann Radford came to try to prevent Marines from being evacuatedfor combat stress. But when the Marines went into action, she stayed at herassigned place in camp."They are their own first line of defense," she said. In previous combattours, "they have learned stress management and reaction to trauma by doing it."Trouble often begins when they got home. At the Parris Island Marine base,where she works, Radford sees a lot of drinking and some spousal abuse. "That'swhen the work begins," she said. That work may require having a Marine reliveemotional trauma, a delicate process that's best done away from combat.But she is deployed to Afghanistan, she said, because the Department of
 
Defense "likes to have a psychiatrist out here." Given the political pressures athome to care for deployed troops, "it's a box to check off."Before a mission, DeLeon and other Marines are razzing one another about howthey'll behave if they get wounded."You'll be lyin' out there going, `Hey, I can't feel my legs!"' jokes Cpl.Elvin Hendrix, "and we'll go, `Gunny, you ain't got no legs!"'Acute stress among troops in Afghanistan is rising significantly, according toa new mental health study by the Army. The main reason: Combat here isintensifying. Three times as many soldiers reported being wounded in 2007 as in2005, and those troops who killed an enemy combatant rose in that period from 13percent to 21 percent, according to the Army surveys last October and November.As a result, the incidence of depression, anxiety and acute stress was"significantly higher" than in a previous Army survey in 2005. One of fivesoldiers now says that acute stress causes them to work less carefully.Most soldiers get stress management training. Two years ago, about half saidthe training was not helpful. In the new survey, two-thirds said the training isinadequate.Training encourages junior leaders to watch for stress and take steps assimple as telling a soldier or Marine to take a few hours off to catch up onsleep, sending him or her to the chaplain - or assigning extra chores to chaseaway boredom.In the hours before they launch a 4 a.m. attack, Marines sprawl restlessly oniron bunk beds. Idle chatter has died away.In the dark, whispers:Hey, man ... You OK? You scared?(In a shaky voice) Nah.Good, because you shouldn't be.The scary thing about combat stress, a lot of Marines say, is that continuedexposure doesn't get you used to it.It makes it worse."I hate the blood and gore part of this," says one of the Marines' most combatexperienced members. "I always throw up."This is Gunner Robert Tagliabue, a warrant officer who is the senior weaponsexpert for the 1st Battalion, 6th Marines, the 1,200-man infantry unit of the 24thMEU. He's been in and out of combat since the U.S. invasion of Panama in 1989.With the battalion, he returned from a combat tour in Iraq less than a year ago."I remember the first guy I killed, at near point-blank range. This was inDesert Storm [1991], and the guy came up suddenly, and I just reacted. I thoughtlater, Jeez, what have I done?"Tagliabue says he has mild post traumatic stress disorder: "I talk in mysleep, and [my reactions to] thunderstorms are a family joke."
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