Grand Opening

I still recall Dr. Hook’s The Cover of the “Rolling Stone,” my generation’s lament over what it takes to get noticed around these parts. What lyrics might have been spawned had BuzzFeed, The Daily Kos, and YouTube then been available?

Sean Azzariti, cannabis activist, twice-deployed Marine with PTSD, got his notice as he made his purchase of Colorado’s finest Bubba Kush yesterday, before God and all news outlets, as the cries of hurrah and humbug began wafting their way around the globe.

If only I could decide which way to waft.

Intoxicants are dangerous. There are successful PTSD treatments.

Yet the existence of treatments does not entail their availability. Sadly, even the available is sometimes the incompetent.

“Bird’s ready to land, green light’s on,” the soldier tells me. “You see it in each other’s eyes, no need to talk, the fear, Death. I still see them, those eyes.”

No hymn to weed here. But I see those eyes, too, of the so-called living.

So many eyes. So much to be done.

Making Peace With Warriors (Abigail Deaton)

This morning my eldest, Abby, a rising junior at Goshen College, a Mennonite college in northern Indiana, requested that the following Gospel excerpt be read at our church, First Mennonite of Indianapolis.

The Gospel According to Saint Matthew, 8:5-13
King James Version, Authorized

And when Jesus was entered into Capernaum, there came unto him a centurion, beseeching him and saying, “Lord, my servant lieth at home sick of the palsy, grievously tormented.” And Jesus saith unto him, “I will come and heal him.”

The centurion answered and said, “Lord, I am not worthy that thou shouldest come under my roof: but speak the word only, and my servant shall be healed. For I am a man under authority, having soldiers under me: and I say to this man,’ Go’, and he goeth; and to another, ‘Come,’ and he cometh; and to my servant, ‘Do this,’ and he doeth it.”

When Jesus heard it, he marvelled, and said to them that followed, “Verily I say unto you, I have not found so great faith, no, not in Israel. And I say unto you that many shall come from the east and west, and shall sit down with Abraham, and Isaac, and Jacob in the kingdom of heaven. But the children of the kingdom shall be cast out into outer darkness: there shall be weeping and gnashing of teeth.”

And Jesus said unto the centurion, “Go thy way; and as thou hast believed, so be it done unto thee.”

And his servant was healed in the selfsame hour.

She then gave the sermon that follows below:

Average age is about twenty-one. Seventy-five percent are white; twenty-five percent are other minority groups. Most are middle to upper middle class. At some point in the term, they serve abroad, see things that they will never forget. They’ll come back with stories, with people, with memories forever in their hearts. And they never really come back the same.

That describes roughly the average student at Goshen College. But that also describes the average combat veteran returning from the recent wars in Afghanistan and Iraq. Granted, there are quite a few differences between a student at a pacifist college and a combat veteran. Our stories don’t tend to end with “And then I never saw him again,” for example. Our stories don’t tend to involve as much violence, as much death. Our stories don’t tend to leave us feeling as if our sense of peace and trust in humanity has been stripped from our very soul.

The number of veterans who will need to be treated for years because of the emotional scars of war has been labeled the major mental health crisis of our generation. More than 2.2 million service members have been deployed since the war in Afghanistan began. According to a study done by the not-for-profit organization RAND, twenty percent of those who have returned show signs of mental health problems. These mental and emotional scars ultimately lead to serious repercussions that forever change the lives of these warriors and their families.

If we are really called to be peacemakers, it is time for us to serve those in the service.

The most widely-known and commonly-diagnosed mental health issue among the military is posttraumatic stress disorder, or PTSD. In the past ten years there have been a total of 88,719 reported cases of PTSD in all branches of the military. The National Institute for Mental Health defines PTSD as “an anxiety disorder than can develop after exposure to a terrifying event in which grave physical harm occurred or was threatened.” The three common symptoms of PTSD are  “re-experiencing symptoms” such as intense flashbacks or night terrors; hyperarousal symptoms, which are essentially a heightened awareness of one’s environment; and avoidance symptoms. These symptoms come together to cause extreme anxiety. These men and women are having intense, horrific flashbacks and are also so aware of their environment that they can appear  paranoid. It causes them to become extremely anxious, angry, and fearful, and therefore they avoid people who don’t understand.

Other problems facing service members are traumatic brain injuries (TBI) and substance abuse. According to a Frontline report, over 400,000 cases of TBI have occurred during the recent war. TBI’s can cause an array of physical as well as mental and emotional problems such as lack of concentration and focus, self-control problems, and difficulty with mood changes, to name a few.

In the Time Magazine article “America’s Medicated Army,” Mark Thompson reported that over 20,000 troops are taking antidepressants and sleeping pills. Many times troops are obtaining psychotropic and/or pain medications without prescriptions. When they come home and are unable to obtain these prescription drugs, the withdrawal symptoms are so bad and the emotional pain so intense, they commonly self-medicate.

The wounds of war do not stay on the battlefield, but are often dragged home. In a recent study done by Dr. Steven Sayers and his colleagues, forty percent of veterans expressed feeling as if they were strangers in their own homes. Sayers also found that veterans with PTSD or depression are five times more likely than other veterans to have family issues. Combat experiences leads to a sixty-two percent higher likelihood of divorce. And according to a US Army report, over the past six years cases of child and spousal abuse have gone up 177 percent.

But the most shocking statistic is not of those wounded, but of those lost. The cover of Time Magazine for the week of July 23, 2012 was a picture of a soldier with the title, “One A Day” printed under it. According to the article inside, “The War on Suicide,” on average one soldier commits suicide every day. Since that article was published, 335 soldiers have committed suicide.

And those are only active duty soldiers.

Further on in the article, the author says that among veterans, a suicide happens every eight minutes. Since that article was published, therefore, the number of veterans who have taken their own lives has reached 6,030.

If every person attending the upcoming convention of the Mennonite Church-USA in Phoenix were to commit suicide twice, we would almost hit that number.

We have a crisis on our hands. As peacemakers, we are called to serve in times of crisis. So why are we just sitting here?

I understand that as pacifists, we are not always sure how to react to soldiers, those with whom we disagree on a fundamental level. But as peacemakers, we do not have the best record of being peaceful when it comes to dealing with warriors.

In 2008, Ernest Martin, a retired Mennonite pastor, wrote an article in The Mennonite [the church’s national periodical] entitled “Human Sacrifice.” The last paragraph of this article is as follows:

We hear of instances of soldiers intentionally falling on an explosive to save comrades. Risking life and losing life for the benefit of another follow the example of Jesus’ sacrificial love. But initiating, supporting and participating in human sacrifice for advancing personal, ideological, and economic goals is God-rejecting idolatry. Kyrie eleison.

For those of you who don’t know, kyrie eleison means “Lord, have mercy.” But my question is: why can we not show that same mercy? If a young veteran were to come up to you and say, “I saw my buddy die out there to save my life. Within split seconds I watched what was once a body, what was once a friend, a husband, a father, what was once a man turn into an unrecognizable pile of flesh and blood,”—I would hope your first response would not be “Sorry, but you know: it’s God-rejecting idolatry.”

Because if it is, you might as well be talking to Veteran Number 6,031.

It isn’t about them or us. It isn’t about patriotism or pacifism It isn’t about war or peace. It’s about people suffering and people serving. It’s about warriors and peacemakers. Take down those barriers and see the person on the other side.

My father is the inspiration for this speech. Four years ago my father started working as a psychiatrist at the Veteran’s Administration Hospital in Indianapolis. Day after day my father goes in to work to serve men and women no older than myself. And day after day he comes home with horror stories sketched in his mind, with tales he cannot tell us, with burdens to hold that were not his to bear. But he bears them—because he embodies the core value of being a compassionate peacemaker. On Goshen College’s website, it says that compassionate peacemakers “embrace ‘shalom’—the peace that God intends for humanity.” Day after day my father sees those who have lost their humanity and helps them find peace once more.

Jesus was approached by a soldier. But not only was he a soldier, he was a Roman. He was a Gentile. He was a warrior. The peacemaker and the warrior disagreed on fundamental levels.

The soldier came up to Jesus to serve his servant, to help his fallen comrade. And what did Jesus do in return? Did Jesus scorn the soldier? Did he ask him to leave the Army? Did he say, “I’ll give you grace, but only if you follow me?”

No. He looked at the man, amazed, and said, “Truly I tell you: I have not found anyone in Israel with such great faith.”

I’m not saying to go become a psychiatrist at a VA hospital. I’m not even asking anyone to go visit veterans at a hospital. What I am asking for is a change of heart.

I’ve been a nanny for two veterans. I’m a friend of several soldiers. And I’m a Mennonite for peace. I don’t think those contradict.

If you choose to befriend a soldier or welcome back a veteran, just remember to love with no strings attached. They aren’t asking you to change your views, so don’t go in trying to change theirs.

Eastern Mennonite University professor Lisa Schirch wrote:

When you start to love people you disagree with, everyone starts looking a lot more like a human being doing the best she can with what he knows and has experienced.

If you don’t feel comfortable doing any of that, then I ask just one thing: Stop seeing a military. Start seeing a person.

Kyrie eleison.

As a father, I admire my daughter, admire the woman she has become. I so look forward to the life that she is hoping to create. I am so thankful for every moment that I can have with her.

As a fellow Mennonite, however, my response can only be a direct, simple, and heartfelt one:

Amen, my sister. Kyrie Eleison. On all of us.

On Massacre and the Innocents, Newtown, Old Pain

As a psychiatrist who works at a VA during a time of armed conflict, I have become used to having to decide each day how much I am willing to accept detente with the unspeakable, for how long today, for what reasons now, just now.

As the day wore on today, I felt Newtown, Connecticut throughout my hospital, not just on the flat-screen TV’s scattered throughout the cafeteria, the waiting areas, uniting Fox News with CNN (and perhaps somewhere on this planet, MSNBC) for God knows how long (please, bring back the fiscal cliff, a Sean Hannity-Rachel Madow smackdown, anything, anything), but even more I felt it in the tension that slowly infiltrated our very floor, floating its ways to those floors above, perhaps, I cannot say. It was a familiar tension, though.

It is the tension I feel every time I walk into our clinic that serves the men and women coming back from Afghanistan and Iraq, the tension that refuses to be tamed by mere words, that will stride right up to you as you walk through the door and just smirk at your puny hope that you might avoid its becoming your companion for the next hour, the next day, maybe even the next lifetime.

It is the tension of souls that know what they had hoped they would never have to know, that know that they will never not know again.

Words come easily for me. I talk for a living, after all, write as a passion. How can I not be aware that at this moment, then, with each letter on my screen deposited by that cursor,I am trying to do what I know cannot be done: send words off to ferry back to me twenty dead children, their six adult defenders–and even, yes, a lad clad in black, the age of my eldest, of men and women who are enduring ungodly heat and bullets of their own in the hills where, yes, civilizations go to die.

For many of the men and women whom I serve, it is the screams of the children and those who cared for them that will not release them into the nights that never seem to end, one after another after another. I hear these stories spoken by twenty-five-year olds, thirty-five-year olds, men and women who have at least had the decency to pass through puberty. Soon, though, in mere days, I will have colleagues from New York to Boston who will hear essentially the same stories, though now spoken by eight- and ten-year-olds, the same ones whom we have watched, in photographs, paraded single-file,  arm-to-shoulder, dazed, sobbing, the same pair of second-or-so graders who stood bereft in the midst of tree-like weeds and weed-like trees, Hansel and Gretel with no need for bread crumbs, thank you, just “away,” please, far away.

The “Massacre of the Innocents” is what they call the story in the Gospel of St. Matthew, the one in which the boys are slain for having been born and raised in the wrong place at the wrong time. Ah, how they debate about it, the scholarly “they.” Did it really happen? If it did, why didn’t the Jewish historian Josephus write about it? But were there even enough children in that town to warrant a mention during the age of a Herod who made Sadam Hussein look like Fred Rogers?

An old story, old pain.

How the unspeakable does engender words, though, doesn’t it? Did for Matthew and Josephus, does for us now. In blogs. In scholarly writings that debate how much pain is worth a mention in the historical Who’s-Who. In tweets screaming as succinctly as possible for either gun control or kindergarten guns, for the ACLU or the NRA. In hour after hour after hour of media analysis about insanity vs. evil, what’s-expected vs. what-do-you-expect, this just came in, film at 11, check out our website.

Yet when President Obama spoke to the nation today, it was his pauses that did the talking. Much ado is being made and will be made of the tears. It was in those few-seconds-long silences, though, the ones that spoke without speaking, that he showed the nation that he had indeed absorbed enough of the true Truth to allow that Truth to do what it demands: render silence silent. In those moments he showed us that the most any of us can do in situations such as Newtown is imagine what we can’t imagine in order somehow to absorb what we can’t absorb.

Tonight I remember the families of those killed. I remember the survivors: the children, the teachers and staff. I remember the combat veterans, young and old, who still dream the cries of the innocent. I remember the first-responders, the police and medical personnel who, like infantry and medics through the centuries, had to see what no one should have to see, yet which must nevertheless be seen–and when the time finally comes, spoken–so that the next generation might, just might not have to see the same ever again.

Finally, words find the unspeakable.

But only for a few paragraphs.

In the end, the unspeakable always wins.


May they all rest in peace.

Brother, Can You Spare a Career?

Recently I received the following thoughtful reply to the post, Thanksgiving and the Grammar of Hope:

Dr. Deaton,

Have you ever heard of something called a quarter-life crisis? It’s probably always existed, but maybe not coined until recently.

Every time I read your posts I find I’m not JUST reading about PTSD and combat – I’m reading about individuals within a generation figuring out how to move forward – and subsequently finding themselves in a sort of “crisis” at mid-20s. I’ve heard of these exact same situations (and questions) from both the civilian side and the veteran side through your blog and others.

I feel like you and your patients are battling “The War” and at the same time the “Quarter-Life Crisis”.

This week I have thought often about this comment, especially in light of my post earlier this week, The Ethics of PTSD Disability, or “Meet Brandon, the Rational Soldier, which outlined my thoughts about some persons’ concerns that modern combat veterans may have “incentives” not to get better so that they will not lose their government disability payments.

I agree with the commentator that there are many similarities between these populations (civilian and military). I also believe, though, that it is useful to understand how combat veterans differ in important ways from their non-combat-exposed peers who also struggle with the question “Whereto from here?”

Again, first, it is important to remember that in the United States we have long had an all-volunteer military.

Second, it is also important to remember that while there were some times during the current conflict in which the military more readily inducted troops who had been, shall we say, struggling in life (educationally, vocationally, morally, you name it), that has been, throughout the course of the conflict, far more the exception than the rule. Troops may or may not have enjoyed “traditional classrooms” in their high schools (and even colleges), but the vast majority of those who have been serving in the modern American military are quick-learners and driven. Those that aren’t usually don’t make it far enough to get themselves (and just as importantly, others) into trouble.

But third–and for the purposes of this post, most important–from the very moment troops walk into boot camp, they are imbued–maybe better put, infiltrated and colonized–with a sense of purpose/mission. One does not endure those weeks of training without committing oneself absolutely to the missions of performing at one’s best, whether physically or mentally; of committing oneself to the life of the men and women next to whom one is standing; and of committing everything one has, even one’s life, to ideals that are bigger than oneself.

I simply cannot overstate this.

Most civilians do not get this: most troops–and to this day, most veterans, young or old–can remember the physical sensation, down to the very gut, soul, and neuron, of mission, of having a purpose, even when the day-to-day could be boring beyond belief. For even the boring was something that was endured so that a goal could be achieved, no matter how small, for all small goals united, eventually, to a big goal that could cost one everything.

Thus, in a very significant way, young veterans are not having quarter-life crises. They are having “quarter-life-having-been-lived-and-now-what” crises. It’s not that they are searching for purpose that they’ve never had. They are searching to find a purpose equal to the one that they once had!

Modern combat veterans are not lost. They have lost.

Ask any modern combat veteran, no matter whether she has lost a limb or he has lost his skin’s integrity, whether she has lost her concentration abilities or he has lost his ability to sleep through the night without hearing screams and gunfire, whether she looks like a million dollars or he looks like death warmed over: would you go back over there, if you could, in your uniform, with buddies old or new? What answer will get, immediately and forcefully?

Yes. None other. Yes.

If you can’t begin to get to get that, whether or not you ever will be able to get that–then you’ll never get combat veterans. No. None other. No.

If you are ever to understand modern combat veterans, then you have to know that even when the veteran voluntarily left the military, most likely he or she was ready to go–and not. And certainly you must understand: for many, many veterans who were medically discharged–even with their “oh, I’m going to get so used to this, I just won’t be able to give it up” disability pension–they left the military not only involuntarily, but with a heart and soul that were devastated.

The military was going to be their career. They were going to make something of themselves. They volunteered for the military in a time of War. They were–and are–ergo, warriors. Warriors strive, build, fight, not just for kicks and giggles, but for emotional, physical, spiritual fulfillment. Most (I’ll even say, almost all) don’t want to hurt. They don’t want to kill. But they will do both, if they have to, to protect. It is the mission of protection that fulfills, not the violence.

If you think otherwise, then you don’t get it. Go right ahead: trot out some bad eggs for Prosecution’s Exhibit One through How-Many-Ever, pontificate, j’accuse with the best of them. But you’ll run out of examples, and mighty soon.

What you will be left with instead are men and women trying to come to grips with what they did and did not do–but all for a mission, a purpose, a reason, even if simply to survive and to bring home with them those about whom they cared most deeply.

Many enlisted men came into the military quite young, although many, true, were older. No matter: young or old, most were quick-learners and driven. Many advanced quickly. Many ended up responsible for the lives of men and women who were their peers, sometimes even their elders. They learned to make important decisions, often quickly, often with precious little information. When they succeeded, very often they were recognized for those successes, publicly. Not only were they on a mission, they knew that they had already been and were going to continue to be an important part of that mission. Not only were they going somewhere, they were going there with their mojo.

And then all that stopped.

Maybe they asked for it to stop, i.e., they left voluntarily, tired of the hassle, wanting to get back to some semblance of a family, an education. Maybe they fought tooth and nail to prevent it from stopping, by hiding, bargaining, begging away their struggles, their challenges. Maybe they were sent away ruthlessly. Maybe they were sent away regretfully.

No matter: one day, it stopped.

And then, all warrior-like, they were expected to wait their turn for the cashier at the Arby’s who’s just learning the new system.

Or answer to some so-called “manager” who is two years younger than they are and who has never branched much outside the surrounding counties of the godforsaken town they all grew up in, except maybe once to go to Disneyland or Disney World or Yosemite when they were in middle school.

Or try not to sucker punch the guy working next to them who’s bellyaching about that no-good son of his third wife, who, by the way, thinks she’s one of the Khardashians or something, sitting around all day watching Ellen and The View like she does, spending (and eating) him out of house and home just to keep that loser kid from moving in with his even-bigger-loser father, good riddance!

Once they commanded respect, these combat veterans. Once they spoke and things happened, big deal things. Maybe they were just twenty-two, twenty-five, twenty-eight years old, but they were making their mark, doing it right, making a difference, even in the boring and down times.

Now, if they’re lucky, they’ll get an occasional “thank you for your service!” Eventually, somebody somewhere will ask them, “Did you kill anybody?” More than a few somebodies will say to them, “You know, you’re different now that you’re back.” They might realize that the math that they could do in their head before that IED exploded is now, well, more challenging, and that the kid right out of high school, sitting next to them in their community college classroom, is looking at them funny.

In 1932, a song came out, made famous by such pretty-boy crooners as Bing Crosby and Rudy Vallee, that eventually became a sort-of theme song of the Depression, as dubious an honor as that was. It went like this:

They used to tell me I was building a dream
So I followed the mob
When there was earth to plow or guns to bear
I was always there, right on the job.

They used to tell me I was building a dream
With peace and glory ahead
Why should I be standing in line
Just waiting for bread?

. . .

Once I built a tower up to the sun
Brick and rivet and lime
Once I built a tower, now it’s done
Brother, can you spare a dime?

Once in khaki suits, gee, we looked swell
Full of that Yankee Doodle Dum
Half a million boots went slogging through Hell
And I was the kid with the drum.

Say, don’t you remember? They called me “Al.”
It was “Al” all the time.
Why don’t you remember? I’m your pal.
Say, buddy, can you spare a dime?

So now, eighty years later, comes the question: “brother”–or as the veteran, Al, said a bit more bluntly in the song, “buddy”–can you spare a career?

It’s an age of technology and globalization these days, iPads and group projects via Skype.

I can hear it now:

“So, well, there’s this vet, see, good guy, truck got blown up by an IED in Afghanistan, lost his best friend since boot camp. He’s looking for something to do with himself, see? I mean, the kid’s only twenty-five, and he’s got three kids of his own already, and he and his wife aren’t doing that hot, worrying about money and all that, you know, but I think it might work out if we could find him some work, but, you know how it is, he drove trucks in the Army and so, well, it’s not like he learned how to run computers or anything, but he was medically discharged, and he’s wanting to find something to do, and, you know, he’s only twenty-five, so he can’t live off the government forever, you know what I mean? So, I mean I know that you’re not sure you want him for that job that takes all those hours of focus and concentration, and I understand that, and I know that you guys are doing that team-thing you’re doing and you’re a little worried that he might fly off the handle or something like that, but trust me, that won’t happen, or if it does, he’s got a counselor at the VA, and you can call her and . . .

“He’s just a kid, you know, kind of like those kids you get right out of college, not really sure what they want to do now that they have to go out on their own, without someone telling them what to do, so maybe you could just find him something, you know, Christmas coming up and everything, sort of a patriotic duty, think of it that way. I mean, don’t go overboard or anything, I mean, he’s got his disability, so he’s not going to need that much, maybe a little something for some extras, you know.

“Yeah, I know, wouldn’t it be nice, huh, not to have to worry about a paycheck and just sit around and play video games, all day? I agree, but hey, we don’t want him getting to too used to that, you know, bad for him, so if we could just find him something, you know, anything, give him some reason to get up in the morning, you know what I mean? Maybe you got something that would keep him away from people most of the time, something simple, no real responsibility–I mean, sometimes these guys just can’t handle that. I don’t know, he was a sergeant or something in the service, so it was not like he was an officer or anything, with responsibilities, stuff like that. And it’s not like he’s wanting some kind of career now or anything like that, you know? He just needs some extra bucks at the Holidays, odds and ends, that kind of stuff.”

Yup. That’s why he volunteered to run the risk of dying in the middle of a desert, just so that he could play his video games and not have to worry about doing anything like, say, making a meaningful, purpose-filled life. I mean, he was in the military, after all.

No big deal.


Veterans’ Day 2012

Today is Veterans’ Day, the first since I began writing the blog. This time of year is always a colorful one at our VA: we get  more than our usual share of visits from bagpipers (I’d never quite heard “The Marines’ Hymn” sound similarly) and Future Farmers of America (great flowers). Cute kids hand out cards with a squeaked “Thank you for your service!” and there are some great sales in the PX (Oscar de la Renta sweaters, seriously!)

They say that if you’ve seen one VA, you’ve seen one VA. In theory, they could also say that if you’ve met one veteran, you’ve met one veteran. One cannot deny the fact, for example, that at least for a few veterans, their military experiences were somewhat akin to an extended Oktoberfest in Germany, Korea, Alaska, etc.

Yet that would not be at all fair, for in a very important way, if you have met one veteran, you have met all veterans, no matter when they served, where they served, how they served, in what branch they served.

I’ve said it many times before: there are much easier ways to get an education than by going through boot camp, a statement as true in times of peace as in times of war. In basic training one learns–body, heart, and mind–that one may have not only to kill, but also to die, and furthermore that one may have to do both precisely because one is not the center of the universe, because one has chosen to become part of a group that has volunteered to defend a larger group from those who would harm the innocent.

Some persons in this world will voluntarily choose martyrdom to promote the cause of peace, i.e., will choose their own deaths rather than inflict death on another.

Many, if not most persons, however, feel no need whatsoever to make a similar choice. Those who choose to serve in the military take up a different calling, therefore: they choose to serve the “many” such persons, if necessary, unto death so that the innocent will not have to be forced into martyrdom–or, perhaps better put, will not have to be slaughtered.

Every veteran knows that and can look another veteran in the eye and know that the other veteran knows that as well.

And so today is November 11. Because of this blog, however, because of the men and women I have been privileged to serve, this year I remembered Veterans’ Day early, on November 4, three days after November 1, All Saints Day.

We in the Mennonite tradition are more of the “Low Church” ilk, meaning that we have, through our history, tended not to take much notice of such “High Church” occasions  as Advent, Lent, Epiphany, etc. At our Indianapolis congregation, however, we have for several years now chosen the Sunday after All Saints Day to remember those in our congregation and in our lives who have, in the words of the writer of the Epistle to the Hebrews, joined our “great . . . cloud of witnesses.”

In recent years we have done so in a visually striking way: at the front of the sanctuary, on a table before the pulpit, small, flat votive candles are floated in glass bowls filled with water. Initially, as a member of our pastoral staff reads off the names of all members of the congregation who have died during our church’s nearly sixty years of existence, another staff member lights a candle as each name is read. Afterwards, we in the congregation are invited to come forward as we would like to light a candle for those whom we remember and whom we honor.

This year, as the members of the congregation came up front, the rest of us sang a song from the Taizé Community of France with the words, “Within our darkest night, You kindle the fire that never dies away,” a simple melody accompanied by organ, a solo flute, and a solo violin, the congregation and the instruments performing a canon of sorts again and again until all had lit their candles.

As I sat there, four names came to my mind: Danny, TJ, Mike, and Donald, the names of the best friends of four of the men I’ve had the honor to serve. All four men died in front of the men whom I’ve come to know. All four of the men I’ve come to know pause at the mention of these names, no matter how often, no matter when.

I walked up to the table and took the long, fireplace match from the women who had been standing in front of me. The match had burned down about a third of the way, still quite afire, ready. I lowered the flame down to one of the white votives floating in the water. It bobbed ever so slightly, requiring that I hold the match steadily, right at the tip of the wick, to await the few seconds until the flame recreated itself, fire one more time symbolizing lives engulfed, spirits rekindled, light continued.

For a moment I stood there, match now burned nearly halfway down, still alighted, nonetheless, both flames, match’s and candle’s, reflecting in the water below.

I lifted the match near my lips and blew. The carbon remains fell into the water, not scattering, merely floating, remnants, reminders that none of these four men ever reached his twenty-second birthday.

It was time to go back to my seat. Others were awaiting their turn. Death waits for no one.

Tonight I see that floating candle in my mind. Yet on this Veterans’ Day I also recall that life waits for no one as well. The dead float in our souls not simply to be remembered, but even more to be revived, reborn, remade. Life goes on for each of the men whom I continue to serve. Danny’s buddy struggles to keep his emotions under control long enough to feel a future. TJ’s buddy is coming closer every day to accepting that he must take time to grieve so that he will find the time to rebuild. Mike’s buddy is taking that time even as we speak.

And Donald’s buddy finally got his old job back.

Thankfully, though death and life do not, hope waits for us all.

If we only dare hope that it will.

To Danny, TJ, Mike, Donald, and now well over two thousand men and women from OEF/OIF/OND, I say “thank you.” To my Uncle Raymond and those who died in Europe and the South Pacific over half a century ago, I say “thank you.” To the best buddy of Danny’s father and those who died with him in Southeast Asia now almost a half century ago, I say “thank you.”

And to all of you who survive, “thank you.” No matter whether one agrees with the wisdom of violence, we all agree to its existence, and on this day that was supposed to have marked the end of the “War to End All Wars,” I thank those who wish to find meaning in protection, even protection unto death. War may or may not ever be justified, ever be wise. War is never a good. Yet its end has not come, nor, sadly, will it.

Thank you to all those who have been and are still willing to live faithfully in light of that.

The Onion Takes Manhattan, or A Tale of Two Essays

It is the best of times. It is the worst of times.

While I apologize to Mr. Dickens, I have to say, as a psychiatrist who works for the VA, that no truer words have e’er been spoken.

I have lived to see battlefield medicine reach a level from which many a man, many a woman, who otherwise might have become a name etched on a monument, has instead been able to return home to loved ones, to life.

And I have lived to see such men, such women struggle, claw their way, beg-borrow-steal to find a life worth returning to.

I have lived to see my profession, mental health, finally take seriously the long-term consequences of combat.

And I have lived to see some in my profession define “taking seriously” as prescribing pills as if there were no tomorrow; as manualizing protocols to get the job done in as few steps as possible, as if emotional healing were an advanced form of “Name That Tune” in three notes; as being oh-so-proud of itself for its evidence–its chi squares, p values, meta-analyses and all–while farming out the long-term emotional, the existential, the spiritual to the chaplains for them to clean up once the real work of psychological treatment is over.

The best, the worst.

If Dickens told us a tale of the London and Paris of old, then this week I had the opportunity (or the misfortune, rather) of reading tales from two publications that purport to represent (and proudly, I might add) less the best and the worst of today, but perhaps more the sublime and the ridiculous: The New York Times and The Onion.

Last Sunday, in the Sunday Review section, Nicholas Kristof wrote the essay, “War Wounds,” a devastating piece on the consequences of combat in the life of one man, Major Ben Richards, a 2000 honors graduate of West Point, who is, in Kristof’s words, “a brilliant man tracking his [own] cognitive deterioration.” Since having survived the explosion of two roadside bombs, Richards, fluent in Mandarin, who at one point pioneered cooperative work with Sunni Muslims in Iraq, has struggled to maintain enough adequate attentional focus to monitor the whereabouts of his toddler at his own home, let alone to write the papers in a Georgetown University graduate school class that he once would have breezed through without a second thought.

Kristof, who wrote earlier this year another excellent piece about which I commented in the blog, (In Memory of Ryan), pulls no punches as he sits down with this man and his wife, both only in their mid-thirties, in an Iowa home that became their refuge after Major Richards could no longer manage a teaching position at West Point:

[M]y take [says Kristof] is that whatever political leaders say in Washington, and whatever directives emerge from the Pentagon, not nearly enough is changing on the ground. Mental health still isn’t the priority it should be. Just about every soldier or veteran I’ve talked to finds that in practice the mental health system is clogged with demands, and soldiers and veterans are falling through the cracks. Returning soldiers aren’t adequately screened, diagnosis and treatment of traumatic brain injury are still haphazard, and there hasn’t been nearly enough effort to change the warrior culture so that getting help is smart rather than sissy.

The essay makes clear that both Richards and his wife have struggled with a dual obstacle course far more daunting than any that the good Major might have faced in his Army training maneuvers: the Department of Defense and the VA. Mrs. Richards struggled to find a kind word about anybody connected with either system, while, to his credit, Major Richards–Army loyal to the bitter end–tried to relate the best spin on his own tale that he could.

If Mrs. Richards somewhat held her tongue, however, other with whom Kristof spoke felt no compunction to follow suit.

“The V.A. certainly doesn’t care,” said Jim Strickland, who runs the V.A. Watchdog Web site. As he observes on the site’s home page, “This country is capable of drafting you, putting you in boot camp, teaching you to kill someone, and then putting you in a war zone within six months. So why can’t they process a claim that fast?”

What do I say after that?

Well, I did say something, the first time that I have ever commented on a Times article. I believe what moved me to do so was Kristof’s poignant one-,two-word descriptions of the Major’s struggle to maintain his composure as he related his disappointment over his injuries and his shortened military career. I wrote:

Sad to say, I can’t thank Mr. Kristof enough for his continued focus on the needs of our combat veterans. I’m sad to say precisely because I walk into a VA every day, trying not to lose hope, focusing day in and day out just on the man, the woman in front of me. Yes, we deserve a great deal of the calumny we get. Yet I’m still proud to work for Secretary Shinseki, for my Medical Center Director, for my Chiefs of Psychiatry and Mental Health Services. As a psychiatrist who sits with the tears, the rage, but also the hopes and the courage of these men and women, I’m honored to be allowed into their lives. And they keep coming,

We need your voice, Mr. Kristof, and the voice of brave men like Major Richards over and over. If not, the country will forget before it even has the decency to remember in the first place.

I agree with Mr. Kristof that the Major is anything but a failure. He’s still watching over his troops by refusing to live as if he were a failure. So many men and women have wept in my office because they had to give up a career that had finally given them meaning, all because of wounds that many would prefer to chalk up to some crazy notion of golddigging on the Government’s dime, as if men and women who volunteer in a time of war to do what they believe is right are the type who were really looking eventually for taxpayers to subsidize their cigarettes and bon-bons.

Keep calling all of us to task. Please.

So, all in all, one scrapbook-of-crummy-times essay should have sufficed for the week. But then came The Onion.

For any who might not know, The Onion is (allegedly) as far from The Times as mere mortals can travel. It’s an often-hilarious, always-irreverent newspaper spoof that has been skewering both the Right and the Left (although, admittedly, a bit more the Right) since 1988. Let’s just take a gander at a few of the “paper’s” lead stories this week to get a flavor of our publication here:

Putin Learns Putin is Behind the Plot to Assassinate Putin

Ugandan Powerball Jackpot Hits 31 Grains of Rice

Jennifer Aniston Engaged to a Guy Who Frankly Will Never Replace Brad

Need I say more?

However . . .

Another story also appeared in this week’s edition:

It Would Be an Honor to Serve My Country, Return With PTSD, Sit On a Mental Health Care Waiting List, Then Kill Myself

We ain’t in Kansas no more, Toto.

Purporting to be a “commentary” by an Army private who is about to be deployed to Afghanistan, it takes “black humor” to realms unknown. Some (e.g., Time magazine) found it tasteless and even vile. Far many more, however (e.g., persons posting comments on The Onion’s Facebook page), found it disturbing, satire at its most truth-filled, its most gut-wrenching, its most awful. Here are excerpts:

It’s a matter of principle, really [why I joined the Army]. From a young age I was taught that throughout our history, Americans have had to stand up and fight for the freedoms we enjoy. I always knew that when the time came, I would serve with honor and nobly suffer from post-traumatic stress disorder until my only recourse was to end my own life. So it’s with eager anticipation that I head off to the battlefield to defend, be ignored by, and then—left all alone, with my personal demons closing in—kill myself for the land I love so dearly.

I know no greater honor than relying on an agency [the Veterans Benefit Administration] with a backlog of more than half a million claims that can’t get its sh** together enough to transfer its paper files to a central computer.

And to see the look on my child’s face as he watches his own father, fresh off the battlefield, crying in a fetal position in the corner of his living room because he can’t get the help he needs, even though he’s been calling doctors for three straight months—tell me, is there any feeling greater than that? I don’t think there is.

So when I finally can’t take it any longer and decide to check into a hotel to end my own life, please know that I have but one simple request: My agonizing struggle and tragically preventable death should be the last thing on anyone’s mind. Because the only thing that’s important for someone like me, who will be dedicating his life to serving his country, is that my government lets me waste away until I become a shell of my former self.

That’s what being an American soldier is all about.

God, I wish I could laugh at this. I always gladly take laughter over nausea. Not my lucky day, though–or maybe more accurately, my lucky life.

I read this as I ended a week in which, happily, good has occurred: Will Do, Sir is sincerely trying to communicate more openly with his girlfriend. Buddy, Got the Time? is doing his best not to get into the same old Abbott and Costello routines from Hell with his young-adult son. Inside, Outside, Anywhere is trying to find ways to get his energy back into the world and into the lives of others. Maybe a Letter was proud to help out a good friend with some remodeling work. New Year, Old Challenges is also going to help a buddy remodel–at least two states away, much to my patient’s relief. The new guy from 525,600 Minutes has decided that perhaps he doesn’t have to be ashamed to admit that he’s depressed after all and therefore that he doesn’t have to freak out about trying an antidepressant.

But I read this as I ended a week in which, sadly, No Trouble At All revealed to me some truths–not about himself–that have been haunting him for weeks, more than explaining why his combat trauma symptoms have been skyrocketing. Quite the Handful struggled with several of us treaters over proper medications–and not at all pleasantly, I might add.

And I read this as I ended a week in which, even more sadly, three men entered my life within a matter of about six hours: a mortician whose traumas span a lifetime, culminating in body of a peer after body of a peer after body of a peer; a scout who lost, at one point, nearly a buddy a day, “hanging in there” until a natural disaster destroyed every thing in his life, finally forcing him to remember every one who had been swept away from him; and a chemical weapons man, so tolerant of alcohol that he hadn’t even felt that drunk when his blood alcohol content was over 300, desperate to hold his marriage together, hoping that some Librium would be all it would take to smooth everything over, so not wanting to admit to himself that he had not been drinking himself into oblivion solely for kicks, so not wanting to whisper to me, in answer to my “One day you’re going to face this,” a tear-embroidered “You’re probably right.”

The Muppets Take Manhattan is a fun, no-brainer little romp from the Eighties that used to keep my kids in stitches long enough for me to catch a good half-hour of shut-eye back in the day. Kermit, Miss Piggy, and the whole crew vow to take their college senior variety show to Broadway, with thrills and chills ensuing along the way, culminating in Miss Piggy’s clobbering Kermit into kingdom-come to restore his memories and, with a cast of hundreds of chickens, dogs, rats, etc., etc., to keep the show going on. Moral of the story? Dreams can come true–even, for Miss Piggy, ones of marriage to a certain, dashing young frog.

I’m not quite sure whether The Onion took Manhattan or vice versa, whether “all the news that’s fit to print” ended up in an op-ed piece or in a devastating–what, parody? Truth that no one dares speak in polite, conventional company?

I ended up, though, with a moral very different from Kermit’s and Piggy’s, one that I have to sit with every day of my working life, one that I have to feel, even occasionally embroider with my very own tears:

Dreams can be killed, by an IED, by an indifferent public who dares to harrumph and tut-tut a biting farce, all the while living out every word of that farce every day.

I am thankful that dreams can nevertheless be re-formed. I am glad that I have the honor every day of being part of that reformation process for the children of my peers. As a society, as Londoners, Parisians, New Yorkers, Hoosiers: we all should be doing nothing less than the same.

Mr. Kristof, editors of The Onion: never let us forget that–especially before many of us even have the decency to remember that in the first place.


A Mennonite at the VA?

As some readers know, just this past week I enjoyed my one Warholian fifteen-minutes-of-fame:  one of my posts made it to WordPress’s home page, sort of my version of being “on the cover of the Rolling Stone,” if you know what I mean.  It was in that Warholian post, Conical Combat Linkages, that I revealed that I’m a “Mennonite by choice.”  According to my stats, more than a few people now know this about me.

Interestingly, also last week Anna Groff, an editor of one of our Church’s national periodicals, The Mennonite, contacted me about an article she’s putting together on Mennonites who work at the VA.  Apparently there is not a huge crew of us, surprise, surprise.

For readers who may not know: Mennonites are a Protestant group who were originally known as “Anabaptists” during the Reformation.  Originally from Switzerland, southern Germany, and Holland, many came over to the United States in the eighteenth century, first living in the Pennsylvania area, then moving to the Midwest, especially Indiana and Ohio, with later groups settling in Kansas and points West, or in the western regions of Canada.  There also is a large group who live in Central America and in Paraguay.

Don’t ask about the latter two.  It’s complicated.

(I did feel compelled to mention the latter, however, given that a group of one of our more distant, conservative cousins, the Beachy Amish Mennonites, living in Nicaragua, were described in a not-too-flattering front page article in the New York Times today.  For those who have read the piece, just rest assured: when I say distant, I mean distant.  I’ll leave it at that.)

Traditionally Mennonites, like the Quakers, have felt strongly that the Christian faith requires its adherents to avoid violence, seek peace, and refrain from participating in wars.  In other words, we are usually referred to as pacifists.

Ergo the title of this post.

Anna sent me a list of thought-provoking questions to answer for her article, and so I decided: well, since I’ve identified myself as Mennonite on the blog, I might as well answer her questions in a post.  After all, readers–and even more, patients–should know whom they are getting when they get me so that, well, they can decide whether they even want to get me at all.

Because this is such a complex issue that speaks so directly to many areas of my life about which I feel strongly and deeply, my essay in answer to her questions is quite long, even for me!  Also, it has a certain in-group-ness about it which may not be agreeable to many readers.  Moreover, for many readers a discussion of issues of faith itself might not be the way you’re wanting to while away your next more-than-several minutes of your life.

Given that, I have posted the essay separately, under the title Letter to a Mennonite Pastor, which can be accessed either through the link just provided or through the “Thoughts” menu above.  It may end up of interest only to fellow Mennonites.  (It may end up of interest to absolutely no one at all.)  Still, as I deal in it directly with my role as someone who is both a member of a particular faith community and as someone who serves combat veterans, I hope that others might find that the discussion in it will, at least in some way, prove enlightening.

Many thanks to all those who have visited the blog these past few days, and especially many thanks to those of you who “liked” the Conical Combat Veteran post and to those of you who have subscribed.  I hope that I continue to write posts that each of you will find worthy of the respect and caring every returning combat veteran deserves.

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