US soldiers serving in Iraq and Afghanistan who seek help for combat stress can receive brief treatment in the field, according to Theodore Nam, MD, chief of inpatient psychiatry at WRAMC, who spoke at the annual meeting of the American Psychiatric Association earlier this year. Treatment, provided with the expectation that soldiers soon will return to their units, includes a few days of regular meals and sleep, counseling, and possibly medication for mild to moderate mood and anxiety disorders. The "PIES" principle--proximity, immediacy, expectancy, simplicity--"aims to conserve the fighting force," Nam said, "without overdiagnosing those who are physically and psychologically drained." Soldiers whose symptoms persist or worsen, he noted, are evacuated for more definitive diagnosis and treatment. A recent study of members of combat infantry units indicated that as many as 17% of those exposed to combat in Iraq and about 11% of those who served in Afghanistan reported symptoms of PTSD, depression, or anxiety. Returning soldiers may be more likely to seek medical than psychiatric help. But those caring for soldiers are well aware that psychological trauma also requires attention. Thus, every soldier evacuated for medical or surgical reasons sees a psychiatrist within 48 hours of arrival at WRAMC. Making such visits universal avoids the stigma associated with a psychiatric evaluation.