One Soldier's Tale of How War Drove Him Crazy

"When it got really bad, I dumped 5 tons of sand into my basement to remind me of Afghanistan," Jim told me. "I would just spend the entire day down there in my sandbox, smoking marijuana and working on peace of mind. It made me realize that you can close as many doors as you want, but ghosts walk through walls."

Jim speaks with apparent ease about his war experiences and what they cost him. His stories are punctuated with vivid detail and bemused laughter, mostly at his own expense: How could he have been so naïve ... how could he have failed to see what was going on around him?

He rubs his hands up and down his thighs frequently. It's a kind of nervous gesture that he explains is a result of a spinal injury he sustained in an IED explosion -- his legs still go numb from time to time. "But they don't get numb to the point where I fall down anymore, so I won't complain about progress," he said.

That stoicism is an apt metaphor for the rest of his life, for the experience he shares with so many servicemen and women returning from the conflicts in Iraq and Afghanistan.

It's been almost 30 years since PTSD entered the official lexicon, 30 years in which U.S. combat troops have been continuously deployed in some part of the world or other, churning out a steady stream of psychologically wounded soldiers in need of care. In that time, untold millions have been spent on research, and countless pharmaceutical and therapeutic protocols have been explored.

To what end? In 2008, the Institute of Medicine published the results of a survey -- commissioned by the Department of Veterans Affairs -- of all of the available drug and therapy treatments available for PTSD.

The IOM committee found that "no drugs have adequate data showing efficacy," and it recognized the value of only one therapeutic approach: exposure therapy, a form of psychotherapy requiring a "considerable investment of time, emotion and effort." To that, I would add another requirement: money.

The committee also noted that the vast majority of drug trials were funded by pharmaceutical companies and that many trials were conducted by those who had developed the products.

They were also struck "by the scant evidence exploring some of the possibly unique aspects of PTSD in veterans."

Jim knows all about that. Back when he was spending all his time in his sandbox, he heard blasts coming from the living room upstairs. Sometimes he thought they were mortars. Sometimes mines. In Afghanistan, Jim recalls, "there were so many mines. So many people missing a hand, a leg, an arm -- or two -- or eyes. Out there, entire villages are mined. Mines under stairs, under floors, in walls, just mines everywhere. You really have to be careful."

Six years later, he is still being careful, still working on feeling safe enough to be a little visible in the world after his tour in Afghanistan (which is why I'll just call him "Jim").

On Sept. 11, 2001, when he was just a senior in high school, he watched the Twin Towers fall on TV, skipped classes for the rest of the day, and enlisted in the Army. By the summer of 2003, he was in Kandahar, with "hate, anger and vengeance" in his heart.

One of his first assignments was driving the "jingle truck," a 1974 Mercedes Benz tractor-trailer, covered with garish graffiti, and "with a big-ass American flag on the back." The underside of the truck was lined with chains and bells, so it actually jingled as he drove. "They made me drive all around the circle highway, from Jalalabad to Herat, from Kandahar to Spin Buldak, with one security truck in front of me and one behind. I was bait. I was a human target so the Taliban militants would have something to fire on, so our guys in the security trucks would have something to fire back at.