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Authors: Rebecca Frankel

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No one is entirely sure
why John Russell snapped that day at the Liberty Clinic in Baghdad, or what drove him to kill five people. According to a 325-page report published in October 2009 investigating the incident, he'd been exhibiting erratic behavior for weeks and threating suicide.
7
When this mental break occurred, Russell was just six weeks from finishing what was his third deployment to Iraq. While his rampage was unprecedentedly deadly, he was far from the first soldier to crack under the strain of combat.

Since the Iraq and Afghanistan wars, post-traumatic stress disorder (PTSD) is so prevalent among US servicemen and women that it has earned classification as an outright epidemic, reaching catastrophic numbers in the military. Of the soldiers, Marines, airmen, and sailors coming home from Iraq and Afghanistan, one in five will return with PTSD, adding up to 300,000 so far. (About 380,000 who deploy to these two wars will suffer from a traumatic brain injury.)

Untreated and unaddressed, PTSD frequently leads to volatile behavior and suicide. The recent rate of suicide among active-duty service members, as well as among recent veterans, is rampant. Currently, every 80 minutes a veteran takes his own life. From 2005 to 2010 a service member committed suicide once every 36 hours. The 1 percent of Americans who have served in the US military represents 20 percent of the country's suicides.
8
“Suicide,” as journalist Tina Rosenberg reported in September 2012, “is now the leading cause of death in the Army.”
9

The symptoms have been the same war after war: records dating back to the ancient Egyptians tell of warriors and soldiers who were psychologically wounded by the battlefield. The Romans and Greeks also noted similar, damaging phenomena after combat.
10

In later eras, there was an agreement among the symptoms soldiers felt when they had been damaged by war—anger, anxiety, depression, obsessive thoughts of going home, insomnia, loss of appetite, heart palpitations, and bouts of fever. In the seventeenth century Swiss military doctors called it “nostalgia.” The Germans and the French had words for it that meant “homesickness.” And the Spanish termed it
estar roto,
meaning “to be broken.”
11

During and after the Civil War, such afflictions took on the name Da Costa Syndrome after a doctor, Jacob Mendes Da Costa, made a clinical study of it with 300 soldiers, publishing his reports in 1871.
12
Afterward, though, it became better known as “soldier's heart.” During World War I, physicians fashioned the term “shell shock,” originally coined by Captain Charles Myers in 1915 to describe a syndrome in which physical and neurological ailments were thought to be a direct result of the force of a blast, a literal shaking of the brain. Within a year, though, many of these same symptoms—treacherous headaches, ringing in the ears, memory loss, feelings of being disoriented, an inability to sleep—were exhibiting in soldiers who had never suffered a blast. Instead military physicians determined that this was not shell shock but rather a break in nerves, or “neurasthenia.”
13
During World War II the syndrome became known as “combat fatigue.” In Vietnam the condition was notorious for violent flashbacks and was believed to have been compounded by the poor reception servicemen received upon their return home. To make matters worse, men who reported feelings of depression, paranoia, sleeplessness during wartime were thought to be fainthearted, or cowardly would-be deserters looking for some way out of their soldier duties. This attitude persists today and is still an obstacle to effective treatment.

Though combat stress dogs like Boe are few, canine therapy is a growing trend, one that continues to gain legitimacy in the world of psychotherapy. And dogs have long been regarded as a therapeutic tool for psychologically wounded patients.

Sigmund Freud supposedly brought his dog Jofi, a Chinese chow, into his therapy sessions. The father of psychoanalysis not only felt the dog
provided a soothing presence, but also used Jofi to gauge his patient's inner mood. If the dog was relaxed, it meant the patient was at ease. If the dog tried to leave the room during the session or showed any signs of discomfort, it revealed the patient was particularly anxious. Freud loved his dog, but he also believed that the emotions of dogs were exhibited more purely, writing, “Dogs love their friends and bite their enemies, quite unlike people, who are incapable of pure love and always have to mix love and hate in their object relations.”
14
Perhaps that is why he relied on Jofi's “judgment” of his patients.

While the idea of using dogs for therapy—actually selecting for breed and temperament and then training them—would take years to take root, it was around Freud's time that militaries started employing dogs to help wounded soldiers,
physically and emotionally.

During World War I, military dogs deployed by the French Legion who, for one reason or another, were no longer able to fulfill their combat duties, were retrained to be the companions of blind soldiers. They were taught to anticipate approaching cars, to alert their charge to drops and inclines in the road, and even find the soldier's favorite haunts and guide him safely to the homes of his friends and family.
15
The process for acquiring such a dog was fairly uncomplicated: men who needed a guide dog simply sent letters to the War Dog Service. But as Harold Baynes reported from France, despite the accessibility of the dogs, it wasn't a very popular service. This, he wrote, was largely “because of the feeling that a blind man led by a dog must necessarily appear to be an object of charity.” The stigma of helplessness and desperation attached to this kind of handicap must have been so potent that even Baynes (not so sensitively) believed that a soldier making his way through the city with a guide dog would have been indistinguishable from a common beggar.
16

It seems an obtuse, thoughtless assessment, but it was, disappointingly, representative of the time.

The November 5, 1927 edition of the
Saturday Evening Post
featured a stirring article by a woman named Dorothy Harrison Eustis. Though a native of Philadelphia, Eustis had been living in Switzerland and had just
traveled to the city of Potsdam, Germany, where she saw firsthand how the country was rehabilitating its “war blind.” What she witnessed had a profound effect on her and would forever change her thinking about the future of any blind person.

In darkness and uncertainty he must start again, wholly dependent on outside help for every move. His other senses may rally to his aid, but they cannot replace his eyesight. To man's never failing friend has been accorded this special privilege. Gentlemen, I give you the German shepherd dog. . . .

No longer dependent on a member of the family, a friend or a paid attendant, the blind can once more take up their normal lives as nearly as possible where they left them off.
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In a small Tennessee town a man by the name of Frank read Eustis's article out loud to his blind son, Morris. The young man had lost his right eye in a riding accident when he was six years old. The left eye was damaged beyond repair ten years later during a high school boxing match. Morris was so inspired by Eustis's experience he sent her a letter four days later, asking her for the address of the school and any other details she would share. She responded and they negotiated a trade—she would bring Morris abroad, where he would receive his education and even be given one of the school's dogs—if, in return, he promised to show off his success and promote the cause once he returned to the States.

Morris agreed and traveled overseas to meet with Eustis. He was paired with a dog named Kiss (whom he quickly renamed Buddy).
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By the time their training was done, Morris Frank was moving through the sleepy town of Vevey, Switzerland with Buddy with total comfort and ease. When the pair made the trip back home and docked in New York, a crowd of spectators had gathered, including reporters who had come armed with photographers. It was a skeptical if not altogether unkind crowd, and one reporter shouted out, daring Frank to cross West Street to prove to them all what a dog could do for a blind man.

Compared to the roads of
Vevey, West Street was a high-speed interstate of danger. Buddy had never ventured anything like this—cabbies jeered out the window, trucks barreled by them, horns honked from all sides. As Frank lifted his foot off the curb he relinquished all control over entirely to his dog, and for three long minutes Frank was completely directionless. To the shock of all watching, they made it across without a hitch. He dropped his arms around Buddy, jubilant and relieved, his heart still thudding. “Good girl, good girl,” he commended her.

Eight years later he and Buddy had packed away 50,000 miles behind them preaching the good word of guide dogs. They helped to establish the Seeing Eye School in 1929 for training dogs to lead the blind in Morristown, New Jersey, and by 1936 the school had paired dogs with 250 blind men and women.
19

When Japan bombed Pearl Harbor, Eustis and Frank, still friends and colleagues, made an immediate decision to rejoin forces. By then Morris Frank was no longer a young man and had another dog, Buddy II. Eustis too had long since retired from their cause, but they reunited to organize and fund this project—veterans of World War II would have guide dogs if they needed them.

The ability of dogs to boost not only a wounded soldier's confidence but also his morale did not go unnoticed. As early as 1919, the US military brought dogs in as a therapy tool for their psychiatric patients at St. Elizabeth's Hospital in Washington, DC.
20
But it was during World War II that dogs made their mark helping veterans recover from war.

The Associated Press filed over the newswire direct from the Anzio beachhead in Italy one such story of a dog named Lulabelle. Lieutenant Colonel William E. King, a chaplain, was making his rounds of a hospital tent visiting the beds of the wounded. On this particular day he'd brought along his dog, who was so small she often made these visits in the chaplain's pocket. One of the nurses stopped the chaplain and pointed out a soldier lying on his back, his gaze fixed on the ceiling. He had lost both hands and was, the nurse said, lucky to be alive. He'd been virtually nonresponsive since they brought him to the hospital. But when he saw
Lulabelle he tried to speak and the chaplain went over to his bed to see what he wanted. The request was a simple one—he asked the chaplain to put the dog on his bed. Lulabelle obligingly scrambled across the man's chest to lick his face.

“I used to have a dog, sir,” he explained. “That's the first time a dog has licked my face since I left home.” And then he smiled. When the chaplain left the hospital that day he did so without Lulabelle. Instead she stayed on that bed, curled up with the young man, her head resting over his shoulder.
21

A similar encounter and act of benevolence would bring canines into the halls of the American Air Forces Convalescent Hospital in Pawling, New York. In the summer of 1944, a Red Cross volunteer got the idea that a dog might break the melancholy of one recuperating airman, Lieutenant Colin, who'd shattered his leg. Dogs for Defense, the very same organization responsible for providing the military with its canine fighting force, arranged for Colin to get a dog, a German shepherd puppy named Fritz. The change in Colin was extraordinary: he improved so much that his recovery time exceeded doctors' expectations by six months.
22

Fritz's presence at Pawling and Colin's undeniable progress kicked off a small movement at the hospital. Soon, other patients were asking for their own dogs.

And, just as they had during World War I, war dogs who had been wounded or for other reasons had finished their tour of service were paired with wounded soldiers to become healing companions. Soon hospitals in Massachusetts and others around New York State were requesting and receiving dogs for their patients. Nearly two years after Lieutenant Colin was paired with Fritz, the hospital in Pawling installed an 80-foot kennel fully outfitted to house the 50 dogs living at the hospital.

As one former pilot, and a Convalescent Hospital patient who benefited from this movement, wrote, “the Red Cross got me Patty, the swellest Irish Setter you ever saw. We're never apart. . . . And I've been feeling better since the day I got her.”
23

Over the next few decades, animal-assisted therapy slowly began attracting attention in the civilian world. Therapist Boris Levinson, owner of
a dog named Jingles, once forgot to remove the dog from the room during a therapy session, only to notice that a young patient, a withdrawn boy, became noticeably more relaxed with Jingles in the room. Levinson took note of this canine-inspired improvement and Jingles became a regular fixture in his therapy sessions. In 1962, Levinson published an article on the phenomenon, “The Dog as Co-Therapist.”
24

But while animal-assisted therapy became popular during the 1960s and 1970s, it really wasn't until the 1990s that scientific evidence started to accumulate that suggested more conclusively that dogs have a tremendously positive effect on lowering stress and anxiety. A 1998 study showed that, after a half hour spent with a dog, psychiatric patients exhibited a reduction in their anxiety that was two times the effect of other, more standard stress-alleviating therapeutic activities. In 2003, the woman who conducted this study, Sandra Barker of Virginia Commonwealth University, reported that patients awaiting electroconvulsive therapy were less fearful after spending 15 minutes with a dog.
25
The American Heart Association released a study in 2005 that showed that 12 minutes of time spent with therapy dogs improved “heart and liver function, reduced blood pressure, diminished harmful hormones, and decreased anxiety in heart patients.”
26
And finally, in March 2010 Barker published a third study on the “buffering effect” dogs have on human emotions by measuring the cortisol level of their human companions to determine their stress level.
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