By Wendy Sarubbi | November 18, 2013 1:37 pm

Medical students who want to help veterans deal with the physical and emotional scars of combat need to focus on one skill – listening – veterans and their healthcare providers said at a special Veterans Week event November 12 at the UCF College of Medicine.

Student representatives from the American Association of Medical Colleges (AAMC) teamed up with the M.D. student Military Medicine Interest Group to hold a “Joining Forces” event focused on the special health issues vets face when they return from military service. Those issues include:

Post-traumatic Stress Disorder, described by Orlando VA Medical Center psychiatrist Dr. Patrick Dean, himself a U.S. Army veteran, as “the natural result of being in the unnatural experience of combat…It doesn’t mean you’re crazy, it doesn’t you’re broken.”

PTSD symptoms include flashbacks, nightmares, hyper-vigilance and isolation that result from a person’s exposure to a traumatic event. Veterans talked about substance abuse, refusing to leave the house, an inability to get along with bosses and co-workers and instigating fights as examples of their responses to PTSD. Most said they didn’t know they were suffering from the condition. “I didn’t know I had PTSD. I was just out there, lost,” said Army veteran Luis Perez. “I was avoiding everything.”

Military Sexual Trauma, defined as sexual battery or sexual harassment while in military service.

Such sexual abuse is especially traumatic for military personnel, whose training focuses on teamwork, trust and group survival. VA psychiatrist Dr. Janet Murray said 24 percent of female veterans and 1 percent of males report sexual trauma, but that the number, like civilian sexual assaults, is likely higher. Because soldiers have few boundaries between their work, off-duty and free times while in combat, such abuse is likely to continue.

Transition issues, that occur as veterans go from a highly disciplined culture where the mission comes before individual needs to a civilian society that speaks a different language, operates under a different leadership hierarchy and has not faced the violence of combat.

Veterans told medical students of the struggles in transitioning from a “shoot first, ask questions later” culture to one that required them to ask for help and sometimes battle a federal bureaucracy to get help from the VA. A veterans’ first joyful reaction to being out of the military can abruptly change when that soldier’s entire identity is different as a civilian, as are social, relationship and work expectations.

Trust issues, arising from isolation, a mistrust of the civilian medical profession and the inability of civilians to understand the traumas of combat.

When a College of Medicine student asked what physicians in training could do to better serve veterans, the answer was simple and profound: “listen.” A simple checklist of symptoms does not create trust, they said. Listen to what’s being shared – and also what’s not.

“Listen to what we’re saying,” said VA peer support specialist John Royal, himself a veteran. “We may not be saying it in your language. But we need someone who will listen.”

Fourth-year medical student Casey deDeugd has enlisted in the Air Force as part of the national Health Professions Scholarship Program. During an orthopedics rotation, she worked at the Center for the Intrepid at San Antonio Military Medical Center, a research and treatment facility for war veterans with limb amputations. Casey hopes to become an orthopedic surgeon and do her residency training in the military. She helped plan the Joining Forces Event and told the veterans and VA healthcare professionals how her clerkship experience has inspired her to help veterans. “I can’t event express the amount of gratitude I feel,” she said.

That gratitude was the theme of a hand-made flag lapel pin that students gave to all of the Joining Forces participants. The pins were made possible by an AAMC grant and as fourth-year student Jennifer Bazemore passed them out, she asked all the College of Medicine students to wear the pins on their white coats “and think about your veterans and what they shared with us today.”

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