Mind Field

"Now's the time to find out not only what they did but under what circumstances and how many," MacNair says. Does shooting a sniper differ from firing on a family running a roadblock? Do reservists respond to bloodshed differently from enlisted men? Does engaging the target make a soldier a walking mental time bomb?

Getting the proper clearance to ask those questions presents MacNair with a bureaucratic paradox: Researchers must publish their findings in professional journals to be taken seriously by the medical establishment and government policy makers, but if the government doesn't ask the proper questions, MacNair has no data to compose a study.

The National Vietnam Veterans Readjustment Study follow-up, which might provide that data and which should have been implemented last year, has stalled because the project's administrators have asked for bids from survey companies willing to do the work cheaper, says the VA's Murtaugh.

Meanwhile, the United States is conducting its biggest ground action since Vietnam, armed with the same old questions.

"It's not that people are arguing it [the theory] -- they're ignoring it," MacNair says. "So far, no one has hopped up to prove me wrong."

So far, there's been little incentive to prove her wrong.

Matthew Friedman, the executive director of the Department of Veterans Affairs National Center for PTSD and a professor of psychiatry and pharmacology and toxicology at Dartmouth Medical School, wrote the editorial accompanying The New England Journal of Medicine study. Because psychotherapy and prescription drugs have improved, he writes, and because soldiers are being welcomed home as heroes rather than as killers, their readjustments may not be as traumatic as those suffered by soldiers returning from Vietnam. He tells the Pitch that there are lingering questions about whether reservists and National Guard troops with less-rigorous training will develop mental illness more often than enlisted soldiers. But from a clinical perspective, he says, because the treatment for PTSD is the same across the board, looking for individual PTSD triggers is pointless.

If MacNair can prove otherwise, her research might have vastly unintended consequences: Her theory could help the military train soldiers to be better killers.

That much is clear at the Kansas City VA Medical Center. There, Dr. Hemant Thakur's small office is decorated with pictures of former patients and snapshots of himself in fatigues in Guatemala. Formed in the '80s in direct response to veterans' mental-health complaints, his PTSD clinical team now serves more than 1,000 veterans from different wars -- soldiers who charged the beach on D-Day, Blackhawk commandos in Somalia, Special Forces operatives who carried out covert missions -- and gains, he says, 40 new patients a month. Now he's working with 45 combat veterans from Iraq.

One of the first questions Thakur asks in private interviews is whether a soldier has a confirmed kill.

"It is a known fact that killing somebody is a traumatic event," Thakur says. "If the Army wants someone to fight a war, then they have to train them to kill someone."

For the most part, MacNair has decided to leave the physical statements to her Vietnam-era colleagues and the new generation of activists.

But on September 8, when the death toll for U.S. troops in Iraq had reached 1,000, she stood at another peace vigil at Mill Creek Park. An amber sunset streaked the Plaza skyline as sedans and sport-utility vehicles zoomed past.

There were new numbers: 865 members of the armed forces had died in the 14 months since the president had declared the end of major combat operations. The body count since the return of sovereignty to Iraq last June: 150.

MacNair stood among a dozen demonstrators, mostly members of the KC Iraq Task Force, who held anti-Bush signs. She wore a black dress with a black scarf wrapped around her forehead, her mourning outfit.