FOR MORE THAN TEN YEARS YOU HAVE BEEN THE VOICE ADVOCATING FOR A CULTURAL CHANGE WITHIN THE CANADIAN MILITARY AS IT RELATES TO PTSD. THESE MANY YEARS LATER, DO YOU SEE THAT THERE IS A CHANGE HAPPENING?

Yes. It would be wrong to say that even a conservative institution like the military one of the sort of the bastions of our nation has not moved. It has. It has by, as we would say, 'Force des choses' because of the levels of casualties that are in your face. And it is not as much just the level of casualties but it's the impact of those casualties on the ability for the army in particular to continue to do its task because there are so few troops.

I mean we've got now troops from my old regiment in ten years of service who have been on seven missions. We have troops now who've got more combat time than World War II vets. Yet the country's at peace. And so as we were ineffective with operational stress injuries or battle fatigue and that after World War II - and in fact thank God the Legion was there where my father and others could go and drink and have a good time with their buddies and vent - we in this era have been trying really to build from scratch an ability to handle this injury, which is by far the most prevalent injury of our timeframe.

And that is only because they're in combat and as other soldiers were, but the nature of the combat is, amongst the civilian population the horrific extremes, which they see and face. The ethical and moral and legal dilemmas of the use of force and non-use of force - those have been added onto what the old combat stress used to be, where armies were facing armies.

And that has taken us a long time 1) to figure out but 2) to get into the mind of the military as an impact on the soldier's. Meaning: military people are very visual people. It's also a very Darwinian outfit. I mean only the fittest and the strongest and you need 100% all the time. And so it has a fundamental intolerance to things that don't work. A piece of equipment doesn't work? Hey, we can't achieve our mission. We've got to repair it and we need new equipment. And so you're continuously always on the equipment side.

But on the people side you're continuously educating and training your own people also because we're not mercenaries, you can't import them. So you have this internal building capability, except that we can handle doctrines and trainings to do things, drills. We can handle the equipment, all that's got to be done. We've got a real hard time with stuff we can't readily see and touch or feel or manage and that's between the ears. And so the street people of the fifties were the young veterans. They were, remember the 'rubby-dubs' and so on. They were veterans by the thousands abandoned. Well, we have some today but we have finally been able to crack the code inasmuch as an operational stress injury is an injury, not a disease.

IS THERE STILL A STIGMA THOUGH?

Oh yes. I mean of course there's a stigma.

THERE'S OBSTACLES TO ADMITTING THIS?

Yes, I mean let's start with the civilian population from which we all come from. I mean I've got a mother and father too and so on, there were all these soldiers. The young troops coming in were all keen; they're instilled with a sense of purpose. They're given good training, good equipment and so they feel as if they're, you know, there's no silver bullet that's going to stop me. And so you have that coming in. And then you've got those vets of the last 20 years who are coming out of the field who are some physically injured and that's always perceived as an honourable injury of course. Visual - look at your medium, I mean you're medium can see those and all the stuff around that.

But the operational stress injury side has been more difficult for the first non-veterans to accept. You know, 'That won't happen to me,' and 'They're wimps,' that sort of thing. And also for colleagues amongst themselves because we build the effectiveness of the unit not only on its equipment and training but on the cohesiveness of the individuals to each other.

And so when one is not responding to that cohesiveness then it is difficult to grasp it, unless you can see it. There's, you know - why is he not, or she not being able to cope? What's the matter? And because you're in the intensity of either the operations or the training beforehand and so on, you tend to put them aside. You tend to not want to get engaged and you tend to be rather ruthless.

And so it is not ill will in the cultural shift that's required, it's just a recognition that - hey, that injury is just like Joe Schmoe's who lost an arm. And we are now being able to see, commanders and troops amongst themselves, recognizing that the best of them could be injured by this. And so the term 'injury' is now acceptable.

HOW BIG A PROBLEM DO YOU THINK THIS IS? AND I'M TALKING NOW ABOUT AFGHANISTAN SPECIFICALLY. DO WE KNOW WHAT THE MAGNITUDES OF THE OPERATIONAL STRESS INJURY PROBLEM IS GOING TO BE?

Well, it's sort of like you know, do we know what will happen to what was going to happen to our veterans after World War II you know? How long would they have to stay in hospital, would we have to keep, you know, Veterans hospitals and stuff like that. And what will be the longer-term impact of operational stress injury on these people is yet to be determined.
We have people saying that, you know, with age the operational stress gets worse. You know, the old theory when I came back which lasted a long time, was - hey, listen, get some rest, work hard and with time it'll go away. Well with time and a lot of work it gets worse! Because with time you can get bushwhacked by the traumas that sneaks up on you through sounds and smells or an event or from fatigue. Because fatigue reduces your ability to withstand the emotional anxieties that are within you and so you become more vulnerable to pushing yourself to the ultimate extreme of potential suicide.

So it is this recognition, yes, that it is an injury now. We've got to prepare people for that injury. And we've got to look for the effects of that injury afterwards. However, has it made its way to the extent that it is as honourable as the other one? We're working on that. Remember you're starting from a very close, and I said before, fundamentally Darwinian outfit. I mean that's the aim. And so you try to build a tolerance from an institution like that, that demands so much is very difficult.

The other thing if I may, is what I've captured as an angle to this having lived it and then trying to be an advocate of change and so on, is something that is not necessarily evident in the civilian world as such. And that's called loyalty. Loyalty is something that from the first day a recruit arrives is instilled. It comes from pride in this uniform, pride of oneself, self-discipline and pride of elements that create an atmosphere of cohesiveness, your regimental colours and the music and the history of the regiment and all these kind of things.

And so we create not only the loyalty within the group but we create a loyalty between the soldiers because they can't survive the training individually. You've got to do it together. And the organisation requires that there be an extraordinary sense of loyalty between you in order to build the operational effectiveness between ... oh, you look out for your buddy and this and that. Not just because you're trying to protect them because by doing your job right he's going to be able to do his and so on.

So loyalty is engrained. When you are injured physically and emotionally and not able to do what your buddies - you're pulled out of the stream. The first reactions of these anxieties comes from the fact that I'm no more with the guys. I've let them down, you know.

Now the physical side has an incredible array of instruments to attenuate that - and in fact we even now have physically injured people who are deployed, you know. People have lost a limb are now deployed and doing staff jobs and so on in the field because they can still meet the criteria of being deployed.

And so there's a certain renaissance that you can have from the physical side. But the psychological side is not the same. Because when you are affected psychologically by this, you feel as if you cannot sustain that level of loyalty to your friends. And that creates an enormous anxiety.

But what's worse is, is that you are not responded to in that loyalty. The system doesn't answer the same way. And so you feel disenfranchised. And in fact you feel as if you know, it's well, they really don't want to have you around. Because they're not too sure how you're going to act. You know if a guy's got an artificial leg how he'll react but in your case they're not too sure. And so there's a break of loyalty.

AND SO MANY OF YOUNG MEN AND WOMEN WHO ARE DIAGNOSED WITH THESE TYPES OF STRESS INJURIES INVARIABLY ARE DISCHARGED. THAT SEEMS TO BE THE POLICY.

Well, I mean it's because the level of capability - there are more than we think who have varying levels of PTSD or depression and so on, who still can sustain a career but not maybe at the same levels of responsibility because what is the big delta with post traumatic stress is your inability to cope with stress, your inability to cope with the operational demands. I mean that's how I was released. There was one line after 35 years in the army, there was one line and it said - "This officer cannot command troops in operations anymore".

AND YOU ACCEPT THAT BECAUSE MANY PEOPLE THAT WE'VE SPOKEN WITH FEEL VERY ABANDONED AS YOU SAY, AND FEEL THAT IT'S UNFAIR. IS IT UNFAIR?

I felt as if I had been destroyed by that statement. But they were right.

YOU ACCEPTED IT?

I realised - and then I crashed and became very aware that without the therapy, without the medication, and without a bosom buddy to be able to vent and so on, that I wasn't even able to sustain a reasonable level of stress, let alone the operational stress that was required of me.

So they were absolutely - they were right in doing that. But it was how you were sort of taken care of that was the problem. Very, very, very, very few of my colleagues ever communicated with me. And over the years my therapy has permitted me to reach a certain plateau and my medication helps me keep that plateau, because I know I would never to be able to return to operations and so on.

Colleagues have approached me over this but a lot of them didn't want to come close because 1) they weren't sure what to say or how to handle it or how I would react and so on. And others just felt that it was not comprehendible that you know we would have that injury and not be able to sustain in.

DO YOU SEE THAT THAT'S CHANGED IN ANY WAY SINCE YOU WENT THROUGH THIS? IS IT EASIER NOW FOR A SOLDIER WHO FINDS HIMSELF IN THAT POSITION?

I think that the atmosphere is more attuned to it. The question is the peer pressure and at the cold face you know in the platoon, in the section, in the company, in the operational units. I think that more headquarter garrison units are capable of absorbing and comprehending. And they also have the flexibility of letting these people go to therapy and adjust and absorb although they're all overworked of course. But absorb that.

But the operational units are pushed to ensuring that everyone is capable to conducting the mission. And that's where most of the casualties are and that's where it's the most ruthless. And that ruthlessness has not been eliminated. It's been attenuated but it's not been eliminated.

And so when you're a company commander and you've got 150 soldiers under you and you've taking them into a theatre, we must remember the fact that the Canadian army has been in the war zones for the last 20 years. Seeing people at peace, the Canadian army has been at war, it's been in the field, it's looking forward to a day when it can come back to garrison to lick its wounds. But it's been in the field and fighting.

And so when you have the leaders who are held responsible for the operational capability and the effectiveness of the mission, but also for the responsibility for ensuring that the troops are able to do the job, then they have to take some very difficult and often in a sort of an ethical dilemma of whether or not that individual should come or not.

The individual because of that loyalty not just the stigma, as we were saying of the, you know - but the loyalty of not understanding why you can't handle the stress, why you're crying, why you're raging you know and then becoming normal. The individual is locked into that loyalty thing that creates enormous dilemmas on both sides. The commander on whether or not he knows he's not perfect you can see the eyes, the actions. And the commanders now all see the signs. They've been educating now for the signs so it's not as if they're ignorant. And that in itself was a great step forward.

But they guy he wants to come and we don't want to lose him and so they've got to make a difficult decision and at times that decision is ruthless. It's not scientific; it's human. It's professional, but it's not scientific. The individual is caught up by striving to stay with the group, not wanting to be disloyal to the group and in so doing is pushing oneself also and is very intolerant of being told - listen buddy, you're injured.

And so it took me - when I was finally told that I couldn't serve anymore, I went into catastrophic failure for over seven months because it -. your whole life being - and the fact you felt disloyal. You felt like you've let the team down.

AND WHAT IS THE OBLIGATION IN THE MILITARY TO HELP PEOPLE WHO ARE GOING THROUGH THAT KIND OF TAILSPIN, THROUGH NO FAULT OF THEIR OWN?

Of course I mean it's an injury and what is the obligation of the military or the Canadian government to the family? Because contrary as my mother in law said you know, through World War II when my father in law commanded a regiment, she wouldn't have gone through what my wife did within Rwanda because in those days there was no information. Today the families live the mission with the troops through the media

DO YOU THINK THE MILITARY'S DOING ENOUGH FOR FAMILIES? BECAUSE ONE CERTAINLY HEARS COMPLAINTS THAT THERE'S NOT ENOUGH INFORMATION, THERE'S NOT ENOUGH SUPPORT?

The Family Support Centres have been massively enhanced and some are more effective than others. But the investment, it's not a money thing. It's competency, skills and so on. But the support for the psychological side of it you know that the spouse or the children need, that side is still very weak. And the New Veterans Charter was to cover that but we've seen that that has not been put into effect.

And I would pull the families out of the provincial system outright and make them part of either National Defence or Veterans Affairs responsibility, the immediate family. Because it's that type of world we're in. This is not an old world. This is the new world. Whenever somebody is killed in Afghanistan - like I live in Quebec City, well in Valcartier there's 2,500 families who are sucking in [their breath] and so you live it, these are not historic stuff, this is of our era where we haven't still adjusted that.

I WANT TO ASK YOU, YOU SAY STRIDES HAVE BEEN MADE AND I THINK EVERYBODY'S IN AGREEMENT. BUT STILL THERE ARE THOSE WHO FALL THROUGH THE CRACKS AND WHERE IN YOUR OPINION ARE THE BIGGEST CRACKS? WHERE ARE THE BIGGEST HOLES?

The biggest holes are right now the reserves for one, as a group. Where they are sent back to their reserve units, where there is no capability in reserve units. They have no funds or competencies at all. They're often away from big major bases where there are certain skills. They're in towns that don't have even the professional and therapeutic skills. It's fine to go see a psychiatrist, psychologist but if they know nothing about the military, I mean it gets pretty difficult to start doing - I've lived through that experience of trying to get support. And so they are the time bombs out there. Particularly those who then lead the reserves and how are we handling those veterans and taking care of them?

AND WHY IS MORE NOT BEING DONE FOR THEM? I MEAN THEY FORM THE BACKBONE OF TODAY'S MISSIONS, THERE ARE MORE RESERVISTS -

There's no doubt. My own regiment, we now have with the next gang going, a third of that militia regiment are veterans. And in the field they're performing magnificently and their families are supporting them in the efforts they do. But it is as if we still haven't you know, gone to the next step of saying - yeah, this is complicated. So how do we handle this? And they're in every town of the country.

Now so you can imagine the extent of solving this problem. That's fine - solve it. We are grasping still the regular force problem because there's still people falling through the cracks there, let alone the reservists. So I think there's got to be a deliberate dimension of reservists and how do you solve that problem that's yet to be done?

IS THERE A POLITICAL CONTEXT TO THIS; IS THERE SOME REASON IT MAKES IT MORE DIFFICULT? IS IT A MONETARY PROBLEM TO HELP THE RESERVISTS, MORE THAN WE HAVE? I MEAN THIS IS NOT A NEW PROBLEM, RIGHT, WE'VE BEEN DEALING WITH THIS NOW FOR SOME TIME.

Well I mean, the reservists have been deployed with us since Kosovo and through Yugoslavia and so on. So you're right, the scale though has been significantly more with Afghanistan. I mean we've got to recognize that.

I don't think, no it's not the political side as much as the rules and regulations side of the House, of adapting them more so that they recognize the part time soldier who's employed full time, who returns part time who are out in far away [parts of the country]. Veterans Affairs have also the problem of trying to handle those cases because they are also rather regionally structured. But that is technical. That somebody sitting down saying, 'Alright, we solve it now.' You know. And so it's maybe money but it's the willingness to take that problem on and to put the horsepower behind it to solve it.

YOU'VE TALKED ABOUT A TICKING TIME BOMB. WHAT DO YOU SEE WITH THESE PEOPLE COMING BACK WHO DON'T HAVE THE RESOURCES? WHAT'S THE IMPLICATION OF THAT GOING TO BE?

Well, interestingly enough, a colleague of mine, General Boutet, who was seconded to Veterans Affairs when we were doing these reforms in the late nineties, he was a Brigadier General. And he at the end of his five years started to bring to my attention that a lot of these soldiers become problem childs you know, because of the nature of the injury they are emotionally unstable. So they over-react, they are taking booze, drugs, to attenuate the pain, which gets them into trouble.

So all of a sudden we've got these people who are ending up in jail left, right and centre. Are ending up in front of financial institutions where their massive debt, beating up potentially you know, the local people, even families. And ending up as problem children of society. And we haven't sort of captured how to make sure the information is out there for when these people are in trouble that the lawyers and everybody recognizes - hey, maybe this is a person who's suffering from PTSD.

Nor have we tried to follow that and tried to over three, four, five years, followed the individual in how he's doing. Now, that becomes difficult because 1) you have your freedom of access to information of your charter of rights, so people can't impose. But secondly it is quite demanding of trying to follow these people and even offer to them to come and have an evaluation done and so on.

So there's got to be a change of rules for veterans that we can follow them for longer periods of time. In the case of, even in my case, it took four years for this injury to really kick in. People recognized that I was having problems but it took four years before I became totally ineffective.

The group that reinforced me in Rwanda are the twelve, eight, nine have had varying levels of PTSD. One of them committed suicide last year. That's fourteen years after. Suicide. The ultimate abandonment, the ultimate anxiety, the ultimate all of a sudden sense of isolation, of unable to handle anymore this pain. And it in itself is being horribly mishandled. Even though there is a program in the forces, of suicide prevention, but it is nowhere near the recognition of what suicide is.

I mean there are regiments who won't recognize that one of their soldiers who's committed suicide, you know, a year or so after a mission, should go on the list of those who are a casualty of the mission. If you're killed in operation, your name is on the Honour List. But if you kill yourself due to the injury of that operation, then you're not recognized. So I am pushing now more and more I've got a small team working on suicides. Particularly since my colleague Major Racine killed himself last year, who was suffering from PTSD and was still serving.

The enormous impact of suicide. I am working with the concept that is based on the following: in 1997 when I went public because I was getting nowhere inside and went public with PTSD as an injury because so many were suffering. I went to the Americans who have PTSD clinics. I went to the head of the American clinic and I asked him to help us build our system. And I said - Listen, we don't have ten years, we've got a bunch of stuff. No one has ever debriefed the Somalia gang, many of the Yugoslavian gang have never been debriefed. The Gulf War gang are still even being shunned by the system, you know, and never been debriefed. I mean these are all casualties.

So I said, 'I need something fast.' And he said, 'Well, you know, we're going to help you because we don't want you to go through what we did.' And I said, 'What was that?' He said, 'We lost 58,000 so many in Vietnam. In 1997, twenty years after, recorded they had over 102,000 suicides.' So Vietnam wasn't 58,000, Vietnam was 160,000. And so it's not 131 casualties we've got now. What is it? 145? 150? 160?

DO WE KNOW?

No. And we feel, I feel and it's an argument that I'm raising and I'm getting more data that both Veterans Affairs and National Defence on the pure technical-ness, not the commanders, the technical meaning the lawyers and the medical people, are downplaying the impact of the operational trauma to being the primary source of the suicides.

They're saying - Well, they're preconditioned, or it's one of the factors of ... and sort of verbiage like that. So they're de-linking, with the old vets it was no better either, World War II and Korean veterans.

But I think that in this timeframe that the recognition of suicide as being a possible ultimate injury, that is casualty that is part of the operational mission has got to be established.

AND WHAT DOES THAT HELP ACHIEVE THEN? I MEAN IF YOU RECOGNIZE IT THAT WAY DOES IT CONTRIBUTE TO SOLVING THE PROBLEM AND PREVENTING SUICIDE?

Yes because I think the intensity of the care and support we give to the troops when they're in theatre has got to be sustained in garrison. That link of loyalty, that link of support has got to be sustained in garrison. Because it is in garrison where this injury becomes worse. While in the field, a physical one, you assume you know the maximum impact, and so when you're back in garrison you're in essentially a recuperative process you know. And build around that.

However, so things get better and the prosthesis comes on and all that stuff. But with this injury, the injury gets worse if not treated in garrison. And leads to suicide. Now some will say - yeah, well even people who are injured physically have committed suicide. Yeah, but when you look behind it, what was the cause of it? Yes of course, living with less a leg was an impact but was it also the trauma of the combat that tipped the scales?

And so suicides have got to I think be taken as an entity of operational casualties and from there bring it back. And I think we'll pick up a lot of the ones who are falling through the cracks because ultimately this injury, PTSD, leads to suicide in extreme. I've tried it four times.

I'm not dead because I was lucky that there were people that by chance or by concern, checked. And so it is a reality. The Governor General, Madam Jean called me after going to the funeral of my colleague and she knew he would have been with me in Rwanda. And as Commander in Chief, was very, very effusive with the sympathy of that small group that we are.

And we met again this year and went to his grave. But she says that it should be a concern, suicide. And I said that I'm going to look into it and look into it. So you link suicide as the ultimate impact of this injury and you say - this counts, this suicide counts in the numbers.

And then start moving backward. I think then you will - and it's not to glorify suicide because you know we have this theory that the less you talk about suicide, the less there will be. Uh - prove that. Prove that. Prove that in an organisation that has an overarching sort of entity loyalty. If it's with GM or if you're working you know in a company or you're part time you know the sense of loyalty is not necessarily there. Your loyalties are often elsewhere than your workplace.

But within the military the loyalty is a fundamental premise of your operational capabilities. And that you don't turn it off when the uniform comes off. I'll give you one last example. In 1971 after Mr. Trudeau massively cut the forces we had a plan called Restore. And it was early retirement of people who wanted it, particularly the elder ones. And we still had some vets from Korea and so on.

And within a couple of months these people were out on the street. We gave them a bunch of money, but that was it. There was no retraining; there was no adaptation. These people had lived in military quarters, they'd lived on bases all their life, they'd been in combat; they were out.

Three years later, four years later, we started to get these calls that oh, so and so has died. And so and so has died. And we never heard it as suicide. But we heard well, he seemed to have died of a broken heart. He never was able to adapt and he felt totally abandoned and some went to booze and stuff like that. This is not an insignificant element and those who fall into the cracks still have that loyalty eating away at making that injury worse.

WHEN YOU RAISE THIS WITH THE POWERS THAT BE, THE PEOPLE WHO COULD CHANGE THIS AND WHO COULD MAKE THIS KIND OF SUICIDE PREVENTION THAT YOU TALK ABOUT A CENTRAL PLANK - WHAT REACTION DO YOU GET?

It is positive, it is concerned. The senior people there is no doubt in my military mind of the grasping the significance. The lower ranks, the troops you know who are trying to handle with this, and are living the experience, there is a sense. It's the middle gang. The functionaries, you know, who feel that they've got the responsibility of the purses of the government. Who feel they've got the responsibilities of not setting up precedents and of applying the rules and so on. They're the ones both in DND and in Veterans Affairs, they are the ones who are making it more difficult.

I THINK WHAT PEOPLE WILL BE SURPRISED TO HEAR IS THAT SOMEBODY LIKE YOU WHO HAS BECOME, FOR BETTER OR WORSE, THE FACE OF PTSD IN THE MILITARY IN THIS COUNTRY ...

Not a very nice face then, it's a bit of an ugly face then.

AN EXCELLENT FACE. AND HAS GONE THROUGH THE TREATMENTS AND KNOWS THIS NOW BUT STILL, STILL YOU SUFFER. STILL YOU FEEL THAT YOU'RE NOT CURED. THAT I THINK IS WHAT PEOPLE DON'T UNDERSTAND ABOUT YOU.

Depending on the levels you achieve a capability of normalcy. And some will become totally normal, essentially. But many depending on the impact of it is' because you have different levels of PTSD of course' you will never become normal. It's like losing the arm, you never become normal but with the prosthesis you become pretty effective. In this case you don't become normal but that prosthesis never fully meets the requirements.

AND SO FIFTEEN YEARS LATER, WHAT IS IT THAT TRIGGERS THAT FOR YOU?

This conversation today. It's dreary and dull outside, raining. The sense of isolation all of a sudden, fatigue, it could be a sound. Give you an example: When I went into Sierra Leone a few years back, well now 2001 so it's a few years back. But I was trying to get child soldiers out of the rebel force and I was in Freetown and I was crossing the street and from an angle I saw a vendor who had coconuts in the this little stand and he had a machete. And as I'm crossing the street he chopped the top off a coconut, brown and white. The sound and seeing that rendered me berserk. And three of my colleagues held me against the wall of a building for over five minutes. And I re-lived the whole of the three months in Rwanda. I calmed down and fifteen minutes later I gave a briefing.

BUT THAT WAS SIX YEARS, SEVEN YEARS LATER?

If they had not been there I probably would have killed that guy. I had lost all reality. And that's what happens. It is - you never know.