The New Lost Generation

Suicide rates for troops returning from Afghanistan and Iraq are out of control, and post-traumatic stress disorder is reaching epidemic proportions. But is the Pentagon willing to tally the true cost of war?

When the war is over, when the troops are finally home and reunited with their families, when the dead have been buried and the wounded cared for -- then comes the reckoning. Sometimes it happens quickly, with the terrible cost of war weighed against the tyrants silenced, rebellions crushed, or populations rescued. Sometimes the reckoning takes longer, after the parades are over, flags furled and cased, subjects quietly changed. But no matter the form, the reckoning always comes. And after Washington's current military campaigns, it will be a heavy one indeed. Nine years, more than $1 trillion, at least 5,600 dead and 43,000 wounded. These are the costs of the Iraq and Afghanistan conflicts -- the ones we can tally.

Less visible, but no less important, is that these wars are creating a new version of what writer Gertrude Stein called une génération perdue, a lost generation, analogous to the shellshocked men who returned home after the horrors of World War I. Many soldiers coming home today have struggled to reintegrate into civilian society, their mental wounds running deeper than any bone or flesh cuts ever could. And the country and the military will be changed by their return.

Rand Corp. now estimates that about 20 percent of returning veterans either have or will develop post-traumatic stress disorder (PTSD). The suicide rate in the Army is out of control: During the first half of 2009, more American soldiers committed suicide than were killed in combat. In June, an average of one soldier a day committed suicide. A couple of years ago, just after I completed my second deployment, I came close to killing myself too.

The Army's field manual for "combat stress" -- the current term in vogue for mental-health problems in and after combat -- offers some context for what PTSD has done to our ranks in the past. In Europe and Africa during World War II, the proportion of mental traumas among all casualties was close to one in four -- one mental health case for every three blood wounds. On Okinawa island in the Pacific theater, the ratio for the 6th Marine Division (which suffered more than 2,600 wounded and added about 1,300 combat exhaustion casualties) was one in two, or half as many mental health evacuations as blood and bone wounds. This statistics varied wildly in Vietnam, but rose dramatically as the war went on. At first, proportions were roughly one mental trauma per 10 wounded. Later, neuropsychiatric cases constituted almost 60 percent of medical evacuations (though this number is skewed by the inclusion of drug and alcohol cases.) As many as one in five Vietnam veterans suffered PTSD, and even as late as 1990, one in 10 still did.

At present, it's not clear whether these wars have brought on more psychological trauma than earlier conflicts. We do know that more soldiers have been evacuated from Iraq and Afghanistan for mental-health issues than for combat wounds. It's possible that better body armor, mine-resistant vehicles, and a smaller number of force-on-force engagements have produced fewer blood-and-bone casualties, so we just see more of the mental-health trauma than we used to. 

We don't yet know where the current balance between blood and mental wounds lies. Between 2002 and 2009, there were about 33,000 wounded in action in Iraq and Afghanistan. During that same period, about 4,700 troops were evacuated for mental-health reasons -- just over 14 percent of all troops serving in theater.  But this figure only counts those cases so dramatic that the soldiers were sent home from the war. Doctors always prefer to get soldiers back to their units rather than out of theater, and not everyone who is treated appears on the record. My doctor kept my treatment quiet to keep from tarnishing my record and to protect my Top Secret security clearance. In short, that 14 percent is just a fraction of the actual number of soldiers suffering.

But the differences between today and earlier conflicts run much deeper than numbers alone reveal. What's different about these conflicts is their conduct, which leaves little down time and has nearly everyone in the line of fire. In prior wars, combat units served at the front of combat for a set period of time before being rotated to the rear to rest and refit, and support units were mostly kept in the rear area. Counterinsurgency doesn't work that way. China's Chairman Mao Zedong once said that insurgents must live in a population the way a fish swims in the sea. The same goes for counterinsurgents. There is no front line and no rear area; soldiers and units are always at war. Every movement a unit makes is a combat patrol, and every contact with a local is a political act. There is no down time, no rest. And both our soldiers and their commanders know that this is a significant factor in the development of PTSD.

The Army is aware of the psychological toll of the current wars on soldiers: The most recent mental-health survey notes that "soldiers on their third or fourth deployment report significantly more acute stress, psychological problems and . . . marital problems." And among the winners chosen in the Army's recent mobile-phone "app" competition was Telehealth Mood Tracker, a "self-monitoring app that allows users to track their psychological health...[and] experiences associated with deployment-related behavioral health issues."  

That may not be enough. At exactly the time that U.S. soldiers are being asked to do more than ever, the well of U.S. support for the wars abroad is drying up. After World War II, veterans came home to a hero's welcome and a booming economy; they embraced civilian life. It was only later, the Deparment of Veterans Affairs recounts, that World War II veterans developed PTSD -- after the parades, once they had retired, when the family was gone, and friends were dying off, the painful memories came back.

Today, there is no such hero's welcome for returning troops. In fact, ask a soldier who has served in these wars what surprises him most about returning home, and he will likely tell you he's shocked that America isn't at war. "Look around you," he will continue. "Does this look like war?" And he'd be right: It does not. We've been in Afghanistan for nine years. We've had no draft, no mobilization of industry, no substantive change in our behavior here at home. At the same time that the U.S. military was first entering Afghanistan, our president told us to go shopping, and we did. Most won't even notice when the soldiers come home.

Nor are jobs eagerly awaiting soldiers when they return. The law requires that a soldier mobilized for war can get his old job back when returns. But what if the company has gone under, as so many have in this recession? What if he or she is gone for more than the five years that Congress mandates employers must hold a job for a mobilized reservist? After that point, there is little the government can do. Programs to help veterans make the transition back to the civilian marketplace help, but with the jobless rate for young veterans at over 21 percent, lots of soldiers stay in military service for the steady paycheck.

What all this will mean for the United States is a generation of men and women who struggle both in and out of the military. They will come from the lowest and the highest ranks; in 2009, two generals admitted they had been treated for the disorder. But there is still a real stigma attached to seeking care for mental-health issues. In the Army's most recent mental-health assessment, more than half of the soldiers queried said they feared they would be considered weak if they sought treatment. I know this is true because I was also afraid to seek treatment for PTSD in Afghanistan. I thought the soldiers in my airborne unit would think I was broken.

At the end of America's involvement in the Vietnam War, the Army was traumatized. Rampant drug use, poor leadership, and severe racial problems threatened to overwhelm the entire military institution. Today, drug use is back, and young officers are leaving the Army at alarming rates. We haven't descended to the dark days of the post-Vietnam era, but the stress of long, repeated deployments is dangerous -- to both the military itself and families awaiting the return of loved ones. The fallout from Vietnam reverberated for decades; it was a long and hard period for the services and for the country. The coming reckoning will happen in an America where politics are blood sport, and where neither political party has recently covered itself in glory. Like war itself, it will be a grim, untidy business.

I don't know how the United States will determine the cost of these wars. I suspect the vast majority of the population will simply shrug and go about their lives. Memorial Day will still mark the beginning of summer rather than a day of solemn reflection on the cost of war. But try as America may to move on, many of its soldiers will not. The risk of another lost generation is at hand.



Anchor Baby Boom

The fuss over birthright citizenship has been around as long as the 14th Amendment has -- and it's not going away anytime soon.

Hours after a federal judge blocked the most controversial parts of Arizona's hard-line immigration law on July 28, U.S. Senator Lindsey Graham had an idea. That evening, Graham, a South Carolina Republican, announced that he was thinking of introducing a bill to change the 14th Amendment, which grants citizenship to the children of immigrants born in the United States.


"People come here to have babies," he told Fox News. "They come here to drop a child. It's called 'drop and leave.' To have a child in America, they cross the border, they go to the emergency room, have a child, and that child's automatically an American citizen. That shouldn't be the case. That attracts people here for all the wrong reasons."

On a night that otherwise might have disappointed anti-immigration conservatives, Graham's comments immediately shifted the focus of the heated debate from Arizona's law, which required police to check the status of suspected illegal immigrants, to "anchor babies" -- an alleged plot by immigrants to score citizenship and a place in the U.S. welfare state, first for their children and eventually for themselves. A handful of Graham's Republican colleagues have agreed that the issue warrants further investigation, with Senate Minority Leader Mitch McConnell pressing for congressional hearings on what he described as the "burgeoning" business of birth tourism, and House Minority Leader John Boehner arguing Aug.8 on Meet the Press that it's "worth considering" repealing the 14th Amendment.

McConnell pointed to a Washington Post story about brokers who arranged for Chinese women to bear children at specialty "baby care centers" in the United States -- charging more than $14,000 for tourists to give birth in the U.S. so their children would be citizens. But there is scant evidence that there are elaborate schemes to exploit this loophole outside of a small handful of rich Chinese couples. And it's even less clear that illegal immigrants have deliberately decided to take advantage of the law en masse. About 4 million children in the United States have at least one parent who entered illegally, according to the Pew Hispanic Center: not an insignificant number, but still a very small fraction of the U.S. population, which is about 310 million.

Although Graham's ploy amounts to little more than high-voltage political theater, the Republican remarks reignited conservative scaremongering that illegal immigrants -- and even would-be terrorists -- were using the amendment to exploit the immigration system. The attacks tap into emotionally charged themes that have shaped the American immigration debate for decades -- and evoke the immigration battles of the 19th century, when the 14th Amendment was adopted.

As its opponents frequently point out, the U.S. version of birthright citizenship is unusually inclusive. Over the past few decades, Australia, Britain, France, and other industrialized countries have modified and restricted their own birthright laws in the face of similar concerns about immigration and the capacity of the modern welfare state. But supporters of U.S. birthright citizenship defend the provision as uniquely American. They recall the historical origins of the 14th Amendment, adopted during Reconstruction after the Civil War by Abraham Lincoln's Republican Party to protect the children of freed slaves.

In a recent Washington Post op-ed, liberal columnist E.J. Dionne cites an impassioned 1859 defense of birthright citizenship by Carl Schurz, a German immigrant and Republican legislator. Birthright opponents denounced the law for naturalizing the country's "entire colored population," warning that a scourge of "Gipsies" would imperil the nation. Rushing to defend the law, Schurz declared: "All the social and national elements of the civilized world are represented in the new land ... their peculiar characteristics are to be blended together by the all-assimilating power of freedom. This is the origin of the American nationality, which did not spring from one family, one tribe, one country, but incorporates the vigorous elements of all civilized nations on Earth."


Modern immigration advocates argue that America's melting-pot inclusiveness has been the basis of the country's success -- and that expanding legal citizenship is likewise crucial to future progress. "Successful integration has always been a multigenerational process.... Kids learn English and have better educational outcomes, all in the course of a generation," says Marc Rosenblum, a senior policy analyst at the nonpartisan Migration Policy Institute. "To treat those children differently and to make them second-tier residents isn't likely to reduce unauthorized immigration -- it's likely to lead to further polarization, inequality, and exploitation."

The argument for birthright citizenship reflects the larger argument for expanding the pathway to legal citizenship: It provides a quicker route for immigrants to become full tax-paying members of society, improving social cohesion, educational advancement, and productivity. A landmark 1997 study by the National Research Council showed that while immigrants without a high school education had a net negative fiscal impact -- consuming $16,000 more in services than taxes, at the time of the study -- highly skilled immigrants had an exponentially higher fiscal impact, contributing $198,000 more in taxes than services. Because of this, and other arguments that the legal status of immigrant parents should not affect U.S.-born children's citizenship, the few times that the policy has been challenged in the Supreme Court, it has been upheld.

Nonetheless, the attacks on birthright citizenship have refused to die. During the 1960s and 1970s, the father of the modern anti-immigration movement, retired ophthalmologist John Tanton, played on fears of American declinism and dwindling resources by fixating on overpopulation. "To govern is to populate," wrote Tanton in 1986. "Will the present majority peaceably hand over its political power to a group that is simply more fertile?... As Whites see their power and control over their lives declining, will they simply go quietly into the night?"

Driven by a preoccupation with immigrant fecundity, Tanton laid the groundwork for groups that are now at the heart of the anti-immigration movement -- and whose views and rhetoric have gradually trickled into the mainstream. Although the legislation has generally remained on the fringes of the debate, at least one bill addressing birthright citizenship has been proposed almost every year in Congress since the early 1990s. Michele Waslin, senior research analyst at the Immigration Policy Council, a pro-immigration group, notes that one congressional hearing on the issue was held in 1995, shortly after California voters passed a ballot initiative to prevent illegal immigrants from availing themselves of public education, health care, and other social services. (A federal court ultimately struck down the measure, known as Proposition 187.) "It's the same argument -- about how much all these kids cost to educate and provide health insurance," says Waslin.

The same fears -- that immigrants are exploiting the U.S. welfare state, overpopulating the country, and taking away opportunities -- drive the current debate, amplified by a sluggish economy and a hyperpartisan and polarized political climate. Washington has spent more than two decades trying to reform the country's outdated immigration laws in light of changing demographics and rapidly globalizing economy, most recently in 2007, when George W. Bush's administration tried to pass an overhaul. At the time, a group of Republicans had cast themselves as pro-immigrant reformers, citing findings like the 1997 National Research Council study, which showed that U.S. immigrants -- both legal and illegal -- paid an average of $80,000 more in taxes than they consumed in public services in the long term. They even argued that higher fertility levels among immigrants would actually bolster the country's economy by making the labor force younger and healthier.


Threatened by such heresy from within the GOP, anti-immigration activists hauled out hot-button issues like "birthright citizenship" to fan the flames of the conservative opposition during the Bush years, successfully using such tactics to defeat Bush's immigration plan and push pro-immigrant Republicans like Senators John McCain and Graham further to the right. Conservative flamethrower Tom Tancredo, then a Republican congressman from Colorado, introduced his version of the "anchor babies" bill in 2007, though like all its predecessors it was a political act rather than a legislative one. The topic is "like a code word -- it activates this whole bundle of issues about immigrants gaming the system and so on," says Rosenblum. "It's very strategic and calculated."

It also glosses over some seriously complex issues. The hard fact is that the U.S. economy has changed since the 19th century, when explosive industrial growth required a constant incoming migrant workforce. There's overwhelming evidence that though encouraging immigration improves a country's economic productivity and average income in the long term, the immediate impact is more variable. In a recent study, economist Giovanni Peri shows that, during times of economic recession, immigration has a negative impact on native employment and average income rates in the short-term -- largely because the legal immigration system isn't flexible enough to adapt to the needs of the labor market. Of course, unchecked immigration and naturalization rates aren't solely responsible for the feeble state of the modern U.S. economy. Still, any new policy on both legal and illegal immigration must fit the fluctuating, modern-day needs of the economy and labor market, rather than simply responding to the hopes or fears of the American psyche.

The American public knows this: The majority supports an immigration overhaul that includes both a pathway to legalization for illegal immigrants and worker-visa reforms. The problem is that congressional leaders, cowed by the explosive politics surrounding the issues and recalcitrant lawmakers (including middle-of-the-road Blue Dog Democrats as well as Republicans), insist a comprehensive bill would be impossible to pass in the near future. If legislators ever took up the issue in seriousness, there might even be a place for reconsidering birthright citizenship on its socioeconomic merits. Countries such as New Zealand and Britain have modified their birthright citizenship laws to require that one parent is a citizen or a legal permanent resident, for instance. But as long as the discourse amounts to describing immigrant women giving birth in terms that recall farm animals -- "dropping a child" as a horse might "drop" a foal -- the movement seems doomed to irrelevance. If Lindsey Graham truly wants to change the 14th amendment, in other words, he'd be best off keeping his bright ideas to himself -- at least for now.

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