Three Walls Behind The Wall

The Three Walls Behind The Wall

By Michael Kelley

The origins of myth are often rooted in fact and tangible experience. Over time, embellishment and exaggeration give life and color to a fact's humble beginnings, and before you know it, Big Foot is roaming the woods of the Northwest, the neighbors are being harvested by bug-eyed, gray-skinned aliens who have not the sense to wear warm clothing, and Elvis Presley is frequenting Wyoming coffee shops.

Over the last three decades, a host of minstrels have danced heavily upon the reputation of the Vietnam veteran, sowing rumor into fact on the fertile fields of an all too willing, gullible and complicit American press and American people. Saddest of all, perhaps, is the fact that many Vietnam veterans themselves have been duped into embracing the same folklore as if it were Gospel, tricked into believing the worst in themselves against all evidence to the contrary.

America first fell victim to a particularly pernicious fable of that genre beginning in 1980, one that has grown to startling proportions over the last two decades.

A typical example appeared in a 1996 veteran organization's newsletter. Among its otherwise thoughtful observations was a statement emblematic of a general misrepresentation now the cause of severe heartburn among many of us whom it colors. Without attribution of any sort, the author emphasized our war's tragic legacy by informing us that "Since the end of the Vietnam War, approximately 150,000 veterans have taken their own lives."

Although it has been widely reported since 1980 that 58,000 Vietnam veterans have died by their own hand, the 150,000 figure was a substantial extrapolation of those early estimates. More recently, the figure has grown to 200,000, an apparent suicide total almost four times greater than the war's death toll!

While the author may have simply been restating popular speculation about that war�s long-term effects, that otherwise unsupported assertion serves to perpetuate perhaps the most tenacious and destructive myth yet to emerge among the ocean of myth surrounding Vietnam experience.

The simple truth is that no factual basis for either estimate (or anything in between) has ever been published. None whatsoever.

But if the rumored figures have no basis in fact, then just where did they come from in the first place? More importantly, is there any substance to those origins?

Fortunately, the primary research into their origins was published in a 1990 issue of the American Journal of Psychiatry,

"Reports of large numbers of suicides among Vietnam veterans began to appear in 1980. In that year, a manual on the treatment of post traumatic stress disorder included a statement that more Vietnam combat veterans had committed suicide than were killed in Vietnam. In 1981, [the March 18, issue of the Seattle Times reported] that since their return from Vietnam more than 50,000 veterans had committed suicide. The reported number in [the June, 1985, issue of Discover magazine] was 58,000, and it was 60,000 or more in books published in 1986 [Spencer, D., Facing The Wall] and 1987 [Williams, R., Introduction in Unwinding the Vietnam War: From War Into Peace], In 1987...[CBS 60 Minutes, Vietnam 101, 4 Oct 86] broadcast that more than 100,000 Vietnam veterans had committed suicide. In 1988, a network news anchor [CBS Reports: The Wall Within, 2 Jun 88] asserted that between 26,000 and 100,000 suicides had occurred among Vietnam veterans depending on which reputable source you believe."

Other recent examples include:

Nam Vet : Making Peace With Your Past, a book by Chuck Dean, 1990 � cites 150,000 suicides.
Suicide Charlie, a book by Norman L. Russell, 1995 � cites estimated 200,000 suicides.
Open Hands and Hearts website at http://www.angelfire.com/ca/outlaw22/ - "Approximately three times as many KIA have committed suicide since the war ended." That would be 174,000.
PTSD, Point Man Ministries website, at: www.mcpages.com/PointMan/ptsd.htm cites 150,000 suicides.
Hill 881-S, NBC Dateline, April 1998 � Reported range of 9,000 to 60,000 suicides.
Another Brother, PBS documentary, Feb 99, Tami Gold, Hunter College NY � 60,000 suicides.
Fall To Grace, by Eric Karlson (Epilogue). Appendix entitled, The Toll Of The Vietnam War, cites: "20,000 VN Veteran Suicides through the end of 1993" (Federal Practitioner, by Bullman & Kang, Mar 95)" and also cites a former VA Doctor, Joel Brende, who was said to have claimed 200,000 suicides in an interview with Alexander Paul quoted in Friendly Fire (Bryan, p. 380).

Tracing the Myth to its Source:

This ongoing nightmare appears to have drawn its first breath on the pages of a 1980 text used widely throughout the US Department of Veterans Affairs Veterans Outreach Center Program (the Vet Centers), a text regarded as the first primary reference to the treatment of PTSD.

In that first edition of Post-Traumatic Stress Disorders of the Vietnam Veteran appears the following statement: "...the possibility of suicide is always present. More Vietnam combat veterans have died since the war by their own hands than were actually killed in Vietnam. (Williams, �79)".

That otherwise unsubstantiated claim is credited to an unpublished, 1979 paper entitled Vietnam Veterans, written by one T. Williams presented at the University of Denver, School of Professional Psychology, in April 1979. What makes that citation of special interest is the fact that a Tom Williams also happens to be the editor of the text itself. Moreover, the statement and its footnote were removed from subsequent editions of that DAV publication.

Its credibility is further tarnished by the fact that in 1983, a noted PTSD authority presented a report to a House Veteran Affairs Subcommittee which stated included this statement: "For many years [we] have been greatly alarmed by the seemingly large incidence of suicide among Vietnam veterans. Unfortunately, there does not exist, at present, a comprehensive study to document the prevalence of suicide among Vietnam veterans." [emphasis added] (Wilson, 1983).

If as Dr. Wilson claimed in 1983, there existed no comprehensive study of issue, then where did T. Williams divine that answer in 1979?

Consider also the staggering implication of Williams claim: if 58,000 veteran suicides had taken place between 1968 and 1979, that would indicate a rate 5,800 suicides per year or almost 16 Vietnam vet suicides every day for ten solid years! That fact alone should have sparked serious concern, but silence and heads nodding in passive agreement were all it seemed to have evoked.

From all appearances, Mr. Williams "authoritative" observation triggered the firestorm of speculation that soon followed.

Whatever their actual source, it is well past time these alleged facts were subjected to some long overdue scrutiny and a few simple tests of logic and probability.

The Anecdotal Evidence

Apart from the accuracy or inaccuracy of the statistical manipulations which follow later in this monograph, there is one thing that clearly should warn us all that there is something seriously wrong with suicide estimates in question. That one thing is common sense.

Actual experience offers an appropriate example of that point.

At least 45 men from this author's infantry unit were killed in action during its four years and one half years in Vietnam. If either the 58,000 or 150,000 total were accurate, it would suggest we should expect between 45 and 135 suicides among the unit's post-war dead. As far its Company Association can determine however, not a single former comrade has taken his own life since coming home.

Most Vietnam veterans know intimately at least several names now etched on the walls of our memorials, yet of the hundreds this author has surveyed informally, exceedingly few can give name to even a single comrade taken by suicide.

During this author's seven years with the California Vietnam Veterans Memorial Commission, the commission was approached by perhaps five families who requested that their suicide-victim son's name be added to the memorials granite walls. California lost approximately 5,700 of its sons to the war, and if between 5,700 and 16,100 more had been taken by suicide, would it seem unreasonable to expect the number of contacts to have been much greater?

How could such staggering totals go unnoticed by so many?

The Direct Evidence

Although the author's own significant experience in the Vietnam veteran community suggests that the popular numbers are greatly exaggerated, there is also substantial statistical and scientific evidence to throw a cloud on them as well...

Without exception, medical and psychiatric studies of actual Vietnam veteran mortality yield conclusions that contrast sharply with the rates under scrutiny.

In a 1987 report notable for its complexity, the National Centers for Disease Control concluded that mortality in Vietnam veterans was 17% higher than for Vietnam-era veterans (i.e., those in the military who did not serve in Vietnam) during the first five years following discharge. Thereafter, mortality among Vietnam veterans fell to levels equivalent to that of era veterans.

An article in the Journal of the American Medical Association immediately following the release of the CDC study concluded that the CDC data indicated that Vietnam veterans were about 65% more likely to die from suicide than non-veterans of the same age group, for the first five years following discharge but thereafter their suicide rate fell to normal levels.

While the predicted 65% higher risk might at first seem a stunning variance, comparing projected suicide totals based on that difference paints a much less dramatic portrait.

On average, the annual suicide rate among US. males approximates 1.11% of death from all causes. A 65% higher rate translates to only 1.83% of death from all causes (simply 1.11% multiplied by the factor 1.65). In other words, where 1.11 of every 100 US. male deaths were the result of suicide in 1987, the projected rate for Vietnam vets would only be 1.83 out of one every 100 Vietnam veteran deaths. From that perspective, the difference in rates was actually very small.

By that, the following is meant: Over the 30 years since veterans first began returning from Vietnam in significant numbers, the overall rate predicted by the CDC/AMA article should be the weighted average of a 1.83% suicide rate for five years and a 1.11% rate for 25 years. That weighted average is 1.23%. In other words, the CDC data indicates that only an average of 1.23% of all Vietnam veteran deaths between 1967 and 1997 were likely the result of suicide.

Although those initial studies form the nucleus of documented Vietnam veteran mortality studies, there is other, hard evidence we can review. Shelby Stanton's Vietnam Order of Battle indicates that US Army lost 37,895 dead from all causes and, of that total, 354 dead were reported as suicides.

It would seem reasonable to presume that stress levels within a combat zone would likely equal, if not surpass, those of civilian life, and yet less than one percent of all Vietnam Army deaths during the war were attributed to suicide?

There is little doubt that for compassionate reasons combat zone suicides may have been under-reported by the military (and the same is likely true of the civilian world as well). If the in-country rate had been identical to CDC/AMA's 1.23% predicted rate, its total would have been closer to 713 deaths, or almost double the reported total. Still, even the adjusted rate is simply dwarfed by those of popular folklore.

The 1997 Australian Mortality of Vietnam Veterans - The Veteran Cohort Study

In 1997, the Australian Department of Veterans Affairs published a comprehensive report on Vietnam veteran mortality covering all Australian Vietnam veteran deaths from the start of the war until December 31, 1994. This study ranks as perhaps the most important study of Vietnam veteran mortality to date.

Among its four conclusions was this observation: "4. Although the estimated excess risk is statistically not significant, this study does not preclude an excess risk of death from suicide." In other words, this exhaustive study found nothing to suggest that the risk of suicide was higher among its war veterans than among their peers in the general population.

Of particular importance is the fact Australian researchers were able to identify their entire Vietnam veteran population (59,036) and to verify the status of 57, 231 of those veterans as of the effective date of the study. Of that 57,231 total, 3,840 had died during or after the Vietnam War.

Those figures are of great significance because they show their total mortality as of December 1994 was about 6.71% (simply 3,840 divided by 57,231); our first and only, clear and direct look at any actual Vietnam veteran population's overall total mortality.

Applied to our own 3.1 million total Vietnam vet population, suggested US mortality as of January 1, 1995 (including KIA) should have been about 208,010. Subtract our 58,000 KIA, and the remainder is 150,010 post war deaths as of 1995 ( at time when claims of 150,000 suicides were common).

If the Australian experience reasonably mirrors our own (and it is difficult to imagine why it would not), the 1.23% CDC/JAMA predicted suicide rate suggests the American Vietnam veteran suicide total as of January, 1995, should have been only about 1,845.

Absent other published data, the claims can be tested indirectly.

The Indirect Evidence

Over 58,000 US soldiers died within the Vietnam combat zone or as a direct result of wounds and disease incurred within the combat zone, while an estimated 3.1 million men and women served in the South East Asian Theater between 1964 and 1975.

Citing National Center for Health statistics, the World Almanac reports that of a total US population of 252 million in 1992, there were 24,260 male suicides and 2,177,000 deaths from all causes in the United States. Total male suicides then were about 1.11% of all deaths that year.

Presuming the suicide rate matched the population growth curve between 1967 and 1992, then on average, the annual US. male suicide rate was about 20,500 male suicides per year. If we expand that per year average to account for population growth over the years between 1992 and 1996, the annual average increases to about 20,800. In other words, roughly 603,200 male suicides were reported in the US between 1967 and 1996.

If those calculations are reasonably accurate and the 150,000 suicide figure is fact, then about 24.9% of all male suicides in the US. since 1967 have been committed by Vietnam veterans, even though they constitute a mere 2% of total US. male population. Does that seem plausible?

Males suicides constitute approximately of 85.1% of all US suicides; therefore, if we divide the 603,200 male suicide total by .851, we should derive an indicator of the combined male and female total for the same period. That total is 708,813. Our analysis then suggests that if the 150,000 myth were fact, then 21.2% of all suicides in the US. since 1967 have been committed by 1% of the total US. population.

According to the Summer 1996 issue of VANTAGE, the Oakland VA�s Regional Newsletter: "More than 9.2 million military personnel served on active duty during the Vietnam era [including in-country vets], a period of 11 years from August 5, 1964 and May 5, 1975. Over 8.3 million are alive today; their median age is 48. An estimated 3.1 million served in the Southeast Asian Theater [Vietnam, Laos, Cambodia, Thailand and South China Sea], [and] an estimated 2.6 million served within the borders of Vietnam and its adjacent waters."

In other words, total combined Era and Theater veteran mortality to date is estimated to be 900,000 deaths (9.2 minus 8.3), including those who were killed in Vietnam. If we remove the 58,000 who died in Vietnam from the 9.2 million total, we are left with 9.142 million.

Presuming that the mortality rate has been roughly the same for both Era and Theater vets (a presumption supported by the CDC study), then 33.9% (3.1 million divided 9.142 million) of that mortality was suffered by Theater veterans. That suggests the total mortality among all Theater veteran survivors has been about 305,100, or 10.16% of the Theater vet population.

Apply the CDC/JAMA predicted 1.23% suicide rate to a total mortality of 305,100, and the predicted 1996 suicide total would be 3,752

If 150,000 of that 305,100 total mortality was suicide, then about 50% of all Vietnam veteran mortality is the result of suicide, a rate 44 times the national male suicide rate (49.18% v. 1.11%).

The Vet Center Experience

The historical experience of the U. S. Department of Veterans Affairs Vietnam Veterans Outreach Program also provides an important perspective. Vet Centers funded by that program provide psychological counseling for Vietnam and era veterans, many of whom suffer moderate to severe PTSD.

During the Sacramento Vet Centers first eleven years, only two patients (both inactive clients) were known to have committed suicide. A former patient is rumored to have provoked a gun battle with the police, so to err on the side of caution let us stipulate that the Vet Center suffered three client suicides.

Of the approximate 4,400 patients the Sacramento Vet Center counseled during that period, patients who presumably represent a cross section of the most psychologically damaged segment of the Vietnam Vet population, only three are known to have committed suicide.

If we apply the VA-derived overall mortality rate (10.12% overall mortality over 29 years, prorated for 11 years) to Sacramento's 4,400 patients, it suggests that a total of 3.83% should have died from all causes between 1988 and 1996. That total would be 168 predicted deaths from all causes.

Folklore suggests that of those 168 predicted patient deaths, between 20% and 50% would be suicide - that is 33 to 84 suicides, and yet, the actual total was only three.

If we apply the Australian study's overall 6.71% mortality using the same line of reasoning, the predicted overall mortality (all causes) falls to 2.54%, or 111 patients. Folklore tells us 22 to 55 of those client deaths should be suicide, but the actual total was three.

It should come as no surprise that the national average male suicide rate (1.11%) applied to either VA or Australian predicted overall mortality (111 patients or 168 patients), indicates the suicide range should fall between 1.2 and 1.86 suicides where the total was three.

Suicide Reported as Accidental Death

During the research for this study, an effort was made to contact most sources citing the mythical suicide totals as fact. When presented with the research and data supporting much lower totals, it was not uncommon for high-rate advocates to assertion that a large percentage of Vietnam veteran accidental deaths are skillfully disguised suicides, or are being reported as accidental deaths by sympathetic Coroners.

Single-car accidents are an example often put forth as the source of underreported suicides and there is in fact data that suggests that a higher rate of single-car accidental death among Vietnam veterans, as is the case also for accidental death in general. But while the frequency of accidental death among Vietnam vets appears to be slightly elevated, it simply does not rise to a level that would support the mythical suicide totals in any respect.

While for compassionate reasons it is certainly possible that County Coroners might in some circumstances report suicide as accidental death, it seems logical to surmise the same frequency of misreporting would be consistent across the board for both veteran and non-veteran alike. In other words, the overall national suicide rates would be skewed the same percentage among both populations.

Additionally, Coroners form a highly educated and ethical group of professionals whose standards of occupation are so stringent that the frequency of such misreporting would likely be very low in any case.

Comparing veteran and non-veteran accidental death rates sheds even more light on the implausibility of the "Hidden Suicide" arguments.

According to the National Center for Health Statistics, US Department of Health and Human Services, 4% of all mortality in the US was attributable to accidental death on an annual basis between 1992 and 1994. Accidental death is further broken down into motor vehicle accidents, which constituted 1.92% of all mortality during that period, or slightly less than one half of all accidental death.

The "Hidden Suicide" argument's foundations begin to crumble in the light of the fact that we know to some degree of certainty that the frequency of reported accidental deaths has been quantified among Vietnam veterans at approximately five percent (5%) of their overall mortality. Keep in mind, the 5% figure is the actual reported rate, which we have been asked to believe includes disguised suicides and underreported suicides.

At the same time, Tim A. Bullman, and Dr. Han K. Kang, reported in their article (A Study of Suicide Among Vietnam Veterans, Federal Practitioner, Mar 1995: 9-13.) that "Research has indicated that 1.6% to 5% of motor vehicle accidents may be suicides." They also added this observation, "Even if one assumes that 5% of all [Vietnam veteran] accidental deaths are hidden suicides, the additional number of suicides among Vietnam veterans would not exceed 4,000."

Even if we presume ALL Vietnam veteran accidental death was disguised suicide, then according to the predicted VA and Australian overall mortality figures, additional unreported suicides would range from 7,500 to 15,255; still nowhere near the mythical numbers when combined with the CDC/JAMA predicted "normal" totals (1,845 to 3,752).

Conclusion

It is the author's opinion that to accept the mythical rates of Vietnam veteran suicides, one must abandon science and common sense altogether.

Of no small significance in that regard is the fact that high-rate claims remain completely without substantiation of any sort. In all the exhaustive research and reading that went into the preparation of this monograph, not so much as a single shred of verifiable data was unearthed that would even remotely suggest Vietnam veterans were killing themselves in greater numbers than our enemy could, despite the many published claims the suicide total ranged from 50,000 to 200,000.

Absent evidence to the contrary, it is impossible to conclude other than that the popularly reported rates of suicide among Vietnam veterans form a myth of colossal dimensions.

And yet the underlying question remains unanswered for us: just how many Vietnam veterans have committed suicide since coming home?

It is imperative the reader understand that apart from the Australians, no one knows the precise answer to this perplexing question. All the numbers and estimates for US Vietnam veteran suicide totals (including the author�s) are based on statistical extrapolations from limited sample populations.

If one third of all Vietnam veterans were now deceased (i.e., 1 million -
a number likely far in excess of the actual total), the CDC/JAMA 1.23% predicted suicide rate suggests the suicide total would be only 12,300 suicides. Even if the entire 3.1 million population were now deceased, our predicted suicide total would not exceed 38,000.

One VA sponsored study indicates that as of 1983 there were fewer than 9,000 Vietnam veteran suicides, and that "...no more than 20,000 Vietnam veterans died from suicide from discharge through 1993" (emphasis added). It went on to say that the total would not exceed 24,000, even if we presumed 5% of all reported accidental death was really suicide.

In Estimating the Number of suicide Among Vietnam Veterans, an article published in the American Journal of Psychiatry, June, 1990, its six co-authors specifically studied the reports that 50,000 Vietnam veterans had committed suicide. They concluded that: "We found no evidence to substantiate the claim that Vietnam veterans have experienced a sustained epidemic of suicide in which 50,000 or more veterans have died." and, " Our estimates indicate that fewer than 9,000 suicides occurred among all Vietnam veterans at a time when there were claims
of at least five times as many such deaths. [emphasis added]

Tim A. Bullman, and Dr. Han K. Kang (A Study of Suicide Among Vietnam Veterans, Federal Practitioner, Mar 1995: 9-13.) concluded that: "Epidemiological studies, however, have suggested that the actual number of suicides in Vietnam veterans may be much lower than previously believed. Several studies have examined cause-specific mortality in select groups of Vietnam veterans relative to expected mortality in non-Vietnam veterans, and none reported a statistically significant excess of deaths due to suicide among Vietnam veterans." They went on to say, "Vietnam veterans in general do not appear to be at increased risk of suicide. Instead, select groups of Vietnam veterans may be at increased risk. These groups include those veterans with PTSD and those who were wounded." [emphasis added]

Australian and US VA study indicates our total postwar mortality (as of 1995), fell in a range of from 150,010 to 305,100 deaths from all causes.

Total predicted suicides based on US VA data is 1.23% of 305,100, or 3,752

Total predicted suicides based on the Australian data is 1.23% of 150,010, or 1,845

Given what verifiable data is now available, it would seem reasonable to estimate that as of 1996, a total of somewhere between 2,000 and 20,000 Vietnam veterans had taken their own lives.

It is the author's firm opinion that the preponderance of the data suggests the actual total, as of 1996, fell between 2,000 and 5,000, but in any case likely did not exceed 1.23% of all Vietnam veteran mortality.

In the final analysis, Vietnam veterans appear die from suicide at about the same rate and for the same reasons that everyone else in America does. On the other hand, the data does reveal that the relatively small percentage who were exposed to actual combat in Vietnam (probably no more than 30% of the total who served in the war) suffer a substantially higher risk of suicide than their Vietnam veteran counterparts who were never exposed to significant combat.

Reflections:

Mark Twain once wryly observed that, "The history of the race, and each individual's experience, are thick with evidence that a truth is not hard to kill and that a lie told well is immortal." Nothing anyone could say would more accurately characterize my efforts to determine whether there was substance to popular, unsubstantiated claims of extraordinary suicide risk among the veterans of the American War in Vietnam.

To be fair, I found little evidence of intentional misrepresentation; rather, what I consistently encountered was an almost universal and unfettered willingness to accept negative characterizations of the Vietnam veteran as inherently accurate.

For me, the most shocking aspect of this research was my exposure to the repeated and blatant complicity of the media and veteran organizations in perpetuating these myths without any apparent effort to verify their factual basis. The general disregard for accepted source verification practices was simply appalling, particularly in light of the fact that virtually all the scientific literature on Vietnam veteran mortality is readily accessible in almost any public library.

How could it be that some of the most respected and powerful magazines, TV news journals and veteran organizations in this country apparently never made any substantive effort to verify the accuracy of the obviously staggering suicide rates they in turn were passing on to the American people as fact?

How could there not have been doubt or concern that we were being asked to believe that the same Vietnam veterans who fought so ferociously to survive a war were then coming home and surrendering to death at their own hand in far greater numbers than the enemy had been able to take?

Why were we so accepting?

Of equal shock was the indignant and contentious reception presenting the factual evidence to those extolling the suicide folklore often provoked. Few open minds were encountered in the journey; no hunger to explore the data, no sign of hopefulness that the data might be accurate and the mythical numbers wrong. That circumstance has puzzled and saddened me greatly to this day.

Once I�d unearthed what appeared as incontrovertible fact, my natural presumption was that the veteran community would embrace with fervor any tangible evidence a widely circulated slander on their character was patently false. Instead, it soon became apparent that many veterans want to believe the myth and some were even angered anyone would dare to suggest our suicide rate was anything but astronomical.

It was disheartening to discover that not only has the general public fallen victim to the popular stereotype of the Vietnam veteran, but so have many Vietnam veterans themselves.

I will let this final image speak for itself: if 150,000 Vietnam veterans were suicide victims between 1967 and 1997, that would mean that on average, fourteen Vietnam veterans would have committed suicide every single day for thirty solid years!

Anyone who actually believes some fifteen Vietnam vets have committed suicide every day since 1967 is welcome to that opinion. However, it is exceedingly dangerous and irresponsible to offer such assertions as fact without the data to support them, or without at least acknowledging that all the actual mortality data now available tells us the total should fall somewhere between 2,000 and 20,000.

And even if one sincerely believes that veteran suicide data has been skewed or corrupted by a government conspiracy of immeasurable magnitude, it nonetheless remains the only data available while the popular estimates based on impression and instinct remain simply pure, unsubstantiated speculation.

Epilogue:

In August, 1999, the Washington Post ran a 1,500 word synopsis of this article under the title, One Vets Mission to Set The Record Straight (Washington Post Outlook Section, B-2, 15Aug99). In response to the article, a retired US Department of Veterans Affairs psychiatrist, Dr. Douglas B. Price, sent me a note thanking me for tackling this issue. The letter was dated 17 Aug 99, and among others, it contained the following observations:

"In October, 1979, Indu Sud, M.D. and I started a therapy group for Viet Nam combat veterans who were hospitalized at the Washington DC VA Medical Center; these veterans did not fit in with the other patients, and Dr. Sud suggested we start a group for them. This was before there was an official diagnosis of Post-traumatic stress disorder...(The group disbanded recently with my retirement; it may have been the first therapy group in the VA for Viet Nam vets.)

Some time in the early �80s, there began to appear in the media reports of high incidence of suicide among veterans of Viet Nam. Our vets pounced on the reports, accepting them without question. Dr. Sud and I did not believe the reports, for our experience had not supported that statistic. Finally, I contacted Central Office and eventually received a report that completely contradicted the published reports. VA [Central Office] did issue a press release to the [same] effect.

Like you, we were amazed that the veterans had difficulty in accepting, initially, our clinical impression, and then the VA report. We stuck to our guns whenever the topic came up and referred to the report.

Dr. Sud and I thought that the reason for the reluctance to accept the data was because the general attitude [among] many Viet Nam veterans [was] that nobody was listening to them and society had continued to ignore them. Many of course had thought about suicide, some even contemplated it, and a few had killed themselves; this might have fueled their acceptance of the erroneous reports. It is probably a complicated issue... PTSD has always been tinged with politics.

There is a curious parallel with the suicide myth, namely that our prisons are full of Viet Nam combat veterans. In the mid-80s, after hearing this repeated over and over...I secured from the Justice department statistics that showed the percentage of Viet Nam veterans in federal [prisons] was lower than the percentage of vets in the general population. Veterans, like those you surveyed, have trouble accepting these data."

-- End of Article --

The author spent eleven months as an infantryman with the 101st Abn Div in Vietnam and was retired from the US Army as a result of wounds suffered there. Since 1978, he has been active in the arts related to the Vietnam experience and was an Associate Member of the California Vietnam Veterans Memorial Commission, 1984-1991. His artwork hangs in museums throughout the world, and he is the author of a number of articles and a soon to be released encyclopedia of military installations of the Vietnam War entitled Where We Were.

"The principal difference between a cat and a lie is that a cat has only nine lives." -- Mark Twain

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Williams, Tom, Editor, The Symptoms of Post Traumatic Stress Disorder: Chronic and/or Delayed (chapter), Post-Traumatic Stress Disorders of the Vietnam Veteran: Observations and recommendations for the Psychological Treatment of the Veteran and his Family, 1980 (1st ed.), Disabled American Veterans National Headquarters, Cincinnati, OH: 11.

Wilson, John P. Ph.D., Post-Traumatic Stress Syndromes Among Vietnam Veterans: The Implications for Future Research, testimony before the House Veteran Affairs Sub-committee on Hospital & Health Care, Washington, DC. (March 24, 1983). p. 6.

Additional Bibliography

Suicide Bibliography reproduced from the Vietnam War, Social History website at the University of Texas, Austin at: http://www.lbjlib.utexas.edu/shwv/articles/suic-bib.htm

Boman, Bruce. "Antisocial behavior and the combat veteran: a review (with special reference to the Vietnam conflict)." Medicine and Law 6.3 (1987): 173-187.

Boyle, Coleen A., Pierre Decoulfe, Nornam Hearst, Thomas B. Newman and Stephen B. Hulley. "Postdischarge Mortality from Suicide and Motor-vehicle Injuries among Vietnam-era Veterans." New England Journal of Medicine 317.8 (1987): 506-7.

Centers for Disease Control Vietnam Experience Study. "Postservice Mortality among Vietnam veterans." Journal of the American Medical Association 257.6 (1987): 790-795.

Farberow, Norman L., Han K. Kang and Tim A. Bullman. "Combat Experience And Postservice Psychosocial Status as Predictors Of Suicide In Vietnam Veterans." Journal of Nervous and Mental Disease 178.1 (1990): 32-37.

Fontana, Alan and Robert Rosenheck. "Attempted suicide among Vietnam veterans: a model of etiology in a community sample." American Journal of Psychiatry 152.1 (1995): 102-9.

Fontana, Alan and Robert Rosenheck. "An etiological model of attempted suicide among Vietnam theater veterans. Prospective generalization to a treatment-seeking sample." Journal of Nervous and

Mental Disease 183.6 (1995): 377-83.

Fontana, Alan, Robert Rosenheck, and Elizabeth A. Brett. "War zone traumas and posttraumatic stress disorder symptomatology." Journal of Nervous and Mental Disease 180. 12 (1992): 748-755.

Haberman, Michael A. "Spontaneous trance or dissociation: a suicide attempt in a schizophrenic Vietnam veteran." American Journal of Clinical Hypnosis 28.3 (1986): 177-182.

Hearst, Norman, Thomas B. Newman, and Stephen B. Hulley. "Delayed effects of the military draft on mortality: a randomized natural experiment." New England Journal of Medicine 314.10 (1986):620-624.

Hendin, Herbert and Ann Pollinger Haas. "Suicide and guilt as manifestations of PTSD in Vietnam combat veterans." American Journal of Psychiatry 148.5 (1991): 586-591.

Hendin, Herbert and Ann Pollinger Haas. "Suicide." Chap. in Wounds of War: the Psychological Aftermath of Combat in Vietnam p. 160-182, New York: Basic Books.

Huffman, Robert E. "Which soldiers break down: a survey of 610 psychiatric patients in Vietnam." Bulletin of the Menninger Clinic 34.6 (1970): 343-351.

Hyer, Lee; McCranie, Edward W; Woods, Marilyn G; Boudewyns, Patrick A. "Suicidal behavior among chronic Vietnam theatre veterans with PTSD." Journal of Clinical Psychology 46.6 (1990):713-721.

Kramer, Teresa L., Jacob D. Lindy, Bonnie Lepper Green, Mary C. Grace, and Anthony C. Leonard. "The comorbidity of post-traumatic stress disorder and suicidality in Vietnam veterans." Suicide and Life-Threatening Behavior 24.1 (1994): 58-67.

Lawrence, Charles E., Andrew A. Reilly, Phillip Quickenton, Peter Greenwald, William Page, and Amy Kuntz. "Mortality Patterns of New York State Vietnam Veterans." American Journal of Public Health 75.3 (1985):277-279.

Matsakis, Aphrodite. "Suicide and the Vietnam veteran family." Chap. in Vietnam Wives: Women and Children Surviving Life with Veterans Suffering Post Traumatic Stress Disorder. Kensington, Maryland: Woodbine House, 1988.

Parson, Erwin Randolph. "Life after death: Vietnam veterans' struggle for meaning and recovery." Death Studies 10.1 (1986): 11-26.

Pollock, Daniel A. and Herbert Hendin. "PTSD and risk of suicide." American Journal of Psychiatry 149,1 (1992): 142-143.

Pollock, Daniel A, Philip Rhodes, Coleen A. Boyle, Pierre Decoufle and Daniel L. McGee. "Estimating the number of suicides among Vietnam veterans." American Journal of Psychiatry 147.6 (1990): 772-776.

Sumrok, Daniel, Steven L. Giles, and Mildred Mitchell-Bateman. "Public health legacy of the Vietnam War: post-traumatic stress disorder and implications for Appalachians." West Virginia Medical Journal. 79.9 (1983): 191-198.

Thomas, Terry L., Han K. Kang, and Nancy A. Dalager. "Mortality among women Vietnam veterans, 1973-1987." American Journal of Epidemiology. 134.9 (1991): 973-980.

Visintainer PF, M. Barone, H. McGee and E. L. Peterson. "Proportionate mortality study of Vietnam-era veterans of Michigan." Journal of Occupational and Environmental Medicine, 1995 Apr, 37.4 (1995): 423-8.

By Michael Kelley
Email: kelleyc@ix.netcom.com
www.vwam.com/vets/m60mike.htm