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Suspected Fort Hood Shooter Saw the Toll of PTSD

It seems unfathomable that an Army psychiatrist trained to heal soldiers with psychiatric injuries could then fire on fellow soldiers.

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hide captionThis undated photo shows Maj. Nidal Malik Hasan, the suspected shooter.

The Uniformed University of the Health Sciences/AP

Maj. Nidal Malik Hasan is blamed for a shooting rampage at Fort Hood, Texas, that killed 13 people and wounded 30.

Nader Hasan, cousin of the alleged shooter, suggests that one factor may have been that the Army psychiatrist had treated scores of soldiers and Marines who returned from Iraq and Afghanistan with PTSD.

"He had people telling him on a daily basis the horrors they saw there," Nader Hasan, told the New York Times. But he said he had no idea why his cousin may have shot other soldiers. The 39-year-old psychiatrist expected to be deployed soon to Iraq or Afghanistan but objected to the deployment, his cousin said. According to the Associated Press, Hasan was going to be part of a combat stress team that treats soldiers showing signs of psychiatric problems.

Before moving to Fort Hood, last summer, Hasan had spent most of his medical career at Walter Reed Army Medical Center. He was an intern, resident and then a fellow.

One former colleague said that although he wasn't familiar with Hasan's specific assignments, psychiatric residents do the same work. That means Hasan would have treated patients with PTSD. And he also would have seen patients who, as a result of their physical injuries, brain injuries or PTSD, were getting ready to leave the Army. They first go through a medical review board and a psychiatrist like Hasan would evaluate them to make a recommendation about their level of disability, which guides decisions about whether they are then entitled to disability payments.

As investigators talk to Hasan's former colleagues at Walter Reed, one of the big questions is whether there were any warning signs to suggest Hasan should not have been treating patients. One source told NPR that Hasan had run into problems when he was in a post-graduate program at the Uniformed Services University of the Health Sciences. Hasan was placed on an "extended curriculum," a kind of probation. The problem was that he had been proselytizing for his Muslim faith to patients and colleagues.

Another source told NPR that there were continued problems when he went to Walter Reed; he would get into fights about his religion. Noel Hasan, his aunt, says however that Hasan was the victim of these arguments. She told the Washington Post that her nephew had endured continuous harassment for his Muslim faith in the years after the Sept. 11, 2001 attacks. "Some people can take it, and some cannot," she told the Washington Post, explaining that her nephew had wanted to get out of the military and had offered to repay all of his medical training.

There were also signs that Hasan had done his job well. He rose to the rank of major. And a recent supervisor at Fort Hood, Col. Kimberly Kesling, deputy commander of clinical services at Darnall Army Medical Center, told the Associated Press, "up to this point I would consider him an asset."

Easing A Stigma

When I first did stories about troops returning from Iraq and Afghanistan, it was NPR policy to spell out post-traumatic stress disorder. Now we routinely just say, "PTSD." The reason is that most everyone now knows about PTSD. And the condition generally stirs sympathy, some of its stigma is now gone.

Military psychiatrists are the unsung heroes of that significant change. They've been strong advocates for troops with PTSD. They've insisted that psychiatric illness be seen as an injury of war, just like an injury caused by bullets and bombs. They've educated families, who often are the ones who persuade soldiers to seek treatment. Most of all, they've forced big changes within the military itself, where commanders had routinely expected troops to shake off a problem like PTSD.

Military psychiatrists like those who work at Fort Hood and Walter Reed, are under increasing stress themselves, as growing numbers of soldiers deal with PTSD.

A 2008 report from the Government Accountability Office noted shortages of staff at military and veterans hospitals trained to care for PTSD and traumatic brain injuries.

It's a problem because another study, by the independent Rand Corporation, found about one third of soldiers come back from Iraq with PTSD, a head injury, or both.

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