The Tears They Cry: Women Veterans & PTSD

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My friend Marsha is the oldest of seven and the daughter of a World War II combat veteran. Marsha’s father, like most men of his generation, spoke very little about his war experiences and what happened in the war was never directly known by most of his children.

Serving in Vietnam

Like many women in her generation, Marsha studied nursing. The military was known to recruit from nursing school

Second Lt. Kathleen M. Sullivan treats a Vietnamese child during Operation MED CAP. Credit: U.S. National Archives and Records Administration via Wikimedia Commons

regularly because they were in desperate need of nurses to care for the injured and dying in Vietnam. Like most of her fellow students, Marsha had no experience in traumatic nursing. When she found herself in Vietnam, war was all she heard and smelled, even when she closed her eyes.

Marsha worked 12-hour shifts in the intensive care recovery room — a semi-circular rubberized structure with tubes that blew in air to keep inflated — and prayed she didn’t do anything wrong. The intensive care beds were emptied as quickly as possible to make space for the next batch of patients. Unless the men were burned, they were typically gone within 24 hours.

In addition to death, Marsha experienced incoming rocket attacks. In order to temporarily escape, most of the nurses wouldn’t leave their rooms at night. They would hide away and listen to music, write letters, and read books. But Marsha didn’t want to hide.

Nurses weren’t issued weapons, and Marsha eventually bought an M-16 from a nurse who was leaving the country. She didn’t ask the nurse where she got the gun; she just knew it worked and that she wanted it. Unfortunately, it didn’t provide Marsha the comfort she sought. Marsha drew 365 boxes on a piece of paper each day of the year she had to serve and every morning she’d get up and color in a square.

After returning home from Vietnam, Marsha struggled to find purpose, traveling the U.S. and camping out in a van. She picked lettuce with migrant workers and was homeless for a time, searching nightly for shelter and a place to shower.

Male Veterans Aren’t the Only Ones Traumatized

Approximately 7,500 American women served during the Vietnam era. Many, like Marsha, were nurses, but some filled other clerical or personnel positions. While post-traumatic stress disorder (PTSD) has been well-studied among men who served in Vietnam, the women who served during that time have been neglected. It’s understandable that the men who served our country during Vietnam got greater attention — there were far more of them, and their military jobs put their lives at greater risk. Regardless, more attention, support and resources needs to be given to the women who served in Vietnam and it does not take away from our men.

Until recently, no large scale population-based study had examined the rates and

Second Lt. Kathleen M. Sullivan treats a Vietnamese child during Operation MED CAP. Credit: U.S. National Archives and Records Administration via Wikimedia Commons

predictors of PTSD in the women who served in Vietnam, with particular attention paid to their common and unique war-zone experiences. The findings published online in October in JAMA Psychiatry indicate that women who served in Vietnam meet current and lifetime criteria for PTSD at higher rates than previously documented: 13.5 percent and 16.9 percent, respectively.

Funded by the Veterans Administration (VA), this comprehensive Health of Vietnam-Era Women’s Study documents the long-term effects of wartime exposures in women, including:

Verbal or physical sexual harassment
Sexual assaults
Compulsory pressure to perform jobs under enemy fire

Sadly, the negative mental health effects of military service have followed these women for six decades. Thankfully, there are ways to help these women decades after their service in Vietnam.

All VA health care providers — not just those in specialty mental health clinics, but those in primary care clinics and every other department that treats women — need to screen for PTSD in these older women. They need PTSD treatment, even all these years later.

Help for the Next Generation

Perhaps the biggest implication of these findings is for the next generation of military women: a population that is large and rapidly growing.

What do these results mean for them? Early and improved interventions can prevent the late-life mental health consequences of war for women. Surely we don’t want more generations of military women reaching grandmother status with untreated symptoms of PTSD.

Serving Other Veterans

Eventually, Marsha’s life took a turn for the better. She married another Vietnam veteran and found her calling. Since the VA at the time, and some might argue even today, was a man’s organization, Marsha knew that women veterans needed a place of their own. Their psychological and physical safety needed it. Through many years of advocacy and lobbying, she raised enough financial support to start a mixed gender transitional residence for 50 veterans at a VA in rural Pennsylvania, the first of its kind and now a model for other programs.

Marsha now speaks for women veterans who have no voice and for those to whom no one will listen. She advocates for those who suffer or are in pain and who can’t find their way out of the box they’ve trapped themselves in. For those who are afraid to open the door to a new life and can’t forgive themselves. For those who forget to eat, nobody cares for, and the ones who are lost to themselves.

We need to help them.

Joan Cook, who teaches psychiatry at Yale School of Medicine, wrote this piece as a Public Voices Fellow at The Op-Ed Project.

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