YOUNTVILLE -- To the heart of Napa Valley come these damaged warriors, fresh out of clues or control, or jail.
Justin Moore walked off a job in Livermore after his second tour in Iraq, hit the bourbon and stabbed the father of his girlfriend's child with a pocket knife. Chris Kuykendall, of Vallejo, grew aimless and drank, then the former Marine manhandled his girlfriend and landed in a Solano County jail cell. Ryan Kahlor, of Escondido, came home from Iraq and wound up in the hospital four times after picking fights "so people would kill me." Army reservist Kurt Furtado of Watsonville pointed a pistol to his head. He leveled a sword to his chest.
"Part of me got killed over there," said Furtado, 50. "This demon was taking control of my life, isolating me, pushing me into the bottle, destroying Kurt -- the man who went over there."
One by one, they arrived last spring to an unusual private residential treatment program for veterans of the wars in Iraq and Afghanistan, with no clear idea of when they would leave -- five months maybe, or eight or 10.
The Pathway Home occupies a Spanish-style building on the sprawling grounds of the Veterans Home of California, up a long drive that runs between a lush golf course and the Domain Chandon Winery. The program is not run by the feds or the state, although a $1.3 million state grant has helped supplement private donations. The idea: An open-ended regimen of free treatment specifically for Iraq and Afghanistan veterans.
"There's a sense of hopelessness you can't address in a 30-minute session once a month. Fear, mistrust and hopelessness, general paranoia," said Fred Gusman, the director. "We want them to learn how to take those combat glasses off and see the world as if they never were deployed."
As many as 38 veterans bunk up here for classes in addiction, parenting and relationships, anger management, yoga, massage, chiropractic. They bowl with local Rotarians, practice fly-fishing and mingle in town, staying tethered to the world while they unravel life with post-traumatic stress, and for many, mild traumatic brain injury. Wives or girlfriends often join them in couples counseling -- part of a focus on their eventual return to the everyday.
When they are deemed ready, sometimes after several months, they join in small groups that meet in Room 4138, a spare, second-floor room with a sink, a mirror and a long conference table. This is "Trauma Group," where they recount horrific experiences in combat, vent over life back home, share the numbness and isolation, shout, weep.
"You leave it all in there, whether you're pissed off, breaking down," said Kuykendall, 29. "We talked about what we saw, how we dealt with it. You feel that numbness because over there you can't be compassionate. Once you've been on the dark side for so long, teaching yourself to be in the light is hard. It's strange."
It's also exhausting, several of the veterans said.
"It'll make your body shake. It makes the pain flow throughout your body. It's like remembering being the most scared you've ever been in your life but still having to react. No one understands. I mean the guys in the room know," he said. "Treatment is a hell of a thing. It's either be numb and kind of a robot, or muscle through it, feel the pain and try to be human again. I want to love again. I want to feel joy. I don't want to be a robot."
More than 2.2 million American troops have served in the wars in Iraq and Afghanistan, including more than 900,000 with two or more deployments, according to the most recent Defense Department figures. According to a 2008 RAND Corporation study, nearly 20 percent of them report symptoms of post-traumatic stress or major depression once they return. The study pegged a public cost as high as $6.2 billion in the two years following deployment, in medical care, lost productivity and suicide.
The Department of Veterans Affairs offers a variety of inpatient, outpatient and residential treatment programs for veterans with PTSD, with time limitations for how long veterans may stay. Many advocates agree that agency has made progress, with greater funding and focus, but that the availability of treatment still lags. An imposing bureaucracy, delays in receiving benefits and a lingering stigma over PTSD don't help, turning many returning veterans and their families sour.
Some see programs such as Pathway as a model, and a symptom.
"The fact Pathway Home even exists is proof about how the system works at the government level," said Margo Mims, the daughter of a Vietnam vet with PTSD, describing her relief when Kuykendall, her fiancee, entered the program. "Millions of dollars are spent training guys to go to boot camp, and there's no program to train them how to come out of the military successfully. Now you have a person who's highly trained and you just create a weapon that you unleash on the families."
For some veterans, the flexibility at Pathway is important, said J.P. Tremblay of the state Department of Veterans Affairs
"You're there as long as you need to be there. And if you need some follow-up you can always come back," he said. "To my knowledge, all the VA programs are limited-term programs. Once you're at the end, that's it."
Gusman earlier helped develop mental health programs at the VA and served as a director of the National Center for PTSD, which runs a 90-day residential program in Menlo Park. He watched, he said, as residential care programs built up after the Vietnam War for post-traumatic stress receded, making a ramp-up now more difficult.
"What is a large institution supposed to do? You're charged with helping old vets and dealing with Vietnam vets showing up after they lost their wife. This is a different generation," Gusman said. "It's not just the government. It's part of a public health problem we still haven't woken up to -- the cost to the country when police come out, domestic violence, the impact on the kids. We're so slow. We're going to pay dearly in the long run."
Pathway clientele sees about 20 percent of its veterans referred from the military, including the National Guard. VA facilities refer most others, he said. Some veterans leave the program frustrated. A handful have been sent away to addiction programs, Gusman said. One committed suicide. About 90 percent "do well," in part because they tolerate lapses, Gusman said.
"It's either their best alternative or their last resort," he said. "If they do screw up, we're not going to toss them out on the street ... A lot of people don't understand, anger in a war zone can be a useful tool. Suppression can be a useful tool."
Ryan Kahlor described a "love-hate" experience at Pathway. He bucked the program, he said, but was scared to leave.
"Every single person in that place has a kill count. Everyone around me now (at home) doesn't know what the (heck) I've been through. They've never been in a vehicle struck by a land mine, never worn the blood of their friend, never had a friend killed beside them," he said. "I wish I could take all the dudes I was with at Pathway and drop them down on my cul-de-sac."
Pathway has graduated about 200 veterans in three years, while struggling for funding as it tries to expand to 60 beds and add a program for women. It ran through an initial $5.6 million bankroll from California philanthropist David Gelbaum; the $1.3 million state grant was designed to bridge the gap as the program seeks new private funding, said Tremblay.
The Concord Vet Center has referred three veterans to the center, including Kuykendall. It seemed to fit his need for a respite, said readjustment counselor Nathan Johnson. "He was in a relationship, had a young son. He just seemed overwhelmed," Johnson said. "When he was in jail, you'd expect he would be kind of freaked out. He looked relieved."
Some veterans have spent as much as a year at Pathway. Kahlor spent six months and Kuykendall seven before they graduated in November with a group of 11. They each craft detailed transition plans, and the program sends out weekly text messages with individual inspirations and stress checks, ready to counsel or intervene if a veteran reports trouble.
"Your wife is number one. You have many grandkids to get to know," is a text Furtado has received while at Fort Lewis, Washington, where he is seeking a medical discharge. His memory suffers from a blast, he said, but he now has techniques to keep from lapsing into "flashback mode."
"I spend a lot of time alone. That's when the demon can sneak back in, say 'Hey,' " he said. "Basically they saved my life and my family."
Kuykendall, 29, returned recently to Yountville and sat on the steps of a gazebo, recalling his downward spiral and the help he finally got. He is engaged to Mims and attends community college, aiming to become a firefighter.
"This place is like a utopia for us veterans. This is a safe haven," he said. "You're just trying to get your sanity back. I feel like I've gotten a little of it back."
His daily nosebleeds keep coming, and he has suffered seizures that doctors can't explain. But he sees a future now, he said. Not like before.
Contact John Simerman at firstname.lastname@example.org