Veterans Affairs committee  I think in the whole issue around mental health disorders, I don't like the term, these are brain disorders. Whether it's caused by toxic effects of chemicals, the toxic effects of cumulative or traumatic experiences, it impacts the brain in a negative manner and that's what we need to be focused on.

Veterans Affairs committee  That's a good question. Typically the records should show vaccinations and a use of medication. Do the records actually show that? That's a good question. That's something that should be put to the military. When I go home I'm going to check my own medical file to see whether that's actually noted.

Veterans Affairs committee  I think that's dependent on the unit itself. Typically, in the deployment I was at, it was handed out on Fridays from basically the pharmacy.

Veterans Affairs committee  Whether it's due to a traumatic brain injury, PTSD, major depression, or mefloquine, right now we're limited in what we can look at and actually analyze. So what do I do? I use my current medication regime and my talking regimes to treat the symptoms they're struggling with.

Veterans Affairs committee  Let's be clear. At the present time I don't necessarily treat PTSD. What I treat are the symptoms the person is struggling with.

Veterans Affairs committee  Dr. Mark Gordon has been working on this area for about 19 years in the U.S. He's been working with U.S. veterans including Green Berets, Navy Seals, Army Rangers, etc. He was looking at traumatic brain injuries particularly, but he's also found that with post-traumatic stress disorder there are certain metabolic pathways when individuals have got brain trauma.

Veterans Affairs committee  Certainly you can have effects throughout the week, but the highest concentration, the highest frequency, is on the day you actually take the medication. It's simply the way the medication is absorbed etc. Pretty much most people are guaranteed vivid if not full-out nightmares on that day.

Veterans Affairs committee  That is a tough question, and that is something that needs to be very carefully considered by Veterans Affairs. Generally speaking, with our medical records within the Canadian military, if you're on medication, we should have a record of that, but records get lost.

Veterans Affairs committee  We follow orders, you know? The mission comes before life and limb. It's very simple. That's what we're trained to do. In a deployment, the idea of not following orders is basically unthinkable and chargeable. I believe there was—and I don't remember this gentleman's name—a military member who refused to have his vaccination before deploying, and he was court-martialled.

Veterans Affairs committee  As far as I'm aware, no. Particularly, a lot of the units—you have to realize—get down to platoon size, etc. You may not necessarily have any medical staff there at all, or the medics may not necessarily be aware of all the potential consequences of this type of medication. As I mentioned, I was a senior medical officer when I was deployed to Rwanda, and I didn't know.

Veterans Affairs committee  Very briefly, I can't speak now...because I'm not in the military, but certainly during my time I treated individuals with PTSD, a major depression. For instance, I put them on antidepressants, got them to a point where they were deployable; and so they did deploy overseas on psychiatric medications, but you have to screen those individuals very carefully.

Veterans Affairs committee  As I've already mentioned, we have standard pharmacotherapy. Most of the medications we use for PTSD are not actually recommended for PTSD in regard to things like sleep, curtailment of irritability, etc. We know that pharmacology, by itself, is not the answer. The talking therapies, similarly....

Veterans Affairs committee  I think when any soldier's behaviour appears aberrant, we need to understand what's going on with that. We have highly trained individuals in the Canadian Forces who are basically trained to apply lethal force. We need to understand what's going on. Yes, PTSD can be an issue, but I wouldn't have raised those concerns back in 1996 and again in 1998 if I did not think they were valid and we needed to attempt to address them.

Veterans Affairs committee  If I could just add to that, yes, the diagnostic part is important, particularly for individuals, when they think they're going crazy, and Veterans Affairs requires a diagnosis. It's important in that regard, but there is a great deal of overlap. The important piece we need to focus on is how we are going to treat this.

Veterans Affairs committee  Good afternoon, ladies and gentlemen, and my fellow veterans. I greatly appreciate the opportunity to be able to speak to this committee. To start off with, I'm going to just take you through a 40-year journey that I've been on since 1976 when I first entered into medical practice, eventually joining the Canadian Forces.