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Archive for the ‘Iraq’


The Deadly Cost Of 1%

When the 1 Percent Fails to Contribute Its Fair Share, Veterans Pay Dearly

Jon Soltz

Co-Founder of VoteVets.org, Iraq War Veteran

 

Over the last few weeks, thousands of people from across the country have taken to the streets to demand the biggest corporations in the U.S. pay their fair share of taxes. Last week, Bank of America was the latest corporation to face the wrath of shareholders and protesters for its business practices; this week,it’s JPMorgan Chase, which is at the center of shareholder anger after losing $2 billion in investments, and Morgan Stanley, which has slashed jobs and rewarded its executives with lavish pay and bonuses despite its role in thefinancial meltdown.

The America that allows huge corporations to cut jobs here at home and get large tax breaks in the process is not the America I fought for. What has happened to basic fairness in our economy when so many troops come back from their service, unable to find a decent job, yet still pay more in taxes than the likes of billionaires or huge corporations like GE?

Veterans have served our country at considerable sacrifice. No one enlists to become rich or famous. We’ve spent significant time away from our families and worked in life-threatening situations. We care about our country and we invest in it every day with our time and expertise. We work hard and play by the rules. Along with almost everyone else in this country, veterans pay our taxes so that our kids can go to school, so we have clean air and water, and healthcare when we need it. Veterans also pay our taxes to help provide people currently serving in our military with the resources they need, both in the field and when they come home.

As it turns out, big corporations aren’t playing by the same rules — and our communities are paying for it. Families are struggling to stay in their homes, facing joblessness and cuts to vital services. Our children’s schools are crumbling and the American Dream — a good life for those who work hard and play by the rules — is receding further and further out of sight.

Many who served in Iraq and Afghanistan were part of the National Guard. While they can’t be laid-off while deployed, there was no guarantee the company or small business they worked for would exist when they came home. Military families are particularly hard-hit, often having to make do with less income while loved ones are deployed, and expenses like child care increase in a temporary one-parent household. They need relief.

Yet corporations like General Electric, Wells Fargo and Bank of America rake in billions and get away with paying no federal income taxes, or are taxed at a lower rate than those serving in the military. Their refusal to pay their fair share has cost our economy billions of dollars that could fund Medicare, education, veterans’ services, and create jobs for men and women returning from service.

Tax-dodging General Electric was once a shining example of American enterprise, providing good jobs that could support families. Entire towns and cities grew around GE plants and generations of families worked for GE for their entire lives. Innovation and job creation went hand in hand and as GE grew, so did our economy.

Now, GE is the poster-child for corporate tax-dodging. GE keeps billions offshore, avoiding U.S. taxes. It lavishes millions on executives while cutting tens of thousands of jobs, and employs an army of tax attorneys and political lobbyists like Capitol Tax Partners (which also lobbies for Goldman Sachs, JPMorgan Chase, State Street Corporation and other Wall Street giants that crashed the economy) to buy influence, invent and lobby for corporate tax loopholes, and keep GE ahead of its tax bill.

From 2008 to 2011, while hundreds of millions of Americans lost their jobs, their homes, and their dreams, GE made $10.5 billion in U.S. profits. Rather than pay federal income taxes, GE received $4.7 billion from U.S. taxpayers. We pay income taxes even on our unemployment insurance, but GE got away with paying a scant 2.3 percent in taxes over the last decade.

GE claims they’ve used these loopholes to create jobs. But that’s not true. Since 2004, GE has cut 32,000 jobs, even though the corporation’s board of directors is stacked with “job creators.” Meanwhile, the unemployment rate for the youngest age bracket of Iraq and Afghanistan veterans topped 20 percent last year.

Those of us who served this country didn’t do so in order to safeguard tax loopholes for the wealthiest 1 percent and giant corporations. We have a deep sense of duty and loyalty to our communities, to our children’s futures, and to seeing our fellow Americans achieve their dreams.

It is time that those of us who served our country, and those we served for, join together to demand an economy and an America that work for all of us.

Jon Soltz is an Iraq War Veteran and Chairman of VoteVets.org.

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It Got Ugly, Then It Got Worse…


Author, End This Depression Now! Paul Krugman

The following is excerpted from “End This Depression Now!” available now from W.W. Norton & Company.

 

CHAPTER ONE: HOW BAD THINGS ARE

 

I think as those green shoots begin to appear in different markets and as some confidence begins to come back that will begin the positive dynamic that brings our economy back.

Do you see green shoots?

 

I do. I do see green shoots.

–Ben Bernanke, chairman of the Federal Reserve, interviewed by 60 Minutes, March 15, 2009

In March 2009 Ben Bernanke, normally neither the most cheerful nor the most poetic of men, waxed optimistic about the economic prospect. After the fall of Lehman Brothers six months earlier, America had entered a terrifying economic nosedive. But appearing on the TV show 60 Minutes, the Fed chairman declared that spring was at hand.

His remarks immediately became famous, not least because they bore an eerie resemblance to the words of Chance, aka Chauncey Gardiner, the simpleminded gardener mistaken for a wise man in the movie Being There. In one scene Chance, asked to comment on economic policy, assures the president, “As long as the roots are not severed, all is well and all will be well in the garden. . . . There will be growth in the spring.” Despite the jokes, however, Bernanke’s optimism was widely shared. And at the end of 2009 Time declared Bernanke its Person of the Year.

Unfortunately, all was not well in the garden, and the promised growth never came.

To be fair, Bernanke was right that the crisis was easing. The panic that had gripped financial markets was ebbing, and the economy’s plunge was slowing. According to the official scorekeepers at the National Bureau of Economic Research, the so-called Great Recession that started in December 2007 ended in June 2009, and recovery began. But if it was a recovery, it was one that did little to help most Americans. Jobs remained scarce; more and more families depleted their savings, lost their homes, and, worst of all, lost hope. True, the unemployment rate is down from the peak it reached in October 2009. But progress has come at a snail’s pace; we’re still waiting, after all these years, for that “positive dynamic” Bernanke talked about to make an appearance.

And that was in America, which at least had a technical recovery. Other countries didn’t even manage that. In Ireland, in Greece, in Spain, in Italy, debt problems and the “austerity” programs that were supposed to restore confidence not only aborted any kind of recovery but produced renewed slumps and soaring unemployment.

And the pain went on and on. I’m writing these words almost three years after Bernanke thought he saw those green shoots, three and a half years after Lehman fell, more than four years after the start of the Great Recession. The citizens of the world’s most advanced nations, nations rich in resources, talent, and knowledge–all the ingredients for prosperity and a decent standard of living for all–remain in a state of intense pain.

In the rest of this chapter I’ll try to document some of the main dimensions of that pain. I’ll focus mainly on the United States, which is both my home and the country I know best, reserving an extended discussion of the pain abroad for later in the book. And I’ll start with the thing that matters most–and the thing on which we’ve performed the worst: unemployment.

The Jobs Drought

Economists, the old line goes, know the price of everything and the value of nothing. And you know what? There’s a lot of truth to that accusation: since economists mainly study the circulation of money and the production and consumption of stuff, they have an inherent bias toward assuming that money and stuff are what matter. Still, there is a field of economic research that focuses on how self-reported measures of well-being, such as happiness or “life satisfaction,” are related to other aspects of life. Yes, it’s known as “happiness research”–Ben Bernanke even gave a speech about it in 2010, titled “The Economics of Happiness.” And this research tells us something very important about the mess we’re in.

Sure enough, happiness research tells us that money isn’t all that important once you get to the point of being able to afford the necessities of life. The payoff to being richer isn’t literally zero–citizens of rich countries are, on average, somewhat more satisfied with their lives than citizens of less well-off nations. Also, being richer or poorer than the people you compare yourself with is a fairly big deal, which is why extreme inequality can have such a corrosive effect on society. But when all is said and done, money is less important than crude materialists–and many economists–would like to believe.

That’s not to say, however, that economic affairs are unimportant in the true scale of things. For there’s one economics-driven thing that matters enormously to human well-being: having a job. People who want to work but can’t find work suffer greatly, not just from the loss of income but from a diminished sense of self-worth. And that’s a major reason why mass unemployment–which has now been going on in America for four years–is such a tragedy.

How severe is the problem of unemployment? That question calls for a bit of discussion.

Clearly, what we’re interested in is involuntary unemployment. People who aren’t working because they have chosen not to work, or at least not to work in the market economy–retirees who are glad to be retired, or those who have decided to be full-time housewives or househusbands–don’t count. Neither do the disabled, whose inability to work is unfortunate, but not driven by economic issues.

Now, there have always been people claiming that there’s no such thing as involuntary unemployment, that anyone can find a job if he or she is really willing to work and isn’t too finicky about wages or working conditions. There’s Sharron Angle, the Republican candidate for the Senate, who declared in 2010 that the unemployed were “spoiled,” choosing to live off unemployment benefits instead of taking jobs. There are the people at the Chicago Board of Trade who, in October 2011, mocked anti-inequality demonstrators by showering them with copies of McDonald’s job application forms. And there are economists like the University of Chicago’s Casey Mulligan, who has written multiple articles for the New York Times website insisting that the sharp drop in employment after the 2008 financial crisis reflected not a lack of employment opportunities but diminished willingness to work.

The classic answer to such people comes from a passage near the beginning of the novel The Treasure of the Sierra Madre (best known for the 1948 film adaptation starring Humphrey Bogart and Walter Huston): “Anyone who is willing to work and is serious about it will certainly find a job. Only you must not go to the man who tells you this, for he has no job to offer and doesn’t know anyone who knows of a vacancy. This is exactly the reason why he gives you such generous advice, out of brotherly love, and to demonstrate how little he knows the world.”

Quite. Also, about those McDonald’s applications: in April 2011, as it happens, McDonald’s did announce 50,000 new job openings. Roughly a million people applied.

If you have any familiarity with the world, in short, you know that involuntary unemployment is very real. And it’s currently a very big deal.

How bad is the problem of involuntary unemployment, and how much worse has it become?

The U.S. unemployment measure you usually hear quoted in the news is based on a survey in which adults are asked whether they are either working or actively seeking work. Those who are seeking work but don’t have jobs are considered unemployed. In December 2011 that amounted to more than 13 million Americans, up from 6.8 million in 2007.

If you think about it, however, this standard definition of unemployment misses a lot of distress. What about people who want to work, but aren’t actively searching either because there are no jobs to be had, or because they’ve grown discouraged by fruitless searching? What about those who want full-time work, but have only been able to find part-time jobs? Well, the U.S. Bureau of Labor Statistics tries to capture these unfortunates in a broader measure of unemployment, known as U6; it says that by this broader measure there are about 24 million unemployed Americans–about 15 percent of the workforce–roughly double the number before the crisis.

Yet even this measure fails to capture the extent of the pain. In modern America most families contain two working spouses; such families suffer, both financially and psychologically, if either spouse is unemployed. There are workers who used to make ends meet with a second job, now down to an inadequate one, or who counted on overtime pay that no longer arrives. There are independent businesspeople who have seen their income shrivel. There are skilled workers, accustomed to holding down good jobs, who have been forced to accept work that uses none of their skills. And on and on.

There is no official estimate of the number of Americans caught up in this sort of penumbra of formal unemployment. But in a June 2011 poll of likely voters–a group probably in better shape than the population as a whole–the polling group Democracy Corps found that a third of Americans had either themselves suffered from job loss or had a family member lose a job, and that another third knew someone who had lost a job. Moreover, almost 40 percent of families had suffered from reduced hours, wages, or benefits.

The pain, then, is very widespread. But that’s not the whole story: for millions, the damage from the bad economy runs very deep.

 

 To Be Continued…

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True Enemy Of The State?

‘Beyond Debate’

 

Jose Padilla, the American citizen detained as an enemy combatant after he was arrested by the Bush administration in May 2002, was denied contact with his lawyer, his family or anyone else outside the military brig for almost two years and kept in detention for almost four. His jailers made death threats, shackled him for hours, forced him into painful stress positions, subjected him to noxious fumes that hurt his eyes and nose and deafening noises at all hours, denied him care for serious illness and more.

This treatment was indisputably cruel, inhumane and shocking, in breach of the minimum standard required for anyone in American custody, especially a citizen. Some of it was torture, though Mr. Padilla should not have had to prove that to show his treatment was unconstitutional.

Seeking money damages of $1 — to make a point about accountability — Mr. Padilla sued John Yoo, the draftsman of legal policies for the Bush war on terrorism. Mr. Padilla said Mr. Yoo violated the Constitution by helping to shape policies that led to the unlawful detention and interrogation of Mr. Padilla and then writing legal papers to justify that approach.

In 2009, a Federal District Court in California ruled that Mr. Yoo was not immune from the lawsuit: the violations of rights Mr. Padilla alleged were “clearly established at the time of the conduct” and any “reasonable” federal official would have understood that.

But this week, in a misguided and dangerous ruling, a three-judge panel of the United States Court of Appeals for the Ninth Circuit decided that Mr. Padilla’s lawsuit cannot go forward because Mr. Yoo is immune. The unanimous opinion contends it was not “beyond debate” that Mr. Padilla, a citizen declared an enemy combatant, was entitled to the same protections as any accused criminal or convicted prisoner — or that his alleged treatment was clearly established to be torture in the years he endured it.

Until a year ago, the law gave officials so-called qualified immunity to shield them when they performed responsibly. In holding them accountable for exercising power irresponsibly, it required simply that a reasonable person would have known about the right he violated. Last May, however, the Supreme Court ruled that “existing precedent” must put any question about such a right “beyond debate.”

That is an unworkable standard and the Ninth Circuit decision shows why. The Bush administration manufactured both “debates” — about torture and enemy combatants. Any future government can rely on this precedent to pull the same stunt as cover for some other outrage.

By using the “enemy combatant” category, the Bush administration stirred debate that had not existed about whether rights of an American citizen in custody depend on how he is classified. By coming up with offensive rationalizations for torturing detainees, it dishonestly stirred debate about torture’s definition when what it engaged in plainly included torture.

The Ninth Circuit was wrong to swallow those deceits and to dwell on whether Mr. Padilla’s mistreatment was torture. Even if somehow it did not qualify, its cruel, inhumane and shocking nature badly violated his rights as a citizen — and international law on the treatment of detainees. Even at the time, the issue was beyond debate, and Mr. Yoo should have known that.

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It Takes A Badass To Know A Badass, Right?

Boasting About Bin Laden

By ROSS DOUTHAT
 

Savvy politicians know that it’s usually a good sign when a political advertisement provokes cries of outrage from the opposition. The picture gets murkier, though, when that same advertisement prompts high-minded expressions of disappointment from the politician’s own supporters. Sometimes that’s a signal that the ad in question has overreached and risks a backlash. But sometimes it’s just a sign that those high-minded supporters don’t recognize the weakness that the ad is trying to exploit, or just don’t have the stomach for a necessary fight.

This is the dilemma the Obama re-election campaign faces with the ad it released recently suggesting that Mitt Romney might not have given the order to send Navy SEALS to kill Osama Bin Laden. The attack clearly touched a nerve with Republicans, but it also earned the White House a rebuke from several liberals, including no less a left-wing eminence than Arianna Huffington.

On the Early Show on CBS, Huffington called the ad “despicable,” suggested that questioning an opponent’s ability to serve as commander-in-chief is “not the way to run campaigns on either side,” and compared the attack to the “3 A.M. phone call” ad Hillary Clinton’s campaign released in 2008, which made a similar case against then-candidate Obama’s ability to make the toughest national security decisions.

When even Huffington thinks a Democratic attack goes too far, it usually has. And yet a moment’s scrutiny reveals that her argument doesn’t make much sense. Why do we have election seasons, after all, if not to argue about which candidate would be better-suited to making decisions that put Americans in harm’s way overseas? How can we not politicize national security, given how central it is to the work of the modern presidency, and how unconstrained the executive branch’s national security powers have become no matter which party holds the White House?

These are the arguments that Hillary Clinton partisans mounted in defense of that “3 A.M. ad,” and that George W. Bush’s partisans mounted in defense of his 9/11-centric 2004 re-election campaign. And those arguments were right! It’s one thing to say that candidates shouldn’t impugn one another’s patriotism. But impugning a rival’s judgment, as the Obama camp’s Bin Laden advertisement just did, is precisely what a presidential campaign is for.

Strategically, too, the White House has every reason to press these kind of arguments to the hilt. As I’ve noted in this space before, most of President Obama’s record is unpopular – sometimes deeply so – with the voting public. But the big exception is national security, where polls often show that Obama has built up a fair amount of credibility with voters. Foreign policy thus offers the White House its best (and perhaps only) opportunity to draw contrasts with Romney by highlighting the president’s actual accomplishments.

Whereas on domestic issues the Romney camp can answer almost every Obama attack by changing the subject to the unemployment rate, on foreign policy the Republican message is much more muddled and uncertain. In the usual order of things, Romney would be simply try to out-hawk the president, but this is not a hawkish moment in American politics. Outside of the most Republican portions of the electorate, the Iraq War is still widely regarded as a bad blunder, and even conservatives are increasingly supportive of a speedy exit from Afghanistan. Public opinion on Iran is unsettled, but there is next to no support for the kind of stepped-up American intervention in Syria that some Republicans have championed.

Meanwhile, by keeping much of the Bush-era anti-terror architecture in place and stepping up covert warfare from Waziristan to the Horn of Africa, the president has effectively undercut the soft-on-terror arguments that Republicans used so effectively against John Kerry in 2004. Indeed, the most compelling criticisms of this White House have come from libertarians and anti-interventionists on both the left and right, on issues ranging from the dubiously-legal “kinetic military action” in Libya to the White House’s willingness to order the assassination of an American citizen abroad.

Senator Marco Rubio spoke at a conference at the Brookings Institute in Washington on April 25.Shawn Thew/European Pressphoto AgencySenator Marco Rubio spoke at a conference at the Brookings Institute in Washington on April 25.

This explains why the Republican Party’s foreign policy rhetoric can seem so opportunistic and confused. The Rand Paul-led, anti-interventionist wing of the party arguably has a more coherent case against the president than the more hawkish wing, which often finds itself emphasizing what it has in common with the president – as Florida Senator Marco Rubio did in a widely-touted foreign policy address defending interventionism last week. (Tellingly, the word “Iraq” did not appear in his remarks.) Yet the hawkish line of attack is still the Republican default, and Mitt Romney’s case — to date, at least — against the president has generally circled back to its tropes and premises.

The result is an incoherence that James Poulos described well in a recent column in Forbes:

With Obama, the GOP has become like Woody Allen’s neurotic diner: the food is horrible, and such small portions! The president is condemned for leading and for leading from behind; for relying too much on talk and too much on drones; for slavishly kowtowing to foreign leaders and for arrogantly refusing to stroke foreign leaders. Obama’s foreign policy has paralyzed the GOP by laying bare just how much Republicans collectively refuse to fully commit to one grand, unifying possibility in international affairs — including the possibility of stepping away from sweeping principles and playing it by ear for a while.

Arianna Huffington’s qualms notwithstanding, it would be political malpractice for the president not to exploit this kind of confusion with national security attacks on his opponent. Indeed, Republicans who care about these issues should welcome them. Advertisements like the Bin Laden spot and political stunts like last night’s almost-victory speech in Afghanistan present a challenge to the right, but also an opportunity.

The rough-and-tumble of a presidential campaign affords conservatives their best chance yet to come to terms with the Bush era in foreign policy and its aftermath — to figure out what they think about the recent past, where they stand at present and where they would have the country go from here.

 

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Public Enemy #1 Dead And That’s A Bad Thing

Republicans way out of bounds attacking President Obama for ad on order to take out Osama Bin Laden    Mike Lupica

 

The political party of the “Mission Accomplished” banner on the aircraft carrier Abraham Lincoln in May 2003, the party that gave us George W. Bush as an adorable dressup fighter pilot, now accuses Barack Obama of “spiking the ball” because he runs an ad about the order to take out Osama Bin Laden in May 2011.

Are they kidding? If it had been Bush who ordered the hit on Bin Laden, the Republicans would have wanted to make the day it happened into an instant national holiday. Instead they send out Sen. John McCain to issue a statement about the President who kicked McCain up and down the Electoral College four years ago.

“Shame on Barack Obama,” McCain says, “for diminishing the memory of Sept. 11 and the killing of Osama Bin Laden by turning it into a cheap political ad.”

Listen: You don’t have to line up with Obama on health care or the stimulus program or bailing out the automobile industry. You can talk about how he hasn’t done enough about jobs, about the deficit, about him making the talk-show rounds. You can line up with all the bullhorn media yahoos obsessed with getting Obama out of office, and all the deep-pocket donors who will spend any amount of money to make sure that happens in November.

But the idea that this President isn’t allowed to remind people that nearly 10 years after Bin Laden killed nearly 3,000 of our own in New York and tried to blow up lower Manhattan it was his — Obama’s — order that finally took the guy out is plain stupid, even for a smart guy like John McCain.

I frankly don’t remember McCain being offended nine years ago when Bush made that jet landing on the Lincoln and stood in front of that “Mission Accomplished” banner and said, “In the Battle of Iraq, the United States and our allies have prevailed.”

After that day, after Bush took that victory lap, there were more than 4,000 more American casualties in Iraq and so many more wounded, and that is just the count of American dead and wounded. In a war Bush started. In a country that had nothing to do with Bin Laden or Sept. 11, 2001.

Bush was the one who declared that this country would get Bin Laden “dead or alive.” Only it didn’t happen on his watch, didn’t happen until May 1 of last year, didn’t happen until Obama gave the order and SEAL Team Six went up those stairs in Pakistan and took the bastard out.

Is this some huge pressing campaign issue in the America of 2012? It’s not. More than anything, Bin Laden’s death is just another reminder about how long a year is in politics, and especially presidential politics. On that Sunday night one year ago, when word began to get around about what had happened across the world in Pakistan, there was this cockeyed notion that the 2012 campaign was over before it had even begun, that it was game, set, match for Obama.

 

Can Obama run only on that in 2012? Of course not. But the Republicans also aren’t allowed to somehow use Bin Laden against him. It actually seems to make them a little crazy — or crazier — that they can no longer campaign against Obama with the idea that he is soft on terrorism, now that the opposite of that is true.

And by the way? The previous administration’s idea of an aggressive war on terror was to start a corrupt war in Iraq. Maybe Sen. McCain could be a little more offended about that, even late in the game, than he is about Obama using Bin Laden to make some political hay.

Barack Obama was the one who had to issue the order on Bin Laden and did, even as others in his administration were telling him it was a mistake, there was too much risk involved, that the downside of a failed mission for Obama — already being compared with Jimmy Carter — was him looking as bad as Carter had with the failed hostage rescue in Iran in 1980.

So Obama made the call, and Bin Laden was shot dead by Navy SEALs, and if it wasn’t the end of the movie, it was at least a form of closure for those who lost family or friends on Sept. 11. So this was an American President giving you a real mission accomplished, taking out a real weapon of mass destruction, not imagined ones.

And please imagine what the cheering from the other side would have been like if it had been Bush who made the call on Bin Laden, if Bush had still been President when it happened. They wouldn’t have just spiked the ball in the end zone, they would have started a conga line that stretched all the way down Pennsylvania Ave., would have danced all the way to Election Day.

 

 

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The Price Of War Mongering

Veterans and Brain Disease By

He was a 27-year-old former Marine, struggling to adjust to civilian life after two tours in Iraq. Once an A student, he now found himself unable to remember conversations, dates and routine bits of daily life. He became irritable, snapped at his children and withdrew from his family. He and his wife began divorce proceedings.

This young man took to alcohol, and a drunken car crash cost him his driver’s license. The Department of Veterans Affairs diagnosed him with post-traumatic stress disorder, or P.T.S.D. When his parents hadn’t heard from him in two days, they asked the police to check on him. The officers found his body; he had hanged himself with a belt.

That story is devastatingly common, but the autopsy of this young man’s brain may have been historic. It revealed something startling that may shed light on the epidemic of suicides and other troubles experienced by veterans of wars in Iraq and Afghanistan.

His brain had been physically changed by a disease called chronic traumatic encephalopathy, or C.T.E. That’s a degenerative condition best-known for affecting boxers, football players and other athletes who endure repeated blows to the head.

In people with C.T.E., an abnormal form of a protein accumulates and eventually destroys cells throughout the brain, including the frontal and temporal lobes. Those are areas that regulate impulse control, judgment, multitasking, memory and emotions.

That Marine was the first Iraq veteran found to have C.T.E., but experts have since autopsied a dozen or more other veterans’ brains and have repeatedly found C.T.E. The findings raise a critical question: Could blasts from bombs or grenades have a catastrophic impact similar to those of repeated concussions in sports, and could the rash of suicides among young veterans be a result?

“P.T.S.D. in a high-risk cohort like war veterans could actually be a physical disease from permanent brain damage, not a psychological disease,” said Bennet Omalu, the neuropathologist who examined the veteran. Dr. Omalu published an article about the 27-year-old veteran as a sentinel case in Neurosurgical Focus, a peer-reviewed medical journal.

The discovery of C.T.E. in veterans could be stunningly important. Sadly, it could also suggest that the worst is yet to come, for C.T.E. typically develops in midlife, decades after exposure. If we are seeing C.T.E. now in war veterans, we may see much more in the coming years.

So far, just this one case of a veteran with C.T.E. has been published in a peer-reviewed medical journal. But at least three groups of scientists are now conducting brain autopsies on veterans, and they have found C.T.E. again and again, experts tell me. Publication of this research is in the works.

The finding of C.T.E. may help answer a puzzle. Returning Vietnam veterans did not have sharply elevated suicide rates as Iraq and Afghan veterans do today. One obvious difference is that Afghan and Iraq veterans are much more likely to have been exposed to blasts, whose shock waves send the brain crashing into the skull.

“Imagine a squishy, gelatinous material, surrounded by fluid, and then surrounded by a hard skull,” explained Robert A. Stern, a C.T.E. expert at Boston University School of Medicine. “The brain is going to move, jiggle around inside the skull. A helmet cannot do anything about that.”

Dr. Stern emphasized that the study of C.T.E. is still in its infancy. But he said that his hunch is that C.T.E. accounts for a share — he has no idea how large — of veteran suicides. C.T.E. leads to a degenerative loss of memory and thinking ability and, eventually, to dementia. There is also often a pattern of depression, impulsiveness and, all too often, suicide. There is now no treatment, or even a way of diagnosing C.T.E. other than examining the brain after death.

While the sports industry has lagged in responding to the discovery of C.T.E., and still does not adequately protect athletes from repeated concussions, the military has been far more proactive. The Defense Department has formed its own unit to autopsy brains and study whether blasts may be causing C.T.E.

Frankly, I was hesitant to write this column. Some veterans and their families are at wit’s end. If the problem in some cases is a degenerative physical ailment, currently incurable and fated to get worse, do they want to know?

I called Cheryl DeBow, a mother I wrote about recently. She sent two strong, healthy sons to Iraq. One committed suicide, and the other is struggling. DeBow said that it would actually be comforting to know that there might be an underlying physical ailment, even if it is progressive.

“You’re dealing with a ghost when it’s P.T.S.D.,” she told me a couple of days ago. “Everything changes when it’s something physical. People are more understanding. It’s a relief to the veterans and to the family. And, anyway, we want to know.”

 

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No Preparation For This Cost Of War

Beyond The Battlefield: Afghanistan’s Wounded Struggle With Genital Injuries

 

Before they went off to fight in Afghanistan, the guys of 3rd Battalion, 5th Marines talked quietly about their deepest fear. Not dying. Not losing a leg or an arm.

It was having their genitals ripped off, burned away or crushed in the fiery blast of an improvised explosive device.

This was no idle concern to young men bursting with testosterone. The makeshift bombs known as IEDs are taking a frightening toll in Afghanistan, the blasts shearing off arms and legs, ripping through soft flesh, crushing organs and bone, and driving dirt, rocks and filth deep into torn flesh — often leaving the genitals shredded or missing. Some guys said they’d rather be dead.

Mark Litynski, a 23-year-old rifleman with Lima Company, knew the odds. He’d been married to Heather for almost a year, and children were in the future they planned together.

I ought to freeze my sperm so we could still have kids if something happened, he thought.

The idea nagged at him. But in the rush of last-minute training before they packed their sea bags and weapons and then took a few days of boisterous leave, he kept putting it off. Where do you go to freeze your sperm, anyway? Who would you even ask?

By the time they loaded on the buses at Camp Pendleton, it was too late. Should have done it, Mark thought as they boarded the plane in September 2010.

Weeks later, Mark was on a combat patrol in Sangin, southern Afghanistan, walking behind an engineer sweeping for IEDs, marking their path with yellow spraypaint. IED detectors aren’t foolproof. There came a bright flash and searing heat, then the upward blast ripped off both of Mark’s legs and most of his left arm, slashing into his remaining arm, shattering his pelvis and driving a rock and other debris up into his abdominal cavity.

Amid the bloody carnage, all the skin was ripped from his penis and his testicles were gone.

Days later, after trauma surgeons in Germany finished trimming and suturing his stumps and temporarily closing his abdominal wounds, he managed to say a few words to Heather on the phone.

“I’m so sorry,” he croaked.

“I love you,” she told him, blinking back tears. “We will pull through this together, as a team.”

‘THEY WEREN’T PREPARED FOR THIS’

The decade of U.S. combat in Afghanistan has left Afghans and Americans with a seemingly endless series of woes. But among the most devastating are the blast wounds that have left more than 16,000 young Americans severely wounded.

Several hundred have suffered genital injuries in addition to amputations and burns, leaving them unable to father children and struggling to engage in something resembling the sex they used to have, often without the aid of what many view as the primary symbol of their manhood.

“Who’s going to want to be with me now?” wondered Marine Staff Sgt. Glen Silva, 39, after an IED blast shattered his leg, ripped open his lower torso and severed most of his penis.

It was a legitimate concern. Silva’s girlfriend stayed with him at Walter Reed National Military Medical Center in Bethesda, Md., through many of his 42 surgeries. But one day he was wheeled back to his room to find she had gone, leaving a nine-word handwritten note: “I can’t take this any more. I’m outta here.”

Silva, the Litynskis and others agreed to share the painful and intimate details of their ordeals in order to spotlight what they feel is a life-altering but often hidden wound, one that is frequently given inadequate attention and care within the military health care system. Those who cannot regain their sexual function or drive are given little understanding or aid, they say. In Mark and Heather’s case, it took the intervention of The Huffington Post to get them an appointment with Walter Reed’s specialist in sexual dysfunction.

“They weren’t prepared for this,” Silva said of the Walter Reed staff.

Since 2005, more than 1,500 soldiers and Marines have been carried off the battlefield with genital wounds. But since late 2009, when President Barack Obama ordered a “surge” of 30,000 combat troops into Afghanistan and approved a new tactic of increased foot patrols, the pace of genital injuries has accelerated.

In the year before the surge, 170 combat troops suffered genital wounds, mostly from IED blasts. In 2010, according to Pentagon data, that number leapt to 259. Last year, the Defense Department counted 299 cases of genital wounds that James Jezior, a urologist who does genital repair surgery at Walter Reed, characterizes as “devastating.”

“I remember lying on my side, dust everywhere, and I looked down and saw my arms were split open and squirting blood and I had just two bloody stumps above my knees,” said Marine 1st Lt. James Byler, 26, who was blown up a few weeks before Mark Litynski. “My first coherent words to my Marines were, ‘Hey! check my nuts!’” His genitals were severely damaged, but intact.

“It’s the male instinct, the first thing you care about,” Byler said. “In past wars, guys didn’t live if they got injured as badly as me, but we’ve gotten so good at the medevac process now that guys who are catastrophically wounded are surviving. Now you have all these further complications — like, you know, what’s going to happen with my genital wounds?”

Military surgeons and specialists acknowledge that they often don’t know the answer, because, until recently, they had little or no exposure to such injuries.

‘I AIN’T GOING TO NO SEX-CHANGE DOCTOR’

In past wars, most casualties were head and chest wounds caused by shrapnel from mortars and artillery or from bullets. Walter Reed, the nation’s premier military hospital, attracts some of the best talent in military medicine. But doctors there say their only relevant experience with sexual dysfunction had long been with older prostate cancer patients, who obviously have vastly different medical and psychological needs than young men with severe battle injuries.

During the past decade, IED blasts have become the primary cause of U.S. battle casualties, killing or wounding 34,360 American troops in Iraq and Afghanistan, according to the most recent Pentagon data. One reason for the increasing incidence is that modern body armor protects the chest but leaves the lower torso exposed to the upward blast of buried bombs, a vulnerability that insurgents have exploited.

Many victims end up at Walter Reed, where surgeons are able to repair some damage to the penis. Jezior uses tissue he cuts from inside the patient’s cheek or lip to rebuild the urethra, which carries urine through the penis from the bladder. Oral tissue is used because it is hairless and used to being wet, Jezior explained, and is rolled into a tube to replace the damaged urethra. He grafts skin from the patient’s thigh or groin to rebuild the outer layer of the penis.

But for guys like Staff Sgt. Silva whose penises have been partly or totally destroyed, options are few. Expertise within the military on penis replacement, or phalloplasty, is so limited that some Walter Reed patients have been referred to civilian surgeons who specialize in sex-change operations. It’s an option not well received in the ranks.

“I ain’t going to no sex-change doctor,” Silva growled. Besides, he had seen photos of the penises they had made with surgical flaps from patients’ forearms. “I could do better with Silly Putty,” he snorted.

But there is hope that doctors may soon be able to regrow a penis from the smooth muscle and endothelial cells of patients like Silva. Advances in regenerative medicine have surged during the past decade. At the Wake Forest Institute for Regenerative Medicine, a team led by Anthony Atala reported last year that they had regenerated the penises of 12 New Zealand white rabbits. Once they healed, the rabbits were placed in cages with female rabbits. All attempted copulation within one minute and four females became impregnated.

Can he grow a penis for Silva? “We are always cautiously optimistic. This still requires a lot of work to make sure it works well,” Atala said in an interview. “As much as it works in the laboratory, it may not work in the human.”

“But,” he added, “we have a good history. Hopefully this holds some promise for the future.”

Atala is seeking regulatory approval to begin experimental penile regeneration in humans. He has met with Silva to discuss the procedure and said he wants to move forward “as expeditiously as possible,” though he declined to provide a more specific timeframe.

Still, even if surgeons can physically rebuild genitals, making them work effectively and pleasurably is vastly more challenging. Achieving erection, orgasm and ejaculation involves a complex interplay of sensory nerves, muscles and blood-vessel functions, any or all of which may have been damaged by an IED blast.

“Even if you can regenerate tissue, it doesn’t mean you can make that tissue function exactly the way it did before — mostly because of nerve function,” said Robert Dean, an andrologist who is Walter Reed’s lone specialist in sexual dysfunction.

‘WHO’S GOING TO WANT TO BE WITH ME?’

A genital wound doesn’t mean the end of pleasurable or productive sex, however, according to Dean and other specialists. It’s a common misconception, Dean said, that sex must include an erection, orgasm and ejaculation. “After an injury, the ejaculation function may be gone, but orgasm isn’t,” he said. “Erections may be difficult to achieve, but orgasms are still possible.”

That’s the theory. But predicting how well individual genital-wound patients will recover is nearly impossible, doctors admit.

Much is unknown about the secondary effects of a powerful blast on human organs. Apart from the obvious physical damage, the concussive blast wave seems to affect sexual function in ways that are not clear. Byler, for instance, suffered little visible physical damage to his genitals, but his testosterone levels and sperm count dropped alarmingly after he was injured.

He and many other genital-wound patients are given replacement doses of testosterone. Low testosterone levels can depress sex drive and decrease energy levels, but the treatment often requires precise dosages and a lengthy process of trial and error. And often, its effects are masked, as many patients are also taking a cocktail of other drugs for pain and anxiety or to control swelling and fight infection.

It’s a situation that breeds intense frustration. Genital-wound patients are anxious to know what their sexual future looks like. But doctors at Walter Reed often are unable to reassure them that their sexual functions will ever return in whole, in part or at all. It can take a year, even two, for answers to begin to emerge, Jezior said.

Even then, he said, “We absolutely do not know how well their reactions will be with what they have remaining, how functional they will be. It takes a lot of time to heal, a lot of recovery, every part of the body has to heal before your erections become what will be their end-state.”

Some patients, he added, “will not get back to a functional state.”

But it can be difficult to determine who will recover, and how much, medical officials said, largely because there is a relative paucity of data on the long-term medical and psychological effects of the available treatments and the wounds themselves.

That uncertainty can add yet another crushing psychological burden for young men already struggling with the loss of arms and legs.

“You hear a lot of, ‘This is the best we can do, but the fact of the matter is, we have never seen this type of injury before, so we [doctors] really don’t know what to tell you,’” said Byler, speaking of his experience as an amputee and genital-injury patient at Walter Reed.

Byler said he never even saw a urologist until four or five months after he was wounded. “There’s a lot of things they can do for limbs that are lost, like my legs — but no one really addresses the genitalia,” he said. “You need someone to come look at the damage and give you an honest assessment of what they think it’s gonna be. Because otherwise you’re left wondering, who’s going to want me? Who’s going to want to be with me?”

Doctors at Walter Reed acknowledge having long failed to recognize that while young men may accept the loss of a limb, even the loss of several limbs, they are often far more devastated by damage to their genitals.

“There certainly was a disconnect,” said Jezior. “It was an eye-opener for us that there is a grieving when it comes to significant injury to the genitalia that needs to be dealt with.” Still, he insisted that the care provided to genital wound patients at Walter Reed is “pretty incredible, with a lot of support.”

‘WE SAVED HIS PENIS’

Mark and Heather Litynski, however, did not feel supported after Mark was wounded. Their experience was bitter, frustrating and far from the future they had imagined.

They grew up two miles apart in the Minneapolis suburb of New Hope. When Mark shipped out to Afghanistan in September 2010, Heather went home to wait for his return.

She was holding down a temporary job at Starbucks in November when two Marines arrived, accompanied by her mother and sister. Mark was alive, they told her, but in critical condition with “severe lower torso injuries.” They handed her a terse medical report describing his wounds. When she read “bilateral [both legs] above-knee amputations,” Heather collapsed to the ground in shock.

It was far worse than she had feared. But he was alive.

“When I found out, I started crying, but very quickly I got over it because you’re just so glad they’re alive and doing well,” Heather said.

Two days passed, an agony of waiting, before doctors could talk to Heather about the extent of Mark’s injuries. There were a lot of other things to worry about — the potential for deadly infection, of possible brain damage, the trauma of losing two legs and his arm. But one thing the doctors said hit home: “We saved his penis!”

“‘Saved his penis!’ Got something!” Heather recalled with a chuckle.

Mark has also accepted his wound, just as he has gotten used to his wheelchair, his prosthetic legs and mechanical arm. “When I found out about it [his testicle loss] I was kind of … you know, ‘Should have done the sperm-freeze thing,”’ he said. “But … we’re making it through. It’s not the end of the world.”

Of course, it wasn’t as simple as that.

As surgeons at Walter Reed were working to repair Mark’s abdominal wounds and shape his leg and arm stumps, they also began reconstructive work on his penis. They prescribed doses of Viagra or Cialis to see if he could get an erection. A duty nurse administered the first dose while Mark had a full-length catheter inserted in his penis. His erection was painful.

But stimulation is necessary and common early therapy for genital-wound patients, said Dean, the hospital’s sexual-dysfunction specialist. “Even though they are not really close to wanting to use it, because they have physical therapy to go through and pain issues, we start rehab therapy to see what effect that has, because we don’t want the [penile] tissues to atrophy,” he said.

Severely wounded patients like Mark typically spend a few months in intensive care at Walter Reed. Then they transfer to an apartment in one of the comfortable new housing units at the hospital and continue their physical and occupational therapy as outpatients. Once Mark got a set of prosthetic arms and learned to walk on his new prosthetic legs, he joined other wounded patients on fishing trips, even a snowboarding in Vail, Colo., just over a year after his injury.

Things weren’t easy, though. “He was very affectionate before, he used to always have his arm around me, hold my hand, just come by and kiss my head,” said Heather. “That’s how he was.” But as his physical wounds healed, the couple’s sense of intimacy did not return. Nor did Mark’s sex drive. He was lethargic. He had ”zero” desire, she said.

Mark was taking testosterone to replace the hormone normally produced by his testicles. Heather suspected the dosage was wrong, but she couldn’t get anyone at Walter Reed to listen.

“Every time we’d go to the doctor, it was always kind of awkward and embarrassing,” she said. “I’d have to bring it up and ask them — they never asked us. I was always given a vague answer — ‘Oh, well, he’s still on some medications that can decrease the libido …’ And I’m thinking having sex once every couple of months with your spouse is more than a little ‘decrease’ in libido.”

Heather started wondering if Mark was suffering from traumatic brain injury or post-traumatic stress, but she felt there was no one who had answers or even seemed to care. The frustration inevitably strained their marriage. Out of guilt, Mark began fiddling around with his testosterone patches, trying to adjust the dosage, desperately hoping to find a way to help.

“All of our complaints to his primary care doctors, his urologist — nothing got us anywhere,” Heather said. Then, as a result of an interview with The Huffington Post, they made contact with Dean.

In a January interview, Dean had enthusiastically described his work with genital-wound patients and their spouses. “We address how you are going to walk and dress yourself, how you’re going to have sex in the future and how you’re going to have children in the future, if possible,” he said.

A few weeks later, I mentioned Dean and his work to Mark and Heather, and was astonished to learn that they had never heard of him, despite having lived in his hospital for 15 months. Before they heard about Dean, Heather said, “I was never referred to any doctor that could really help us.”

Within days, they met with Dean, who ran some tests and ordered a change in Mark’s testosterone therapy. He expects dramatic improvement.

But the Litynskis’ disappointments haven’t ended.

‘IT JUST DOESN’T SEEM RIGHT’

The Pentagon, alarmed at the rising incidence of genital wounds, has rushed $19 million worth of protective garments to Afghanistan, including 165,000 pairs of blast-resistant briefs and 45,000 diaper-like garments to protect the genitals from upward blast..

For those who have already suffered genital wounds, there is less help.

Couples like Mark and Heather, who want the option of natural childbirth, can turn to in vitro fertilization, using donor sperm. But the process is expensive, well beyond the means of typical enlisted soldiers and Marines. At Walter Reed, the cost of a single in vitro procedure runs from $4,800 to $7,000, and success may require many attempts.

Yet the military’s medical insurance program, Tricare, specifically excludes coverage for the procedure, even in cases where the husband’s reproductive organs have been destroyed in combat.

The Department of Veterans Affairs has added to the frustration. Through its insurance program, the VA pays up to $100,000 to the severely wounded to compensate for loss of income and to help finance cars adapted for their use and other new needs. Late last year, the VA also agreed to pay up to $50,000 for damage to or loss of genitals in combat, but its $100,000 lifetime cap on such compensation does not account for veterans who have been wounded as catastrophically as Mark Litynski.

Along with many others severely wounded in combat, Mark has been awarded the full $100,000 for the loss of both legs. Because of the cap, however, he will not receive the additional $50,000 for his genital wounds — money that could help pay for fertility treatment or adoption.

Defense Department officials repeatedly refused, over a period of several months, to respond to The Huffington Post’s questions about the limits on compensation or gaps in care for those with genital wounds. Finally, Pentagon spokeswoman Cynthia Smith said in a statement that the department is “working to provide” reproductive services “to severely injured service members without additional costs to them.”

Smith was unable to provide details. Heather Litynski said she has not been contacted by anyone in the Defense Department offering to help pay for fertility procedures.

Considering that Mark volunteered to serve his country and was severely injured in that duty, “it seems like it should be up to the government” to compensate them, Heather said, for not being able to have their own children together.

“It just doesn’t seem right,” added Heather, a registered nurse who typically has a sunny disposition and a quick smile. She and Mark had long planned to have children. But adoption is expensive. And apart from being costly, there are some aspects of artificial insemination or in vitro fertilization that can be hard for some couples to accept.

“It may be difficult using another man’s sperm,” she said. “The idea does bother me sometimes.” And having their insurance refuse to pay for it “is pretty disappointing,” she added.

Last year, the U.S. Army’s surgeon general commissioned a study of blast injuries, including genital wounds, and concluded that military care has lagged behind. “These are complex problems that are not commonly seen in civilian life,” said Army Col. Jonathan Jaffin, a trauma surgeon who directs the Army’s Dismounted Complex Blast Injury Task Force, which was established to improve the treatment of the severely wounded.

Like many others, Jaffin acknowledged that the military has fallen short, that it cannot fully answer the questions of couples like Mark and Heather Litynski, let alone resolve their problems. “We’re trying to gather data but we don’t have a good answer as to all of the problems we’re seeing,” he said. Genital wounds, he said, are “a very difficult problem, not just a physical problem but one that involves the family, the social dynamics, psychological and spiritual aspects.”

“We are doing everything we can to provide the very best care” for the severely wounded, Jaffin added. “I don’t think any of us will ever say we have the complete solution. We’re going to have to keep pushing, keep making it better.”

‘I WOULDN’T CHANGE IT FOR ANYTHING’

Mark and Heather are still living at Walter Reed, hoping Mark’s new hormone treatments will help ease the strain in their relationship. Yet despite their ordeals, they both seem determinedly upbeat and ready to take on the next phase of their life. Soon they’ll move back to New Hope, Minn. Heather will look for work as a nurse while Mark goes back to school to study business.

And they are weighing the costs and benefits of in vitro fertilization, artificial insemination and adoption.

“We definitely want to have children. It’s going to be a big expense for us,” Heather said. “It is disappointing to me — so much has been done and given to us because of his combat injuries, which is wonderful. I feel the care and concern from the public and different charities and organizations — it’s so much, it is overwhelming.

“But there is the huge gap in alternative family planning. There’s no compensation, no help. There are charities that offer to help but I’m thinking it should be the responsibility of the government.”

They will struggle ahead, she said. But their lives will be different from what they had anticipated just two years ago. “Yes, it is different, but it’s still livable, still very positive,” she said.

“Like anything else, you move on,” Mark said. As for life ahead? “Looks pretty good. It’s disappointing, but we will still have kids — some way we will have kids, and I will look at them as if they had my DNA. It’s not that traumatic to me, as long as we’re still able to raise kids, it doesn’t necessarily matter where they came from.”

And despite the traumatic turns his life has taken, Mark said he doesn’t for a moment regret his decision to enlist in the Marines.

He served, he said, “to make a difference, not just for the United States, our citizens, but over there — we were making a difference for the people of Afghanistan.

“I wouldn’t change it for anything,” he said.

David Wood’s ebook, “Beyond the Battlefield: The War Goes on for the Severely Wounded.”

 

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There Is Never A Good Excuse For Rape!

Fox News contributor Liz Trotta has taken a provocative stance on reports detailing a spike in sex assault in the military.

“What did they expect?” she asked in an on-air discussion Sunday.

Trotta and Fox News anchor Eric Shawn were discussing recent news that the Pentagon is allowing women to serve closer to the front lines.

“And the sexual abuse report says that there has been, since 2006, a 64% increase in violent sexual assaults,” Trotta, an author and journalist, tells Shawn.

“Now, what did they expect? These people are in close contact, the whole airing of this issue has never been done by Congress, it’s strictly been a question of pressure from the feminists,” she said.

Trotta also said that the “feminists” wanted too much money to fund programs for sexual abuse victims. “You have this whole bureaucracy upon bureaucracy being built up with all kinds of levels of people to support women in the military who are now being raped too much,” she told Shawn.

Shawn responded by saying that perhaps women in the armed forces should be protected better. Trotta then shot back that the purpose of the military is “to defend and protect us, not the people who were fighting the war.”

A U.S soldier committed a violent sex crime every six hours and 40 minutes in 2011, a report released in January found. Army Vice Chief of Staff Gen. Peter Chiarelli called the rising violence against women “unacceptable.”

Trotta has been under fire before for her commentary. She previously joked about assassinating President Obama during his successful campaign in 2008. She later apologized.

 

 

 

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