|The New York Times nytimes.com
Losing Private Dwyer
By LAWRENCE DOWNES
The photo below captures everything that Americans wanted to believe about the Iraq war in the earliest days of the invasion in 2003. Pfc. Joseph Dwyer, an Army medic whose unit was fighting its way up the Euphrates to Baghdad, cradles a wounded boy. The child is half-naked and helpless, but trusting. Private Dwyer’s face is strained but calm.
If there are better images of the strength and selflessness of the American soldier, I can’t think of any. It is easy to understand why newspapers and magazines around the country ran the photo big, making Private Dwyer an instant hero, back when the war was a triumphal tale of Iraqi liberation.
That story turned bitter years ago, of course. And the mountain of sorrows keeps growing: Mr. Dwyer died last month in North Carolina. He was 31 and very sick. For years he had been in and out of treatment for post-traumatic stress disorder and addiction. He was seized by fearful delusions and fits of violence and rage. His wife left him to save herself and their young daughter. When the police were called to Mr. Dwyer’s apartment on June 28, he was alone. They broke down the door and found him dying among pill bottles and cans of cleaning solvent that friends said he sniffed to deaden his pain.
He had been heading for a disastrous end ever since he came home.
Two of his best friends were Angela Minor and Dionne Knapp, fellow medics at Fort Bliss, near El Paso, Tex. For a while, they were part of a small, inseparable group that worked together, ate out, went to movies and called one another by their first names, which is not the military habit.
Joseph was a rock, Ms. Minor said, a guy who would change your oil and check your tires unasked and pick you up by your broken-down car at 3 a.m. Ms. Knapp said he was like an uncle to her son, Justin, who was having trouble in kindergarten and brightened whenever Mr. Dwyer went there to check on him.
Ms. Knapp was called up to Iraq, but Mr. Dwyer insisted on taking her place, because she was a single mom. He had no children at the time, and besides, he had enlisted right after 9/11 just for this. He went and stunned everybody by getting his picture all over the newspapers and TV.
A few months later, he was home. He was shy about his celebrity. He was also skinny and haunted. Ms. Minor said he was afraid. Ms. Knapp said paranoid was more like it.
It didn’t help that El Paso looked a lot like Iraq. Once he totaled his car. He said had seen a box in the road and thought it was a bomb. He couldn’t go to the movies anymore: too many people. In restaurants, he sat with his back to the wall.
He said that Iraqis were coming to get him. He would call Angela and Dionne at all hours, to talk vaguely about the “demons” that followed him all day and in his dreams. He became a Baptist, doggedly searching Scripture on his lunch hour — for solace. His friends knew he was also getting high with spray cans bought at computer stores.
“He would call me in the middle of the day,” Ms. Minor said. “I’d be like: ‘Why are you at Best Buy? Why aren’t you at work?’ I could tell he’d been drinking and huffing again.”
His friends tried an intervention, showing up at his door in October 2005 and demanding his guns and cans of solvent. He refused to give them up.
Hours later, gripped by delusions, he shot up his apartment. He was glad when the SWAT team arrived, Ms. Knapp said, because then he could tell them where the Iraqis were. He was arrested and discharged, and later moved to Pinehurst, N.C. His parents tried to get him help, but nothing worked. “He just couldn’t get over the war,” his mother, Maureen, told a reporter. “Joseph never came home.”
It’s not clear what therapy and medication could have saved Mr. Dwyer. He admitted lying on a post-deployment questionnaire about what he had seen and suffered because he just wanted to get back to his family. Ms. Minor said he sometimes skipped therapy appointments in El Paso. One thing that did seem to help, Ms. Knapp and Ms. Minor said, was peer counseling from a fellow veteran, a man who had been ambushed in Iraq and knew about fear and death. But that was too little, too late, and both women say they are frustrated with the military for letting Mr. Dwyer slip away.
Private Dwyer, who survived rocket-propelled grenades and shocking violence, made his way back to his family and friends. But part of him was also stuck forever on a road in Iraq, helpless and terrified, with nobody to carry him to safety.
|From The Army Times armytimes.com
Medic in famous photo dies after PTSD struggle
By Kelly Kennedy - Staff writer
Posted : Tuesday Jul 8, 2008 6:35:20 EDT
During the first week of the war in Iraq, a Military Times photographer captured the arresting image of Army Spc. Joseph Patrick Dwyer as he raced through a battle zone clutching a tiny Iraqi boy named Ali.
The photo was hailed as a portrait of the heart behind the U.S. military machine, and Doc Dwyer’s concerned face graced the pages of newspapers across the country.
But rather than going on to enjoy the public affection for his act of heroism, he was consumed by the demons of combat stress he could not exorcise. For the medic who cared for the wounds of his combat buddies as they pushed toward Baghdad, the battle for his own health proved too much to bear.
On June 28, Dwyer, 31, died of an accidental overdose in his home in Pinehurst, N.C., after years of struggling with post-traumatic stress disorder. During that time, his marriage fell apart as he spiraled into substance abuse and depression. He found himself constantly struggling with the law, even as friends, Veterans Affairs personnel and the Army tried to help him.
“Of course he was looked on as a hero here,” said Capt. Floyd Thomas of the Pinehurst Police Department. Still, “we’ve been dealing with him for over a year.”
The day he died, Dwyer apparently took pills and inhaled the fumes of an aerosol can in an act known as “huffing.” Thomas said Dwyer then called a taxi company for a ride to the hospital. When the driver arrived, “they had a conversation through the door [of Dwyer’s home],” Thomas said, but Dwyer could not let the driver in. The driver asked Dwyer if he should call the police. Dwyer said yes. When the police arrived, they asked him if they should break down the door. He again said yes.
“It was down in one kick,” Thomas said. “They loaded him up onto a gurney, and that’s when he went code.”
Dwyer served in Iraq with 3rd Squadron, 7th Cavalry Regiment as the unit headed into Baghdad at the beginning of the war. As they pushed forward for 21 days in March 2003, only four of those days lacked gunfire, he later told Newsday. The day before Warren Zinn snapped his photo for Military Times, Dwyer’s Humvee had been hit by a rocket.
About 500 Iraqis were killed during those days, and Dwyer watched as Ali’s family near the village of al Faysaliyah was caught in the crossfire. he grabbed the 4-year-old boy from his father and sprinted with him to safety. Zinn grabbed the moment on his camera. The image went nationwide and Dwyer found himself hailed as a hero.
He did not see it that way.
“Really, I was just one of a group of guys,” he later told Military Times. “I wasn’t standing out more than anyone else.”
According to Dwyer, he was just one of many who wanted to help after the terrorist attacks of Sept. 11, 2001. He’d grown up in New York, and when the towers came crashing down, he went to see a recruiter.
“I knew I had to do something,” he said. Just before he left for Iraq, he got married.
But when he returned from war after three months in Iraq, he developed the classic, treatable symptoms of PTSD. like so many other combat vets, he didn’t seek help. In restaurants, he sat with his back to the wall. He avoided crowds. He stayed away from friends. He abused inhalants, he told Newsday. In 2005, he and his family talked with Newsday to try to help other service members who might need help. He talked with the paper from a psychiatric ward at Fort Bliss, Texas, where he was committed after his first run-in with the police.
In October 2005, he thought there were Iraqis outside his window in El Paso, Texas. When he heard a noise, he started shooting. Three hours later, police enticed him to come out and no one was injured.
Dwyer promised to go to counseling, and promised to tell the truth. He seemed excited about his wife’s pregnancy.
But the day he died, he and his wife had not been together for at least a year, Thomas said.
And almost exactly a year ago — June 26, 2007 — Dwyer had again been committed to a psychiatric ward. Thomas said police received a 911 call that Dwyer was “having mental problems relating to PTSD.” “We responded and took him in,” Thomas said. “He’s been in and out.”
Military Times could not reach Dwyer’s family, but his wife, Matina Dwyer, told the Pinehurst Pilot, “He was a very good and caring person. He was just never the same when he came back, because of all the things he saw. He tried to seek treatment, but it didn’t work.”
She told the paper she hoped his death would bring more awareness about PTSD.
In 2003, Dwyer was still hopeful about the future, and about his place in the war.
“I know that people are going to be better for it,” he told Military Times. “The whole world will be. I hope being here is positive, because we’re a caring group of people out here.”
|From FOX 17 WXMI wxmi.com
From war hero to war haunted
LI vet depicted in famous struggle with menacing stress disorder that escalated to a standoff
BY INDRANI SEN, STAFF WRITER
October 23, 2005
Army Spc. Joseph Dwyer angled a mirror out the back window of his apartment in El Paso, Texas, trying to make out the Iraqis in the evening gloom. He couldn't see them, but he felt that they were out there somewhere, ready to attack.
Holding his 9-mm handgun tight, the 29-year-old medic from Mount Sinai phoned in an air strike using military code. He directed the fighter jets to his own street address.
Then he heard a noise from the roof - maybe an Iraqi trying to get in? - and that's when Dwyer began firing.
Nobody was hurt in the three-hour standoff Oct. 6 in which Dwyer, deep in a post-traumatic stress-induced delusion, barricaded himself into his apartment, fighting off an imaginary Iraqi attack.
Back then, an image of hope
So much has changed for Joseph Dwyer. Only two and a half years earlier, in March 2003, a startling battlefield photograph of him cradling an injured Iraqi child showed America a hopeful image of the new war.
Dwyer, who is still in the service, is being treated by psychiatrists on the Army base in Fort Bliss, Texas. He was released on bail and faces a misdemeanor charge of discharging a firearm in a municipality.
During his 92 days in Iraq, Dwyer was attached temporarily to the 3rd Squadron of the 7th Cavalry Regiment of the 3rd Infantry Division. The unit scouted for the division which saw heavy combat in the first days of the war as U.S. forces swiftly moved north from Kuwait to Baghdad. One Army officer called the unit "the tip of the tip of the spear."
"It took 21 days to get to Baghdad," Dwyer said last week, speaking by telephone from the William Beaumont Army Medical Center in Fort Bliss, Texas. "We had four days that we didn't get shot at."
Dwyer came back to the United States in June 2003, and visited his family on Long Island on July 4. He seemed happy to be back and easy to laugh, but he was also gaunt and fidgety, said his sister, Christine Dwyer-Ogno, 38, of Mount Sinai. His wife, Matina, declined to comment.
"We didn't think of his mental health," said Dwyer-Ogno. "We were just so glad to have him back in our arms."
He was back, but he wasn't the same, and he continues to struggle. Dwyer can no longer go to movies or other crowded public places. At restaurants, he'll only sit facing the door, with his back to the wall. A month ago in Texas, he crashed his car when he swerved to avoid what he thought was a roadside ambush by Iraqis.
Concerned about Dwyer's increasingly strange behavior and his use of inhalants to get high, three friends staged an intervention days before the El Paso standoff. They tried unsuccessfully to persuade him to give up his weapons and to get the help he needed.
He knew on some level that they were right, Dwyer said, but he still couldn't do it.
"I'm a soldier," he said. "I suck it up. That's our job."
Dwyer is one of many Iraq and Afghanistan veterans who suffer from post-traumatic stress disorder, or PTSD. Known in previous wars as "shell shock" or "combat fatigue," PTSD was identified as a psychiatric disorder in 1980 after its symptoms were seen in returning Vietnam veterans. Those with PTSD often relive the stressful event in nightmares or flashbacks; avoid activities, places, or people that are reminders of the trauma; and have a sense of perpetual vigilance, as if on sentry duty. PTSD is often compounded by substance abuse.
Almost one in six soldiers returning from Iraq have symptoms of PTSD, major depression or anxiety, a study published in July of last year in the New England Journal of Medicine found. If the study, led by Department of Defense researcher Col. Charles W. Hoge, is an accurate predictor, more than 25,000 of the 154,000 who have served in Iraq will have mental health problems.
Always a quiet kid, Dwyer enjoyed a happy childhood on Long Island, family members said. Son of a New York City Transit Police lieutenant, Dwyer loved to fish, and he played golf for Mount Sinai High.
He signed up for the Army two days after the Sept. 11, 2001, attacks. At the time, he was was living in North Carolina, working as a transporter at a hospital and considering going into a nursing program. But his plans changed when his older brother, Patrick, lost two close colleagues in the attacks.
"They knocked my towers down," Dwyer said. "So I was ready to go."
In March 2003, a week into the Iraq war, it's easy to see why the photograph of Dwyer cradling an Iraqi boy struck a chord and why it ran in newspapers nationwide. Dwyer's face is worried but resolute, his mouth slightly open as if gasping for air. His eyes, behind square glasses, focus on a distant point - perhaps the field hospital where he later treated the boy's broken leg. The boy, about 4 years old, wears nothing but a stained jacket, a kaffiyeh scarf tied around his leg and a grimace of terror.
But Dwyer hated the fame the picture earned him.
"To be honest . . . I was embarrassed by it," he said. "I saw so many heroic things like that. It kind of made me stand out as the glory boy, but really it was one team, one fight."
An indelible image
To Dwyer, the moment captured in that famous photo is not the most significant among the blur of impressions that stay with him from that day in a farming village by the Euphrates River.
Ali, the boy in the picture, was struck by shrapnel when an enemy weapons cache blew up in a firefight, Dwyer said. Ali's mother, older brother and grandfather also were hurt.
Dwyer remembers daylight coming after a night of shooting and his awful realization that there were homes and families in the firing line. He remembers the awkward modesty of Ali's pregnant mother as he checked her for bombs before she was moved to the field hospital. He remembers the quick work of another medic who pulled a piece of shrapnel "the size of a silver dollar" out of Ali's bloody knee.
What Dwyer mentions only in passing is this: During the firefight the night before, a rocket struck the Humvee he was driving. No one was killed, but something fundamental shifted in Dwyer. He started to accept the inevitability of his own death in Iraq.
"That made it easier for me to do my job," he recalls. "It made it harder to think about mom and wife, and them having to bury me, but it made it easier to do my job."
First signs of trouble
When Dwyer returned to Texas after a brief trip to Long Island, he shrugged off the attention that the picture brought him with his characteristic modesty, said Dwyer's close friend and fellow Fort Bliss soldier Angela Barraza.
In retrospect, she said, it's clear he was already having trouble coping. He seemed isolated, away from those he served overseas with because he had been temporarily attached to a unit from Fort Stewart, Ga., and returned before them when other medics became available.
"He told me every time he talked to me that he was doing good," said Dwyer's mother, Maureen Dwyer, who now lives in North Carolina. "But he didn't sound good."
He told his family very little of what he'd been through, said his father, Patrick Dwyer.
"None of us really know how to react," his father said. "None of us really know what combat is like."
Dwyer had lost 30 pounds in Iraq, and in Texas he gained back 50 with a speed that drew teasing from co-workers. He hated leaving his "brothers" behind in Iraq, he said. He obsessively scanned television and Internet images of the war, looking for faces he knew.
Unable to sleep without nightmares and trying not to worry his wife, Matina, Dwyer talked to Barraza about the disturbing images, she said.
"He would refer to the flashbacks and the things in his heads as 'demons,' " said Barraza, 23, of Sound Beach. "That scared me a little."
Struggle to make things right Even as he struggled, Dwyer tried to right himself. With Barraza and his wife, Dwyer - born a Roman Catholic - started to attend a Baptist church in Texas. Dwyer says he found God in Iraq. He also gave up his social drinking. In December 2004, he was baptized.
Of those returning Iraq and Afghanistan veterans in last year's study who screened positive for PTSD, depression or anxiety, the majority had received no treatment, the researchers found, with 23 percent to 40 percent reporting that they had. Even more disturbing to the study authors, those who screened positive were twice as likely to report concern about being stigmatized for seeking mental health services - meaning those who most needed help were least likely to seek it.
"This finding may indicate that within the military culture, 'succumbing' to PTSD is seen as a failure, a weakness, and as evidence of an innate deficiency of the right stuff," an editorial accompanying the study said.
Initially, Dwyer was getting no psychiatric treatment, something he blames himself for because, he explained, he faked the post-deployment assessment sheet he filled out on his way home through Kuwait.
"Did you see any dead bodies?" was one of the test questions, he recalled.
"Did you fire your weapons?"
"Did you see any tanks burning?"
"I just answered no, no, no, down the line," Dwyer said. "I wanted to go home, take a shower, hug my wife."
Leary of psychiatry
Even as a medic who had referred others for mental health treatment, Dwyer said, he was suspicious of psychiatrists and didn't want to look bad in front of his fellow soldiers.
In a routine medical checkup in March 2004, Dwyer said a doctor concerned about his demeanor referred him for counseling. He was put on anti-depressants, but he didn't keep up with the counseling. Over the past two years, he has had brief stints with different counselors, but until now nothing has stuck. This summer, he said, he was put in the barracks at Fort Bliss for 72 hours after he trashed his apartment trying to find an Iraqi he thought had gotten in. He then spent 11 days at Beaumont Hospital, for his PTSD and because his inhalant use was discovered.
Treatment of PTSD and other combat-related mental health issues has come a long way since the Vietnam War, said Col. Elspeth Cameron Ritchie of the Office of the Surgeon General. Soldiers receive psychological preparedness training before they go to war, education and outreach while serving in a war zone, and a post-deployment health assessment on their way home. The disorder is considered treatable, usually with psychotherapy and anti-depressant drugs (often Zoloft and Prozac).
A little over 160,000 Vietnam veterans were receiving disability payments for PTSD treatment last year, according to the U.S. Department of Veteran's Affairs, along with about 13,500 veterans from the first Gulf war and 10,000 Korean War veterans. PTSD is considered harder to treat when it has been allowed to advance over the years, or become "chronic."
"What's different is that we're seeing soldiers now at three to four months from deployment," said Charlene Thomesen, chief of mental health services at the Northport VA Medical Center. "Our hope is that by this early intervention, we'll avoid the incidence of chronic PTSD."
In the month leading up to the stand-off in which he thought Iraqis were attacking his apartment, Dwyer's behavior was erratic. One day, he was driving on a highway in Texas. A van was pulled over on the side of the road, and three men got out, one carrying what was probably a tire iron.
"Out here in El Paso, these roads kind of look like Iraq," Dwyer said. "Sometimes, when the sun hits, you get that feeling."
Dwyer's combat instinct kicked in before he could have a conscious thought.
"I was going to get ambushed," Dwyer said. "They were actually Iraqis in my mind."
Dwyer sped through a red light, swerved down a side street and into a 7-Eleven parking lot, where he hit a curb and crashed into a sign. Nobody was hurt.
Dwyer didn't tell his superiors at Fort Bliss, which he now regrets. But his friends were worried. Over the next few weeks, his wife Matina was getting scared, and Dwyer sometimes locked her out of the apartment, Barraza said. When his pastor stopped by unexpectedly, Dwyer opened the door carrying a gun in his back pocket, Dwyer himself recalled. Barraza decided to fly down to El Paso from New York and, with two other friends, confronted Dwyer.
"The first thing we said was 'We want your weapons,'" she said. He refused to give them up.
Still, Dwyer admitted he had a problem. Later in the day, he was calm enough to enjoy an outing with friends to the park. Over the next few days he talked about how much he loved his wife, how he hated what he was doing to her. He promised to get help.
The morning of Oct. 6, some 12 hours before the standoff started, Dwyer called Barraza from outside his the Fort Bliss clinic where he works. He seemed disjointed and absent-minded. He drove home, and his friends say he spent part of that day sniffing an aerosol computer-cleaning product. He says he used the time to clean his guns, and, while inhalants were in the house, "I wasn't using like I had used it before."
A colleague alerted two of Dwyer's superior officers, who came to the house and tried to persuade him to go to the hospital.
One of the officers tried to put his foot in the door when Dwyer wouldn't let him in, Dwyer said.
"That's when I pushed him out and barricaded myself into the house," he said. "That's when my mind changed, I think . . . I was in danger for my life in my mind, even though I wasn't."
Barraza puts it another way. "He was not Joseph at that point," she said. "He was a soldier in Iraq."
Getting the word out
Dwyer says he's glad to be in the hospital now, where he is receiving daily therapy sessions, and this time he says he is sticking with the program.
"I know I've got to work with them," he said. "I know I've got to tell them 100-percent the truth."
He wants to get the word out to his fellow soldiers about PTSD. He'd like them to shed their fears about the stigma, and to get help: "There's a lot of soldiers suffering in silence."
Although his tour of duty is scheduled to end in November, Dwyer said, he will probably extend it to get the treatment he needs. After that, he plans to move to North Carolina to be near his parents and in-laws, and to become a paramedic.
Dwyer is still nervous about the challenges ahead. "I know I don't need to be carrying a weapon," he said. "And I'm scared of going home without having one, even though I know probably nobody's going to attack me."
He thinks sometimes of the children he encountered in war. He has heard that Ali, the little boy from that village by the Euphrates, is walking again. He recalls the giggles of other children he met in Iraq when he let them taste Tabasco sauce from Army-issued meals on the tips of their fingers.
And he thinks of his own child, due next spring. Last week in Texas, he saw the tiny heart beat on an ultrasound device. He hopes he or she does not have to experience a war.
"What would be awesome," he said, "is if they never have to go through that."
Copyright © 2008, Newsday, Inc.
|From CNN cnn.com 07/20/08
Celebrated soldier fell victim to 'demons'
PINEHURST, North Carolina (AP) -- Officers had been to the white ranch house many times before over the past year to respond to a "barricade situation." Each had ended uneventfully, with Joseph Dwyer coming out or telling police in a calm voice through the window that he was OK.
But this time was different.
The Iraq war veteran had called a taxi service to take him to the emergency room. But when the driver arrived, Dwyer shouted that he was too weak to get up and open the door.
The officers asked Dwyer for permission to kick it in.
"Go ahead!" he yelled.
They found Dwyer lying on his back, his clothes soiled with urine and feces. Scattered on the floor were dozens of spent cans of Dust-Off, a refrigerant-based aerosol normally used to clean electrical equipment.
Dwyer told police Lt. Mike Wilson he'd been "huffing" the aerosol.
"Help me, please!" the former Army medic begged Wilson. "I'm dying. Help me. I can't breathe."
A half-hour later, he was dead.
When Dionne Knapp learned of her friend's June 28 death, her first reaction was to be angry at Dwyer. How could he leave his wife and daughter like this? Didn't he know he had friends who cared about him, who wanted to help?
But as time passed, Knapp's anger turned toward the government.
A photograph taken in the first days of the war had made the medic from New York's Long Island a symbol of the United States' good intentions in the Middle East. When he returned home, he was hailed as a hero.
But for most of the past five years, the 31-year-old soldier had writhed in a private hell, shooting at imaginary enemies, sleeping in a closet bunker and trying desperately to huff away the "demons" in his head. When his personal problems became public, efforts were made to help him, but nothing seemed to work.
This broken, frightened man had once been the embodiment of American might and compassion. If the military couldn't save him, Knapp thought, what hope was there for the thousands suffering in anonymity?
"This is what I want to do"
Like many, Dwyer joined the military in the aftermath of the September 11 attacks. The son and brother of New York cops, he wanted to save people, not kill them. So he became a medic.
In 2002, Dwyer was sent to Fort Bliss, Texas, and immediately fell in with three colleagues: Angela Minor, Sgt. Jose Salazar and Knapp. They spent so much time together after work that comrades referred to them as the Four Musketeers.
Knapp had two young children and was going through a messy divorce. Dwyer stepped in as a surrogate dad, showing up in uniform at her son Justin's kindergarten and coming by the house to assemble toys that Knapp couldn't figure out.
When it became clear that the U.S. would invade Iraq, Knapp became distraught, confiding to Dwyer that she would rather disobey her deployment orders than leave her kids.
Dwyer asked to go in her place. When she protested, he insisted: "Trust me, this is what I want to do. I want to go."
Dwyer assured his parents, Maureen and Patrick -- and his new wife, Matina -- that he was being sent to Kuwait and would probably stay far from the action.
But Dwyer was attached to the 3rd Infantry's 7th Cavalry Regiment, what one officer called "the tip of the tip of the spear."
On March 25, 2003, near Baghdad, Iraq, Army Times photographer Warren Zinn watched as a man ran toward U.S. soldiers, carrying a white flag and his injured 4-year-old son. Zinn clicked away as Dwyer darted out to meet the man and then returned, cradling the boy in his arms.
The photo -- of a half-naked boy, a kaffiyeh scarf tied around his shrapnel-injured leg and his mouth set in a grimace of pain, and of a bespectacled Dwyer dressed in full battle gear, his M-16 rifle dangling by his side -- appeared on front pages and magazine covers around the world.
Suddenly, everyone wanted to interview the soldier in "the photo." The attention embarrassed Dwyer.
"Really, I was just one of a group of guys," he told a military publication. "I wasn't standing out more than anyone else."
A changed man
Returning to the U.S. in June 2003, after 91 days in Iraq, Dwyer seemed a shell to friends.
The 6-foot-1 soldier had dropped to about 165 pounds, causing the other Musketeers to immediately think of post-traumatic stress disorder. Dwyer attributed his skeletal appearance to long days and a diet of MREs (Meals Ready to Eat), and his friends accepted the explanation.
But they soon noticed changes that were more than cosmetic.
At restaurants, Dwyer insisted on sitting with his back to the wall so no one could sneak up on him. He turned down invitations to the movies, saying the theaters were too crowded. The arid landscape around El Paso, and the dark-skinned Hispanic population, reminded him of Iraq.
Dwyer, raised Roman Catholic but never particularly religious before, now would spend lunchtime by himself, poring over his Bible.
When people would teasingly call him "war hero" and ask him to tell about his experiences or about the famous photo, he would steer the conversation toward the others he'd served with. Dwyer once confided that another image, also involving a child, disturbed him.
He was standing next to a soldier during a firefight when a boy rode up on a bicycle and stopped beside a weapon lying in the dirt. Under his breath, the soldier beside Dwyer whispered, "Don't pick it up, kid. Don't pick it up."
The boy reached for the weapon and was blasted off his bike.
In spring 2004, Dwyer was prescribed antidepressants and referred for counseling. But his behavior went from merely odd to dangerous.
One day, he swerved to avoid what he thought was a roadside bomb and crashed into a convenience store sign. He began answering his apartment door with a pistol in his hand and would call friends, babbling and disoriented from huffing.
In summer 2005, he was removed to the barracks for 72 hours after trashing the apartment looking for an enemy infiltrator. He was admitted to Bliss' William Beaumont Army Medical Center for treatment of his inhalant addiction.
But things continued to worsen. That October, the Musketeers decided it was time for an intervention.
Dwyer refused to surrender his guns but agreed to let Matina lock them up. Less than a week later, his paranoia reached a crescendo.
On October 6, 2005, Dwyer barricaded himself in his apartment. Imagining Iraqis swarming up the sides and across the roof, he fired his pistol through the door, windows and ceiling. After a three-hour police standoff, Dwyer was admitted for psychiatric treatment.
In a telephone interview later that month from what he called the "nut hut" at Beaumont, Dwyer told Newsday that he'd lied on a post-deployment questionnaire that asked whether he'd been disturbed by what he'd seen and done in Iraq. The reason: A PTSD diagnosis could interfere with his plans to seek a police job. Besides, he said, "I'm a soldier," he said. "I suck it up. That's our job."
Dwyer told the newspaper he was committed to embracing his treatment this time.
In January 2006, Joseph and Matina Dwyer moved back to North Carolina. But his shadow enemy followed him there.
Losing touch with reality
Dwyer was discharged from the Army in March 2006 and living off disability. That May, Matina Dwyer gave birth to a daughter, Meagan Kaleigh.
He seemed to be getting by, but setbacks would occur without warning.
In June 2007, Matina Dwyer told police her husband had become enraged when she took away his AR-15 assault rifle and threatened that "someone was going to die" if she didn't give it back. She moved out and sought a protective order.
The following month, Dwyer checked into an inpatient program at New York's Northport Veterans Affairs Medical Center. He stayed for six months.
He came home in March with more than a dozen prescriptions. But within five days of his discharge, Dwyer's symptoms had returned with such ferocity that the family decided it was time to get Matina and 2-year-old Meagan out.
On April 10, Matina Dwyer filed for custody and division of property.
Dwyer's grip on reality loosened further. He was sleeping during the day and "patrolling" all night. Unable to possess a handgun, he placed knives around the house for protection.
In those last months, Dwyer opened up a little to his parents.
What bothered him most, he said, was the sheer volume of the gunfire. He talked about the grisly wounds he'd treated and dwelled on the people he was unable to save.
When Maureen Dwyer saw Zinn's photo, she'd had a premonition that her son wouldn't come home from Iraq.
"And he never did."
The health care "dance"
Police are treating Dwyer's death as an accidental overdose. Friends and family see it differently.
The day of the 2005 standoff, Knapp spent hours on the telephone trying to get help for Dwyer. She was frustrated by a military bureaucracy that would not act unless his petrified wife complained and with a civilian system that insisted Dwyer was the military's problem.
In a letter to post commander Maj. Gen. Robert Lennox, Knapp expressed anger that Army officials who were "proud to display him as a hero ... now had turned their back on him..." (Lennox said Dwyer "had a great (in my opinion) caregiver.")
Some wondered why the VA couldn't involuntarily commit Dwyer. But Dr. Antonette Zeiss, deputy chief of the VA's Office of Mental Health, said it's not that simple.
"Veterans are civilians, and VA is guided by state law about involuntary commitment," she said. "There are civil liberties, and VA respects that those civil liberties are important."
Zeiss said that although caregivers must be 100 percent committed to creating an environment in which veterans feel comfortable confronting their demons, the patient must be equally committed to following through.
"And so it's a dance between the clinicians and the patient."
Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America, feels that the VA is a lousy dance partner.
"I consider [Dwyer] a battlefield casualty," he said, "because he was still fighting the war in his head."
Nightmares in his head
The Sunday after the Fourth of July, Knapp attended services at Scotsdale Baptist, the El Paso church where she and Dwyer had been baptized together in 2004.
On the way out of the sanctuary with her children, she checked her phone and noticed an e-mail: Joseph had been buried that day.
She made it to her car. Then she lost it.
Trying to explain, she told the kids that, just as they occasionally have nightmares, "sometimes people get those nightmares in their head and they just can't get them out, no matter what."
Despite the efforts she made to get help for Dwyer, Knapp is trying to cope with a deep-seated guilt. She knows that Dwyer shielded her from the images that had haunted him.
"I just owe him so much for that."
Since Dwyer's death, Justin, now 9, has taken to carrying a newspaper clipping of the Zinn photo around with him. He shows it to playmates and tells them about the soldier who used to come to his school and assemble his toys.
Justin wants them to know about Spc. Joseph Dwyer. His hero.
Copyright 2008 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.
|From The Telegraph UK telegraph.co.uk
US Iraq war hero Joseph Dwyer dies of apparent drugs overdose
By Tom Leonard in New York
Last updated: 2:17 AM BST 09/07/2008
A US army medic who became a symbol of American heroism and integrity in the Iraq war has died of an apparent drugs overdose.
The premature death of Joseph Dwyer at the age of 31 has highlighted the neglect many American veterans believe they face once they return home.
He was made famous by a photograph, taken in March 2003 during the first week of the war, in which he is seen running to a makeshift hospital.
In his arms, the soldier was cradling an injured Iraqi boy who he had rescued from crossfire.
The arresting image, held up by the war's supporters as the human face of the invasion, was reproduced around the world and Specialist Dwyer was hailed as a hero.
However, he was always uncomfortable with the media attention, attempting to deflect its focus on to his entire unit. He had done no more than any of the other soldiers in his unit, he told reporters.
It emerged that Mr Dwyer's post-war civilian life was also no different to that of many fellow veterans.
For years, he struggled against post-traumatic stress disorder (PTSD), drug abuse, unemployment and marital breakdown.
On June 28, Mr Dwyer, 31, called a taxi to take him to a hospital near his home in Pinehurst, North Carolina, after earlier taking presciption pills and inhaling fumes from a computer cleaner aerosol.
When the driver arrived, Mr Dwyer said he was too weak to open the door. Police had to kick it down and found he had collapsed. Within minutes, he had died.
Police in several states had been dealing with Mr Dwyer for several years as he suffered from violent delusions that he was being hunted by Iraqi soldiers.
He was in and out of psychiatric care, once being committed after he started firing at imagined attackers inside his home, leading to a three-hour police siege. He had also crashed his car several times after swerving to avoid imagined roadside bombs.
Mr Dwyer's family said he had also been struggling with depression and sleeplessness, symptoms associated with PTSD. He would spend nights hiding in a wardrobe clutching a knife, and started inhaling from aerosols to help him sleep.
His mother said the army could have done more to help him.
"He loved the picture, don't get me wrong. He just couldn't get over the war," said Maureen Dwyer.
"He just wasn't Joseph. Joseph never came home. Talking to him, he knew he was going to die."
His wife, Matina, said: "He was just never the same when he came back, because of all the things he saw.
"He tried to seek treatment, but it didn't work."
She said she hoped that her husband's death would bring more attention to PTSD issues.
A recent report by the RAND corporation, a US think tank, criticised as inadequate the treatment of the one in five American troops who exhibit symptoms of PTSD or depression following service in Iraq or Afghanistan.
Mr Dwyer, a New Yorker who enlisted after the September 11 terrorist attacks, got married just before leaving for Iraq. His unit, a squadron of the 7th Cavalry Regiment, was in the vanguard of the initial US thrust and involved in fighting almost every day for the first three weeks.
On the day before his famous photograph was taken, Mr Dwyer's Humvee vehicle had been hit by a rocket-propelled grenade - an event which his family said sparked his depression.
After seeing the village of Al Faysaliyah caught in the fighting, he grabbed a four-year-old boy from his father and rushed him to safety.
When he returned home after three months, he was exhibiting the symptoms associated with PTSD.
In restaurants, he would always sit with his back to the wall and he avoided crowds. At home, he would pile his furniture up against the walls, too.
As his marriage fell apart, he stayed away from friends, abused inhalants and got into frequent trouble with the police.
In 2005, he and his family gave an interview to try to help other veterans struggling with PTSD.
"I know I don't need to be carrying a weapon. And I'm scared of going home without having one, even though I know probably nobody's going to attack me," he said.