For many American soldiers in Vietnam, the stress that comes with being on the battlefield didn’t end when they left the war zone. It followed them home.

“I had people calling me Uncle Tom and (accusing me of) fighting the white man’s war,” said Ernest Montgomery, 66, a Vietnam veteran who moved to Killeen after Hurricane Katrina destroyed his home in New Orleans in 2005.

In some ways, the treatment at home was as stressful as being stationed in Vietnam, said Montgomery, a former artilleryman with the XXIV Corps.

“We couldn’t be open with it,” said Montgomery, who was drafted into the Army and was sent to Vietnam in 1970 at age 22. “I don’t remember what I was like before the war.”

Montgomery said the stress of war coupled with the stress of the cold, sometimes hostile, reception back home contributed to his development of post-traumatic stress disorder.

“You’re always expecting something to happen,” Montgomery said, describing his as “functional PTSD.”

To “numb the pain,” Montogmery said he became addicted to heroin for years. However, his wife, Patricia, ultimately pulled him back from the brink and into a sustainable lifestyle.

“Even though I acted like a fool for a long time, she stuck with me,” said Montgomery, a retired truck driver.

Many Vietnam veterans have similar stories. While the term PTSD only came out after the war, its understanding was influenced greatly by the experiences and conditions of Vietnam veterans.

Shell shock

It’s been widely known for centuries “that combat puts these tremendous stresses on an individual, a soldier, and some men break under the stress, and some men don’t,” said David A. Smith, a history professor at Baylor University who specializes in military history.

“It deals with the human condition, and the way it confronts combat,” Smith said. “But the primary understanding was that men went to pieces because of the immediate stresses of the battlefield, and then once you removed them from those stresses, the effects would then go away.”

Long-term effects, months or years after the war, were not believed to be a factor.

It was called “shell shock” in World war I, and “battle fatigue” in World War II.

“They’re very vivid terms,” Smith said. “You have no sort of ambiguity as to what you’re dealing with, but neither has with it an appreciation, that once you remove the soldier from the shells and the battle, that this disorder continues.”

It wasn’t until Vietnam veterans began to get more attentive care, and psychological and psychiatric work delved into the issue, that specialists realized “this is something that doesn’t go away,” Smith said.

As researchers developed the modern theory behind PTSD in the 1970s, an unlikely movie that debuted in 1982 helped the public understand what many Vietnam veterans were going through.

“What really clued a lot of people in was the first ‘Rambo’ movie,” Smith said.

Unlike the superhero-like main character Sylvester Stallone played in “Rambo: First Blood Part II” and “Rambo III,” the first movie in the series, known simply as “First Blood,” depicted a troubled, highly decorated Vietnam veteran trying to reconnect with old Army buddies. In “First Blood,” John Rambo soon finds out that many of his old Army buddies are dead as he drifts from town to town.

“That’s the first time in mainstream culture that you really got a sense” veterans are still dealing with the effects of the war years later, Smith said.

A different war

Vietnam was different than other wars, perhaps fueling symptoms of PTSD to enhanced, unmistakable levels.

“It was a different kind of combat than the United States had ever experienced,” Smith said. “It was an irregular war and the United States was not equipped to fight an irregular war.”

For many American soldiers, “the difficulty in identifying who was an enemy, and who was not an enemy” was not always clear, Smith said. “Especially with the (Viet Cong) operating in South Vietnam; it really put a brand new, ongoing stress with the soldiers in the field.”

That, coupled with the hostile treatment Vietnam veterans received from the broader society when they came home, only worsened the problem.

“The parades and stuff didn’t help (World War II hero) Audie Murphy deal with his PTSD, but the warm welcome certainly didn’t exacerbate it any,” Smith said. “And I think that the hostility with which the Vietnam vets were received back into society truly made the stress worse.”

In 1980s and ’90s, PTSD was researched further. By the time the wars in Iraq and Afghanistan began, programs, at least on a limited basis, were in place to help veterans returning from war.

Nowadays, PTSD awareness and treatment are a part of society, both on and off Army posts.

“I see a lot more support within the active-duty framework,” such as posters on walls or elsewhere, Smith said.

“It’s a shame that it took so long for people to really start to understand this, given that we’ve fought an enormous number of wars before Vietnam,” Smith said. “I wish Audie Murphy could have gotten the help that is available now to people.”

Modern programs

Programs to treat PTSD now include everything from heavy medication to service dogs, and some war veterans say medical marijuana can help.

Retired Lt. Gen. Don Jones, a Vietnam veteran and Killeen resident, helped pave the way for more PTSD treatment in 2008 with a program at Scott & White.

Jones went to the commander of the Carl R. Darnall Army Medical Center when he was the president of the local chapter of the Association of the United States Army, and asked the Fort Hood hospital’s commander what the group could do to help.

“She reminded me that she had two divisions, close to 40,000 soldiers, coming home from Iraq, and said, ‘I only have three mental health counselors’.”

Jones approached Scott & White about a partnership, and the Scott & White Military Homefront Services was born.

The program uses grant funding, and has served more than 38,000 clients in Central Texas since 2008.

The program “is primarily prevention — catch them before they need heavy medications or full-up psychiatric help,” Jones said. Counselors help deal with survivor’s guilt, flashbacks or other symptoms.

Vietnam veterans still enter the program from time to time, Jones said.

For Montgomery nowadays, he gladly wears shirts or hats announcing his status as a Vietnam veteran. The hostility of the 1970s is gone, replaced by many other understanding veterans in the Killeen-Fort Hood area.

“This is freedom for me now,” he said.

Contact Jacob Brooks jbrooks@kdhnews.com or (254) 501-7468

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