Report From Iraq: Less Fighting Can Create Its Own Emotional Wounds

Almost a year ago, To Your Good Health, A Health Care Newsletter, carried an interview with Dr. Anthony Dingmann, a psychiatrist and Medical Director of the State Department of Mental Health for the Cape and Islands.

As a lieutenant colonel in the Massachusetts National Guard, he was preparing to leave for his second tour of active duty in Iraq. He spoke at length about the mental health issues faced by our returning service people.

Now he’s back with his family in Bourne after a four-month deployment, working mainly out of the DMH Pocasset facility and also seeing some private patients. We caught up with him recently and he reported some startling and infrequently reported changes in American troop involvement. Changes, he explains, that also have affected the soldiers’ state of mind.

For obvious reasons, Dr. Anthony Dingmann never gets involved in the political implications of what he’s discussing, the “Surge” pro and con, etc. But the cause and effect corollary is clear.

American casualties in Iraq appear to be down. Why? Draw your own conclusions, but here’s what Dr. Dingmann has to say about conditions now as compared to his previous deployment.

Our soldiers are doing less fighting.

“The stresses now are not combat itself, but the lack of combat, “Dr. Dingmann related. “There was less fighting in my area, less mortars (coming in) since 2006, a large safety perimeter. The soldiers only go out and come back. Much less fighting, but you don’t hear (much) about that at all.

“Oh, they still put on the uniform and they have to keep their mind on combat…but they don’t do it. And that’s often why past combat issues keep coming back with them,” he continued.

“Actually, there are more Iraqi wounded than American…police, army, civil defense, government people and some civilians caught in a cross-fire or in accidents. We seem to be in a time of transition there. Some areas are hot, some nothing.”

As a psychiatrist, who not only screened potential patients but also treated them on a regular office-hours schedule, Dr. Dingmann was not exactly in the front lines. But, he says, “I’m sure the combat hospitals were just as low-key as we were.”

He mentions three middle-aged doctors (two surgeons and a pulmonologist) who “joined the reserves just to be deployed so they could ‘give something back,’” and who found themselves in Iraq with virtually nothing to do.

“We’re in a time of transition,” he offered, “and there is some questioning as to ‘If things are not so hot, why do we need all these people?’”

When too much down time became an issue in the “Old Army,” troops traditionally were given make-work duties like policing the parade grounds, marching back and forth or digging holes and filling them up.

Not so in Iraq. All those jobs today are being done by American civilian contractors, even the cooking, Dr. Dingmann related, leaving trained Army cooks with little to do.

Ironically, general morale is not that bad, he pointed out. “There was more ‘What the hell are we doing here? The war stinks.’ earlier,” he said. “Now there is more understanding of why we’re there, very few pot-shots at the government. The attitude is ‘We’re here to do a job and the morale is there to do it and get it done.’”

The difference, he said, seems to be in the timing. When the war started, the services and reserves were full of young people who had joined up for the money or for the schooling opportunities and didn’t know what they were getting into, he said. They have been replaced by soldiers and Marines who enlisted after the war began knowing full well what they’d be facing.

Generally, the emotional problems faced by the troops remain unchanged. Multiple deployments, long periods away from home and, mostly, “What will I face when I get there?”

This uncertainty, Dr. Dingmann adds, is worst for the citizen soldiers. As for the regulars who may face adjustment problems, “While you’re in the military, you always know where to go (for help)” Dr. Dingmann concluded. “But for the reserves and National Guard, it’s a problem. When you get home, you’re all alone.”