18th paragraph from the end reads: "But she and Dr. Arthur Blank Jr., one of the nation's leading authorities on PTSD, said patients on that many medications must be monitored closely. Blank said doctors often rely primarily on pills to deal with PTSD, but he said they should only supplement regular private counseling. Silvertooth and Blank, who had no involvement in Oligschlaeger's case and could speak only in general terms, also said alcohol can amplify or interfere with PTSD medications, creating a dangerous combination."http://www.statesman.com/news/content/news/stories/local/06/15/0615marine.html
HEALTH & MEDICINE
Dead Marine's family says he didn't get proper care
Chad Oligschlaeger was struggling with post-traumatic stress disorder when he was found in barracks, parents say.
By Marty Toohey
Sunday, June 15, 2008
Cpl. Chad Oligschlaeger returned from Iraq in early 2006 haunted by the memory of a fellow Marine he thought he should have saved.
He began drinking himself to sleep to dull the flashbacks and the nightmares, friends and family say. He told them he was accused by a superior of faking to avoid his next deployment.
After a second tour in Iraq, Oligschlaeger came home to Round Rock on leave and slept for days, a shell of the McNeil High School student who had pushed his friends into every kind of mischief imaginable, giggling all the way. He told his family the dead Marine was talking to him.
In the spring, two years after the nightmares began, he told his family that doctors had diagnosed him with post-traumatic stress disorder and put him on at least six types of medication. The Marines sent him to alcohol rehab and were arranging treatment at a mental health clinic.
But weeks before his death, Oligschlaeger declined to re-enlist, and his unit left him with no supervision and nothing to do for days on end, according to family and friends, who say he called them at all hours, slurring his speech, unable to recall what medications he had taken.
He was found dead in his room at the Twentynine Palms Marine base in California on May 20. He was 21.
First Lt. Curtis Williamson, a Marine Corps spokesman, said the Corps' policies prohibit commanders from discouraging mental health treatment or leaving physically or mentally wounded troops uncared for. He said an investigation is under way, during which details, records and the cause of death cannot be released to the family or the public. "These allegations," he said, "will be taken very seriously."
But Oligschlaeger's family is alleging that two years of obvious problems and calls for help from Oligschlaeger were ignored. Their complaints echo those of veterans' advocates, who say that even with new government policies, better treatment and increased public awareness, there are still barriers separating soldiers and Marines from proper care for conditions such as PTSD that affect mental health.
"They wouldn't give Chad the help he needed. But he was wounded, every bit as wounded as someone who lost an arm or leg," said his father, Eric Oligschlaeger of Round Rock.
Oligschlaeger was found dead at a time when studies are showing that more troops are dealing with mental health problems than previously thought. The most comprehensive independent study, published in April by the RAND Corp.'s Center for Military Health Policy Research, found that one-third of service members sent to Iraq or Afghanistan return suffering from a combination of severe depression, PTSD and brain injuries.
Only half the troops who need care seek it, often fearing stigmatization or retribution, according to the report, which also found that "only slightly more than half who receive treatment get minimally adequate care."
Moments of war left haunting memories
Chad Oligschlaeger, his family says, saw things in Iraq that he could not leave behind.
His first day in Ramadi a densely packed city where the streets rang with gunfire he saw a nearby Marine killed by a mortar lobbed onto the base, he told his family. A lieutenant handed him a body bag.
On Feb. 18, 2006, during a night patrol, a friend and mentor to Oligschlaeger, 2nd Lt. Almar Fitzgerald, was riding in a Humvee that was attacked. The blast from a roadside bomb left "Fitz" severely wounded, according to military releases. Eric Oligschlaeger said his son's Humvee arrived shortly after the attack and Oligschlaeger helped load Fitzgerald's stretcher into the back. But it was too wide to fit, momentarily delaying their departure, Eric Oligschlaeger said.
Fitzgerald died three days later at a U.S. military hospital in Germany, according to the releases.
Eric Oligschlaeger said his son described a delay that lasted at most a few moments, but Chad was dwelling on those seconds. When Oligschlaeger came home on leave that April, his friends say they noticed subtle changes.
At age 10, he'd met Brad Blackaller, and it took only a day for him to ask, "Are we best friends yet?" When Blackaller said he already had one, Oligschlaeger replied, "Why can't you have more than one?" After Ramadi, Blackaller said, the burly, brown-haired hockey player with the sly smile and more best friends than he could count was jittery about standing in a grocery line.
Oligschlaeger's mother, Julie Oligschlaeger, who lives in Phoenix, says her son made the 275-mile trip from Twentynine Palms most weekends with a few Marine buddies. Sunday mornings, mother and son had breakfast together. She and Oligschlaeger's fiancée, Adrianna Avena, who also lives in Phoenix, say he spent months brushing aside questions about Iraq.
Then, six months after returning from Ramadi, he learned he was being sent back.
He started having flashbacks. He drank Seagram's Seven whiskey until he passed out. He thrashed violently in his sleep, crying out about Fitzgerald. Avena learned the safest way to wake him was a light touch on the heel.
"Chad told (the Marines) he couldn't go back in his condition," she said.
Oligschlaeger told his family that he saw a military psychiatrist and laid out the drinking and the nightmares. But later that day, Oligschlaeger told his family, he was called in by a superior and accused of making up problems to avoid deployment. Julie Oligschlaeger said her son worried about a dishonorable discharge and that no decent employer would hire him.
Williamson, the Marine spokesman, confirmed the identities of superiors accused by the family of discouraging Oligschlaeger from seeking help. But they are not allowed to give interviews during the investigation, he said. Their names are being withheld from this article because they did not have the opportunity to comment.
Williamson would not comment on Oligschlaeger's case specifically but said any attempts to discourage him from seeking mental health treatment, as is being alleged, would be "not acceptable or condonable under Marine Corps standards."
Stigma inhibits mental health treatment
Across the military, standards are changing. The Defense Department has been scrambling to hire psychiatrists in the wake of a yearlong Pentagon study, which concluded in May 2007 that the number of mental health professionals in the military is "woefully inadequate." Last month, as part of a larger initiative to eliminate the stigma associated with mental health care, Defense Secretary Robert Gates visited a new PTSD treatment center near El Paso and declared that security clearances could no longer be denied to troops seeking treatment. Some commanders have also been encouraging their troops to think of the mind like a piece of equipment, something that may need maintenance when used in harsh conditions.
But change takes time. In February, during a Senate Armed Services Committee hearing about soldiers allegedly deployed against doctors' orders, Army Secretary Pete Geren testified that troops unfit for duty shouldn't be sent to war zones but couldn't be sure they weren't. Meanwhile, troop surveys consistently find the main barrier to treatment is fear that careers will suffer.
"There's more help available," said Paul Sullivan, the executive director of the advocacy group Veterans for Common Sense. "But it's got to get a lot better, quickly, or we're going to have a social catastrophe among returning veterans."
After diagnosis, a host of medications
In April 2007, Oligschlaeger and Ramadi had changed. The city had calmed. Amid the pace of life there, Oligschlaeger seemed stable to family members during phone calls home, they say.
He returned on Thanksgiving from his seven-month tour in Iraq optimistic about his post-military life, his family says. While visiting Avena in Phoenix, he proposed at P. T. Cook's restaurant, so nervous that he got on his knees and almost forgot to pop the question. Oligschlaeger toured the firefighters' academy in Phoenix. Avena bought a house in nearby Scottsdale.
But when Oligschlaeger went home on leave to Round Rock, he would not leave the house. He told his father that he didn't like how people stared at him.
In February, Oligschlaeger told his family that he was having hallucinations of Fitzgerald sitting next to his bed in the evenings, talking to him. He began to dream about killing Adrianna in anger.
At some point, he was diagnosed with PTSD, according to the family. But without medical records, determining when is difficult. The family says that he saw several psychiatrists in February but did not mention being diagnosed with PTSD until early May.
Julie Oligschlaeger said that during a brief visit in March, her son left behind an empty bottle of zolpidem, a prescription sleep aid, dated March 7, as well as bottles of trazodone and fluoxetine (both prescription antidepressants) dated March 20. His family says he later told them he was also taking lorazepam (a panic-reducing sedative) and seroquel (an antipsychotic).
In early April, the Marines sent Oligschlaeger to an alcohol rehabilitation center in Point Loma, Calif., his family says. He spent nearly a month there, but he complained of flashbacks so vivid that he would run terrified from the room. He thought the sergeant picking him up from treatment accused him of faking symptoms.
But, he told his family, the Marines were planning additional treatment: a stay in a mental health facility in Napa Valley. They were waiting until a bed opened up.
The medications mentioned by Oligschlaeger's family are nothing to be alarmed about, said Dr. Erin Silvertooth, an Austin psychiatrist who has counseled PTSD patients. Silvertooth said PTSD medications are often used in concert to target specific symptoms, because "there is no magic PTSD pill."
But she and Dr. Arthur Blank Jr., one of the nation's leading authorities on PTSD, said patients on that many medications must be monitored closely. Blank said doctors often rely primarily on pills to deal with PTSD, but he said they should only supplement regular private counseling. Silvertooth and Blank, who had no involvement in Oligschlaeger's case and could speak only in general terms, also said alcohol can amplify or interfere with PTSD medications, creating a dangerous combination.
Mixing alcohol, pills
On May 10, Oligschlaeger's older brother, Chris, and his girlfriend, Sara Pawlowski, visited Phoenix. Chad Oligschlaeger, obviously drunk, complained he couldn't find his pills.
"I just saw you take them," Pawlowski recalls telling Chad Oligschlaeger.
The family's worries deepened. Eric Oligschlaeger, who paints houses for a living, took a job delivering newspapers in Oak Hill in anticipation of paying for the post-military treatment.
The Marines encouraged Chad Oligschlaeger to renew his contract. He said no.
In the days after that, the family says, Oligschlaeger would call from different points on the base, wandering in a haze. He told his mother no one asked or cared why he wasn't going to work. His new roommate in the barracks was house-sitting off base.
On Friday, May 16, Oligschlaeger told his father Napa Valley was still full. He then called Blackaller and said he wasn't visiting Avena in Phoenix to save on gas.
On Monday, Avena bought her wedding dress. Her call went to Oligschlaeger's voice mail.
On Tuesday, voice mail again. In a panic, she called her fiancé's old roommate and asked, "Can you check on Chad?"
At 11:30 p.m. in Round Rock, Eric Oligschlaeger's doorbell rang.
"By then," he said, "I knew what it was about."
The Marine told Eric Oligschlaeger his son was dead but said he could not give any details.
Two days later, on a breezy desert morning, the Marines held a memorial service for Oligschlaeger at Twentynine Palms. There, Julie Oligschlaeger says, she asked the lieutenant colonel commanding her son's battalion, "What happened to eyes on your Marines?"
Oligschlaeger's funeral was May 31 in Austin. At it, the family played Johnny Cash's rendition of "The Ballad of Ira Hayes," a song about a disillusioned Pima Indian who helped raise the U.S. flag at Iwo Jima. In the song, Hayes turns to whiskey after the war, hoping to dull the nightmares and survivor's guilt. He died at 32.
Eric Oligschlaeger knew it was an unusual choice for a funeral. But, he said, during the first deployment, his son's unit had listened to it every morning.
To the family, it seemed a fitting choice.