With a Silver Star medal clipped to his Air Force jacket, 1st Lt. Thomas Cahill spoke humbly about his efforts to pilot a rescue helicopter through enemy fire while flying low over eastern Afghanistan's snow-capped mountains.
His "uncanny skills," his citation read, for keeping the Pave Hawk airborne in thin air at low rotor speed with mortar rounds whizzing by, resulted in saving three men during that mission on March 3, 2002.
"As dark as it was, impacting the terrain was my first enemy," he said five years ago after his award ceremony at Nellis Air Force Base. "I would say it was probably luck."
In the years since Operation Anaconda, Cahill's enemy changed. So did his luck.
His enemy became post-traumatic stress disorder, or PTSD, an anxiety condition that stirs nightmarish memories of terrifying ordeals from the battlefield. It can cause sleep loss and erratic, impulsive behavior and make a person short-tempered.
As for his fortunes, he became a court-martialed captain this year. He was confined in the brig at Nellis until his release a month early in September for good behavior.
Cahill's attorneys argued that his PTSD caused him to lose focus in his job with the 561st Joint Tactics Squadron and do things out of character.
"It was one of those cases where the hero has feet of clay," one of his attorneys, Craig Mueller, said days after Cahill's case concluded.
"Who rescues the rescuer?" Mueller asked. "The Air Force admitted they didn't recognize his PTSD and change of behavior until the end of his tour. There are eight or nine people today who wouldn't be alive if it wasn't for him."
In the general courts-martial, Cahill pleaded guilty May 27 to charges related to off-base thefts after his arrest by Las Vegas police in 2006 for stealing a car-haul trailer in the southern Las Vegas Valley.
He also was charged with stealing an all-terrain vehicle, a race boat, making a false official statement, conspiracy to commit larceny, conduct unbecoming an officer, receiving stolen property and obstructing justice. The race boat and all-terrain vehicle theft charges were dropped from his guilty plea, but the other charges stood.
Cahill was sentenced to five months' confinement. In lieu of a $10,000 fine, he paid $8,000 in restitution to cover the thefts, a Nellis spokeswoman said Friday.
Part of his sentence entailed counseling for post-traumatic stress disorder. It's called "cognitive behavioral therapy," or changing thoughts to change behavior.
For his plea, Cahill's attorneys said, he will be allowed to retire honorably from the Air Force as a captain, enabling him to pursue veterans benefits and continued counseling for PTSD through the Department of Veterans Affairs.
Cahill declined to be interviewed but offered an apology in a handwritten statement that went on to state, "My decision is based on my fear of any retaliation that could come from my speaking out about the lack of proper treatment for my PTSD."
His mother, Susan Peek, also declined interview requests. She testified on Cahill's behalf, as did his brother.
Air Force officials at Nellis wouldn't comment about Cahill's case but confirmed he has returned to duty with the 99th Mission Support Group.
They said they don't have a specific program to deal with post-traumatic stress disorder among active duty troops but focus on awareness and hope that those with PTSD voluntarily seek help through the base's mental health program.
"What we do in the Air Force is a lot of prevention education," said Lt. Col. Kevin McCal, a Nellis psychologist, who served in Afghanistan and commands the 99th Medical Operations Squadron.
"Awareness is a big piece of this, and the second piece, of course, is because there's awareness we're getting support and resources" for preventive education.
An airman, soldier, sailor or Marine deployed for extended periods in the war zone "can come back a different person," McCal said.
"When you come back, will your morals have changed, and will your beliefs change? It's possible that ... some of those things might be challenged," McCal said.
"It's unlikely you'll come back and say something like, 'It's OK to beat my wife,' when it wasn't before. Or, 'I think I want this in the store, so I'll just take it.' You'll still recognize right from wrong."
Still, he said, there may be an inability to adjust to life away from the battlefield. "You're blowing off whatever you thought was important, rules, morals, whatever it was."
"You could come back an individual that has a shorter temper because your patience is not what it used to be. You could come back and be an individual that doesn't sleep so well for whatever reason. And that could be directly because of symptoms of nightmares and so forth."
Some who suffer from PTSD don't seek help because "in their eyes, they're like, 'Oh. I'm strong enough I should be able to handle this.' And therefore they stop talking, and the symptoms get worse."
Among the symptoms are forgetfulness, fatigue and family problems.
"Mental health has always been a tough thing to deal with, because there is no blood test. There's no black-and-white answers to what we have or what they're dealing with," he said.
McCal said although numbers of active-duty PTSD cases at the base have increased since the wars in Afghanistan and Iraq, some cases will fall through the cracks.
"All you can do is keep getting those cracks smaller. There's always going to be someone out there that won't come forward."
And few of those who check in for help are pilots.
"I won't say they're scared of mental health, but they don't like to go anywhere which may risk their flying status. ... That's their bread and butter. That's who they are," McCal said.
Helicopter rescue pilots, he noted, have a more close-up view of the battlefield than, say, a fighter jet pilot.
"Rescue pilots have to land usually under hot fire, pick up somebody who is hurt or injured, more likely severely if they're called in. So, they have a higher degree of danger.
"I don't think the public needs to be scared that the military is getting wiped out by PTSD, or that parents have to worry that all kids that go to war are going to come back with some kind of four-letter disorder, because they won't, all of them," McCal said. "But they do need to know that if their kids come back and they're not the same somehow and different to see if they can get them some help. Again, it's all about education."
Contact reporter Keith Rogers at krogers @reviewjournal.com or 702-383-0308.