Be sure to read the sidebar to this story, Breaking It Down: The Hard Stuff.
Jesse Tinsley/The Spokesman-Review
Former VA social worker and Vietnam vet Carroll McInroe believes that the numbers of sufferers of terrible maladies like PTSD and traumatic brain injury have been overstated, and that the extent of the back-pain epidemic has been swept under the rug.
Daniel Kramer
Iraq vet Anthony Gonzales was diligent in documenting his back injury on the way out of the service and has been able to draw disability pay. He says that the medical treatment he got in the VA was frustrating and ineffective.
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After two tours of duty in Iraq, Matthew Gonzales says he has the body of a 45-year-old. Trouble is, he's 30.
Before the war, the South Houston High School product was an avid athlete — a runner and a kayaker, a barrel-chested hard-charger whose Facebook picture shows him riding a racing motorcycle. After two years in the broiling Iraqi scrub with the Army's First Cavalry Division, those prewar-style frolics are over for him now, barring medical treatments he can't afford.
Gonzales wasn't wounded. He doesn't suffer from PTSD or a traumatic brain injury. Instead, he says, his back is ruined and his knees are shot. "I can't run no more. I stay in back pain every day," he says. "Basically, it comes from just jumping out of trucks with all that gear on."
Gonzales once weighed himself with and without gear. Unladen, he clocked in at 185 pounds. Loaded up for battle with an 80-pound pack and 40 pounds of body armor, he tipped the scales at close to 300 pounds. And he was loaded up day after day, week after week, month after month.
Today, his legs regularly go numb from sciatica. He can't stand on his tiptoes or the balls of his feet. He can't bend over, and he has to lie down to put on pants. When sitting, he has to have one of his legs pointed out in front of him.
Matthew Gonzales is far from alone. Social worker Carroll McInroe saw hundreds of guys like him in his five years as the Iraq/Afghanistan coordinator in the Spokane, Washington, office of the Department of Veterans Affairs. A Vietnam vet who served in Army Intelligence, McInroe helped returning Operation Enduring Freedom and Operation Iraqi Freedom veterans re-acclimate to civilian life. He saw scores of kids with PTSD, and some with severe traumatic brain injuries.
As terrible as those cases were, McInroe believed then and believes now that neither is the most common debilitating ailment veterans of those conflicts face.
"I interviewed five to eight kids a day, totaling about a thousand," he says. "Particularly among the young infantryman and Marines, I would notice them groaning and moaning and grabbing their backs when they would sit down. Some of 'em, a small percentage, would come in just literally dragging their leg. Scraping on the floor."
McInroe, a retiree whose years in the rainy Pacific Northwest have done nothing to erode his steely Texas ranch country accent, says the guys would never mention their aching backs. He would have to draw that out of them himself.
"They would just sit down and go on and talk about their combat — I was assessing them for PTSD and traumatic brain injury and all that sort of thing," he says. "Since I always wanted to know everything about my kids — my vets — by the second week I started asking them, 'What's the matter with your back? How come you guys are always having trouble sitting down?' And that's when they started opening up.'
"Oh Jeez, my fuckin' back is killin' me," he heard, all too often.
McInroe started to ask each and every vet who came through his office if they were suffering back pain. Just about all of them had pain, he says. "I would say 70 percent of them. And not just a little. I'm talking chronic stuff here — misaligned vertebrae, bulging discs, herniated discs, the whole list of back problems." At national conventions, he would share his informal findings with his counterparts at other VA facilities. They told him much the same situation prevailed in their offices. He called around to military hospitals and asked the nurses what their most common complaint might be. Back pain, he was always told.
He saw nothing like that among his cohorts in Vietnam. Since grunts have humped heavy packs since Napoleon's day with no resulting epidemic of back woes, McInroe believes that modern body armor is to blame. "It's too heavy. You can't just put 120 pounds on a 19, 20-year-old musculoskeletal system, 14 hours a day, 365 days a year and not create some real serious problems."
And in his view, this is a real serious problem indeed. If McInroe's estimate — that 70 percent of returning veterans have moderate to severe back problems — holds true across the nation, the costs to America's taxpayers will be enormous, and the bill will do nothing but grow and grow over the next 50 years.
"Typically, when your back is injured it's injured for life," McInroe says. These things just get worse, he says, and adds that veterans who were 50 percent disabled in 2008 will be 70 percent disabled in a couple of years. The peak years for World War II disability payments were in the 1980s, 40 years after Hiroshima and Nagasaki.
And then there are the other costs, namely, addictions to powerful, narcotic pain pills such as OxyContin, Percocet and Vicodin. According to VA statistics, narcotic addictions are the fastest-growing substance-abuse issue today's military is facing.
McInroe says the VA's doctors are enormously overworked, and that they routinely put in 12-hour days, even if they are only paid for eight. "The quickest way for them to see the most patients is to just write scripts. "Not all of them, but a lot of doctors are guilty of over-medicating," he says. "We didn't realize this at the time, but within a few weeks these guys were becoming addicts, and the doctors just kept givin' 'em pills. There was nothing else to do — no pain clinics." (See "The Hard Stuff.")