One of my two week summer trainings in the California Army National Guard was to Panama for a mission referred to as Nuevos Horizontes (New Horizons in English) in 2001. The purpose of this mission was nation building for Panama after the invasion to remove Manuel Noriega from power in 1989. Our California National Guard medical unit provided medical support for Army Engineers building roads and schools in Panama. Our Aid Station was adjacent to the mess hall, showers and LZ (landing zone).

One day the troops working on the LZ carried a young sergeant writing and thrashing about yelling, “Check Fire, Check Fire.” I immediately knew what the problem was and I was the only person with mental health as a specialty on this rotation. We were in Panama, but he was in the Gulf War in Iraq in his mind. The doctor on this rotation was a surgeon; this was not her line of specialty. We put him on a litter and I called for the pharmacy tech. I asked do we have Thorazine. The answer was no. I asked do we have Compazine (same family, high doses may be helpful). The answer was again no. Do we have Benadryl for injection? The answer was yes. I ask for 200 mg for injection (a hefty dose but this was an emergency situation). I got the injection ready then asked the surgeon, “Is this OK?” She nodded her approval.

After a short time the Benadryl began to sedate the psychotic soldier. After he calmed down he confirmed my suspicions. He had served in the Gulf War and was the sole survivor of a friendly fire incident that killed the rest of his platoon. We continued to sedate him with Benadryl (use what you have) overnight and I discussed medivacing him for psychiatric treatment; he certainly had a VERY SEVERE case of PTSD. The surgeon refused saying she would talk to him every day instead. I had extensive experience working in the VA and knew I was much more qualified to help this soldier if the surgeon did not agree with sending him for proper treatment.

I developed a new plan. I went to the Base Commander with a request to use the mess hall after hours for a PTSD information session. He of course agreed (I did not tell him about my conflict with the surgeon). I made flyers announcing this session and of course gave one to the recently psychotic sergeant. Many combat veterans came to my information session where I described the symptoms of PTSD and made referrals to VA Vet Centers for continuing care. Many of the soldiers who attended my information session did not know help was available and were grateful to have referrals for PTSD.

As an aside, when I returned home from Vietnam I had a bit of combat stress. I refused to go in the park fearing I might be ambushed. During this Panama rotation a group took a walk thru the jungle during off hours to visit a nearby beach. I was fearful the same thing may happen if I were exposed to the jungle however went along with the program. There was no more paranoid; time heals many things.