Story originally appeared July 21, 2008.
PINEHURST, N.C. ? Officers had been to the white ranch house at 560 W. Longleaf many times before over the past year to respond to a "barricade situation." Each had ended uneventfully, with Joseph Dwyer coming out or telling police in a calm voice through the window that he was OK.
But this time was different.
The Iraq war veteran had called a taxi service to take him to the emergency room. But when the driver arrived, Dwyer shouted that he was too weak to get up and open the door.
The officers asked Dwyer for permission to kick it in.
"Go ahead!" he yelled.
They found Dwyer lying on his back, his clothes soiled with urine and feces. Scattered on the floor around him were dozens of spent cans of Dust-Off, a refrigerant-based aerosol normally used to clean electrical equipment.
Dwyer told police Lt. Mike Wilson he'd been "huffing" the aerosol.
"Help me, please!" the former Army medic begged Wilson. "I'm dying. Help me. I can't breathe."
Unable to stand or even sit up, Dwyer was hoisted onto a stretcher. As paramedics prepared to load him into an ambulance, an officer noticed Dwyer's eyes had glassed over and were fixed.
A half hour later, he was dead.
When Dionne Knapp learned of her friend's June 28 death, her first reaction was to be angry at Dwyer. How could he leave his wife and daughter like this? Didn't he know he had friends who cared about him, who wanted to help?
But as time passed, Knapp's anger turned toward the Army.
A photograph taken in the first days of the war had made the medic from New York's Long Island a symbol of the United States' good intentions in the Middle East. When he returned home, he was hailed as a hero.
But for most of the past five years, the 31-year-old soldier had writhed in a private hell, shooting at imaginary enemies and dodging nonexistent roadside bombs, sleeping in a closet bunker and trying desperately to huff away the "demons" in his head. When his personal problems became public, efforts were made to help him, but nothing seemed to work.
This broken, frightened man had once been the embodiment of American might and compassion. If the military couldn't save him, Knapp thought, what hope was there for the thousands suffering in anonymity?
Aftermath of Sept. 11
Like many, Dwyer joined the military in the aftermath of the Sept. 11 attacks.
His father and three brothers are all cops. One brother, who worked in Lower Manhattan, happened to miss his train that morning and so hadn't been there when the World Trade Center towers collapsed.
Joseph, the second-youngest of six, decided that he wanted to get the people who'd "knocked my towers down."
And he wanted to be a medic. (Dwyer's first real job was as a transporter for a hospital in the golf resort town of Pinehurst, where his parents had moved after retirement.)
In 2002, Dwyer was sent to Fort Bliss, Texas. The jokester immediately fell in with three colleagues ? Angela Minor, Sgt. Jose Salazar, and Knapp. They spent so much time together after work that comrades referred to them as "The Four Musketeers."
Knapp had two young children and was going through a messy divorce. Dwyer stepped in as a surrogate dad, showing up in uniform at her son Justin's kindergarten and coming by the house to assemble toys that Knapp couldn't figure out.
When it became clear that the U.S. would invade Iraq, Knapp became distraught, confiding to Dwyer that she would rather disobey her deployment orders than leave her kids.
Dwyer asked to go in her place. When she protested, he insisted: "Trust me, this is what I want to do. I want to go." After a week of nagging, his superiors relented.
Dwyer assured his parents, Maureen and Patrick ? and his new wife, Matina, whom he'd married in August 2002 ? that he was being sent to Kuwait and would likely stay in the rear, far from the action.
But it wasn't true. Unbeknownst to his family, Dwyer had been attached to the 3rd Infantry's 7th Cavalry Regiment. He was at "the tip of the tip of the spear," in one officer's phrase.
During the push into Baghdad, Dwyer's unit came under heavy fire. An airstrike called in to suppress ambush fire rocked the convoy.
As the sun rose along the Euphrates River on March 25, 2003, Army Times photographer Warren Zinn watched as a man ran toward the soldiers carrying a white flag and his injured 4-year-old son. Zinn clicked away as Dwyer darted out to meet the man, then returned, cradling the boy in his arms.
The photo ? of a half-naked boy, a kaffiyeh scarf tied around his shrapnel-injured leg and his mouth set in a grimace of pain, and of a bespectacled Dwyer dressed in full battle gear, his M-16 rifle dangling by his side ? appeared on front pages and magazine covers around the world.
Suddenly, everyone wanted to interview the soldier in "the photo." Dwyer was given a "Hometown Hero" award by child-safety advocate John Walsh; the Army awarded him the Combat Medical Badge for service under enemy fire.
The attention embarrassed him.
"Really, I was just one of a group of guys," he told a military publication. "I wasn't standing out more than anyone else."
Returning to the U.S. in June 2003, after 91 days in Iraq, Dwyer seemed a shell to friends.
When he deployed, he was pudgy at 6-foot-1 and 220 pounds. Now he weighed around 165, and the other Musketeers immediately thought of post-traumatic stress disorder.
Dwyer attributed his skeletal appearance to long days and a diet of MREs (Meals Ready to Eat). He showed signs of his jolly old self, so his friends accepted his explanation.
But they soon noticed changes that were more than cosmetic.
At restaurants, Dwyer insisted on sitting with his back to the wall so no one could sneak up on him. He turned down invitations to the movies, saying the theaters were too crowded. He said the desert landscape around El Paso, and the dark-skinned Hispanic population, reminded him of Iraq.
Dwyer, raised Roman Catholic but never particularly religious before, now would spend lunchtime by himself, poring over his Bible.
When people would teasingly call him "war hero" and ask him to tell about his experiences, or about the famous photo, he would steer the conversation toward the others he'd served with. But Dwyer once confided that another image, also involving a child, disturbed him.
He was standing next to a soldier during a firefight when a boy rode up on a bicycle and stopped beside a weapon lying in the dirt. Under his breath, the soldier beside Dwyer whispered, "Don't pick it up, kid. Don't pick it up."
The boy reached for the weapon and was blasted off his bike.
In late 2004, Dwyer sent e-mails to Zinn, wondering if the photographer had "heard anything else about the kid" from the photo, and claiming he was "doing fine out here in Fort Bliss, Texas."
But Dwyer wasn't doing fine. Earlier that year, he'd been prescribed antidepressants and referred for counseling by a doctor. Still, his behavior went from merely odd to dangerous.
One day, he swerved to avoid what he thought was a roadside bomb and crashed into a convenience store sign. He began answering his apartment door with a pistol in his hand and would call friends from his car in the middle of the night, babbling and disoriented from sniffing inhalants.
Matina told friends that he was seeing imaginary Iraqis all around him. Despite all this, the Army had not taken his weapons.
In the summer of 2005, he was removed to the barracks for 72 hours after trashing the apartment looking for an enemy infiltrator. He was admitted to Bliss' William Beaumont Army Medical Center for treatment of his inhalant addiction.
But things continued to worsen. That October, the Musketeers decided it was time for an "intervention."
Minor, who had moved to New York, overdrew her bank account and flew down. She, Knapp and Salazar went to the apartment and pleaded with Dwyer to give up his guns, or at least his ammunition.
"I'm sorry, guys," he told them. "But there's no way I'm giving up my weapons."
After talking for about an hour and a half, Dwyer agreed to let Matina lock the weapons up. The group went for a walk in a nearby park, and Dwyer seemed happier than he'd been in months.
But Dwyer's paranoia soon returned ? and worsened.
On Oct. 6, 2005, when superiors went to the couple's off-base apartment to persuade Dwyer to return to the hospital, Dwyer barricaded himself in. Imagining Iraqis swarming up the sides and across the roof, he fired his pistol through the door, windows and ceiling.
After a three-hour standoff, Dwyer's eldest brother, Brian, also a police officer, managed to talk him down over the phone. Dwyer was admitted for psychiatric treatment.
In a telephone interview later that month from what he called the "nut hut" at Beaumont, Dwyer told Newsday that he'd lied on a post-deployment questionnaire that asked whether he'd been disturbed by what he'd seen and done in Iraq. The reason: A PTSD diagnosis could interfere with his plans to seek a police job. Besides, he'd been conditioned to see it as a sign of weakness.
"I'm a soldier," he said. "I suck it up. That's our job."
Dwyer told the newspaper that he'd blown off counseling before but was committed to embracing his treatment this time. He said he hoped to become an envoy to others who avoided treatment for fear of damaging their careers.
"There's a lot of soldiers suffering in silence," he said.
In January 2006, Joseph and Matina Dwyer moved back to North Carolina, away from the place that reminded him so much of the battlefield. But his shadow enemy followed him here.
Dwyer was discharged from the Army in March 2006 and living off disability. That May, Matina Dwyer gave birth to a daughter, Meagan Kaleigh.
He seemed to be getting by, but setbacks would occur without warning.
On the Fourth of July, he and family were fishing off the back deck when the fireworks display began. Dwyer bolted inside and hid under a bed.
In June 2007, police responded to a call that Dwyer was "having some mental problems related to PTSD." A captain talked him into going to the emergency room.
Later that month, Matina Dwyer moved in with her parents and obtained a protective order. In the complaint, she said Dwyer had purchased an AR-15 assault rifle and become angry when she refused to return it.
"He said that he was coming to my residence to get his gun back," she wrote in the June 25, 2007, complaint. "He was coming packed with guns and someone was going to die tonight." She declined to be interviewed for this story.
In July 2007, Dwyer checked into an inpatient program at New York's Northport Veterans Affairs Medical Center. He stayed for six months.
He came home in March with more than a dozen prescriptions. He was so medicated that his feet flopped when he walked, as if he were wearing oversized clown shoes.
The VA's solution was a "pharmaceutical lobotomy," his father thought.
But within five days of his discharge, Dwyer's symptoms had returned with such ferocity that the family decided it was time to get Matina and 2-year-old Meagan out. While Dwyer was off buying inhalants, his parents helped spirit them away.
On April 10, weary and fearful, Matina Dwyer filed for custody and division of property.
Loosening grip on reality Without his wife and daughter to anchor him, Dwyer's grip on reality loosened further. He reverted to Iraq time, sleeping during the day and "patrolling" all night. Unable to possess a handgun, he placed knives around the house for protection.
In those last months, Dwyer opened up a little to his parents.
What bothered him most, he said, was the sheer volume of the gunfire. He talked about the grisly wounds he'd treated and dwelled on the people he was unable to save. His nasal membranes seemed indelibly stained with the scents of the battlefield ? the sickeningly sweet odor of rotting flesh and the metallic smell of blood.
Yet despite all that, Dwyer continued to talk about going back to Iraq. He told his parents that if he could just get back with his comrades and do his job, things would right themselves.
When Maureen Dwyer first saw Zinn's famous photo, she'd had a premonition that it might be the last picture she'd ever see of Joseph.
"I just didn't think he was going to come home," she said. "And he never did."
Accidental overdose? An autopsy is pending, but police are treating Dwyer's death as an accidental overdose.
His friends and family see it differently.
The day of the 2005 standoff, Knapp spent hours on the telephone trying to get help for Dwyer. She was frustrated by a military bureaucracy that would not act unless his petrified wife complained, and with a civilian system that insisted Dwyer was the military's problem.
In a letter to post commander Maj. Gen. Robert Lennox, Knapp expressed anger that Army officials who were "proud to display him as a hero ... now had turned their back on him..."
"Joseph Dwyer who had left to Iraq one of the nicest, kindest, caring, self-sacrificing and patriotic people I have ever known," she wrote, "was forced to witness and commit acts completely contrary to his nature and returned a tormented, confused disillusioned shadow of his former self that was not being given the help he needed."
While Dwyer was in the service, Minor said, the Army controlled every aspect of his life.
"So someone should have taken him by the hand and said, `We're putting you in the hospital, and you're staying there until you get fixed ? until you're back to normal."
But Dr. Antonette Zeiss, deputy chief of the VA's Office of Mental Health, said it's not that simple.
"Veterans are civilians, and VA is guided by state law about involuntary commitment," she told the AP. "There are civil liberties, and VA respects that those civil liberties are important."
The family would not authorize the VA to release Dwyer's medical records. But it appears that Dwyer was sometimes unwilling ? or unable ? to make the best use of the programs available. In an e-mail to The Associated Press, Lennox, the former Bliss post commander, wrote that Dwyer "had a great (in my opinion) care giver."
Zeiss said the best treatment for PTSD is exposure-based psychotherapy, in which the patient is made "to engage in thoughts, feelings and conversations about the trauma." While caregivers must be 100 percent committed to creating an environment in which the veteran feels comfortable confronting those demons, she said the patient must be equally committed to following through.
"And so it's a dance between the clinicians and the patient."
Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America, feels the VA is a lousy dance partner.
Rieckhoff said the VA's is a "passive system" whose arcane rules and regulations make it hard for veterans to find help. And when they do get help, he said, it is often inadequate.
"I consider (Dwyer) a battlefield casualty," he said, "because he was still fighting the war in his head."
'Nightmares in their head' The Sunday after the Fourth of July, Knapp attended services at Scotsdale Baptist, the El Paso church where she and Dwyer had been baptized together in 2004.
On the way out of the sanctuary, Knapp checked her phone and noticed an e-mail.
"I didn't know if you had heard or not," a friend wrote, "but I got an email from Matina this morning saying that Joseph had died on Saturday and that the funeral was today."
Knapp maintained her composure long enough to get herself and the children to the car. Then she lost it.
The children asked what was wrong.
"Joseph is dead," she told them.
"You said he wasn't sick any more," Justin said.
"I know, Justin," his mother replied. "But I guess maybe the help wasn't working like we thought it was."
The kids were too young to understand acronyms like PTSD or to hear a lecture about how Knapp thought the system had failed Dwyer. So she told them that, just as they sometimes have nightmares, "sometimes people get those nightmares in their head and they just can't get them out, no matter what."
Despite the efforts she made to get help for Dwyer, Knapp is trying to cope with a deep-seated guilt. She knows that Dwyer shielded her from the images that had haunted him.
"I think about all the torture that he went through when he came back, and I think that all of that stuff could have happened to me," she said, stifling a sob. "I just owe him so much for that."
Since Dwyer's death, Justin, now 9, has taken to carrying a newspaper clipping of the Zinn photo around with him. Occasionally, Knapp will catch him huddled with a playmate, showing the photo and telling him about the soldier who used to come to his school and assemble his toys.
Justin wants them to know all about Spc. Joseph Dwyer. His hero.