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Sniffing Gas Could Prevent PTSD, Study

By: Christine Hsu

August 28, 2014

Gas could help prevent post-traumatic stress disorder and other memory-related conditions, according to a new study. Researchers from McLean Hospital found that xenon gas, which is used in humans for anesthesia and diagnostic imaging, can help reduce the vividness of traumatic events. “In our study, we found that xenon gas has the capability of reducing memories of traumatic events,” Edward G. Meloni, PhD, assistant psychologist at McLean Hospital and an assistant professor of Psychiatry at Harvard Medical School said in a news release. “It’s an exciting breakthrough, as this has the potential to be a new treatment for individuals suffering from PTSD.” “We found that a single exposure to the gas, which is known to block NMDA receptors involved in memory formation in the brain, dramatically and persistently reduced fear responses for up to 2 weeks. It was as though the animals no longer remembered to be afraid of those cues, ” he added. “The fact that we were able to inhibit remembering of a traumatic memory with xenon is very promising because it is currently used in humans for other purposes, and thus it could be repurposed to treat PTSD,” researcher Marc J. Kaufman, PhD, director of the McLean Hospital Translational Imaging Laboratory, said in a news release. “From here we want to explore whether lower xenon doses or shorter exposure times would also block memory reconsolidation and the expression of fear. We’d also like to know if xenon is as effective at reducing traumatic memories from past events, so-called remote memories, versus the newly formed ones we tested in our study,” he added. The findings are published in the journal PLOS ONE. http://www.counselheal.com/articles/11073/20140828/sniffing-gas-prevent-ptsd-study.htm

How Congress Plans to Prevent Military Suicides

A shooting at Fort Hood last month has pushed military mental health back into the congressional spotlight.(JIM WATSON/AFP/Getty Images)

A shooting at Fort Hood last month has pushed military mental health back into the congressional spotlight.(JIM WATSON/AFP/Getty Images)

By 

May 7, 2014

 

Lawmakers hope to use an annual defense bill as a vehicle for mental-health screenings.

Jacob Sexton, a 21-year-old member of the National Guard, fatally shot himself inside an Indiana movie theater during a two-week leave from Afghanistan in 2009.

Sen. Joe Donnelly will unveil legislation Wednesday named after Sexton that would require service members to get an annual in-person mental-health assessment. Donnelly hopes it helps stop others from taking their own lives.

“This is about working nonstop with Jacob’s parents to prevent other families from experiencing that same pain,” the Indiana Democrat said in a video obtained by National Journal that will be released Wednesday.

 

Donnelly’s legislation, formally called the Jacob Sexton Military Suicide Prevention Act, follows the Pentagon’s latest suicide numbers released late last month. The report found a decrease in the number of reported suicides among active-duty troops, but an increase in reserve and Guard members killing themselves.

There were 319 suicides reported among active members in 2012, compared with 261 in 2013, according to preliminary data. But suicide within the ranks of reserves and National Guard members increased from 203 in 2012 to 213 last year.

And while suicide is historically underreported, the Pentagon says a total of 841 service members attempted suicide at least once in 2012.

Meanwhile, the number of service members who kill themselves after they leave the military has increased dramatically. The VA estimates that 22 veterans commit suicide each day, totaling about 8,030 veterans every year.

Many service members already have an annual mental-health screening, but Donnelly’s bill is aimed at closing the gaps for in-person assessments. For example, Air National Guard members currently have an annual online assessment, but face-to-face examinations take place only every five years.

Lawmakers and service organizations worry that the stigma attached to mental-health issues keeps service members—both past and present—from asking for help or reporting mental-health problems. Attempting suicide is currently considered a crime under the military’s rules.

“Right now, the best and most consistent screening is happening only for those within the deployment cycle, and it leaves reservists and Guardsmen like Jacob underserved,” Donnelly said.

In addition to the mental-health screenings, Donnelly wants an annual report from the Pentagon to the Armed Services committees detailing the screenings and what care or follow-up was recommended. The Defense Department would also have to submit a report on how to improve its response on mental-health issues. And a committee to improve mental-health services for National Guard and reserve troops would be formed with the Department of Health and Human Services.

Donnelly isn’t alone in his search for solutions. Lawmakers have introduced a handful of other proposals to address mental-health issues in the military. Some argue such measures could help prevent a shooting like the one at Fort Hood last month, when Ivan Lopez, a 34-year-old Army specialist, fatally shot three people and injured 16 others before turning the gun on himself.

Republican Rep. Glenn Thompson of Pennsylvania, Democratic Rep. Tim Ryan of Ohio, Republican Sen. Rob Portman of Ohio, and Democratic Sen. Jay Rockefeller of West Virginia have introduced the Medical Evaluation Parity for Service Members Act in their respective chambers. Instead of requiring annual in-person mental health screenings, the legislation would require screenings for military recruits and for reserve and National Guard forces that transfer to active duty.

Donnelly and other lawmakers hope to get their proposals included in the annual defense bill, the National Defense Authorization Act. The bill has been passed for the last 52 years, and it’s likely the best vehicle for avoiding partisan fighting. And Donnelly’s legislation will get early bipartisan support, with Mississippi Republican Sen. Roger Wicker expected to endorse the proposal.

Donnelly originally introduced a version of the bill last year, with a pilot program on mental health screenings instead of annual in-person screenings for all servicemembers. The Pentagon was required to submit a report with feedback on screening tools included in the program, as part of the last year’s defense bill.

The report—part of a bipartisan push spearheaded by Donnelly—also asked for an assessment of new tools that could be used to improve mental-health screenings and better identify suicide-risk factors for service members. Donnelly received the report in March, and used it to help craft his new legislation.

“There is not one solution, there’s no cure-all to prevent suicide. But this problem is not too big to solve. We can start by improving our methods of identifying risk factors before it is too late,” he said.

http://www.nationaljournal.com/defense/how-congress-plans-to-prevent-military-suicides-20140507

Marine battled back, yet fell to suicide

Farrell Gilliam was buried in Fresno Jan. 21, carried to his grave by Marine pallbearers and friends. (Courtesy Gilliam family.)

Farrell Gilliam was buried in Fresno Jan. 21, carried to his grave by Marine pallbearers and friends. (Courtesy Gilliam family.)

 

 

By Gretel C. Kovach MARCH 28, 2014

*GRAPHIC LANGUAGE

He rarely spoke of it. Not to his family or best buddies, fellow Marines or medical staff watching over him.

But Cpl. Farrell Gilliam had endured far more by the time he died this year at age 25 than most people could comprehend.

The Camp Pendleton infantryman survived three months of combat in 2010 with the “Darkhorse” 3rd Battalion, 5th Marine Regiment in Sangin, Afghanistan — one of the deadliest battlegrounds of the war.

Amid firefights and insurgents’ bombs, Gilliam saw limbs strewn across the ground. He loaded broken, bleeding bodies for medical evacuation, and grieved for the friends they could not save.

Gilliam’s tour ended early when his legs were blown off by an improvised explosive device, or IED. “Farrell’s Fight,” his struggle on the homefront that his big brother helped him chronicle online, included more than 30 surgeries and three years of rehabilitation.

It was a story of triumph over wounds that would have been fatal in earlier conflicts. A story that was coming to an end, but not how anyone who knew him expected.

 

Gilliam was months away from a medical discharge from the Marine Corps and a new life as civilian college student. Physically, he had one surgery left to remove hardware in an arm. Psychologically, he was suffering from invisible wounds he hid behind smiles and upbeat banter.

Or so his family discovered on Jan. 9, when Gilliam committed suicide by shooting himself in the head in his barracks room in San Antonio.

Gilliam finally succumbed to his battle wounds, said Sgt. James Finney, his former squad leader in Afghanistan. It doesn’t matter who pulled the trigger — to him Gilliam was killed in action just like the other 25 from their battalion.

“It was an 8,000-mile sniper shot,” said Finney, 27, now an infantry instructor. “His passing was directly due to a situation because of his wounds received in Afghanistan. I don’t care what anyone else thinks.”

The suicide rate for active-duty troops spiked in 2012 to nearly one a day, a record during this era of warfare and twice as high as a decade before. At least 350 took their lives that year, more than the number of service members killed in combat. (Final numbers for 2012 and a year-end tally for 2013 are pending, a Pentagon official said.)

Last year, 45 Marines committed suicide and 234 tried to. It was by far the highest number of suicide attempts for the service since at least 2003.

Among veterans of all the armed forces, at least 22 commit suicide daily, according to estimates from the U.S. Department of Veterans Affairs.

Gilliam’s death blindsided his family and friends. Amid their raw first waves of grief, anger and irrational guilt, they pray that sharing his story might inspire others to stop suffering silently. Or spur a family to intervene. Or close a gap in support or education.

“I want no family to have to go through the pain that we are going through. If there’s just one person who gets that help that saves them … then it’s worth it,” said Gilliam’s brother, Daniel Lorente, 30, of Palo Alto, who cared for him full time as his non-medical assistant early in his rehabilitation.

Cpl. Farrell Gilliam and his brother Daniel Lorente in a Palo Alto fire truck in 2011 on the way to Gilliams flying lesson with a cousin. Courtesy photo

Cpl. Farrell Gilliam and his brother Daniel Lorente in a Palo Alto fire truck in 2011 on the way to Gilliams flying lesson with a cousin. Courtesy photo

Combat

As a teenager, Gilliam scored high on tests but was uninterested in school. He was introspective and brash, a gun-lover who wanted more excitement than the Navy had offered his parents. He enlisted with the Marines at age 17 so he could serve his country and “blow s* up.”

“He just wanted to be a grunt,” said his mother, Lisa Gilliam of Fresno.

After a sea tour, Gilliam volunteered for combat. He deployed in October 2010 as an infantryman and designated marksman to Sangin, a Taliban stronghold in southwestern Afghanistan where U.S. Marines were taking over from British forces.

Four Marines died in a bomb strike on the first day. Gilliam served on the quick-reaction force, manning the Mark 19 grenade launcher or .50-caliber gun, pitching in with litter teams after roadside bomb attacks and shootouts.

When he called home Christmas Day, apologizing for upsetting his mother by missing the holiday for the first time, he sounded like a man fighting to survive.

“Is it bad?” Lorente asked. “Are you guys doing OK?”

“We are taking hits. S* is just rough right now,” Gilliam said. “We are doing everything we can.”

Cpl. Farrell Gilliam (right) on a 2010-2011 deployment to Sangin, Afghanistan.

Cpl. Farrell Gilliam (right) on a 2010-2011 deployment to Sangin, Afghanistan.

Gilliam shielded his mother from the worst so she wouldn’t worry. But Lisa Gilliam, a pediatric nurse practitioner specializing in surgery and trauma care, realized after that phone call that her son was going to need help.

“I could tell in his voice,” she said. It was exhausted. Haunted. “I knew he was not going to come home the same as he left.”

A week later, on Jan. 5, 2011, Farrell Gilliam stepped on an IED. The Marines were walking through a desert neighborhood of mud-walled compounds near their base, toward a distant radio tower.

Gilliam, a team leader, was at the back of the patrol. About 10 Marines had trod ahead, marking a narrow path as they went, before he triggered a pressure plate buried in the dirt.

Finney heard the explosion. He looked back and saw a cloud of dust. No one answered him on the radio but he could hear yelling. When he crested the hill, he saw Gilliam inside a bomb crater.

One of Gilliam’s grenades had detonated in the explosion, mangling his side. His feet were blasted away and his right arm broken.

Gilliam was the first from their squad of “Regulators” to be wounded. “I didn’t want to believe it, but at that point we’d kind of gotten used to guys getting hurt,” Finney said.

By then, 24 had been killed with the battalion. Gilliam and the Lima Company quick-reaction force had responded to 18 urgent casualty evacuations, most of them limb amputations.

Navy hospital corpsmen and Marines worked rapidly to stop Gilliam from bleeding to death. They cinched his legs with tourniquets, stuffed his guts back in his belly and injected him with morphine.

One Marine held down Gilliam’s thrashing body while another calmed him, assuring him he would be fine.

On the drive to Forward Operating Base Nolay, a corpsman jammed his fingers in Gilliam’s wounds to keep him awake. To keep him alive until the medevac flight crew finally put him to sleep.

Gilliam was terrified he would die on that helicopter, like a squad leader from his company, Sgt. Ian Tawney.

Lisa Gilliam heard her son speak of it only once. It was after he arrived on Jan. 9, 2011, at Bethesda, Md., and the National Naval Medical Center. He was in the intensive care unit, suffering terrible flashbacks.

“What are you afraid of?” a chaplain asked.

Gilliam recounted every detail. His voice was hoarse from the breathing tube that had just been removed. He was crying.

“I remember putting one of my guys on the medevac. They took off and he died later,” his mother recalled him saying.

Then one day they put him on the helicopter, too. And Gilliam was afraid. So afraid.

“That I was going to die later, too,” he said.

REHAB

Both legs had to be amputated above the knee because of debris rammed into his flesh, trauma from the explosion and infection. Gilliam also lost half of his abdominal muscles, a section of arm bone and portions of his testicles.

On the upside, his brain and face were intact, he kept both arms, and with help from hormone treatment, he could expect to father a child normally.

When Lisa Gilliam’s husband, from whom she was long separated, called saying their son was badly wounded and may not live, she screamed into the phone as if he were dead.

Gilliam’s family members thought he was protected in the war zone by his training and armored Humvees.

“I didn’t know what an IED was. I had to look it up,” Lisa Gilliam said. “What the hell are they out there doing looking for IEDs? I thought they were shooting guns behind bunkers like you see in the World War II movies.”

Her daughter Sarah, 22, just didn’t understand. “I thought she was trying to tell me he was dead. I couldn’t comprehend: he’s lost his legs but he’s alive?” How could that be?

Gen. James Amos, commandant of the Marine Corps, pins on Cpl. Farrell Gilliams Purple Heart medal while the young Marine is in the Intensive Care Unit at Bethesda, Maryland Jan. 28, 2011.Courtesy photo

Gen. James Amos, commandant of the Marine Corps, pins on Cpl. Farrell Gilliams Purple Heart medal while the young Marine is in the Intensive Care Unit at Bethesda, Maryland Jan. 28, 2011.Courtesy photo

The first year of recovery was rough for Gilliam. He was overcome by bouts of anger, fear, depression and frustration, even as he fantasized about returning to combat.

“I remember him saying, ‘We need to hurry up and get me better so I can go back.’ I was like, ‘You are going to kill Mom if you go back!’” his brother Lorente said.

Gilliam responded: “What? This time around if I step on an IED, I’ll just get new (prosthetic) sticks and I’ll be fine!”

Medications clouded his mind and made him vomit regularly for five months straight. He flushed them after one surgery, then had to order more to cope with the pain.

illiam sometimes slipped into what his mother called “black moods.” He would sit, unresponsive, for hours or even days at a time.

“He would just, like, check out. He would be fine and then it would be like turning off a light switch and he would just be somewhere else. You couldn’t reach him. You couldn’t talk to him,” she recalled.

In time, those dark spells grew shorter and less frequent.

These were normal struggles for a young man coming to terms with half his body blown away, according to his father, Mike Gilliam, a civilian defense worker from Ridgecrest, Calif. Family and fellow Marines tried to help him adjust.

“His first sergeant told him, ‘You ain’t got that much to be angry about.’ He knew it. He just had to get over it and get some perspective. And he was,” Mike Gilliam said.

“You’ve got lots of guys out there who lost both their arms and one leg and they just lay in their bed twitching. Or they get their brain rattled and they don’t think straight anymore. They lose their jaw.

“Good grief, he came out pretty good. The politicians, they loved to pose with him. He was a photogenic case,” he said. A handsome young man with dark almond eyes and a mischievous grin whose bedside visitors included the president and the commandant of the Marine Corps.

Gilliam got over his “attitude problem,” his father said, and tried to recover as quickly as possible. Soon he was zipping around corners of the VA Palo Alto on one wheel of his chair, a move immortalized as a “Farrell turn” at the hospital where Gilliam’s portrait still hangs.

“Every time I saw him, he was in good spirits,” said Finney the former squad leader. Even while coming out of physical therapy, which can be tiring and painful. “He always acted like he was going to beat it.”

Cpl. Farrell Gilliam is reunited with his unit for the first time in May 2011 at Camp Pendleton, at a memorial ceremony for 25 killed in action serving in Sangin, Afghanistan with the 3rd Battalion, 5th Marine Regiment. Courtesy photo

Cpl. Farrell Gilliam is reunited with his unit for the first time in May 2011 at Camp Pendleton, at a memorial ceremony for 25 killed in action serving in Sangin, Afghanistan with the 3rd Battalion, 5th Marine Regiment. Courtesy photo

 

TEXAS

In October 2011, Gilliam transferred to Brooke Army Medical Center in San Antonio, home to one of the nation’s top rehabilitation programs for the more than 1,500 Iraq or Afghanistan war veterans with an amputated limb.

He would be far from family in California, but they thought the Center for the Intrepid — with its surf tank and other amenities — offered him the best long-term chance of recovery.

Gilliam moved into the wounded warrior barracks at Fort Sam Houston, among its detachment of about two dozen Marines and equal number of staff members.

On Jan. 5, 2012, he celebrated the first anniversary of his “Alive Day,” when Marine amputees mark the moment they cheated death in combat, and toast those who weren’t so lucky. Gilliam wrote on his Facebook page: “One year ago today I got blown the f* up, but I’m here on the river walk in San Antonio getting hammered with my buddies.

“SUCK IT TALIBAN, YOU LOSE,” he wrote.

More than 500 people hit “like” on the post. After a long string of supportive comments, including jabs at Taliban living in caves, Gilliam wrote: “this just made my day.”

Cpl. Farrell Gilliam with his grandmother, Theresa Stavens, brother Daniel Lorente, and mother Lisa Gilliam in Bethesda, Maryland March 2011 on Gilliams first outing from the hospital. Courtesy photo

Cpl. Farrell Gilliam with his grandmother, Theresa Stavens, brother Daniel Lorente, and mother Lisa Gilliam in Bethesda, Maryland March 2011 on Gilliams first outing from the hospital. Courtesy photo

During visits home last year for the holidays, he seemed to be thriving. Independent again, full of life and plans for the future. And more outgoing than before he was wounded.

Gilliam had reconciled himself to a wheelchair because his missing abdominal muscles made it difficult to use prosthetic legs. But he didn’t let that confine him.

He bought a big truck with hand controls and drove it to New Mexico to see a friend. Cruising with his sisters, he would dance in the driver’s seat to anything from Angels & Airwaves rock to classical music.

Gilliam ate only organic food, worked out diligently and adopted the Paleo Diet. On Thanksgiving, he propped his cookbook on the counter and mixed up pumpkin muffins with almond flour.

“I was in awe,” his brother Lorente said. “Whatever they are doing in San Antonio has changed my brother into this young man who was going to be able to take over the world if he wanted to.”

There was a nice young lady in the picture. A part-time job waiting for him and studies toward an English major at Arizona State University, for which he had already started online classes.

Gilliam loved reading — especially Kipling, Wordsworth and Emerson — a pastime he shared with his good friend James McCain. The two were going to be roommates after Gilliam left the Corps.

Gilliam had served with the U.S. senator’s son, a 25-year-old Marine veteran, before deploying to Afghanistan. When they reconnected after Gilliam was wounded, McCain was impressed to find “practically the only other person on the planet” who knew about the philosophy of naturalism.

He was “a really deep young guy I really enjoyed talking to,” McCain said. They spoke almost every day.

“The sweetest guy I ever met really. There wasn’t an angry bone in his body. When I would get pissed off, I would end up calling him. ‘Jim, we’ll be alright,’ he would say. That taught me a lot about life,” McCain said.

Gilliam never mentioned wanting to kill himself, not even in jest, McCain said. But he remembers the one time his friend revealed the burden of his wounds.

They were drinking beers one afternoon about six months ago. Gilliam was on the couch when McCain got in his chair to wheel over some refills. “Man, this is the best beer-getting chair!” McCain joked.

“Yeah, it’s pretty awesome when you don’t have to be stuck in it the rest of your life,” Gilliam said.

McCain and Gilliam celebrated New Year’s with friends in Arizona. After exchanging a pile of books, Gilliam left on Jan. 3 for Texas. “‘Alright man, see you soon,’ he said. And that was it,” McCain said.

“He seemed fine. His normal self.”

TRIGGER

Gilliam told his sister Sarah that he had a great time in Arizona and didn’t want to return to San Antonio. “He didn’t want to sit in his room and wonder when he would see everybody again. It just went downhill from there,” she said.

He sat alone in the barracks drinking a bottle of Scotch, ignoring his sister’s protests.

“It was an overwhelming sense of isolation, from everybody and everything,” Sarah said.

A couple days later, on Jan. 5, on what he now called his “Survival Day,” Gilliam wrote a long post on Facebook. He ruminated over each moment of the IED attack and thanked everyone by name who helped him.

“Three years ago today I won (or lost) a game of hide and seek with an IED in Afghanistan,” he wrote.

“Doc Brown, Doc Gojar, Gutierrez, Griff, and Finney, and countless other surgeons, doctors, nurses and corpsmen helped keep my name off the KIA list.

“Every morning I wake up and realize that I am actually alive, I think about all of you,” he said.

He mentioned his hope that stem cell technology could give him a new pair of legs, then wrote: “I love you guys. I think about you every day and will continue to do so until I can no longer think due to Alzheimer’s, dementia, or death. Thank you.”

On Jan. 9, three years to the day after he returned to the United States from Afghanistan, Gilliam sent a mass text to his closest relatives and friends.

“I love you. Far more than you know,” it said.

Responses filled all of their phone screens: I love you too, brother; Love ya, Gilly …

Sarah was worried. “How ya doing by the way?” she texted.

No response.

“Seriously though are you ok?”

No response.

“IF YOU REALLY LOVED ME YOU WOULDN’T MAKE ME WORRY.”

An hour after that, a barracks resident heard the gunshot.

The family of Camp Pendleton Marine Cpl. Farrell Gilliam, from left, sister Erin Gilliam, brother Daniel Lorente, mother Lisa Gilliam, and sister Sarah Gilliam, at Seaport Village in San Diego on Saturday. Cpl. Gilliam, who was terribly wounded in Afghanistan, recently took his own life. Marines and relatives don't consider it suicide and is petitioning to have his name on a stone memorial with the other 25 members of the battalion killed in action. Hayne Palmour IV

The family of Camp Pendleton Marine Cpl. Farrell Gilliam, from left, sister Erin Gilliam, brother Daniel Lorente, mother Lisa Gilliam, and sister Sarah Gilliam, at Seaport Village in San Diego on Saturday. Cpl. Gilliam, who was terribly wounded in Afghanistan, recently took his own life. Marines and relatives don’t consider it suicide and is petitioning to have his name on a stone memorial with the other 25 members of the battalion killed in action. Hayne Palmour IV

AFTERMATH

Lisa Gilliam saw two Marines at her door and thought they were gathering donations.

They said her son had passed, but she couldn’t believe it. She screamed: “How do you know? How do you know!”

Gilliam didn’t appear to suffer from depression, PTSD or suicidal tendencies. He quit all medications several months earlier, as far as his family knew.

“The universal reaction was, ‘Where did this come from?’” his father said. “No one was under the impression that he was going through any kind of battle in this regard.”

To this day, he can’t accept it. Maybe a brain lesion or seizure was to blame, he wonders, though naval investigators ruled the shooting a suicide.

Lisa Gilliam was disturbed to learn that her son hadn’t received psychological treatment for two years.

He didn’t seem to need it, she agreed. As in the civilian world, the military can’t force personnel into psychological care unless they appear in danger of hurting someone, she was told.

“He put on a great face in the day. But I think nights, alone in the barracks there at San Antonio, were probably hell for him. The Marine Corps and the military in general, they need to look at these different stages. They can’t say just because they aren’t showing signs, that there’s nothing going on upstairs,” she said.

When the troops return home, “the war is not over for them. It rages for them in their heads and their hearts. Farrell’s physical was the least of his problems, apparently. We didn’t think so, but look at where we are at now.

“That’s what PTSD is. It’s like a tumor that you can’t see. If it’s not treated, it’s going to kill you.”

As a family, they have so many questions about Gilliam and other combat veterans.

Why bother to heal their bodies if you can’t heal their minds? Why do wounded Marines have single rooms instead of being forced to buddy up? Why couldn’t Gilliam live with a Jack Russell therapy dog like he wanted? Why is it so easy to sneak a gun into the barracks?

And the most important question of all. The one they know can never be answered: Why did he leave them?

As the Corps grapples with fallout from 13 years of combat, it encourages Marines to look out for each other and for signs of distress. Many are reluctant to ask for help because of the stigma against psychological care, a fear of appearing weak and mistrust of medical providers who haven’t seen combat.

“We are a stubborn breed,” said Capt. Ryan Powell, a spokesman for the Marine Corps Wounded Warrior Regiment.

PETITION

After Gilliam died, Marines who served with him in Sangin started talking about the battalion’s 26th KIA.

Mark Soto, the father of a “Darkhorse” Marine who struggled with suicidal impulses but got help, started a petition. It asks the Corps and Defense Department to add Gilliam’s name to the memorial stone at Camp Pendleton for the 5th Marine Regiment war dead.

It quickly gained more than 1,000 supporters.

Jim Binion, whose stepson Sgt. Matthew Abbate was killed in Sangin, encouraged readers of his “Hella Sick Clothing” blog on Facebook to sign the petition.

When some objected to Gilliam being counted among the KIA, Binion replied: “Farrell woke up to pain every day, and PTSD like you can only think of in nightmares, and one night the demons got him.

“If you have a problem with us pushing for Farrell, feel free to leave the page. But I know what Matt expected from me. He would not leave a brother behind.”

Finney, the former squad leader, said Gilliam deserves respect for being one of the few Americans who volunteered to be a Marine grunt. On top of that, “he goes to a combat zone and receives a Purple Heart. It makes him 1 percent of 1 percent of 1 percent.”

Then he quoted from Henry V. The same words Gilliam used on Memorial Day 2012 when he beseeched the public to “remember our fallen, so they will not die.”

“Our 25, the giants of our generation, who fell in battle against the mighty Taliban, in the far off lands of a place called Afghanistan. A place the rest of us will never leave.”

Then from Shakespeare: “He which hath no stomach to this fight let him depart. But we in it shall be remembered. We few, we happy few, we band of brothers! For he today that sheds his blood with me shall always be my brother.”

McCain said he doesn’t understand why one of the strongest people he ever met wanted to end his own life. “We never will,” he said. “He’s just gone and I will always love him.”

Lisa Gilliam is proud of her son, but angry too. “He overcame so much. He was wounded to a horrible degree and yet he, he got through it. He did everything they asked him to do.”

So many surgeries, they stopped counting. All of his physical therapy. Learning to respond gracefully when children pointed and stared.

To kill himself, “sorry for my French, but it’s a big f* you to everybody, to everybody that had a part in his care and helping him come so far,” his mother said.

The family is strong and will persevere, but “it’s devastating,” his brother Lorente said, starting to weep. “It was such a battle on the homefront. It was a battle for us as a family for so long. I hate to see my Mom have to suffer, and my sisters …”

Sarah is angry too, they all are. “But maybe that’s the whole problem — he fought for so long and he just couldn’t anymore,” she said. “It’s easy to think you did this to me. But it wasn’t about any of us. It was about what he was going through.”

Then there’s the guilt. “We wish we could take the pain away. We wish we could have done more,” said his sister Erin, 20.

 

While in treatment during the summer of 2011 at the VA Palo Alto Polytrauma Center, Cpl. Farrell Gilliam stayed up all night building a Lego toy that he donated to a childrens program. Courtesy photo

While in treatment during the summer of 2011 at the VA Palo Alto Polytrauma Center, Cpl. Farrell Gilliam stayed up all night building a Lego toy that he donated to a childrens program. Courtesy photo

Now they mourn him, each in his own way.

Gilliam had a generous and gentle heart, his relatives said. When Sarah needed a kidney transplant in December, he argued with his mother that he should be the one to donate since he was younger.

When Erin admired a $1,500 special edition set of Harry Potter books, he gave them to her at Christmas. “He was very insightful. He took the time to know people,” Erin said.

Gilliam’s father had returned to work immediately after Gilliam was wounded. He didn’t know what else to do. No one knew what to say to him then, and they know even less now.

“You see your son in a box, you find out what you believe,” Mike Gilliam said. For him, it’s the resurrection. “I anticipate seeing him again. … He got a head start on the rest of us. But we will see him.”

What to feel is more difficult.

“Everybody around me is screaming their heads off. I’ve got nothing. I’m just kind of dealing with the situation. I am kind of waiting until the lights are out and everybody is tucked into bed and there is nobody around.

“A parenting thing you know, you deal with the problems after nobody else is around,” he said.

A son dies young, before his father — Mike Gilliam expects he will be dealing with it for years.

“What he was going to be. I miss that” most of all, he said. “What he was gonna be …”

FINAL REST

Strangers and friends. Medical staff from both coasts. Marines who fought with him in Afghanistan. Hundreds and hundreds across the country paid their respects after Gilliam died.

“They came from all over,” his brother Lorente said. “It was really moving how many people’s lives he touched. It was absolutely humbling.”

It started in San Antonio at the airport.

“We have the privilege and the honor today to be escorting a fallen warrior home to his final resting place,” the announcer said. Everyone in the terminal froze and fell silent.

Gilliam was loaded into the cargo hold of the plane under the scrutiny of his staff sergeant. The Marine escorted his body, standing vigil beside him every moment, until he was buried.

When the plane landed in San Jose, firefighters shot two arcs of water over the aircraft in salute. Police stopped Friday afternoon traffic to make way for the hearse and more than 100 Patriot Guard motorcycle riders.

On the drive to Fresno, every overpass was crowded with people. Firefighters standing at attention atop their trucks. A Marine honor guard. Sheriff’s deputies. Forestry workers.

Finney, Gilliam’s former squad leader, was among the Marine pallbearers who carried his coffin draped in red, white and blue.

After a volley of rifle fire in salute and the playing of taps, the Gilliams released a flock of white doves at Beth Israel Cemetery in Fresno, where he was buried Jan. 21 with full military honors.

Gilliam’s sisters tattooed his final text message prominently on their bodies. When she feels sad, Erin Gilliam rubs the flesh of her inner bicep where her brother’s words are inked. Sarah Gilliam has the words on her wrist.

“If anything good comes out of this,” Sarah said, “I just want it to be that somebody gets help that nobody thought they needed.”

Farrell Gilliam in 2008, on a sea tour with 1st Battalion, 1st Marine Regiment.

Farrell Gilliam in 2008, on a sea tour with 1st Battalion, 1st Marine Regiment.

gretel.kovach@utsandiego.com; (619) 293-1293; Twitter @gckovach; Facebook: U-T Military

 

 

 

 

 

The Marlboro Marine: 2004 and Today

marlboroTwo lives blurred together by a photo.

By Luis Sinco, Times Staff Photographer

Times photographer Luis Sinco made James Blake Miller an emblem of the war. The image would change both of their lives and connect them in ways neither imagined.

The young marine lighted a cigarette and let it dangle. White smoke wafted around his helmet. His face was smeared with war paint. Blood trickled from his right ear and the bridge of his nose.

Momentarily deafened by cannon blasts, he didn’t know the shooting had stopped. He stared at the sunrise.

His expression caught my eye. To me, it said: terrified, exhausted and glad just to be alive. I recognized that look because that’s how I felt too.

I raised my camera and snapped a few shots.

With the click of a shutter, Marine Lance Cpl. James Blake Miller, a country boy from Kentucky, became an emblem of the war in Iraq. The resulting image would change two lives — his and mine.

I was embedded with Charlie Company of the 1st Battalion, 8th Marine Regiment, as it entered Fallouja, an insurgent stronghold in Iraq’s Sunni Triangle, on Nov. 8, 2004. We encountered heavy fire almost immediately. We were pinned down all night at a traffic circle, where a 6-inch curb offered the only protection.

I hunkered down in the gutter that endless night, praying for daylight, trying hard to make myself small. A cold rain came down. I cursed the Marines’ illumination flares that wafted slowly earthward, making us wait an eternity for darkness to return.

At dawn, the gunfire and explosions subsided. A white phosphorus artillery round burst overhead, showering blazing-hot tendrils. We came across three insurgents lying in the street, two of them dead, their blood mixing with rainwater.

The third, a wiry Arab youth, tried to mouth a few words. All I could think was: “Buddy, you’re already dead.”

We rounded a corner and again came under heavy fire, forcing us to scramble for cover. I ran behind a Marine as we crossed the street, the bullets ricocheting at our feet.

Gunfire poured down, and it seemed incredible that no one was hit. A pair of tanks rumbled down the road to shield us. The Marines kicked open the door of a house, and we all piled in.

Miller and other Marines took positions on the rooftop; I set up my satellite phone to transmit photos. But as I worked downstairs in the kitchen, a deep rumble almost blew the room apart.

Two cannon rounds had slammed into a nearby house. Miller, the platoon’s radioman, had called in the tanks, pinpointed the targets and shouted “Fire!”

I ran to the roof and saw smoldering ruins across a large vacant lot. Beneath a heap of bricks, men lay dead or dying. I sat down and collected my wits. Miller propped himself against a wall and lighted his cigarette. I transmitted the picture that night. Power in Fallouja had been cut in advance of the assault, forcing me to be judicious with my batteries. I considered not even sending Miller’s picture, thinking my editors would prefer images of fierce combat.

The photo of Miller was the last of 11 that I sent that day.

On the second day of the battle, I called my wife by satellite phone to tell her I was OK. She told me my photo had ended up on the front page of more than 150 newspapers. Dan Rather had gushed over it on the evening news. Friends and family had called her to say they had seen the photo — my photo.

Soon, my editors called and asked me to find the “Marlboro Marine” for a follow-up story. Who was this brave young hero? Women wanted to marry him. Mothers wanted to know whether he was their son.

I didn’t even know his name. Shell-shocked and exhausted, I had simply identified Miller as “A Marine” and clicked “send.”

I found Miller four days later in an auditorium after a dangerous dash across an open parade ground in the city’s civic center. Miller’s unit was taking a break, eating military rations.

Clean-shaven and without war paint, Miller, 20, looked much younger than the battle-stressed warrior in the picture — young enough to be my son.

He was cooperative, but he was embarrassed about the photo’s impact back home.

Once our story identified him, the national fascination grew stronger. People shipped care packages, making sure Miller had more than enough smokes. President Bush sent cigars, candy and memorabilia from the White House.

Then Maj. Gen. Richard F. Natonski, head of the 1st Marine Division, made a special trip to see the Marlboro Marine.

I was in the forward command center, which by then featured a large blowup of the photo. “You might want to see this,” an officer said, nudging me to follow.

To talk to Miller, Natonski had to weave between earthen berms, run through bombed-out buildings and make a mad sprint across a wide street to avoid sniper fire before diving into a shattered storefront.

“Miller, get your ass up here,” a first sergeant barked on the radio.

Miller had no idea what was going on as he ran through the rubble. He snapped to attention when he saw the general.

Natonski shook Miller’s hand. Americans had “connected” with his photo, the general said, and nobody wanted to see him wounded or dead.

“We can have you home tomorrow,” he said.

Miller hesitated, then shook his head. He did not want to leave his buddies behind. “It just wasn’t right,” he told me later.

The tall, lanky general towered over the grunt. “Your father raised one hell of a young man,” he said, looking Miller in the eye. They said goodbye, and Natonski scrambled back to the command post.

For his loyalty, Miller was rewarded with horror. The assault on Fallouja raged on, leaving nearly 100 Americans dead and 450 wounded. The bodies of some 1,200 insurgents littered the streets.

As the fighting dragged on for a month, the story fell off the front page. I joined the exodus of journalists heading home or moving to the next story.

More than a year and a half would pass before I saw Miller again.

Back home, I immersed myself in other assignments, trying to put Fallouja behind me. Yet not a day went by that I didn’t think about Miller and what we experienced in Iraq.

National Public Radio interviewed me. Much to my embarrassment, the Los Angeles City Council adopted a resolution in my honor. I became a finalist for the Pulitzer Prize. Bloggers riffed on the photo’s meaning. Requests for prints kept coming.

In January 2006, I was on assignment along the U.S.-Mexico border when my wife called. “Your boy is on TV. He has PTSD,” she said. “They kicked him out of the Marines.”

I’d spoken with Miller by phone twice, but the conversations were short and superficial. I knew post-traumatic stress disorder was a complicated diagnosis. So once again, I dug up his number. Again, I offered simple words: Life is sweet. We survived. Everything else is gravy.

As the third anniversary of the U.S.-led invasion approached, my editors wanted another follow-up story.

So in spring 2006, I traveled to Miller’s hometown of Jonancy, Ky., in the hollows of Appalachia. I drove east from Lexington along Interstate 64, part of the nationwide Purple Heart Trail honoring dead and wounded veterans, before turning south.

Mobile homes and battered cars dot the rugged ranges. Marijuana is a major cash crop. Addiction to methamphetamine and prescription drugs is rampant.

Kids marry young, and boys go to work mining the black seams of coal. Heavy trucks rumble day and night.

Miller showed me around. At an abandoned mine, he walked carefully around a large, shallow pool of standing water that mirrored the green wilderness and springtime sky. He picked up a chunk of coal.

“Around here, this is what it’s all about,” he said. “Nothing else.

“It was this or the Marines.”

Often brooding and sullen, Miller joked about being “21 going on 70,” the result, he said, of humping heavy armor and gear on a 6-foot, 160-pound frame.

Before he was allowed to leave Iraq, he attended a mandatory “warrior transitioning” session about PTSD and adjusting to home life.

Each Marine received a questionnaire. Were they having trouble sleeping? Did they have thoughts of suicide? Did they feel guilt about their actions?

Everybody knew the drill. Answer yes and be evaluated further. Say no and go home.

Miller said he didn’t want to miss his flight. He answered no to every question.

He returned to Camp Lejeune, N.C. His high school sweetheart, Jessica Holbrooks, joined him there, and they were married in a civil ceremony.

Then came the nightmares and hallucinations. He imagined shadowy figures outside the windows. Faces of the dead haunted his sleep.

Once, while cleaning a shotgun, he blacked out. He regained consciousness when Jessica screamed out his name. Snapping back to reality, he realized he was pointing the gun at her.

He reported the problems to superiors, who promised to get him help.

Then came a single violent episode, which put an end to his days as a Marine.

It happened in the storm-tossed Gulf of Mexico in September 2005. His unit had been sent to New Orleans to assist with Hurricane Katrina relief efforts. Now a second giant storm, Hurricane Rita, was moving in, and the Marines were ordered to seek safety out at sea.

In the claustrophobic innards of a rolling Navy ship, someone whistled. The sound reminded Miller of a rocket- propelled grenade. He attacked the sailor who had whistled. He came to in the boat’s brig. He was medically discharged with a “personality disorder” on Nov. 10, 2005 — exactly one year after his picture made worldwide news.

Back home in Kentucky, the Millers settled into a sparsely furnished second-story apartment. Four small windows afforded little light. The TV was always on.

Miller bought a motorcycle and went for long rides. He and Jessica drank all night and slept all day. He started collecting a monthly disability benefit of about $2,500. The couple spent hours watching movies on DVD, Coronas and bourbon cocktails in hand. Friends and family gave them space.

Miller had hoped to pursue a career in law enforcement. But the PTSD and abrupt discharge killed that dream. No one would trust him with a weapon.

But at least he didn’t have to go back to Iraq. He started to realize he wasn’t the only one traumatized by war.

“There’s a word for it around here,” Jessica said. “It’s called ‘vets.’ ” She talked of Miller’s grandfather, forever changed by the Korean War and dead by age 35. Her Uncle Hargis, a Vietnam veteran, had it too. He experienced mood swings for years.

Sometimes, Miller’s stories about Iraq unnerved his young bride. He sensed it and talked less. Nobody really understands, he said, unless they’ve been there.

On June 3, 2006, the Millers renewed their vows at a hilltop clubhouse overlooking the forests and strip mines. It was a lavish ceremony paid for by donors from across the country who had read about Miller’s travails or seen him on television. Local businesses pitched in as well.

His father and two younger brothers were supposed to be groomsmen but didn’t show up. His estranged mother wasn’t invited.

Miller looked sharp in his Marine Corps dress uniform of dark-blue cloth and red piping. Jessica was lovely in white, her long hair gathered high.

Instead of a honeymoon, the young couple traveled to Washington, D.C., at the invitation of the National Mental Health Assn. The group wanted to honor Miller for his courage in going public about his PTSD. Its leaders also wanted him to visit key lawmakers to share his experience.

As a boy, Miller confided, he had embraced religion, even going so far as to become an ordained minister by mail order. He knew the Bible verses, felt the passion for preaching.

That’s how he found his new mission: to tell people what it was like to come home from war with a broken mind.

Three days after their wedding, I tagged along as the young couple flew to the nation’s capital. Easily distracted by the offer of free drinks for an all-American hero, Miller stayed out until 3 a.m. He was hung over when he met with House members a few hours later.

Miller chatted up GOP Rep. Harold Rogers, the congressman from his district. He smoked and frequently cursed while recounting his combat experiences. I cringed but stayed on the sidelines, snapping photos.

Miller shuffled from one congressional office to the next, passing displays filled with photos of Marines killed in Iraq. As he told his story over and again, the politicians listened politely and thanked Miller for his service. One congressman sent an aide to tell Miller he was too busy to meet. No one promised to take up his cause.

After Miller picked up his award, he took a whirlwind tour past the White House and Lincoln Memorial, but his mind was elsewhere. At a bar the night before, free booze had flowed in honor of the Marlboro Marine. Miller wanted more.

“Let’s get drunk,” he said.

I returned to Los Angeles the next morning, thinking I would catch up with Miller in a couple of months.

A week later, Jessica called. After they got home, Miller’s mood had become volatile. He was OK one minute and in a deep funk the next, she told me. Then he’d disappeared. She hadn’t seen him for days.

Could I come to Kentucky and help?

Why me? I thought. I am not Miller’s brother. Or his father. I could feel the line between journalist and subject blurring. Was I covering the story or becoming part of it?

I traveled all night to get to Pikeville, Ky., and soon found myself with Jessica, making the rounds of all the places Miller might have gone. I wanted to be somewhere else — anywhere else.

Finally, the next morning, Jessica saw her husband driving in the opposite direction. She did a U-turn, hit the gas and caught up with him down the road.

He got out of his truck. A woman sat in the passenger seat.

“Who is that, Blake?” Jessica demanded. “Who is she?”

He said her name was Sherry. They had just met, and he was helping her move. Jessica didn’t believe him.

I thought: Didn’t I attend this young couple’s fairy tale wedding just 10 days ago? Now, here they were, in a gas station parking lot, creating a spectacle.

Jessica grilled Miller. He bobbed and weaved. He appeared sober and sullen. Then he dropped a bomb. He didn’t want her anymore and had filed for divorce.

“You guys might want to go home and talk,” I suggested.

There, the tortured dialogue escalated.

Jessica pleaded with Blake to stop and think. They could quit drinking, she said. They’d get help for him and as a couple. Maybe they could move away — anything to work it out.

Miller slumped on the couch. I sensed his unease and feared he would become violent, so I stayed for a while even though I felt intrusive. But he remained strangely calm, albeit brooding and distant.

I returned the next morning. He called his attorney and put the phone on speaker. If uncontested, the lawyer said, the divorce would become final in 60 days. Jessica went to the fire escape to gather herself.

Miller remained unmoved, chain-smoking. The local newspaper had been calling him about rumors that he was getting divorced. It was a major local story. Finally, he wrote a statement. He asked for compassion and respect for their privacy.

The next day, I found Miller in a back bedroom at his uncle’s house. He told me that he had come close to committing suicide the night before. He had thought about driving his motorcycle off the edge of a mountain road.

He showed me the morning newspaper. His divorce was the lead story.

I felt torn. I didn’t want to get involved. I desperately wanted to close the book on Iraq. But if I hadn’t taken Miller’s picture, this very personal drama wouldn’t be front-page news. I felt responsible.

Sometimes, when things get hard to witness, I use my camera as a shield. It creates a space for me to work — and distance to keep my eyes open and my feelings in check. But Miller had no use for a photojournalist. He needed a helping hand.

I flashed back to the chaos of combat in Fallouja. In the rattle and thunder, brick walls separated me from the world coming to an end. In the tight spaces, we were scared mindless. Everybody dragged deeply on cigarettes.

Above the din, I heard what everybody was thinking: This is the end.

I’ve never felt so completely alone.

I snapped back to the present, and before I knew it, the words spilled out.

“I have to ask you something, Blake,” I said. “If I’d gone down in Fallouja, would you have carried me out?”

“Damn straight,” he said, without hesitation.

“OK then,” I said. “I think you’re wounded pretty badly. I want to help you.”

He looked at me for a moment. “All right,” he said.

luis.sinco@latimes.com

http://www.latimes.com/news/nationworld/nation/la-na-marlboroman11nov11-blurb,0,5435312.blurb

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