First of two parts
DIXON It has been more than two years since Emmett Spraktes last stanched the blood of wounded and dying soldiers as a flight paramedic in Afghanistan.
Yet in some ways, the horrors and rigors of the battlefield are just starting to catch up with him. The back and hip pain that wake him in the middle of the night. The vivid dreams of bodies decimated by roadside bombs. The startled reactions to noises of everyday life.
Spraktes, a California National Guardsman who completed tours as a ground medic in Iraq and a flight medic in Afghanistan, unwinds at his Dixon home by riding his horse, knocking back a vodka and orange juice in the evening, lounging by the outdoor fireplace with his young son Joe. A former law enforcement officer and recipient of the Silver Star medal for bravery for his military service, he takes counseling and does physical therapy.
But life is different.
"I'm not the guy I was before," said Spraktes, whose injuries have prompted him to retire from the California Highway Patrol at age 50. "My perceptions are different. You cannot be the same person you were after going through something like that."
The wars in Iraq and Afghanistan have cost more than 6,200 American lives, shattering families, creating widows and widowers and leaving children without parents. But the impact on disabled veterans like Spraktes is harder to measure.
Almost 5,000 disabled Iraq-era veterans live in the Sacramento region, according to federal data, and 2,000 are classified as "50-percent disabled," unable to do half the things they did before serving in combat. Spraktes is one of them.
Disabled vets in the region are heavily concentrated near Air Force bases, but they are neighbors to all of us. About 225 live in Roseville. Another 175 are in south Sacramento. Davis and Woodland are home to 160 of them. The small agricultural town of Dixon, where Spraktes lives, has the highest concentration of disabled vets in the region along with nearby Vacaville, according to a Bee analysis of U.S. Department of Veterans Affairs data of ZIP codes with populations greater than 10,000.
With a population of 18,300, Dixon is home to 89 of those veterans. About one of every 200 of the town's residents is a disabled Iraq-era war veteran, more than double the national average.
Roughly 800 of the region's Iraq-era veterans suffer from disabling post-traumatic stress disorder, an affliction triggered by memories of terrible events. Symptoms include nightmares, flashbacks, emotional numbness and difficulty concentrating.
As the last American troops leave Iraq this month, communities across the region are preparing for a wave of damaged warriors who will need help finding jobs, dealing with psychological and physical injuries and struggling with family problems. By the end of the year, 30,000 veterans will be returning from Iraq nationwide. Another 40,000 will be returning from Afghanistan next year.
"They already are coming out of the woodwork," said Jeffrey Jewell, readjustment counselor at the Sacramento Vet Center on Howe Avenue, which provides therapy and other services to combat veterans from throughout the region. "We're all swamped."
Close to 70 percent of the center's 400 active clients are veterans of the Iraq or Afghanistan wars. Many are just starting to have symptoms of PTSD and other disorders years after their deployments.
Dixon offers veterans warmth, services
Located about a half-hour's drive west of Sacramento and 22 miles from Travis Air Force Base in Fairfield, Dixon has the feel of a military town. It's a community where businesses display American flags all year, the Veterans Memorial Hall is a social hub, and the graves of thousands of soldiers jut from land that once grew alfalfa and beans.
Veterans of all eras can be found at the Memorial Hall, where they huddle with counselors, play cards and take tai chi classes. They gather at Bud's Pub & Grill to tell war stories and nurse cocktails. They sell farm equipment and cars.
Spraktes, who grew up in Sacramento, said veterans likely settle in the area in part because of the solid reputations of the Solano County Veterans Administration and the David Grant Medical Center at Travis. The poor economy may be spurring more young people to join the military and live in Dixon, he said.
Kevin Dunn, 31, who served in Iraq with the National Guard, recently considered moving to Michigan for a job promotion. He passed up the chance, he said, because he wants to continue therapy here for the PTSD linked to his war service.
"I've got to do it for my family," said Dunn, a fleet service foreman at a Ford dealership in Dixon who lives with his wife, Lindsey, and three young daughters. "I don't want my kids to have a father who is checked out."
A broad-shouldered, self-described "man's man," Dunn was unwilling at first to accept that his marital problems, anger issues, nightmares, alcohol dependence and other struggles were tied to his experiences in Iraq. Dunn trained as a combat infantryman and served in the country in 2003 and 2004.
"I'm tough. I'm a survivor," he said. "I got out of that hellhole alive, and I didn't want to talk about it. But there are times I can't stop thinking about the things I saw."
Through therapy at the Vet Center, Dunn now understands that certain sights and sounds, including loud voices and vivid images of war, can trigger symptoms like alcohol abuse and flashbacks. He is learning to identify those triggers and deal with them before he "explodes," he said.
"My advice to returning veterans is to come home and live your life for a little bit, but at some point you have to revisit where you were and what you saw and did," he said. "Start talking to people about it. Deal with it before it really hurts you."
CHP didn't prepare vet for Iraq's horrors
Dunn joined the Guard as a path to college and never envisioned going to war. But he has no regrets. "My military career was my greatest asset, and war was my greatest liability," he said.
Spraktes, by contrast, joined the Guard in hopes of going to combat as a flight medic.
"We were a country at war, and I felt I had something to offer," he said. "I figured the National Guard would be the quickest way to get there."
A CHP officer and paramedic, he signed up as the Iraq war was beginning in 2003. More than three years later, Spraktes went to a field artillery unit in Iraq and spent a year caring for wounded people on the ground.
"I had lots of experience on the streets seeing pretty ugly things," he said. "But I was exposed to things in Iraq that I could never have been prepared for."
In Balad, he and his team saved countless soldiers and civilians, many of whom suffered burns and other injuries from explosions. But the images seared into his brain are of other things, "like the Ranger who came to our base with a shoe box containing the remains of his friend" whose body had been blown apart.
In Afghanistan in 2009, he finally got to work as a flight paramedic. There, he and his crew flew to remote areas to rescue soldiers injured in firefights. Called to places too cramped for a helicopter landing, they dangled down to their patients from hoists, sometimes wearing night vision glasses and shouldering heavy equipment.
"I will never forget the faces of the young men and women looking up at me, dying, begging for help as we're flying down toward them," Spratkes said.
On July 17, 2009, Spraktes was called to the mission that made him the first California National Guardsman to receive the Silver Star while engaging the enemy.
On that day, as his mates lowered him from the noisy, vibrating chopper into enemy gunfire on the ground, he was sure he was about to die.
After uttering "a selfish prayer," he said, he thought about his children, and contemplated the fact that he never got the horse or the 1961 Ford Falcon that he always wanted. Dodging bullets that ripped through the air and ground, he stayed with five sick and wounded infantrymen until they could be plucked to safety.
Stigma of admitting problems lessens
After his deployment ended, Spraktes bought that horse and car. They are comforting distractions from the memories of his war service, which left him with ankle, neck and back injuries and ringing in his ears. Recently he was diagnosed with PTSD.
"When I first got back from Afghanistan, everything seemed wonderful," Spraktes recalled. "The air smelled so clean, the grass was so green. I had so many choices. I could do whatever I wanted."
Two years later, his body aches and "the dreams and intensive nightmares are just starting," said Spraktes, who is divorced and shares custody of his youngest son with his former wife. He also has two adult children.
He does daily physical therapy and, like Dunn, is undergoing counseling that is helping him respond to his thoughts and feelings in healthy ways.
"Overall I'm very grateful for everything I've experienced," he said. "But I still have my bad days."
Jewell and fellow staffers at the Vet Center, most of whom have served in the military themselves, are preparing to help the next wave of veterans with services ranging from medical treatment to family therapy to addiction counseling.
The center, which is federally funded, offers classes in anger management, PTSD 101, art therapy and even Latin dancing. Meanwhile the California Department of Veterans Affairs is gearing up to help returning Iraq and Afghanistan soldiers with job training, education and pension benefits.
It is a huge improvement from the Vietnam era, "when we didn't have the kind of understanding that we do now about these things," Jewell said. Congress established vet centers in 1979 to help Vietnam veterans readjust to civilian life, and the program has grown dramatically.
While the military's "macho" culture has not disappeared, Jewell said, veterans face less stigma about acknowledging health problems linked to their combat duty.
"Unfortunately, there is still a lot of denial among veterans that they might have a problem," said Jewell. "They come home, and they just want things to be normal. But no one is unaffected by being in a combat zone. We all need to accept that."