Upon reading yesterday’s post on my Post-Traumatic Stress Injury (PTSI) presentation, a reader asked why I call the malady by that name instead of the more commonly used Post-Traumatic Stress Disorder (PTSD). The answer is that the disease, as I suffer from it, is not an internal disorder—something gone awry in the head—but an externally inflicted wound on the soul. It seems obvious to me that, with rare exceptions, any normal and healthy person would suffer damage to the psyche from observing or participating in combat. It’s that ghastly.

Technically, PTSD refers to a disorder, while PTSI signifies a biological injury. In the U.S., service members and veterans diagnosed with PTSD aren’t eligible to receive the Purple Heart, the medal for service members wounded or killed as a result of enemy action while serving in the U.S. military. But in Canada, it’s different. Instead of PTSI, the Canadian military use the phrase Operational Stress Injury (OSI) when referring to the effects of psychological warfare trauma, including PTSD. Those with OSI are eligible to receive the Canadian equivalent of the Purple Heart.

Even if the U.S. did award the Purple Heart to those service members and veterans suffering from PTSI, I wouldn’t be eligible. During my years of operating on the battlefield, I was a civilian under cover as a member of whatever unit I was supporting.

All the technical discussion notwithstanding, PTSI is and remains a serious illness. My guess is that most everyone who experienced combat is afflicted with it to some degree. It never fades or goes away. The victim’s only recourse is to confront it and learn to live with it.

I’ve spent almost fifty years—since the fall of Saigon—doing just that.

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