Adjusting to War's Physical Trauma

What does it take to heal — and live with — the physical trauma of war? Dr. Tracy Ringo, a medical corps officer with the Army National Guard, was sent to Baghdad to work with wounded soldiers in 2004. Now, Dr. Ringo is back in the United States, where she works with returning Iraq war veterans.

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FARAI CHIDEYA, host:

This is NEWS & NOTES. I'm Farai Chideya.

Today, we wrap up our month-long look at the relationship between black Americans in the military. We've talked about the economic impact of signing up, black anti-war activism, and the impact of war on families. Yesterday, we heard from two soldiers living with deep emotional scars from combat. Today, we examine how troops who are physically wounded cope on the battlefield and at home.

Next, we'll get the personal story of a soldier who was gravely wounded in Vietnam.

But first, we've got Dr. Tracy Ringo, a medical corps officer with the Army National Guard. In 2004, she was sent to Baghdad to work with wounded soldiers. Now, Dr. Ringo is back in the U.S. where she works with returning Iraq war veterans. Welcome.

Dr. TRACY RINGO (Medical Corps Officer, Army National Guard): Good afternoon.

CHIDEYA: So, tell me a little bit about your job in Iraq.

Dr. RINGO: In my job in Iraq, I was the medical officer in the Green Zone. I was the head of the palace clinic and responsible for thousands of military personnel, civilian and also Iraqi citizens.

CHIDEYA: What kind of injuries did you end up treating?

Dr. RINGO: We saw shrapnel wounds, fractures, burns, heart attacks, dehydration and a lot of gastrointestinal illnesses.

CHIDEYA: I understand that during Ramadan, one of the most important Islamic holidays, you saw a pretty - the aftereffects of a pretty gruesome attack.

Dr. RINGO: Absolutely. There was total destruction. Three una-bombers at three different sites simultaneously proceeded to bomb the sites that - at noon, where most of the troops would visit during lunchtime or on break. And I guess it was a - there was intelligence that this may happen. And so, we were - it was off limits, but most people didn't take it seriously. So there ended up being a lot of destruction, but not as much as it could have been if we wouldn't have had the intelligence prior to.

CHIDEYA: If someone has been injured, and let's talk about your role here in the U.S., and they come to you, why are they coming to you? What are you expected to do for them?

Dr. RINGO: Well, I think the soldiers, when they redeploy, they come back to the units. And I am a - first of all, my first mission is to deem soldiers medical fit - medically fit for deployment, and once they come back to make sure that all their redeployment and medical issues have been addressed.

Most of them will have a six-month period where they have medical insurance from TRICARE, from being sent over after the year when they return back. What I'm seeing is that, after the six months that they had a fracture or if they've had heart attack or blood pressure issues or severe wounds, that after that six months, that they are not getting the follow-ups that they need, and some of them are still suffering with - not a 100 percent…

CHIDEYA: They're not well.

Dr. RINGO: Right. They're not maximizing their condition because they don't have the medical insurance to continue with the follow-ups.

CHIDEYA: Does that distress you that some people who have gone out and served are coming back and they don't seem to be getting what you would think a veteran would get?

Dr. RINGO: Absolutely. Most of these soldiers are between the ages of 18 and 24 that I'm seeing that are returning back, they're mostly college students living on a limited income and they don't have the ability to go out and get the MRI that they need.

CHIDEYA: What do you do then? What do you do to help?

Dr. RINGO: Well, recently, they - we do have lots of different physicians that are in the military that we can have them come to our office and give them different benefits because they're soldiers. But recently, they developed a plan where now all the soldiers that are in the military can have health insurance. And that just started October the 1st. So now, this is a solution to the problem.

CHIDEYA: People come to you for evaluation sometimes, fitness evaluations - am I ready to go back into combat? When you sit down with someone who's being evaluated, who's had an injury and who's up for another tour in Iraq, does anyone ever say to you, you know what, I just can't take it. I don't care what the physical symptoms are. I can't take it. You've got to let me out of this.

Dr. RINGO: They do. But believe it or not, it's very rare. Most of the soldiers are very dedicated. And they feel like this is their duty. They feel like it's an honor to serve their country. And so, sometimes, I have to discipline soldiers and tell them that they cannot go back for various conditions that have not been totally addressed.

And initially, it was due to just not being able to get the proper care to have the conditions at 100 percent where they're able to deploy, but I have had soldiers who have been in treatment, been in counseling, still undergoing counseling and still having adjustment issues, so it's - within a 12-month period, it's really too soon to talk about redeployment. So I've had some that say, yeah, I don't know if I'm ready to go back. But for the most part, most of them are willing to go back for the good of the unit.

CHIDEYA: We've been hearing a lot about the traumatic head injuries that are happening now that some people who might have died in the past are surviving but with head injuries and other injuries that go through body armor or helmets. What do you do when someone might have an injury that's not apparent to the eye, but that has deeply wounded them?

Dr. RINGO: Well, what we're doing now is that we have a simulator where even prior to deployment, the soldiers are asked to go through a cognitive study to see what their actual status is prior to deployment so that we have an objective way to compare once they're back from deployment to say, well, what's the soldier - what was their baseline?

So when they come back, we see lots of depression or just people who aren't the same. They may have different relationships with their spouse or their friends, having trouble coping. They may have been the best employee at their jobs and now, they're the worst, and people really understanding what's going on. And it's a real long adjustment period, but the good news is, it takes about two years for the post traumatic stress disorder that we're seeing a lot of. After that, it pretty much does go away. So it gets better. And that's one of the things that we could tell the soldiers that you're going through this big adjustment period now, but it will get better.

CHIDEYA: Well, Dr. Ringo, thank you for your time and for your service.

Dr. RINGO: Thank you.

CHIDEYA: Dr. Tracy Ringo is a medical corps officer with the Army National Guard. After a tour in Iraq, she now works with returning veterans. She was at the Cleveland Clinic Studio in Cleveland, Ohio.

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