Making His Experience Count

In Jim Dwyer’s line of work, it doesn’t hurt to have been shot in the head.

The faded scar above his left eye, tattooing the spot where a “friendly fire” round struck him during the Vietnam War, seals his credibility with the emotionally wounded veterans he has counseled for the last 25 years. He has been there.

Now Dwyer rubs the mottled blemish in thought as he talks about America’s fresh crop of combat soldiers. He knows that in time, perhaps later rather than sooner, many of them will bring the horrors of the Iraqi battlefields to his office at the Veterans Affairs Medical Center in West Los Angeles.

“We have to start thinking about how to reach out to them,” said Dwyer, 55, sounding gung-ho but also a touch sad. “The adrenaline gets going.”

The New York native, who served as an Army intelligence specialist, directs the medical center’s treatment program for post-traumatic stress disorder. He is a pioneer of sorts, having started in the field before the government recognized the disorder as a diagnosis in 1980.

He has helped hundreds of returned soldiers cope with a conflict they didn’t sign up for -- the fight to fit back in.

It can be a lifelong struggle. Dwyer’s patient load includes still-young veterans of the 1991 Gulf War, but also octogenarians who remain haunted by World War II. The afflictions they share erase differences in age, race, upbringing and income brackets.

“We have guys who look like Fortune 500 CEOs, and we have guys who look like they live on the street,” Dwyer said.

All of them once looked like the men and women on the front in Iraq, he added -- tender faces under dirty helmets.

“It’s very, very disturbing to see them on TV,” he said, leaning forward on the government-cheap conference table in his spacious but worn office.

Dwyer is silver-haired, wears owlish glasses and has a professional listener’s manner of knitting his brows at every spoken word, even his own.

“I see this innocence in these soldiers, and I’m aware of the disasters that could happen to them.... I just want to encourage them to come in and talk and grieve.”

When they do come in, he is certain, they will have been driven by the kinds of memories that become waking nightmares: mind movies, constantly replayed, of carnage and chaos, of killing strangers and watching buddies die, of making mistakes that cost the lives of civilians or comrades.

They will come in angry. A large number will be divorced and alcoholic, drug addicted and paranoid. Some will be suicidal. Most will be lonely, whether surrounded by family or not.

Dwyer has seen it again and again. His program, at the West L.A. center and a clinic in Commerce, treats 1,200 veterans a month. He handles 100 himself.

About 70% of the patients are Vietnam veterans; their war gave post-traumatic stress disorder psychiatric legitimacy, after much debate and study.

In earlier wars it was labeled “shell shock” or “combat fatigue.” Psychoanalysts often regarded the symptoms as signs of deeper traumas, reaching back to childhood.

Like other experts, Dwyer says enough has been learned about the ailment to conclude that combat alone can trigger it.

“These guys are going to have a hard time,” he said of the troops in Iraq. “All combat veterans do.”

He noted that the war already has resulted in friendly-fire deaths, which can devastate those responsible. “It’s bad enough to kill the enemy,” he said.

Dwyer was near Na Trang when an errant rifle shot creased his skull.

“Everybody was very embarrassed about it,” he said, smiling uneasily.

The wound did not send him home. He got patched up in Japan and finished his year in Vietnam, where he lost several friends.

If he had any form of post-traumatic stress, he said, “I think helping other veterans helped me tremendously.”

Dwyer took a circuitous path to Veterans Affairs. After Vietnam, he earned an English degree at the University of Wisconsin. He was there when antiwar activists bombed the math building in 1970, killing a researcher.

Later, after a stint in the textile business, he joined the Volunteers in Service to America, became a Peace Corps recruiter and earned a master’s degree in social work from Vanderbilt University.

Along the way, he married a fellow therapist, Susan O’Hara, who treats victims of noncombat post-traumatic stress in private practice. They have a 12-year-old son, Zachary, and Dwyer thinks about him whenever he watches the newscasts from Iraq.

“I’m just thankful that he’s not older,” he said. “I know now why my father cried when I went to Vietnam.”

He said if his son ever considers enlisting in the military, “I might have him talk to people who went through it.”

Scott Stanger went through it, and ended up as Dwyer’s patient. The 51-year-old Wilmington resident served as a medic in Vietnam. He said he can’t shake “what I saw there. The atrocities.”

A burly man with ham-sized forearms, Stanger sat in Dwyer’s office and fidgeted, uncomfortable in his skin. The windows behind him offered a view of ragged palm trees and weedy lawns, where middle-aged men walked with canes.

“I really thought I could handle it,” Stanger said of his depression and anxiety attacks. Eventually, he had to give up as a drug counselor and go on disability. “I sort of rolled off the table.”

Dwyer entered the room, and Stanger visibly relaxed.

“Of all the staff here, he’s the one who will always have time for you,” Stanger said after Dwyer had left. “He helps you indirectly, by listening. You can tell he’s compassionate. He’s not a phony.”

Dwyer spends a lot of his time conducting group counseling sessions -- 15 veterans talking things out.

“You have small victories,” Dwyer said. “A guy stays out of the hospital. Another guy says he’s going to hurt someone but he doesn’t. There was a guy who told us he was going to burn down the Valley but he didn’t.”

Defeats can be crushing. Dwyer recalled a “star patient” who grabbed a gun, holed up in an apartment and was shot to death by the police.

“I heard about it on the radio, and I just couldn’t believe it was him,” Dwyer said. “I didn’t know if I could keep on doing this. There have been times when I thought I’ve had enough.”

But the images from Iraq and the inevitability of more patients, recharge him.

“You get revved up, ready to go,” he said. “You really want to help.”