Bill Koutrouba, a Spanaway resident who became a pioneering advocate for post-traumatic-stress care in the Puget Sound area after serving three tours in Vietnam as a combat medic, died Oct. 13 at Madigan Army Medical Center after a long illness. He was 70.

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Bill Koutrouba’s three tours in Vietnam as a combat medic were just the beginning of the help he gave his fellow soldiers coping with the wounds of war.

In battle, he stanched bleeding limbs and held soldiers as they took their last breaths. He received six Purple Heart awards for his own wounds in combat, and three Silver Star medals for bravery.

At home, the Spanaway resident became a pioneering advocate for post-traumatic-stress care in the Puget Sound area during the 1980s and 1990s. He spoke up about his inner battles and guided veterans on civilian tours to Southeast Asia to confront their memories.

Mr. Koutrouba, 70, died Oct. 13 at Madigan Army Medical Center after a long illness.

In his last days, he received praise from Army Surgeon General Lt. Gen. Patricia Horoho, who thanked him in a letter for his service during the war and his willingness later in life to speak out about post-traumatic-stress disorder (PTSD).

“It is impossible to determine just how many people you saved in your lifetime,” she wrote. “I imagine it is legions.”

Mr. Koutrouba was a main character in the 1990 PBS documentary “Two Decades and a Wake Up,” which chronicled the first civilian trip he made to Vietnam after the war.

He traveled there for the film with Seattle documentary producer Stevan Smith and members of Mr. Koutrouba’s PTSD support group.

At the time, Mr. Koutrouba admitted battling thoughts of suicide.

“They’re never going to make me well,” Mr. Koutrouba said in an excerpt from the documentary quoted in a 1990 New York Times article. “I get suicidal. I just want to find a way to live with my memories of that war. This trip should help.”

Indeed, it marked a turning point in Mr. Koutrouba’s life, Smith remembers.

“That war was always going to be a part of him, but it was no longer a destructive one,” Smith said last week.

Smith and Mr. Koutrouba stayed friends through the years. They traveled to Vietnam several times together, leading other vets on tours of their old battlefields.

They also encouraged the Department of Veterans Affairs and as many veterans as they could to use similar trips as therapy for PTSD.

“The whole idea (is) that you can go back and have a competing memory — that it is a country at peace, this land that you once fought over,” Smith said. “It’s not a war anymore, it’s a country.”

Mr. Koutrouba is survived by his wife of 43 years, Burnice Koutrouba. They knew each other as children growing up in Boston and reconnected in 1969 after Mr. Koutrouba’s third and final tour in Vietnam.

The couple raised their five children from previous marriages in Spanaway.

Mr. Koutrouba retired from the Army out of Fort Lewis in 1979 as a sergeant first class. He went to work for the VA at American Lake and lobbied to receive disability for his PTSD.

Today, veterans diagnosed with PTSD automatically receive a 50 percent disability rating from the military. But it was an uphill fight for the Koutroubas, Burnice remembers.

“This was really unheard of at that time,” she said. “The VA had a hard time admitting that veterans had that problem.”

She said her husband’s PTSD was obvious to her soon after they married. He had nightmares and headaches.

“I believed in my husband, Bill, and to me it was so worth it to help him to make sure that he was OK,” she said.

Some visions never left him. He recently told longtime friend Allen Andersen, of Tacoma, that he continued to see soldiers he’d seen die in Vietnam.

Andersen comforted him. Mr. Koutrouba “was feeling that he was being tortured. He was having these boys come to him that he held while they were dying,” Andersen said last week.

“I told him, ‘Bill, you would clean them up, you’d hold them, you’d tell them the chopper’s coming. You’d love them until they left.’ “

And when he would see visions of them years later, “they were just there to say thank you,” Andersen told him.

Funeral services for Mr. Koutrouba are scheduled for 1:15 p.m. Monday at Mount Tahoma National Cemetery, 18600 S.E. 240th St., in Kent.