Wednesday, November 11, 2009

As Army doctor, valley physician knew stress

Dr. Frank Batcha discusses soldiers’ challenges

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By PAT MURPHY
Express Staff Writer

Dr. Frank Batcha assists children during his tour of duty in Iraq. Photo by Courtesy photo

Although wartime newsreels occasionally captured U.S. soldiers breaking down in tears from battlefield stress, the most memorable scene was in the film "Patton," when Gen. George Patton (portrayed by actor George C. Scott) slapped a GI suffering combat fatigue and malaria and called the soldier (in real life, Charles Kuhl) a "coward."

As valley physician Dr. Frank Batcha observed last week, "stress has always been around" among combat troops, but mostly known as "shell shock" and "combat fatigue" in World War I and II, and "soldier's heart" as far back as the Civil War.

Since the Vietnam War and especially now in the Iraq and Afghanistan operations, stress has been given a more descriptive medical name: post-traumatic stress disorder, a condition that is said to afflict one out of every eight men and women returning from duty in Iraq and Afghanistan.

Dr. Batcha saw PTSD up close and firsthand during 12 months he spent in Kirkuk, Iraq, in 2004-2005 providing medical care for combat soldiers as a major in the medical corps (later a lieutenant colonel) and, when time permitted, caring for Iraqi families on trips in the countryside.

Batcha, 48, who is a physician with St. Luke's Family Medicine, said the Army now provides all personnel an annual briefing on preventing suicides, hundreds of which have occurred among returning troops. The New York Times reported this week that at Fort Hood, Texas, the Army's largest facility, 76 suicides have been recorded since 2003, with 10 this year.

"There's a very big push for making sure both medical and non-medical personnel" are capable of spotting symptoms of stress.

During his Iraqi tour, Batcha said he saw all the traditional and classic symptoms—lack of concentration, difficulty carrying out tasks, anger, depression.

For soldiers, stress can begin, Dr. Batcha explained, when they're first deployed from stateside posts to the combat theater in Iraq and Afghanistan.

"Separation from family, not knowing if you're going to be hit with an IED (improvised explosive device), not knowing who is your enemy, everywhere is the front" are among the various stress causes, he said. Additionally, he said "one of the biggest stresses is moving, changing the place where they live, if it happens forcibly," and then "the austere conditions" of combat duty.

While he was in Kirkuk, Batcha said that his camp was hit perhaps 100 times by rocket fire from terrorists.

Until Vietnam, he said, anti-depressant medications for treating stress had not been developed, and dealing with stress symptoms and conditions did not become a major medical field until recent times. Medical experts now believe stress is a biochemical matter. When parts of the brain fail to communicate, he said, stress couldn't be dealt with effectively. Medication helps bridge that gap.

When stress seemed present in personnel he treated, Batcha said medication and counseling were immediately considered. However, he said doctors tried to avoid removing stressed soldiers out of their units and to rear areas.

"They do better not being evacuated," he said, explaining that unit relationships and buddies represent part of the therapy.

Batcha said "combat stress teams" involving chaplains, psychologists and behavioral management counselors were also available to treat stressed soldiers.

Of concern, however, is the ability of some soldiers to hide their stress out of fear that it will damage their Army career.

The same stressful conditions can affect some soldiers while others may not be affected. The latter group, Batcha said, may be better equipped "by genetics or their upbringing for dealing with all types of adversity."

Editor's note: In the interest of disclosure, the Express notes that Dr. Batcha is the reporter's general practice physician.