When there’s a war going on around you, there’s not a lot of time to think. If there was, perhaps you’d have the presence of mind to avert your eyes when possible, to avoid seeing the things you’re doing, even if all you’re doing is following orders. Get in position, prepare the artillery, check the coordinates. And sometimes, around 15 miles later, you come across the effect of your actions. You don’t avert your eyes—that would be impossible—but you see things without really seeing them because looking too hard would be a little too much. These are the things that make war what it is—things you never imagined were part of the deal when a recruiter at your high school career fair called your name and you looked back.

Most of us back home have a different version of the war in Iraq—a version whose images have been cleaned and cropped. But it is possible, of course, to find the images of the real war if, for some reason, you want to. They’re gruesome. They’re so disturbing and so unlike the images we’ve seen that after a few moments spent here, in what feels like the dirtiest corner of the Internet’s underbelly, you come to appreciate the censuring hand that has cropped these images from history’s wide frame.

But for thousands of soldiers who have fought in Iraq and Afghanistan, including 5,959 from the New York metropolitan region, things are not so easy. A recent Army study found that one of six returning Iraq veterans suffers from post-traumatic stress disorder, or PTSD, a psychiatric ailment that affects people who have witnessed exceptionally traumatic events. Unlike us, they have not been shielded from the pictures of things left behind on the battlefields of Mosul and Falluja. It’s estimated that 17,000 Iraqi civilians have been killed in this war, and at this writing, 1,487 American soldiers have died (while another 11,069 U.S. troops have been wounded). Nineteen of the Americans killed were New York City residents, eight of them from Brooklyn. Casualties or not, all the soldiers who have gone to Iraq have witnessed a lot of violence and death—images that, for veterans with PTSD, can’t be turned off with a press of a button.

The first dead bodies Alex Ryabov saw were two Iraqis in civilian clothing. Born in Ukraine and bred in Brooklyn, Ryabov was the type of kid who loved violent video games and fireworks. When a Marine Corps recruiter approached him at a career fair during his junior year at Midwood High School, eventually showing him a video of things exploding, Ryabov was hooked. He enlisted in 2000, at the age of 17. He was lured by the promise of a free education, health insurance, and the chance to own a rifle and shoot it. War was the last thing on his mind.

But he was there when the war began. On March 20, 2003, three nights after President Bush delivered his 48-hour ultimatum to Saddam Hussein, Ryabov woke up in Kuwait. That morning he marched into Iraq, where, just over Kuwait’s border, his unit encountered farmers tending their land in the early light of dawn.

Ryabov doesn’t look much like a Marine. In the six months since his term ended, his hair has grown longer and his frame appears small hidden under a baggy shirt. At 22, he’s incredibly articulate and takes his time to describe his experience in Iraq, where he served as the ammunitions chief for his unit, “in charge of the A to Z’s of the artillery,” or in other words, heavy weapons on wheels. His unit traveled along the highways and when their orders came, they would pull over, load their weapons, and fire from the side of the road. They rarely knew their target, which was some 15 miles from where they parked.

“The image of those dead bodies has been burned into my mind,” Ryabov says, tugging at his shirt and adjusting uncomfortably in a restaurant booth. “Their eyes were just glazed over, and you knew that that person’s soul was no longer in their body.” Typically, his unit didn’t see the effect of their long-range weapon attacks, but once they pulled alongside the site they had recently targeted, and there he found the image that would haunt him the most. “You try and block it out, because there was nothing you could do,” he explains, “but it looked just like someone had put all of these people and things in a blender and then poured it out. And that was from my unit’s fire.” Such horrors are one of the reasons that upon returning, Ryabov helped found Iraq Veterans Against the War, which advocates for the withdrawal of troops and adequate services for veterans, many of whom had similar experiences.

Ryabov now suffers from PTSD. The effects of his illness were apparent long before he admits to being diagnosed with PTSD. He squirms in his seat, and when somebody drops a pizza tray at the restaurant where we’re talking, Ryabov nearly panics. “I have terrible anxiety,” he says, “I have trouble sleeping. I don’t mean I lie there for an hour, but I’m dead tired, and after four hours, I still can’t fall asleep. Every night, there’s bad dreams...I’m extremely paranoid, every sound I hear I think someone is trying to break into my house. I never feel completely safe.”

Typically, symptoms of PTSD begin three to six months after combat deployment, which, inconveniently, is just about the same time many Iraq veterans are finally settling into life back home. Physical symptoms include headaches, abdominal pains, and a weakened immune system, but it’s what the illness does to the mind that is most troubling.

Dr. Herbert Stein, a psychiatrist who runs the PTSD Clinical Team at the New York City Veterans Affairs Department, explains that PTSD is so distressing because it causes the brain to relive the traumatic experience. “Like when we dream, we really think we’re there, we don’t think we’re in a dream,” he says. “That’s how it is for people with PTSD. They’re right back there in that moment.”

Some medical professionals have estimated that 15 percent of all veterans returning from Iraq and Afghanistan may require treatment for PTSD, and there’s serious concern over whether the VA can adequately handle these cases. A report released in February by the Government Accountability Office found that fewer than half the veterans receiving medical assistance through the VA are even screened for PTSD and officials at six of seven VA medical centers surveyed in the study stated that they may not be able to meet an increase in demand for PTSD services.

When Alex Ryabov first started experiencing symptoms, he was hesitant to get help, and in that he is not alone. The recent Army study, published in the New England Journal of Medicine, found that the majority of soldiers suffering from PTSD indicated a reluctance to receive treatment because of the stigma attached to receiving mental health services in the military. “Marines are supposed to be the toughest of the tough,” Ryabov explains, “and there’s also a fear that you’ll lose your benefits if you talk about it.” It took him months of feeling anxious before he “realized it was time to drop all the macho stuff and take care of myself.” Now Ryabov talks comfortably about his illness, as he believes it will help others.

Treatment for PTSD varies, but typically it includes individual and group therapy and medication. “The goal is getting them to integrate what happened to them a little better,” says Dr. Stein. “We want to get them to remember it, which is a lot different than re-experiencing it.” Even with treatment, however, many soldiers may experience symptoms throughout their life.

If PTSD is left untreated, the consequences can be dire. Often, it leads to substance abuse problems, major depression, and even suicide. Yogin Singh, the director of the Homeless Veterans Reintegration Program of Black Veterans for Social Justice, a social service agency, has seen an increasing number of Iraq veterans with PTSD become homeless. “We’ve claimed to learn lessons from Vietnam,” he says. “But the government is not making enough resources available to take care of people who are returning home damaged. These vets don’t only want a parade, they want help. They want to know what’s going to happen when the drums stop beating.”

In late February, PBS announced that it would release two versions of A Company of Soldiers, a documentary about an army unit in Baghdad in the weeks following the U.S. presidential elections. In the “raw” version, expletives are used 13 times, and PBS has warned local stations that airing this version may result in fines from the FCC. Therefore, PBS is also distributing a “clean” version, in which the bad words have been censored.

When this documentary was filmed in November 2004, most of us back home were recovering from the long fight of the elections and preparing for the holidays, attacks from Iraqi insurgents had increased dramatically. One hundred and thirty seven American troops were killed—the most deadly month since the war began.

For the time being, we have a choice about which version of this war we want to make our own. In our war, we don’t have to see dead American soldiers coming home in coffins, because the Bush administration won’t allow it. We don’t have to think about Iraqi civilian casualties because, as General Tommy Franks famously declared, “we don’t do body counts.” And if the language of soldiers engaged in direct combat in city streets offends us, we can make those words disappear.

But one day it’s likely that we will have to face the reality of this war because people like Alex Ryabov will remind us of the things that really happened. When he talks about how he suffers from the things he did and the things he saw, we will regret his illness. And not only because of what it’s done to him, but because it will remind us that there is more to this war than we allow ourselves to know.