An IED on the Rocks, Please, With a Twist

It’s been a long month of starting new jobs, new high schools, new colleges, new furniture settings, along with Lord-alone-knows-what-new-else’s. My wife has sworn on all that is Holy that she will never again gaze upon, let alone touch a Banker’s Box. I have to concur. We’re just hoping against hope that 1-800-GOT-JUNK has a franchisee somewhere within fifty miles of us.

But the blog kept calling, thankfully. Even more, so did the memories of the men and women whom I’ve had the honor to serve.

We weren’t supposed to have met, for example, he and I.

As I was finishing my last couple weeks at the VA in Indianapolis, I had made a pact, I guess you could call it, with the nursing staff not to take on any new patients. It had seemed only fair, after all, given my then lame-duck status. All in all, I kept up my end of the bargain.

Except for this one time.

I’ll blame one of my other colleagues (and why not? I’m gone, you know). He was the one to knock on my door at about 1400h one day to tell me, “Doc, you’ve got to see this guy. I know you’re leaving, but it’s bad.”

When I walked out my door, I saw in the waiting room a young man sitting about twenty feet from me, his hands gripping the sides of his chair for dear life, staring off to his right, my left, God-knows-where, having clearly been doing so for God-knows-how-long, given the tone of his forearm musculature. His shaved head accentuated his angular features, his gymnast’s posture and physique. He was wearing the nondescript dark shirt and dark basketball shorts that so often these days are the “just rolled out of bed” uniform of choice for men his age.

That would, of course, have assumed that he’d slept at all the night before.

“Sure, I’ll see him,” I said.

It’s been a good couple months now since he and I met, so many details have faded in my aging brain. His life had been falling apart, though, pain pills, the usual. His wife had had it. His family had had it. He’d managed, however, to get hold of some Suboxone (the opioid substitution medication) on the street, and he knew that if he could just take it regularly, he wouldn’t wake up every day obsessed with finding the next pill, given that the “next high” had long before been a luxury that had, through the miracle of the body’s ability to adjust to the effects of opiates, faded into distant memory.

He had, in other words, become part of that elite group that uses opiates not for fun, but for survival.

He was doing all he could not to be irritable with me. I assured him I wasn’t offended by his periodic failures in that endeavor. Clearly he was dope sick. At times I could practically map the waves of nausea as they progressed from his gut, cell by excruciating cell, throughout his body.

What I can never forget, though, is one line of his story.

“They called me the ‘IED magnet,’” he told me. “Thing was: I was always the one who lived.”

Many others—and I mean many others—had not been so fortunate.

Neither can I forget his intensity as he told me his tale, an intensity only somewhat heightened by the strength of his withdrawal symptoms. He had the gaze that I’ve come to see so often in many young combat veterans: one both hollow and piercing, as if the ocular orbit out of which these veterans peer seems suddenly to project a rocket-propelled grenade of psyche straight toward my own eyes, no warning, no mercy.

But when I started to talk to him about combat trauma, he could only say, “Please. I’m sick. Can we just talk about that later?”

He agreed to come back a couple days later, although because he was having such difficulties getting along with his family, he was not sure he could find a ride.

But he did.

He returned in garb just as collegiate, but now more appropriate for a grueling one-on-one at the basketball court, rather than for a semi-stupor on the pull-out couch in the living room, sheets not included. His gaze had followed the lead of his garments: more lively, more suave, even.

“This stuff is amazing,” he said to me. “I feel like a human again.”

And, indeed, he was acting like one.

That was not, however, comforting me, I’m afraid.

For again, although the details fail me all these weeks later, the image does not: his sitting there in the chair in my office, one ankle calmly pivoting over the other knee, opining at length about whatever, his child, his failing marriage, the war.

Note: I didn’t just write The War. Just . . . the war.

Similarly, I also cannot forget my own experience at that moment, my sitting there, watching him, listening to him, wondering over and over and over, with his each calm explanation, his each pensive musing: “Wait a minute . . . was I . . . was he . . . am I missing something? Did I overreact the other day? What the . . .?”

Finally, I had to speak it.

“I’m sorry, but . . . I can’t help but notice that you seem to be talking about The War almost as if we were sitting over cocktails in smoking jackets, chatting in British accents about some ‘dreadful little incident, you know, old chap?’ I mean . . . if I hadn’t met you a couple days ago, right here, in this room, if I hadn’t sat in this very chair and felt you say those words—‘IED magnet’—why . . . well, I’d think, ‘This guy’s doing just fine.’ But . . . I know better.”

For a moment, he said nothing. I said nothing. His eyes, however—and I suspect mine as well—picked up all the conversational slack, for how long, I can’t tell you.

“And so do you,” I finally said right to him, intending it just as tersely as I’d said it.

Our eyes continued to speak to each other, although saying what, I couldn’t have told you.

“Am I right?” I eventually asked. “Or am I overblowing all this?”

Ever so slowly his ankle slid off the opposite knee, his leg just as slowly planting its foot back onto terra firma. Not a cell of the remainder of his body moved. Including his eyes.

“Yes,” he finally whispered. “You’re right.”

Another silence.

“You know,” I said (more like stammered), “when you’re like this, you really hide it, the pain that both you and I know is there. I mean, you’re good, really good at that. No one would ever suspect—unless they knew already, of course. But even then . . .”

He assayed a smile, though all other cells, again eyes included, remained motionless.

“I know,” he said. “But I don’t know how else to do it, to say it, whatever ‘it’ is, you know? I . . . I can see that people want to know that it’s all right, that I’m all right, that the past is the past, that it’s done. So . . . I give them what they want.”

“And then they blame you for being a loser drug addict, right?” I replied. “Since they’re assuming you’ve put all that War stuff behind you?”

Slowly the cells began to shift within him, easing him into a sadness that was only slightly perceptible, yet, for any who would dare look for it, readily discernible.

“You do what you have to do,” he finally said. “You protect them, even when they don’t know it. Goes along with the territory.”

I was not about to let him off that easily.

“Your good looks and your charm are your greatest asset and your worst enemy, you know that, don’t you?”

The semi-smile returned as he inched forward in his chair and then slowly stood up.

“You gave me something to think about today, Doc” he said as he offered me his hand. As soon as I’d shaken it, he turned to walk out the door, only to stop, turn back, grab me one more time with those eyes, and simply say, “Not bad, Doctor. Not bad at all.”

I can’t tell you the number of times I’ve thought about that man in the intervening weeks, how many times I’ve realized that I’ve met him many times before, in that veteran that one time, in that soldier now. So many civilians have no clue whatsoever how sharp, how perceptive many of these men and women are. So many assume that people go into today’s military to escape rotten childhoods, to find something to do with their lives that are going nowhere, to get three meals and a cot that they’d otherwise not be able to put together enough intelligence and common sense to provide for themselves in any reliable fashion.

How wrong, how utterly wrong they often are.

How often I also hear the “twenty per cent” number thrown around, the “official” estimate of the number of returning OEF/OIF veterans who are suffering from combat trauma/PTSD. Occasionally you’ll see a “thirty” pop up here and there, but just as often you’ll read of very smart people marveling that the “rate” isn’t higher than it is, thank Goodness.

Perhaps they’re right. I’m just a country psychiatrist trying to make a living, after all, as one of my former supervisors used to drawl.

I guess if one never asks to take a sip out of the drinks that others are pouring down their throats, though, one never has to know whether those burns making their way down those esophagi are stings of delight or, shall we say, stings of a much, much different toxicity.

Oh well, what you don’t know doesn’t hurt you, right?

I hope that somewhere tonight he is feeling more peaceful.

I wish I could be more hopeful in my hope.

God, be with him.

Lambs, Lions, Lights

I have settled into my new position as the Medical Director of the Warrior Wellness Unit at the TriStar Skyline Madison Campus Hospital in Nashville, Tennessee, and I am proud to be working with a group of professionals who are extremely dedicated to providing the best care possible for men and women serving in the active-duty military, especially those serving at Fort Campbell Army Base, up the road in Clarksville, Tennessee.

Given the nature of inpatient work, I cannot share my experiences with these men and women in the same way that I did when I was working at the VA. Yet I have begun meeting daily with the soldiers on my unit in “Doc’s Group,” in which we are sharing with each other ways that emotions, disappointments, and hopes can be expressed through the arts, including visual art, music, poetry, and essays. Some days I share items that I have collected. Some days the soldiers share items that have come to mean much to them or that they themselves have created.

Periodically I hope to share some of these soldier-created items, whether visual, musical, or literary. I will identify them generically as having been made by a “soldier” who, to maximize anonymity, will always be male. Each entry will have been shared directly with the soldier before it is posted, and he will have approved its publication.

For most of the soldiers, they wish to share their creations and their thoughts so that other active-duty military and veterans who have endured the traumas of combat might know that they are not alone, that there is hope that somehow what could never before be expressed might somehow, in some way find expression in a way that is meaningful and, at least to some extent, healing.

I am honored to work with these men and women, and I am glad to share their creations with you.

_________________________________________________________

“You mean you’d really put this stuff on your blog?” the soldier asked me.

“If you’d like, of course.”

For a few moments, he looked genuinely confused. Then, quietly, he lowered his head and whispered, “Thanks, Doc.”

After a few moments, he looked back up at me.

“I never thought this stuff was very good. I hope I don’t embarrass myself.”

************************

(Until lambs become lions)

Stay the flight of bullets
Blunt the hunters’ knives
Break the shepherds’ cudgels
For Earth belongs to the wolves at night.

He keeps this on the front of his writing notebook. He likes to remind himself that wolves can be both light and dark. Thus, although they are to be respected and even feared, they need not be feared because they are necessarily evil.

“Even wolves,” he told me, “can protect.”

“Furthermore,” he said,  “lions and lambs don’t just have to sit with each other in peace, like the Bible says. Lambs can try to become lions. They never really succeed, you know, but they try, not to become killers, but to become strong for others.”

*********************************

The Soliloquy

Lately I have felt so low
Weighed down by the sin sewn
Into my soul.

Swimming in a sea of lies this high,
Concentrations of bullshit burn my eyes.

Fire running through my veins engulfs my emotions.
I cannot fuckin’ think straight.

Crawling through a reality of broken glass,
If one is afraid to bleed,
One will never last.

Stones fall from the heavens atop my head.
Yet I walk without fear or dread.

For I’m not the only one
Who in this Hell found his faith.
For we are many rams now,
Instead of sheep.

“The stones, they’re like rain, you know?” he said to me. “But you just keep walking.”

*****************************************

Rain falls from the sky, yet the sun still shines.
The wind lightly blows, caressing my skin.
The water runs down my face slowly,
Trickling like a tear,
Rays from the sun warming my soul.

Nature has emotions just like me.
In this moment, I feel like I am one with everything.

“It was just a poem I wrote, Doc, no big deal.”

********************************************

The “Aperion”

There is a place I go from time to time.
It has no name.
Here there is no time.
Why I go, I do not know.

Maybe to be alone.
Think about shit.
Reflect on my life.

There’s no light,
Dark and void, no sound.
Deaf and blind, but conscious still.

Sometimes I walk
But this void is endless.

Questioning my sanity with every pace,
I begin to explore my emotions,
One at a time.
Hatred is always the last to manifest
For I know it the best.

Then I see it,
The unextinguishable flame,
From which all things came

It neither speaks nor listens.
It simply defies the darkness.
It illuminates the darkness of my soul.

I move closer and closer
Letting its warmth warm the numbness of my skin.

I reflect on my travel and trials
I have faced.

I administer my judgment of choices I have made.
I cast my verdict.
My sentence is set.
I need no jury,
For who are they to judge?

I’ve lived, loved, loathed, learned, and laughed.

I enter the fire willingly from whence I came.

May I arise from the ashes and wake again.
For I would carry the fire in me and see
The aperion of all things.

And bring a reality of serenity into being.

“The ‘aperion’ is absolute truth,” he told me, “the one that no one knows. Sometimes the world can feel so bad, I go to that dark place even when I don’t want to. But there is light there, Doc, I know it. Somewhere, there is light.”

_________________________________________________________________

I hope I don’t embarrass myself, Doc,” he had said to me.

Have no fear, soldier. You didn’t.

No way, nohow.

Dear Winston, 02.21.12

Dear Winston,

I was so glad recently to receive your most recent writings. My apologies that it has taken me so long to respond. The last few weeks have been hectic ones: there have been many responsibilities at the hospital, and at home we have been having the pleasure of working with our second daughter as she considers her next step toward college. The practical day-to-day’s of life, in other words.

In addition, I managed to finish the initial manuscript for “Listening to War: Year One,” believe it or not. I know: the book has essentially already been written, given that it’s a compilation of last year’s blog posts. I had a lot of editing to do, though (given my propensity to go on and on in parentheses, such as I’m doing now), plus a lot of formatting.

My wife has always dreaded my suggestion that we periodically bring in a cleaning service for special events, stating that she couldn’t get the house clean enough for the cleaners to come in. Previously I’d thought that was, frankly, nuts. Having now spent so much time editing text so that it can be edited, I have a new appreciation for her position.

Having now read what you’ve written, though, I also know that I have had to prepare myself to write you back. I’ve been thinking about how many of you and your brothers and sisters have told me that when you signed up for the military, you both knew what you were getting into—and had no clue.

Having experienced your essays so far, I can say the exact same about my own undertaking of this project.

I stare at my laptop screen, my dog quietly asleep next to me on the couch, enjoying an early morning quiet that will soon disappear into the frantic details of my very pedestrian life. Not only cannot I not find “the” word, I cannot even find the concept to describe my feelings at the moment.

Both “gratitude” and “appreciation” feel too precious, too diplomatic, even. Yet within those words are a thought and an emotion that, together, indeed form the correct description.

You have invited me into your War Within, Winston. You have asked me to present that War to the world and then to respond to it, to help keep you alive, in my writing, as The War Within speaks.

Having now read these first missives from that War, I know my duty: to hold on to you, to the handsome—may I say it?—boy, yet man who “should” know nothing more than the “battles” of your yukking it up with the other boys/men in front of ESPN, each one of you jockeying for position over who today is the most witty, most incisive pseudo-commentator, all while the “girls”/women are sitting in the other room, talking about what really matters—and doesn’t matter at all.

I make you this promise, Winston: with each essay written by The War Within that I present, I will respond to you. I do understand that you cannot speak you right now, certainly with anything even approaching a consistency that you can find meaningful. The War Within is too powerful.

I therefore can only speak my experience and understanding of you. However, I hope that such an experience and understanding can become close enough to the “you” of you that they can serve as an anchoring points for you to grab onto and then to respond to, correcting me when I get you wrong, encouraging me when I get you right.

If in doing so I give you a spot at which you can spend a few moments with you as The War Within rages around you, then I will have accomplished what I am most glad to accomplish.

“Looking forward” to accomplishing? Not hardly. But then as you sat on that plane to Kuwait, preparing yourself to do what you had chosen to do, whether or not others agree with or support that choice, you weren’t “looking forward” to your upcoming accomplishments as well, were you? You knew that you might not return, after all.

You didn’t yet know, though, did you, that you might not return.

My job is to let you know that he did. Whether you now know it or not.

I am glad to choose that job. That, I can say with certainty.

Let us begin.

Thank you,

Doc

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