By Bombs and Brainspotting Blindsided

“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.

“Yes.”

“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.

JD/rjsd

Semper Silouan

I got out of Nashville quite late this past Monday, so I was heading into a long trip up I-65. It turned out not too badly, though, all said and done. Eastside Indianapolis should probably be farther than four-ish hours away from Northside Nashville, but the weather was great, the truckers were anything but reserved in their speed, and I was listening to interesting ideas about trauma and the brain (spare me what you’re thinking), so the destination was achieved with minimal consternation: my first time back to Indy since the move this summer, a quick one, in and out, for a conference at which I presented on Wednesday. I’d planned on keeping a low profile, hoping to catch up on dictations (thanks to the miracle of Citrix and an iPad) in quiet, quiet, quiet.

Silouan had other plans, however. Not so much as to the low profile. More as to the quiet.

Great name, Silouan.  Check it out on the Fount of All Knowledge, i.e., Wikipedia. Apparently it’s the Russian version for Silvanus, Latin for Silas, the companion of Saint Paul (as in “old time religion” and “good enough for Paul and Silas, good enough for me,” remember?) Middle English is Selwyn. Greek is Σιλουανος,  Silouanos.

My nerdiness embarrasses my children to no end.

Silouan Green is a Marine’s Marine. Think Jethro Gibbs on NCIS, raise him up a couple of inches, replace the graying brunette with closely-cropped sandy-brown—more spare on the top, granted, but certainly no worse for the wear, trust me. He strode onto the main stage of the conference as if he were just checking on the house before heading out to the lake, blue dress shirt, open-collared, slate-gray khaki’s, flat front (what else? why waste the cloth?) His voice didn’t command attention, just claimed it.

Our Marine’s Marine grew up in small-city Indiana before heading to college down here in my new neighborhood, Vanderbilt. Math major, officer candidate school, top graduate. Getting the picture?

So what else to do other than to become a Marine pilot?

In case you’re wondering, it’s no walk in the park to become a Marine pilot.

That he did, though, très à la Gibbs, with fervor and (I have no doubt) aplomb. Fly, he did as well. Until the day his plane’s engine caught fire on take-off.  And he and his fellow pilot were ejected from the aircraft. And his fellow pilot didn’t make it. And he sort of did.

To say that Silouan mesmerizes as he tells his story of trauma and recovery is to be unfair both to him and to Mesmer. In no way does he resort to the cheap parlor tricks of some reformed huckster, lulling listeners into an emotional trance with the prosody of his voice, the alliteration of his words, luring their souls onto the stage, syllable by syllable, only then to slap them to attention with an emotional zinger, a climax leading to a denouement of the audience’s tearful adoration of the bravery of this “suffering soul” who has overcome nevertheless, whether by the grace of God or the force of Will (or both).

Hardly.

Instead Silouan let me sit in my chair, body and soul, and brought himself to me. His energy, his candor, his roughness, his softness, his him: with each anecdote, each exhortation, all of it filled the room, never demanding I join it, always inviting me to. Here was a man whose military career had meant so much to him, he’d spent nine months sleeping with a loaded gun to his head, each night granting himself the option of allowing the Corps the luxury of not having to pursue his (forced) medical retirement any further. Here was a man who, through grace and through love, finally decided to give Life another chance instead.

When I got back home to Nashville, I could describe him to colleagues in only one way: an utterly disarming mixture of unabashed cockiness and true humility.

So why write of him, you ask?

First, I’m more than willing to offer him free advertising. If you’re looking for a veteran who’s suffered not only the loss of a friend, of his health, of his career, but even more the loss of his very identity, a veteran who has re-found and reformulated that identity in spite of an exhausted body and soul that had been doing what they could to thwart him, a veteran who is willing to speak to anyone who will listen about despair and hope in a way that will never leave you the same—check out www.silouan.com. Get him to come speak. Advertise well. Prepare to walk away different from how you arrived. Period.

He has also put together an excellent study guide to help traumatized individuals to re-find- and reformulate their very own identities, www.theladderupp.com.  I’m planning on using it with every soldier who comes to our facility.

Even more, though, I write of him to honor his pain, to honor his continuing recovery, and to remind everyone—veteran, family member, friend, mental health professional, human—that Life can bring down even the unabashedly cocky, the competent beyond your wildest dreams, the golden boys and girls who will do what you could never hope to do better than you could have ever dreamed of doing it and that Life is nonetheless still willing to give them a humble second chance. Or three.

If Life will do that for them, it’ll do it for all of us.

Semper fidelis, the Marine’s motto, “always faithful.” Silouan is certainly that. But like most of his fellow Marines, soldiers, and the men and women of the Navy, the Air Force, and the Coast Guard, it doesn’t stop there. Semper paratus, so says the Coast Guard, “always ready”: that, too. Semper fortis, “always strong”? As much as any person can be on any given day, sure. Semper humilis, “always humble”? What if we think of the humble as those who are not so much lowly as they are grounded, down-to-earth, unafraid to look up and acknowledge something, some ones, Someone higher?

So let’s just make it easier on ourselves, shall we? Semper Silouan. Enough said.

To Err Is Human, To Forgive Is Gary Cooper

I’m not sure that even now he fully understands the impact of his presence, this soldier, notwithstanding our having discussed it several times. Of average height and very strong build, he, to be fair, would not necessarily stand out on an Army base filled with men of such description, if all you were to do were to view him in a still pose, standing or sitting.

It’s how he moves.

I’ll never forget first seeing him walk, sit down, lean forward, fold his hands, bend his head downward. He was not the first burdened soldier I’d met, not by a long shot. Yet there was something so measured about him, so willing to accept the load, no matter how heavy. It was as if Atlas had volunteered to Zeus to bear the weight of the heavens so that no one else would be so encumbered, no hint of martyrdom anywhere, simply duty and faithfulness.

Unfortunately for him, though, he had taken on weight that had been unfairly farmed out to the innocent, whether by the questionable decisions of superiors or by Life. As a veteran of four Middle East deployments, he had had more than his share of opportunities to do that.

Only then to return home and to discover that Life does not cease to provide such opportunities once you’ve hopped a plane back stateside.

More pertinent to this tale, moreover: true to form, to his character, he was even willing to bear such a weight for me.

It was probably our second, maybe third time speaking together. Already, in just those short encounters, I had come so to admire him, even as I had also come to feel so much sadness at his recurring assumption that if someone was going to have to take the “hit” for Life’s cruelties, it might as well be him.

The conversation that day took an innocent enough turn, in retrospect, a discussion of possible future options, as I recall, tossed out as one scenario among many.

I said what I said.

He didn’t respond as he could have. As I babbled on, he simply nodded his head in that most soldierly of manner, the ever-ready “Roger that, sir,” I’m sure, right there on his lips.

It was I who had to stop in mid-sentence, smacked in the psychic face by the import of the words I had just spoken to him.

You see, I had just “tossed out” an option that would have been impossible precisely because of something that had happened to him, something about which he had felt the greatest of blame, even though there had been none for him “realistically” to take on. For a moment, I had acted as if what had most rent his heart had never happened at all. I might as well have been talking to Atlas about that oversized beach ball on his shoulders.

This was not the first time this had happened to me, of course, although fortunately a mistake of this gravity is a rare one. Once I realized my mistake, I think I must have just sat there open-mouthed, wide-eyed, the whole bit. All I can remember is his face, a single swallow, a deep breath with his mouth closed, in and out, no change in countenance whatsoever, followed by that look of being willing to take the hit one more time and then to listen attentively to whatever my next words might have been.

“Oh, my God, I’m so sorry,” was all I could utter. I then spoke my mistake out loud.

“That’s all right,” he whispered, although the quick catch in his voice revealed that it had been anything but.

“No, it’s not,” I shot back, quite aware of my need to allow him, even urge him to put blame where blame was due. “You deserve better than your doctor even momentarily forgetting what I forgot.”

His discomfort was crescendoing. “Really, sir, it’s OK. I forget things all the time. No big deal, really.”

This was a hard decision point for me. On the one hand, I needn’t—and what’s more, shouldn’t—keep harping on something that a soldier has no desire to rehash. He or she has the right to request that we just let it go, already.

Yet somehow I knew that this was not one of those times.

For a few frantic microseconds, I dove inward, trying to interrogate every neuron I possibly could: “Why did I do that?”  Only one thought, more image than language, came to me: I was already experiencing him as the strong, good, fulfilled man that he could and can be.  I was, in other words, already experiencing him as having moved forward.

“You know,” I finally said. “I have no clue as to whether this will make things better or worse, but I do want you to know: I think at that moment I was experiencing you as the strong man you are, even though I realize that you’re feeling anything but that. Even though I know full well that you are struggling, I still think of you, feel you as the man who I know you want to become.”

For a few seconds, he stared at me, still not angry, but less anxious as well. He then looked down and even, for an instant, smiled, more out of recognition than out of anything approaching levity.

“You know, one of the other soldiers told me that exact thing, just yesterday, that I’m exactly the kind of guy he sees himself wanting to become. It . . . it helped.”

I leaned forward.

“You appear to be having no problem forgiving me for my blunder, am I right?”

He looked back at me. “Absolutely.”

“Then, maybe,” I replied, “could you see how all the rest of us, whether alive or not, would have no problem forgiving you—if in fact there were actually something to forgive? The hardest person on you is you.”

He dropped his head back down. “It’s always been that way.”

“Do you see, then,” I went on, “how because of what just happened, we proved together at least one instance of something that you’ve doubted much of your life: that words can make a difference, that trying to work something out is more than half the answer to whatever it is that comes between two people? All your life you’ve felt that words really don’t make a difference, so just soldier on. Sure, you’ve been to War four times: so you know that’s very often the case, the only case. But it’s not always the case, especially between two people who are trying to understand each other. Good intentions may not always lead to good results, but sometimes they’re all we have—and they really are at least better than silence.”

It took only him only a few seconds to look back at me with both that same “what do you know” smile and the words that I’d been expecting all along: “Roger that, sir. Roger that.”

Gary Cooper was certainly a complex man in real life, but on the silver screen he came to stand for all men of few words, yet of deep feeling. I’m not so sure that the sheriff in High Noon was ultimately that interested in forgiveness, truthfully. So I’m glad his counterpart in my life turned out to be more amenable to the notion.

The soldier has worked hard to understand himself, to give himself over to what cannot be changed, to begin to change what can. He’d have always been the type to live the Serenity Prayer more than say it, truth be told, though I’m sure he’d not be against it. Wise men, young ones included, are willing to give even the standardized a shot.

He’s still frustrated, no doubt of that, sad as well. But together we discovered that words can make at least the beginning of a difference when said sincerely by two persons trying to make Life better. The old analysts always said that there is no such thing as a “mistake.” It’s never random when we disappoint one another. I’m afraid they’re probably right.

Thank goodness that in spite of that, my Sergeant Cooper was willing to give voice to at a least a few more words than “yup,” “nope,” and “can’t rightly say.”

I am indeed most fortunate.

 

JD/rjsd

A Goede Hombre

I received the text earlier this week, at 1404h, Central Daylight Time, Tuesday, July 2, 2013, a picture.

He looked great, wearing what appeared to be a simple, black suit/tux, sporting with it a white, pointed-collar shirt, well-starched, and a formal black tie, half-Windsor knotted. I suspect the picture had originally been taken at his older brother’s wedding not long ago.  He had that certain “brother of the groom” air about him, after all: slightly annoyed to be all decked out on a day that wasn’t exactly his, yet pleased well enough all the same, knowing full well, of course, that he looked mighty fine in these trappings, if he did say so himself.

In the background was an American flag and the unmistakable emblem of the United States Marine Corps. He would, undoubtedly, have been far more proud of those than he would have of his handsome mugshot.

I have finally made the move to Nashville. I have finally found the time to sit quietly with my cup of Tazo Zen tea. I have finally found the courage to announce, again with the permission of his family, that on Friday, July 5, 2013, another fine young man whom I had the honor to serve was laid to rest.

He died early in the morning hours of my final day of service at the VA in Indianapolis. I learned of his passing late that afternoon. As had been Ethan’s death (Reporting for Duty, Sir), his had not appeared to have been self-inflicted, and it had come without warning. He had spoken to family and to his best friend mere hours before, in good spirits, looking forward to his and my final meeting together before my move, even more looking forward to plans for treatment and for a new chance at a life perhaps less pain-filled, definitely more hope-filled.

He was buried in a community far both from my former home and my new one. I had a couple chances to speak with his mother. I asked her to convey my sincerest condolences to his father, his brother, his grandfather, and all those whom he had loved and who had loved him.

I did not, therefore, hear “Taps” a third time in as many months. Yet as I sit here, watching the Cumberland River quietly drift by me, ferrying branches big and small toward destinations perhaps just around the bend, perhaps miles away, with the occasional speed boat barreling by, ferrying revelers trying to swig down one last Miller Lite before heading back to post-Fourth of July reality, I can so easily imagine a bugler standing on the shore opposite me, looking me directly in the eye, nodding, lifting his instrument to his lips to announce not only to me but to anyone else within earshot that another who tried the best he could to do the best he could has departed us, only then, after the fading of the last note, lowering that instrument, tucking it under his left arm, raising his right hand in that four-count salute rendered only to those who deserve it, holding it, lowering his arm in another four counts, then looking up at me, nodding, and finally with a sharp about-face, turning to walk away from the bank, into the trees, into the memory and the imagination from which he had come.

My patient—let’s call him “Kurt”—came from a successful family of international entrepreneurs, his father’s lineage Dutch, his mother’s, Hispanic. He’d attended the finest of schools as a boy, a teenager. Easily he could have attended the finest of universities after that. He was smart, multilingual, bearishly handsome, affable, after all: Cambridge, New Haven, New York, Princeton, all would have gladly welcomed him, no questions asked.

But this boy had an energy that only the Marines could handle.

He was so proud of his unit. He had given me a copy of its insignia, all ready to be mounted on my rear window should I have so desired (and with his full permission, I might add, implying that such would have been enough to get me through any subsequent interrogations by fellow Marines as to why I might have been claiming  the right to be lollying around town with such an honored accouterment).  He was a Marine’s Marine.

Thus, he never forgave himself for the training incident the week prior to his deployment, the one during which his right arm was so shattered, he finally had to lose one bone altogether in order to preserve whatever function allowed to him, the one after which he was separated  permanently from the other two men on his team whom he’d come to love more than Life itself . . .

From the other two men who—along with Kurt’s replacement, less prepared than Kurt had been—died only weeks later in an IED explosion that Kurt, to his final moments, I’m certain, believed with his every living cell that he could have avoided had he been there or, at the very least, he could have endured with his friends together, one final time.

From that point on, Kurt’s life was embedded within pain. He had to take pain medications at levels that still cause me to tremble at the very thought. He endured constant nightmares of a vicious home invasion he had survived as a youth—with night after night after night of such nightmares ending with his escaping (which, in real life, he had), while his Marine buddies, captured in the dream, were slaughtered by the intruders, over and over and over again.

Yet, there was not always pain between us.

The day had not started out well, almost two years ago, now. His pain had been  so acute, he was considering suicide. He refused to stay in the hospital. I refused to let him leave. It was tense, to say the least. Finally I had to call the VA Police to stand watch outside my office as I arranged the admission in the secretary’s office next door.

Then I heard it.

“Hey, Doc!” came the policeman’s voice, not exactly panicked, but not exactly calm either.

Good God, I could only think.

“What?”

“Uh, sir . . . I’m not quite sure how to tell you this, but your patient just jumped out your office window.”

I kid you not.

Now, fortunately, it was a first-floor office. Yet it was still a good six-foot drop.

I had barely turned around before seeing said policeman zoom around the corner, heading toward the front door of the building, the words he’d been  shouting into his walkie-talkie lingering behind him like an ether cloud, as sound apparently could not travel as fast as that man was moving. I’ll never forget walking up to my office, by this point all alone (since all others within fifty feet had made similar dashes around said corner), only to see my office window wide open.

I’d not even had a clue that the window could have been opened.

But that’s not the best part.

Within five minutes, Kurt marched right back in, now accompanied by three policemen and a host of other witnesses, with that same nonchalant look that, come to think of it, he’d shown in that picture from his brother’s wedding.

“What happened?” I asked (a stupid question, I know, but I couldn’t think of anything else to say).

“I needed a cigarette,” he told me, as calmly as all get-out. “The cop said I couldn’t go out to get one, and I knew I couldn’t smoke upstairs in the hospital, so I just decided I’d find me a way to get one more cigarette while I still could.”

I do so wish there had a been a picture of my face at the moment, given that my memory of his face was that he was still struggling to figure out what all the big deal was about.

“Are you kidding me?” was all I could say, standing there, as I was,  in front of a good half the Hospital’s police force, along with God and all Nature, to boot.

“He’s not,” the original policeman chimed in. “Really. By the time we got out there, he was just standing there, putting his lighter back in his pocket, taking a few puffs, asking us why we were all so upset.”

Kurt just smiled. “I told ’em I just wanted to smoke a cigarette. I guess they didn’t believe me.”

I repeat: kid you not.

I swear to God, also: by the next day I had so many environmental engineers swarming into that office, I’d have died hermetically-sealed in said room should any disaster have struck thereafter, nuclear or otherwise. I wonder if, now that I”m gone, Homeland Security is using it as a holding cell for those too dangerous for Gitmo.

One of my other patients, a former Marine officer, had heard the “Legend of the Jumping Marine” somewhere along the way (who hadn’t?), and I’ll never forget the smile as wide as the nearby White River when he spoke to me about said affaire mémorable.

“Now that’s a Marine, I tell you. You tell them to go take that hill, and they ask you ‘How many times, Sir?’ You gotta love ’em.”

Indeed, you do.

So I sit here, now sipping San Pellegrino, and I ask myself, “What can I say?” How can I honor him in the same way that phantom bugler did only a short time ago, disturbing the peacefulness of the river in my mind’s eye not so as to upset, but rather so as to remind, to call me to remember what it means for some men and women to choose to accept a life that they were not forced to accept, to choose to face risks that many of us would have preferred that they not have faced, whether for reasons of love or for those of ideology

I can only do so at this moment, I believe, by honoring his pain, honoring it so that others may know the depth of his suffering, honoring it so that others, perhaps, can begin to know something of the sufferings of many, many of his brothers and sisters who have served in combat, who entered War and left War with a capacity for emotional power that few had allowed themselves to realize before, let alone even to accept now.

With each passing day, with each troop or veteran I meet, I become more convinced that many, many civilians simply cannot begin to fathom the physicality of the warrior’s emotions, whether that warrior be a man or a woman. Granted, there are some civilians (more than a few, I might add) who are “warriors in spirit,” who can indeed find themselves caught up, sometimes quite frequently, in similar depths. Yet most civilians, I assert with solid confidence, must learn the following formula and apply it, whether they think they should have to or not:

Take whatever emotion you have ever felt in your life—joy, curiosity, grief, rage, anxiety, sensuality, shame, whatever—localize it in your body, and then imagine it now crashing down into your gut with a force that draws your every inner organ into it like some whirlpool out of Hell. Then repeat, shoving all of it down into that whirlpool even more deeply. Then repeat. Eight more times.

By the time you hit Whirlpool Ten, you’ll be close to the emotional experience of the Warrior. Not there. But close.

I have yet to meet a troop or a veteran who has not known, full well with bells on his/her toes, that he or she was going to have to “Move On” from his/her wounds of the extremities, of the brain, of the soul.  That’s never the issue, no matter how many times, no matter who adds the adverb just to that phrase, as if somehow the person uttering such nonsense were finally giving said troop or veteran the psychological equivalent of a reminder that s/he could have also had a V-8.

It’s never about “moving on.” It’s about what one has to drag along, from the very depths of one’s soul, whenever one does move on.

Everyone has experienced gut-wrenching emotions. Not everyone has had to experience such emotions every single time that door marked “Emotions” is opened, even when one is desperately, desperately hoping that the last five loads of psychic lumber with which you’d tried to nail that door shut will hold, please, dear God, please.

I sometimes read “pain experts” pontificate about the “psychological overlay” of pain as if they were finally giving us the news that we’d never considered and that will now finally open all of us to the Promised Land of the cognitive. I know about all the evidence. I know about all the good intentions of all who have so published in the journals, opined in the op-ed pieces, spoken to the cameras in the well-orchestrated segments of the latest news show, the latest radio spot.

Yet Kurt’s grief over his fallen buddies, his shame over his injuries, his anxiety over his future: they so Hurt with a capital H, so overran his biological pain receptors with the same ferocity, the same violence with which those intruders had once overran his boyhood home, he had to sweat with psychic blood every ounce of hope that he was able to earn. Hope, for him, was a hill that made Iwo Jima look like Kiddieland.

But he always asked me the same thing, every time, every time: “How many times do you want me to take it, Sir?”

How many times.

Until the day you have been able to imagine your whole body being wracked with an emotion so powerful that it brings you to your knees, always figuratively, often literally, with each sunrise; until the day you have been able to imagine the courage it takes to rise up, under such circumstances, and walk ten miles or, maybe, just take the dog out; until the day you can feel your most powerful emotion in your most painful of spots and can then say to yourself, “Oh, my God: do you mean it can feel worse than this?” and know that there are men and women out there in their teens, in their twenties, thirties, forties, fifties, sixties and beyond who can answer a resounding “Yes!” while trying not to relive, yet never to forget horrors and truths that, hopefully, you’ll never even have to imagine imagining—until then, please, please, please: never speak to a troop or a combat veteran the equivalent of the English words, “Move on.”

My title, of course, is a polyglot admixture, the Dutch goed with the Spanish hombre, the admixture of “A Good Man,”  the admixture that was Kurt, the admixture that could have taken a much easier road, but whohad refused to do so, the admixture who so many times had wanted to give up on that hill called Hope, so far from Bill Clinton’s Arkansas hometown of the same name, the admixture who had many, many times stumbled and fallen as he’d tried to take that hill, the admixture who had nevertheless kept trying, kept trying, semper fidelis to the end.

As with Porthos, as with Ethan, I have not earned the right to salute you, Kurt, my friend, as that bugler did in my mind mere minutes ago. So I can only give you what I gave them, unfortunately only in the Spanish of your lengua maternal and not also in the Dutch of your paternal tongue.

But do know that if  I could have spoken both languages, I would have. As always, Kurt. As always.

El dolor ha pasado, Kurt. Duerme siempre en paz.

The pain is over, Kurt, hallelujah. Rest in peace.

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.

“Taps,” Déjà Vu

One week ago today, I again headed south of Indianapolis, seven weeks to the day after I had begun a similar trip for a similar purpose, all-too-sad, all-too-soon.

It was time to bury Ethan (Reporting for Duty, Sir).

Small-town funeral homes have a certain cross-similarity to them. Either they are restructured, early-twentieth century, Victorian-style homes far too small for their grand claims to shepherd one’s dearly departed to Glory, or they are unassuming, generic, one-story, brick-faced edifices that could pinch hit for a Knights of Columbus hall, if that ever were to turn out to be necessary.

Either way, you usually can’t miss them, GPS or no GPS.

As I did for Porthos’ funeral those weeks before (“Taps” and the Last Musketeer), I made my way into the parking lot, where I was properly tagged for the eventual procession (here, a rectangular, orange paper tag to hang on the rear-view mirror, sort of a souvenir, I guess you could say), and I then backed myself into the parking spot at the rear of the building, glad that my blue Volkswagen Beetle could be maneuvered thus without much worry for the mammoth SUV to my left.

I had arrived early, as I had not been able to come down for the viewing the night before. When I got inside, I eventually caught up with three colleagues who had already been there: Ethan’s two therapists and his Family Care Coordinator. After quick greetings that were regretted by all only because of their location, not their intention, I headed into the main salon.

There to my left was an open casket, flag-draped, Ethan’s body lying within, holding a Bible, oriented toward a long-before-taken family photo that was keeping vigil over him. To the right were two easels smothered in pictures of an always-smiling young man, sometimes goofily mugging before the camera, sometimes simply enjoying the very fact that this very person was taking a snapshot of him at that very moment.

On one easel he was clad in various, well-coordinated outfits of Army chic, accessorized with appropriate guns here and there. He was a few pounds lighter than I had known him, but not by much. Unlike many such pictures that I’ve seen through the years, his were never posed in the “Don’t Tread On Me” stance so common for the young and—yes, I’ll say it—the well-armed. His smile, his innocent, “Good morning to you, Sir” smile, was ubiquitous.

Next to it was another easel of more contemporary, always civilian pictures, same dizzying mixture of the goofy and the mundane, by himself, with others, eating, drinking, showing off, sitting.

Same smile, but . . .

Well, eyes have a way of outlining otherwise-genuine smiles to provide an onlooker with a clue that perhaps, just perhaps, this smile is having to work overtime to keep at bay other facial expressions far less pleasant, far less tranquil.

Then over to the left, on the other side of the casket, was a display of military memories. As I walked toward it, I could see his dress uniform from his Airborne division, a stunning oil portrait of him in that same uniform, his Purple Heart award . . .

. . . and his boots. It was the boots that brought me short, threatened me with more than a tear or two. Empty boots—ones with a gun propped up in them, helmet perched on gun’s end—are the “soldier’s memorial,” the makeshift tombstone, the one honor all military men and women can give to a fallen comrade in the field before all are returned home. A soldier’s boots (almost as much as his gun) keep him alive.

At that moment, I felt Ethan more intensely than I had in days.

It was then that I turned to see his mother and stepfather come into the room. I went up to them and (emboldened by the last funeral, I guess you could say) embraced them both. His stepfather then said, “The pastor would like to talk to you.”

I accompanied him to another room around the corner, where I met a man a good ten years older than I, with the smile and the build of a preacher who knows not only who the best cooks in his congregation are, but also where to find them, 24/7.

“Thank you, Doctor,” he said as he shook my hand. “Will that be OK with you?”

My face must have shown the obvious question with the word what inserted before the words be OK, for Ethan’s stepfather quickly stage-whispered to us both, “We were wondering, Doctor, if . . . if you’d be willing to read what you wrote about Ethan during the service.”

“In fact,” the pastor added, “I’ve got a copy of it. Right here.”

As he handed it to me, both the men smiled smiles that seemed to be assuring me that this really wasn’t quite the bombshell it appeared to be.

“Of course,” I replied. “I would be honored.”

Soon the room was full of folks of all ages, all dress, from the semi-formal to the tank-top and shorts. There were handshakes, a few backslaps, but overall everyone was settling into a quiet that was fully recognizing the loss that each was continuing to experience.

Then Robin came in, accompanied by her father, then joined by Ethan’s parents. She was dressed in a simple black dress, one for which, I’m certain, Ethan would have most readily complimented her. Her tears had apparently decided to take a break, but they’d more than left a residue that they could return to at a moment’s notice. She sat in a wingback chair on the front row, right in front of her husband’s body, slipping from view as she sank into the overstuffed cushion. Parents seated themselves on both sides, and then for a few moments, silence.

Then, over the speakers, the sound of a banjo.

It only took a few bars for the song to reveal itself: it was the old gospel hymn, “I’ll Fly Away,” sung in perfect Appalachian harmony, melody and tenor, almost as if taken note for note from the movie, O Brother Where Art Thou?

I don’t know what it is about that song. Perhaps it has its own, special neuronal bundle somewhere inside my noggin, ready to be tweaked and ignited at a moment’s notice to flood me with revival meetings of long ago, I don’t know. Yet something about it always makes me wish I could exchange my bass-baritone, if only briefly, for a nice, soft second tenor that can modulate from chord to chord, carrying me away, “by and by,” to “oh, Glory” and beyond.

Barely had the song ended and my smile begun to relax when other chords took their place, guitar, violin, cello. A gasp went through the audience,clearly far more acquainted with the standard repertoire of Nashville than I am.

It was Tim McGraw’s “If You’re Reading This,” a simple ballad, written as a letter from a soldier to his wife and family “just in case.” It’s a song of pride, of sorrow, a song of hope for peace, of hope for good lives for all those left behind, long after the soldier has given up his. It’s quintessential Country. Many tears were shed.

Soon Ethan’s best friend got up to speak, his voice breaking even as he stood firmly at the podium, proud of the man whom he’d loved more than any other, the man whose name his son bears as part of his. In their brevity, his words spoke volumes.

It was then my turn to take my place at the mike. I looked at the words before me. I was very glad that, this time, I no longer had to use pseudonyms. My own voice held firm itself until those final words: if anyone had the heart of an angel and the resolve of a guardian, it was Ethan. A few moments’ pause, and then when I was done, I turned to find myself face-to-face again with the oil painting—and with a smile that, depending on one’s theology, one can only hope has returned somewhere, by and by.

The service ended, folks began to pass before the casket. Strong, handsome young men, some in sunglasses that were almost certainly hiding a multitude of sins behind them, grabbed onto each other for dear life to stand before their buddy one last time. Old, young, they all passed by, we all passed by. I shook his father’s hand and thanked him for the honor of knowing his son. I embraced Robin as she thanked me for my words and for my commitment to Ethan. I embraced his mother, his stepfather, all of us knowing, without saying, that words only get in the way at moments such as these, only in the way.

The procession to the cemetery was long, car after car rolling past the respectful gazes of drivers who’d stopped their cars, persons peering out of downtown eateries and offices. We all scrambled to find parking somewhere near the graveside once we’d arrived at our destination. It looked as if it could begin pouring any minute.

The same strong, handsome young men who had gathered at that coffin in tearful embrace then, without a word, lined up, slowly slid their friend’s flag-draped coffin out of the hearse, steadied themselves, and in a unison that was felt, not commanded, carried their pal—even, in a way, quietly marched him—to his final place of rest.

The pastor said a few words, and then the VFW Honor Guard sprang to attention, guns cocked, fired, cocked, fired.

And then the bugle, a “Taps” perhaps even a bit more andante than had been Porthos’ those weeks before. Same clear tones, however, same perfect intervals, same call from across at least two hundred years of history.

After the last tone had faded, two soldiers took their places at the ends of the casket, just as their predecessors have done so many thousands of times before, and they ever so slowly, ever so precisely lifted, folded, folded, folded, until finally one saluted the other, after which that one handed the triangular flag over to the most senior soldier in attendance, who then gently lowered it into Robin’s lap, words whispered, salute rendered.

It was done.

As the family gathered together in embraces and tears, I bade farewell to my colleagues, who were hoping that they might miss the worst of the oncoming downpour. As I’d brought my umbrella, just in case, I decided to turn back to look at the casket. It was perhaps more “in state” than it had been up to that point, silent, a monument holding the remnants of a life that had suffered, a life that had loved, a life that had smiled.

As I walked up to it, I stood alone. Slowly I lowered my fingers to his coffin and remembered a similar touch only weeks earlier. I wondered about the appropriateness of repeating again the Latin phrase I’d spoken to Porthos. For a few moments it felt like a formality quite out of place with the guitar chords and gospel songs of rural Indiana.

Yet it was at that moment, believe it or not, that I thought of opera, an art form at which I suspect Ethan would have more giggled than to which he would have wasted any moments of life listening. But you know, really: opera, country music . . . worlds apart, yet the same world, no? Rodolfo crying out at the death of Mimi, Tosca tossing herself in grief-stricken rage off the heights of Rome, Butterfly contemplating that knife as Pinkerton stands nearby with his American bride, Rigoletto holding his dying daughter, Gilda, as she sings of joining her mother in a far-off Heaven: are any of their griefs, their words that different from the griefs, the words of songs sung far less loudly, yet no less sincerely, in quiet recording studios, at fairground amphitheaters big and small?

Perhaps at that moment Ethan and I met one last time. Like many of the men whom I serve, he was often in awe of my doctor-lawyer pedigree. He would have had no doubts whatsoever that I could be one of those types who gets into all that “fat lady singing” nonsense. Yet when we were working together, trying to hold between us unspeakable pain that was slowly allowing itself to be spoken, we were just two guys from Indiana, one a generation older than another, both trying to make Life work as best as we can.

War tried to destroy him. It made a good go of it. But as I contemplated that smile one last time at that grave, both Ethan and I knew better.

Yes, I did say the words: Cruciatus consumptus est, Ethan. Requiesce in pace. The torment is over, Ethan. Rest in peace.

Yet also I had to whisper just a few more words, ones that I suspect I could have taken the melody to Ethan’s tenor and we’d have both sounded just fine, thank you, sounded just fine.

Fly away . . . oh Glory, fly away.

Amen.

“Taps” and the Last Musketeer

It’s time to get this written.

Spring has slowly been intimating its way into Indiana these past several days, although, admittedly, I’m being kind in giving it this much due. Still, the snow is gone, and temperatures are edging toward their becoming worthy of some notice beyond “scorn.” Yet while the thermometer has only been cooperating begrudgingly, the barometer has been anything but: beautiful, nearly cloudless skies have been ours to enjoy.

Funny, isn’t it, how the living prefer sunshine for funerals.

As I have noted in previous posts (Goodbye, My Friend and In Memoriam: Porthos, 1985-2013), my patient, Porthos, a combat veteran of two deployments to Iraq, age twenty-seven, died in an auto accident a little over a week ago. He had grown up in a town that had once had the decency to be out in the boondocks, but which has, over the years, become another bedroom community for Indianapolis. It’s quite a hike, nevertheless, from my house, so I headed out in plenty of time, ostensibly so that I could secure an adequate parking spot.

In reality, I was just needing the time to myself.

All the way down there, I couldn’t stop thinking about a topic so near and dear to so many therapists’ hearts, minds, and critiques: boundaries. Truly, I’m not sure what some therapists would do if they weren’t policing not only their own, but everyone else’s, twenty-four seven, usually with, if I may so say, a certain self-satisfied, ethical purity.

Yet in spite of my snarkiness, the topic is indeed a critically important one, signifying as it does the question of how much should the personal and the professional be allowed to co-mingle in a therapeutic relationship. Certain answers to that question are easy, of course: no sexual favors, no financial manipulation, for example. Others plague all young therapists and many older ones: when, if ever, does one accept a nominal gift from a client/patient? How much does one reveal about one’s personal life, one’s experiences, one’s disappointments?

Or . . .

Does one embrace a patient’s grieving father, his grieving mother, his grieving brother—his grieving best friend who also has medicine bottles in his bathroom cabinet that have printed upon them my name?

As the traffic thinned out, as the several lanes merged into two, I had to wonder: for whom was I going down there? For Porthos? His family? My other patient, his battle buddy through both deployments, Athos?

For me?

After thirty years in this business, I have come to the conclusion that the answer to all such questions is E, i.e., “all of the above.” I can live with that. I have learned that these things have a way of working themselves out.

I pulled into the lot of the funeral home with more than enough time to spare before the service, dutifully then backing into my parking spot as I was instructed, my purple “Funeral” flaglet well-perched on the roof above me.

Men and women were already there, though, even more dutifully standing guard along the sidewalk leading to the entry door, all clearly my senior, most dressed in leather, many with the familiar POW-MIA emblem from the Vietnam era emblazoned on their backs, holding the United States flags that so readily were flapping in the cool breeze, their Harleys parked only feet away, ready to be mounted, to be driven at the head of a procession to the cemetery, in a silence that not even the loudest of mufflers could pierce.

About ten minutes later, Athos and his fiancée arrived in their SUV. After backing the car in almost directly across from me, he turned off the engine and, in moments, was looking directly at me. The smile of recognition was there on his face, yet he knew it as well as I did: neither of us wanted to be seeing each other at that moment. He zipped an open palm past his face, once, in that muted “Hi” so often seen in old home movies when a person has that ridiculous light glaring into his or her face, hoping against hope that Uncle Maury will just move on to the next relative and leave me the heck alone.

I got out of my car first, only then to watch him somewhat pour himself out of his, almost as if he were maple sap reluctantly exiting through that spigot in the trunk of the tree during a sub-zero winter. Yet door shut, he turned to me in his suit, dark shirt, dark tie, a little too slender, true (as countless maternal types had reminded him at the viewing the night before), yet still ready for his Jos. A Bank’s photo shoot. He smiled again at me, adjusted his tie as he did his obligatory “look both ways,” so well learned in first grade, and then began to walk across the driveway toward me.

He marched right up to me, eyes refusing to let anything even approaching a tear to leak out, trying to maintain some semblance of a smile. His beard was well-trimmed. His hair was neatly cut, longer than military, definitely, yet still a certain “short chic.” Tobey Maguire’s Nick Carraway was back, in other words, at your service. Preparing to bury Leonardo DiCaprio’s Gatsby.

For a second or so, we just looked at each other.

“Thanks for coming, Doc,” he finally said, a certain hesitancy more than apparent.

This was it. I knew it. The boundary decision.

So I made it.

I opened my arms wide.

His eyes saw their chance, and for just a few seconds they forced his entire facial musculature to contract in response, both giving in to tears and refusing to do so, as he nearly fell into me, wrapping his arms around my upper body, his head in an instant buried at my neck, his body seeking my ballast to help steady those eyes and get those partners back in line, buddy-boy, and I mean, right now.

“I don’t know if I can get through this, Doc” he whispered, quickly, desperately, right into my ear.

“I know you don’t,” I whispered back into his. “You don’t have to think you will. You just will. You’ll do it, and you’ll have no clue how. For his family. For him.”

For a few seconds, nothing, then another whisper entered my ear. “Thank you, Doc.”

Just as quickly we separated and looked at each other. His smile was trying to weasel its way back into place.

“I’ve got to go in and see his folks. You’re coming to the cemetery, aren’t you?”

“Of course,” I replied.

He cleared his throat, adjusted his tie one more time, and then his sunglasses. “OK, great, I’ll . . . I guess I’ll see you inside?”

“Of course.”

The smile having reasserted itself, he was gone with the nod of a head.

Several minutes later I entered the funeral home myself, making my way to the large room where just the night before I’d walked in to see at the end a large wooden casket, carved and stained in such a way as to remind any onlooker of a life that had been honorably, even beautifully lived. A United States flag, well-folded into its triangular form, lay on top of one end of the casket, various pictures and a sports jersey on the other.

As I took my seat in the far back corner, by all the pictures that had been assembled and displayed along the back of the room, I looked down to see on the table next to me a five by seven of two very young-appearing men, stocky, I think, more because of all the outfit and combat gear each was sporting than because of any good, home-cooked meals out in the desert. Each had a “go ahead, cross me, I dare you” look chiseled on his face. I had both to smile and to bite my lip.

Porthos and Athos, bodies so proud, yet eyes already having begun to be transformed by War.

In Central Indiana, it usually seems as if all funeral homes are constantly jockeying for the title of “Most Gaudily Edwardian.” Fortunately, this one had bowed out of competition at a more respectable moment. I was quite glad, in fact, that as the music began to be piped in, it was not the usual, top-ten hits of nineteenth-century, Methodist hymns being played far too slowly and far too cheesily on a Hammond, draw-bar spinet.

Quite the contrary. It made me smile without any lip-biting.

It was Josh Groban.

All I could think: Porthos, a veteran of many a barroom scuffle brought on by some unsuspecting, churlish drunk who’d made the poor decision to “dis” or threaten one of Porthos’ buddies; Porthos, the guy who’d argue a point with you well into near-absurdity just to prove to you that you couldn’t run over him . . .

Porthos, the man who, after being awakened one more time by the terrors of nightmares that had left him drenched in sweat, would calm himself by watching Harry Potter movies, over and over again, so often that he could quote entire scenes by heart . . .

Of course, Josh Groban. Of course.

Soon the room was packed not just with the usual cadre of retired individuals who apparently plan their golf schedules around funeral services, but also—even mostly—with dozens of young men, still well-built as their hairlines were receding, and dozens of young women, still with sensuous smiles after having put on that extra pound or so after their last pregnancy. Some were dressed to the nines. Some were wearing T-shirts and jeans. All would embrace over and over, smiles radiating “It’s been too long,” yet voices soft enough not to remind any of them that one of their gang, though still in the room in body, was now quiet, quiet as he’d never been in high school, never in the Army, never in life.

At some point, Porthos’ mother saw me, came over, hugged me, and said “Thanks for coming.” My reply was as it had been to Athos: “Of course.” We looked briefly at each other, two parents of different children, yet both parents nonetheless. We both knew there was nothing more to say. We left it at that.

Eventually his older brother and his girlfriend made it toward the front of the room, then his younger brother and his husband. His younger brother, D’Artagnan, caught my eye. He smiled, waved sheepishly, as did I in return. Once more, we left it at that.

Finally, as Porthos’ mother took her place next to her youngest son, his heartbroken father walked in and took his place on her other side, the college professor dressed for a no-nonsense lecture, ready to see his son off with the honor the younger man deserved.

Athos and his fiancée were barely a few seats away from them.

As the service progressed, as the National Guard chaplain whom Porthos had so deeply admired spoke, as Indiana’s Adjutant General looked on, as both his father and his younger brother tearfully remembered him, admired him as their hero, as the quintet of friends apparently from high school sang in Appalachian open harmony, quite in tune, a song drenched in country-western fervor, yet universal in sentiment, I could only think: my God, what if I hadn’t come?

Boundaries, schmoundaries.

I have to wonder: if more of my VA colleagues across the nation were to attend just such services, feel the lives of the men and women we have served, absorb the sadness and the futility of lives cut off far too soon, whether in battle, in the accidents of those who had always imagined themselves indestructible, in the self-destructions of those who could no longer imagine a future without excruciating pain of body and soul—what then? Who would we be? To whom, to how many in this country could we then announce, scream, pontificate, plead to not forget, not abandon, not leave these same men and women worrying one more day about where their next meal will come from, about whether they will have a roof over their heads?

The service over, I was one of the first to be escorted up front. For a couple seconds, I stood before the casket, not even sure I was wanting to have the wherewithal to understand the import of the moment. Just as quickly I turned to meet the eyes of his younger brother, to embrace him and hear him say “Thank you,” to hear myself once again saying “Of course.” Then it was his mother, same.

Then it was his father.

For a moment we looked at each other, Dad to Dad. As we embraced, his voice broke ever so softly. “Thanks for helping him talk about what he needed to talk about.”

This time, my “Of course” served more as my defense against the breaking of my own voice.

I shook the hand of his older brother, and then I turned to see Athos sitting there, head down, quickly batting at his eye. He looked up at me, and then in an instant was standing, and one more time, boundaries were . . . well, I don’t know, they just were.

Another firm embrace. Another “Thank you” whispered into my ear. Another “Of course” whispered into his.

The cemetery was not that far from the funeral home, though it wasn’t a stone’s throw either. It was quite a line of cars making its way down the divided highway, led by the police car and a pack of very loud, very silent Harley-Davidsons. Interesting, I thought: out in this more rural area, cars were stopping as the procession went by, even when they were going the opposite direction on a divided highway. You’d never see that in Indianapolis.

We wound our way to the rear of the cemetery—to the burial ground of soldiers from all the way back to the Civil War. His was a beautiful spot, right next to an ancient tree. The family sat down in the tent. The rest of us gathered along the sides. Across from us were the two rows of marksmen (and women), standing at attention, ready. To the far right, a lone man stood, also at attention, a bugle tucked underneath his arm.

Men and women in uniform gathered to the left of us, all ages, each falling into a respectful parade-rest. Six men then came to full attention and, in well-orchestrated fashion, marched their way to the back of the hearse. With a series of precise, right-angle turns, one of them made his way to the door and opened it.

There he was, Porthos, casket draped in the flag that he had more than once told me that, in spite of all his suffering, he would serve under again and again.

Ever so precisely the men maneuvered the casket out of the hearse. Ever so precisely they carried it to the grave site. Ever so precisely they rolled it into place. Ever so precisely they stood back, turned, marched off.

The chaplain spoke a few words. The crowd recited the Lord’s Prayer. A few more words from the chaplain, and then another man in uniform precisely made his way to the casket, precisely and respectfully requested that all stand.

From across the way the commands were barked.

Rifles clicked. Fired.

Clicked. Fired.

To the right, men and women stood at full attention, their white-gloved right hands slowly making their way to a salute as the bugler slowly, precisely brought the instrument to his lips.

Ever so slowly, ever so precisely, ever so, dare I say, musically, he made his way up the major chord, each note clarion-like and yet not, both forceful, yet haunting.

He hit the final high sol easily, sustaining it just long enough, then made his way down the octave, perfect interval by perfect interval, until the final do filled the air, no vibrato, just tone, a good eight counts.

Porthos would have loved it.

As the guns were firing, the salutes lifting, the bugle playing, one uniformed soldier stood at the head of the casket, a second at its foot. As the final note of the song faded, the two men clicked into action, lifted the flag draping the casket, and ever so slowly, ever so precisely began to fold it, in half, in half again, then right triangle by right triangle.

Finally only one of the two men was left standing there, holding the folded flag, as Indiana’s highest-ranking National Guard officer walked slowly up to him. The man handed the General the flag, then saluted. He walked off.

And then it happened.

From behind the family, Athos stood and walked toward the General. At full attention, he put out his hands, and slowly the General lowered the flag into his, ending with a salute, older man to younger, both living and dead.

Athos then turned and made his way to stand in front of Porthos’ parents, to be met there by Porthos’ Uncle Jack, a Vietnam veteran whom Porthos had often spoken to me lovingly about, his inspiration for taking his energy, his mind, his body to serve, even knowing that death could result, by his hand, to his dearest friend, to himself.

Athos handed Jack the flag. And he saluted.

Jack nodded, turned, knelt down, and handed the folded flag finally to Porthos’ mother, his father right beside her.

Minutes later, the service was over.

People began to walk around, speak softly, hug. I looked over to see Athos embracing his fiancée, whom I’d only met for the first time the night before, a woman who’d been Porthos’ childhood buddy, the girl he’d taken to Prom “just because,” the woman who’d have never known Athos, whom Athos would have never known, would have never found comfort with, had it not been for that wisecracking charmer from Indiana.

Eventually I made my way over to him. He was standing next to Aramis’ brother-in-law: Aramis, the first of the Musketeers to die, in battle, the kid from the big family in Maryland, the man whose body Athos had lovingly guarded to his final resting place (Taking Him On Home).

Athos looked at me and swallowed. For a few seconds we stood there. The tear was trickling down his cheek. I think one was trickling down mine as well. I can’t quite remember.

Slowly he walked toward me, and once again boundaries evaporated. This time, though, I could feel the shaking of tears in his chest as he embraced me, not sobbing, just . . . tears.

“I’m not ready to let him go,” he finally whispered into my ear.

“I know,” I replied.

Slowly he pulled back. As we looked at each other, we both knew there was nothing left to say. He nodded, as did I. Then he turned away.

I wondered whether he was going to finish what he had to finish.

He did.

He’d told me the night before. “The last salute. That’s what’s going to be the hardest.”

I watched him as he went over to another man, his age, in full uniform. Briefly they spoke. Then, together, they walked up to the casket. People continued to walk around, speak softly, hug.

The two men assumed full attention. They looked down at the casket. Then, in a fashion just as the men and women had assumed at the sounding of “Taps,” just as the General had done to the flag and to him, Athos and his friend slowly began to raise their right hands to their foreheads, the entire journey from chest to brow extending over four, slow beats, at the end of which their hands stood still, as did Time, one last time.

Although not in heart, but at least in body, the last Musketeer had done it: had let his second brother go, had saluted him one last time at a casket, had taken his place, unwillingly, yet bravely, as the last one standing.

Slowly both men lowered their hands. Slowly they turned away—and then embraced.

About five minutes later, I turned to find him standing in front of me.

“You still in the hospital this week?” he asked.

“Yes.”

“Maybe I could come by on Friday?”

“Of course.”

I think we both attempted something like a smile. That may be the best either of us can hope for. For a while.

Eventually it was time for me to go. I walked over to the casket and lowered the tips of the fingers of my right hand down onto it.

I, of course, had not earned to right to salute.

And so I thought what I needed to think, whispered what I needed to whisper.

Words that I now must write.

For I, too, don’t want to let Porthos go. And I, too, like Athos, must find a way to begin to do just that.

And so I type what I whispered to his body—perhaps, I hope, in some way even now whisper to him. Even though I could not salute him, I could say something, something that perhaps as his psychiatrist—and even more, as his somewhat boundary-bending friend—only I could say.

You see, I was by no means the only one to whom he bared the terrors and grief of his soul. He did to Athos. He did to his chaplain. He did to a few other buddies. Yet I do know that even with them, he’d only been able to graze against the guilt in his soul, the grief in his heart, the suffering in his mind.

With me, however, he had honored me enough with his trust to allow me to watch him begin to grasp those demons more firmly, to take the risk with him that everything could blow up, to have the faith that it wouldn’t, to feel together what never should have been felt by him in the first place.

Perhaps, then, there are words that only I can pronounce, not as some sort of blessing—far from it—but rather as a statement of fact, a “performative” utterance, as the literary critics are wont to say, words that by their very speaking both acknowledge what “is” and bring that “is”into being.

I have to laugh, actually. Porthos gave me no end of grief about being a “Harvard hot-shot.” He, more than anyone, would have enjoyed the ridiculousness of some Westside Indianapolis boy acting as if he could spout off some highfalutin’ Latin nonsense in the tradition of the Lux et Veritas so proudly displayed on anything Harvardian one can buy at the Coop in Cambridge.

Yet at the same time, sometimes I would wake up in the morning to find that he had texted me in the middle of the night to tell me that another nightmare had awakened him, shook him to the core, but that he was “going to be OK, Doc. I’m feeling a little better.” Why?

Because he’d watched a couple Harry Potter movies.

It was J. K. Rowling, of course, who helped make Latin fashionable again, with her spells, curses, and family names that hearken back to the language of Rome. How Porthos would have so appreciated, then, at least one word in the phrases, that wizarding word for a curse that could, if left unchecked, destroy both body and soul of any man or woman who had to endure it.

He knew something of that process, after all.

Yet, thankfully, he also knew of other processes as well. He knew, like Harry, that ultimately what saves us all is simply faithfulness and love.

I only hope that well within boundaries, yet well not constrained by them, he learned something of the latter two from me, enough so that I can say what I have to say, perhaps the only good I can see arising out the sadness sounded in that bugle’s call, in that beloved brother-in-arm’s salute.

And so one last time, now with fingertips touching wood only in spirit, I let you go, Porthos. As your doctor, I give you the final diagnosis to set you free.

Cruciatus consumptus est, Porthos. Requiesce in pace.

Indeed, the torment is over, Porthos. Rest in peace. Amen.

Amen.

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