Three years after his third deployment to Iraq, Staff Sgt. James Simon was medically discharged from the Army because of lingering injuries from the battlefield.
"I was military retired because I had PTSD, traumatic brain injury and I got messed up over there," said Simon, who served with 4th Battalion, 64th Armor Regiment, 4th Infantry Brigade, 3rd Infantry Division at Fort Stewart, Ga.
Simon, 40, is among the 32,220 service members who left the battlefield with serious injuries in a war that cost 4,488 lives. Ten years after the war started in Iraq, post traumatic stress disorder is one of the top medical issues facing deployed soldiers along with traumatic brain injury and major loss of limbs.
A gunner operating a .50-caliber machine gun, Simon was with the 3rd Infantry Division training in Kuwait before the brigade joined Marines and other armed forces for the land march to Baghdad, which started 10 years ago this week.
"We got halfway there and they wanted us to set up outside the city," said Simon, whose parents live in Ellerslie, Ga. "They went in and we went in a couple of hours after that, after the heavy fire and rockets and all that."
In a support role, soldiers in Simon's unit picked up bodies and weapons and resupplied soldiers with ammunition. "There was still a lot of fire fights going through there," he said. "Most of everything was blown, damaged or killed. We had to maneuver between where we were going and where they were going. We weren't going the same way."
Much of Simon's first deployment was spent guarding checkpoints near Saddam Hussein's and his sons' palaces after the leader's soldiers fled north of Baghdad or faded into the city.
"A lot of soldiers, the Iraqi soldiers, didn't want to fight," Simon said. "The ones who didn't went into hiding and ran away. Saddam left his palace."
The city of Baghdad was a scene of destruction and death. "It was just all day, every day, you smelled nothing but dead bodies, buildings blown up," he said. "It was just mayhem. There was no organization until they cleared the city. Most of the time everything was just out of whack."
One of Simon's close calls occurred when four vehicles loaded with Iraqi soldiers in civilian clothing tried to overrun a security checkpoint, forcing him to fire the .50 caliber on the advancing vehicles. They were armed with AK-47 rifles and rocket-propelled grenade launchers.
"I would say it was about a good hour fire fight," he said. "People came after the checkpoint."
None of the 4th Brigade soldiers were lost in that battle.
The injury that would later force him to leave the military occurred on Simon's third deployment in 2007. He was part of a convoy picking up equipment left by American forces when an explosion ripped into a nearby vehicle.
"An RPG -- or something like that -- I forget what it was, but it hit one of the vehicles I was standing next to and I got hit in the face with shrapnel and a big-ass piece of metal," he said. "It knocked me unconscious. The last thing I remember was waking up in a hospital."
Married and the father of three children, Simon said he lost his memory for about a month. "I didn't know where I was at," he said. "I didn't know I had family. I didn't know I was married. I didn't know my name."
The blast occurred sometime in the fall of 2007. Simon said he was in a hospital in Balad, Iraq, for about two months before they sent him back on duty with his unit.
He still wasn't well, with blurred vision, severe migraines and nausea. "They never got me out of there," Simon said. "They just waited until it was time for me to redeploy."
He returned to Fort Stewart in 2008 and started asking other soldiers questions about what he was experiencing. Those conversations led Simon to get the help he needed.
Whether soldiers remain in the military or transition out, they can still get the same treatment for their injuries, said Terry Beckwith, public affairs spokeswoman for Martin Army Community Hospital at Fort Benning. More than 400 wounded warriors are housed at Warrior Transition Battalion Complex, where ill and wounded soldiers are provided needed services.
Beckwith said the Army gets support with treatment from the Bradley Center and The Pastoral Institute in Columbus because there are more soldiers than doctors who can see them.
Many Fort Benning soldiers with traumatic injuries see Lt. Cmdr. Amy Cason, acting chief of social services with the U.S. Public Health Service. Cason said most of the soldiers she's treated recently are dealing with trauma they experienced nearly 10 years ago. "If I were to look at the last three and a half years, look at soldiers on that level, very often it is not the most recent deployment, it is not the most recent trauma that they pinpoint," she said. "It is something that occurred in 2004 or before."
For soldiers who are hurting, trauma doesn't discriminate. While you may think the ill soldiers would come from the infantry, Cason said she has seen many from the ranks of medics and even cooks. Soldiers who work in the kitchen also take part in recovery of bodies and other duties.
Brad Soule, chief of psychiatry for the Central Alabama Veterans Health Care, which covers central Alabama and part of west Georgia, said veterans returning from Iraq and Afghanistan are experiencing problems similar to those who served in World War II, Korea and even Vietnam.
Many veterans have problems sleeping because of bad dreams and react unexpectedly to noise or popping sounds from plastic material used in packages.
"Typical problems are those of adjustment," Soule said. "When you are exposed to war it changes you. We call that an honorable wound which PTSD is. Many of these people find war to be sort of an isolating experience. It's hard to view life the way they did before they went off to war. It's harder to feel joy."
A plastic bag fluttering alone in the gutter might seem innocent to most people, but not to soldiers who have been driving the roads of Baghdad. "It might look like an IED (improvised explosive device) and send your blood pressure rising through the roof," Soule said.
Trauma from an event in war can appear after a long delay. Soule said one of his World War II patients recalled the Bataan death march. Soldiers returning from Iraq may feel pretty good until something happens.
"Maybe they will be hospitalized with chest pains or suddenly flooded with nightmares," Soule said. "Something comes on and all of a sudden everything comes tumbling out of the closet. More often than not, people know right away that they got a memory to take back home they wished they didn't have."
Without getting too graphic, Soule said you can imagine seeing soldiers under fire and the impact of engagements on the enemy.
"We are talking about mayhem, physical damage to people," he said. "Images people bring home are the ones that would break your heart."
Some key symptoms of PTSD are avoidance, re-experiencing and withdrawing. A person also may be hypervigilant and unable to feel comfortable in crowds.
Prompt assistance by health care professionals makes a difference. "As soon as we can intervene for treatment, we have a higher percentage of recovery. We can do something," Cason said.
Treating PTSD is not like treating strep throat, Soule said, but people can get better.
"People carry these honorable wounds with them," he said. "War changes people. We are able to help people adjust and live fulfilling lives. Obviously we are not eradicating everything and everybody, and that is the first thing we tell people. There is not a silver bullet."
Soule points out that, unfortunately, some victims are lost to suicide in the fight against PTSD.
"We put a lot of energy into preventing outcomes like that," Soule said. "Obviously, there are casualties to this. We do feel that the outreach we make very early in case detection makes a difference."
Cason said she hopes people realize the situation is a condition that does not have to be a life or death sentence.
"It doesn't have to be something that is a declaration you carry around the rest of your life," she said. "Yes, you can have PTSD in that diagnosis and after treatment it is possible to either achieve full recovery and/or significant recovery so that you can manage symptoms and move forward."
Simon lives one day at a time, taking medication and going to the VA for treatment.
"It's still a struggle," he said.