BY Richard Currey

The Vet Center in Silver Spring, Maryland, is tidy, quiet, calm. One walks into a space pervaded by a sense of peace and balance. Which is precisely the ambience that Center Director Wayne Miller wants to achieve.

“This is where a veteran comes to share very difficult experiences, to get in touch with feelings that may have been suppressed—maybe for years,” he said. “You’ve got to be in the right environment for that to happen.”

The Silver Spring facility is one of more than three hundred Vet Centers nationwide. The Centers (officially known as Readjustment Counseling Services, or RCS), are part of the Department of Veterans Affairs. VA pays the bills and salaries—but the Centers operate independently.

This independence is critical to the Vet Centers’ long-term success. By the mid-1970s so many Vietnam veterans had found the VA to be so openly hostile to their needs that it was clear some other kind of resource was needed. And like so many needed resources for veterans, launching the Vet Center concept involved a sustained effort by many individuals, years-long support of VVA, and congressional legislation in the form of the Vietnam Veterans Readjustment Counseling Act of 1979. (See Mary Stout’s “How VVA Saved the Vet Centers.”)

Vet Center services are free (no copay or fees for service), walk-ins are welcome (none of the lengthy registration process that marks VA medical facilities), and—key to the Centers’ success—counseling sessions are confidential with records held separately from VA Medical Centers, never shared with VA without the written consent of the veteran, and separate from and not shared with other Vet Centers or the VA benefits system.

With nearly two thousand employees (70 percent of whom are veterans), the Vet Centers have grown from providing basic PTSD counseling for male vets to offering a range of services that embrace women vets and veterans’ families. They deal with PTSD linked with substance abuse, military sexual trauma, marriage and family therapy, LGBTQ issues, bereavement counseling for family members, benefits assistance, and referrals when needed to VA Medical Centers.

Over the last decade, more than sixty new Vet Centers have opened around the country. A fleet of eighty vehicles allows the Mobile Vet Centers program to offer easy access to services to those who cannot travel or live too far from Vet Center locations.

The progress by the Vet Centers over the last thirty years has been enviable, meeting critical needs of veterans and their families and demonstrating surprising agility (among federal agencies) in evolving to reflect the vast social and cultural changes in the veteran population and the nation at large. But as the number of veterans has grown to what is now estimated to be about 20 million, so has the demand on Vet Centers to increase their range of services and see more clients. The central RCS headquarters has instituted new requirements for documentation and metric-based objectives, in turn increasing workloads and sparking unrest among some Vet Centers staff.

“Here’s the thing,” Miller said. “We’re busier than ever. When the Vet Centers launched thirty years ago, we weren’t thinking about the fact that our wars would not stop. We were thinking Vietnam was the last big, long war, at least for a while. But that has not been the case. So the Vet Centers have had to expand and innovate. We’re now offering more services to a wider range of people than ever before.

“There are growing pains, but growth is also an indicator of success. Overall, the Vet Centers are enormously popular with veterans, and I think they will be around for as long as we keep fighting wars and sending vets home in some form of distress. I’m fortunate that the VA has given me the opportunity to do this work. We’ve never had to worry about funding or supplies, and the staff we need has pretty much always been there.”

On July 4, 1969, the Marines of Kilo Company, 3rd Battalion, 7th Regiment were on patrol in Quang Nam Province. Wayne Miller marks the day here at home—the great American holiday of flags and fireworks, cookouts and parades—as one in which he is often upset, irritable, and apt to get angry for the most minor of reasons.

“We all have these dates,” Miller said. “They’re ‘stuck’ dates—dates that something happened that changed your life forever. And every year you have to cycle through that date and memory another time.”

For Miller, it is the day he was severely wounded when his platoon was caught in a mortar barrage. Miller’s left leg was severed, his right leg and hand nearly lost. He was peppered with shrapnel wounds and temporarily paralyzed from the neck down.

After six months in military hospitals he was honorably discharged from the Marine Corps and dropped without ceremony back into civilian life with only the barest understanding of what had happened to him.

The country had changed in the two years Miller was away. The national uprising against the Vietnam War, a movement collecting strength when he enlisted in 1968, fully ignited just three months after Miller’s return when, during an antiwar demonstration at Kent State University in Ohio, four students were shot dead by National Guardsmen.

The reaction across the country was, for many, one of disbelief, shock, anger. Hundreds of college campuses shut down as four million students went on strike. Five days after the shootings more than 100,000 people marched on Washington to protest American involvement in Vietnam.

Meanwhile, Wayne Miller was living with his parents in the suburbs of Washington, D.C. “My thoughts were mostly on my own situation. I thought my life was over. I thought that nobody would ever love me, that I’d never find a job, that I was condemned to a lonely life as a burden on my parents and on society. And apparently I wasn’t supposed to talk about Vietnam or about being a veteran and certainly not a disabled one—that had all somehow become a bad thing, too.”

At the time, Miller said, “services we take for granted today either did not exist or were not accessible to somebody like me.” There was not yet an understanding that the inherent danger in ignoring returning veterans—essentially compelling them to remain silent about what they had been through—was the underpinning of more severe distress and dysfunction. But by the mid-1970s medical science was seeing that taking care of vets, including their psychological needs, was better than simply pretending they did not exist. As that shift occurred, Wayne Miller’s life began to take shape and find meaning.

“I bumped around for a while. Had a hell of a time getting started with an education. I was ‘Never-Graduate-Wayne.’ ” Miller ultimately received a B.S. from Frostburg State College, where he was a member of the varsity gymnastics team, and went on to receive an M.A from George Washington University. He joined the staff of the Vet Center in Silver Spring in 1989 as a peer counselor. He had found his home.

When Miller joined the Vet Center staff he was told that to stay on he would need more credentialing—a counseling degree and a certification. “The Vet Centers were evolving from peer counseling to therapy done by trained counselors,” he said. “So I went back to school, got a second masters degree, this time in clinical social work. I participated in all the VA continuing education programs, and over time I built my career. That dream I thought I’d lost on July 4, 1969—the whole thing about how all I was ever going to be was this guy in a wheelchair getting drunk and telling war stories—well, God had other plans.”

Miller has a full, hearty laugh, an open, welcoming face, and is an easy talker with a practiced ability to let himself be the butt of the joke. “Hey,” he said, “Who better to talk to these vets about their problems? I’ve walked it, I’ve talked it—and I bought the T-shirt!” He’s a natural counselor, a man who can speak of horrific events and dire outcomes with an air of calm and acceptance. It’s as if his body language says: Yes, it was bad out there, very bad, but here we are, so let’s see about the business of carrying on and rebuilding a life.

A guiding principle in Miller’s work, as both a therapist and a veterans services administrator, “is to distinguish between a vet’s needs and his or her wants. A vet’s needs are already met if they’re sitting in this room. They have food, shelter, and so on. But their wants? That’s a different story. They want to be happy, they want to be normal, and that’s where we start to peel back some layers.”

Miller said his own journey has helped him to a deeper understanding of any given veteran’s personal situation. “There was a time when I thought my wants would never be met. Coming through my own crisis has brought me to a place where I can help vets understand their wants and how to meet them in healthy ways.”

Younger men and women—those in their 30s, 40s, and 50s—now make up the majority of American veterans. Has PTSD changed in any way for them?

“You know,” Miller said, “PTSD is like a duck: You can call it what you want, but it’s always going to be a duck. War stress is always going to be war stress. What triggers that stress is what makes the difference. For Vietnam, it was jungles and rice paddies. For Kuwait and Iraq, it’s the desert, the sand, and the sun. So the differences over time are the triggers. But after all is said and done, it’s still the duck you’ve been looking at all along.”

One change Miller noted is that contemporary approaches to PTSD now acknowledge that it’s not only a combat-related entity. “The thinking used to be that if you weren’t in combat you don’t have PTSD, so stop fakin’ it. But we’ve come to understand that all kinds of trauma can leave an individual with PTSD: sexual trauma, car accidents, air crashes.

“Another important thing is that different kinds of military exposure can bring about PTSD. It’s not just folks in combat. Anybody who serves in support of a combat operation—on board a ship, a cook, a driver, medical personnel, no matter what they did—it’s possible to sustain invisible wounds. What support personnel are exposed to can be very difficult and leave lasting scars. It’s often the folks you never see or hear about that are the real heroes. They’re wounded vets, too, and as deserving of our care as the ones who are out on the front lines carrying guns.”

In war, Miller said, “there’s no OK or not-OK. There’s no one way or the other. There are no absolute moral guidelines. It’s always about the larger picture. Each individual is unique.”

Wayne Miller’s experience as a veteran, coupled with extensive professional training and a natural gift for empathizing and bonding with others, has led him to become a kind of icon in the annals of the Vets Centers. He still “loves to come in to work every day,” and reflects on the privilege of dealing with people’s lives everyday.

“Have I helped a great many? I think so. I certainly hope so. I’m definitely going to keep trying to do so.”