Suicide by Rental Truck: Why the U.S. Gets Violent Wake-Up Calls From Vets

Recent headline-making events in two of America’s most famous party-hardy cities sent us back to our well-thumbed copy of Touching the Dragon, a 2018 memoir by James Hatch.

Never heard of Hatch? Well maybe that’s because he spent much of his military career as a Navy SEAL “warfighter” always “close to the enemy” in Bosnia, Africa, Iraq, and Afghanistan, but never seeking headlines. A survivor of 150 combat missions, Hatch returned home in bad mental and physical shape; in fact, his crippling wounds of war ended his career. Then, adding insult to injury, he was “forced to reintegrate into a society that I had spent two decades defending, but in which I didn’t feel I had a place.”

In his insightful and prophetic book, Hatch warned that his generational cohort of “special operators,” who experienced a similar “volume of fighting,” were now facing: “A serious volume of aftermath. Marriages falling apart. Alcoholism. Guys getting kicked out of their houses. Guys drowning in opioids. The real recoil hasn’t even hit yet.”

During this holiday season, that “recoil” was definitely felt in different—but now sadly familiar ways—by the dozens of civilians left dead or injured in Las Vegas and New Orleans.

The final missions of Army Sergeants Mathew Livelsberger and Shamsud-Din Jabbar left millions of other Americans scratching their heads.  Why would two much-saluted young men—who served their country so honorably at home and abroad, for a combined total of 33 years—both rent trucks in two different locations, within the same week? And then turn them into instruments of mass and/or self-destruction?

In notes left behind, Livelsberger, a decorated Green Beret combat veteran, insisted that his action “was not a terrorist attack” but rather “a wake-up call” necessary because “Americans only pay attention to spectacles and violence.” His declared goal was “to cleanse my mind of the brothers I’ve lost and relieve myself of the burden of the lives I took.” Jabbar, a former information technology specialist, left video messages announcing that he had switched sides in the “war between the believers and the disbelievers” and had become a follower of ISIS.

Asymmetrical Warfare

The two soldiers spent a total of four tours of duty in Afghanistan, where only one set of combatants had B-52 bombers, fighter jets, helicopter gun-ships, long-range artillery, and tanks. As a result, both Jabbar and Livelsberger were familiar with key tools of the “asymmetrical warfare” waged by the Taliban (suicide vests, improvised bombs, and speeding vehicles packed with explosives).

Back home, they geared up, in equivalent fashion, and became domestic terrorists. But their actions were definitely not without precedent. In fact, the most reliable predictors of who will perpetrate mass violence in modern-day America is military service.

According to the University of Maryland’s National Consortium for the Study of Terrorism and Responses to Terrorism (START),  “A U.S. military background is the single strongest individual-level predictor of whether a subject …in the PIRUS ( Profiles of Individual Radicalization In the United States) data is classified as a mass casualty offender.” A record of military service, START explains, is, in fact, an even more reliable predicator than mental health problems or a criminal history.

Consider the long list of those who preceded Din Jabbar and Livelsberger down the same path. In 1995, Gulf War veteran Timothy McVeigh parked his Ryder truck, with a home-made bomb, outside the federal building in Oklahoma City. He walked away, leaving 168 people dead and 680 injured, a crime for which he was executed in 2001.

Jabbar, who  contemplated murdering his own estranged family,—seemed to be channeling the murderous energy of another quiet  Texan, Charles Whitman.  A former Eagle Scout and Marine sniper, Whitman killed 15 people and injured 31 during a 1966 shooting spree conducted from the clock tower of the University of Texas at Austin. (On his way to campus, he did fatally stabb his wife and mother.)

More recently, in 2009, at Fort Hood, Texas, Major Nidal Hasan, an Army psychiatrist, murdered 12 soldiers and one civilian, and injured 30 others, a crime for which he is now on death row. In March of 2018, Albert Wong, who saw combat in Afghanistan (where Hasan was headed before his killing spree), shot himself and three care-givers at a veterans clinic in Yountville, California.

 That same year, ex-Marine Ian David Long, decorated for his service as a machine gunner in Afghanistan, killed twelve people at a country and western bar in Thousand Oaks, California. And just sixteen months ago, in Lewiston, Maine, Army Reservist Robert Card slaughtered 18 of his neighbors at a local bowling alley, while wounding 13 others. Both Card and Long killed themselves to avoid capture.

If readers are noticing a pattern here, it’s because there is one.  While veterans’ advocates correctly point out that the majority of former service members are certainly not mass murderers, it is also true that a tiny subset of veterans have been responsible for a disproportionate number of mass shootings and other violent attacks.

  Military Socialization

One big factor behind that data point is their military training and indoctrination.  As retired Army Lieutenant Colonel David Grossman explains in his book, On Killing: The Psychological Cost of Learning to Kill in War and Society, the cultivation of anger and aggression is critical to overcoming normal human resistance to killing other people. This becomes part of the socialization of all military recruits, even those who never see combat.  For those who do, the battlefield deaths of close friends and comrades, can, according to Grossman, further “enable killing.”

As clinical psychiatrist Jonathan Shay reported in his 1994 study Achilles in Vietnam, “replacement of grief by rage has lasted for years and become an entrenched way of being” for many sufferers of combat-related Post Traumatic Stress Disorder (PTSD) Researchers at the VA Puget Sound Health Care System in Seattle, Washington, found that, among Iraq and Afghanistan veterans, anger was “independent from, albeit related to, ptsd.”

Veterans who had been diagnosed with ptsd or “subthreshold ptsd” reported increased levels of anger, hostility, and physical aggression, particularly in their intimate relationships.

If service members have a history of behavioral problems, before enlisting, being in the military can make them worse. Albert Wong suffered from PTSD, which is why he was a patient of Pathway Homes (the northern CA treatment center made famous in Thank You For Your Service). But, like Ian David Long, his mental health issues predated his active duty.

Both Wong and Long were troubled children and adolescents. Wong was raised by a series of friends and foster parents and had difficulty in high school. According to one news account, friends and neighbors did not report their concerns about Long’s aggressive behavior when he was a teen-ager because they didn’t want to spoil his dream of enlisting to “kill for his country.”

Better screening of recruits like Wong and Long might have kept them out of the military.  Unfortunately, when both signed up—thanks to simultaneous wars in Iraq and Afghanistan—the U. S. military was suffering from a “serious recruitment crisis.” As a result, screening and drug testing standards were relaxed and even a felony conviction was not necessarily disqualifying.  In 2017, the Army even waived a previous ban on signing up young men and women with a history of “self-mutilation, bipolar disorder, depression, and drug and alcohol abuse.”

Traumatic Brain Injury 

Sevice-related traumatic brain injury (TBI) can be a toxic affliction of former soldiers with past combat exposure, like Livelsberger, and even those, like 40-year old Robert Card, who never served abroad. Dave Philipps’ investigative reporting in The New York Times, has revealed how Card, an experienced Army Reserve grenade instructor, was subject to repeated blast injuries that seriously damaged his brain. The result was increasingly erratic and, ultimately, very deadly behavior.

Philipps’ latest reporting has focused on Livelsberger’s blast exposure in training and when deployed. An Army nurse and former girlfriend, Alicia Arritt, had no trouble recognizing his symptoms—anger, aggression, depression, and inability to concentrate – because she had encountered them before among her  patients still on active duty (as Livelsberger was until his “wake up call” in Las Vegas).

The Department of Defense (DOD) tends to downplay such links, at the time and after-the-fact. In the Card case, it took an independent commission, appointed by the Governor of Maine, to confirm that Card’s superior officers failed to heed warnings about him from fellow soldiers, concerned family members, and mental health clinicians.

During his treatment at a civilian psychiatric hospital, three months before his rampage, Card was found to be experiencing psychosis, having homicidal thoughts, and even had a “hit list.”  Last Fall, on the first anniversary of the Lewiston massacre, survivors and relatives of victims notified the DOD of their intention to sue for damages.  As the group’s lawyer asked, “How many other Robert Cards are out there right now, suffering from mental illness, with ready access to assault weapons?”

Fortunately, as part of the just approved National Defense Authorization Act (NDAA) Congress has finally required the DOD to set  limits on blast exposure, consider its impact on the brain in designing  new weaponry, and “standardize and improve the detection, treatment, and reporting” of blast injuries.

These harm reduction measures won’t make medical detection any easy because imaging techniques don’t always confirm the impact of blast injuries. That’s why friends, family members and care givers for service members or veterans need to better understand and be alert for symptoms like those displayed by Livelsberger and Card

Access to Skilled Care?

 It’s even more important to expand access to public hospitals and clinics operated by the Department of Veterans Affairs (VA). Due to restrictive eligibility rules legislated by Congress, the VA-run Veterans Health Administration (VHA) currently covers only half of the nation’s 19 million former service members.

 Unlike the DOD, which just ignores the impact of PTSD, blast injuries, and other service-related injuries until forced to acknowledge them, the VA has an actual track record of treating mental and physical health problems.

Unfortunately, President-elect Trump and former Georgia Congressman Doug Collins, his nominee for VA Secretary, have little appreciation for the VA’s essential role. Rather than supporting its direct care and related research functions, they will be expanding a costly and largely unnecessary network of private sector providers, known as the Veterans Community Care Program (VCCP).

Before even more VHA patients accept referrals to the VCCP, they should check out a research study published this month in Health Affairs. The headline sums up its findings: “Veterans May Be Seeing Lower-Quality Clinicians in the VA Community Care Network.” Among the documented shortcomings of outsourced care is the fact that most doctors, in private practice, are not familiar with links between blast injury and depression or PTSD and related anger and aggression.

Dr. Harold Kudler, a Duke Medical School professor, is a skilled care-giver who does recognize those symptoms based on years of experience with VA patients. As he told us: “It’s important to remember that neither PTSD, traumatic brain injury, moral injury, depression or even schizophrenia are likely to make you a mass shooter. That said, these recent events in Las Vegas and Louisiana, like so many others, make it clear the burden that so many of our veterans bear.”

Without a properly functioning healthcare system of their own, too many former soldiers will be left to carry that burden themselves. If they crack under the strain of doing so, the consequences can be devastating– not only for their friends, family, and former comrades, but everyone else on the receiving end of a “mass casualty “event.

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