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JOHNSTOWN, Pa. -- In the years since he had returned from a volunteer tour in May 1970, Elmer "Snubby" Burket was a self-described workaholic, sharing his life with his wife, raising a son, keeping up his house and always taking jobs where he could be by himself -- milkman, dock worker, pipe cutter, stock-room staffer -- as he tried to just slip back into society and put the war behind him.
But the anger would not fade away.
"I just couldn’t live with the monster inside of me that was eating me alive," he said. "I hated everyone, everything, and most of all I hated myself. I just wanted to get a knife and cut myself wide open and get this monster out of me."
Burket, who fought mostly around Pleiku in Vietnam’s Central Highlands, could not escape the why-did-I-live question that came along with returning home from Vietnam after seeing so many friends die in battle.
"Survival guilt was the biggest thing," Burket said. "You really, really struggle with survival guilt. It’s like you shouldn’t be here. You know what I mean? You shouldn’t have made it through what happened and what went on. It wasn’t fair that those guys lost their lives and I didn’t. Why was I saved? Why was I spared?"
Post-traumatic stress disorder rates are fairly consistent across veteran populations from the United States’ modern-era wars.
About 11% to 20% of those who served in Operation Iraqi Freedom and Operation Enduring Freedom, along with 12% of Gulf War veterans, have the condition in a given year, according to the U.S. Department of Veterans Affairs’ National Center for PTSD. About 15% of Vietnam veterans were currently diagnosed at the time of the most recent study in the late 1980s.
The disorder manifests itself in various ways, including depression, anger, substance abuse and even suicide, with 17 U.S. veterans on average taking their own lives every day, per a 2019 Department of Veterans Affairs study.
Johnstown-based Veterans Community Initiative works with Cambria County Veterans Court Program, helps veterans find professional counseling or points them toward “rap groups”- where veterans can open up about their experiences with others who would understand.
"We saw people coming forward for the first time that - for years and years - had never talked about it," said Tom Caulfield, director of Veteran Community Initiatives in Johnstown. "Their co-workers, in some cases even their family, didn’t know what they had done in the military or even if they had been in the military at some time. It was like an outlet for them finally of getting something. Not that they necessarily trusted each other or anyone. But, at least now, they started to have a vehicle."
Ellen Stewart, a licensed professional counselor with Croyle-Nielsen Therapeutic Associates Inc., helps veterans who are living with post-traumatic stress disorder after experiencing the horrors of war work through issues that are often rooted in childhood experiences.
The goal is to "find out why isn’t the pressure valve working," Stewart said, adding that empathy for the client’s experiences is important.
"I’ve never seen someone turn into a pink mist vapor, but my clients have," she said. "And they understand something I don’t have, so I just treat that with respect and say, ‘I don’t understand that. I do understand this. But I don’t know that. But I have respect for it.’ "
About 20% of Stewart’s clients served in the military, and PTSD is more common among the veterans she treats than in the rest of clients. The disorder manifests itself in a variety of ways - from obvious violent outbursts to subtle signs that might not even be noticeable to untrained eyes.
"They’re the ones that back into the parking space," said Stewart when talking about veterans with the disorder. "They never pull in forward. They can tell you who in a restaurant owns a gun and who doesn’t own it. They have learned to read and to be hyper-vigilant because they had to because, if they weren’t, they were going to be dead.
“So how do you turn that off? And why are some people more hot-wired? Why do some people have the ability to let go of it and other people don’t?"
She added: "We go through the process of that trauma," Stewart said. "We give their trauma voice and we find a resolution and reprocess those memories so that they’re not triggered all the time. It’s almost like digging up land mines."
Matthew Paterson was involved in a firefight on his first patrol in Iraq.
He still can sense the shockwave from a rocket explosion during another combat moment - the wind, the ringing in his ears, the white light.
The gun battles, the explosions, pointing weapons at children and the mutilated bodies all became part of day-to-day life for Paterson, a 2000 Greater Johnstown High School graduate, who now, at 38, lives in Conemaugh Township, Somerset County.
"You turn into an animal," he said. "That’s the best way to describe it. After taking contact and you start fighting, you turn into an animal -- to where you do what you have to do to survive.”
But Paterson has found ways to keep the angry beast at bay -- talking through his issues in therapy, creating flow art paintings, volunteering at the Cambria County Veterans Memorial Museum, staying close to his home and being a bit of a self-described hermit.
He also shares his story with fellow veterans and other people, so they can learn the reality about PTSD.
Paterson also wants those he encounters to know "it’s OK to have PTSD."