The men and women we honor on Memorial Day weekend are not all lost on the battlefield.
Veterans who survive combat too often have been denied care for their damaged bodies and minds. In every war, including the American Revolution, caring for wounded veterans has been a cost this nation's leaders have been reluctant to pay.
That is the story told in a new book by Lexington authors Robert J. Topmiller and T. Kerby Neill, Binding Their Wounds, America's Assault on Its Veterans (Paradigm Publishers, $22.95).
Topmiller served as a Navy hospital corpsman with the Marines at Khe Sanh, one of the longest and bloodiest battles of the Vietnam War. He wrote about his horrific experience in a previous book, Red Clay on My Boots. Topmiller earned a doctorate in history from the University of Kentucky and taught at Eastern Kentucky University.
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Binding Their Wounds grew out of Topmiller's combat experience; his study of the Vietnam War and veterans' issues; his many trips to Vietnam to help orphans with birth defects likely caused by Agent Orange, the defoliant used by the U.S. military; and his outspoken opposition to the war in Iraq.
But friends think this was a book too painful for Topmiller to finish. In August 2008, he left home with the manuscript, checked into a motel and killed himself. Neill asked Topmiller's widow and publisher for permission to finish the book.
"I had lunch with Bob about 10 days before he died, and he was talking about the book," Neill said. "I'm a clinical psychologist, and I had no inkling at our lunch that he was in the kind of distress he was in."
Neill and Topmiller, who was 59 when he died, became friends through their work as peace activists and a shared passion for veterans' issues. Neill, a Navy veteran and retired psychologist, had worked several years in the Veterans Administration.
Neill finished this book with help from many people, including Peter Berres, a Vietnam veteran and scholar who wrote a chapter about Agent Orange. George Herring, a University of Kentucky historian and leading expert on the Vietnam War, wrote the forward.
After telling Topmiller's compelling story, this well-written book chronicles the history of broken promises to and mistreatment of America's veterans. In every war, veterans have had to lobby, protest and even fight to get promised compensation and care from politicians who wanted to save money or "move on." Minority and female veterans fared even worse than white men.
The book explores the government's attempts to deny care to veterans exposed to radiation, Agent Orange and other chemical hazards. And it details how the Bush administration was unprepared to care for so many injured soldiers in the early years of the wars in Afghanistan and Iraq.
Today's combat veterans return home with physical wounds that would have killed previous generations on the battlefield. But perhaps the biggest challenges now, as always, are the unseen wounds.
This psychological damage has gone by different names throughout history: "soldier's heart" in the Civil War, "shell shock" in World War I, "battle fatigue" in World War II and Korea. Now referred to as "post-traumatic stress," these injuries have been a huge problem for Vietnam veterans and those returning from Iraq and Afghanistan.
The Senate Veterans Affairs Committee last week grilled VA officials about rampant suicide, which has surpassed combat as the leading cause of death among active military personnel. Veterans now account for about 20 percent of the nation's 30,000 suicides each year.
Neill said significant progress has been made in care for veterans in recent years, from electronic medical records and post-traumatic stress treatment to training and pay for family caregivers. But he said more must be done, despite projections that veterans' care will push the cost of the wars in Iraq and Afghanistan past $3 trillion.
Toward the end of his life, Topmiller seemed more distressed by what was then happening in Iraq than what had happened in Vietnam. "He had hoped we had learned the lesson of wars of choice," Neill said.
As with any medical issue, the cheapest and most effective treatment is prevention.
That is why Neill focused the book's last chapter on how to prevent future wars.
War has become too easy, Neill said. Powerful economic interests encourage military adventurism, and an all-volunteer military distances most affluent Americans from the tragic consequences.
"The size of our military and what we invest in it is perhaps one of the reasons we use it so carelessly," he said.