UW News

April 8, 2010

Dr. Evan Kanter: On a mission to treat and prevent psychiatric casualties of war

When the United States went to war in Afghanistan and Iraq, many people began thinking about costs — the cost of deploying troops, the cost to purchase guns and missiles, and the cost of American lives. But what about the health costs?

“Health costs are generally not taken into account when we make political decisions to go to war,” said Dr. Evan Kanter, assistant professor in the Department of Psychiatry and Behavioral Science at the UW School of Medicine and an adjunct assistant professor of global health. “The long-term costs of providing medical care and disability benefits to veterans will likely be greater than the military operational costs of these wars.”

A year ago, Kanter started brainstorming for a conference on the topic of war and global health. The idea was picked up by the annual Western Regional International Health Conference, which is hosting the conference “War and Global Health: Transforming Our Profession, Changing Our World” on campus April 23-25.

The student-run conference will focus on the health consequences of war and the role of health professionals in prevention of war.

“We need to approach war as a problem in public health, just like you would cigarette smoking or AIDS or malaria,” said Kanter. “War is responsible for more death and disability than many major diseases combined.”

The content of the conference overlaps with Kanter’s recently developed 30-hour course, “War and Global Health.” He was awarded a grant from the Center for Global Studies at the Jackson School of International Studies to develop the course and will be teaching it in the next academic year. For the past three years, he has also been teaching a 10-hour course, “War and Mental Health,” which has received outstanding reviews.

Kanter has been treating the casualties of war for more than 12 years, which, he said, has led him to a commitment to work towards prevention of war.

He devotes three days a week to his psychiatry practice at the VA Puget Sound Health Care System, where he specializes in post-traumatic stress disorder (PTSD) — an anxiety disorder that results from traumatic experiences.

His patients range from World War II veterans to soldiers recently returned from Iraq and Afghanistan. They also range in lifestyles — from Microsoft employees to a community of bikers.

“One thing I enjoy about psychiatry is that you get to have intimate interactions with people who you would probably never interact with in regular life,” Kanter said. “I’m an academic, geeky guy … and yet I have some really close relationships with people who are totally into Harleys.”

In a 2008 article in The Journal of Life Sciences, Kanter describes how disheartening it can be to treat patients whose families and social relationships become compromised as a result of their PTSD. He has seen patients who have had chronic nightmares for 60 years and Vietnam War veterans who avoid the sound of helicopters and the smell of diesel fuels for fear of triggering traumatic memories.

Kanter also teaches about the impact of war on civilian populations. He has traveled to Iraq and Gaza on humanitarian missions.

He is inspired by the healing capacity and resilience he sees in both veterans and civilians. He said in Gaza one-third to one-half of the population meets the criteria for some diagnosable mental health disorder.

“In the face of tremendous military violence, more than half the [Gaza] population doesn’t get a psychiatric disorder,” Kanter said in a teach-in on Gaza held on campus last year. “As we look at the people most affected by mental health problems, we should also look at the people who are resilient and who are able to go on in the face of such violence.”

Kanter started his career as a neuroscience researcher studying memory and became interested in how traumatic and non-traumatic memories are encoded differently in the brain. He enrolled simultaneously in Ph.D. and M.D. programs at the University of Wisconsin-Madison and unexpectedly fell in love with clinical psychiatry.

In 1994, Kanter moved to Seattle to begin his psychiatry residency and continued practicing in the UW system.

In 2009, Kanter served as national president of Physicians for Social Responsibility (PSR), a nonprofit organization that addresses the gravest threats to human health, especially focusing on nuclear weapons proliferation and global warming. He is active in PSR’s “Code Black” campaign to shutdown the TransAlta coal plant in Centralia, Wash., which accounts for 10 percent of all carbon emissions in the state.

Dr. Kanter will give two presentations at the upcoming conference: “The Wounds of War: Focus on Veterans of Iraq and Afghanistan” and “Elimination of Nuclear Weapons: The Public Health Imperative.”

To register, please visit the Western Regional International Health Conference web site.