No Purple Heart For PTSD Diagnosis The Pentagon announced that soldiers suffering from post traumatic stress disorder do not qualify for the Purple Heart because it's not a physical wound. Some veterans hoped the award might honor their sacrifice, and take away some of the stigma that comes with the diagnosis.
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No Purple Heart For PTSD Diagnosis

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No Purple Heart For PTSD Diagnosis

No Purple Heart For PTSD Diagnosis

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NEAL CONAN, host:

This is Talk of the Nation. I'm Neal Conan in Washington. Earlier this month, the Defense Department decided that the Purple Heart will not be awarded to troops who suffer from post traumatic stress disorder. Originally created by George Washington to recognize distinguished service, for many years now, the Purple Heart has honored soldiers, sailors, airmen and marines who suffer physical wounds in combat. This month's decision calls PTSD a secondary effect caused by witnessing or experiencing a traumatic event. Opponents argued that a mental wound is just as real as one that bleeds, that the medal could help reduce the stigma attached to post traumatic stress disorder and help more sufferers seek treatment. Others believe just as passionately that PTSD is not the same and at the current standards should not be changed.

The Purple Heart and Post Traumatic Stress Disorder. And we want to hear from military members of the audience, Vets and active duty, should PTSD qualify for the Purple Heart? 800-989-8255 is the phone number. The email address is talk@npr.org. You can also join the conversation on our Web site, that's at npr.org. Just click on Talk of the Nation. We begin with Kelly Kennedy, a staff writer for Army Times who's here with us in Studio 3A. Nice to have you on the program.

Ms. KELLY KENNEDY (Staff Writer, Army Times): Thanks for having me.

CONAN: And this came to public attention last spring when the Secretary of Defense then and now, Robert Gates, visited Fort Bliss, Texas and said he would consider whether the Purple Heart should go to PTSD sufferers. What happened after that?

Ms. KENNEDY: Well, basically, they started a conversation. It turned into a big to-do on the blogosphere, essentially where people were arguing back and forth should this be - should people get the Purple Heart for post traumatic stress disorder? And basically people were arguing back and forth that it was - that it's, like you said, it's absolutely a wound of war. And that - but then people were saying that it wasn't the same as bleeding on the battlefield and therefore, it would denigrate it somehow to give the Purple Heart to someone with a mental disorder as opposed to an actual wound that bleeds on the battlefield.

CONAN: And how was this decision made at the Pentagon?

Ms. KENNEDY: Well, they decided that it was more of a disease than an injury. There's a couple of things going on there. With a gunshot wounds, you can see it immediately. So, it's pretty easy to say this is really to combat - a combat-related injury. With posttraumatic stress disorder, for it even to be diagnosed as that, it needs to be - the symptoms need to be there for a few months. So for them to award a Purple Heart, it would have to be way after the fact. So essentially they said that it was an injury, that it was not - or that it was a disease and it's not intentionally caused by the enemy as a gunshot wound would be, so it's not - it doesn't qualify for a Purple Heart.

CONAN: Secondary effect. And I think there was some argument that it could also happen in non-combat situations, traffic accidents, say.

Ms. KENNEDY: Sure, but if you were wounded in Iraq in a traffic accident, that wouldn't be eligible for a Purple Heart either, so not really sure if that would be a good defense. I mean, I guess the argument with post traumatic stress disorder is if it's - if it's designated that it's combat-related, then it should be considered a combat injury as opposed to something like malaria as a disease that you could get no matter where you're at, so.

CONAN: And who actually made the decision? Was it the Secretary of Defense?

Ms. KENNEDY: It was David S.C. Chu who handles health affairs or did handle health affairs for the Defense Department. And then the Secretary of Defense agreed with his decision.

CONAN: Now, after years of criticism that they were not paying enough attention to this problem, the Defense Department and the Veterans Administration have lately bolstered their capacity to diagnose and treat PTSD. How did that factor into the decision?

Ms. KENNEDY: Well, that's another big part of the argument is, if you say that post traumatic stress disorder is worthy of a Purple Heart, then they're saying that that might help get rid of some of the stigma that's attached to the disease. And it's actually - it actually played into the argument on the blogosphere - was that there's such a stigma already attached to it that that's why they were saying it would denigrate it, like some people don't necessarily believe that it's a real injury or that people are faking it or something, you can't see it and that causes a problem.

CONAN: I think people who are not in the military might remember that scene in the film "Patton" where a soldier with what was then called shell-shock, battlefield fatigue, said he couldn't go back into combat, was slapped by General Patton which caused a great brouhaha in his career. But that's the sort of attitude that this is somehow perceived by some people as a form of cowardice?

Ms. KENNEDY: I mean, it's getting better, but certainly that does still exist. I mean, it's funny if you go out with the troops that have seen a lot of combat, they believe in it. But if you go out with the troops that haven't necessarily, it's harder to make that point that it does exist.

CONAN: We're talking with Kelly Kennedy of the Army Times about the PTSD and the Purple Heart. If you're in the military or if you were, give us a call, 800-989-8255. Email is talk@npr.org, Jason is on the line. Jason, calling us from Rochester, New York.

Mr. JASON: Hi, Neal. I'm a Gulf War veteran. I'm 38 years old, and I waited until I was 37 to go get help for PTSD, and I can tell you that it has had a dramatic effect on my life. And that anyone who thinks it doesn't rank the Purple Heart, either - your guest there just said, you know, it's not intentionally caused. It's absolutely intentionally caused. We have troops that do nothing but specialize in psychological warfare. But the main reason I told your screener is that I think that they denied giving you the Purple Heart because then it legitimizes PTSD and it forces the military and the VA so that they'd have to take that person as far as treatment for the rest of their lives for - excuse me, for compensation, for stuff like that.

CONAN: Well, tell us about that if you would, Kelly Kennedy. Does the Purple Heart convey benefits as well as recognition?

Ms. KENNEDY: Well, if you get the Purple Heart for posttraumatic stress disorder, it certainly makes it combat related. That's known. If your PTSD is bad enough that it forces you out of the military at a medical discharge, it's automatically 50 percent in benefits, so I guess you could make that argument, but at the same time, people are being medically discharged for PTSD and they are being awarded that, so.

CONAN: Would they get any additional benefits if they got the Purple Heart?

Ms. KENNEDY: It will just be proof, I guess.

JASON: But then my point I made, Neal, was that the VA will - what I can tell you because I have gone through the VA system - will do what it can to - for the rest of your life say, OK, well, now you're getting treatment. We're going to reduce what you deserve as a result of this PTSD. PTSD isn't going to go away. Nightmares I have aren't going to go away, the social problems I have - there might be times where it's better or worse, but it's going to be with me forever. And like I said, adding the Purple Heart to it would force the military and the VA to look at it, like you said, as an injury and not something that, you know, I acquired like schizophrenia or something. So, I'll let you get on to the next caller but great show. Thanks.

CONAN: All right. Thanks, Jason, very much for the call. And, well, let's introduce two people with different opinions on this subject. And let's introduce D.J. Skelton, an army captain with the Purple Heart. He's with us from member station, KUST, in Santa Cruz, California. Nice to have you with us today.

Captain D.J. SKELTON (Army Captain, Purple Heart Recipient): Oh, thank you. It's a pleasure to be here.

CONAN: And with us here in Studio 3A, also is Jason Forrester, director of Policy and co-director of the National Guard Program at Veterans for America in Washington D.C. He's with us here in the Studio 3A. Nice to have you with us as well.

Mr. JASON FORRESTER (Director of Policy, Co-director, National Guard Program, Veterans for America, Washington D.C.): Thank you, Neal.

CONAN: And D.J. Skelton, let's begin with you. I guess in response to that call we just heard, a veteran who has PTSD and says this is absolutely a wound of war.

Capt. SKELTON: You know, it's interesting. I think there's a difference of understanding between what is a wound and what is a mental illness, whether you talk about a clinical definition or that. There's no question that leaving the country and moving into a new environment that is hostile in nature, as many of us have done for this nation, in itself is a traumatic event. Being away from our families for so long, let alone being in an environment in which every moment there's someone close by that wants to take your life is traumatic as well. That's not a normal event, and your body will react to that mentally and sometimes physically. And that traumatic stress, I would venture to say that every single service member that deploys suffers from some type level of stress but...

CONAN: Well, PTSD is a specific diagnosis.

Capt. SKELTON: That's right, as a mental illness. And I think the differentiation or the argument that's being made now is George Washington's original intent with the awarding of the Purple Heart specifically states in that order those who have shed the blood by - have shed blood from the enemy will be recognized from all of their fellow countrymen from doing that.

So in that sense, we're talking about a physical injury that has been sustained by a direct enemy, and that was their word of the qualification of the original intent. It's been preserved for so many centuries of the Purple Heart. There's no question amongst any of us that even without being physically wounded like I was, there is stresses on the body that decay and deteriorate to the point where one is diagnosed as having a mental illness called the Post Traumatic Stress Disorder.

And that needs definite clinical intervention and definitely needs help, and that isn't going to go away. My nightmares are not going to go away the rest of my life. My anxieties are not going to go away the rest of my life. But I don't think that should take away from the original intent of George Washington of why we had to recognize. There's a big difference between...

CONAN: OK.

Capt. SKELTON: Standing in front of an enemy that wants to take my life and living which is - for many of our...

CONAN: And I don't mean to cut you off. I just want to give Jason Forrester a chance to present the other side.

Mr. FORRESTER: No, I think Captain Skelton makes a very good point. I draw from his point that we know that there are incredible negative consequences of sending our troops into combat. One of the positive aspects of the conversation that we're having today is that it helps to educate the population in general about the various needs that have been created as a result of the way the all volunteer force has been used during the post 9/11 period.

There have been incredible accomplishments. There's been incredible valor, honoring of service on the battlefield. But at the same time, the way that our country has used our military, our military, it has resulted in incredibly negative consequences for tens of thousands, hundreds of thousands of soldiers. I don't think that until we have some black and white test of what is a mental illness and what does a mental illness look like, and is there a blood test for mental illness, then yes, we'll never satisfy some of the concerns about the legitimacy because there certainly are some concerns about people who are faking, sub-faking psychological problems.

On the other hand, we know that a very high percentage, according to some studies, as many as half of the people who have post combat psychological problems continue to grapple those problems without having them discussed. So bringing this into the neighborhood of a legitimate wound of war, as Secretary Gates has said, as Secretary - Admiral Mullin, among others, have said, helps to enlighten the debate and make us get closer to the point where we can decide if it does reserve the Purple Heart.

CONAN: We'll continue talking about the Purple Heart and PTSD with D.J. Skelton, captain in the U.S. army and also with Jason Forrester, director of policy and co-director of the National Guard program at Veterans for America. We have another question for Kelly Kennedy of Army Times as well. So if you would all stay with us.

If you'd like to join the conversation, we want to hear from our military listeners today, 800-989-8255. Email is talk@npr.org. This is NPR News.

This is Talk of the Nation. I'm Neal Conan in Washington. At the beginning of the year, the Pentagon decided it would not award the Purple Heart, the honor given to those wounded or killed in enemy action, to war veterans who suffer from PTSD, or Post Traumatic Stress Disorder, because it is not a physical wound.

We're talking with Captain D.J. Skelton. He fought in Iraq where he was wounded in the second battle of Fallujah. We're also speaking with Jason Forrester, director of policy and co-director of the National Guard Program at Veterans for America. We want to hear from military listeners today, active duty or vets, should PTSD qualify for the Purple Heart? Give us a call, 800-989-8255. Email us, talk@npr.org. You can join the conversation at our Web site. That's at npr.org. Click on Talk of the Nation. Kelly Kennedy of the Army Times also with us here in Studio 3A.

Before we let you go, we just announced that that decision was made at the beginning of the year. Any possibility, probability, that the Defense Department's going to revisit that decision any time soon?

Ms. KENNEDY: It doesn't sound like it is. It sounds like this was a pretty final decision for the time being.

CONAN: For the time being. The Defense Department, having made such a decision, normally does not turn around and revisit the same question for numbers of years.

Ms. KENNEDY: Well, it does sound like they're done with it for a while, (laughing) yeah.

CONAN: For a while. OK. Kelly, thanks very much for your time today.

Ms. KENNEDY: Thank you.

CONAN: We appreciate you coming in.

CONAN: Let's see if we can get another caller on the line. And let's go to - and I'm sorry, we've lost that. Let's go to - this is David - David with us from Phoenix, Arizona.

Mr. DAVID: Thank you for having me on. I really appreciate it, wonderful show.

CONAN: Thank you.

Mr. DAVID: The issue of Post Traumatic Stress Disorder in the VA, which was being mentioned the caller earlier, there's a preferential treatment group for the recipients of the Purple Heart. They get a higher level of priority, and that would be a benefit to people with PTSD. It would bring to the forefront the fact that the majority of the PTSD veterans really don't seek out treatment as they should. I'm a veteran of 12 years. I was in the 82nd Airborne Division myself, and there are people that are out there that are ashamed of that, and there are wounds that you can't see.

I mean, imagine the traumatic brain injuries that are going on across Iraq from IEDs. Little particular blood on the battlefield, but no less a wound. Is the Purple Heart being awarded for that?

CONAN: What do you say to that, D.J. Skelton?

Mr. SKELTON: You know, I think the PTSD amongst all of us - it's interesting. The theme that I've heard so far with all - to include the last caller - is the stigma of the U.S. military, and I think there's a correlation being made that I kind of want to stop that train of thought when it comes to not awarding the PTSD to - or the Purple Heart to those that only suffer from PTSD or diagnosed with PTSD and the military's stigma or the stigma within the military that stepping up and saying, hey, I'm having a hard time dealing with this post trauma of being deployed and what's happened to me in combat as being a negative and being punishable is not the case.

Other examples of it throughout the military, yes, they are but not to the extent at all, nor is it a majority of what it used to be like in the Vietnam War or previous major conflicts. I think across the military, and I can only speak for the U.S. army, across the U.S. army, there's a huge difference on support and praise amongst the ranks in the chain of commands and the allowing in facility and the environment of soldiers that are having a hard time adjusting, stepping up and saying, I need help, and we're not kicking them out of the army. We're keeping them in. We're rehabilitating them.

Mr. DAVID: Right. But it influences their ability for promotion. It also influences their ability to interact with their peers. It does create a stigma. It just does. You say it's a mental illness. Mental illness creates a stigma...

CONAN: Jason Forrester...

Mr. David: To interact and be promoted is definitely affected.

CONAN: Jason Forrester, I think David is right. There is a stigma.

Mr. FORRESTER: Yeah, well - and back to Captain Skelton's point - I mean, think it's a question of how you look at it. Have improvements been made? Yes. How far do we have to go? I would answer that with a long ways to go. And what I say is backed up by what the Chairman of the Joint Chiefs of Staff Admiral Mullen bravely said a year ago at a session here in Washington D.C. at the Center for A New American security speech that he gave, his first public address, when he said that he will not allow to happen after Iraq and Afghanistan what happened after Vietnam.

To have that come from the top man in the military sends an incredibly constructive signal throughout the ranks. But you also have to look behind what he's saying and what he had said even recently when he, Admiral Mullen, chairman of joint chiefs, has specifically said, that there needs to be sophisticated one on one screening for everyone who comes into combat. As he describes it, we have sophisticated screening for the physical wounds, but we do not have a commensurate level of screening for psychological ones. This comes straight from the man in charge of the military.

CONAN: And how does the Purple Heart change that?

Mr. FORRESTER: The Purple Heart would change this in the sense that if we were to come to an agreement that it was a legitimate wound that deserved the Purple Heart, then that would certainly address the question that it is not a real wound, that they're quote/unquote, "lesser heroes." That's certainly something that, a myth, that needs to be busted as well. As if people come back from combat and they're having trouble adjusting to civilian life, it's not a matter of somebody slapping him around like General Patton did or telling them to pull themselves up by their bootstraps.

Some people will be able to pull themselves back together. That's not the case for probably the majority of people. They will need help, and they will need a lot more help than they've been getting. I was in Fort Drum New York a year ago, the most heavily used brigade in the U.S. army of the 10th Mountain Division, people are having to wait two months after having self-reported psychological problems to have an appointment on base.

CONAN: OK. David, thanks very much for the call.

Mr. DAVID: Thank you very much.

CONAN: So long. Let's go now to Brian. Brian's with us from Colorado Springs.

Mr. BRIAN: Hey, Neal, how are you doing?

CONAN: Very well, thank you.

Mr. BRIAN: Yeah. I'm sort of in between on this one, but I'm going to go with the captain. I say no, but not for the same reasons. One, I have a Purple Heart, and I also have PTSD. As a matter of fact that's where I'm at now, waiting to see the doctor, but it's such a separate issue. It's an emotional thing, and it's not so much the intent of what Washington had because, actually, his intent for the award was not for a wounds...

CONAN: It was for distinguished service.

Mr. BRIAN: Correct. That's actually what it says on the back of the little metal they gave me. But, yeah, the PTSD - I always call it my burden to bear, but the last speaker was correct about Fort Drum. Even here at Fort Carson, once I went to the doctor and reported my issues, it took six months for them to find me a doctor to go to, and now I actually go to an Air Force doctor.

But again, I say, no. And it's a matter of tradition. But if you even look at the army regulation, it took us forever to realize concussions warrant the Purple Heart. I mean, people didn't even know that.

CONAN: And traumatic brain disorder, TMI, Traumatic Brain Injury, which has been described as the signature wound of the war in Iraq

Mr. BRIAN: Correct, and I have that as well, and I've been back about a year, and they just finally hooked me up for the doctor for that. So it's not been pleasant, but...

CONAN: What distinction do you draw? It's just a tradition in your mind, the fact that if you bleed it's a Purple Heart, if you don't, it's not?

Mr. BRIAN: No, it's not the bleeding. I just go with the tradition just for the fact that, I guess, like a - that lady from the Army Times meant, it's the immediacy of it. It is extremely hard to go back. My issue was I don't want another award. I just wanted help. And, you know, I'd rather the Army focus on that than the award.

CONAN: Let's see if we can get a response from Jason Forrester.

Mr. FORRESTER: Yeah, well, I don't think I could have put it any better than the gentleman just did that people won't help, people deserve help, and as a country, we have a sacred obligation to ensure that those who come home from combat get all the help they need. And I know a lot of people can easily sign up for that statement. But when we start drilling down into what exactly that means, when we send a high percentage of our force, as listeners know, we have an all-volunteer military, as General Casey, the chief of staff of the army has described it, we have an all-volunteer uniform army that is going through a long war.

The natural consequence of that is multiple deployments with oftentimes inadequate time at home, which has the consequence of greatly raising the psychological burdens, the psychological wounds of war. These findings come straight from the Army itself.

People can go tot he VeteransforAmerica.org Web site and find various reports that the Army has put out which basically says, the deleterious effects for extension of tours - of multiple tours - are obvious. And then at the same time, when we have a situation where we continue to have an adequate number of doctors and professionals who are helping soldiers readjust. Thank God there is some improvements that had been made, because Lord knows what it'd look like if we hadn't had these improvements. But we have so far to go compared to what a standard of care that these service members serve.

CONAN: I'm not hearing Capt. Skelton disagree with any of that. All he's saying is that it should not be recognized by the Purple Heart.

Mr. FORRESTER: Well, no, and I agree with that in the sense that we need to make sure that the wound is a legitimate wound of war before we award our highest - one of our highest medals of distinguished service for that. I see this as an incremental process. It took more in a decade after the Vietnam War for us to even understand this acronym PTSD we now so often repeat, which in itself is inadequate to describing what are the psychological consequences of war.

So I think this could be a discussion later on where it'll be clear, but it will take time.

CONAN: Brian, good luck with the doctor.

Mr. BRIAN: Thank you, sir.

CONAN: Appreciate it. Let's see if we can go now to Darren. Darren with us from Fort Richardson in Arkansas.

Mr. DARREN: Hello. Yes, my comment is that to me this isn't an issue of whether or not PTSD is a real injury or whether or not they're stigmatized. I think both that is true. To me, as a captain, I'm a mobilized reservist, and I'm serving in a post-9/11 world. I volunteered to serve this military after 9/11, knowing that I could be deployed. And if I were injured here in support of the war on terrorism, here at Fort Richardson, Alaska, I'm not entitled to get the Purple Heart no matter how grave my injury, and that's because that's not the medal for that type of injury.

And the Purple Heart is a medal specifically designed for physical injuries sustained on the battlefield, and I just don't think PTSD meets that criteria just like even if I lost a limb here in support of the war on terrorism back home, I don't get the Purple Heart.

CONAN: Well, it's unlikely that that diagnosis existed. And when I think it was Douglas MacArthur who changed the definition of the Purple Heart to be for wounds suffered in combat.

Mr. DARREN: Well, I don't disagree with that. It's just my gut feeling on the Purple Heart is when people see a soldier wearing the Purple Heart, they expect that that soldier sustained physical injury and spilled blood like the other captain said earlier in this show.

CONAN: Well, D.J. Skelton, is that part of your argument that this is what people's expectation of it is?

Capt. SKELTON: You know, I don't about it. I think that's true with the expectation of visually seeing someone with a Purple Heart pendant on the chest. There is that connotation or that understanding that they stood in front of an enemy and was wounded, physical injury sustained from that encounter. Again, what I am seeing is, I think everyone agrees throughout, and I've spent a lot of time with some of our highest leaders, not just within the military but some of our cabinets and on the Hill in Congress.

We recognize the fact that PTSD is real, and we recognized it in policy. In fact, there has been extremely in-depth comprehensive studies, for instance from RAND and many other think thanks that are phenomenal in trying to capture the reality that this is real in this current war that we're seeing a unique psychology coming out of this war, because for the first time, we're having a all-volunteer force, like Jason said, that is having to go back, not just close the chapter once, but have to reopen, regroup, go back into a combat zone, reintegrate back in the society, and with a short dwell time, go back, and that's unheard of.

That's never happened in this country, and that has a different effect, psychologically, on the body than others, but I have to go back and say, I think it's hard to pinpoint what is, you know, the intent of the Purple Heart. You could go to combat in just the fact that you're away from you family for a year, not be able to deal with it. Should that be awarded the Purple Heart? I don't think so. I think to preserve the original intents is to stand before a hostile encounter and walk away from it in a manner that, you know, you should have died, but you got wounded in the consequences of it.

I think that's the differentiation here between who should be awarded that and who should not.

CONAN: Darren, thanks very much for the call.

Mr. DARREN: Yeah, thanks for having me.

CONAN: We're talking about PTSD and the Purple Heart. You're listening to Talk of the Nation from NPR News. And we wanted to get - we're getting a lot of phone calls from people in - and we're not going to get a chance to get to all of them, and we thank you all who have written in, and emailed us, and called us, and gone on our Web site, but this from Brian via email.

As a medical resident, I do my outpatient clinic at the VA. Almost all of my regular patients who have seen combat have PTSD. Despite my attempts, I've been unsuccessful to convince any of them to get treatment, largely due to the stigma around having any psychiatric diagnosis. These vets turn to drugs or alcohol or both to deal with their problems, which lead to another set of health problems. Recognizing PTSD as a Purple Heart worthy will decrease the stigma, increase the use of counseling and recovery resources, and save us all money and personal heartache in the long run.

Let's see if we can get one more caller in on the conversation, this is Justin, Justin with us from San Antonio.

Mr. JUSTIN: Yeah, hi.

CONAN: Hi, Justin. You're on the air. Go ahead, please.

Mr. JUSTIN: Yeah, my comment was in reference to the original definition of the Purple Heart. And, you know, has that been revived or looked at as modern warfare has changed? You know, with the multiple deployment and kind of indirect injuries, you know, I was wondering if some of the guest speakers could comment on that.

CONAN: Jason Forrrester, has - is it still the definition that was defined by Douglas MacArthur?

Mr. FORRESTER: Well, as you pointed out, Neal, the qualifications for earning a Purple Heart have changed over time. So I would put that on that sort of - I would describe that as the evolution of the Purple Heart track. On the other track, I would put understanding of the psychological wounds of war. There are things that are happening that I predict will lead to this becoming a less contentious discussion in the years to come. For instance, it was the U.S. Congress that, about a year ago, through legislations, said that, if you have a psychological wound or war, you deserve a 50 percent, 5-0 percent disability rating. If you got a 30 percent disability rating when you're discharged in the military, you get lifetime medical coverage through the Army's - through the military's Tricare system.

So that's a hint that the Congress sees these wounds marked great wounds of war that deserve that form of lifetime treatment. Once again, back to what Secretary Gates said around a year ago when he was at Fort Bliss. Why did he open this discussion? He could have easily quashed this discussion with a single no as an answer to the question of do you think this deserves the Purple Heart, this being the psychological wounds of war. He didn't say that. He opened up the possibility. So I see that, among other things, as moving us toward the understanding.

CONAN: So you think this conversation is not closed?

Mr FORRESTER: No, I don't think it's closed. And I think - also I would respectfully say that any decisions made by the Bush administration, Pentagon, could easily be reviewed by an Obama administration, Pentagon, and will be in many, many cases.

CONAN: And same men in charge. Briefly, D.J Skelton, we just have a few seconds left, but do you think this ought to be an open discussion?

Capt. SKELTON: I think it should be an open discussion, especially since we have so many new people in leadership, not just in the executive branch but also in Congress and the military. But one quick thing, we keep mentioning Fort Bliss. Fort Bliss is a phenomenal example of the only in-patient active duty for those that have been diagnosed of PTSD, and we established it two years ago, and it's a 30-bed in-patient, and it's...

CONAN: We're out of time, I'm sorry. We got to go. Justin, thank you very much for the call. D.J. Skelton, thank you for being with us. Also, Jason Forrester. PTSD and the Purple Heart. This is NPR News.

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