LONG FORK, Ky., April 13, 2006 -- You may know him from the iconic photograph, showing the exasperation and grit of a U.S. Marine.
He is Lance Corp. James Blake Miller from Jonancy, Ky., holler -- a small valley between mountains -- in the eastern part of the state named after his great-great-great-grandparents, Joe and Nancy.
To many Americans, this picture of a young American fighter has become a symbol of what is right with the nation. That may be true, but the deep, psychological wounds Miller has sustained in Iraq make him a symbol of something else, too.
Miller suffers from post-traumatic stress disorder, a condition he says the American people do not truly understand.
"I tried to explain to people that I was suffering from PTSD [post-traumatic stress disorder], and they were thinking that this guy is a head case," he said. "That's the reason that I am doing this."
"I want people to understand what PTSD is and what it can do to you -- what it can do to your life. There's no real way to actually correct it, but I mean with the support of friends and family, and actual psychiatrists and things like that, it's something that can be dealt with," he said.
Miller's story is not unique. A recent study published in the Journal of the American Medical Association indicates that more than one in three troops back from Afghanistan or Iraq sought professional help for mental health problems within a year of returning, with one in five reporting PTSD or mental trauma.
Miller joined the Marines as a high school senior in November 2002, driving almost an hour to the Pike County seat to enlist.
He was following in the footsteps of his grandfather, a Korean War veteran, he said.
"I can remember my grandmother talking about him and stuff like that, and just talk about the type of person you know it changed him into," he said. It made him a man, she would tell him.
6½ Packs a Day
After basic training in Paris Island, S.C., Miller went to Iraq in June 2004. His cigarette habit, which began when he was 12, went from a 1½ packs a day to 6½ packs a day.
He was a radioman with the First Battalion, Eighth Marines, Charlie Company, when he and his unit were caught in a nightmarish firefight in Fallujah in early November 2004.
They started taking fire from every direction, he recalled.
From a rooftop, Miller called in two tanks, which fired at an enemy location.
"It was actually right inside the building where we were at, and it was nuts," he said. "It was like you could feel your heart, like it just felt like it was coming out of your chest. It was insane."
After the battle, an embedded photographer -- Luis Sinco from The Los Angeles Times -- captured Miller grabbing his first moment of peace.
"I was watching the sunrise, and I was just. … I was so amazed," he said. "I was just like, here I am 20 years old. I got my whole life ahead of me. You know, I hadn't really done anything. In the 20 years I had been here, what had I actually done?'"
"And, you know, thinking this is so beautiful just to watch the sunrise and wondered if I was ever going to get the opportunity to see that again."
Miller said he didn't like looking at the photo, however.
"I don't care much for it," he said. "I mean, if it made one person here in the states stop and think for one second at how grateful they should be, you know, just for what they do have and the freedoms that they do have, then it was worth it."
Within a day, the photograph appeared in at least 100 newspapers around the world. Many called him the "Marlboro Man," because of the cigarette he's seen smoking.
To his surprise, he learned his superiors considered pulling him out of combat and sending him back to the states because of the publicity he'd received, but Miller resisted the idea.
"I was like no way," he said. "I mean I came in here with the guys that I am with, and some of them aren't even able to get back out of here."
Miller came to hate the photograph also because he is smoking in it. Today, he's down to 1½ packs a day.
The Philip Morris Co. wanted to pay Miller to use his image on a commemorative cigarette case with a desert camouflage design, he says, but he declined, saying it wouldn't be fair to his fellow Marines -- especially those left behind after being killed in Fallujah.
For Miller, Marlboro conjures vivid and warm memories of watching the movie "Harley Davidson and the Marlboro Man," starring Mickey Rourke and Don Johnson, with his father, who raised he and his two brothers as a single parent. Because of his nicotine habit, Miller was called "Smokey" as a kid. He even has a tattoo of a Marlboro Red cigarette on his left forearm, but he's now trying to quit altogether.
Stateside, but Struggling With Aftereffects of War
After almost eight months, Miller's tour in Iraq ended. His unit was sent to the Gulf Coast to help with safety and security during the aftermath of Hurricane Katrina. He says it was another wrenching assignment -- one that reminded him all too much of Fallujah.
Miller had already begun to show serious signs of strain -- extreme irritability and nervousness.
Even though he was back home, he suffered though sleepless nights, exhaustion, blackouts, nightmares, and uncontrollable body movements.
"In my sleep, I'd pull my trigger finger," Miller said.
Visiting his girlfriend -- now his wife -- Jessica at her dorm at Pikeville College, he imagined that he saw a dead Iraqi civilian.
The breaking point came when Miller and his unit were put on the USS Iowa Jima with Hurricane Rita about to hit land.
Someone onboard, a Navy man, made a whistling noise, like the sound of a mortar.
"I think they were trying to aggravate the Marines onboard, and when the guy had made the sound, I don't remember anything other than hearing it at the beginning. And after that what I suppose happened was that I had grabbed him, put him against the wall, slammed him to the floor, and I was on top of him and I had no recollection of doing it."
Bringing Attention to a Misunderstood Affliction
Doctors examined him and quickly diagnosed him as suffering from PTSD. Last November, exactly one year after his iconic photograph was first published, Miller received an honorable but early discharge, because of his disorder.
Today, he drives a couple hours to the Veterans Hospital to talk to a psychiatrist several times a month.
Miller said he found people did not want to hear about PTSD.
"People don't understand that you can get PTSD from anything. It's a near-death experience and being able to escape that and just to be able to relive that," he said.
He still worries his PTSD may one day trigger another violent outburst.
"If I was to act out, I don't know what I'd do. I was really scared at first when I found out that this was actually what it was, that what if I had done something to my wife or to someone I cared about or loved?"
"And that tore me all to pieces. I had no idea how to deal with it."
Nevertheless, Miller is trying to move on with his life -- and to quit smoking for good.
He's trying to deal with it now, but he's become an icon for an altogether different kind of struggle.