Veterans For America

John Martins, the Press of Atlantic City

BRIDGETON - The only thing German Sanabria ever let slip to his big brother about the two tours of duty he served in Iraq was a chilling, guilt-laden admission.

“He said, ‘I’m responsible for hundreds of killings,’” Victor Sanabria said Friday as he sat at a local bar near the Cumberland County Courthouse. “That was it. ‘My squad was responsible for hundreds of killings.’”

On Friday, as friends and family of the 26-year-old German struggled to come to terms with his death earlier that week at the hands of police, they mulled over the last 20 months of his life, searching for an explanation as to how he was able to hide so successfully the fact that his mind was slowly unraveling.

According to veterans’ advocates, German Sanabria’s silent downward spiral is an experience shared by tens of thousands of veterans who have left the military in the past six years with minds fractured by war-induced stress.

In one estimate by the Department of Defense, almost 85,000 veterans of the conflicts in Iraq and Afghanistan have sought post-discharge treatment for mental health-related conditions at Veterans Affairs hospitals across the country. More than 38,000 of those have been diagnosed with post-traumatic stress disorder.

Department of Defense officials and private advocacy organizations acknowledge that the military system is not structured to effectively meet the mental-health needs of its servicemembers. They point to a systemic over-reliance on self-reporting to screen for psychological wounds, which some surveys suggest are suffered by as many as 50 percent of soldiers.

Making the problem worse, advocates say, is that many servicemembers do not seek the psychological help they need until after they have left the military base.

Adrienne Willis, a spokeswoman for the Veterans for America advocacy organization, or VFA, said service members should have mandatory, face-to-face evaluations so that combat-driven psychological conditions can be diagnosed while they’re still on base.

“A lot of the people who have severe mental-health problems are let off without any diagnosis or without having any treatment,” Willis said Saturday. “They’d be much better off being diagnosed earlier rather than later before their readjustment process starts.”

In a study that was released the day Sanabria was killed, the VFA outlined several reasons soldiers provide false information on their self-assessments, which are called Post Deployment Health Assessments, or PDHAs. Some factors include the considerable stigma on mental-health treatment, the desire to leave the base quickly or fear that promotions may be affected.

On Sanabria’s most recent PDHA, dated Dec. 14, 2005, Sanabria noted that his health got worse during his second deployment. He wrote that he had been in “sick call” five times during the tour.

When it came to the psychological questions, however, Sanabria wrote that he was not interested in counseling for stress-related issues. He also responded no to questions asking whether he was having nightmares or other psychological or emotional issues.

A Fort Stewart spokesman said Friday that Sanabria’s military file had already been transferred to the National Personnel Records Center’s Military Personnel Records archive in St. Louis, Mo. There was no response Saturday to an expedited request for Sanabria’s records sent to the Missouri facility Friday.

When Victor Sanabria, 27, searched his brother’s bedroom after his death, however, he found a thick folder containing documents outlining the several times German complained about vomiting, headaches and other symptoms of combat-related stress during his first tour of duty.

Some of those records indicated that German was examined and received a diagnosis of tinnitus, a constant ringing of the ears. The other documents, though, show no evidence that Sanabria received any counseling or therapy before his discharge.

An unquiet mind

When he was killed Wednesday morning, family members said, Sanabria’s tattered grip on reality had finally broken. In the weeks leading up to his death, Sanabria’s paranoia-fuled panic that someone was out to hurt him slowly consumed him.

He was irrational, friends said, and he talked about how he had to kill the devil before the devil killed him. Victor Sanabria said that German felt the mob was after him. Victor’s wife, Aidaliz Morales, said German responded negatively to large crowds.

On a trip to the National Aquarium in Baltimore last week, Morales added, German suffered a panic attack and had to leave.

His family’s efforts to get him the help he needed in his final days were fruitless. They drove him against his will to the Philadelphia VA Medical Center on Monday, where he ducked out unnoticed while his family sat waiting to hear word of a diagnosis.

“It was so hard to get him there,” Victor Sanabria said, recalling how he had to hold his brother back from jumping out of the car when they stopped to ask for directions. “He thought we were taking him to the enemy. He said, ‘Drive me to Georgia. Take me down south. That’s where I’ll be safe.’”

After he left the VA hospital, German spent the night away from home and didn’t return until Tuesday. Less than 12 hours later, several minutes before daybreak, he attacked his 79-year-old stepfather with a steak knife, stabbing him about five times.

Family members said German was delirious, thinking his stepfather, Frank Garcia, was an enemy. According to authorities, police shot and killed him when he disobeyed commands to drop the knife and turned back toward his stepfather.

His last words, Victor Sanabria said, were, “They got me.”

As German’s friends looked back at the months leading up to his death, they reflected on how well he was able to hide his inner torment.

From the moment he came home in May 2006 from a four-year enlistment in the U.S. Army’s 1st Battalion, 41st Field Artillery regiment, he rarely spoke of his time in the war zone.

German brought several medals and certificates of wartime valor home with him. He also bore physical scars from his time on the front lines, including the marks on his left hand where medics removed glass from a combat incident.

Yet for the most part, friends and family said, he remained silent about the traumas of war.

“Whatever the war did to him, he didn’t want to talk about it,” said Brien Marsh, 26, German Sanabria’s high school friend. “Inside, it was eating him up. He didn’t tell anybody because he didn’t want to burden anybody.”

Much was happening when he came back to Cumberland County. Victor Sanabria was planning for a wedding, which German helped him put together.

Work also needed to be done on the Atlantic Avenue house where their mother, Eva Neira-Garcia, lived with her husband. German, who moved back into the house in which he grew up, helped put up a fence around the property and do other chores.

He also began readjusting to civilian life. He enrolled in a paralegal studies program at Cumberland County College, where he made the dean’s list last year. His brother and new sister-in-law also announced that they were expecting, and a little girl was born into the family four months ago.

Although German seemed present for these happy moments, friends said that now, in retrospect, they notice a sliver of detachment.

“His mind was somewhere else,” Marsh said. “He was never like that until he came back from Iraq. He was stuck there.”

A family’s anger

German Sanabria’s family and friends expressed anger last week at what they called the system’s failure to give German adequate medical care. Marsh said he found it particularly unbelievable that certified screeners - at two hospitals - did not find enough evidence to involuntarily commit him.

Morales, German Sanabria’s sister-in-law, said German showed the hallmark signs of deep psychological turmoil in his last days. He would talk to himself or laugh at himself. He would refuse to drink liquids that he didn’t pour himself, she said, out of fear that he would be poisoned.

This behavior, she said, was happening immediately prior to his intake interview at the Philadelphia VA Hospital.

“How could they do this to him?” Marsh said Friday. “If you’re mentally unstable, you’re not yourself. When someone is that far out, how can you not notice it when untrained people can notice it?”

A message left Thursday with the Philadelphia V.A. Medical Center was not returned.

As for the Sanabria family, Victor said his mother is no longer interested in staying in Bridgeton. The memories are too painful for her, he said, and she is considering leaving the area.

“She’s selling the house,” he added. “She’s leaving this town. This is not a place she wants to be anymore.”