Young and brave and eager to serve God and country they march off to war, never fully understanding the bloody toll it will take on their lives and their youth.

"Older men declare war. But it is the youth that must fight and die." - Herbert Hoover

Whenever tensions among nations rise to fever pitch and it becomes clear that force is the path that will be taken, it is always the youth of those countries involved who are called upon to fight the wars. So many march off to war never to return, they remain forever young. Even as we know that death is the ultimate tragedy, survival also carries with it the scars of battle.

In World War I it was known as shell shock, the condition of those who had seen and felt horrendous things that the brain could not process. In World War II this condition was referred to as "combat stress reaction". Much stigma was attached to the mental disorder. While it was identified by the medical community as a traumatic injury, it was, for the most part, not considered a recognized injury on the whole by the military community. The prevailing thought was that one suffering from this diagnosis basically 'lacked character'. Unfortunately, this has been a strong theme throughout the many wars and conflicts fought since World War I.

It has taken the military years to finally embrace the fact that there is more than just physical injury incurred in war. There are just as many victims who are suffering from the mental stresses of war.

As each war has come along we have learned new and more sophisticated ways of killing and maiming one another. The latest wars have given us 'Improvised Explosive Devises' (IEDs). These little numbers are lethal and if they do not kill they severely maim and cause lasting traumatic brain injury. Many of the soldiers who seem to escape these encounters soon find out that their hell has just begun.

Among surviving soldiers wounded in combat in Iraq and Afghanistan, traumatic brain injury (TBI) appears to account for a larger proportion of casualties than it has in other recent U.S. wars. According to the Joint Theater Trauma Registry, compiled by the U.S. Army Institute of Surgical Research, 22 percent of the wounded soldiers from these conflicts who have passed through the military's Landstuhl Regional Medical Center in Germany had injuries to the head, face, or neck. This percentage can serve as a rough estimate of the fraction who have TBI .... The true proportion is probably higher, since some cases of closed brain injury are not diagnosed promptly. (New England Journal of Medicine)

So many of these young soldiers returning home have the appearance of being 'normal'-- they do not reflect the internal processes that are taking place and in-turn taking their toll. Those with traumatic brain injury (TBI) can suffer from defects in reasoning, memory, and problem solving. These injuries cause changes in behavior and most often deep depression. Hence the rise in suicide rates among our military -- such irony that they would survive the horrors of combat only to succumb to death by their own hands. How much anguish must one be experiencing to be able to suspend their natural survival instincts and give into the void?

"Weapons are tools of ill omen.' War is a grave matter; one is apprehensive lest men embark upon it without due reflection. " - Sun Tzu

What we subject our soldiers to is beyond the pale. No training in the world can prepare them for the bloody sting of battle, for seeing a comrade in arms blown away before their eyes -- to feel and experience death all around them.

How does one spend a year or more engaged in war and then come home and be expected to forget or at least stow away all the horrors of war. How can they be expected to assume their previous place in society as if nothing had happened to them? Hence, these battle-worn warriors live lives of quiet desperation and some are unable to cope with the night-terrors and living nightmares that are relentless in their ability to torture and torment their victims.

As if the experience alone wasn't enough there are the additional effects of something similar to PTSD that doctors describe as "traumatic loss" and "moral injury." It is the experience of guilt over surviving. They feel as if somehow they betrayed or abandoned those who were killed.

If we continue to send our youth into harm's way as we engage in one war after the other, then we need to be enlightened and prepared to treat their complex mental injuries as much as the physical ones that are suffered. The mental and emotional injuries, if left unattended, can and have proven to be fatal. At the very least they are debilitating to the extent that these young people will cease to live productive lives. They are those with the most promise, our children, if you will, and they should not be left behind.

"The soldier above all others prays for peace, for it is the soldier who must suffer and bear the deepest wounds and scars of war." - Douglas MacArthur