Quote Originally Posted by Rob Thornton View Post
We also need to consider scale - just the sheer numbers of men and women exposed to wartime conditions in places that even when somewhat stable are different enough from most of America to have you looking over your shoulder. I think when training is as it should be, and entry criteria are held high, we build the foundations for physical and moral strength to see most people through, but as war is sustained we fight the battle of exhaustion in many ways - while units and leaders are doing their very best to uphold standards, there is still a significant strain on the individual, their families, communities, maybe even the national psyche.
Rob, Slap, Ken--
Part of my reason for suggesting a look at the first responder community is the issue of scale and continuous contact with tragedy. I sometimes wonder how those folks can continue to go to work day after day, night after night, given the horrific stuff they deal with. I complete agree with folks' points about what I'll summarize as a "shattering of our sense of the normal." This "out of the normal" becomes the normal for those folks who routinely work trauma events. Ever notice how "warped" a sense of humor health care workers have?

Here's a couple of other semi-related items--not about PTSD issues, but about "Staying the Distance" and morale in trying circumstances:

A sidebar related to health care workers (credibility claim: my wife's a nurse): Acute care workers usually get to see their patients recover and go home. Long term care (nursing homes) workers aren't so lucky--their charges just get worse and worse intil the day they day. This is not a trauma issue, but a different form of job-related stress that may be the reason why we hear about the cases of elder abuse in nursing homes (relates to the lashing out against "civilians" done by troops in the COIN world).

And one other on customer service employees:
The turnover/churn rate in customer service related jobs (particulalrly call center folks) is probably one of the highest of any occupation. I think this has to do with the attitude displayed by those that call and complain--when your clientele doesn't value you, you tend not to value yourself and look for work elsewhere to boost your self esteem. Think about this in the context of folks at home judging the job being done by our deployed forces as a reason associated with our reported declining enlistment/re-enlistment/officer retention crises.