The myth of the lone drone warrior is now well established and threatens to become as enduring as that of the lone lawman with a white horse and a silver bullet who rode out into the Wild West to find the bad guys. In a similar fashion, the unsung hero of Washington’s modern War on Terror in the wild backlands of the planet is sometimes portrayed as a mysterious Central Intelligence Agency officer. Via modern technology, he prowls Central Asian or Middle Eastern skies with his unmanned Predator drone, dispatching carefully placed Hellfire missiles to kill top Al Qaeda terrorists in their remote hideouts.

So much for the myth. In reality, there’s nothing “lone” about drone warfare. Think of the structure for carrying out Washington’s drone killing program as a multidimensional pyramid populated with hundreds of personnel and so complex that just about no one involved really grasps the full picture. Cian Westmoreland, a US Air Force veteran who helped set up the drone data communications system over southeastern Afghanistan back in 2009, puts the matter bluntly: “There are so many people in the chain of actions that it has become increasingly difficult to understand the true impact of what we do. The diffusion of responsibility distances people from the moral weight of their decisions.”

In addition, it’s a program under pressure, killing continually, and losing its own personnel at a startling and possibly unsustainable rate due to “wounds” that no one ever imagined as part of this war. There are, in fact, two groups feeling the greatest impact from Washington’s ongoing air campaigns: lowly drone intelligence “analysts,” often fresh out of high school, and women and children living in poverty on the other side of the world.

A Hyper-Manned Killing Machine

Here, then, as best it can be understood, is how the Air Force version of unmanned aerial warfare really works—and keep in mind that the CIA’s drone war operations are deeply integrated into this system.

The heart of drone war operations does indeed consist of a single pilot and a sensor (camera) operator, typically seated next to each other thousands of miles from the action at an Air Force base like Creech in Nevada or Cannon in New Mexico. There, they operate Predator or Reaper drones over countries like Afghanistan, Iraq, Pakistan, Somalia, Syria, or Yemen. Either of them might have control over the onboard Hellfire missiles, but it would be wrong to assume that they are the modern day equivalent of the Lone Ranger and his sidekick, Tonto.

In fact a typical “combat air patrol” may have as many as 186 individuals working on it. To begin with, while the pilot and the sensor operator make up the central “mission-control element,” they need a “launch-and-recovery element” on the other side of the world to physically deploy the drones and bring them back to bases in Afghanistan, Saudi Arabia, and elsewhere. As with so much that the US military now does, this work is contracted out to companies like Raytheon of Massachusetts.

And don’t forget another key group: the imagery and intelligence analysts who watch the video footage the drones are beaming from their potential target areas. They are typically at other bases in the United States.

Each member of the flight crew has an Air Force designation that specifies his or her task. The pilots are known as 18Xs, the sensor operators are 1Us, and the imagery analysts are 1N1s. The launch and recovery personnel are often former drone pilots who have quit the Air Force because they can make twice as much money working overseas for private contractors.

In charge of the flight operators are a flight operations supervisor and a mission intelligence coordinator who report to a joint force air and space component commander. In addition, there are “safety” observers and judge advocates (military-speak for lawyers) who are supposed to ensure that any decision to launch a missile is made in accordance with officially issued “rules of engagement” and so results in a minimum number of civilian deaths. They are often situated at the Combined Air and Space Operations Center at al-Udeid Air Base in Qatar.

But Predators and Reapers don’t fly solo. They typically roam in packs of four aircraft known as “combat air patrols.” Three of them are expected to be in the air at any given time, leaving one on the ground for refueling and maintenance. A fully staffed patrol should have 59 individuals in the field doing launch and recovery, 45 doing mission control, and 82 working on the data gathered.

Bear in mind that the Air Force is currently staffing 65 such combat air patrols around the clock, and the Central Intelligence Agency may well be operating quite a few more. (It is possible that the two fly all missions jointly, but we have no way of knowing if this is so.) In other words, toss away the idea of the lone drone pilot and try to take in the vast size and complexity (as well as the pressures) of drone warfare today.

This, by the way, is why Air Force officials hate the popular industry term for drone aircraft: “unmanned aerial vehicle.” The military notes correctly that drones are in every meaningful sense manned. If anything, of course, they are hyper-manned, when compared to, say, a traditional F-16 fighter jet. (In fact, the preferred military term is “remotely piloted aircraft.”)

How PTSD Hits the Drone Program

In covering Washington’s drone wars, the media has tended to zero in on the top of the kill chain: President Obama, who every Tuesday reviews a “kill list” of individuals to be taken out by drone strikes; the CIA general counsel who has to sign off on each decision (John Rizzo did this, for example); and Michael D’Andrea, the CIA staffer who oversaw the list of those to be killed until he was replaced by Chris Wood last year.

In reality, these decision-makers at the top of the drone pyramid see next to nothing of what happens on the ground. The people who understand just how drone war actually works are the lowly 1N1 imagery analysts. While the pilots are jockeying to keep their planes stable in air currents that they cannot physically feel and sensor operators are manipulating cameras to follow multiple individuals moving around on the ground, the full picture is only obvious to the imagery and intelligence analysts. They are steadily reviewing both real time and past drone footage and comparing surveillance data to see if they can spot potential terrorists.

Many of them are in their teens or slightly older with perhaps a year of formal military training. They are outranked by drone pilots, officers with degrees and years of training at the Air Force Academy, who will typically pull the trigger on a Hellfire missile.

Add to this picture one more fact: the Air Force is desperately short of people to do such work and losing them faster than it can train new recruits. As a result, Washington’s drone wars are operating at perhaps two-thirds of what the Air Force would consider ideal staffing levels. This means that drone personnel are now expected to work double- and triple-duty shifts. As one drone commander explained to an Air Force historian: “Your work schedule was 12-hour shifts, six days a week. You were supposed to get three days off after that, but people often got only one day off. You couldn’t even take your 30 days of annual leave—you were lucky to get 10. When you have mainly a non-vol[unteer] community, what do you expect? It’s not going to be a happy place.”

These overworked, under-trained, underpaid, very young drone personnel are now starting to experience psychological trauma from exposure to endless killing missions. They are the ones who see and have to live with the grim scenes of what is so bloodlessly called “collateral damage.”

“They are often involved in operations where they witness and make decisions that lead to the destruction of enemy combatants and assets,” Dr. Wayne Chappelle, an Air Force psychologist, wrote in the August 2013 issue of Military Medicine. “They can still become attached to people they track, experience grief from the loss of allied members on the ground, and experience grief/remorse when missions create collateral damage or cause fratricide. It is possible there are drone operators who perceive the deployment of weapons and exposure to live video feed of combat as highly stressful events.”

Chappelle’s studies have already shown an increased level of post-traumatic stress disorder (PTSD) among these personnel. He is now working on new studies aimed at focusing on exactly which of them are most affected, at what point in the decision-making, and why. The Air Force hopes that Chappelle can help them reduce the incidence of PTSD—from which they are losing personnel—by offering advice on just how psychologists and chaplains working alongside drone operators might counsel them on their ongoing traumatic experiences. Otherwise it faces the problem of staffing its missions, fulfilling a growing demand for ever more drone strikes in ever more countries, and a new phenomenon as well: growing criticism and resistance to its killing machine from within.

Cian Westmoreland, who was not even involved in active targeting work, is nonetheless typical. He says that he is experiencing nightmares about the 200 or so “kills” that he was credited as having supported. As he wrote recently, “I started having dreams about bombs. I once dreamt I saw a small girl crying over a body on the ground. I looked down and it was a woman. I looked at the girl and told her I was sorry. I looked at my hands and I was wearing my [battle dress uniform]. They were covered in her mother’s blood.”

Westmoreland’s nightmares pushed him to speak out—and he is just one of a growing number of Air Force veterans who have chosen to do so. An imagery analyst I recently interviewed told me that junior personnel were deeply affected when they saw civilians, including women and children, in the line of fire.

“If the pilot really wants to, they can ignore us and push the button without us agreeing,” the analyst added. “We are often completely helpless because airmen are terrified of officers. It is an unbalanced chain of command.”

What’s striking is the whistleblowers coming forward are not pilots and officers but the lowest ranked personnel in the drone teams.

PTSD in the Global Wild West

The trauma of desktop warfare comes mostly from the voyeurism of watching death thousands of miles distant and can, in some cases, be tuned out and eventually turned off. The same cannot be said for the experiences of targeted communities.

Washington experts regularly claim that the surgical elimination of top Al Qaeda leaders in Pakistan and Yemen has reduced terror in these communities, but actual studies on the ground suggest that the very opposite is true.

Last month, Alkarama (the name means “dignity”)—a Geneva-based human rights organization that specializes in the Arab world—published “Traumatizing Skies,” a special report on the impact of drones in Yemen. One hundred participants were interviewed from the villages of Qawl and al-Sirin between July and September last year and evaluated using the same American Psychiatric Association standards for PTSD that Chappelle’s team used on drone analysts.

“An overwhelming majority of adult respondents are seen to be suffering from numerous drone-inflicted symptoms of PTSD, which are even more prevalent amongst children,” writes Radidja Nemar, Alkarama’s regional legal officer for the Gulf countries. “The situation has transcended the question about whether or not an individual has lost a family member to a drone attack, simply because trauma has become pervasive in a society living constantly under the fear of drones.”

Their situation differs from that of the pilots or analysts who can and do quit their jobs when they begin to suffer. The victims have no such options. They can’t escape the drones regularly buzzing overhead. “The common denominator in most of the cases is the feeling that life has no value and that death could happen at any moment and without apparent reason,” wrote one of the Yemeni survey researchers. “This shared feeling hinders most everyday activities in the villages and results in constant anxiety and fear. The deterioration of the living conditions in general, as added to the lack of healthcare services and the mental suffering of the populations, are aggravating their general feeling of hopelessness, frustration, and anxiety.”

The most distressed respondents were women, partly because they felt the drones violated their modesty. Girls reported the highest percentage of sleeplessness and nightmares. Not least was the impact on women’s daily lives, already far more restricted than those of men. Atiqa, a 55-year-old mother of three, for instance, explained that her blood pressure problems had become more severe, forcing her to stay in bed for several days at a time. Fatima, a 40-year-old mother of five, reported that women like her were unable to enjoy the few opportunities where they could meet other women, like weddings, for fear that such gatherings would act like drone magnets.

Similar reports have emerged from Pakistan, says Dr. Mukhtar-ul-Haq, the head of the psychiatry department at Peshawar’s Lady Reading Hospital. He has studied the impact of the drone war on Waziristan, a tribal borderland near Afghanistan. “The vast majority of people report being perpetually scared of drone attacks day and night,” Dr. Haq said in a video conference call held by Alkarama to mark the release of its Yemen report. “The constant noise makes them experience bouts of emotional trauma and symptoms of anxiety. They often manifest themselves in the form of physical illness, heart attacks, and even suicide.”

Joining the Alkarama conference call was Brandon Bryant, a former Air Force sensor operator, who has experienced PTSD, thanks to his work with drones. He has become one of the most outspoken critics of Washington’s killing program. “The leadership only looks at this program as a numbers-based thing…how many people were killed,” says Bryant, whose unit took part in 2,300 kills. He estimates that he personally killed 13 people with Hellfire missiles. “They don’t care about the human beings doing the job or the human beings affected by the job.”

Although they never served together, Bryant and Westmoreland recently discovered each other’s work at a screening of the film Drone by Norwegian filmmaker Tonje Schei. The two Air Force veterans have now joined forces to seek justice for affected communities. They have set up an online organization of national security whistleblowers and their supporters, giving it the symbolically bloody name of Project Red Hand. Through it they are calling for others from the drone program to join them in speaking out.

“Many of us are people who looked down one day to see our hands painted red,” they write in the organization’s mission statement. “To those [to] whom we direct our words, we are not your adversaries. We are only a mirror. Through our crimson hands we only seek to show you your reflection. We believe that truth deserves its own narrative. We hope that people like you will also stand up and join us in our efforts. We are also living proof that there is life after this, and if you trust us, we will show you a better world.”

In bucking the military system and Washington’s cherished drone war program, perhaps Bryant and Westmoreland are themselves the ones who are taking on the classic Wild West roles of the Lone Ranger and Tonto. They have ridden into the badlands of the national security state to challenge the injustice of an outlaw system of killing that extends across significant parts of the planet. In the face of such an implacable program, one can only hope that they will find their silver bullets.