“It’s finished, over. Everyone knows now. I’m a drunk, that’s it, face it, nothing more. I’ve lost everything.”
I can’t say this was the first time that I had heard such an opening line from a patient. Such regrets are pro forma among addicts who have, at least for the day, come to the end of the line. Sometimes everything changes with such statements, à la The Hallmark Channel, sometimes not. It’s the stuff 12-step meetings and skid rows are made of.
Granted, this particular soldier had “hit bottom” (as the AA folks are wont to say) in a particularly, shall we say, noteworthy way. He’d hidden his alcohol dependence well for years, even from those closest to him. He’d never done anything small his whole life, though, so why not expose oneself as grandly as one can? Would we still be talking of Icarus had he not taken that selfsame route?
Right around the time my patient and I met, the Irish actor Peter O’Toole died. His obituary in the New York Times was a fitting tribute to Life lived intensely and hard, a life in which one works hard to reframe regrets as opportunities—and woe to anyone who dares intimate they might be otherwise. It would be a stretch to claim that my patient resembled the man who made T.E. Lawrence alluring enough to fill a Cinerama screen for four hours, intermission notwithstanding. Yet in spirit, they could have been brothers: success, booze, the whole bit.
Who knows, perhaps I was thinking of the Shakespearean actor O’Toole as I was listening to the opening lines of my patient. To steal inelegantly from Queen Gertrude, I found myself musing, “The man doth confess too much, methinks.”
“You started out in the Marines, didn’t you?” I asked him.
“Yeah, but then I got out. When 9/11 hit, I had to get back in, but the Marines wouldn’t take me. The Army would, though. The rest is history.”
That much of history, I had already known, and thence my Hamlet-ian suspicion. For I had known that he had been involved in the initial fighting in Iraq, the “Shock and Awe” that did so much more than both for all those involved at that time, civilian or military.
You were in the initial invasion, correct?”
Still wrapped in his shame—not wallowing, mind you, just wrapped—he scarcely seemed to register the question.
“Quite the time, eh?” I asked.
That, he registered. He looked directly at me, not with hostility, nor with anguish, but more with the detached empathy of a good 60 Minutes interview by Scott Pelley.
“It was hell,” he replied. “But we did what we had to. I don’t let it bother me that much.”
The Bard in me continued wondering.
“Did you drink this much before the War?”
For a couple seconds, he just stared at me, as if I’d just said something to him in Ukrainian, or Armenian, maybe. Then his eyes darted to the right, his head tilted ever so slightly, sort of like that puzzled dog you see looking at the gramophone in the old RCA Victor ads.
“Come to think of it,” he said as he looked back at me, “I guess not. I mean, I had my problems, but . . .”
“Nothing like that,” I filled in.
Another pause, his eyes apparently scanning the entire library of his frontal lobe one last time, just to make sure.
“No,” he answered, his eyes returning to mine empty-handed. “I guess not.”
I decided to go for it.
“So how do you know whether the War’s been bothering you or not? You basically haven’t been sober since you hit stateside some ten years or so ago.”
In a matter of seconds, that brought another eyes-darting, head-tilting to the right, not one this time of canine puzzlement, though, but rather one far more familiar to me from my past few years of working with combat veterans: the long look down a road marked “To Baghdad.”
“All I remember is a blast,” he said softly, to no one in particular, or so it seemed. “It was meant for me, you know. I was all hot-shot, gung-ho. I had the military experience, so my Command used me to help gather information from locals. I was always at the same spot, every day, and that day I just happened to turn back to check on something, wasn’t where I should have been, where I always was, right across from where that car bomb went off. I . . . I shouldn’t be here.”
He looked back at me, almost as if he were trying to refocus his eyes after having stared at the sun.
“God, so . . . so much happened.”
“You ain’t been soused all these years for nothing, eh?” I said, meaning it just as pointedly as I had said it.
As reality set in, he shook his head, just slightly.
“No one knew, my wife, my Command, nobody. I can’t believe I’ve hidden it all these years, the drinking. I . . . I just couldn’t take it any longer.”
I leaned forward. “It’s not just the drinking, you know. It’s the drinking and the War. You’ve got to face them both. No either-or here.”
For a few seconds, he didn’t even breathe, staring. “How do I do that?” he finally said, quite genuinely, poised as if he dare not ask.
I looked into his eyes. More often than not, the gaze of those who are coming off alcohol has a certain cloudiness to it, as if the entire brain behind it were stuck in a perpetual state of “Huh?” Not his, though: coordinated, focused, driven he still appeared, with the look that his Command must have seen so many years ago, the same look that somehow, through all the leftover remnants of the booze from the nights before, Command must still have been seeing day in, day out since.
“I want you to talk to my colleague tomorrow,” I answered. “She works with a form of treatment called Brainspotting. It’s an off-shoot of something they call EMDR, Eye Movement Desensitization and Reprocessing. You might have heard of that one. It’ll sound totally wacko, Brainspotting, I’ll warn you: it’s based on the idea of presenting the brain with alternating stimuli via hearing, touch, while having you find a spot in your visual field that, believe it or not, does seem to be almost a nodal point for the body’s experience of emotion. Most of the soldiers around here are skeptical as all get out about it—until after they’ve done it once. Give it a chance. With your detoxing, I’m not sure you’re ready for it, but we’ll see what she says.”
He gave me the smile of someone waiting for the punch line.
“This something like voodoo hypnosis?” he asked.
“Talk to her,” was all I replied. “See for yourself.”
When I spoke with him the next evening, after he had worked for a couple hours with my colleague, he had neither the clouded look of the alcoholic nor the steely look of the up-and-coming sergeant. It was a look well-familiar to me since I have been working here at the unit in Nashville: the look of someone who’s just ridden the park’s meanest roller coaster ten times and somehow, in some way is actually feeling . . . calm. Exhausted. But calm.
“So how was it?” I asked, barely able to keep the “I told you so” off my face.
“My God,” he stage-whispered, just tired enough not to have the energy to slap that look off my face, just with-it enough to let me know how lucky I therefore was. “What was that? I mean, she had me dredge up stuff I hadn’t thought of in years, and . . .”
“And you’re OK enough with it,” I replied, well familiar with this conversation. “Not ‘OK’ in that you’re fine and dandy, but OK enough, exhausted, but OK.”
Apparently after my words had found their correct spots in his cortex, delayed a bit more than usual by some routing neurons that were still shaking their heads at each other and asking “What the hell . . .?” he simply said, “Yeah.”
I love that moment.
“You’re going to need to put together a solid recovery plan,” I said to him, “and you’re going to have to keep talking to her—and then keep talking to someone after you leave here. It’s both, not one or the other. You’re not ‘just an alcoholic.’ You’re not just another veteran with PTSD. Don’t let anyone tell you otherwise, even though you’ll find a few who’ll try.”
After a few seconds, neurons apparently having decided to get back to work, he leaned forward. “So there’s hope?” he asked.
“Sounds as if your body is saying so,” I replied.
He half-smiled, half-grimaced. “My body is telling me to get some sleep.”
I love that moment as well.
“Sounds like a good idea,” was all I could say.
Techniques aside, established or controversial, we all now respect the brain for what it is: in the words of Dr. Samuel Wang from Princeton, it’s a “survival machine, not a computer.” It does what it needs to do in order to keep us doing what we hope to keep trying to do, day in, day out. It will lead us down one path of destruction if by doing so it senses that it can avoid what, to it, appears to be an even worse path. Our brains and our bodies are efficient, not necessarily wise. Sometimes we don’t know a good path until it’s laid out before us in neon chartreuse, long after we’ve exhausted every other, even blatantly ludicrous alternative.
Thank goodness we sometimes can be hit from our blind side, whether having been previously blinded by the light of an explosion or the darkness of an addiction. Thank goodness that some Icarus’s can learn, can take the risk of flying just a bit lower than their energy might otherwise take them, for a while, for a purpose, until an AA sponsor can be found, until certain memories can be processed with words and without, until a body can find more internal order, until a life can create more external order, until such Icarus’s can land on a safer shore, only then to take off one more time, not as a desperate escape, but simply as a way to get to the next challenge. And the next.