Above: Sgt. Paul Sasse, kneeling, poses with other Special Forces soldiers in Iraq in 2007. Courtesy Jason Inman

The Triangle of Death

Sasse grew up in a military family and joined the Army in 1999 when he was 19.

"My mom told me I always wanted to be a soldier, but to be honest, I don't recall why I joined or much else from before the blast," Sasse said in an interview in January in jail.

Wearing an orange felon jumpsuit, Sasse, who spoke in a rapid, stuttering ramble that his family said developed in the last few years, told how he ended up behind bars.

A career soldier who wanted to reach the rank of sergeant major like his stepfather, Sasse was assigned to an infantry battalion in 2001 and got married in 2003. He deployed to Afghanistan in 2004 for an uneventful tour then came back to a baby son who he soon learned was autistic.

Sgt. Paul Sasse sits in the rear gun turret of the Humvee in 2006 in Iraq where he was later almost killed. Courtesy Jason Inman

In 2006, he joined the 1st Special Forces Group, stationed at Joint Base Lewis-McChord in Washington, and deployed with the group to Iraq in 2007.

It was the most dangerous time in Iraq, and the group patrolled one of the most dangerous areas, a bomb-infested warren of Sunni villages and farms south of Baghdad that troops fittingly called the Triangle of Death.

"It was bad," Sasse said. "We were pretty much driving around waiting to get blown up."

Sasse was the rear gunner crouched in the trunk of a modified Humvee that belonged to the group's sergeant major.

The sergeant major, who rode in the back passenger seat, was a seasoned veteran whom soldiers say the unit looked up to as a mentor and great leader.

"The fact that the sergeant major rode around with us on every mission just showed you what kind of man he was," said Inman, driver of the Humvee.

In the festering Iraqi insurgency, where anyone could be the enemy, Sasse struggled to protect his sergeant major. At one point, he gunned down a civilian car that got too close, soldiers said, and it stuck with him, he said — not just because he had killed a civilian but because, given the vicious uncertainty of the Triangle of Death, he would do it again if he had to.

When it came to hidden bombs, though, there was nothing a soldier with a machine gun could do.

A near-surgical EFP strike on Sgt. Paul Sasse's Humvee in Iraq in 2007 pierced both passenger windows, injuring everyone in the truck and killing the group's sergeant major. Courtesy Jason Inman

On May 9, 2007, the team was driving down a road when it was hit. Four well-aimed armor-piercing roadside bombs, known as explosively formed penetrators, or EFPs, slammed into the truck. Black smoke swallowed the road. One EFP hit the engine. Two hit dead-center in the passenger-side windows. And one hit the rear, right next to Sasse.

The blast hurled Sasse against the side of the Humvee, cracking his helmet and knocking him out.

When he came to a minute later, everything was covered in the dust of the Humvee's 2-inch-thick blast-proof glass, which the EFPs had turned into fine white powder.

"It was so white I thought I was dead," he remembered. "Then I started feeling sick and threw up. That let me know I was alive."

Sasse crawled forward through the dust into the back seat to check the damage. Inman, the driver, was bleeding from his shoulder. Shrapnel had shredded the gunner's leg. Sasse turned to the sergeant major. He gasped. The blast had ripped off most of his throat and face.

Sasse fumbled for his medical kit and pushed a bandage into the commander's spurting neck to stop the bleeding. He used another to cinch together his skull.

"We knew sergeant major was gone," said Inman, recalling the scene. "But Paul kept working on him. He worked on him until the medics pulled him off."

When the team put the sergeant major's body in a bag, Sasse helped dress the wounds of the gunner and took over the gun turret.

A helicopter took the gunner, Inman and the body of the sergeant major away, but Sasse stayed with the convoy, driving several more hours to resupply other teams, soldiers said. At the time, TBI and PTSD were not as well understood, and there was an expectation for troops to "suck it up," soldiers said. Sasse did.

"He was never the same, though," said his mother, who talked to him regularly by phone while he was in Iraq. "He didn't seem to understand where he was or what was going on."

His unit gave him two weeks of recovery time away from combat before he returned to doing missions. Sasse had panic attacks and fainting spells, soldiers said, but he stayed in Iraq.

"We lost a lot of people and could not really spare anyone," he said in jail. "I couldn't really go home just because I was a little hurt."

'Wire him up'

When the Special Forces group returned home in November 2007, Sasse's family could tell something was off. He avoided people. He had lost his sense of humor.

"He had horrible short-term memory and no memory of large parts of his past," his wife at the time told the court in March. He couldn't recall their wedding. He stuttered and had problems fastening buttons, she said. And the man who had always been kind and calm was suddenly angry all the time.

They divorced.

"Since I couldn't remember much of the marriage, it really didn't affect me," Sasse said.

He was transferred to a unit at Aberdeen Proving Grounds in Maryland.

Sgt. Paul Sasse heads into court at Fort Carson. After waiting hours, his arraignment was rescheduled. Michael Ciaglo / The Gazette

In November 2008, medical records show, Sasse went for help. A brain injury doctor at Walter Reed Army Medical Center wrote that Sasse had "difficulties with learning and attention" and spent much of the evaluation time "staring into space," but the doctor said she believed that Sasse's problems "stemmed from psychological sources" rather than a brain injury and recommended psychotherapy.

At a psychiatric evaluation two months later, medical records show, Sasse had many of the symptoms of PTSD: nightmares and flashbacks, panic attacks, guilt, loss of interest in life, depression, anxiety. But the Army psychiatrist diagnosed him with attention-deficit disorder and sleep disorder. She prescribed him uppers for the day and downers at night.

"Wire him up then make him crash," said Inman, who retired from the Army after having his hand blown off in Iraq. "They didn't want to hear the real problem, and he did not want to disclose it because it would be a career ender. They both tried to hide it until it got to the point where they couldn't anymore."

In Maryland, Sasse fell in love with a fellow soldier, and they married in 2009. They have two daughters.

Sasse was still struggling with memory and concentration as well as symptoms of PTSD. He would wake up screaming and sometimes was consumed by rage. His second wife said in court testimony that he started hitting and choking her.

In July 2010, Sasse transferred to the 10th Special Forces Group at Fort Carson. Two months later, a doctor cleared him for deployment, saying his brain injury caused headaches and memory problems but the soldier "can still do his job well," records show.

In November 2010, the group deployed to Iraq.

"I thought I could handle it, but everything got worse," said Sasse, recalling the deployment. "My nightmares got worse; my sleep pattern got even worser; my PTSD, my TBI — all worse."

Hiding symptoms

A 2010 study published in the American Journal for Public Health shows troops are nearly twice as likely to have PTSD after a second deployment and nearly three times as likely after a third. Several recent studies also show traumatic brain injuries have a "cascade effect" where initial damage can cause further deterioration of brain cells for years. Increasingly, science is revealing that when it comes to combat, what doesn't kill you doesn't make you stronger; it makes you more likely to break.

When Sasse's unit returned to Fort Carson in May 2011, he was unraveling. He lost weight. He couldn't sleep. When he would jump out of planes during training, he found himself hoping his parachute wouldn't open.

He began fighting even more with his wife. During one argument in summer 2011, he repeatedly banged her head against the center console of their car, court documents show, but the beatings went unreported.

In November 2011, after another fight, she left the state with their daughters and told her husband she wanted a divorce.

That week, the head doctor of the 10th Special Forces Group noticed something was off about Sasse and sent him to the group's psychologist, Craig Jenkins.

There are no definitive tests for TBI or PTSD. Medical providers have to make a diagnosis based on past events and current symptoms, which can be difficult to accurately document. Soldiers widely believe a PTSD diagnosis will end their career and said it is easy to deny symptoms and fool the tests. On the flip side, several media reports have suggested, Army doctors are cautioned not to overdiagnose PTSD, which can be a drain on Army resources. In addition, there is a widespread belief that soldiers fake PTSD to get out of work and maximize benefits.

With all these factors in play, Sasse tried to downplay his symptoms.

"If I told them, I might lose my kids and my job," he said later. "If I didn't, my problems would get worse. It's a lose-lose situation."

The Special Forces psychologist noted in medical records that Sasse complained of headaches, increased anxiousness and "difficulties remaining on topic" but did not mention concerns of PTSD or TBI.

An Army doctor refilled Sasse's ADD and sleep medication prescriptions and sent him back to work.

Sasse continued to deteriorate throughout winter and spring until he could no longer do his job.

"He would call me almost every day during that time; I could hear him on the phone falling apart," his mother said. "Why wasn't my son treated?"

His commanders repeatedly sent him to the doctor, concerned something was wrong, records show.

In March 2012, his first sergeant, Lawrence Gamble, wrote to the unit psychologist, telling him to assess Sasse, saying, "Sasse is not the same person I knew before (the 2007) deployment, and he needs more help than he is probably letting on."

The psychologist diagnosed Sasse with anxiety disorder, gave him the anti-anxiety drug Propranolol and said there was no reason Sasse could not deploy once he was feeling better, records show.

In May 2012, Sasse's commander sent Sasse back to the psychologist saying Sasse had "noticeable memory problems; Never seems present in the room even though you're interacting with him; Seems to have lost the concept or concern of the impact of his actions," records show.

The psychologist, noting Sasse was "very distressed" and "in tears at times," diagnosed the soldier with the chronic PTSD soldiers said he had been showing symptoms of for five years. He recommended intensive treatment.