Ohio seeing dramatic increase of PTSD cases

More returning troops from Iraq, Afghanistan at risk for suicides.

Minutes before he put a gun to his chest and pulled the trigger on the morning of Jan. 3, Curt Fike sent a text message to his sister saying he was about to end his life.

The Marine who served three combat missions in four years in Iraq sent another message to his co-workers at the Dayton National Cemetery, saying, “Take good care of me when I’m at the national cemetery.”

In his note to his family, Fike apologized for doing something that was “so, so stupid,” but he couldn’t see a way out of the pain or any path to a normal, healthy life.

Suicide rates are spiking among veterans of Iraq and Afghanistan, especially those, like Fike, who suffered from post-traumatic stress disorder or traumatic brain injury. “In my mind, it’s a combat loss, and certainly his conditions and injuries were related to his service in Iraq,” said Bill Wall, program manager for the Freedom Center at the Dayton VA Medical Center, which serves as a post-deployment clinic for veterans of the Iraq war.

From 2009 to 2011, the number of patients diagnosed with PTSD in Ohio has risen from 12,934 in 2009 to more than 20,000 in 2011. At the Dayton VA, 26 percent of veterans returning from Iraq and Afghanistan have been diagnosed with PTSD. Last year, the VA treated 2,311 veterans with PTSD, but Wall estimates “you could have at least double that number that could be out there. So probably another 2,000 folks out there are probably struggling with PTSD who haven’t been seen yet.”

Before his service in Iraq, Fike was a fun-loving jokester, a popular football player at Badin High School who seemed on track to marry his high school sweetheart.

After returning from the war, Fike was prone to angry outbursts and flashbacks so severe that a road sign for Fairfield could be mistaken for one for Fallujah. He slipped into alcohol abuse to numb the pain.

Fike, who had worked as a groundskeeper at the Dayton National Cemetery since 2006, took great pride in his work tending the graves of fellow veterans. The 29-year-old Hamilton soldier made it home, when so many of his buddies did not, only to become a different kind of war casualty: a victim of suicide, brought on by PTSD and a traumatic brain injury.

“He was so young, and he saw an incredible amount of tragedy and death,” lamented his mother, Jody Merrill of Hamilton. “Marines are pumped up to be superheroes; they are not supposed to have emotions. Something has to change.”

‘If only we had known’

Fike sought help at the Dayton VA in the months before his death, attending several sessions with psychologists but missing several others. During his final visit on Oct. 25, 2011, he told his psychiatrist, “I feel like something horrible is about to happen. I have such terrible road rage and I cannot control my anger. I have had to pull off the road lately to contain myself of others while I’m driving. I have never felt this way before.”

Merrill believes that signs were missed — and that more effective intervention, including hospitalization, might have saved her son’s life. “He was definitely crying out for help, but nobody did anything for him but push meds,” she said. “He needed some psychiatric treatment and quickly. I think when he poured his heart out and didn’t get a reaction, or treatment, he felt that going there was futile. The system is definitely broken.”

Fike never threatened suicide in his sessions, according to Wall: “There were no red flags in his medical records that would have required hospitalization,” he said. Road rage is not uncommon among veterans, he noted, and “the therapist’s job is to work on a heavy set of problems and to learn how to manage symptoms and work on quality of life.”

But Merrill wants to know: “What does constitute an emergency? When do you call someone? When someone picks up the gun and threatens to kill himself?”

Merrill is particularly upset that no one contacted her, as his emergency contact, when Fike admitted to feeling a murderous road rage as well as impulses to harm his girlfriend. He also told his VA counselors about having such severe flashbacks that he mistook a road sign for Fairfield as a sign for Fallujah.

“It’s not just the grief of losing him that kills me; it’s the fact that one phone call from the VA to me might have saved his life,” Merrill said. “Yet no one took the time to make that important call.”

Wall explained that privacy laws prohibit the VA from contacting anyone, including families and emergency contacts, without the patient’s consent. “By law, we can’t do it,” he said, adding that the only exception is when a patient threatens to harm another individual. “If the patient talks about committing suicide, he is hospitalized, but even then we can only tell the families that he has been hospitalized and what his condition is.”

Now that her son is dead, Merrill has full access to the medical records that were forbidden to her beforehand. “That’s all backward,” she said. “Family is first line of support, and there are tons of things we could have done, if only we had known.”

It was only after Fike’s death that his mother learned he had been diagnosed with a traumatic brain injury suffered during a rocket blast on his third tour of duty as an HVAC mechanic. The diagnosis explained Fike’s partial hearing loss as well as the frequent headaches that made him feel as if he were wearing a helmet. Traumatic brain injuries also can cause anger, forgetfulnessness and depression, experts say.

“He already had been subjected to daily bombing. On his third tour, there was a horrible incident, when the rocket blew a hole in the ground the size of your living room,” Merrill said. “Curt and his buddy were the first on the scene.”

Two staff sergeants died in front of his eyes — a tragedy that haunted Fike, along with many other indelible images from Iraq. “He would be out on a convoy and he would see dead Iraqis and packs of dogs eating them,” Merrill said.

Larry James, dean of the School of Professional Psychology at Wright State University, said that multiple deployments, such as Fike’s, are a strong contributing factor in PTSD. He predicted that more and more veterans of Iraq and Afghanistan will be diagnosed with PTSD as the years and decades pass. “This is the tip of the iceberg,” noted James, a combat veteran and former chief of psychology at Walter R. Reed Medical Center in Washington, D.C. “This could be the next epidemic.”

Not the same person

At the end of his junior year, Fike started dating Angela Bley. “We started talking at an after-prom party and the sparks flew,” Bley recalled. “He was very outgoing, always the life of the party, always in a good mood.”

When an acquaintance committed suicide, neither could understand it. “The Curt I knew would never do something like that,” she said.

They broke up briefly a couple of years after high school, and Fike enlisted in the Marines. Bley confided to her sister, “I really do love him and I think I’m going to spend the rest of my life with him.” The couple got back together, and Bley recalled, “I was so proud of him, and I figured we could tough it out.”

Fike came out of boot camp feeling positive and upbeat, Bley said. “He couldn’t wait until he got out and we could start a life together. He always talked about the military in a really positive way, and he constantly talked about being motivated.”

After his third and final deployment, Bley said she noticed a huge change in Fike. He started drinking heavily. He showed an aggressive streak she had never seen before. “One day, in his barracks, he broke down crying and he kept saying, ‘If you only knew what I know.’” On another occasion he said, “It’s so messed up over there, I can’t even explain it.”

Bley suspects many other veterans are experiencing the same symptoms: “You go from being in a war zone, scared for your life, and three days later you’re eating dinner with your family.”

Eventually, Bley broke up with Fike because of his drinking and his anger issues. She now lives in Beaufort, S.C., and is engaged to be married next month. “Curt and I were together for more than five years, and I will always remember him,” she said. “I have boxes and boxes of pictures and cards and letters. He was my whole childhood. He was very romantic and sweet and loving.”

Wall said The Freedom Center knows that families are key to successful healing — and that isn’t easy. “The post-deployment self isn’t the same as the person you knew before,” he said. “Often they’re not as emotional. They don’t laugh as much and they’re often more frustrated and have less tolerance for activities. They might be uncomfortable going out.”

Wall said that Fike exhibited many of the classic symptoms of PTSD: nightmares, sleeplessness, flashbacks and hyper-alertness. Other common problems are known as “avoidance symptoms” — shutting off emotions and shutting oneself off from the world, avoiding painful reminders such as places, people and conversations.

Merrill said that her son distanced himself somewhat from the family during the last year of his life. He was busy, she figured, with his job in Dayton, his new girlfriend and her young son, and his new home at 26 Firwood Drive in Dayton that he took such pride in fixing up. “He was really good at hiding it,” Merrill said.

She knew that he drank too much and that he struggled with PTSD, but nothing prepared her for the hysterical call from her daughter, Annie Fike, after receiving her brother’s suicidal text around 8:55 a.m.

Merrill called Hamilton 911 dispatchers and waited four minutes before being given a contact for dispatchers in Dayton. “Minutes matter,” Merrill said, “and when Curt was in that state, those minutes must have felt like hours.”

In a frantic 911 call, placed at 9:13 a.m., Merrill told a Dayton police dispatcher about her son’s text stating that “drugs and alcohol had taken over his life” and that he was going to kill himself. “He said he was sorry for what he was doing and he loves everybody,” she told the dispatcher. Police were dispatched at 9:15 a.m., less than two minutes into Merrill’s 911 call, but 20 minutes after the suicide text had been sent.

Merrill raced to Dayton at 90 mph, repeating the mantra, “Baby boy, you better be there,” as she continually dialed his cellphone. “I was in total denial,” she recalled. “I thought he was crying out for help and he would get the help he needed.”

A short time after her own call, a clearly distraught co-worker, Daniel Barford, called 911 after rushing over to Fike’s home when he received the suicidal text. “He’s in the bathtub with a shotgun, and he’s gone,” he said. “He’s an Iraq Marine.”

When Merrill pulled up and saw the coroner’s van parked outside the house, she knew.

Fike was buried six days later between two other Iraq veterans, killed in action, whose graves he had tended. “He took great pride in providing a beautiful resting place for his fallen brethren,” Merrill said.

She said she forever will grieve for that lost potential, and she won’t stop fighting for changes that will prevent future tragedies. “He will never have babies of his own; he will never have that joy,” Merrill said. “There were so many good things ahead of him if he had just hung on and learned that life is worth living. My fear is that others are feeling the same way and the families don’t know and they can’t help them.”

Mother makes a difference

Army suicides have more than doubled since 2004, while the suicide rate in the National Guard more than doubled from 50 in 2009 to 112 in 2010. According to a 2010 study by the Department of Veterans Affairs, the suicide rate among Vietnam veterans and Gulf War veterans is little different from that of the general U.S. population. The suicide rate among veterans of Iraq and Afghanistan is significantly higher, the study concluded, and veterans with PTSD or other psychological disorders “should be monitored closely.”

Wall said Merrill’s advocacy already is making a difference in the way the Freedom Center is doing business, and he commends her willingness to speak out so soon after her loss. “She’s not complaining — she’s looking for answers,” Wall said. “PTSD has a huge degree of mortality, and we have to do everything we can not to have another loss.”

One of the most significant changes: Veterans coming to the Freedom Center will be asked to complete a “release of information” form so the clinic staff can have a two-way conversation with specified family members. If Fike had signed such a consent, clinic staff could have contacted Merrill when he started having problems.

That’s a good first step, Merrill said. “I don’t think Curt was ever asked if the information could be shared,” she said. “I think he would have wanted them to reach out to me.”

Wall said the clinic must respect the patient’s right to privacy, but “we can highly encourage collaborations between clinic staff and patients’ families. We’ve learned a lesson, thanks to Jody’s insights.”

Merrill said her efforts will be worth it if she can spare just one other family: “They’re sending these kids back to us and we have no idea what they’re dealing with or how to help them.”

It’s another way of honoring her son’s memory and, perhaps, to remember the person he truly was.

“I always admired him for seizing the moment and doing exactly what he wanted to do, especially when it came to adventure and having fun,” Merrill said. “Curt lived more life in his 29 years than most of us will ever live in a lifetime.”

Contact this reporter at (937) 225-2209 or mmccarty @DaytonDailyNews.com.

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