One of the oldest freshmen at Yale University is a 25-year veteran with a service animal and Post Traumatic Stress Disorder.
52-year-old James Hatch sustained a brain injury during a 2009 rescue mission in Afghanistan. The incident left Hatch with permanent PTSD. At one point, Hatch put a gun in his mouth and threatened to take his own life. His wife summoned police, who took Hatch to a nearby hospital. At the behest of his doctors and his friends, Hatch sought treatment for his PTSD. Now, he and his service dog Mina will be attending classes at an ivy-league school.
Hatch said he wanted to go to Yale so he could become a better person.
PTSD Through the Years
The little-noticed 2019 film Rambo: Last Blood ended a film franchise that dates back almost 40 years. John Rambo took medication to control his PTSD, which he developed in the Vietnam War. That is a far cry from the character’s premier in 1982. In First Blood, Rambo was essentially a PTSD monster.
First Blood was one of several PTSD/Vietnam-themed movies in the late 1970s and early 1980s, like The Deer Hunter, Jackknife, and Taxi Driver. Even though World War II ended roughly 40 years earlier, understanding of this disease had not progressed much. General George Patton made several remarks strongly implying that soldiers with “battle fatigue” did not suffer physical combat wounds and were simply trying to shirk their duties.
PTSD entered the national consciousness in the First World War. Back then, physicians usually diagnosed this condition as “shell shock” or perhaps “railway spine.” Railway spine referred to the rigid way these victims walked. Yet despite the obvious connection between these conditions and physical symptoms, most doctors insisted that PTSD was just a “processing disorder” and victims just needed some time away from the front.
That attitude was actually an improvement over American Civil War PTSD diagnoses. When PTSD symptoms appeared, doctors usually said the victim suffered from nostalgia, or advanced homesickness. The prescribed treatment was participation in a vigorous offensive campaign. Ironically, this treatment simply made the condition worse.
One of the first mentioned of combat-related PTSD goes back much further than that. In William Shakespeare’s play Henry IV, Part I, Lady Percy describes PTSD symptoms in her husband Hotspur, who had just returned from a war:
O my good lord, why are you thus alone (isolation)? For what offense have I this fortnight been a banished woman from my Harry’s bed (unreasonable anger against family members)? Tell me, sweet lord, what is ‘t that takes from thee thy stomach, pleasure (disinterest in pleasurable activities), and thy golden sleep (sleeplessness)? Why dost thou bend thine eyes upon the earth (depression), and start so often when thou sit’st alone (heightened awareness)? Why hast thou lost the fresh blood in thy cheeks and given my treasures and my rights of thee to thick-eyed musing and curst melancholy? In thy faint slumbers I by thee have watched, and heard thee murmur tales of iron wars (nightmares and flashbacks).
This wide range of symptoms, and the long history of PTSD, strongly suggest that PTSD is a physical injury. There is scientific evidence on this point, as well.
Is PTSD a Physical Injury?
Researchers know that exposure to combat stress erodes the cerebral cortex. In some cases, that erosion may occur slowly over time after repeated exposure to combat stress. In other cases, a single firefight or IED detonation may cause the damage.
The cerebral cortex controls logical responses to stressful situations. This part of the brain also governs problem-solving abilities and other such tasks. So, it is important for college freshmen with PTSD to stick with their recovery program.
When one part of the brain gets smaller, other parts of the brain get bigger. In this case, the amygdala expands into the space vacated by the shrinking cerebral cortex. The amygdala controls emotional responses to stressful situations. That enlargement explains symptoms like depression, heightened awareness, anger, and the others mentioned above.
To better understand the relationship between the cerebral cortex and amygdala, think about a rider and horse. If the rider, which is the cerebral cortex, is weak, the horse, or the amygdala, may run wild.
Traditional brain injury treatments are a combination of surgery, physical therapy, and medication.
Brain surgery is not really an option in PTSD cases, There is no bleeding or other such trauma to correct. The PTSD brain is not injured; its cells are simply redistributed. Surgery cannot address that issue.
Physical therapy, however, is quite effective. Experienced brain injury therapists can train other parts of the brain to assume lose cerebral cortex functions. Many of the aforementioned World War I shell shock victims bounced back nicely after extended physical therapy. They were never completely cured, but they could return to work and the other things they enjoyed.
Finally, after therapy ends, many PTSD victims take SSRI antidepressants. Selective serotonin reuptake inhibitors prevent the reabsorption of serotonin, a chemical which gives people a sense of well-being. SSRIs are not right for everyone. These powerful drugs often have extremely serious side-effects. Examples of SSRI antidepressants include Prozac, Zoloft, Paxil, and Luvox.
These treatments sound expensive, and they are expensive. Fortunately, Defense Base Act benefits are usually available in these situations. These benefits normally include payment for all reasonable medical expenses.
Generally, the DBA insurance company directly pays all medical bills. Most victims never see the statements, and they are not financially responsible for any unpaid charges.
Lost wage benefits are normally available as well. If the victim has PTSD or another temporary disability, the DBA usually pays two-thirds of the victim’s average weekly wage for the duration of the illness. The average weekly wage includes not only regular cash compensation, but also performance bonuses, overtime, and noncash compensation, such as housing allowance and tuition reimbursement.
Most DBA claims settle out of court, mostly because the victim’s burden of proof is rather low. The victim must establish a nexus between the medical condition and contractor deployment. A nexus is a direct or indirect connection.
Contact Barnett, Lerner, Karsen, Frankel & Castro, P.A. for more information about the DBA process.