Vietnam veterans wounded forgotten warriors

Wounded Forgotten Warrior Project

Combat PTSD Wounded Times
Kathie Costos
March 9, 2019

I wanted to show what it is like driving into work at 5:00 am with very little traffic on the road. Much like when I got into working on PTSD back in 1982, the road was paved by others out there long before I even heard the term.

Vietnam veterans are responsible for everything we know about what trauma does. It is not that others never experienced it, but they were the ones who did something about it.

During the filming of the video, the commercial for Wounded Warrior Project came on and I lost my mind. It came on right after I ran down the things that have been forgotten, including the fabulous work done on the Forgotten Warrior Project. It told their stories to stop them from suffering in silence.

They are the wounded forgotten warriors! Their project was to heal their generations and all others who came before them and for those they knew would come after them.

In the video you will hear about IFOC, Nam Knights and Point Man International Ministries. 

I trained with the IFOC. I am a Lady of the Knight with the Nam Knights. I am Florida state coordinator of Point Man. So yes, I believe in them and what we do!

Please look them up if you want to know about about fabulous efforts to do real peer support.

God has called us for this reason

My dear friend Lily Casura over at Healing Combat Trauma sent this.

Ministering to the military and their families
Karen.Herzog@bismarcktribune.com
Posted: Thursday, February 18, 2010


“Being in boots overseas is an awful lonely time,” said Maj. David Johnson, a chaplain with the North Dakota National Guard. And when veterans return from deployments, he said, they are “forever changed.”

Johnson, along with other Guard chaplains, met with local clergy and pastoral ministers Thursday at Lord of Life Lutheran Church for Clergy Day 2010, spending the morning offering guidance as to how ministers can help military men and women and their families.

With North Dakota soldiers and airmen serving in places such as Iraq, Afghanistan and Africa, and closer to home during floods, snow emergencies and other natural disasters, clergy and congregations can serve as a source of comfort and support during difficult separations and after returning home, Johnson said.

"For some of our military members, their church is their bedrock and faith plays an instrumental role in their lives. It is essential that area clergy understand some of the unique challenges and stresses placed on today's military members and their families," he said.

In 2009 alone, more than 900 North Dakota soldiers and airmen deployed overseas.

Chaplain Bill Ziegler, the state chaplain for the Guard in the state, said that the Guard wanted to give pastors tools to minister to military families, who often live in “a different world” because of their loved one’s service.

There also is a need for more military chaplains, he said, particularly Catholic priests. Clergy Day 2010 also hopes to find clergy who feel God is calling them to do more in this arena, Ziegler said.

Currently, four chaplains serve about 1,000 members of the Air Guard, with a fifth coming on board soon, he said. The more than 3,000 members of the Army Guard are served by four chaplains, with five candidates coming up, he said. There also are roles for chaplains’ assistants, he said.

“We’re not there to bless bombs and bullets,” he said, “but to be with the soldiers and airmen in all the challenges they face.”

Like hospital chaplains, military chaplains are trained in “psychological and spiritual first aid.”
read more here
Ministering to the military and their families

Reading it is a a mixture of hope and frustration for me. It's wonderful that the military chaplains are calling on communities to get involved in PTSD. What is not so wonderful is there is a resource in the communities that is not being used because they are not the right kind of Chaplains.

I belong to the International Fellowship of Chaplains. We are trained, certified, insured and fully invested in working with people after traumatic events. We are also fully invested in restoring the spiritual relationship between God and man. We live the life of Chaplains 24-7. Some work within police departments and fire departments. Good enough for these service members but not good enough for the military or the veterans needing help to heal from traumas of combat. We work with civilians after traumatic events but not good enough to work with families of veterans or military families. How is this possible given the fact that PTSD is a wound to the soul?

I've worked with veterans since 1982, have taken more training and certification classes than my office wall has room to hold the certificates, yet I'm not good enough. I live with PTSD everyday in my home, yet managed to stay married for over 25 years, but I'm not good enough to work with families so that they can have what they need to not only cope, but thrive.

My videos have been used by military, psychologists, therapists, you name it, but no matter what I do, no matter what I know including tracking PTSD everyday on this blog, I am not good enough.

I'm not the only one being left unused. The IFOC trains Chaplains all over the country and some of us are in rural areas where help for the veterans is hard to get. We are in big cities where the numbers are staggering. Just because we do not have a degree from a seminary we are not welcomed yet when you talk to a Chaplain you can fully understand that when it comes to knowing what is in the Bible, we live it. Not only living it, but walking the walk side by side ready to help others through their own "shadow of the valley of death" just as most of us have. Our faith was not tested by passing a test on paper, but tested by passing day to day life facing more horrors than most people will ever know willingly putting ourselves into dangerous circumstances, hearing stories the best horror writer could never contemplate and then seeing the restoration of hope in their eyes.

We see a family fall apart when they find out someone in their home will not be walking thru the door ever again. We see them after a car accident has taken away someone they love in one single blow. We see them when firefighters and police officers have fallen in the line of duty just as we see them when they are taken to the hospital. Over and over again when tragedy strikes, we are there willingly but over and over again, we are overlooked when the need is greater than the workers.

Matthew 9:37-38
37 Then saith he unto his disciples, The harvest indeed is plenteous, but the laborers are few.

38 Pray ye therefore the Lord of the harvest, that he send forth laborers into his harvest.

God has called us for this reason.

IFOC Chaplain Army

Posted to Great Americans by NamGuardianAngel on September 13, 2009

Click to Play View Details

We are not in competition with the "acceptable" Chaplains, but fill in the need when they cannot simply because most of them have not been trained in crisis intervention. Can you imagine anything more in need of crisis intervention than servicemen and women returning from combat after multiple traumatic events? There are few Chaplains to go around as it is and most admit they don't know anything about PTSD.

When you think about Christ picking His disciples, we think about the twelve but not the over seventy He sent out or the many more spreading the Good News around the world willing to die for His sake. What if they were treated as not good enough to spread the messages Christ delivered? Romans were putting them to death but they were still willing to face any threat in order to serve God willingly putting themselves into harms way for nothing more than the glory God would reward them with after their life was over. They expected hardship in order to be of service to others.

The importance of having Chaplains fully involved in healing the troops and veterans cannot be emphasized enough. PTSD is a spiritual wound and needs to be healed with addressing the same kind of understanding as psychologist treat it but again, with those experienced with and specially trained to treat it for what it is instead of mental illness from other causes. PTSD only enters the person after trauma so treating it like any other mental illness will not work and has not worked. It needs to be treated with the soul in mind and not just the mind of the soul.

They need to use all Chaplains trained in crisis and not just the ones with a degree.

This is what an IFOC Chaplain can come up with along with about 30 more.

PTSD I Grieve

Posted to Great Americans by NamGuardianAngel on September 11, 2009

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Wounded Times receives endorsement from Vietnam and All Veterans of Brevard

A few months ago I was contacted by Bill Vagianos, Vietnam and All Veterans of Brevard, offering support for the work I do. I was stunned because up until now, I often traveled wondering how anyone had any clue who I was. I asked Bill if God sent him to me because his email came at a time when I was really depressed. (You know, one of those times in my life when I was wondering if what I was doing was worth it or not. One more time when bills were more than we had coming in. ) Then he told me that he had been reading my blog when I posted how hard it was to do this work while my family was suffering financially for it. I worked since I was 14 and had never been without a paycheck until January of 2008.

This is my work, my job, my ministry and what I was called to do when I fell in love with my Vietnam vet husband along with every other Vietnam vet. Since then, my arms expanded to reach out to the newer veterans, police officers, firefighters and survivors of trauma. Most of what I do is kept private. What you see on this blog is only part of what I do everyday. If I post 10 articles, there were about 60 more I had to read. Then the videos on the blog take more time. I do this because I remember being alone, or at least feeling alone because in the beginning, I just didn't know how many others there were living with PTSD.

This is the email I received from Bill today as an endorsement. He had great compassion for me since I told him that I was not really good at advertising what I do, so instead of just saying I have his support, he wrote this.

Chaplain Kathie,

Thank you for the powerfully inspiring presentation you made at the General Membership meeting of the Vietnam and All Veterans of Brevard (VVB) last evening. You provided enlightenment and hope for many of the members in attendance, myself included.

I began following Wounded Times about 18 months ago and remain in awe of your prolific writing and depth of knowledge regarding PTSD and many other veteran issues of concern. It is profoundly clear that your blogs are well-researched and reality-based.

And you message is clear that you are committed to bring a sense of normalcy to our fellow veterans, active troops, police officers, firefighters and other trauma survivors.

As you stated, we Vietnam veterans manifested PTSD as a legitimate diagnosis, having it recognized by the American Psychiatric Association as a disability related to combat and forcing the VA to treat the disorder.

Your unique and seemingly tireless approach to eradicating the sense of aloneness sufferers of PTSD experience through assemblage of compelling stories about people experiencing trauma, suffering the after affects of trauma, and trauma survivors reaching out to help others is powerfully healing. As you described, “Quiet heroes have been turning their own pain into missions of support to others”.

I realize that the cost of your commitment to your calling, training, licensing fees, insurance, computers, Internet, website fees, phone charges and travel expenses to name a few, have been absorbed by you and the financial burden on your family is huge. I am also aware that you recently lost your income.

The VVB is happy to financially support your supreme efforts and just cause in service to our past and present veterans and first responders. Please accept our donation.

In Service to America,

Bill Vagianos, President
Vietnam and All Veterans of Brevard

There is an old, yellowing copy of a pamphlet I was handed by a Vet Center councilor,
(This is the paper I was holding last night.)

The first page is the introduction and sums up what was going on in 1978 but was kept America's dirty little secret.

"Most Vietnam veterans have adjusted well to life back in the United States, following their wartime experiences. That's a tribute to these veterans who faced a difficult homecoming to say the least.

However, a very large number of veterans haven't made it all the way home from the war in Southeast Asia. By conservative estimates, at least half a million Vietnam veterans still lead lives plagued by serious war-related readjustment problems. Such problems crop up in a number of ways, varying from veteran to veteran. Flashbacks to combat, feelings of alienation or anger, depression, loneliness and an inability to get close to others, sometimes drug or alcohol problems, perhaps even suicidal feelings. The litany goes on."

This pamphlet hangs on my office wall just above my desk to remind me of why I do what I do when things get too stressful, I get too depressed over the lack of attention PTSD gets, when I get one more email about a veteran on the brink of suicide or from a family member after it's too late to save them. I leave it hanging there to remind me when I cannot find the will to go on as my own financial stresses take turns for the worst and I begin to wonder if this is worth it when I know I could go back to working for paychecks. I used to do accounting and was very good at it and paid well for doing it. The last job I had ended January 2008 and that was the last paycheck I could depend on. I worked for a church as head of Christian Education. It's what led me to become a Chaplain. For any suffering I go through doing what I do, I know veterans are paying the price a lot higher than any price I pay helping them.

I started doing outreach work in 1982 and have been doing it for over half my life. In 2004 we moved from Massachusetts to Florida so that I could work part-time and devote more time to this work. The need increased and the numbers I was seeing coming in terrified me. I knew the suffering all too well after living through the worst of it with my own husband.

Years ago I realized there were many stories about traumatic events but scattered around the world. This was before Afghanistan and Iraq. I began to put stories together on an AOL blog. This lead to the blog now called Screaming In An Empty Room. I began Wounded Times because I had blended too many political posts with posts about veterans and this became a problem when veterans were looking for posts about them, so I limit the political posts on Wounded Times unless it has a direct bearing on our veterans. With whatever time I had between working and helping veterans, I tracked the stories around the country and internationally for one simple reason. PTSD is a human wound that strikes after traumatic events. It was important to have as many stories as possible all in one place to bring a sense of "normal" to our veterans, troops, police officers, firefighters and survivors.

Until Vietnam veterans made headway addressing PTSD, having it recognized as a disability related to combat and forcing the treatment of it by the VA, there was not much done on mental health following traumatic events. What they managed to do was bring Post Traumatic Stress Disorder into the awareness of the mental health community. What we see today in the response to traumatic events is directly due to their efforts. This also caused the reporters to cover stories of after trauma as well as the event itself.

Realizing the only way to eradicate the stigma associated with feeling alone, my mission became to focus on compiling stories of humans suffering after trauma as well as reaching out to help others. Quiet heroes have been turning their own pain into missions of support to others.

Wounded Times focuses on trauma with a spotlight on the military/veterans. There are stories about the VA and the DOD along with civilian life. I post about traumatic events effecting police officers, emergency responders, firefighters and survivors to also bring in the fact that our troops and veterans, while a minority of our population, are still humans. The difference is their traumatic exposures happened a lot more often than what we face in our lifetimes.

The need to have these reports all in one place is key to the mission of Wounded Times. I also do editorials to add in over 25 years of knowledge to say what is not being said. As a Chaplain, I try to address the need for spiritual healing since this is a common condition of people after trauma. The majority either believe God judged them or abandoned them following traumatic events after combat. This also happens with many others. Understanding what PTSD is enables the survivor to reconnect to their faith and know that God did not do this to them.

Wounded Times is about healing and understanding PTSD. This is why I produce videos on PTSD. In 2005 I understood that no matter how much I wrote, I could not break through to the people needing the information fast enough. I now have over 25 videos. These videos are now available on Wounded Times, Nam Guardian Angel PTSD Shield and Great Americans. If there is a need to have a DVD for service groups or individuals, I ask for a donation to help cover the cost of what I do. These videos are used all over the country by mental health providers, service groups and veterans groups. If anyone cannot afford to donate, they are not turned away.

I travel with these videos doing presentations to bring understanding of this complicated wound to any group wanting to understand as simply as possible believing once they understand, they will be able to provide the support to those suffering from it as well as their families.

I have been trained to respond to traumatic events because heading off PTSD is vital. I can also explain to the survivors what they may face so that they will seek treatment as soon as possible should the event set off the need for mental health care. Believing the sooner PTSD is addressed, the better the recovery, understanding what it is will assist the survivors in watching for signs they may need help as well as to watch for signs in others to assist them in getting help. The prevalence of PTSD we see today would not be so great had the information been available to them.

So far, training, fees for licensing and insurance have been out of pocket. I spend an average of 70 hours a week working on the blog, videos and reaching out with veterans thru emails. This has caused a huge financial burden on my family. Aside from lost income when I work outside of this, we have had to cover those expenses along with computers, Internet and website fees, phone charges and travel expenses. This is why your support of my work is so important. I cannot maintain Wounded Times without your help and I cannot continue my ministry to others without financial support.

I have set up a Charter of the International Fellowship of Chaplains so that donations are tax deductible. Your support will help me to continue to reach veterans and everyone else wounded by PTSD across the nation and internationally. It will also allow me to pay for advertising so that others needing help will not have to find Wounded Times or my videos accidentally. I have received too many emails from veterans on the brink and families when it was too late to help because they could not find my site sooner. Your support will help save lives and prevent families from having to feel lost.

Thank you for your support and believing in the work I do.

Chaplain Kathie

Senior IFOC Chaplain
Kathie Costos DiCesare

web site
www.namguardianangel.com
blog
www.woundedtimes.blogspot.com
"The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive veterans of early wars were treated and appreciated by our nation." - George Washington

Certifications and Training

IFOC Certified, ordained, licensed and insured senior chaplain
Trauma Grief and Loss
Critical Incidents Stress
Critical Incidents Stress Management
Critical Incidents Stress Debriefing
Crisis Intervention and Peer Support
Military Cultural Competence
DEEP, Disaster and Extreme Event Preparedness

Administrator of Christian Education 2 years
Veterans outreach and trauma specialist, over 25 years
Producer of PTSD educational videos
Female veterans
Hardest Times You Could Imagine
Sisters After War
The Voice, Women at War
Women at War
Combat Veterans
Wounded Minds
Hero After War
When War Comes Home Part one and two
Wounded and Waiting
Veterans Day Memories of Vietnam
Veterans Everyday
PTSD, It’s All About Soul
PTSD Final Battle of War
PTSD Not God’s Judgment
Nam Nights of PTSD Still
Lean on Me
Death Because They Served
Homeless Veterans Everyday
Coming Out of the Dark

National Guards
PTSD I Grieve

Civilians
PTSD After Trauma
IFOC Chaplain Army Of Love
Point Man Ministries
Veterans Outreach, Home Free



There you have it. Now back to work for me.

Less than 20 percent of VA facilities use Chaplains

In addition, less than 20 percent of facilities reported utilizing the Chaplain service for liaison and outreach to faith-based organizations in the community (e.g., inviting faith-based organizations in the area to a community meeting at a VA Medical Center (VAMC) to explain VHA services available, having a VA Chaplain accompany the OIF/OEF coordinator to post-deployment events in the community). Although facilities would need to tailor strategies to consider local demographics and resources, a system-wide effort at community based outreach appears prudent.

Less than 20% use Chaplains! As posted several times on this blog, the VA needs to change the rules of who they will allow to be Chaplains when you consider how few Chaplains they use. They need to be all over the country, especially in rural areas where help is hard to find. They need to be in every community doing the outreach work that has to be done to catch up to the need. One day we may actually get ahead of this but right now, we need to do everything humanly possible on an emergency basis just to catch up to the need. It is ridiculous that the tool of Chaplains is there, trained and ready to go but while the International Fellowship of Chaplains is good enough for the police, fire fighters and emergency responders, they are not good enough to take care of the veterans that are not being taken care of right now, today!

Everything that Dr. Michael Shepherd recommended is exactly what I've been trying to do since I started doing all of this. It is exactly what frustrates me the most. We know what needs to be done but they are not doing it. How many lives, marriages, families, careers and futures could have been spared needless suffering if they implemented all of this years ago when we finally understood what needed to be done?

This is the whole testimony

Testimony By Michael Shepherd M.D.
Physician, Office of Healthcare Inspections
Office of the Inspector General
U.S. Department of Veterans Affairs
Mr. Chairman and Members of the Committee, thank you for the opportunity to testify today on suicide prevention and the Office of Inspector General (OIG) report, Implementing the VHA’s Mental Health Strategic Plan Initiatives for Suicide Prevention. My statement today is based on that report as well as individual cases that the OIG has reviewed and reported on involving veteran suicides and accompanying mental health issues. In the process of these inspections, clinicians in our office have had the opportunity to meet with and listen to the concerns of surviving family members, and to witness the devastating impact that veteran mental health issues and suicide have had on their lives.

The May 2007 OIG report reviewed initiatives from the Veterans Health Administration’s (VHA) mental health strategic plan pertaining to suicide prevention and assessed the extent to which these initiatives had been implemented. In prior testimony, we have stressed the importance of the need for VA to continue moving forward toward full implementation of suicide prevention initiatives from the mental health strategic plan. In terms of other changes VA could make, we would offer the following observations:

Community Based Outreach – In our report, we noted that while several facilities had implemented innovative community based suicide prevention outreach programs, (e.g., facility presentations to New York City Police Department officers who are Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans, participation by mental health staff in local Spanish radio and television shows) the majority of facilities did not report community based linkages and outreach aimed at suicide prevention. In addition, less than 20 percent of facilities reported utilizing the Chaplain service for liaison and outreach to faith-based organizations in the community (e.g., inviting faith-based organizations in the area to a community meeting at a VA Medical Center (VAMC) to explain VHA services available, having a VA Chaplain accompany the OIF/OEF coordinator to post-deployment events in the community). Although facilities would need to tailor strategies to consider local demographics and resources, a system-wide effort at community based outreach appears prudent.

Timeliness from Referral to Mental Health Evaluation – In our report we noted that while most facilities self-reported that three-fourths or more of those patients with a moderate level of depression referred by primary care providers are seen within 2 weeks of referral, approximately 5 percent reported a significant 4-8 week wait. Because these patients are at risk for progression of symptom severity and possible development of suicidal ideation, Veterans Integrated Service Network leadership should work with facility directors to ensure that once referred, patients with a moderate level of depression and those recently discharged following hospitalization are seen in a timely manner at all VAMCs and Community Based Outpatient Clinics (CBOCs).

Co-Occurring Combat Stress Related Illness and Substance Use – Substance use may contribute to the severity of a concurrent or underlying mental health condition such as major depression. The presence of alcohol may cause or exacerbate impulsivity and acute alcohol use is associated with completed suicide. In a recent study published in the Journal of the American Medical Association (JAMA), Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning from the Iraq War, Milliken et al., found that soldiers frequently reported alcohol concerns on the Post Deployment Health Assessment and Reassessments “yet very few were referred to alcohol treatment.”

Regardless of why a patient begins to abuse alcohol, with frequent and/or excessive use, physiologic and psychologic drives develop until alcohol misuse ultimately takes on a life of its own that is independent of patient history and circumstance. Functional ability and quality of life become dually impacted by both underlying anxiety and depressive symptoms and co-morbid substance use issues. For patients with concurrent conditions, an effective treatment paradigm may require addressing the primacy of not only anxiety/depressive conditions but also of co-morbid substance use disorders. VA should consider augmenting services that address substance use disorders co-morbid with combat stress related illness for inclusion in a comprehensive program aimed at suicide prevention.

Enhanced Access to Mental Health Care – Treatments for mental health problems may take time to show effect. For example, antidepressant medication, when indicated, may take several weeks to several months to effect symptom reduction or remission. For some patients, treatment may necessitate multiple visits that occur consistently over time and may entail multiple modalities including individual and/or group evidence based psychotherapy, medication management, and/or readjustment counseling. Therefore, efforts that enhance patient access to appropriate treatment may help facilitate both patient engagement and the potential for treatment benefit.

For example, ongoing enhancements in the availability of mental health services at CBOCs may help mitigate vocational and logistical challenges facing some veterans residing in more rural areas who otherwise may have to travel longer distances to appointments at the parent VAMC.

In certain locations, the VA may want to consider expanding care during off-tour hours to increase the ability for some transitioning OIF/OEF veterans to access mental health treatment while minimizing interference with occupational, and/or educational obligations. This would be consistent with the recovery model for mental health treatment which emphasizes not only symptom reduction but also promotion and return to functional status.

Facilitating Early Family Involvement – Mental health symptoms can have a significant and disruptive impact on family and domestic relationships. Relational discord has been cited as one factor associated with suicide in active duty military and returning veterans. In addition, some studies indicate that family involvement in a patient’s treatment may enhance the ability for some patients to maintain treatment adherence. VA should consider efforts to bolster early family participation in patient treatment.

Coordination between VHA and Non-VHA Providers – When patients receive mental health treatment from both VHA and non-VHA providers, seamless communication becomes an increasingly complex challenge. This fragmentation of care is particularly worrisome in periods of patient destabilization or following discharge from a hospital or residential mental health program. VA’s Office of Mental Health Services should consider development of innovative methods or procedures to facilitate flow of information for patients receiving simultaneous treatment from VA and non-VA providers while adhering to relevant privacy statutes. In addition, VA’s Readjustment Counseling Service and VA’s Office of Patient Care Services should pursue further efforts to heighten communication and record sharing for patients receiving both counseling at Vet Centers and treatment at VAMCs and/or affiliated CBOCs.

Mr. Chairman, thank you again for this opportunity to testify. I would be pleased to answer any questions that you or other Members of the Committee may have.

http://veterans.house.gov/hearings/Testimony.
aspx?TID=18680&Newsid=237&Name=%20Michael%20%20Shepherd%20M.D.

Here are some more links to the hearing

Opening Statements
Hon. Bob Filner Chairman, and a Representative in Congress from the State of California
Hon. Steve Buyer, Ranking Repubican Member, and a Representative in Congress from the State of Indiana
Hon. Stephanie Herseth Sandlin, a Representative in Congress from the State of South Dakota
Hon. Harry E. Mitchell, a Representative in Congress from the State of Arizona
Hon. Shelley Berkeley, a Representative in Congress from the State of Nevada
Hon. Jeff Miller, a Representative in Congress from the State of Florida
Hon. Ginny Brown-Waite, a Representative in Congress from the State of Florida
Hon. Timothy J. Walz, a Representative in Congress from the State of Minnesota
Hon. James P. Moran, a Representative in Congress from the State of Virginia
Witness Testimonies
Panel 1
The Honorable James B Peake M.D., The Secretary, U.S. Department of Veterans Affairs
Accompanied By:
Gerald Cross, Principal Deputy Under Secretary for Health, Veterans Health Administration
Ira Katz M.D., Deputy Chief Patient Care Services Officer for Mental Health, Veterans Health Administration
Panel 2
Stephen L Rathbun Ph.D., Interim Head & Associate Professor of Biostatistics, Department of Epidemiology & Biostatistics, University of Georgia
M. David Rudd Ph.D., Professor and Chair, Department of Psychology, Texas Tech University
Ronald Wm. Maris Ph.D., Distinguished Professor Emeritus, University of South Carolina