By: Michael Althouse

For those of us who have not served in the military, it may be difficult to fully understand the experiences of combat.  There are extremely few circumstances in civilian life that mirror a solider in a combat zone.  When a civilian like myself is working with combat veterans, it is therefore useful to try to increase our understanding of the combat experience.  While it will be impossible to entirely comprehend what the veteran has gone through, a deeper understanding can help us better relate to the veteran’s struggles, their activities post-deployment, and possibly more easily recognize actions as symptomatic of PTSD and other combat-related disabilities.    One simple tool to gain this deeper understanding is to view films that accurately portray the combat experience.  The following is a short list of recommended viewing, with notes explaining their selection.


            This documentary follows a group of soldiers during 2007 in the Korangal Valley of Afghanistan.  The film intersperses the footage from Afghanistan with post-deployment interviews of the soldiers involved.  This technique allows the viewer to both see the events a soldier experienced in combat while simultaneously learning how that experience effected them physically and emotionally.  The film does not hold back any punches: some of the soldiers in the film die.  For those of us who have no reference point for military combat in our lives, the experience of watching this film can be and incredibly jarring introduction to the realities of combat life.

Now, After[1]

            Now, After is a short film made by SSG Kyle Hausmann-Stokes after he returned from Iraq.  The story is told from a returning soldier’s point of view, and graphically depicts how the effects of combat can interfere with daily civilian life.  This film is particularly useful for those seeking to better understand the often times confusing actions from sufferers of PTSD.  It may be surprising to see how routine moments in daily life can trigger flashbacks to a veteran’s time in service.


60 Minutes Presents: Honoring Our Troops[2]

            On May 24, 2012, the news program 60 Minutes dedicated an entire episode to stories from veterans of Afghanistan and Iraq.  The film contains some on-the-ground footage, but it is mostly told through interviews of the veterans recounting their experiences in combat and returning home.  The second segment of the episode in particular recounts the difficulties many combat veterans face returning to civilian life and coping with disabilities.


These films are a useful starting point for anyone wishing to better understand the experience of combat veterans.  While it will not give the viewer a complete understanding of the experience, the films will impart a sense of what combat veterans have faced, and how it has affected their lives.


[1] Viewable at

[2] Viewable at

Written by Paul Silver

In 2008 2-16 Infantry, part of the 1st Infantry Division stationed out of Fort Riley, Kansas deployed to Baghdad Iraq. For many of the Soldiers in the Battalion it was not their first trip to a combat zone. In fact, Finkle was with the unit and wrote the book The Good Soldiers about the combat operations undertaken by the men of 2-16. Thank You For Your Service, however, picks up with the after-war. It begins with Staff Sergeant Adam Schumman, who is waiting for a helicopter in Baghdad Iraq. Schumman is wounded. His evacuation from theater is deemed urgent. However, Schumman hasn’t been shot, no IED has detonated under his truck. By all accounts he is in good physical health. However, Schumman has given up on living. The stress of over 1,000 days of combat have finally caught up with him and now the Army has made the decision to send him home. Over the next 1,000 days Schumman and his wife Sascha will fight a new series of battles to finally bring Adam home.

From there Finkle takes the reader on an emotional tour de force examining the lives of Soldiers, widows and family members all of whom, like Schumman, are engaged in the battle that follows a return from combat. Through their struggles he paints the narrative of the approximately 500,000 veterans of the wars in Iraq and Afghanistan who have returned with either PTSD or TBI, the “hallmark wounds” of the War on Terrorism. Finkle gets inside of the Soldier’s marriages and mental health treatment. He documents their nightmares and insecurities. He juxtaposes all of these with the five words most often uttered by civilians who don’t know how to engage with veterans, “thank you for your service.” What follows then is a portrait of veterans issues more broadly as told by the veterans themselves. Finkle’s book gives urgency to Veteran’s issues and underscores the damage of combat. He does it not just through Schumman’s PTSD, but through other men in his unit and through their families. It is the story of the civil-military divide and the war that in many cases has already been forgotten and uneasily brushed aside with a brusque sentence, “thank you for your service.”

As a veteran myself, I read this book and was mesmerized by it, I found the author to truly understand the plight of returning Soldiers. He captured their grief and their alienation and makes it real for the reader. As a student in the Lewis B. Puller Jr. Clinic, I feel that this book needs to be read by incoming students. It is the sort of material that makes the issues students are about to engage with real. The emotionally wrenching anecdotes give clarity and focus the talking about issues such as PTSD, TBI and survivor’s guilt. The book does not shy away from the issues at any point. It shows the turmoil of Schumman’s perceived failure and weakness on his relationship with his family; an issue that is certainly germane to clinic intake interviews. Furthermore, the book does a fantastic job at underscoring that though a veteran’s wounds may not be visible, it does not mean that they do not exist and that they are not debilitating.


By: Allie Klein


In response to increasing public and congressional scrutiny, the VA spent this year addressing the hundreds of thousands of claims that have languished, undecided, for more than 125 days. As the federal government shutdown began, VA officials warned that it would have a catastrophic impact on claims processing. On October 1, 2013, VA Assistant Secretary of Public Affairs Tommy Sowers predicted that the VA’s massive backlog of disability compensation claims would grow as a result of the shutdown. VA Secretary Eric Shinseki echoed this pessimistic assessment in his October 9 testimony before the House Veterans Affairs Committee. He insisted that shutdown-related furloughing threatened to derail six months of progress against the claims backlog, and could potentially prevent the VA from achieving its goal of eliminating the backlog entirely by the end of 2015.


Now that the shutdown has ended, however, the VA’s claims processing statistics suggest that these fears were misplaced. Though the rate at which the VA processed claims slowed, the total number of backlogged claims continued to fall during the two-week shutdown. The 10,000 claim drop from 421,793 on September 28 to 411,704 on October 19 included 900 claims processed during the shutdown.


Reactions to these statistics in Washington split along party lines. Ranking committee member Rep. Mike Michaud, D-Maine, released a statement lauding the VA’s performance: “While the impact of the shutdown on the backlog doesn’t appear to be as severe as some had feared, at the very least, it’s comforting to know that the current strategy in place is enough to continue reductions, even without overtime.” In contrast, committee member Rep. Doug Lamborn, R-Colorado, seized on the incongruence between the predictions and reality. “This drop is stunning in light of the administration’s threats the backlog would increase as a result of a government shutdown,” said Lamborn.


Committee Chairman Rep. Jeff Miller, R-Florida, pointed his criticisms at the VA’s failure to meet its own internal goal for fiscal year 2013 of reducing the claims backlog by completing 1.27 million claims by September 30. The VA’s end-of-year records show that it fell 100,000 claims short of this benchmark, despite receiving 272,000 less new claims this year than originally forecast. “Instead of debating whether or not VA’s dire predictions regarding the shutdown’s impact came to fruition, I remain focused on a much more important question: Why is the department still falling short of its own backlog goals?” said Miller.


As part of the continuing resolution Congress passed to end the shutdown, the VA will receive an additional $300 million to aid its efforts to tackle the backlog. Only time will tell whether the additional influx of cash will be money well spent.

By: Harrison Baker

The Department of Veterans Affairs (VA) presumes that certain diseases and ailments are service connected if the affected veteran was exposed to Agent Orange. Agent Orange was used primarily in Vietnam for foliage clearing from 1962 to 1975.  Certain naval ships, parts of Korea, parts of Thailand, and certain aircraft, however, were also exposed to the harmful chemical.  The VA provides a list of diseases for which it will grant an automatic service connection to veterans exposed to Agent Orange.


A large part of this list consists of certain types of cancers. A diagnosis of cancer is almost always stressful and can often be confusing. Apart from the medical confusion, the cancers presumptively connected by the VA can also create misunderstandings. For example, a Vietnam veteran who has service connected diabetes related to Agent Orange exposure will not receive presumptive connection for liver cancer (hepatocellular carcinoma) or colon cancer (colorectal adenocarcinoma).


What we commonly refer to as “cancer” is often many different things. Carinomas are the most common form of cancer in the body. Carcinomas normally start in the body tissue. The common carcinomas include breast, colon, and lung cancer. Sarcomas are very rare and are made of different things than a carcinoma. The most common sarcoma is gastrointestinal stromal tumor (GIST).   Blastomas normally occur in children and occur in yet a different part of cells than carcinoma or sarcoma. An adenoma denotes that the issue resides in the tissues of a gland. Lymphoma is a cancer that originates in the lymph nodes, and Leukemia is cancer of the blood. A myeloma is specifically a cancer of the blood plasma.


Very confusing, right? The VA has presumptively connected Non-Hodgkin’s Lymphoma for Agent Orange exposure. This is basically a cancer of the lymphoid tissue, which creates white blood cells to fight infections. Hodgkin’s disease, which is a malignant lymphoma, is also presumptively connected. The VA also recognizes prostate cancer, which would commonly be an adenocarcinoma (gland). The VA recognizes respiratory cancers for a presumptive connection. These are carcinomas that effect the areas in the lung and are broken up into non-small cell and small cell carcinoma. The tissues around the lung also can produce adenocarcinoma, which is quite common, and are classified as non-small cell carcinoma. The VA recognizes all of these categories as they relate to the lungs.

Soft tissue sarcomas are relatively uncommon, but are recognized by the VA for presumptive connection. They mainly develop in connective tissue and can include things like fibrosarcoma. However, the VA lists certain types of soft tissue sarcoma that are not connected, such as mesothelioma.  The VA will presumptively connect Leukemia as well if it is chronic B-cell Leukemia. These also involve the lymph nodes and are divided into what are commonly referred to as PLL and HCL. Leukemia produces too many white blood cells and can effect the immune system. The last type of cancer that the VA recognizes for presumptive connection is multiple myeloma, which is a cancer of the blood plasma.


A cancer diagnosis can be very difficult, but it is important to know what types can get an Agent Orange exposed Veteran compensation. Many veterans who are diagnosed with skin, liver, and colon cancers are concerned about a presumptive connection. Unless the diagnoses meet the VA’s presumptive list, however, the automatic connection will not apply.