In a story he shared with the USO, Thomas Brennan, a medically retired Marine, said, “I destroyed my Purple Heart citation on Christmas Eve. I tore it to shreds. Then I threw my medal in the trash. I stood, staring down at it, angry. Tears rolled down my face. I hoped I would never see one again. That medal reminded me of the moments that ruined my life.”

Although the Purple Heart serves as one of the most recognized and respected medals awarded to members of the U.S. military, many recipients struggle with what the prestigious award represents. It’s a constant reminder of the loss and trauma they experienced and the physical and emotional struggle that follows them—sometimes for the rest of their lives.

Those of us looking in from the outside celebrate and congratulate, but recipients often don’t know what to say or feel.

Brennan said, “People used to ask me what it means to have earned the Purple Heart and I never knew what to say. How can you explain losing a part of yourself?”

At just 21 years old, Jim Furlong watched an enemy soldier toss a hand grenade toward him. “He jumped as high as he could, hand stretched out. It brushed his fingers, then dropped to his feet,” according to an article in the Chicago Tribune. The Purple Heart recipient didn’t talk about what happened for 30 years. It wasn’t until his own son toured in Iraq that he stared talking about the day he lost his leg during the Vietnam War.

Daniel Finn, who received a Purple Heart for his service in Vietnam in 1967, said, “If you see a Purple Heart, they shed blood for their country.”

Originally known as the “Badge of Military Merit,” the Purple Heart is America’s oldest military award. Created in 1782 by General George Washington during the Revolutionary War, it is awarded to soldiers wounded or killed in combat. About 2 million Purple Hearts have been awarded.