Suicide Zoloft 16/05/2006 Iraq Soldier Commits Suicide Summary:

This article reads: "'He told me they had pulled a raid on this house, and a 7-year-old boy came out of an unchecked door and was shot and killed,' Ann says. 'Bobby would walk through hell and back for a child. So this really, really bothered him. He said that the doctor had put him on Zoloft because he could not sleep, and what little sleep he did get, he kept having nightmares.'"

"By the time Guy returned to the doctor two weeks later - on April 3, 2005 - he was taking an entire pill a day. The doctor handed Guy 30 more pills that day and formally increased the prescription to 100 mg daily, with no plan noted for monitoring the drug's effect. That was the last encounter Guy had with a medical professional."

"Eighteen days later, he was dead. And an autopsy found unusually high levels of Zoloft in his bloodstream."

"A Marine investigator spent a month probing Guy's death, interviewing comrades and commanders, collecting military and medical records, and reviewing scientific literature on antidepressants. The result was a 100-page report that concluded Guy was suffering from depression in the weeks before he killed himself, and that, among a number of factors, the suicide was likely caused in part by 'a rapid mood shift, abnormal thoughts, hallucinations, suicidal thoughts, and worsened depression related to his use of the anti-depressant Zoloft.'"



In this three-segment video story Ann and Jim Guy, parents of Marine Pfc. Robert Allen Guy, discuss their son's youth growing up in the small town of Willards, Maryland. He wanted to be a Marine, and his parents supported him with pride. They now live with the anger, sadness and regret over his suicide. They relive conversations they had with Bobbie, in an attempt to understand why he took his own life and to find some meaning in their loss.

Bobby Guy: Segment 1
Bobby Guy: Segment 2
Bobby Guy: Segment 3




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Mentally Unfit, Forced To Fight

Amid Patriotism, Anger And Questions



By MATTHEW KAUFFMAN
The Hartford Courant

May 16 2006

WILLARDS, Md. -- Just off the two-lane main street of this southern Maryland town, a couple doors shy of the big lumber mill that rumbles all day like thunder, Ann and Jim Guy's modest dwelling is the picture of a patriotic American home.

Out front, atop a tall white pole that dominates the postage-stamp yard, a scarlet and gold Marine Corps flag flutters in the wind, bearing the essence of the elite fighting force: eagle, globe, anchor and the venerable motto "Semper Fidelis."

Inside the house, that iconic emblem is stitched into quilts and pillows, engraved into picture frames, and printed on the only coffee mug Ann will put her lips to. "My son," the mug proclaims. "One of the few, the proud." The same Marine emblem adorns the gold ring on Jim's finger, the buckle on his belt, the watch on his wrist, the cap on his head.

And in the small living room, just above the piano laden with yet more Marine mementos, is the emotional epicenter of this home - an oversize portrait of Pfc. Robert Allen Guy in his Marine dress blues - his jaw rigid, his eyes determined.

It is a recruiting brochure fantasy of a proud, faithful military family.

But that family doesn't live here anymore.

They began to vanish at 4:15 p.m. on April 22, 2005, the precise moment Ann pulled open her front door, looked up from her wheelchair and found a somber trio of men in uniform staring back at her.

Bobby Guy, 3rd Battalion, 8th Marine Regiment, 2nd Marine Division, was 26. He had arrived in Iraq just 95 days earlier.

In the months that followed Bobby's suicide, the proud military family disappeared more and more as Ann and Jim learned that the military concluded their son had shot himself in the head and that a month earlier he had been prescribed a potent antidepressant with only spotty attention paid to the dosage or his mental state. They discovered that Bobby had made an urgent request to talk to a chaplain hours before his death - a request that was rebuffed and postponed to a morning he would never see. And they learned a Marine investigator had determined the medication handed to Bobby by the military was partly responsible for his death - until a general overruled that finding.

Today, more than a year after they buried their son at Arlington, the military family that once lived here has been consumed by a despair and anger that spills from Ann's lips with startling venom.

"You don't know how bad I want to go out there and set fire to that Marine Corps flag," she says, her eyes narrow, lips pursed. "The only reason I didn't is because it flies for Bobby. It flies for all the ones that went before him, and all the ones that'll go after him.

"It damn sure don't fly for the Corps."

Always A Dream

Even as a kid, Bobby Guy had wanted to be a Marine, and he always had the physique for the job - tall and muscular like his father. He even walked with the strut of a proud jarhead.

But while he fit the military on the outside, Bobby was sorely lacking in mental discipline, riding through his teens and early 20s on a wave of impulsive behavior.

"Bobby was the wild child," says Ann Guy, 49, who nicknamed her younger son "Barney Badass" for his penchant for schoolyard fights and petty mischief.

"Bobby didn't take nothing off of nobody. You said something he didn't like, he'd go off on you in a heartbeat," Ann says. "But five minutes later it was all done and over with, you know?"

Bobby dropped out of high school and bounced from job to job - all of them short-lived. Ann remembers a summer day when the temperature topped 90, and Bobby saw a swimming hole as a far more logical destination than the workplace.

Employers tended to see things differently.

"Bobby got fired from most jobs he had around here," Ann says. "If he didn't get fired, he usually quit."

And his impulsiveness was in full bloom when women were involved. After meeting a young woman from Canada over the Internet, Bobby would stand at the pay phone of the nearby IGA market - the family owned no phone at the time - chatting for hours on end, until his parents said they would have to surgically remove the handset from his ear.

The two married. It didn't last.

Later, he met a woman from Arkansas on the computer, and eagerly headed south. But he eventually came home.

"Bobby was in and out, back and forth. Bobby would move out, and within six months: `Mom, can I come back home?'" Ann said.

"God knows we've been through a lot with him," she said with a smile that quickly faded. "And I would give anything to go through it all over again, just to have him back."

Bobby grew more serious by his mid-20s, and announced at 25 that he was going to get his high-school diploma and join the Marines. Friends and relatives say he saw it as a way to make amends for his wild youth.

But he hadn't put his Barney Badass days entirely behind him. A form in his Marine files lists his hobbies as "drinking, movies, video games, internet," and shortly after he arrived at Camp Lejeune, he was disciplined for an incident in which he got drunk and shot a fellow Marine with a BB gun.

The war in Iraq had started by the time Bobby enlisted, and both Ann and Jim were fearful. But in June of 2004, when he graduated boot camp at Parris Island, they couldn't help but be impressed by the serious-minded man in the dress blues.

"I was proud. Real proud," Jim says, struggling to maintain his composure. "Reluctant. But proud."

An Able Marine

Bobby Guy's superior officers in Iraq described him as an able Marine who followed orders. But within two months of deploying, Guy was having trouble sleeping and took a chaplain's advice to see the base doctor about medication.

The source of Guy's insomnia is a matter of considerable disagreement between the military and Guy's parents. Military records say Bobby Guy told the base chaplain and doctor that he was upset because his girlfriend had had a miscarriage. Ann says the girlfriend wasn't even pregnant, and that Bobby's troubles were combat-related.

"He told me they had pulled a raid on this house, and a 7-year-old boy came out of an unchecked door and was shot and killed," Ann says. "Bobby would walk through hell and back for a child. So this really, really bothered him. He said that the doctor had put him on Zoloft because he could not sleep, and what little sleep he did get, he kept having nightmares."

A family representative confirmed that Bobby's girlfriend was never pregnant, but said the family would have no further comment because the topic of Bobby's death was too painful.

The warning label for Zoloft, an antidepressant, instructs that depressed patients should be monitored daily for suicidal thoughts or unusual changes in behavior when the drug is first prescribed or when the dose is adjusted.

Guy's medical file indicates there was no follow-up for 14 days, and shows the military has no record even of how many pills the base doctor originally gave Guy or how much of the drug he was taking on any given day.

Although Guy's medical records indicate a prescription for 50 mg - a common starting dose - the doctor had given Guy 100 mg tablets, though he said he couldn't remember how many. The doctor also told an investigator Guy "was cutting the tablets in half ... as a gradual process until he was ready for the full tablet."

By the time Guy returned to the doctor two weeks later - on April 3, 2005 - he was taking an entire pill a day. The doctor handed Guy 30 more pills that day and formally increased the prescription to 100 mg daily, with no plan noted for monitoring the drug's effect. That was the last encounter Guy had with a medical professional.

Eighteen days later, he was dead. And an autopsy found unusually high levels of Zoloft in his bloodstream.

Exactly why Bobby Guy killed himself will always be a mystery. But the fuse may have been lit April 13 - 10 days after his second visit to the doctor - when Guy and two other Marines were ordered to guard an Iraqi detainee who was facing interrogation.

One of the other Marines told investigators he heard Guy say he was "going to play psychological mind games with the detainee" and saw Guy remove the magazine from his rifle. At that moment, the company commander walked through the door and said he saw Guy point the unloaded weapon at or near the prisoner's head and rack the bolt - the mechanical action that ejects a spent round and, if the magazine is attached, chambers a new one.

Guy insisted he was merely disarming his weapon by removing the magazine and ejecting a round in the chamber. And while he acknowledged he did not follow proper clearing procedures, he said he did not point his weapon at the prisoner and that the company commander had a limited view of the incident and was mistaken.

"I'm guilty of an act of stupidity + poor judgment, but I'm not guilty of any war crimes," Guy wrote in a statement to investigators. "I didn't swear my life to the Marine Corps to mess it up."

Ann Guy says she is inclined to believe her son. But she still wonders why he was ever assigned to that holding cell.

"Bobby is on a mind-altering drug, with a loaded rifle, and he is requested to guard an Iraqi detainee?" Ann says with disbelief. "I mean, I am as confused as anything else."

Guy was brought up on charges and faced "non-judicial punishment," an administrative action in which the maximum penalty was a reduction in rank and the forfeiture of a month's pay.

Guy's commanding officer held a hearing on the night of April 21, 2005, and decided to refer the case up the chain of command, where Guy might have faced more serious punishment.

Ann says fellow Marines told her a sergeant had berated Guy after the hearing, telling him "you just signed your ass away" and saying he would do 30 years in Leavenworth prison. The official Marine investigation of Guy's death includes no such allegation, although it notes that during the hearing, a superior officer was "hoping to scare him straight."

After the hearing, around 8:30 or 9 p.m., Guy saw his platoon sergeant near the smoke pit, and asked if the accusation against him amounted to a war crime. The platoon sergeant said it could, because the detainee was a POW.

Guy then asked if he could talk to a chaplain "as soon as possible," and the platoon sergeant headed off to make arrangements with a first sergeant. The first sergeant said there was no chaplain on base and that he would arrange a convoy for Guy - but not until morning.

It is unclear if that news was ever relayed to Guy. But later that night, around 10:15 p.m., Guy grabbed his rifle, left his barracks and headed to a line of six portable toilets, stepping into the first one on the left, and locking it.

Soon afterward, a fellow Marine pulled on the door, and Guy, in a sad tone of voice, said he was in there. The Marine moved two doors down and went in. Guy's platoon sergeant, who had been looking for Guy, also went into one of the toilets.

Minutes later, Bobby Guy, sitting in the dark in Al Karmah, Iraq, rested the muzzle of his rifle against the center of his forehead, just above his eyebrows.

"Corpsman Up!"

The Colt M-16A4 rifle propels a bullet at more 2,000 mph, and the shot drilled a 9mm hole into Guy's forehead and through his brain, before blasting out the back of his skull, leaving a 3-inch by 6-inch opening.

The startled platoon sergeant bolted out of the toilet into the darkness, yelling, "What the hell was that?" while the other Marine pulled on Guy's door, calling his name and asking if his weapon was "Condition 4" - meaning unloaded, with the safety on.

Pulling hard on the locked door, the Marine pointed a flashlight through the crack, and the dance of light settled on a piece of skull, and then blood.

"Corpsman up!" he shouted repeatedly, summoning any medic that could hear him, while the platoon sergeant ripped open the door and began swearing. Officers and corpsmen came running.

But Guy had died instantly.

Marines secured the scene, while the first sergeant assembled all of the platoon sergeants under him and instructed them to tell their men two things.

He told the sergeants to tell their Marines that Guy was dead.

And he told them to let the Marines know that the chaplain was available if they needed to talk.

That is among the most painful details for Ann and Jim Guy. "Part of me feels like, if he had just been able to talk to a chaplain that night when he wanted to talk to a chaplain, he'd still be alive," Ann says.

But Ann also wonders why her son was in Iraq at all, a month after a doctor had put him on a psychotropic drug.

"If he was in such a state that he needed to be put on an antidepressant, they didn't need to send him home to Mommy, but they could have sent him any number of places," Ann says. "I don't care if it was Hamburg, Germany. I don't care if it was Okinawa, Japan. They could have sent him any number of places."

At the very least, she says, they should have put him far enough behind the front lines that he wouldn't have needed to tote a rifle.

A Marine investigator spent a month probing Guy's death, interviewing comrades and commanders, collecting military and medical records, and reviewing scientific literature on antidepressants. The result was a 100-page report that concluded Guy was suffering from depression in the weeks before he killed himself, and that, among a number of factors, the suicide was likely caused in part by "a rapid mood shift, abnormal thoughts, hallucinations, suicidal thoughts, and worsened depression related to his use of the anti-depressant Zoloft."

The investigator recommended that Marines suffering from clinical depression be disarmed and reassigned until a medical officer has certified that their mental state has returned to normal. He also called for a periodic review of government warnings regarding drugs prescribed to deployed Marines, a "safety stand down" focused on training military leaders to better manage Marines suffering from depression, and a review of medical records to identify other Marines taking Zoloft or similar drugs.

But as the report moved up the chain of command, every one of those conclusions and recommendations was rejected.

Guy's commanding officer wrote that while he consults mental health experts, "I make the final decision on a Marine's duty assignment, as well as if he should carry a weapon."

And a commanding general rejected the conclusions that Guy was suffering from depression and that Zoloft probably played a role in his suicide, saying such findings were conjecture or were not supported by the facts.

Saying Goodbye

They had to turn on the outdoor loudspeakers at the Hastings Funeral Home to accommodate the overflow crowd that showed up for Guy's funeral. Willards is home to fewer than 1,000 people, but "everybody knew Bobby around here," Jim Guy says.

In a private room, Ann wheeled her chair up to the casket and gazed at her son, lying unnaturally motionless, his skin pale, his head wrapped with gauze that barely showed his eyes. It was difficult to cover his wounds, but Ann insisted on an open casket for the family viewing. "I cannot say goodbye to a box," she explained to the funeral director.

Bobby Guy was in full military uniform - the Marines provide families with an additional set of medals and pins for burial - right down to his white gloves.

Ann touched her son's face, and then held his hands, carefully checking his fingers, allowing herself one last fantasy that it was all a huge mistake. Bobby, she says, had a habit of biting his nails down to the skin. "I had to feel through the gloves," she says, "because if there's fingernails, it ain't Bobby."

There is a vast network of strangers who spring into action when a Marine dies. Websites appear. Memorial quilts are crafted. Condolence books are assembled and shipped.

A "Marine comfort quilt" arrives from a woman in Missouri, assembled from squares made by other women in Toledo, Sacramento, Arlington, Texas and elsewhere. "In Memory of a Fallen Brother," reads one square. "Semper Fi," reads another.

A blanket is sent by a woman in Iowa, with the message: "In Memory of a True Hero to His Country and Family. PFC Robert A. Guy, 3rd Battalion, 8th Marine Regiment, 2nd Marine Division. KIA April 21, 2005."

The Guys are awestruck by the outpouring of concern. But it cannot extinguish the grief.

"There isn't a day that goes by that I don't cry," Ann says. "Sometimes I cry all day. Sometimes, just parts of the day."

Ann says the night time is the toughest, when she lies awake listening for footfalls that aren't there. But the days aren't really any easier.

Ann's left leg was amputated nearly five years ago, after 11 operations failed to control the hardening in her arteries. She is surprisingly good-natured about it - her e-mail address includes the word "pegleg" - but she now spends most of her time in a motorized wheelchair inside the four walls of her small house.

"It was so hard for me being here day after day. Everywhere I looked, there was Bobby. I mean, I go in the front room, and even though he's not there physically, there's Bobby laying on the couch, with his nasty boots up on the couch arm," Ann says, sitting at the kitchen table, her hands around her Marine Corps mug. "And I come in here, and there's Bobby with his back side up against the washing machine, hands behind him, looking up here at the foodstuffs, trying to figure out what he wanted to eat.

"Everywhere you looked, there was Bobby."

Ann and Jim have also dealt with their own ambivalence about Bobby's death. For most of the last year, they have found it impossible to accept that their son took his own life, with Ann insisting that if Jesus Christ himself told her it was a suicide, she would tell him, "No, sir. I'm sorry, you're wrong."

But lately, they have softened to the possibility.

"I could tell you that Bobby didn't do this, because I knew Bobby," Ann says. "But I didn't know Bobby on Zoloft."

Difficult Moments

A year has now passed since Bobby Guy's death, and the family has made it through at least the first round of difficult dates - the homecoming of Bobby's unit, the anniversary of his enlistment, Christmas.

On Bobby's birthday, Dec. 29, Ann and Jim drove through pouring rain, trying to make the three-hour trip to Arlington. "I never thought I'd have to go to a cemetery to tell one of my children Happy Birthday," Ann says.

But the rain was so heavy it was hard to see the road. "We got about 10 miles on this side of Washington, and I told Jim, I said, `You might as well go back home,'" Ann recalls. "I said we won't even be able to get out of the car. And even if it stops raining, the ground would be soggy, and Jim would have to push me in the wheelchair, and I didn't want him tearing Bobby's grave up."

They turned around, and drove back up on the weekend, on New Year's Day.

Last month, Ann, Jim and their older son, James Jr. - known as Little Jim - piled into a minivan and again headed north and west, over rural roads and highways, and then by foot and wheelchair across a vast expanse of grass at Arlington National Cemetery, to Section 60, Site 8110.

It was April 21, one year to the day since Bobby Guy died. Ann gazed at her son's name, chiseled in white marble, and knelt on the fresh sod to lay a rose at the gravestone. In the distance, rifles pierced the silence with a 21-gun salute for another mother's child.

Back home, on the living-room wall opposite Bobby's Marine portrait, are two family pictures taken at Wal-Mart the day after New Year's 2005 - two weeks before Bobby left for Iraq. The two boys share one picture, Bobby sitting down, Little Jim standing behind him, his arms resting on his younger brother's shoulders, silly grins on both their faces, like they're trying not to laugh.

In the other portrait, Jim's features are disarmingly soft. Ann's eyes are full of brightness and joy.

They are the family that used to live here - before Iraq, before depression, before Zoloft, before a dark night and a high-powered rifle.

"Something has to be done different. It really does," Ann says. "If it keeps one more young man from having to go through this. If it keeps one more family from having to go through this, something has to be changed."

Copyright 2006, Hartford Courant