As he and his troops entered Baghdad in 2003, detachment commander Staff Sgt. Kirk Reese couldn't help but notice the body parts lining the streets.
Reese, a Mt. Pleasant native, is a member of the 1st and 2nd Platoon Truck Co., Headquarters Battalion, 4th Marine Division. In charge of hauling troops during combat operations, his battalion was the first soft vehicle company to go through An Nasiriyah.
About 65 percent of the 13 trucks and 10 trailers under his command were hit by indirect or direct fire.
Day and night the soldiers were objects of mortar and rocket attacks; that was just during Reese's first deployment.
His second deployment in 2004 lasted eight months.
Supporting another security and stabilization operation for the base and local population in the Al Taqaddum region between Al Ramadi and Al Fallujah, Reese's unit received harassing rocket and mortar fire so regularly that after a while "it became entertainment to try and guess where shells would hit."
Reese, who now calls Braddock Hills home, said it isn't unusual for him to wake up jumping out of bed from some nightmare six months after he returned home.
But he said it could be worse.
Being a Pennsylvania state trooper prior to his deployments, Reese was used to seeing people severely injured or dead from such things as automobile accidents.
"I think I was emotionally dead from my regular job, so I don't think it affected me as much as it could have," he said. "I just related everything to a big crash scene."
Staff Sgt. Greg Showman, originally from Champion and now between homes, was deployed with Headquarters Company of the 458th Engineer Battalion. He returned home about two weeks ago after a deployment to Iraq that lasted more than a year.
Although he mainly ran humanitarian missions supplying food and water and wasn't exposed to a lot of combat, Showman still has some adjustment issues.
"Every time I go outside I think, 'where's my weapon?'" Showman said. "I feel like something's missing. And when we were going under overpasses on the turnpike on the way home, I looked up at every one of them. I never used to do that, but when you're over there, you are trained to do that in order to watch for snipers or someone overhead that might be trying to hurt you."
He added that he now feels uncomfortable in crowded areas, too.
"I can't be at a restaurant too long," said Showman. "I don't know what it is. Maybe I'm just not used to being around civilians."
Scott Tracy, licensed professional counselor with an office in Connellsville and a professor of counseling psychology at Chatham College in Pittsburgh, said there are two issues veterans have to deal with when they return home.
The first is adjustment disorder, in which soldiers have a hard time readjusting to their previous lifestyle. The second is post-traumatic stress disorder, in which a person experiences a traumatic event that becomes frozen in memory and can cause reactions years later.
"With adjustment disorder, soldiers had a tremendous responsibility -- facing battle and life-and-death situations -- while serving in the military, and then they return home to a relatively boring experience," Tracy said, giving the example of a soldier who might have been responsible for a $12 million tank, only to return home to his janitorial job.
"Most people think it would be a good experience to come home, but sometimes that's just not the case," Tracy added.
Dan Ziff, clinical coordinator of the PTSD Clinical Team at Highlands Drive Veterans Affairs Medical Center in Pittsburgh, said some symptoms of adjustment issues include jumpiness, inability to relax, guarded or violent actions and being uncomfortable around crowds.
"We hope to see these symptoms subside within two to three months of being home if the soldier has a supportive family and an understanding employer," Ziff said. "We encourage them to return to their routine that they might have had before they were deployed as soon as possible. If there's a noticed disruption in that routine, it might be indicative of a problem.
Increased alcohol or drug use and social isolation might also be signs of PTSD, Ziff said.
"After World War I, the term 'shell-shocked' was coined," said Tracy. "Now it is known as PTSD. Back in those days soldiers would return home to their jobs, maybe a factory, and if there was a sudden loud noise, they'd dive under the tables."
In PTSD, a person's thoughts and feelings are paralyzed in the event, making it difficult for that person to move on with his life, Tracy said. "The person will have nightmares or other sleep disorders, a compromise in the ability to work, seem pre-occupied and turn away from family and friends."
Ziff said the New England Journal of Medicine reported that 15 percent to 17 percent of all Iraq and Afghanistan veterans show signs of major depression, generalized anxiety or PTSD within three to five months of coming home.
Reese said the hardest part of coming back home is maintaining a normal relationship with his wife.
"While I was in Iraq, she was doing everything and making all the decisions back home," Reese said. "We were both working on our own little lives, so when we got back together, you really butt heads a lot. It's really a big issue."
He added that at least two other soldiers in his battalion have had the same relationship problems with their spouses.
"Spousal relationships are a double-edged sword," Ziff said. "They're the best support system, but it also feels very different to the soldier because they were used to a very emotionally cold environment. Sometimes the soldier might feel the spouse is very demanding and their expectations cannot be met."
Ziff's advice to wives and other family members of returning soldiers is simply to be patient.
"Don't expect too much too fast," he said. "Don't pressure them too much. Give them time to digest their experience and come home. Their body will be home long before the spirit, so give the spirit time to catch up."
Rather than a big welcome-home party right away, Ziff suggested the soldier and his or her spouse spend quiet time together.
"Get a family member to watch the kids if they have any, and go to a movie or just out on a date to get reacquainted," Ziff said. "Be patient. Catch up gradually."
Reese said talking to others and to his wife has been the key to coping.
"It's very important for soldiers to talk about their feelings," Tracy said. "Group therapy is probably the best way, which is aimed at getting the person to understand that they're not crazy and that this is a normal response for ordinary people who have experienced extraordinary things."
He added that PTSD is very treatable, but the individual has to seek counseling, which is effective in almost 90 percent of all cases.
"I think people are more open about the disorder now than they were in the past," Showman said. "I think they're more willing to get help."
Highlands Drive Veterans Affairs Medical Center in Pittsburgh has a primary care team specifically for Iraq veterans. For more information, call 412-365-5150.
