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My mother was a true patriot. She scoffed at people who only flew their American flags on Veteran's Day, Memorial Day and the 4th of July. She would thank veterans wherever she went. She had a particular affinity for Vietnam vets whose return home was certainly less than welcoming, so she made a point to always say "welcome home." A perpetual teacher, she encouraged those who disrespected the national anthem to stand at attention and recognize those who lost their lives for us. She used veterans to teach her students lessons about sacrifice, justice, bigotry, honor and camaraderie. She helped so many veterans through fundraising, donations, social support and education that our local VFW bestowed upon her the title of Honorary Veteran. She raised us the same way. This past weekend, my children and I encountered two gentlemen collecting donations for the Veterans of Foreign Wars. My daughter delighted in emptying my entire change purse into the collection bucket in return for her poppy. My son popped a $10 bill in the bucket and tied his poppy around his wrist to make it look like a bracelet. The gentleman thanked the kids for their generous contribution and I told him it was the least we could do. As my mother would do, I looked him in the eye, gripped his hand with the kind of handshake a soldier deserves and thanked him for his service to our country. He replied, "The honor is mine." * An article on NBCnews.com reported that in 2012 the United States military recorded one active-duty suicide death every 17 hours - 350 in total. The alarming number of suicide deaths outnumbered combat-related deaths. The article of course highlighted the problem, but also drew a possible correlation between multiple traumatic brain injuries and a significantly increased risk of suicidal thoughts. Switch to another website where I read a Memorial Day article detailing that the current rates of suicide among veterans is 22 per day with the average age being 59! Post-traumatic stress disorder, debilitating depression and substance abuse disorders are all listed as contributing factors here. For those who have endured the emotional and physical trauma of combat, re-entry into the community is an incredible challenge. Young men and women are expected to return to a normal civilian life; resume parenting, working, schooling, and interacting with people who will never have the slightest clue about what the soldier has seen and done. They are no longer surround by comrades who understand the daily struggles, who have endured common trauma. Instead now the soldiers regularly interact with civilians who have never seen the brutality of war, whose life "stressors" include morning traffic and not having enough time to get to the gym. These soldiers and veterans are people who have been witness to inconceivable atrocity, murder, mass destruction, abuse, loss of life and limb, separation from family and friends, often for years and often on multiple deployments. In civilian society, they may feel isolated, guilty, angry, resentful, disrespected. They may become depressed, abusive, addicted, homicidal or suicidal. Re-entry programs seem to be available but are mostly optional. The Department of Defense reports that it is doing everything it can to address the suicide epidemic, offering over 900 prevention programs and developing a policy which will require military leaders to encourage utilization of those programs. The VA website has special tabs for assistance with housing, education, health-care and child support. But the assistance for making an emotional transition, learning how to best deal with the trauma of war, seems to be dependent upon the soldiers' request for help. The stigma of mental illness and fear of losing a job are two of the main reasons veterans and active duty soldiers don't seek assistance for symptoms of depression and suicidal thoughts. The Department of Defense has released public service announcements that are intended to educated soldiers' and veterans' loved ones about the warning signs of depression, PTSD and potential suicidal ideation. But are we doing enough? Do the rising rates of active duty and post-combat suicide show that our programs are successful? Clearly not. As a health care provider and family member of veterans of war, the numbers cited in these recent article indicate that we are not doing well enough at addressing military suicide risk, for those in active duty or veterans who have returned home. Millions of dollars go into resources to protect our country, but we are clearly not adequately protecting the protectors. Imagine as a family member, your loved one survives active duty combat, and returns home to a hero's welcome only to commit suicide. From where I stand, the only answer is that we return the favor; that we make the health and well-being of our armed forces a priority, whether in the combat zone or in the civilian workforce. We give them helmets and bullet-proof vests, to protect their bodies, but we must be ready to care for the emotional wounds that most certainly remain. We must acknowledge that the traumas of war do not end when they step off the plane and onto American soil. Sometimes, that's when they begin. To the honorable members of our national military, friends and colleagues who have served us and protected us: our nation's debt to you in immeasurable. A simple "thank you" will never suffice. If you have suffered symptoms of sadness, irritability, insomnia, flashbacks, extreme personality changes; if you are cutting or self-mutilating, or are addicted to drugs or alcohol; or have had thoughts of hurting yourself or someone around you, please ask for the help that you rightfully deserve. Please do not hesitate to see your doctor or contact the Military Crisis Hotline is 1-800-273-8255. A million thank yous and again, welcome home.

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©2019 Alexis Hugelmeyer, D.O., P.C.