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

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

I’ll Fly Away

“My wife read your blog. She loved it.”

He surprised me, this handsome fly-boy, with his mentioning the blog. Since my move to Nashville earlier this summer, I’d been wondering how to proceed with it, given my new circumstances, i.e., an inpatient unit from which soldiers could be far more easily identified were I to write of them. It was not only my grief (strong word, but apt) over my leaving the VA that was blocking the writer, in other words, or perhaps taunting him, rather.

“Thank you,” I replied. “Coming from an English teacher, I take that as the highest compliment.”

He was looking at me quite expectantly, with a smile on his face both reserved and a mile-wide.

“How long have you been doing it?” he asked.

“Just under two years. It’s been a bit sparse this year, though, what with my move down here and all.”

He nodded quite amiably, like the good warrant officer he was, well seasoned in the fine art of making senior officers feel as if they’d just said something worth listening to.  I was half-expecting a “Roger, that” at any moment.

“It’d be fine if you wanted to write about me, you know. I wouldn’t mind,” he replied instead, without a hint of hesitation.

“A story you’d like to tell?”

Funny: his smile didn’t really change, yet there it appeared on his face, diffused throughout, the seriousness of all that had happened to him.

“Yes, sir.  Yes.”

I looked down to my left, to the floor next to his chair. A handsome German shepherd, appropriately decked out in his “working dog” attire, lay calmly there, at ease, both nodding off and aware, so aware. I was tempted to ask him, “Wirklich?  Should I?”, as if he actually were one of those menacing hounds on Hogan’s Heroes who used to gobble up those fine French delicacies out of the hands of Corporal LeBeau.

Had I done so, I suspect all the dog would have done would have been to shoot me a look that would simply have conveyed the already-obvious:  “Remember: I’m watching.”

How good it had been to see that smile that day, honestly. Only a few weeks before he’d first entered my office, then sans dog, looking for the world like some extra staggering behind Viggo Mortensen in The Road, post-apocalyptic smack-dab in the middle of Music City USA. He was on too many medications, to be sure. His treaters had known that. I knew that.

But that wasn’t just medications glazing those eyes. If only.

He’d started out his career as an enlisted man, impressing the bejeezus out of every senior soldier he ever encountered, yet completely oblivious thereof. After all, all his life he’d always assumed that he was never going to be good enough, that he was going to have to work twice as hard as everyone else to be half as good, that he would always be “almost . . .”

And assume that, he continued to do as he flew figuratively through the ranks into the position of warrant officer, flew so high that eventually he flew literally through Army flight school, rising, rising to the position of instructor, one deployment down, another, another . . .

Others whom he loved, though, his very own Band of Brothers traveling at the speed of sound, were not as fortunate as he, or so he assured me. They nosedived.  Literally.

He was lucky, he kept telling me. Remember, he was twice-as-hard/half-as-good. He got the long end of the chance-stick. That wasn’t fair. He shouldn’t be alive. They should.

Through all his grief, though, all his explanations, all relayed to me in a tone of desperation that made even me think that perhaps the bad guys were just outside my office door, poised, itching for a soon-to-be-relished opportunity, I could sense that he knew what he knew he knew, even though he was doing all in his power not to know it: that while some survivals were indeed dumb luck, others were anything but. He was good at what he did.

And, almost certainly, better, yes, than others had been.

Survivor guilt is hard enough when all you have to show for it is chance. When you’re also carrying competence, the burden grows exponentially.

But the smile did appear, though, thanks to some med changes (nothing spectacular, trust me), a colleague who has turned EMDR (eye movement desensitization and reprocessing therapy, a trauma-focused treatment) into a quiet, yet explosive tour de force, and—you ready?—Norman Vincent Peale.

How to Win Friends and Influence People. I’m serious here. All your fancy-dancy treatments?  Take that.

I’ll never forget his look when he showed me the life-changing passage, even though, for the life of me, I cannot recall what it said. All I know is that he practically did a 100m sprint to his room to fetch the book, the dog more-than-able to keep the pace, yet clearly unimpressed with the assignment. He beamed as he handed it to me, page dog-eared (sorry, don’t know how to avoid the pun). All I can remember is what he said to me as I looked back up at him after having read the crucial paragraph.

“It’s OK for me to be happy, isn’t it, Doc? It’s really OK.”

What else could I do but beam myself and chuckle?

“Yes, it is. Yes, it is.”

You go, Norm.

And so the day came for him and his fine friend to head back home. It’s such a different experience, this job. At the VA I saw men and women for months at a time, weekly, monthly, you name it. Here I see them daily for a brief while, sit with them at their most painful, work with them to calm at least somewhat the raging storms within them, enough so as to allow them to sleep, perchance not to dream, to find it easier to take the next hill, both literal and figurative.

He flew away. And he didn’t even have to die, hallelujah, by and by.  He could be happy. He could live.

And the dog and I parted friends. I think.

A few days after he left our hospital, I received a note from his wife. She wanted to share with me an essay that she’d written just before my fly-boy had entered our facility, one she’d written solely to put into the words the pain that was tearing her asunder, day after day:

He is a man in a bottle. He sits atop our refrigerator. My husband’s grandfather carved the little figure out of some light-colored wood, balsa maybe. The figurine is a tiny fisherman. Unfortunately, there are no little wooden fish in the bottle with him. He must fish for the pace of mind it brings him, not the thrill of the catch. I wish my husband could find the same peace of mind. He is also in a bottle.

He came home from deployment, but he came home changed. There is a barrier between us now. The glass bottle that shields him from the memories also shields him from life. Anytime he attempts to leave his confinement, he suffers. The memories press in on him, and he retreats again. I miss him; I miss him so much.

I wish I could help, that I could make him better, but it’s his battle to fight, a battle of memories, fear and anxiety, a battle that only he understands. Right now he’s battling it with bottles, the many bottles of medications that crowd his bathroom cabinet. Each bottle, a different form of ammunition against his monsters. To help him sleep, to combat nightmares, to minimize his depression, to bury the anger, to tackle the anxiety, forty pills a day, forty temporary bandaids that cover up the problem, but cannot heal it.

So there he sits, day after day, confined in his bottle . . . out of my reach.

The essay was placed inside a small card, written just the day before. In it, handwritten now, not typed, were the following words:

Thank you so much for all you’ve done for my husband. He’s starting to act like my husband again, and I sure did miss that guy. You helped him find his way back from that dark place, and I hope everything he’s learned from your program helps him stay out of it for good.

I hope so as well. And even though I appreciate the thanks, I do think both she and I need to give thanks where thanks is due: to the good Reverend from Manhattan who, across time and space, reached into the heart of a Nashville pilot and breathed into him the words, “Live, young man. Live.”

Amen to that, Pastor.

And fly away, fly-boy. Fly away.

JD/RJSD

(Note:  By typing these initials, “John/Jane Doe’s” and mine, I am signifying that the soldier about whom the essay is written has approved its content, received a copy, and given written permission for its publication on the blog.)

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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