Don Bankosh stands next to the bathroom door in his bedroom and points to large holes he punched into it during a fit of rage several years ago.
He could have replaced the door. Instead, he keeps it damaged so he won't forget that day and others like it.
It is a daily reminder of his shame at that outburst, a warning to hold at bay the anger, fear, guilt and other effects of the post-traumatic stress disorder, or PTSD, he acquired after nearly two decades as an Army helicopter medevac soldier rendering aid to casualties.
Now, after five suicide attempts, numerous inpatient stays in PTSD clinics, individual and group therapy, prescription medications and the support of his fiancee, Don, 42, says he is happy. And he is vigilant in his recovery.
That's why every day he dutifully follows the to-do list left by his fiancee, Kathleen Zappone, 37, that includes everything from dusting to taking his medications to remembering to eat lunch to cleaning the hardwood floors of the stone house they share on an acre of land in rural Crabtree, Westmoreland County. He needs to keep busy so there is no idle time for the horrific images of death and suffering to invade his psyche.
He never wants to return to drinking to dull the pain, to high-stakes gambling to regain the adrenaline rush he felt as a soldier, to the wrath and guilt that consumed him because of his experiences.
"That chapter of my life is gone, but the effects of that chapter carry over into this life and it's been hell. But for the last year life's been good. I'm at peace with a lot of things but it can be something as simple as a helicopter flying over that can just put me right back there.
"It's a struggle, it's a battle, but I've learned to live with it."
Sitting on his front porch, Don, a divorced father of three, takes a long drag on a Marlboro as he looks across Cemetery Road to a corn field and recounts his life, most of which was devoted to providing aid to those in crisis. The fact he is now the one suffering because of that is not lost on him.
He liked what he did, providing medical evacuation by helicopter throughout the United States and the world -- from Honduras to Saudi Arabia to the Sinai Desert to Egypt and finally to Iraq, where he served at the beginning of the war in 2003. It was there that the accumulation of suffering he had witnessed and repressed finally burst like a failed dam. All he had seen flooded his mind -- the lives lost, the wounded American soldiers and prisoners of war, the maimed and suffering civilians.
In the end, the Iraqi children were the tipping point.
"No one said I was going to see a little kid shot up. To pick up a kid that was one of my kid's ages and he's shot up and he's just looking at you helpless ..." he says, his voice trailing off. "No one told me I was going to see that. I understand it was a war but there was no front line."
The former sergeant who served the world over in peace-keeping and combat roles now lives primarily in a self-imposed radius of six miles around his house. Within that circle he feels safe even as he remains hyper-vigilant about safety.
It's been seven years since he was shipped back to the states for noncombat-related abdominal surgery at Fort Campbell, Ky. But there were other problems that weren't so easily fixed.
He was short-tempered and depressed and didn't know why. It got so bad that he put a 9mm handgun in his mouth but couldn't pull the trigger. Instead, he drank a case of beer with about 150 Vicodin painkillers and a mixture of other prescription drugs -- the first of five such attempts to end his life.
He was diagnosed with PTSD, was medically discharged from the Army in 2004 and, after spending a year in the state of Washington, returned home to Crabtree. His condition made him so frightened that when a siren wailed while he was in a Greensburg hardware store, he ran outside and hid underneath his truck. Another time, after hearing a strange sound outside his home, he "escaped" out of his bedroom window in his underwear, toting a gun.
People in his small community asked him about the "blood and guts" of the war, he recalled with revulsion. They just didn't understand the horror -- that he, like so many other warriors, had the invisible wounds of PTSD, that he was as battle-scarred as if he had been shot.
He turned to drinking -- from morning until he passed out at night. To gambling, his mood spiking with each anticipated win only to dissipate and leave him feeling worse. His actions drove his large family away, a divide he has tried to span without success.
And then, four years ago, a trip to a Lowe's home improvement store started him on the journey to reclaim his life.
"I was ..." Don starts to say.
"A screw-up," Kathleen says, finishing the thought. They laugh.
"My living room was a bar," Don offers.
"You didn't have a bed," she recalls. "You slept on the couch."
That has all changed. Don, who was in denial about having PTSD and the effects it had on him, finally saw them clearly through Kathleen's eyes. But it didn't come easily for the couple, an example of how PTSD, like a pebble thrown in a lake, has a ripple effect upon those close to the person with the condition.
They met at Lowe's where Kathleen still works as a department supervisor. They went on dates and hit it off, but she quickly suspected something was off kilter.
"I didn't know all the stuff going on in his head because he wouldn't put it out there. It was just actions he would take, like drinking a lot and never being home. I just had to peel away the layers. He would hide everything.
"I didn't know too much about [PTSD]. Through the [Veterans Affairs] and all his appointments ... I came to understand more about everything."
The low point -- which turned out to be the key to Don's recovery -- came several years ago when Don left a voicemail message on Kathleen's cell phone saying he was at a casino. Kathleen knew that was a bad sign. Don wouldn't answer his cell phone, so she drove to The Meadows in Washington County but couldn't find him.
The next morning she got a call from Washington Hospital. Don, who had been at a West Virginia casino and lost all of his money, had admitted himself after another suicide attempt. From there, he checked himself into the Coatesville VA Medical Center in Chester County, one of the country's pre-eminent hospitals for PTSD treatment. He was there for the larger part of a year.
"He was at the point that he recognized he did have a real problem and did need to seek help," Kathleen says. "I had helped him realize it a little bit prior to that but he took the step of wanting to go into the inpatient hospital.
"It seems to be OK and under control right now but any slight jab can send it downhill. I think that he should have gotten help a long time ago when he first got out [of the Army] but nobody really cared."
Don agrees. "I didn't want to accept it," he says, "but I've learned from my mistakes. From the torment I've learned how to control it. It's never going to be totally stress-free but to have as little stress as possible and for us to be together [is the goal].
"I'm very happy with myself, with my relationship, with the life we have together. It didn't come easy and it didn't come overnight. It sure as heck didn't come by myself. I probably wouldn't be living if it wasn't for her. With medication and therapy and talking to counselors, it keeps everything on a level keel."
They reach down to pet Zoey and Cleo, their two Labrador retriever mixes, and Baby, their giant and still growing English mastiff. Somewhere not far away are their five cats.
Don looks at Kathleen.
"I'm truly blessed," he says confidently. "I'm still here. I'm alive."
Michael A. Fuoco: firstname.lastname@example.org or 412-263-1968.