Alberto Mendiola was standing off by himself, bored and anxious. He was in a bar on the East Side of El Paso just before midnight, the end of an aimless day he’d spent fooling around with a girl he’d known since high school. Sachie Bakuya was her name. She called him Horse, a nickname from happier days, when he played drums in an El Paso rock band, back before he joined the Army and left for Kentucky and then Afghanistan, and wound up standing in a guard tower, his boots soaked in the blood of his friend Brandon King. A sniper had shot King in the head, and Alberto volunteered to take his place in the tower, where he spent the next few hours standing on the blood-soaked floorboards, keeping a watchful eye for the Taliban in the pomegranate orchards beyond the outpost walls. Now it was a Friday in March 2014, three years since he’d returned from the war, and his life was in shambles. He couldn’t, or wouldn’t, hold down a job, and he’d been collecting disability from the Department of Veterans Affairs for post-traumatic stress disorder for about a year. He was living alone in a barely furnished apartment, estranged from his wife, Nicole, who still lived with their three children and his stepson in the house they’d rented together. That Friday night, Alberto and Sachie had ended up at a place called House of Rock. He didn’t feel like socializing, though, and stood off by himself drinking a Dos Equis while Sachie shot pool with her friends. Alberto eventually ducked out the door and headed to his maroon Ford Focus. He texted Sachie, asking her to leave with him, but he got no response. He started his car and drove to Nicole’s house on Warcloud Avenue. “I just missed my family,” he would later tell me. “I wanted to be with my wife and kids.”

Alberto had grown up in El Paso, in a trailer on the East Side with his parents and three siblings. He’d met Nicole through friends in 2007, when he was only nineteen. From the start, Alberto’s family had concerns about the relationship. Nicole already had a four-year-old son, and she was five years older than Alberto. They argued almost as hard as they partied. But the two were inseparable, and in short order, Nicole was pregnant. Their eldest son was born in July 2008. Alberto’s family had never had much money, and the pressures of supporting a growing family drove Alberto into an Army recruiter’s office in October 2008. In December, Alberto and Nicole married while he was home on leave from basic training. Three months later, Nicole became pregnant with their daughter. Already there were signs of trouble. While Nicole was pregnant, Alberto was accused of physically abusing her on at least two occasions, according to court records. Their daughter was born at Fort Campbell, Kentucky, in December 2009, just months before Alberto shipped out to Afghanistan. While he was deployed, Alberto spent much of his free time either talking to or trying to get through to Nicole and the kids on his outpost’s spotty internet connection.

When he returned from the war, in 2011, he had trouble readjusting. He was drinking more, and he and Nicole fought often. By December, Alberto had been discharged from the Army, a year before his contract was up, for excessive drinking and a spate of domestic violence incidents, all of which amounted to a “pattern of misconduct” sufficient to send him packing, according to his discharge paperwork.

Alberto and his family left Fort Campbell and returned to El Paso, and it soon became clear that war had changed him. Growing up, he’d always been active. “He never wanted to be sitting still,” said his father, Ernesto Sr. But now he seemed dazed and lethargic, lying on the sofa at his father’s house on Tigris Drive. “That just wasn’t like him at all,” his older sister, Patti, told me. “Normally he would always be asking you how you’re doing and a million other questions.” Alberto was irritable too, prone to snap at the slightest aggravation. Ernesto Sr. remembers the shock he felt when he saw Alberto yell at one of his children. “It was over nothing. I had never seen him do anything like that before,” he said. “I told him, ‘Son, don’t talk to him like that.’ It really worried me.” The change in Alberto’s behavior worried everyone, but they didn’t know how to deal with it. “No one from the Army told us about PTSD or anything like that,” Ernesto Sr. said. “I wish we had known more so that we could have helped him better. We really just didn’t know what was happening.”

Alberto found his way to the Department of Veterans Affairs after several emergency room visits prompted by recurring chest pains that he thought might be a heart attack. The VA examined Alberto and eventually gave him a 70 percent disability rating based on his responses to a PTSD questionnaire, which showed that he had obsessional rituals, anxiety, chronic sleep impairment, depressed mood, panic attacks, and a “sense of a foreshortened future.” At some point later, an emergency room doctor gave Alberto a prescription for Xanax, a potent antianxiety medication. The pills made him feel better, until he couldn’t get the prescription refilled. His father remembers Alberto saying, “Dad, I think I’m dying.” “It was weird,” Ernesto Sr. told me. “I would say, ‘Son, you’re fine, there’s nothing wrong with you,’ but it was like he was paralyzed.”

Alberto thought his problems were purely physical, mistaking what were almost certainly severe panic attacks for a heart problem. Like so many veterans with mental health issues, he self-medicated with marijuana and alcohol. As far as Alberto can remember, he never received sufficient or sustained treatment for PTSD from the VA, despite receiving a diagnosis and disability compensation. Nor did he seek help from the VA. “Maybe they offered it to me, but I can’t remember,” he told me. “There’s help there, but they don’t always tell you.”

In his nightmares, he heard grenades exploding in the house. Sometimes he woke up yelling. While they were still living in Kentucky, he’d purchased an AR-15, an ammo harness, and nine magazines. Back in El Paso, he and Nicole would drive out to the desert east of town to shoot cans and jackrabbits, but the rifle wasn’t a plaything. Alberto slept with it beside him, and whenever he went out, he carried it in the trunk of his car, along with the ammo vest and a full combat load of ammunition. He also carried a .40-caliber pistol. Police confiscated the pistol after a domestic violence incident in February 2014 that finally pushed Nicole to file a protective order against him, which forced him to move out of the house. But he still had the AR-15.

It was after midnight on that night in March 2014, when Alberto pulled up to the house on Warcloud Avenue. His head was shaved almost to the skin. He wore a goatee that never would have been allowed in the Army. His neck was thick, and his small frame looked muscular and powerful. He slipped through a gate in the fence on the right side of the home, as he’d done many times before, and crept around to a window that looked in on the kitchen. There he saw Nicole leaning against a counter littered with beer cans. A man Alberto had never seen before sat at the dining room table. He watched Nicole and the man talking and drinking in the house where his children slept. He became enraged. He turned from the window and headed back toward the car to get his rifle.

I’d first met Alberto in August of 2010, when I was embedded as a journalist with his unit in Kandahar Province, Afghanistan. The 1-320th Field Artillery Regiment was part of the storied 101st Airborne Division, which cemented its legacy when it held the Allied line at Bastogne through the bitter winter of 1944 during the Battle of the Bulge. But in the hot, dusty orchards of Kandahar, the 1-320th would not be stuffing shells into howitzers. They’d be tasked with a grittier job. Historically, artillerymen fight from a distance, supporting infantry forces with indirect fire from long-range artillery guns. It’s never been a safe job—artillery positions are prime targets for enemy artillery and aircraft—but it’s comparatively safer than the rifleman’s workload, which includes patrolling enemy hot spots, setting up ambushes in the dark of night, and fighting up close with whatever weaponry you can carry in your arms or on your back. That summer, the Obama administration’s Afghanistan surge was under way. The 1-320th deployed with the 2nd Brigade of the 101st to Kandahar as part of an escalation that saw U.S. troop numbers increase from less than 30,000 in late 2007 to 100,000 in 2010.

Fighting the Taliban in Arghandab was not unlike fighting the ghostlike Vietcong, a comparison that wasn’t lost on Alberto’s fellow soldiers, who likened the valley to the Ho Chi Minh Trail.

The nature of the counterinsurgency fighting in southern Afghanistan at the time required a constant presence of foot soldiers in the remote villages where the Taliban was most deeply entrenched. Drones and special operators could take out the upper echelon of Taliban leadership, but America’s shadow warriors weren’t equipped to push Taliban fighters out of rural population centers and help Afghan troops hold reclaimed ground. That was a job for the infantry. But without a draft, and with the endless rotation of troops to Iraq and Afghanistan in the decade since 2001, infantry units were overextended, and the Department of Defense couldn’t meet the mounting demands for infantry brought on by dual counterinsurgency campaigns. To fill the void, artillery units like Alberto’s in both the U.S. Army and the Marine Corps were temporarily reassigned to infantry roles in some of the bloodiest zones in all of Afghanistan.

The 1-320th was sent to Arghandab, a sparsely populated agricultural district thick with pomegranate and grape orchards near the Arghandab River. Over the course of nearly a decade of neglect by NATO forces, the Taliban had turned the Arghandab into a vital logistics pipeline for fighters, weapons, and cash, and a critical conduit for their poppy exports. They knew the valley’s value as a strategic asset; it had also served their mujahideen ancestors well in the war against the Soviets. They’d mined the district’s villages and footpaths with hundreds of improvised explosive devices (IEDs) and cached weapons and bomb-making materials in safe houses scattered throughout the district. Using a network of trenches, irrigation ditches, tunnels, and the dense overhead cover of pomegranate orchards, they could move fighters into ambush positions quickly and pull them back before U.S. air strikes arrived. Fighting the Taliban in Arghandab was not unlike fighting the ghostlike Vietcong, a comparison that wasn’t lost on Alberto’s fellow soldiers, who likened the valley to the Ho Chi Minh Trail.

Alberto’s battalion came to Arghandab expecting a fight. Their predecessors, a company of paratroopers from the 82nd Airborne Division’s 2nd Battalion, 508th Infantry Regiment, had taken catastrophic casualties. One platoon had nearly half its soldiers killed or wounded by IEDs and small-arms fire during its eleven-month tour. In July 2010, when the 1-320th took over, it was the height of the annual fighting season, and casualties stacked up at a staggering pace. In July on one of their first solo patrols from Combat Outpost Nolen—a high-walled mud-brick compound that served as a patrol base, where Alberto would live for nine months—1-320th soldiers triggered three IEDs. The explosions came at a cost of five legs between three soldiers and shrapnel wounds to two more. On July 14 Brandon King was killed. Two weeks later, on July 30, the battalion suffered three more fatalities and eight wounded in a single day. In the three days that followed, the battalion lost a dozen more to injuries. “First month you’re over there, you’re scared shitless. You might die every day,” Alberto later told me. “You see people get fucked up. Fear like I’ve never felt. Till a month and a half later, you wake up and say, ‘I might die today—who gives a shit.’ ”

When I arrived at COP Nolen, in late August, the fight was still raging. Every evening, Taliban fighters would lay siege to the tiny compound with machine guns, AK-47s, mortars, rocket-propelled grenades, and recoilless rifles. Alberto and his fellow soldiers would line the compound walls, lobbing shells from their M203 grenade launchers and firing thousands of rounds into the orchards that enveloped them on all sides. Blasting away at the unseen enemy served as a daily pressure release, but it wasn’t enough. More than a few of the men were soon frayed at the edges, twitchy, desperate to get out of there.

By the time the 1-320th finally returned to Fort Campbell, in April 2011, 8 men had been killed and 83 wounded during nine months in the combat zone. But these were only the casualties that were visible. I remained in contact with several of the soldiers I’d met in Arghandab, and I became disturbed by how many of them seemed to be struggling mightily with readjusting to stateside life. I was particularly worried about Hunter Wilke, who’d been a sergeant in Alberto’s platoon, one of the more garrulous soldiers I’d encountered during my embed. We’d developed a friendship over the years and talked on the phone from time to time. Wilke, a country boy from Metropolis, Illinois, with a Southern drawl that you wouldn’t normally associate with the Grain Belt, had not had an easy time back home. His marriage fell apart shortly after the deployment, and he was left alone, splitting the custody of his young daughter with his ex and hitting the bottle hard whenever his daughter wasn’t around. Afghanistan had been Wilke’s second deployment. He’d also done a tour in Iraq with the 1-320th, and he’d lost a good friend during the tour in Afghanistan: Kyle Stout, killed by an IED in the mayhem of July 30. A little over a year after the unit came home, another one of Wilke’s longtime buddies from the 1-320th, Justin Junkin, killed himself at the end of a losing battle with Klonopin and survivor’s guilt. Wilke wound up in the Warrior Transition Unit at Fort Campbell, a repository for physically and mentally damaged soldiers on their way out of the Army via medical discharge.

Blasting away at the unseen enemy served as a daily pressure release, but it wasn’t enough. More than a few of the men were soon frayed at the edges, twitchy, desperate to get out of there.

Wilke was leaving the Army because of PTSD, and he wasn’t the only one. “There’s hardly anyone from our platoon still on active duty,” he said. He rattled off a list of names of other soldiers who’d been medically discharged for PTSD or traumatic brain injury, or had otherwise struggled to regain their footing post-deployment. One soldier died in a drunk driving accident, another got kicked out of the Army for smoking weed. Others, like Alberto, had been discharged for other disciplinary problems that Wilke suspected probably had a lot to do with the shock of reentry. I remembered a few of them, and it was hard to reconcile the memory of those tough young men with the stories Wilke was telling me.

I caught up with Jeffrey Aebischer, who had been Alberto’s platoon leader in Afghanistan despite holding the rank of captain (an officer of that rank usually commands a company). He’d left the Army and become an investment banker, but he’d stayed close to Wilke and to Sergeant First Class Allen Manley, one of the senior noncommissioned officers from the battery. They’d go deer and waterfowl hunting together back in Kentucky, and Aebischer watched Wilke’s decline, which had begun before they’d even left Afghanistan. “Wilke was toast by the end of the deployment. Everybody was,” Aebischer told me. I asked him what he thought of Alberto’s struggles. “Not surprising. Not at all. He would’ve been the first person I would’ve expected to go off the rails, honestly,” he said. “They were coming off the rails already when we were over there. He got in a fight with an interpreter, like, two months before we left. I don’t remember why. Guys just needed to get the hell out of there.”

Back at Fort Campbell, in the few months before he left the Army, Aebischer saw a number of soldiers who were coming apart at the seams, and it was clear to him that the Army was fumbling its response to their problems. “People were getting prescribed all kinds of stuff. Whatever they give for PTSD, taking those meds and combining that with drinking—it’s just fatal,” he said. Aebischer doesn’t doubt the authenticity of his former battery mates’ problems. “I don’t really know what we accomplished [during the whole war in Afghanistan], to be honest with you. That makes it even more sad, to me. I think 99 percent of them are absolutely genuine when they’re saying that they’re having issues and PTSD symptoms that they need to be treated for, and I can totally see how they would have PTSD. I mean, these guys were at the tip of the spear for a lot of bad things that happened to people close to them. Everyone that was in the fight over there is probably dealing with issues.”

Rolando Zavala, another sergeant from Alberto’s platoon whom I’d kept in touch with, had also been discharged for PTSD. I remembered Zavala as a sinewy Latino with a deep, commanding voice that didn’t match his stature. Zavala also had a sense of humor, but it rarely came out around the younger soldiers. Despite wrestling with PTSD, Zavala had his life on the straight and narrow. He had moved back to Chicago, where he fathered a second child and where he was pursuing a bachelor’s degree in social work. He didn’t have any substance abuse problems. He was putting his education benefits to good use and enjoying family life. He also had a clear sense of purpose: after graduation, he was planning to use his degree to work with veterans as a recreational therapist. “I’m doing good,” he told me during one of our calls, “but I don’t hang around civilians at all. I just go to school and go home, and I prefer to just hang out with my wife and my family.” Of course I was relieved to hear that Zavala was on steady ground, but I was sorry to hear that he was avoiding “civilians,” a group to which he now belonged. Like so many veterans I’d known—including myself in the early years after my own deployment to Iraq—Zavala seemed to consider himself a man apart from the civilian world.

Alberto climbing a wall on a mission to a village in Kandahar.

Anthony Bowler was a veteran too, though his war experience had been years before he met Nicole Mendiola and had been far less intense than what the 1-320th went through in Afghanistan.

Known to his family as Tony, Bowler was born in Panama, the son of an American Army officer and a Panamanian nurse, and the youngest of four siblings. “He was the spoiled-rotten one,” his older sister, Ana, told me by phone from Dallas, where she works as an elementary school counselor. Ana, 42, was nine years old when Tony was born. “He was this blond baby, so the girl cousins were always taking him around, and all the neighborhood girls would come and look at the pretty baby,” she said, a hint of laughter in her voice. The family moved to El Paso when Tony was ten. Ana and her older brothers strongly identified with the Caribbean, and they struggled to fit in as adults in El Paso’s Tejano culture. “When I would speak Spanish, they wouldn’t understand me, and I’d be like, ‘I’m speaking Spanish,’ and they would say, ‘You speak too fast,’ ” she remembered. “I could never adjust to El Paso.” But Tony fit right in. At school, he was a social butterfly and a sports fanatic. His team spirit ran so strong that he’d dye his hair the school colors.

After high school, Tony enlisted in the Army Reserves, following in the footsteps of his father and his older brother Javier. He earned the rank of sergeant and deployed to Iraq with a support unit from 2004 to 2005. When he got home, he put the war behind him and moved to Dallas, where he used his GI Bill tuition benefits to study massage therapy, with a particular focus on dealing with sports injuries. Once he had finished his training, he moved back to El Paso to start a massage business and to care for his elderly parents. His father, Francis, was in his late seventies and suffering from dementia, and his mother, Luisa, a nurse, didn’t drive. With Ana in Dallas and his two brothers busy with families of their own, Tony took up the slack. He would shuttle his mother to the grocery store and to her appointments, and he’d spend hours driving his father around town and spending time with him at home. “Tony had the patience with my dad,” Ana told me.

“He was very outgoing,” Jacob Duran, a childhood friend, told me by phone from Dayton, Ohio, where he’s stationed with the Air Force. “He was the peacemaker, no drama, always outgoing, always willing to do something.”

Though he was a peacemaker, Tony loved to fight—but only in the cage. He was fascinated with mixed martial arts, and he began training in jujitsu and kickboxing at a couple of local gyms. He would often hang around after training sessions to offer his massage therapy services free of charge. Tony wasn’t a huge guy, but he was solid, at five feet ten inches and almost 190 pounds. Cris Chavez, of 10th Planet Jiu Jitsu, remembered Tony as an eager student who was willing to work hard and take his licks but never lost his sense of humor. Duran told me, “All the pictures I have [of him], he’s telling a joke or he’s laughing at a joke.”

On Friday, March 21, 2014—a few weeks after celebrating his thirtieth birthday—Tony was hanging out with his childhood friend Ramon Duran (no relation to Jacob). On his left forearm, Duran had a tattoo of a heart with the words “Atrévete te te” written on a banner across it. “That was [Tony’s] favorite song,” Duran told me, referring to the hit by the Puerto Rican group Calle 13. “Whenever that would come on, he would dance around. He was actually a pretty good dancer.”

The events that led Tony Bowler to Nicole Mendiola’s kitchen that Friday night began around dusk, when Duran got a text from his friend Jennie Valentine inviting him over to Nicole’s house for a few beers. Duran told Valentine that he was with Tony, and she said to bring him too. They arrived at Nicole’s house and hung around the kitchen counter, drinking and listening to music. After a while, Nicole started putting the kids to bed, and Valentine and Duran left to buy more beer but instead ended up heading to Valentine’s place, where her mom made them food. That left Nicole and Tony alone in the kitchen at the Warcloud home, which is how Alberto found them.

Back at the car, Alberto loaded his AR-15 and strapped on his vest. He walked around to the French doors at the rear of the house. Tony did a double take when he caught sight of Alberto on the other side of the glass. The two men locked eyes for an instant.

Then Alberto kicked in the door, and Tony lunged to hold it shut. Alberto raised his rifle to his shoulder and fired three times. The first shot hit Tony in the chest. As he fell, another round hit him in the neck, ricocheting into his skull. A third round passed through the sheetrock wall behind Tony, barely missing the baby swing where Alberto’s youngest daughter often fell asleep before Nicole carried her to bed. Alberto forced his way into the house, stepping over Tony’s body, which lay slumped across the doorway. He shouted at Nicole, “Look what you made me do, bitch! Do you see that?” Tony’s blood pooled on the floor, filling the room with a metallic odor. “Do you smell that?” he yelled. “This is what it smelled like for me in Afghanistan all the time.”

“You’re not there anymore, you’re in my house,” she said.

Alberto decided everyone had to stay put, even with the body of the man he’d just shot still in the kitchen. Over the next four hours, at two different locations, Alberto held Nicole and the kids hostage, never letting Nicole out of his sight. Alberto remained wildly unstable, talking aloud to himself and occasionally sobbing. He agonized over whether to kill the children, Nicole, and himself. Or just himself. Nicole told him that if he was going to shoot himself, he should go outside to spare the children.

Neighbors had heard the shots and called 911, and soon a police cruiser parked on the street outside, running its lights. Alberto took a fighting stance by the door, telling Nicole, “Don’t try anything funny.” “He said he would shoot at every single one of those cops if they came in,” Nicole would later testify. Seeing no obvious signs of distress in the darkened neighborhood, the police cruiser moved on.

Over the next four hours, at two different locations, Alberto held Nicole and the kids hostage, never letting Nicole out of his sight.

At another point, Alberto handed the rifle to Nicole and told her to kill him. She refused. Alberto started to calm down when Nicole offered to help him escape. “I’ll help you run,” she told him, just hoping Alberto would leave the house. They got in Alberto’s car, and Nicole drove Alberto and the four children to his father’s house on Tigris Drive, about five miles away. He clutched his AR-15 in one arm and his infant daughter in the other as Nicole sped and swerved down Lee Trevino Drive, a six-lane-wide thoroughfare flanked on both sides by an endless stream of fast-food restaurants and chain stores. Alberto warned Nicole to slow down, to not do anything wild that might attract the attention of the cops. When they reached his father’s house, Alberto took Nicole and the kids inside. His sister was already there, and his father and brother arrived soon. Alberto asked his alarmed father for cash and changed into clean clothes that he borrowed from his brother, Ernesto Jr. At some point, he and Nicole went into one of the bedrooms, closed the door, and started shouting at each other. He would eventually hit Nicole in the back of the head, according to court records. Ernesto Jr. took advantage of the distraction to grab Alberto’s keys. With the murder weapon still lying on the passenger seat, Ernesto Jr. rushed to the Mission Valley police headquarters, where he handed over the keys, telling the desk officer that he thought his brother might have killed someone and that the weapon was still in the car.

When the police rang Ernesto Sr.’s doorbell at about 5:30 a.m. on Saturday, March 22, Alberto didn’t put up a fight. Playing good cop, the officer treated Alberto gently, asking him, “Do you remember what happened when you lost it?” “I fucking blacked out, man,” Alberto said, rambling in front of the dash cam. “I’ve already been to hell and back, and now I’m right back in it . . . PTSD, I have it real bad. I have it bad, man. I fucking see people die every day in fucking dreams . . . I’m not at peace. I did some fucking horrible things. I’m gonna die soon anyways . . . There are things that nobody should ever fucking do . . . I know the VA fucking offers to help, too. I should have taken that shit.” The officer kept asking “What happened?” and “Can you describe some of the bad things?”

“I’m in fucking la-la land right now. Everything is a fucking blur,” Alberto mumbled. “I did the worst thing imaginable. And now my family has to pay for it.” Standing on the curb beside the cruiser in Ernesto Jr.’s khaki shorts and T-shirt, he shivered in his handcuffs as the officer helped him smoke a cigarette. At one point, he stepped to one side and threw up. Eventually the officers put Alberto in the backseat of the cruiser, where they left him alone with his thoughts, an internal camera and microphone recording his every word. “What the fuck, Horse? What the fuck, motherfucker?” he muttered, sobbing. He began singing a cadence. “My buddy’s in a foxhole, a bullet in his head. The medic says he’s wounded, but I know that he’s dead.”

The prevalence of PTSD among veterans from Alberto’s unit is probably due to the intensity of the fighting that they encountered in the Arghandab. No one had to explain what they’d been through in Afghanistan to me. I’d seen it with my own eyes. Nor was the concept of PTSD foreign to me. I’d never suffered from the disorder myself, but I knew several guys from my unit who’d battled PTSD after we got home from Iraq, affected by their exposure to combat around Mosul and to a suicide bombing at our battalion’s chow hall that killed 22 people, including 2 of our own. I was dismayed to hear about the battles Alberto’s former platoon mates had been fighting back home, and about the Army’s apparent incompetence in getting them help. But I can’t say I was surprised.

It strained belief to learn that the VA, which is the primary care provider for millions of veterans, had been going out of its way to keep veterans out of doctors' offices.

For years, the VA had been cracking under the combined weight of a growing caseload of elderly Korean and Vietnam War–era veterans and the hundreds of thousands of new patients coming home from Iraq and Afghanistan. Excruciatingly long wait times for appointments—well in excess of the department’s goal of fourteen days from the patient’s preferred date—had become the norm. But few Americans, other than veterans seeking care, knew how bad things were until a whistle-blower from the Phoenix VA went public with his accounts of outright deceit on the part of managers who were determined to hide the true extent of the problem. The whistle-blower, Dr. Sam Foote—who was followed by whistle-blowers at VA facilities across the country with similar accounts—revealed that the Phoenix VA kept a set of data on actual wait times and another set of data with fake wait times that was entered into the VA’s national electronic database to make it appear as if a larger percentage of appointments fell within the fourteen-day window. It was no secret that VA facilities were woefully understaffed, short on nurses, physicians, and clinicians, including psychologists and psychiatrists. These shortages likely contributed to the VA’s reputation for sending veterans out the door with prescriptions rather than treating them with therapy, which required significantly more staff time. Still, it strained belief to learn that the VA, which is the primary care provider for millions of veterans, had been going out of its way to keep veterans out of doctors’ offices. In some cases, schedulers had gone so far as to cancel veterans’ appointments or reschedule them without informing the patients. In other cases, schedulers marked files to make it appear as if veterans had requested cancellations that were actually initiated by the schedulers. General Eric Shinseki, who was the VA secretary at the time, ordered an audit that found 60 percent of VA facilities guilty of gaming the system in some way to fudge the wait-time data. Shinseki, a two-tour veteran of Vietnam with three bronze stars for valor, who lost half of a foot to a land mine, resigned amid the furor.

As it happened, when it came to wait times for mental health appointments, the El Paso VA—where Alberto went to file for PTSD disability—was rated the worst in the country. None of this was news to Congressman Beto O’Rourke, who has represented El Paso since 2013 and sits on the House Committee on Veterans’ Affairs. O’Rourke’s office had been studying complaints about egregiously long wait times well in advance of the Phoenix revelations, and the Democratic congressman was increasingly frustrated over his inability to spur any meaningful action in D.C.

In fact, according to O’Rourke, the El Paso VA hadn’t improved much. As of July 2015, a year after the Phoenix scandal broke, the El Paso VA’s data on mental health appointments were still out of sync with reality. According to a study commissioned by O’Rourke’s office, vets had waited an average of 71 days for mental health appointments in 2014—the year Alberto shot Tony—and 64 days in 2015. Official data from the VA put the average wait time for El Paso–area vets that year at 21 days. Manpower shortages in critical positions were a major factor in the El Paso VA’s lackluster performance. In 2015 the El Paso VA was at 55 percent staffing, with 27 unfilled positions. The staffing shortages and long wait times endured, despite $16 billion appropriated by Congress in August 2014 to address those problems as part of the Veterans’ Choice and Accountability Act.

But the study commissioned by O’Rourke’s office found that wait times for a mental health appointment in El Paso had shrunk only slightly, to 57 days in 2016 and 56 days in 2017. In November 2016, the El Paso VA was still lagging far behind national benchmarks on several key indicators, according to an internal VA report. The report left O’Rourke fuming. “I am very alarmed by this. This is an urgent issue. We are literally talking about people’s lives,” he told the El Paso Times.

The well-documented and complex shortcomings at the El Paso VA are indicative of a veterans’ health-care system that remains in disarray, but whether Alberto ever actually tried to get treatment for his mental health issues from the VA is unclear, even though he sought disability compensation. He had to have an intake interview at the VA to determine his eligibility for PTSD disability, and the VA records show that he declined a referral for a traumatic brain injury screening even though he met the criteria for possible exposure. He’d been near the IED blast that ripped off his friend’s leg, and he’d been close to uncountable explosions from grenades, mortars, rocket-propelled grenades, and land mines. The records also show that Alberto was offered information on how to access mental health services directly through the VA or through one of the local Vet Center community outreach clinics. As the arrest video shows, Alberto knew mental health treatment was available, even if he only understood the vague outlines. But there’s no indication he ever followed up. His family has no recollection of his receiving any sustained counseling, and Alberto himself told me, when I interviewed him at the county jail in September 2015, that he never received any kind of therapy.

Was it possible that, even after his encounters with VA staff—which required him to peel back the scabs over his disturbing memories and which resulted in his formal PTSD diagnosis and disability rating—Alberto could still plead ignorance about his condition? And if he knew about it, and if he understood how his condition was severely and negatively affecting his life, and he still failed to get help, whose fault was that? Could he claim to have fallen through the cracks, or did he consciously slip through them?

‘I'm sure there are plenty of people like Mendiola, who had real PTSD and got put on the street.”

Of course, in Alberto’s case, the chain of culpability extended beyond any of Alberto’s decisions. The people best equipped to catch Alberto before he hit terminal downward velocity were his superiors in the Army, and yet, rather than keeping him in the fold when he started to act out after returning from Afghanistan—where they could monitor him and enforce discipline while he progressed through treatment—they kicked him out. And he wasn’t the only one. In October 2015, National Public Radio broke a story about the Army’s use of “misconduct discharges” to force more than 22,000 soldiers with diagnosed mental health problems or traumatic brain injuries out of the service before their contracts were up. “Why would commanders kick out soldiers for misconduct, instead of giving them more-intensive treatment or a medical retirement on the grounds that they have persistent mental health problems?” the journalists asked. Their sources within and outside the Army suggested a disturbing possibility: “It takes less time and money to get rid of problem soldiers on the grounds of misconduct.”

The story rang true to Jeffrey Aebischer. He saw the Army cracking down on minor infractions. “In the period you talked about . . . there was a lot of illegal drug use and going AWOL. Before, it was not okay. You got in trouble. But during that period, you got put out for that,” he said. “I’m sure there are plenty of people like Mendiola, who had real PTSD and got put on the street.”

At Fort Campbell, where Alberto was stationed, more than 1,500 soldiers had been discharged for “misconduct.” Sure enough, Alberto’s discharge paperwork listed the reason as “pattern of misconduct,” but he may not have been among the number published by NPR. He had not yet been diagnosed with PTSD when he was discharged, despite responding affirmatively to PTSD screening questions several times during his active-duty career, according to his medical records. I wondered how all of it might have played into the downward spiral that carried him to Nicole’s back door that night in March 2014. An innocent man was dead at the hands of an Afghanistan veteran who had a clearly established case of PTSD and who seemed to have been failed by a system that was admittedly unequipped to deal with people like him. But did that mean that Alberto was less than fully responsible for what he’d done?

Alberto’s murder trial began on August 10, 2016, in the 168th District Court, on the sixth floor of the El Paso County Courthouse, an imposing cube of blue reflective glass in the heart of downtown. The following day, Alberto would plead not guilty by reason of insanity, citing PTSD as the underlying cause of the violent outburst that had led to the death of Anthony Bowler.

PTSD-based insanity defenses in criminal trials have met with mixed results. In 2009 an Iraq veteran named Jessie Bratcher was found guilty, but insane due to PTSD, in the murder of an unarmed man in Oregon whom he suspected of raping his wife. Instead of serving time in prison, Bratcher was remanded to a state hospital and was released four years later after the state’s psych board found that he no longer had any “mental disease or defect.” Just the year before Alberto’s trial, Eddie Ray Routh, a Marine veteran who murdered legendary former Navy SEAL Chris Kyle and his friend Chad Littlefield near Chalk Mountain, Texas, in 2013, attempted an insanity defense. The jury didn’t buy it, finding him guilty on two counts of capital murder and sentencing him to life in prison. Alberto’s case differed from Routh’s in several important ways. Routh had shot Kyle and Littlefield in cold blood while participating in a benefit program offered by Kyle to help veterans in need. Critically, Routh had no real combat experience. Unlike Routh, Alberto had been through intense fighting in Kandahar in 2010. He had killed Tony during what the defense would argue was a momentary flashback, a symptom of his PTSD, a tragedy that never would have happened if Alberto had never gone to war. Probably not coincidentally, the very same argument had served to keep Bratcher out of prison. For their part, the prosecutors would present Alberto’s actions on the night of the shooting as those of a lifelong miscreant with poor impulse control and an antisocial disorder—a fit of jealous rage that resulted in murder.

The prosecution’s case began with Sachie Bakuya, who had been hanging out with Alberto up until the moment he left to go to Nicole’s house, then moved to the police officers and forensics experts who responded to the crime.

In court, Alberto wore a dark suit, a white shirt, and a tie, which he rotated every day. The ponytail he’d worn in jail was gone, replaced by a tight fade, his dark hair gelled up in the front. He’d been working out in jail, and he looked strong. I watched him from a bench on the far edge of the courtroom, next to the jury box, surrounded by Tony’s family and friends and young attorneys interested in the case. He sat with an intense expression throughout most of the testimony, occasionally whispering to his attorneys, nodding to his parents and giving a faint smile as the sheriff’s deputies uncuffed him every time he entered the courtroom.

When Nicole took the stand, his lips tightened and his jaw muscles flexed. Nicole, in khaki slacks and a green sleeveless blouse, struggled to maintain her composure as she recounted the frantic hours she’d spent pleading with Alberto not to harm the children. Several women on the jury wiped tears from their eyes as Nicole’s oldest son and Alberto’s stepson, then thirteen, broke down on the stand, describing how Alberto held him and his siblings hostage, along with their mother, threatening to kill the police if they came through the door.

With a few exceptions, the defense’s cross-examinations were procedural. Their fight wasn’t over the credibility of the evidence, or the timeline of events, but over the contents of Alberto’s mind. The prosecution rested on a Monday morning. When the jury filed back into the courtroom that afternoon, I took the stand as the defense’s first witness.

When El Paso attorney Joe Spencer’s private investigator called me way back in the spring of 2015 to ask if I would testify for the defense, I was conflicted. At the time, I didn’t know whether Alberto’s PTSD was legitimate or whether he had drummed up his symptoms as a means of escape. I agreed to testify, but as the trial neared, I began to feel increasingly anxious about my decision. I told myself that I wouldn’t testify for the benefit of the defense but for the benefit of the jury, so the people deciding Alberto’s fate could have an accurate sense of what his war experience had been like, and that I would treat the defense and the prosecution equally. Spencer’s office had listed me as an expert witness, which afforded me the opportunity to sit in on jury selection and remain in the courtroom throughout the entire trial, unlike non-expert witnesses, who were required by law to leave the courtroom after their testimony. Spencer offered to pay my expenses to travel to El Paso for the trial, but I refused.

The defense was primarily interested in a video that I had produced about Alberto’s unit called “Another Day in the ’Dab,” which contains graphic footage and audio recordings of the daily firefights at COP Nolen and a foot patrol into a nearby village that resulted in several casualties. Alberto appears at the end of the video in a still photograph, climbing over a mud-brick wall in order to avoid the predictable footpaths where the Taliban had placed IEDs attached to pressure plates. The courtroom went dark, and the video played on a large pull-down screen on the wall to the right of the witness stand. The sounds of machine-gun fire and exploding rockets and grenades seemed out of place in such a formal environment. Spencer asked me a few questions about the nature of the fighting in Kandahar that summer, and specifically around COP Nolen. He asked me how the fighting there compared with other parts of the country where I’d been embedded with other Army and Marine units. I told the jury that it was some of the worst fighting I had seen anywhere in Afghanistan.

He told of the explosion that earned him his own Purple Heart, and about his difficulty reconnecting with his wife and his family after he came home. “As I was looking at them,” he testified, “I didn’t see my wife and kids. All I saw were threats.”

Along with my video, the testimony of three of Alberto’s former platoon mates, including Rolando Zavala, helped establish the conditions for his PTSD. They testified about his involvement in nighttime small kill-team raids, in which groups of three to five soldiers would set ambushes outside the wire at night, hoping to catch Taliban troops on the move. Alberto often volunteered, they said, and he had a reputation for toughness in the platoon. But they weren’t there as character witnesses; they were there as alternative models of how the half-life of the war continues to affect veterans long after they return home. More than anything they had to say about Alberto, it was their own stories that lent credibility to the reality of living with PTSD. Zavala talked about the IEDs, and the constant barrages against the outpost walls that required extreme vigilance throughout the entire summer and early autumn of 2010. He told of the explosion that earned him his own Purple Heart, and about his difficulty reconnecting with his wife and his family after he came home. “As I was looking at them,” he testified, “I didn’t see my wife and kids. All I saw were threats.”

George Robertson, who lives in Brooklyn, New York, was Alberto’s platoon sergeant. He described the night when he attacked his own sister, after he got back from Afghanistan—something he has no memory of doing. Robertson, who was medically retired from the Army for PTSD, now lives in a veterans’ home in New York City. One day during the trial, I went out to lunch at a Mexican joint around the corner from the courthouse with Zavala, Robertson, and Joshua Strickland, the third veteran who came to testify. As we walked to the restaurant, Robertson hung back several paces behind the rest of us, swiveling around and walking backward every so often to check our six. These were men who—whatever their varying degrees of post-Army success—had never managed to leave the war behind.

But it would be the mental health experts who would make or break the case. The defense’s job was to create doubt in the jurors’ minds about Alberto’s mental competence—did he know what he was doing when he raised his AR-15 to his shoulder, aimed at Tony, and squeezed the trigger three times? Was he intending to kill? The only witnesses who could speak authoritatively to Alberto’s mental state were the experts hired by the defense and the prosecution.

The defense called Dr. James Schutte, a psychologist based in El Paso. Schutte said that he had visited Alberto eight times, and that he’d given him a battery of tests—21 in all—that clearly established the existence and pathology of his PTSD. Spencer asked Schutte if he thought Alberto was insane at the time of the crime. “Yes,” he answered. Another defense witness, Dr. Arthur Ramirez, a former Army psychiatrist and the director of a mental health hospital in El Paso, corroborated Schutte’s assessment that Alberto was insane at the time of the crime.

But testifying for the prosecution, Dr. Timothy Proctor, a forensic psychologist based in Dallas who visited Alberto once, for more than three hours, told the jury that although he believed Alberto’s PTSD was probably genuine, Alberto suffered from other mental health issues that outranked his PTSD. He testified about an incident from Alberto’s teenage years, before he joined the Army, when he’d been convicted on a misdemeanor assault charge after stealing beer from a convenience store and knocking into a woman on his way out. In his opinion, Alberto’s main problem was antisocial personality disorder, and he believed that Alberto had not been insane at the time of the shooting. On the basis of these conflicting accounts, the jury would have to decide Alberto’s fate.

He had been charged with murder, which carries the maximum sentence of life in prison. Spencer argued for two lesser charges: manslaughter and criminally negligent homicide. The prosecution fought hard to keep the manslaughter option off the charge sheet, but Judge Marcos Lizarraga agreed to include it. The not-guilty-by-reason-of-insanity option was the defense’s Hail Mary—a very unlikely outcome—but it had allowed them to explore the full spectrum of evidence and testimony about Alberto’s mental health. If the jury believed that his wartime experiences and lack of adequate treatment had affected his mental health severely, they might at least consider the manslaughter charge, which would save Alberto from spending the rest of his life behind bars.

The jury left the courtroom around lunchtime and deliberated late into the evening. It was early afternoon the next day when the jury finally filed back into the courtroom, ready to announce their verdict. Tony’s family and friends sat on the right side of the three rows of benches. Alberto’s relatives sat on the left. The courtroom was packed, and supporters of the defendant and the victim, who’d been in uneasy proximity for more than two weeks, mostly keeping their cool, were now on the edges of their seats. Sheriff’s deputies stood by the swinging doors, prepared to quell any spontaneous conflict between the two sides. “Most everybody in here has very strong feelings about this case, one way or the other, and I’m going to ask you to please not disrupt the court with very emotional outbursts,” Judge Lizarraga implored. At the request of the judge, Alberto rose to hear the verdict. The clerk read the jury’s decision. “We, the jury, find the defendant, Alberto Antonio Mendiola, not guilty of the offense of murder.”

Tony’s family—Ana, his brothers Angel and Javier, and his mother, Luisa—gasped, their faces contorted in agony. They had waited more than two years since Tony’s death, only to watch a jury find the man that everyone knew had killed their son “not guilty” of murder. Their anguish was tempered a moment later, but only barely. The clerk continued. “We, the jury, find the defendant, Alberto Antonio Mendiola, guilty of the offense of manslaughter.”

The PTSD insanity strategy had paid off. Alberto would go to prison, but if he behaved well in the penitentiary, he could pick up his life on the outside someday. The jury gave Alberto twenty years in prison—the maximum punishment for manslaughter. He’ll be eligible for parole in 2024, after he has served half of his time. The verdict, which landed somewhere between extreme leniency and extreme punishment, wasn’t exactly what either family had wanted.

No judgment was going to bring Anthony Bowler back to his family, and vengeance is a weak palliative. But if we accept that Alberto never would have committed the crime had he not gone to Afghanistan, is it fair to make Tony’s family pay the price for the damage caused by a war they had nothing to do with? Post-traumatic stress disorder can develop in the wake of any trauma, and I couldn’t help but wonder—would the jury’s sympathy extend to an inner-city youth who’d developed PTSD after a traumatic childhood and then gone on to commit a violent crime? Would any attorney attempt a not-guilty-by reason-of-insanity defense for such a man?

Still, I couldn’t shake the sense that the responsibility for Tony’s death stretched beyond Alberto, to the VA system that gave him a disability rating but did not treat him. To the Army that threw him into an intense combat role and then tossed him aside rather than dealing with his obvious mental health and behavioral problems. To the U.S. Congress and presidents who sent him and over a million other soldiers and Marines to war but could never get around to fixing the VA, even years after its devastating weaknesses were exposed. I remembered Joe Spencer telling the jury during the trial, “Every crime is a tragedy, but not every tragedy is a crime.”

Alberto in the El Paso County Jail.

Three days after the verdict, Alberto returned to the courtroom in an orange-and-white-striped convict uniform for his official sentencing. Before Alberto was led away, Judge Lizarraga granted him a few minutes to say goodbye. Everyone was gone except for court personnel, Alberto’s attorneys, and his family. One by one, his cousins and siblings walked up to hug him. When it was his mother’s turn, tears streamed down her face as she pulled him to her. For the first time during the entire trial, Alberto cried.

Months after the trial, Alberto remained in the El Paso County jail annex, awaiting trial for separate charges related to drug possession. The police had found several ounces of weed when they searched his apartment on the day of his arrest. Up until the murder trial began, Nicole had allowed Alberto’s family to take the children to visit him at the El Paso jail once a month, but after the brutal trial, Nicole ended the kids’ contact with him for a time. His parents and siblings tried to visit Alberto every weekend. Patti brought him books about martial arts. “He’s obsessed with Bruce Lee,” she told me. They put on a brave face when they talked about their enduring relationship with Alberto, reluctant to admit how much pain and sacrifice they’ve endured. His parents took on an enormous financial burden to cover Alberto’s legal defense.

“It’s been really hard, man,” Ernesto Sr. told me as we talked outside his house the day after the trial. He’s had to remortgage his home, and he missed many days of work at his machine shop to attend the trial. Alberto has spent much of his time in the jail in solitary confinement. He’s supposed to be getting treatment for his PTSD on the inside, but Ernesto Sr. and Spencer both told me that they fear it’s not really happening.

Ernesto Sr. worries that Alberto’s condition is worsening, and he’s nervous about what awaits Alberto at whatever Texas penitentiary he winds up in. As I prepared to leave, Ernesto Sr. put his hand on my shoulder and squeezed. He seemed to be reassuring himself more than me. We stood silently for a moment. His lips pursed in a show of confidence that was anything but convincing. “He’s going to be okay, man,” he said. “He’ll be home in no time.” He might have said something similar when Alberto left for Afghanistan seven years before.

In some ways, his son had never really come home.

Elliott Woods is a freelance journalist based in Livingston, Montana. This is his first article for TEXAS MONTHLY.