It was unseasonably warm for November in Colorado as Heidi Lieberman approached the door of the Soldiers' Memorial Chapel at Fort Carson. She walked past a few of the large evergreens that dot the chapel grounds and then entered the blockish, modern beige and brown chapel topped with a sharp, rocketlike steeple.
Inside, the chapel was hushed. Camouflage-clad, crew-cut young men packed the pews. Up in front, an empty Army helmet hung on the butt of an upright M16. A pair of brown combat boots sat below, as if they had been tucked under a bunk. A soldier handed Heidi a program for a memorial service. On the front was the image of a soldier, kneeling in prayer below an American flag and illuminated by a beacon of light from above. The inscription just below the kneeling soldier read, "Lord, grant me the strength ..."
It had been five days since Heidi's son Adam, 21, a soldier at Fort Carson, swallowed handfuls of prescription sleeping pills and psychotropic drugs in the barracks, trying to die. With a can of black paint, Adam brushed a suicide note on the wall of his room. The Army, Adam wrote, "took my life." (Read Adam Lieberman's story here.)
Adam had lived. Pfc. Timothy Ryan Alderman wasn't so lucky. Alderman had been found dead of a similar drug overdose in his room in the barracks at Fort Carson in the early-morning hours of Oct. 20, 10 days before Adam Lieberman made his suicide attempt.
Heidi, who was at Fort Carson to deal with the aftermath of her own son's suicide attempt, had decided to attend Alderman's funeral although neither she nor her son had known him. She sank into a pew and tried to reconcile two warring thoughts.
"On the one hand I was thinking, How dare the Army?" she told me later. "It is almost a slap in the face for the Army to present this lovely memorial service. It just seemed so hypocritical. Here was a kid who was screaming for help. He killed himself and they are making nice-nice?"
"On the other hand," she recalled thinking as she scanned the pews for family of the dead soldier, "I was thinking, God, this could have been me."
Both men were 21. Both served long combat tours in Iraq. Both overdosed on drugs. Both had sought help from the Army, and the Army had failed them. Sadly, however, their stories are far from unique.
Late last month, the Army announced data showing the highest suicide rate among soldiers in three decades. At least 128 soldiers committed suicide in 2008. Another 15 deaths are still under investigation as potential suicides. And suicide is only one manifestation of the mental health ills coming home with U.S. troops. Four years after Salon first exposed problems with healthcare at Walter Reed Army Medical Center that ultimately became a national scandal, the situation, at least at some Army posts, has only deteriorated. For the "Coming Home" series, in which today's two entries are the second installment, Salon put together a sample of 25 cases of suicide, prescription drug overdoses or murder involving Fort Carson soldiers since 2004. A close study of 10 of those cases exposed a pattern of avoidable deaths, meaning that a suicide or murder might well have been prevented had the Army better handled the predictable and well-known symptoms of combat stress. (Read the introduction to the "Coming Home" series here.) As Alderman's death shows, part of the problem is an apparent tendency of Army doctors to substitute large doses of prescription medication for adequate mental healthcare.
- - - - - - - - - - - -
Timothy Ryan Alderman grew up in Mulberry, a central Florida town of just 3,200 people, a speck on the map 30 miles inland from Tampa. Though Florida is often thought of as a state full of transplants, Alderman, who went by his middle name, Ryan, had roots in Mulberry. His father had also been raised there, and some of Ryan’s teachers had been his father’s schoolmates. Growing up, Ryan was an avid outdoorsman, hunting rabbit and squirrel and catching bass and bluegill. He was also a passionate skateboarder and surfer. Skateboarding became snowboarding when Ryan joined the Army just after his 18th birthday in 2005 and was stationed at Fort Carson.
Ryan served over a year in Iraq as an infantryman with the 1st Battalion, 9th Infantry Regiment, 2nd Brigade Combat Team, part of the 2nd Infantry Division. His tour, including service in Ramadi, site of some of the fiercest fighting in Iraq, began in October 2006. Soldiers at Fort Carson say he served on 250 missions and had 16 confirmed kills, though it is difficult to independently verify those figures.
It was by all accounts an active and bloody combat tour. His medical records show that when he was in Iraq he did not think he would suffer combat stress afterward, because he "mostly had fun killing people and getting paid for it." If that sounds monstrous, it is actually not unusual for war veterans to describe combat as simultaneously horrifying and thrilling.
Ryan did receive at least three battalion commander "coins for excellence." Some units hand out the engraved, bronze-colored coins as on-the-spot awards for good performance or valor. Correspondence from Ryan's battalion to his family shows that Ryan received one, for example, for extracting another wounded soldier under fire during an ambush.
While Ryan's medical records show he reported no serious mental problems before Iraq, things unwound upon his return in late 2007 and got worse as time passed. In June 2008 Ryan showed up at Fort Carson's hospital and filled out a "behavioral health questionnaire." He reported being "extremely bothered" by disturbing memories, nightmares, panic attacks, trying not to think about the war, emotional numbness, irritation, angry outbursts and jumpiness, among other symptoms.
He reported on the form that his problems began in February 2008, soon after his return from Iraq. On a scale of 1 to 10, Ryan ranked the severity of his situation as an 8. When the form asked, "What are you seeking from this service?" Ryan filled in, simply, "help."
Soldiers face considerable stigma for seeking mental healthcare in some Army units. Old habits die hard, according to the Fort Carson commander, Maj. Gen. Mark Graham, a man with a reputation for working to fix these problems at his post. "We are trying to say that it is a sign of strength and not weakness to come forward and get help."
"What I tell the [officers and non-coms in combat units] is, 'You are not medical professionals. You are not the people that can treat and diagnose this.' So, [their job] is to be caring and compassionate for our soldiers and make sure they get the medical care they need."
"I do think we are making some progress," said Graham, describing the erasure of the stigma for seeking mental healthcare as a top priority. "It is certainly not fast enough for any of us ... It takes time and it takes consistency from the entire Army."
"Any death is regrettable," said Col. Elspeth Ritchie, the Army's top psychiatrist, in an interview. "And certainly suicide -- which is something I've been looking into very closely -- is extremely tragic for all concerned and we always go back and say, 'How could this have been prevented? What could we have done better?'" Ritchie reels off a laundry list of initiatives for improving Army mental healthcare, like the establishment of a 24-7 hotline for soldiers to help arrange counseling and a new policy, started in the spring of 2008, to ensure that seeking mental healthcare won't mess up a soldier's security clearance. The Army's most recent study of mental health issues in Iraq and Afghanistan showed improvements on decreasing stigma. "The trend is the direction we'd like it to go in," said Ritchie.
At least one of Alderman's superiors apparently didn't get the message. There is a saying that the most powerful man in the Army is a sergeant. That's because when a low-ranking soldier needs just about anything, he has to go to his first sergeant. A former roommate of Alderman's who fought beside him in Iraq took Alderman to his first sergeant to get him mental healthcare. "I escorted Ryan to the first sergeant's office," Alderman's buddy told Salon. According to the friend, the first sergeant "blew [Alderman] off" and said, "Everybody sees what you saw" in Iraq. At one point, alleged the friend, another sergeant told Alderman, "I wish you would just go ahead and kill yourself. It would save us a lot of paperwork."
"The Army treated Ryan as if he was the problem," said the friend, "not that he had a problem."
Alderman's medical records show that in June 2008 he had "homicidal ideation" toward his first sergeant. By August, he was "feeling suicidal." Alderman was hospitalized in June, in August and then finally in October because of his symptoms. Records show doctors saw crosshatch lacerations on his arms. The cuts, Alderman would later reveal, were from self-mutilation.
The records show doctors, however, "ruled out" PTSD as the cause of Alderman's problems, and did so without any recorded explanation. As in Adam Lieberman's case, doctors determined that Alderman's problems were his own, and were not related to his Army service. At various times, doctors instead blamed anxiety disorder, bipolar disorder, personality disorder, alcohol abuse, depression "NOS" (not otherwise specified) and anxiety "NOS" -- anything but the war.
Records show that during the summer of 2008, Alderman admitted to doctors that he sought out medication to "numb my feelings." The Army put Alderman in the same substance abuse program as Adam Lieberman, the one Lieberman would later call a "joke."
Alderman's father, Tim, also noticed the change in his son after Iraq, just as Heidi Lieberman noticed a change in Adam. Tim thought Ryan might suffer from PTSD.
Ironically, the Army had educated Tim on PTSD. While his son was in Iraq, the Army had sent Tim "Down Range: To Iraq and Back," by Bridget C. Cantrell and Chuck Dean, a book about PTSD. Tim thought his son's symptoms upon his return made him a prime candidate. He didn't understand why the Army couldn't see the same thing. "I read the book and I knew what to look for," Tim said in a telephone call from his home in Florida. "But he wasn't in my house, he was in their house," he said, referring to the Army.
Tim visited his son in the first week of October during Ryan's last hospitalization. Tim said the visit left him worried that the Army cared little for damaged soldiers. They got pills while being processed out of the military, but not much more. "It looked like a slaughterhouse operation to me," he told me. "Get 'em in. Get 'em out. Get 'em to Iraq."
Ryan's medical records from that period describe his father as "genuine and supportive and tearful at times." Tim also expressed some alarm: His son seemed dangerously stoned on his meds. "Dad noted that Ryan seemed 'out of it' and 'over-medicated,'" according to the records.
Just prior to his death, Ryan Alderman planned to do something about his shoddy treatment at the hands of the Army. He joined a small group of soldiers who wrote and signed sworn statements explaining their predicaments. The plan was to seek some sort of legal help. Salon obtained Alderman's statement from the family of another Fort Carson soldier. (View the statement here.)
He describes "traumatic events" in Iraq, including the death of friends from roadside bombs and a friendly-fire incident in which U.S. Marines fired on his post. "Upon returning from Iraq, seeking help was discouraged," Alderman wrote in his sworn statement. "So I self medicated and started cutting myself to relief (sic) the pain." (Self-mutilation is a relatively common phenomenon among people suffering from post-traumatic stress disorder. It literally cuts through the emotional numbness, allowing the PTSD sufferer to feel something.)
"I still have nightmares about the war and Staff Sgt. Hager," Alderman wrote in his sworn statement, referring to the bloody death of Staff Sgt. Joshua Hager by roadside bomb on Feb. 23, 2007, in Ramadi. Friends say Alderman pulled Hager's dismembered corpse from the wreckage of a vehicle. "I am seeking help but I feel like I'm not being treated right. I mean mental help. I struggle every day with it."
Alderman dated the sworn statement Oct. 13, 2008. He died seven days later.
- - - - - - - - - - - -
While the Army claims Alderman committed suicide, evidence suggests he might just as well have accidentally overdosed on a massive concoction of prescription drugs the Army gave him, plus a couple of his own.
Possible overmedication is a theme running throughout Alderman's hospitalization and care at the hands of the Army. On Oct. 6, one caregiver wrote in his records that Alderman "appears to be heavily medicated," could not complete sentences and was dozing off. A note on Oct. 8 says Alderman was "very dependent on his medications." On Oct. 11, one caregiver on the evening shift described him as being in a "stupor."
By mid-October, the records describe Alderman as "very much drug seeking." Doctors replaced his Valium and Percocet with alternatives. Alderman responded by demanding to be released from the hospital.
On discharge, records show, doctors had Alderman on 0.5 mg of Klonopin for anxiety three times a day; 800 mg of Neurotin, an anti-seizure medication, three times a day; 100 mg of Ultram, a narcotic-like pain reliever, three times a day; 20 mg of Geodon for bipolar disorder at noon and then another 80 mg at night; 0.1 mg of Clonodine, a blood pressure medication also used for withdrawal symptoms, three times a day; 60 mg of Remeron, for depression, once a day; and 10 mg of Prozac twice a day.
Salon contacted an Army psychiatrist who requested anonymity and read him that list of drugs and the dosage amounts. "Oh God," he said. "That's shitty. That breaks all the rules. He was overmedicated. That's bad medicine."
An Army psychologist at Fort Carson examined Alderman on the day of his discharge from the hospital. She described him as "overly sedated and slurring his words." (The Army psychiatrist Salon called said, "Of course he was.") Despite his heavy prescription load, Alderman still wanted pain pills. The Fort Carson psychologist described Alderman as depressed, anxious and sad, but not contemplating suicide or murder. The psychologist sent Alderman on his way to the barracks. It is the last entry. Alderman was found dead five days later.
Col. Kelly A. Wolgast, the commander of Evans U.S. Army Community Hospital at Fort Carson, declined comment on any specific cases, citing privacy law. "I feel for families who have lost a soldier, no matter how it happened," she said in an interview at her office. "We grieve with them. We will completely pledge to those families that we are doing everything that we possibly can to see that never happens to another soldier. Their sacrifice, we believe, is not in vain."
Alderman's autopsy report blames "multiple drug intoxication" for his death. The cause: suicide. In addition to his meds, Alderman took some Xanax and morphine, adding to the toxic combination, but there is little evidence he meant to die. Tim Alderman thinks his son's body succumbed to the onslaught of drugs, more Heath Ledger than Kurt Cobain. In this case, the cocktail included some drugs supplied by the Army, some abused by Ryan. "His body just shut down," claimed Tim. "It was overloaded."
Ryan's former roommate and battle buddy blames the Army for Ryan's death. "I know he didn't commit suicide," he told me. "I don't think he should have been released from the hospital. I know for a fact the Army killed my friend," he added. "I want something done. The Army is killing people left and right and nobody cares."
The Army ruled Ryan's death a suicide, in part, because he had pinned a letter to his wall addressed to his mother who died of an illness years earlier. Tim shared the note with Salon, along with hundreds of pages of medical records.
The affectionate letter doesn't read much like a suicide note. Ryan pledges that, "You will always be in my heart and soul." Tim said Ryan told him about that letter some time ago. Ryan's medical records show he was writing similar letters to sort out his feelings.
Ryan's intentions in the early hours of Oct. 20, however, seem beside the point. A clear-eyed assessment of his war-related problems might have saved him.
The stakes are always high whenever a parent loses a child. They were especially high for Ryan's father, Tim. Tim's wife died in 2004 from illness. His eldest son, Ryan's older brother, died in 2006 in a car crash. Now Ryan, his last surviving child, is gone. "It was the end of [the] family tree," Tim said about his younger son's death. "Everything I started is gone."
(The third installment in Salon's "Coming Home" series will appear tomorrow.)