General Peter Chiarelli has had the sort of career one would expect from a combat arms officer who rose to become Vice Chief of Staff of the U.S. Army, including commands at every level from platoon to corps and a variety of senior staff positions. But in his current job as the Army's second highest officer he sounds more like a psychiatrist or neurologist. Chiarelli has been leading the Army's efforts to address health problems that have anything to do with soldiers' brains, including traumatic brain injuries sustained in combat and everything coming under the label of mental health. An interview of Chiarelli in the latest issue of National Journal highlights why this set of problems, although less conspicuous than either deaths or lost limbs, deserves the high-level attention the Army is giving it.

Chiarelli's efforts do not receive as much public notice as leadership in combat, but they are ultimately as important to national defense, in a couple of respects. One is that they relate directly to the readiness of the force to conduct the missions expected of it. More members of the U.S. military end their lives in suicide than in combat. Either way it means the loss of a soldier. Another respect is that even among those who are living and physically whole, the lives of a substantial piece of the American population have been damaged by the mental after-effects of combat. This involves the various behavioral consequences of what Chiarelli prefers to call post-traumatic stress, leaving out the customary “disorder” usually applied to the syndrome.

Chiarelli expresses two major frustrations. One is that research in treating the ailments he is dealing with has not progressed as fast as the science and technology of handling physical disabilities outside the brain. The other is that there is no end in sight for the high operational tempo that continues to be demanded of U.S. armed forces and that underlies the stress that members of the military are under. That stress in turn leads to the suicides and the other post-traumatic behavioral problems. All of these problems represent a major cost—albeit one that is easy to overlook because it is not as directly visible as many other costs—of calling on members of the armed services to keep doing more overseas.