WASHINGTON (Army News Service, Jan. 22, 2013) -- "I was driving my Ford station wagon across the Woodrow Wilson (bridge) and was suddenly back in Da Nang."
George "Noel" Crawford had just experienced "a hell of a flashback" while driving across the Potomac River near Washington, D.C., and he knew something was terribly wrong.
"I can't deal with this," he said to himself. He immediately drove to nearby Malcolm Grow Medical Center at Andrews Air Force Base, Md.
Crawford, an Army captain and pharmacist who served in Vietnam from September 1967 to September 1968, had that flashback in 1988, two decades after the incident.
"I went into the psychiatry department, and an Air Force lieutenant colonel with flight wings and ribbons going all the way down to his knee says 'how can I help you, colonel?'
"And I said, 'well, I've lost it. I had a flashback just now going across the Woodrow Wilson Bridge, and I'm still shaking.'
"And he says, 'welcome to the club.'
"And I said, 'what do you mean?'
"And he says, 'I used to be an F-4 pilot. I was a throttle jockey. I used to drop bombs on villages until I found out what I did one day. I went into a village I had strafed and bombed. I haven't been in a cockpit since then.'
"So he hospitalized me in what they call the Rapid Treatment Unit. My roommate Gary was a Navy doctor who'd also been in Vietnam. We were both trying to figure out what's wrong with us; it really hadn't come out yet, with PTSD."
Crawford was referring to the diagnosis of post-traumatic stress disorder, commonly referred to as PTSD, which had at the time just recently been added back into the Diagnostic and Statistical Manual of Medical/Mental Disorders, known as the DSM. That guide is used by physicians, psychologists, and psychiatrists to help with the identification and treatment of medical and mental disorders.
He explained that although the diagnosis was in the DSM, people weren't yet familiar with treating PTSD patients.
"So Gary and I grabbed the DSM off the nurse's station and we started thumbing through it and we got ahold of the psychiatrist who was treating us and we pointed to the diagnosis in the book and said to him 'hey, this is Gary and me, right here' and he looked at that diagnosis and says, 'my God, you're right.'
"So they put us in a different treatment type modality. Anyway, to make a long story short, they retired me from the service with (PTSD). And they retired Gary from the service with it too," he recalled.
Crawford, who still has Vietnam buddies with PTSD, said 20 years is not unusual for "you to break down for the first time if it is left untreated."
He likened the force of PTSD to someone trying to balance him or herself on a beach ball in the deep end of a pool "but having it pop up and hit you in the face."
Crawford said it's hard explaining PTSD to someone who has never experienced it. "You experience an event that is outside the normal realm of human comprehension," he said.
"I never thought of harming myself, but I've had friends that have," he said, speaking about one of the many possible outcomes of having PTSD.
"There's a lady in Ohio, Connie, who served with me in Vietnam," he said. She was our ICU nurse in the 2nd Surgical Hospital, a mobile Army surgical hospital based in Chu Lai.
She worked 12-hour shifts, six or seven days a week, caring for the severely wounded men, "boys really," Crawford said. "She also wrote letters to the families of those who didn't make it, letting them know she was with their sons until the end."
"It took her 40 years to find out why she could not get a full night sleep, and was having vivid nightmares of Vietnam and other issues," he said.
Crawford related that he and Connie made contact with one another after 40 years. When he learned of her issues, he insisted that she get herself to the nearest Veterans Administration facility and enroll in a program for PTSD treatment -- which she did.
"After having gone through PTSD counseling, Connie says she now gets a good night's sleep.
"There was just no relief in the ICU," he continued. "Three hundred sixty five days a year, 24/7, all they brought you were those with severe trauma, severe head injuries, traumatic amputations, gunshot wounds. We didn't see very many walking patients, like those with the flu, diarrhea or jaundice. It was always somebody coming in with blood flowing through the bottom of the stretcher and you're trying to save their life under the most adverse of conditions."
Crawford also served as commander of the 563rd Medical Clearing Company, with platoons "spread out from Chu Lai to Quang Tri. I traveled all up and down I Corps."
From about 1955 to 1975, South Vietnam was divided into four military sections or corps. I Corps was the northernmost corps, bordering North Vietnam. At the time, most U.S. forces there were Marines. However, the Army had the 23rd Infantry Division, also known as the Americal Division, at Chu Lai.
He flew a number of "milk runs" with Maj. Gen. Pat Brady, then a major and commander of the 54th Medical Detachment (Helicopter Ambulance). Several of these milk runs, or routine missions, turned into medevac situations, he recalled.
Brady was awarded the Medal of Honor during that time and later wrote a book, "Dead Men Flying: Victory in Viet Nam, the Legend of Dust Off: America's Battlefield Angels."
Not all experiences for Crawford in Vietnam were traumatic.
"I was assisting in triage in the ER when this kid from Alabama came walking in one night, dragging his M-14," Crawford said. "I asked him 'what's with you, Soldier?' And he said 'I don't know but I think it's up here' and he pointed up to his left clavicle and in his right collar there was a bullet hole. I pulled the left part of his shirt back down and there was a butt end of an AK-47 round stuck in his clavicle.
"So I said, 'you just stand over here son and we'll take care of this right now,' and I went over and got iodine swabs, gauze pads, tape and forceps and said, 'this is gonna be kinda like pulling a tooth, but don't worry too much, it may sting a little,'" Crawford said.
"And I popped it out and said 'is this what you're looking for?' and his eyes rolled to the back of his head and he passed out, getting a nice lump on his head," he continued. "I didn't expect that. He was otherwise OK. Boy did I catch hell for that one. The surgeon told me 'next time have them lay down.'"
"So I went down to the dental clinic and drilled a hole through (the bullet) and stuck it on his dog tags and I said 'now you will tell your grandchildren all about this. But don't tell them the stupid medic made you pass out,'" Crawford recalled. "Always the funny things like that that you try to remember, not the other ones."
"Then there was the time I was triaging and there's this kid that came limping in and I said 'what's wrong with you, Soldier?' And he said 'I got hit in the thigh.' So I cut his fatigues away. [Starting] at the knee and going up to his family jewels was a long gash. At the end of the gash there was a lump, about two-and-a-half, three inches high. And I gently felt it and thought to myself 'holy crap, it's a live M79 round.'
"I asked him 'what were you doing?'
"And he said 'I was charging a bunker when this Charlie popped up and fired at me point blank with a grenade launcher.'
"I said 'go over here and sit down in this corner.'
"And I went and got the surgeon, and said, I've got this guy with an M79 grenade round in his leg, and he said 'Crawford, you've been in the grain alcohol in the pharmacy again.'
"And I said 'no, no, no, no.'
"And I went and got the portable X-ray and had the tech shoot a picture of it and pulled the film out and there it was and went over to surgeon and said 'what does this look like to you?'
"And he literally crapped his pants.
"Long story short, we got the kid into a building in back of the hospital on a field surgical table [and] sandbagged him all up. I had seen a bullet-proof windshield from an old French armored car which I retrieved and cleaned up. I placed it over the area we were going to work on.
"Lt. Col. Nate Natchiff, who was the commander and a surgeon, came in and the nurses had donated a pair of panty hose so we could sandbag his family jewels in case the damn thing went off he wouldn't lose those.
"And we opened him up and Nate took the round out and passed it off to the explosives ordnance disposal guy from the Americal Div. His name was Bill Puckett and I still remember him stuttering and shaking like a leaf and asking for a bottle of Johnny Walker Black Label after all of this was over.
"And I thought to myself, 'oh are we in trouble.'
"Bill took that round in a basin of sand and said 'clear the area,' walked down to the beach, heaved it over the cliff, and yelled 'fire in the hole' at the same time. The damned thing detonated when it hit the beach and it shook the whole compound. We just stood there looking at each other and then went and drank some of the Scotch Bill had suggested.
"Nate got the Silver Star. The rest of us got a thank you.
"We were the first ones to take a live round out of a patient and were written up in the New York Times. After that, Soldiers with live rounds imbedded in some part of their bodies started to happen more frequently," he said.
Then, Crawford related the incident in Da Nang that triggered his flashback on the Woodrow Wilson Bridge.
"Now most things I can handle. But what slammed me up against the wall was one afternoon I was going out to the airfield, MAG-13 (Marine Air Group-13), with my first sergeant. And a Sea Knight (CH-46 helicopter) came up from behind us at low altitude, banked over to our left, and never pulled out of the bank.
"They went in upside down just off to our left and crashed. The damn thing blew up and burned. The loading ramp in the rear was up, making escape impossible. Onboard were 12 Marines who never got out. We could hear their screams. We tried to rescue them. One of the Seabees unwound his winch, drove his truck as close as he could and threw the hook into the wreckage and tried to pull it apart, and we could not get those kids.
"I can still see that incident unrolling before my eyes. Those are the things you experience in combat.
"Now see, I went and talked about it.
"I was in a counseling group at the VA, and after many months we got down to the incidents that did this to us. And I told them mine.
"We had a helicopter pilot in counseling, Ron, who had flown UH1 (Huey) helicopter gunships. I said 'I don't know what happened or why,'" referring to the Sea Knight incident.
"Then Ron tried to reassure me, saying 'it happens all the time. He lost his hydraulics on the bank in his turn. And he lost total control. And there was only one thing that was going to happen. He was going to crash.'"
Crawford said that explanation gave him some consolation after having relived it over and over again, "but you never forget. You never really get over it."
The helicopter pilot's explanation of what happened may not seem like much, Crawford said, "but it was a big deal and sometimes those little things can really mean a lot."
He gave an example of a buddy who was in counseling for PTSD with him who got a certain amount of closure for something that might also have seemed almost trivial:
"He was a tank commander and was sitting on top of the turret. His ammo guy was loading ammo inside the tank. And he watched this RPG (rocket-propelled grenade) come toward his tank and he said 'it was like slow motion.' And it hit the hull and drove through and exploded.
"And it blew him off the turret, but they never found the guy inside loading the ammo. They said they found a part of a rib cage.
"But this guy's problem was he could not remember this kid's name. He was striving to remember the ammo loader's name.
"And I said 'all you found was bones?'
"And he looked at me and said 'oh my God that's it. The kid's name was Bonesteel.'
"When I'd said bones,' it triggered a memory and he remembered, and he could finally get through the process.
"Group therapy really works," said Crawford, relating his own experience in VA counseling.
"Tom was the facilitator. He was never in combat but he was one of us. He was really one of us," said Crawford, explaining that the group accepted Tom because "he had such empathy and such insight to our needs that we felt like he was a member of the team.
"Some nights we didn't feel like talking and he'd go down and get a video and we'd watch 'Young Frankenstein.' We didn't want to talk. We just clammed up. On other nights we did talk through our experiences or whatever else was on our minds.
"He was our best buddy and we would have done anything for Tom because he just worked us through the situation and he didn't put up with none of this bureaucratic bullshit. The VA would tell him 'you can't do that,' and he'd say 'go to hell, I'm doing it' and we'd do it."
Crawford said he's glad researchers are exploring many different ways to treat PTSD and he encourages veterans from the wars in Iraq and Afghanistan to seek help. But he cautioned that there's no magic pill that will completely remove the pain.
"While I was in group therapy we started up group therapy for World War II and Korean War veterans. Talk about a time delayed fuse. These folks had never talked or found relief until Vietnam vets started the process.
"You go through therapy, you feel better, you do work, you function, but it's always there; it's just over your shoulder."
Postscript: Crawford said he agreed to be interviewed for this article in the hope "it might encourage veterans, police, firefighters, emergency room personnel or anyone else who has experienced a traumatic event outside the realm of normal human comprehension" to seek treatment for PTSD.
Crawford served 18 years as a Soldier in the Army Medical Service Corps. In 1983, he transferred to the Indian U.S. Public Health Service and retired in 1988 with the rank of commander. He asked readers to "please excuse my coarse language, but that is the way it is when you talk about your experiences."
Related Links:
Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury
PTSD: Knowing what's wrong, getting help
Army standardizes PTSD diagnosis, treatment
PTSD: The dreaded four letters you don't have to fear
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