THE WAR WITHIN

Lance Cpl. Ryan Elkins and a fellow Marine were sweeping their way down a strip of sand that 110-degree day in Ramadi. One of them carried a mine detector, the other an M-16, as they searched for homemade bombs.

It was May 29, 2004.

For Elkins, the explosion on that searing day reverberates still.

Now he lives in the Spokane Valley, where he heads into a small, unobtrusive office on North Mullan Road to help him mend. More than two years have passed. But his memories of that day in Iraq remain vivid.

Like other discharged military members, Elkins showed up at the Spokane Veterans Outreach Center with a mix of anxiety, anguish and bravado. There he found a staff full of veterans willing to hear his story and provide trauma and marriage counseling.

Veterans from Vietnam and other eras have been arriving at the Spokane center with trauma symptoms like nightmares and insomnia since 1981. But now they’re being joined by returning troops from Iraq and Afghanistan.

For the fiscal year ending in September, the center saw 528 new veterans from the global war on terrorism, compared to only 187 for the same period a year ago.

“We want to get them in and say, ‘This is normal,’ ” says team leader Linda Parkes. ” ‘This is an adjustment issue. It’s going to take some time. But you’ll never be the same person as when you left.’ “

Combat vets often mystify and frustrate their families and friends.

They may come home with memories they’re frantic to escape. They may drink excessively to avoid noticing the war scenes crowding their minds. They may hide away in front of a television or isolate themselves in a back bedroom.

Says Parkes: “You can’t be expected to go out and do war for 12 months, and then come back and the next weekend just join society and not have any symptoms.”

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On a recent afternoon, 25-year-old Elkins sits on the couch in a small unit of the Patriot Apartments in the Spokane Valley. He wears cargo shorts, a short “high and tight” Marine haircut and a brown T-shirt that says “Love to Hunt.” His feet are bare.

He tells the story of that burning day in Ramadi, his words dry and impassive. He served as a Marine combat engineer, which meant his job was dealing with explosives. He thinks he knows how it happened:

He imagines that as he and Pfc. Dustin Howell worked their way down the sand carrying a mine detector, an Iraqi insurgent watched them.

Then as the Marines inched their way toward a 155 mm artillery shell buried beneath the sand, and just before their detector could sense it, Elkins thinks the Iraqi signaled another man. The second man may have held a cell phone wired to the buried shell, which was packed with plastic explosives. He might have simply hit “send” on his cell phone.

“Just boom, it went off,” Elkins says. “And that was it.”

Back in Spokane, veterans stream into the center looking for Mike Ogle, who does outreach. A tall, gregarious man, Ogle has red hair, an appealing grin and an edgy intensity. He sets up booths at local fairs and gun shows, places veterans gravitate toward.

He passes out his cards to World War II vets, Korean vets, Vietnam vets, all of them. Many don’t know the center exists.

And when these guys arrive at the office, they ask: “Where’s Mike? Where’s Mike?”

First they tell Ogle their stories. He connects them with people who can help them figure out school benefits or track down a missing combat medal. He recommends they talk to counselors with master’s degrees in clinical social work or psychology.

But he avoids words like “mental health” or “emotional illness.”

In this office, the entire staff, from the former women’s Army Corps team leader on down, is a veteran. They understand well the military culture, the way it rewards emotional fortification, not vulnerability.

Ogle feels driven to help these combat vets. It’s a passion for him. He’s met everyone from a World War II nurse who served in Patton’s army to this ornery farm kid from Oaksdale, Wash., named Ryan Elkins.

Elkins seeks out Ogle when he can.

Ogle served in the Air Force for 20 years as a first sergeant, a role in which he helped airmen get out of jams. He’s a Middle East vet himself. After he was discharged, he found this job, which felt like being a first sergeant again, only without having to level the discipline. Already, he’s talked to thousands of vets.

“I have a hard time separating,” he says. “Truthfully, I guess over the years you learn to do that. But I’m at the stage where, heck, I think I’m having their nightmares.”

Now he’s seeing an influx of vets from Iraq.

Guys come in who were mortared night after night. Bombs blew up along the roads there. Even children were firing on them. Now they’re back in Spokane or Colville. They’re hypervigilant and unable to sleep.

They tell Ogle about their precarious jobs or their estranged wives. They describe how the manhole covers on a Spokane street look just like an IED, the military shorthand for “improvised explosive device,” a makeshift bomb. When they see one, they’ll swerve and speed up, unaware of what they’ve done until a cop pulls them over.

“There’s a saying over there,” Ogle says. ” ‘Drive it like you stole it.’ “

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In the sand of Ramadi that day, other Marines watched Elkins and Howell fly into the air.

Elkins remembers a few seconds when he looked over to check on Howell. Then his vision dissolved. He listened as the Marines hesitated, waiting for a possible secondary explosion, before moving in to take care of them.

Men who were there said later his face looked like hamburger.

Elkins heard medics take him and Howell to the battalion aid station in Ramadi and then load them on helicopters. Between the morphine and the shock, he doesn’t remember pain.

As he flew to a hospital in Baghdad, he slipped out of consciousness.

Spokane’s Veterans Outreach Center opened in 1981 on Division and Mission. It was a place with a pool table, cable TV, a fish tank and counselors who would search the Army-Navy surplus stores for vets.

“I can see it in their eyes,” one of the counselors used to say.

Over the years, the place matured and moved, finally landing in a building on North Mullan Road. The rec-hall atmosphere gave way to professional offices where wives and children feel comfortable, too. Now all of the counselors have graduate degrees.

“The system kind of grew up to match society,” Parkes says.

But it doesn’t advertise. And only a couple of small signs hang out front.

Parkes wishes television commercials could help direct vets and their families to this center. It’s a federal agency, though. It doesn’t pay for ads saying: “Hey, are you living with a combat vet who can’t sleep, hates crowds, drives way too fast? Maybe you should call the Veterans Outreach Center.”

If a family member saw that, they might be able to encourage a vet to call, Parkes says.

They’re usually the first to notice changes.

The symptoms aren’t obvious immediately. When military members return from Iraq, they dive into reunions with their family and friends. It isn’t until the third or fourth month that problems appear.

Often, their marriages suffer first.

The vet numbs out, shuts down, declines invitations. He or she may refuse to return to church or shop at the mall.

“They kind of go off, and the family continues to try to draw them back,” Parkes says. “But due to anxiety, it’s very hard for them to be at a big picnic. And the wife or husband will say, ‘Well, gee, what’s wrong? You’ve changed.’ “

Women veterans show up with unique complications. They’re more likely to have been sexually abused while they were away. And when they return, their babies may not recognize them.

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Elkins doesn’t remember the hospital in Baghdad, or the one in Lundstahl, Germany. He underwent 18 hours of facial surgery there.

It wasn’t until he reached a naval hospital in Bethesda, Md., that he finally woke up. His mother, his father, his ex-wife and his three aunts came to see him.

They nearly drove him nuts, babying him. They wanted to help him to the bathroom, even. Just five feet away.

Because of the coma, he was unsteady on his feet. So he asked for a wheelchair and began to walk through the hospital, holding on to its handles. He made rounds through that huge complex, the commissary and the food court in the basement.

Soon he was asking the Marine liaison’s office for a plane ticket home.

When veterans arrive back in Spokane, they often find their high school buddies clueless and immature.

“Did you kill anybody?” they’ll ask.

That’s the wrong question, Parkes says.

“They’re not proud they’re killing people,” she says. “So when you ask them that, (they think,) ‘Wow, what kind of question is that?’ They shut right down.”

They may find their wives or girlfriends have taken over the chores they used to handle. Their wives now mow the lawns, pay the bills, deal with the car. And sometimes the relationship is over.

Parkes labels all of this, along with the vet’s own anxiety and isolation, as “readjustment issues.”

The longer they go unaddressed, the more severe these issues are likely to become, she says.

Eventually, but not necessarily, the vet may be diagnosed with post-traumatic stress disorder. Some people can pay attention in class and work responsibly while coping with PTSD. Others can’t.

“If you have PTSD,” Ogle says, “it doesn’t mean you’re crazy.”

The vets center doesn’t do mental health treatment. It doesn’t attempt to address disorders such as schizophrenia or bipolar depression. If vets need more than trauma or marriage counseling, Parkes says, they’re referred to other mental health agencies.

Their visits to the vets center are kept confidential. And Ogle wants civilians to know this: “They’re not crazy, warmonger people going out to hurt people in the community. … It’s more self-destruction than anything.”

National statistics show that veterans tend to return to these centers for an average of nine to 12 visits. Some men and women now returning from Iraq and Afghanistan may initially undergo only three or four.

“They’re ready to roll,” Parkes says. “They want to get back to work, they want to go back to school.

But she says even a few visits to sort out education benefits or talk about possible jobs can help.

“At least they know where we are,” she says. “Maybe they’ll look at coming back for marriage counseling. They always know they can return.”

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Boxes crowd the living room of the Elkins’ small apartment on this late summer afternoon. They’re moving to a larger place, with two bedrooms. They’ll need the space in April when their baby arrives.

While Elkins sprawls on the couch, unselfconsciously displaying the wounds of his time in Ramadi, his wife, Jessica, packs their belongings. They were married in July.

Elkins’ right eye looks steadily at a visitor while his left one, blinded by that Iraqi shell, appears to gaze over at his nose. The skin on his face looks rough and scarred, as though by acne, and it still sloughs off particles of shrapnel and sand. So does his right elbow.

His left ear drum is torn, and he strains to hear his small son’s soft voice. His knees ache constantly with arthritis. He hopes to replace his left eyeball one day with a glass eye. Maybe then the doctors can remove a piece of shrapnel lodged there. Maybe his frequent headaches will subside.

He’s earned a Purple Heart for his injuries. But the explosion in the sand of Ramadi doesn’t strike him as a moment to feel proud of.

“For Marines,” he explains, “it’s like you got hurt and didn’t complete the job.”

His old partner, Dustin Howell, now living in Michigan, fared worse. He’s blind, lost fingers and part of his intestine.

Symbols from Elkins’ psyche appear to blossom colorfully on his skin. He wears nine tattoos. He stretches out the inside of his right arm to show off an image of the grim reaper, surrounded by flames.

“Heaven won’t take me,” it reads, “hell’s afraid I’ll take over.”

Another tattoo stretches across the back of his neck. Six letters. They spell “Psycho.” It’s a nickname his Marine buddies gave him for being so wild.

Elkins had planned on a career in the Marine Corps. That ended the day of the explosion. Now he works as a civilian, fitting custom boots at White’s Outdoors.

He has a good life in Spokane, he says. He’s recognized as a Purple Heart recipient at public events. Last spring, he pulled on his dress blues and rode in the turret of a Humvee in the Lilac Parade.

He looks now to hunting to provide the rush he relished at war. He plans to hunt deer this season with the Ruger 77 rifle in his bedroom closet he calls “my baby.”

But life here, he says, can be a little dull. He’s used to being shot at.

When he drives in Spokane, he watches for discarded pop bottles or litter along the side of the road. If he glimpses any, he speeds up. That’s where Iraqis hid explosives.

As Elkins talks, his tone sounds flat, but friendly. He avoids words like “sadness” or “fear.” Even now, his conversation remains filled with the oo-rah spirit of the Marine Corps.

He’d be back in Ramadi right now if it weren’t for these injuries, he says.

“I’m an adrenalin junkie, so I loved it over there.”