There are nearly 24 million American military veterans and approximately
1.5 million active-duty service members. An additional 650,000
men and women voluntarily serve in the various state national guards
and the services’ active reserve components, and are therefore subject
to call-up to active duty. Thousands of others have had their active-duty commitments
involuntarily extended or been recalled from the Individual (inactive)
Ready Reserve after serving their obligated enlistments. Nearly 1.7 million service members
have served in the Southwest Asia theater (especially Iraq and
Afghanistan). Veterans and their families account for nearly one-third of the
population of the United States.
The wars in Iraq and Afghanistan are increasingly costly in deaths, wounds
and illnesses. Recent statistics show a military death count of more than 4,500.
Those who have been wounded, been injured or become ill exceed 75,000.
Some 320,000 (20 percent of troops deployed) already have suffered a traumatic
brain injury (TBI). Some 300,000 (18 percent of troops deployed)
already have suffered from Post-Traumatic Stress Disorder (PTSD).
For 300 million Americans, World War II ended in 1945, the Vietnam War
ended in 1975 and other wars ended in various other years over the long history
of our country. One day, Americans will believe that the wars in Iraq and
Afghanistan ended in a particular year.
But for a large fraction of the men and women who served in past wars
and who serve today, the wars are not over. Many, many veterans carry with
them the physical scars of battle or the psychological trauma of witnessing
disturbing acts, mostly in combat. Many will never fully heal.
Service members and veterans who are serving or have served in the current
wars have special problems not recognized in earlier conflicts. Many have
been killed or injured by new types of improvised explosive devices (IEDs,
usually roadside bombs). Others have been killed or injured by suicide bombers.

They often have been inadequately equipped. The situation became so absurd
that often family members of service members felt forced to purchase and
ship them the body armor the military was not providing. Still, service members
often had to drive Humvees without adequate armor plating. Many have been
asked to do jobs for which they have not been adequately trained.
Many in the “regular” military and the National Guard and Reserves have
had their tours extended or been called back for a second, third or even fourth
tour. Each deployment, of course, increases the servicemember’s exposure to
death, injury, disease and family stress. (55 percent of service members are married;
more than 100,000 women and more than 16,000 single parents have
served in the current wars.)
Although it is the veterans and service members of Iraq and Afghanistan
who today hold the headlines, compelling problems remain for veterans of
every era. Things have pretty well settled down for the “Class of ‘46,” the veterans
of World War II, most of whom were discharged one year after the end
of the war. And, sadly, most veterans of that war have now died of old age or
other causes. (A veteran who was 20 in 1946 is 81 today—if he or she has survived.)
According to VA statistics, of 16,112,566 who served in World War II,
only 3,242,000 survive. (All statistics of this type are for those who served
anywhere during the war; it does not mean that a particular member of the
military served in a particular country or in combat. For the Vietnam Era, for
instance, only about one in three who served in the military was stationed in
For the Korean War, 5,720,000 served and 3,086,400 are still living. For the
Vietnam War, those who served total 8,744,000 and those surviving are
7,286,500. Those serving in the first Gulf War (Desert Shield and Desert
Storm) numbered 2,322,000 and those still living are 2,260,000.
So Vietnam Era vets are still very much around. They are the largest group
since Korea. And their problems (and this is not to minimize those problems
of any other era of veterans) have been devastating. Many continue to suffer
from the often disabling and disfiguring injuries of combat, from the physical
ravages of the herbicide known as Agent Orange and from the psychological
damage known as Post-Traumatic Stress Disorder (PTSD). More than 59,000
26 Introduction
died during the war or from injuries sustained there. More than 153,000 were
As two of the authors of this book noted in a late-1980s court brief, Viet
Vets (those who served in-country):
• Fought in jungles against a native revolutionary army. Success was
measured not by territorial conquest but by body count.
• Unlike in other wars, went to the war zone individually and came
home individually. Most Viet Vets were therefore forced to deal with
stress by themselves.
• Felt to a greater degree than other Vietnam Era Vets the impact of
serving during a war opposed by most of their fellow citizens: those
who served in Vietnam were seen as bearing a special responsibility
for the war.
• Served in a war that by many measures the United States lost. (This
was despite the fact that the U. S. won nearly every battle.) The returning
Viet Vet was met not by victory parades but by condemnation or
The approximately 1.5 million veterans of Iraq and Afghanistan have had
characteristics and experiences that are both the same as and different from
those of their brothers and sisters from Vietnam. The average combat soldier
is 26 (in Vietnam he or she was 19, in World War II also 26). More than at any
time except World War II, troops have been called up, from the National
Guard and the Reserve and also from the Individual Ready Reserve. This
means many soldiers have been jerked out of fairly stable lives, and often more
than once. In particular, it means many have been taken from jobs that they
will want to regain after discharge. Among those called up, professionals and
small business owners have been particularly likely to suffer financial disaster.
One similarity between the Vietnam War and the war in Iraq is that both
eventually became highly unpopular in the United States. But another difference
is the greater popularity of those who have fought in the current wars.
Viet Vets still suffer from having not only fought in an unpopular war but having
been to a considerable extent blamed for it. Some of the authors of this
book have noted a repeat of veterans problems seen 35 years ago. For example,
there have been large numbers of bad discharges as well as an inadequate
or careless administration of veterans educational benefits.
On the good side, military and veterans medicine is much improved. Just
as Viet Vets were evacuated to field hospitals dramatically faster than had been
the case in World War II (or Korea), evacuations in Iraq and Afghanistan have

been accomplished with even greater speed. Once wounds are stabilized, many
service members are rushed to U. S. military facilities in Germany for state-of the-art
care. Those needing it also receive improved medical care in the U. S.
More than one-third of Iraq and Afghanistan vets have already sought medical
care since returning to the U. S.
Once home, service members with medical problems find new difficulties
that bring their own trauma. Treatment facilities are limited, especially for TBI
(traumatic brain injury, the “signature wound” of the wars in Iraq and Afghanistan)
and PTSD (Post-Traumatic Stress Disorder) and especially in areas
where National Guard and Reserve troops live. Little is known about TBI, but
public pressure has forced DoD and the VA to commit increased resources to
In addition, service members awaiting the complex system of separation
for medical reasons often have to wait far from home for four to ten months,
often without family or organized military support. Disciplinary problems are
common among these idle troops, often ending in a bad discharge or inadequate
disability rating. The Department of Defense (DoD) has promised to fix
these problems, but many doubt its resolve to invest the necessary funds.
Even in the medical improvements can be found problems of the most
grave nature. Because medical care is often so fast and effective, many service members
are saved who would have died in any other U. S. war. That’s the
good news and that’s also the bad news: thousands survive with injuries horrendous
enough that in any previous war they would have been fatal. These
include countless disfiguring head wounds. Many will be disabled for life and
many will require care for life. Many of the people with severe disabilities have
serious difficulty “transitioning” to life back in the United States.