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Healing continues for vet, his nurse

McClatchy Newspapers
May 05, 2006

TACOMA, Wash. – The hug seemed to go on forever. Neither wanted to let go. Rory Dunn and Tina Sundem hadn’t seen each other since their lives briefly crossed in an Army hospital’s intensive-care unit in the middle of Baghdad’s Green Zone nearly two years ago.

Dunn is a former soldier from Renton, Wash., who suffered a traumatic brain injury and other wounds near Fallujah, Iraq, in May 2004 when a roadside bomb exploded next to his Humvee.

He has no memory of the earlier encounter. He was in a coma and given little chance of survival.

Capt. Sundem, an Army nurse who treated him and now lives in Roy, Wash., vividly remembers former Spec. Dunn.
“He was so severely wounded I never imagined he would live,” she said.

On a recent dreary evening at a chain restaurant in Tacoma, the two met for the first time since Iraq.

For Dunn, 23, the reunion was a chance to say thank you.

For Sundem, 34, it was another step in her own recovery.

Sundem’s experience in Iraq left her so traumatized that she attempted suicide 10 days before her tour was to end. She was diagnosed with post-traumatic stress disorder and spent time in a psychiatric ward at Walter Reed Army Medical Center in Washington, D.C.

Sundem read about Dunn in The News Tribune last summer. She knew that seeing him would help her confront the darkest memories of her days in Iraq and take some comfort that her nursing skills, at least in Dunn’s case, paid off.
“Since I came back from Iraq, I haven’t been able to touch a patient,” she said. “It’s so sad. That’s who I was. I was good at it. Others with PTSD can go on to become bankers or lawyers. But the thing I am, I can’t be anymore.”
Sundem is not alone. Nearly one-third of U.S. soldiers who were in Iraq during the war’s first year have sought mental health treatment, according to a recent study published in the Journal of the American Medical Association.

About 12 percent of the 220,000 Army soldiers and Marines surveyed suffered serious mental problems, including depression and post-traumatic stress disorder. An earlier study of Iraqi war veterans had found that between 15 percent and 17 percent displayed PTSD symptoms.

No one is sure whether nurses, doctors and medics are more susceptible to PTSD as they treat wounded soldiers who almost certainly would have died on the battlefield in earlier wars. But the Army is concerned.
Maj. Gen. George Weightman, who oversees Army medical training, said the Army tries to prepare its medical personnel for what they will face at military hospitals in Iraq.

“We call them trauma factories,” Weightman said. “It can be a shock when 12 or 15 wounded arrive all at once. In the states, you see people injured in car accidents or wounded by guns or knives. You don’t see high-velocity or explosion wounds. It can get pretty intense.”

Health care professionals in any setting can suffer from “compassion fatigue,” a form of burnout. PTSD, however, can be far more serious.

“We are trained to be objective and not grossed out by the blood and gore,” Weightman said. “But at some point – who knows what will trigger it – the emotional floodgates open. As a civilian you can get away from it. In a combat zone you can’t.”

Before becoming a neurosurgeon, Dr. Jeffrey Poffenbarger was an infantry soldier and an Army Ranger who took part in operations in such places as Haiti. He served 14 months in Baghdad, mostly with the 31st Combat Support Hospital, the same unit Tina Sundem was assigned to.

The pace was relentless, the casualties often horrific, said Poffenbarger, 43, now in private practice in Virginia. He recalled incoming helicopters breaking the day’s quiet, the arrival of mass casualties and making triage decisions about who could be saved and who couldn’t.

“I would see people who have been shot only 10 or 15 minutes earlier – dirty, grimy, with shrapnel sticking out of their skin,” Poffenbarger said. “In any other war, these soldiers would have been dead.”
“It was very hard on some,” he said.

Maj. Mark Brown, a psychiatrist who served in Baghdad and now works at Fort Bliss in Texas, said the stress came from more than just treating the wounded. Gunfire and mortar attacks caused him to worry about the mental health of those he worked with.

But Sundem said it was not the danger of living and working in a war zone that got to her. More than anything, it was the wounded.

“I would lean over and whisper in their ears, ‘You aren’t going to die on my watch,'” she said.

Sundem chooses words carefully as she talks about her time in Iraq. Her kids, Hannah, 4, and Bridger, 3, keep popping out of the family room, where they were supposed to be watching a video. She shoos them away as she talks about the carnage she dealt with in Baghdad.

“I can’t describe the horror,” she said. “I swiped a wounded soldier’s eyeball into a trash can. At times I would think, ‘This kid isn’t going to make it, this kid will be a vegetable.’ It was never ending. There was no escape.”

Sundem said she worked 14- or 16-hour days, six days a week, and the ICU was always filled to capacity. There was no escape. She said she began feeling hostile toward her co-workers and, especially, the enemy combatants she treated. At one point, she didn’t sleep for four days.

Sundem did seek help. She was on medication and had been in contact with a psychiatrist. But near the end of her year in Baghdad, she snapped when she heard a doctor had bad-mouthed her care.

She tried to commit suicide but survived, and the Army sent her to a hospital in Landstuhl, Germany.

“I was a zombie when I got to Germany,” she said. “One doctor said I was the worst case of PTSD he had ever seen.”
While in Germany, Sundem said she couldn’t call home, at first.

“I was afraid to come home,” she said. “I had changed. When I went over there I was a successful, happy person. Every premise of my value system was challenged and destroyed.

“I had lost my faith in God. I had lost my faith in humanity. I felt soiled and impure. I felt like a monster. I didn’t want to poison my children, and I was ashamed of what my family would see in me.”

After a time at a psychiatric ward at Walter Reed and a stint at Fort Leavenworth, Kan., Sundem and her family settled in Roy with a horse named Jade and a dog named Tasha. Her husband, Chad Sundem, is assigned to a Stryker brigade at Fort Lewis and could be headed back to Iraq. He has served two previous deployments in Iraq and one in Afghanistan.

As with Rory Dunn, Sundem is gradually putting her life back together.

“I have good days and bad days,” she said.

The flashbacks come mostly when her mind is idle.

“I can feel them coming,” she said. “It’s like I am there, the smells, the sounds.”

Sundem said she no longer has nightmares about Rory Dunn. After she learned that he had survived, it took her almost six months to make contact.

“He had really haunted me,” she said. “It helps to know he survived.


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