Many who served on battlefields seek refuge from and ways to cope with Fourth of July displays
He knows it's just fireworks, but Andrew Sabin's heart races anyway and he starts to sweat profusely.
The concussive booms sound like Iraq.
The 26-year-old Army veteran from Racine, Wis., didn't have trouble when he returned from the war. But gradually fireworks displays began to affect him.
This Fourth of July, many combat veterans like Sabin will try to stay far away from fireworks displays. Fireworks take them back to combat, when the sound of explosions meant death and injury, not colorful rockets lighting the sky on a peaceful, happy holiday.
"I get nervous and anxious and then I start thinking about mortars. And then the explosions - you start reliving it," said Sabin, who is being treated for post-traumatic stress at the Zablocki Veterans Affairs Medical Center in Milwaukee. "I start sweating, I get anxious and then hyper-vigilant. Then the next thing, I've got to go. Even if I'm looking at them, I still have problems."
Psychiatrists at some VA hospitals begin talking to their patients several weeks in advance to come up with plans to handle fireworks. Some veterans check themselves in to the VA to avoid them, and some increase their work hours to make sure they're busy at night when fireworks are shot off. Others hunker down in their homes, avoiding crowds or family gatherings where someone might ignite a bottle rocket or an M-80. Some self-medicate to cope with the stress, or go off into the woods and camp to get away from civilization.
"It can be a really challenging and difficult holiday," said Eileen Ahearn, a psychiatrist and medical director of mental health at the William S. Middleton Memorial Veterans Hospital in Madison, Wis.
"Parades, big celebrations, even a hero's welcome can be difficult for veterans with PTSD. While we're thinking we're doing a good thing, it can be difficult for the veterans," Ahearn said.
Military members are trained to be vigilant and hyper-aware of their surroundings - skills that help keep them alive in war zones - and for some it's difficult to shut that off when they return to the safety of their homes, said Michael McBride, a psychiatrist at the Zablocki center.
"It's good military training. You have to train your body to respond to that threat. You survived your experience in a combat zone. But the deeper parts of your brain are not willing to let go of that response," he said.
McBride, who has worked as a psychiatrist at the VA hospital for five years, spent eight years in the Army Reserve and was stationed in Iraq in 2008 and 2010. He's now a commander in the Naval Reserve and recently found out that he will go to Afghanistan. Sensitive to noise, McBride avoids family gatherings where firecrackers might be set off.
"We're so well-conditioned. Even though in your mind you know you're in Milwaukee and you're safe, the body just can't shut off," he said.
During the annual Reclaiming Our Heritage event on the grounds of the Milwaukee VA, organizers discuss whether to allow reenactors to fire cannons. While it's a crowd-pleaser for thousands of visitors, it's stressful for veterans at the hospital, McBride said.
Sabin was an Army tank mechanic who spent 16 months in Iraq from 2006 to 2008. He survived mortar attacks and small-arms fire and saw a fellow soldier shot in the knee during a mission. One of his unit's lieutenants was killed by a sniper.
Sabin was okay for a while when he returned home but then slowly began to struggle with survivor guilt and depression. The first time he went to a fireworks display after coming back from Iraq, Sabin struggled to cope with being surrounded by a large crowd of strangers.
"Now I don't go to fireworks. Just seeing or hearing the thumping noises, I try not to be around them because it causes issues," he said.
Bradley Williams, 46, was injured by an improvised explosive device that hit his armored vehicle on his second deployment to Iraq with an Army National Guard unit from Mississippi. He suffered a concussion and ringing in his ears.
For Williams, a patient at the Milwaukee VA hospital, the abruptness of fireworks randomly shot off by kids is more troubling than big displays. In Iraq and Afghanistan - aside from controlled detonations of captured explosives - troops don't know when the next mortar will land or roadside bomb will blow up. Most explosions are a surprise.
"Being caught off guard is the biggest thing," Williams said.
"Nobody wants to admit these things. I'm all about 'hooah!' But they came on and I didn't want to admit it and fought against it."
Several weeks before the Fourth of July, Ahearn and McBride talk to their veterans about their fears. They help them devise plans to avoid fireworks or gatherings where someone might set off firecrackers.
McBride increases medications during this time of year to help some of his patients get through the holiday. He also discusses coping strategies such as wearing earplugs, using deep-breathing techniques or staying inside during fireworks displays.
"Civilians enjoy fireworks. It's a part of the Fourth of July. But vets who served in war zones and [have] gone through mortar and bomb attacks, those sounds trigger to the body that they're under threat," McBride said.
By Meg Jones, Milwaukee Journal Sentinel
July 4, 2012