At 0800 hours yesterday, the lobby of the Veterans Affairs Baltimore Medical Center was filled with dozens of soldiers recently back from Iraq, dressed in their combat fatigues and reporting for yet another one of their duties - to be sure they are holding up both physically and mentally from what they went through in the war zone.
About 100 Maryland National Guard troops who returned from missions in Iraq in February and March had time to sit down with medical professionals - doctors, nurse practitioners, physician assistants - to discuss any enduring aches and pains, any war-related stress they might have. They were told they were entitled to five years of free medical treatment from the VA Maryland Health Care System and anyone who felt the need could set up an appointment for a full mental health evaluation.
"It doesn't mean they're crazy," said VA spokesman Michael E. Dukes. "It means they're smart because they're being taken care of."
Just as it trained these troops to go to war, the military has been training them to return home. It is not always the simpler of the two tasks.
"The intent is that no one falls through the cracks and has any lingering problems from deployment," said Lt. Col. Charles Kohler, a spokesman for the Maryland National Guard. "The soldier came to us whole, and we want him to return whole."
Soldiers were warned, while they were still overseas, that they might find it difficult to readjust to the simple tasks of daily life back in the United States. Soon after they return, the military makes sure they connect with the soldiers' families, offering counseling to both the soldiers and their spouses.
They are told it is normal to have trouble sleeping, to feel down, to be easily startled. What matters is that they learn to recognize when those problems have gone on too long or when their way of handling them - self-medicating with alcohol, lashing out in anger - has taken a turn down a hazardous path.
Maryland National Guard Spc. Chris Leins, 28, said he gets more nervous dealing with crowds now than before he went to Iraq.
"Obviously, you don't trust anybody [in Iraq] and you bring that back here ... and you're leery of everyone," said Leins, a drug and alcohol counselor in Wilmington, Del. "They've worked with us to help us calm our nerves a bit and respond to normal, everyday situations in a normal way."
The military has been working to make sure the transition back to families, jobs and communities is as smooth as possible, knowing that statistics show returning guard members often face divorce or separation in their first year home or drop out of college in their first semester back. Nearly half report psychiatric problems in the first 100 days home.
Veterans Affairs in Maryland has held these screening events for the past 18 months, and there have been occasions when soldiers have been admitted to the hospital with physical problems and committed with severe mental health problems.
Lorie J. Morris, a clinical psychologist at VA, said she teaches these veterans that they have gone through a biological shift. They react to things most civilians would ignore. They are quick to startle and to respond. These skills, while helpful in a war zone, will only cause trouble at home, she said.
She knows some veterans will get agitated if they see a soda pop can on the street - potentially an explosive device if seen in Iraq, someone's litter here in Baltimore. She's even heard of some who would drive off the road to avoid the can, a common response in Iraq and a dangerous one here.
"We teach people this is a normal shift and behaviorally, you need to respond differently, but first you have to be aware of what's going on," she said.
"When you're deployed and you're overseas, you're so focused on your mission, literally everything is taken care of for him - his laundry, his food," Kohler continued. "When you get home, you've got to pick up kids at sports games, you have to pick up groceries, you're going from the simple to the complex, and people don't think of it that way."
When Spc. Keith Lee, 28, enters a store, for example, he looks to see who is around him and makes sure he knows where the nearest exits are - something that was vital in Iraq. "You get used to walking around with a weapon all day," said Lee, who lives with his wife and two children in Cockeysville. "The first day I waked out of my house, I felt like I was missing something."
Staff Sgt. Mark Pheabus said re-entry hasn't been difficult for him. He's single. He went straight back to working security at Camp Fretterd in Reisterstown upon return.
"Some of these guys lost marriages, families, businesses," he said. "Some of them have had problems. You have to feel bad for some of them."