NEW YORK TIMES MAGAZINE
THE LONG ROAD BACK
March 6, 1988
By Kim Heron
THE LONG ROAD BACK
March 6, 1988

By Kim Heron

200Z-070—004
Bill Clouart, one of eight Vietnam veterans whose battle against trauma eventually took them to the north woods.

He is swaddled in down and curled up inside his tent, talking in a muffled voice, straining to find the words that will explain to a stranger what happened to him in Vietnam. He isn't very good at it at first. His account is formal, official : “From February to November 1966, I served with Charlie Company, Second 503d Airborne Infantry, the 173d Airborne Brigade. I was 17 when I joined the Army. I was 18 when I fought in Vietnam." Pausing, he looks out beyond the tent flap. After a day's hike through the New Hampshire forest, our group has stopped for the night in this place, a slope dense with pine trees. In the dark, the snow, falling steadily, is visible only in the beams of our flashlights and the melting, glowing haze of our campfire. "I am very proud of the fact that I fought with the 173d Airborne," he says. "We were involved in heavy combat. I felt very fortunate to escape with my life. But looking back now, it seems that I had to shut down a lot of my personal feelings."

He warms to his topic, explaining that he was evacuated from Vietnam for medical reasons with only 28 days left in his tour. He wonders if someone who wasn’t in the war can understand the sadness and monotony oh his life now. He says he learned in Vietnam to suppress emotions so completely that it became impossible to revive them later on. "It was a way to cope, and it got you through," he says, "but after you were through, you were stuck with a way of functioning. I had an older brother who was killed several weeks after I came back, while I was in the hospital. He was the most important person in the world to me at the time. I couldn't feel anything."

Bill Clouart is 40 years old and a psychological casualty of Vietnam. He suffers from what psychiatrists now call post-traumatic stress disorder, a wasting condition with symptoms that include depression, sleep disturbances, flashbacks, suicidal tendencies, alcoholism, drug abuse, violent outbursts and a pervasive sense of isolation. The disorder, according to a number of veterans' groups, afflicts about 500,000 Vietnam veterans, and of these, perhaps 150,000 are affected severely enough that, without psychotherapy and medication, there is little hope for a normal life.


200Z-007-011
Michael and Betty Hindle at the V.A. hospital in Northampton, Mass. "Marine Corps," he said; the jacket spelled it out.

For three years, Clouart has been in and out of the Veterans Administration Medical Center in Northampton, Mass., one of 16 V.A. hospitals in the country with a post-traumatic stress disorder (PTSD) unit. For these four days in December, though, he is outdoors, participating in "action-oriented" therapy. Clouart and seven other Vietnam veterans, along with two instructors and one reporter, are tramping through the woods of New Hampshire on a trip organized by Outward Bound, the wilderness school founded during World War II to teach survival skills to British seamen. (In the United States, the Outward Bound program now includes courses for adolescents, corporate executives, teachers and others.)

Bob Rheault, a 62-year-old Outward Bound instructor and co-founder of the veterans' program, describes this course as "a deliberate recreation of the combat experience," a supervised journey back into the emotional realm of Vietnam with assigned gear, ground to cover, rations, maps and fear but no guns. Thrown into a situation fraught with a familiar physical vulnerability, the men will be called on to help with rudimentary survival chores and group planning. The hope is that, in the process of cooperation, they'll remember that they are not in the world alone.

The men had seemed distant and cool when the group first met two days earlier, on Ward 8 of the Northampton Medical Center. They had heard that the bonds formed "out there," away from the fluorescent lights and soporific pace of the ward, somehow helped a man to feel better about himself. Still, there was trepidation. Bob Rheault sought to break the ice by telling some of his own story. He had served two tours in Vietnam - the second, in 1969, as commander of the United States Army Special Forces. He resigned that year; he and the Green Berets under his command had been accused of murdering a Vietnamese suspected of being a double agent, and although all charges had been dropped, his military career was at a standstill. He came home, he told the group, to a marriage that fell apart and, at the age of 44, doubts about whether he had any future. He found Outward Bound and has worked at the Hurricane Island school in Rockland, Me., for 17 years. In 1983, he began leading Outward Hound trips from the Northampton V.A. hospital.


200Z-016-012
Anthony Paluszek at the Northampton veterans' hospital. "Nobody out there is like me, and I'm not like them."

The Veterans Administration provides no backing for the program of regular outings. Rheault raises the $35,000 in annual operating expenses himself, much of it from Disabled American Veterans. Impatient with the V.A., which only recently announced plans to study the Northampton project, he is attempting to raise $240,000 this year to continue that program and establish four others, in Augusta, Ga.; Menlo Park, Calif.; Phoenix, Ariz., and Tacoma, Wash., where a pilot program operated last year.

Following Rheault's lead, the veterans introduced themselves, some voicing concern about the outing. At 6-foot-2 and 230 pounds, Gerald Carron was the largest and the frailest, having scored poorly on his fitness test. What worried him was the snow, the cold and the dark. "I don't know about you guys," he said, "but the nights are bad for me." Carron, 39, and his girlfriend of 10 years planned to marry in a week; he wanted to come back to her in one piece.


200Z-061-006
Gery Carron and his bride Susan, at home in Springfield, Mass. The only one holding a steady job, he still gets panic attacks.

"Our squad is the same size as a squad in Vietnam," said Harold Needham, 36, who had been an Army explosives specialist, "so I'm not worried about managing physically. It's the emotional aspect that's bothering me."

Michael Murphy, 36, introduced himself as a helicopter door gunner for the Navy, noting the incongruity: "Hey, when I joined up they didn't tell me squids flew."

Anthony Paluszek, 40, described coming home from Vietnam to New York City in 1969. "The hostility of the antiwar demonstrators was overpowering," he said. "I haven't been able to forget that. What I'm looking for from this trip is not a sense of manhood, but a sense of brotherhood."

Jim Kakides, 38, said he welcomed the physical challenge; which for him would be considerable. Leg injuries from the war made it hard for him to walk long distances. "I want to know if I still have it in me," he said.

"United States Marine Corps, Third CAC, '67, '68, '69," Michael Hindle announced. The gold script on the arms of his red satin baseball jacket said the rest: "Quang-Tri, Dong-Ha, Khe-Sanh, Cam-Lo, Rock-Pile, Con-Thien."

Bill Clouart, who had been on a summer Outward Bound course, said he expected this one to be very different. Emil LeLoup, 43, said he wanted it known that he was going against his will.

Each veterans' hospital operates independently in treating PTSD, and the Outward Bound course is mandatory at Northampton for those patients who meet the ward's fitness standards. "We're very committed to the program as an adjunct therapy," says William E. Boutelle, chief of psychiatric services and founder of the hospital's 25-bed PTSD unit. "It's a kind of watershed experience for these men, and I think they carry it with them."

The standard Outward Bound regimen is modified for the veterans. There is no "solo," where participants spend time alone in the wilderness, nor is the usual degree of stamina expected; war injuries, years of alcohol and drug abuse, and psychological strain make their own demands. All eight members of this group are heavy smokers, and a concession, almost comically antithetical to the Outward Bound credo, would be made to nicotine addiction. The men would also be bringing their "meds," as they called the psychotropic drugs used in the treatment of PTSD - antianxiety agents such as Xanax, Librium and Valium; tricyclic antidepressants such as Sinequan, Vivactil and Tofranil, among others.

We would average about three miles a day for the first three days. On the fourth, having spent the previous night in a cabin at base camp, we would attempt the 4,810-foot summit of New Hampshire's Mount Moosilauke.

We gathered on the sun porch of the ward to be issued our gear -backpacks, parkas, rainwear, sleeping bags, thick rubber Army boots and such extras as neon-orange emergency whistles and bottles of iodine for disinfecting water. We had been told to supply our own clothing, and a last-minute search began for spare socks, sweaters, mittens. Amid the confusion, Harold Needham checked over his gear, then rolled and packed it with great care, saying very little. Our boots, he said, were the same ones he had worn in Vietnam.

-Of the eight Veterans only one -Gerry Carron- has a regular job. He operates heavy equipment at the Westover Air Force Base near Northampton, where the sound of helicopters passing overhead has been known to send him into panic attacks. "That's just something I have to deal with" was Carron's reply when asked at one point whether he should seek a less stressful work environment.

The response is characteristic of these veterans -proud, seemingly indifferent. One lesson they have learned is that, despite outpourings of sympathy from government and the media, few Americans are really interested in hearing about the troubles they are carrying around from a war that ended officially nearly 13 years ago and that, for many of them, is closer to 20 years gone. The vast majority of the 2.8 million Americans who served in Southeast Asia appear to be well-adjusted members of society. Why should these men be any different?

Many, it appears, tried not to be. For years, Gerry Carron knew he was ruining his life with alcohol and drugs -he had become a heroin addict in Vietnam. He knew his homecoming to Connecticut in 1971 had been devastating: "I flew into Bradley Field and my mother picked me up. Some friends came over that evening and said, 'Nice seeing you. We’re going to a party. You want to come?' That was it." But when, four years ago, he first described to Northampton therapists the terror that would seize him at work, he made no mention of the possible link to his army combat tour.

Extreme denial is common among Vietnam veterans with PTSD, who may "self-medicate" their symptoms with various drugs. But had Carron made the connection between his combat experiences and his psychological problems anytime during the 1970's, it is unlikely he would have found help through the V.A. In the eyes of the Veterans Administration, PTSD did not exist until 1980, when the American Psychiatric Association recognized it as a combat-related condition, thus linking it officially to Vietnam in the way that "shell shock" belongs to World War I and "battle fatigue" to World War II.

"People did not perceive 'anxiety neurosis,' or what we now call PTSD, to be a delayed or chronic condition," says Laurent S. Lehmann, associate director of psychiatry for the V.A. "They didn't realize' that it could manifest long after exposure and perhaps be even more forceful than the original trauma."

The cause of PTSD, as defined by the American Psychiatric Association, is "a psychologically traumatic event that is generally outside the range of usual human experience." Research suggests that PTSD can effect changes in the nervous system, and that symptoms can be more severe when the trauma is the work of man rather than the result of a natural disaster. Perhaps most importantly, what happens after the trauma occurs has been shown to affect profoundly the person's ability to resolve it.

That so many Vietnam veterans are afflicted stems from the familiar fact that the Vietnam War was - and, in its long aftermath, continues to be - different from any other in this country's history. Vietnam was a "teenage war" - the average age of a combatant was 19, compared with 26 in World War II. It was a war without clear objectives, either politically or militarily. It was an increasingly unpopular war at home, and animosity was often directed at individual men and women who served.

Then there was DEROS "date of expected return from overseas." Under that system, each combatant, in effect, fought on his own 12month schedule (13 months if he was a Marine). This was expected to reduce the incidence of psychological breakdown in combat, and it seemed to work. Unlike the military's experience during World War II, where the incidence of psychological disorders increased as the war continued, the number in Vietnam remained both constant and at a record low. But, as clinicians later realized, DEROS simply helped to produce a disorder with a longer fuse. As American involvement in Vietnam wound down in the early 70's, psychiatric disorders among veterans began to increase.

DEROS had a more immediate disadvantage, too. Since every combatant fought on a private schedule, friendships were made and dissolved rapidly - which may help explain why Vietnam veterans are less likely to stay in touch with each other than are veterans of other wars, and why victims of PTSD suffer such deep feelings of isolation.

Anthony Paluszek, who looked to the Outward Bound trip for a sense of brotherhood, estimates, as we rest from hiking on the second day out, that he became close friends with about 50 men in his Americal Division outfit. In his 12 months, be saw most of them killed or severely wounded, and those who survived to DEROS were lost to him in the confusion of troop movements or through "short-timing" - the policy by which those nearing the end of their tours were sometimes rotated to the rear.

He says he isn't sure anymore if there is a real difference between physical separation and death. What he does know is that for the past two years, he has grieved uncontrollably for those friends to whom he never got to say goodbye. He has not visited the Wall, the Vietnam memorial in Washington, because he is afraid of what might happen if he went there: "It represents such a frightening confrontation to me that I can't face it."

Our second day is rough going. We are on hilly terrain, fording streams and hacking through underbrush. Jim Kakides's wounded legs are hurting and his pace has slowed. Tony Paluszek does not leave his side all day.

Bob Rheault had encouraged the veterans to "take responsibility for what happens on this trip," but the men seem reluctant to exercise authority. In some ways, they seem frozen in time. Michael Murphy, who flew Huey helicopters in Vietnam, says he feels like "a 19-year-old in a 36-year-old's body," and, at the campfire, he recounts his war stories from a teenager's perspective.

"I love low-leveling down the river," he says one night, "everything whizzing by you. To me, there’s no other feeling like it. We used to put two speakers out the sides of a gunship, turn on all the internal lights, and put this tape on the cassette - Iron Butterfly's 'In-A-Gadda-Da-Vida' as loud as we could get it. And we'd just low-level down the river, everything blaring, with another bird 300 feet behind, flying dark. We'd attract fire and that bird would put a strike in on it. We were crazy, right?"

"We used to mix napalm," says Gerry Carron, in his gentle voice. "Sometimes we did it high, sometimes low. I guess that was when Nixon was trying to cut down because of the Geneva Convention - no more jet strikes - so we did it by helicopter. I dropped quite a bit, day and night, three days at a time."

"Hey, you guys," Michael Murphy calls out. "Look what we brought! " He and Jim Kakides hold up a bag of marshmallows.

It's cold and cloudy when we break camp the next morning. Only the peaks of the hills rising on either side of the trail catch the sun. We skirt a series of frozen beaver ponds, walking single-file across the tops of the dams. Then we are back in the woods, climbing over and around fallen trees. "Watch out for trip wires!" someone calls from the rear of the column, reminding us of the infamous Vietnam booby traps.

We break after a few hours to check our progress and position. Michael Murphy, who has been appointed group leader for the day, removes a compass from one pocket. From another, he takes his prosthetic eye. He holds out both. The cool blue-gray eye stares up from the palm of his hand, a perfect match to the one in his head. The eye has been bothering him, though, and is especially uncomfortable out here in the cold. He has taped a gauze pad over the empty socket, creating the impression that his wound has not healed.

Michael Murphy was wounded in May 1971, on the final mission of his last day of active duty as a door gunner assigned to the Navy Helicopter Attack Light Squadron 3. After tracer bullets tore away his flight helmet and part of his head, soaking him in blood, he continued to return fire until his ammunition was gone. There was talk of a medal for valorous conduct, but such was the chaos surrounding his evacuation that his commanding officer was led to believe he had died of his wounds, and let the matter drop. Over time, the story of his death was passed to Murphy's friends. In 1986, 15 years after his discharge, he contacted some of those friends through a note about a squadron reunion he found in a veterans' newsletter.

Shortly after his supposed demise, Murphy was diagnosed by Veterans Administration doctors as suffering from "anxiety neurosis" in connection with the loss of his eye. He was pronounced 30 percent disabled and allotted benefits according to a compensation schedule. There the matter rested. Over the years, he married, got a job with the United States Postal Service, went to night school and fathered two sons. He found he could counter bouts of depression and anxiety with alcohol and drugs.

In 1979, his marriage broke up, and one day three years later, the crisis came. He was obsessed with the idea that the United States military had allowed him to sacrifice something precious and had given him nothing to be proud of in return. He removed his prosthetic eye and threw it across the room. "I hated it. I hated everything that started coming up," he tells me. "I don't think there's a person here who can tell you why these things surfaced or why it took so long. But when you came home you were forced not to talk about it, and there was probably no one you would trust like the guys over there anyway. Everyone said about my eye, 'Look, forget it, it's in the past.'" Now 165 pounds, Murphy weighed 119 the day a nurse found him lying in the hallway of the Veterans Administration Medical Center in Manchester, N.H. It was during that 1982 hospital stay that he first learned there was something called PTSD. He has been in and out of V.A. hospitals since.

Murphy has taken a number of drugs prescribed through the Veterans Administration, including Elavil and Ativan, on which he developed a dependency. He currently takes the antidepressant Sinequan. "I'm more relaxed now, more happy," he says, then shrugs. "But it's the medication."

Day three is relatively easy. We hike down the Appalachian Trail to a cabin that belongs to the Dartmouth College Outing Club. We will spend the night here, resting up for our attempt tomorrow at the summit of Mount Moosilauke. While the others go farther down the trail for water or stoke the woodburning stove inside, Jim Kakides and I sit on the stone steps of the cabin and survey the crystalline-white landscape laid out before us. Despite having permanently damaged his left knee and severed his right Achilles' tendon while leading a reconaissance patrol in the Mekong Delta in 1969, Kakides in 1970 was determined to put the war behind him and get on with college and a career in general contracting. If he felt anger or frustration, he associated it chiefly with the antiwar demonstrations being held in Boston, an hour's drive south of his hometown of Haverhill, Mass. "Everything I did I volunteered for," he says.

But something was not quite right, even in those first few months back home. He felt alienated from people he knew and was so obsessed with personal safety that he surrounded himself with weapons. "I always kept a rifle at home, I slept with a gun under my pillow, I kept one in my car and I had one on me," he says.

Once, on a visit to his father's restaurant, Kakides says, he put his hand into a lobster tank and was clawed. In front of customers and employees, he hauled the creature out, threw it on the floor and shot it to pieces - "and the funny thing was, I really didn't think there was anything strange about it."

Kakides's business grew. He bought a home of his own and a ski condominium in Colorado. He also drank, took drugs and kept his distance from others. Over time, the business began to suffer; eventually, he went broke. All he has left, he says, is his Cadillac, "and that needs a universal joint." He hasn't worked in three years.

Kakides remembers the names and faces of all 16 men from Haverhill who died in Vietnam, and he puts his head in his hands when he thinks of them. There were others, he recalls, who found ways to avoid the draft and later, launched on successful careers, came to look down on people like him. He brushes away a tear with the back of his hand. "I don't trust anyone," he says flatly.

The next day begins early. We are on the trail by 7, carrying only two packs filled with emergency supplies. We speculate about whether conditions will permit us to reach the summit, and, if so, how long it will take. Why not calculate in cigarettes instead of hours, suggests Dave Nazaroff, the trip's co-instructor, who has won over the veterans with compassion and good humor. Can each smoker limit himself to, say, four? "Anyone who wants to play Dave's game, please raise your hand," someone responds, adding, "You know, a little Librium would settle him right down."

We climb past bobcat tracks and skid across frozen brooks, sending loose stones tumbling down the mountainside. Slowly, hardwood trees give way to conifers, and eventually we are above the treeline. Kakides is in the lead. On an icy patch, he stumbles but Emil LeLoup, second in the column, breaks the fall. Kakides tells him, "I'm going to pick up one foot at a time. We are going to make it to the top."

We reach the summit almost five hours after starting out. The temperature is about 10 degrees, and the wind is gusting to 40 miles an hour. We are frozen and exhilarated. The rest of us are elated that Kakides, with his leg injuries, has been our leader.

The summit is marked by a cross, windblown and encrusted with ice. Under the cross, we bury an offering for the next group of veterans - a button that reads, "POW/MIA-They Still Wait," and a card each of us has signed. Michael Murphy, who picked it out, liked the illustration of a penguin with a head cold. On the inside are the words, "Feel Better Soon."

Back at the cabin after supper, Rheault gives out the patches that all Outward Bound participants receive. These are different, though, surmounted by "Vietnam Veterans" in red, green and gold. "This is not a badge or a medal," says Rheault. "You guys have plenty of those. This is a memento, pure and simple. Some day, I want you to say, 'I remember that experience. I remember, when I reached out to help somebody. I remember saying to myself that I would try to trust.' "

Jim Kakides and Michael Murphy decide to swap patches, so that when they remember the trip, they will remember each other. Later, they walk outside to share a last cigarette and look at the stars. Kakides says he loved getting out from under the triple-canopy jungle in Vietnam. "The sky at night was so beautiful." They haven't felt this good in a long time, they agree. They hug each other.

That night, I lie awake in my bunk, imagining our cabin as it would appear in cartoons -heaving softly with snores and whistles, a wisp of smoke curling from the chimney. I can hear bones turning on the wooden slats and sleeping bags being folded into new positions. In the crawl space above my head, someone is breathing irregularly and mumbling to himself. I wonder whose sleep is being regulated by the "meds" tonight.

I think of what Tony Paluszek said to me as we sat on the rim of the hill outside, watching the sunset. "I'm 40 years old," he said, "and the only place I feel comfortable is in a psychiatric hospital with the other brothers who are 40, too. Nobody out there is like me, and I'm not like them." I wonder if it will always be true.

The veterans on the December course have gone their separate ways now -most home to wives or parents before coming back for another stay on the PTSD ward; their treatment consists of regular stints in the hospital interspersed with visits home.

This Outward Bound program is only four years old, and no followup studies have yet been conducted to evaluate its worth. But Jim Kakides spoke for others who have gone on the course when he said, the day of our return to the ward, "We really helped each other, and I got close to everybody. I feel awake."

Two of the eight will not be returning to Ward 8, however. Soon after the Outward Bound trip, Michael Murphy was thrown off the ward for violating the alcohol rules -he got drunk while still a hospital patient. He has found a berth at another V.A. hospital in New England. Bill Clouart, who also resumed drinking, was injured in a car accident shortly before Christmas. He later returned to Northampton's alcohol rehabilitation ward, but will not be readmitted to the PTSD ward, at least for a while, because he has failed to respond to treatment. "They've told me I'm on my own now," he says.

Bob Rheault has seen men recover from such "terrible downslides." To be realistic, he says, "You're dealing with guys whose chances for success are pretty small. If two or three out of 10 make it, that's a lot. All you can really hope for is to tip the balance for a few."

Rheault is now planning the next outing.

END