Returning on All Souls Day: A Memorium for a Fallen Friend

It has now been ten months since I last posted, ten months of challenge and of growth, times for renewal, then and now.

For a while I have been planning my return to regular blogging, and soon (truly) I will be doing so. Yet, sadly, today I return with an entry I wish did not press itself into my heart, demanding I open up the laptop one more time to remember, to grieve, to honor.


On Friday, 30 October, 2015,  mere days ago, my Facebook friends received the following post:

Yesterday, I lost a soldier and a friend, SFC Jonathan Downing (Ret). His son, Dylan, requested that those who knew him place this photo in profile. I am honored to do so.

JD so often got a twinkle in his eye when he would show off to me his command of Afghani Persian. And how many times did I hear him say to me, “Good to hear your voice, Doc.”

So, my friend, my voice speaks to you one last time.

Today, with a more clouded eye, yet with an eye that will soon twinkle again at your memory, I bid you farewell in another warrior language, one that the Romans carried with them from the edges of North Africa to the edges of Scotland, the language of your SF motto, yet…

…also the language once of a Church that, for over a thousand years, kept within it the hope of a faith that might otherwise have passed away, a language of less-than-perfect, yet faithful men who—perhaps much like young soldiers today, equally less-than-perfect, yet equally faithful—sought to preserve what they knew, for all our sakes, had to be preserved.

Cruciatus consumptus est,
Mi amice iuvenis.
Miles, frater armis, filius, maritus, pater,
Fidelis in vita et in morte:
In aeternatem
Requiesce in pace,
O Vir Bone!

The torment is over,
My young friend. 
Soldier, brother-in-arms, son, husband, father,
Faithful in life and in death,
Into eternity
Rest in peace,
O Good Man.


JD and I never spoke much together about this blog, given that my time these past many months had been consumed in other matters. Yet he always did say that I had a way with words—as did he.

So if my voice has spoken its last, let this blog entry be our final words together, his to me and mine to him.


You wouldn’t recognize me if I didn’t go “professor” on you one more time, my friend. Yet today, 2 November, is the day that the Church has, through the centuries, remembered those who have gone before us, All Souls Day. I had had no plans of honoring this day with words to you, that is true. But that day came, and this day is here.

I also hope you didn’t mind my getting all Latin-y on you, within a Facebook post at that.  “Kinda overkill, Doc,” that’s what you would have told me. I know.

For you never were one to mince words with me, were you. While you ever valued the service that you gave, you were never one to stomach much of the over-valued ‘thank you’s” some of us stateside were too willing to give you. As a Special Forces soldier, you knew War up close and personal. I saw it in your eyes, eyes that would twinkle, yes, yet often, at least when we were together, could not afford to do so. There were too many stories for those eyes to tell, given how words, as they so often did, failed in all ways to do so.  

I do hope that I heard those stories as well as I could. I promise you: I will do my best never to romanticize them. You took them too seriously for that.

And yes, my friend, I know that there was one conclusion upon which you and I could never fully agree. O Vir Bone! I just wrote. How much more you would have wisecracked about the English word “bone” than you would have accepted the Latin word for “good” spoken to a man who, I always asserted to you, deserved its attribution as much as any man I have known. 

Spoken to you.

Yes, those eyes tried to convince me otherwise so many times, convince me that a man who had to act in War in ways that you had to act to protect innocent civilians and well-loved brothers-in-arms should never, would never be worthy of the word “redemption.” 

Your eyes always shouted, even when they whispered, whether in joy or in pain.

But, my young friend, ” mi amice iuvenis,” I am glad to report that if my own whispering shouts, my words that tried to speak the truth to those eyes, if they did not get the last laugh, they at least got the last smile today, this day of remembrance.

You see, JD, many cultures tell stories of redemption, in whatever language. But on this day celebrated by a Church, in its various forms, whose faith you and I shared, I remind you of a story passed on to us in the Gospel According to St. Luke, 23:42, the story of a man who quite clearly, by anyone’s measure, was not ‘”worthy” of redemption by anyone, let alone by Him who, whether facetiously or not, was labeled “King of the Jews” in three languages, right above His head.

Scholars will debate the truth of the story ad aeternum—or better, as you would have said, until the cows come home. No matter. The “Thief on the Cross,” the only name we have allowed him, took a chance at that moment that has stood for the chance that all of us have taken ever since. In making his request that Jesus “remember” him, he spoke of a hope that all of us, no matter what Wars or wars we have fought, hold deeply inside us.

JD, some will say that in my writing to you today I am merely writing to myself, one more wishful exercise that is the product of grief. Perhaps they are correct.

But perhaps they’re not.

And precisely because the older I get and the more I suspect they’re not, I smile.

For now you know.

I suspect that a good old Southern  guy such as yourself might not have heard much about the Taizé Community in France, where an international community comes together to sing quiet songs of sadness and of hope. I can’t hold that against you, guy. I’m the professor, after all, not you.

So as my parting words I leave a song, one that has always touched me, one that I hope will touch all those who loved you. And I smile. For if you would have heard it in life, I suspect you would have doubted that the plea to “remember you” would ever have been heard by Him Whom the Church remembers most this day.

But now, of course, you know.

He did.

Goodbye, my young friend. Rest in peace.


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.

01.01.2013: Dear Doc

I wrote about him last week, the young man from Empty Chairs, Empty Tables. When he came into my office this week, he sat down and said, “Did you read what I wrote?”

I panicked. Good Lord, did I once again forget to do something that I had promised to do? I hemmed and hawed, only for seconds I’m sure, but long enough, apparently, for his proclivity to rescue to kick in.

“I just left the notebook with your secretary,” he smiled.

I at least had the decency not to break down into a muddled “Thank you.”

“It will be good to read it,” I stammered as I sat down.

“I’ve been looking at your blog,” he then said.

“So you saw the entry last week?”

“The Christmas one?”

I smiled. “So you haven’t seen the one about the movie?”

“No, sir.  What movie?”

So I did what I so often have had the opportunity to do: I pulled up the site, and I read him the post. When I was finished, I looked up to see him staring at me, same smooth features, same big eyes, although with a different countenance now, not distressed, exactly, but not sanguine, either.

He swallowed, and then, without warning, apparently to either of us, the tear crawled out of the corner of his right eye.

“I . . .” He swallowed again. “I had no idea that you heard me. I . . . you listened.”

He was genuinely surprised.

I wasn’t sure what to say. I still find myself surprised when combat veterans tell me that they’re surprised that I’ve heard them. It’s not hard, after all. They talk. I listen. If I don’t interrupt them, they keep talking, I keep listening. Straightforward process, all in all, really.

“Would you . . .” I stammer again. “I’d . . . I’d be glad to go get the notebook if you’d like me to  read what you wrote.”

He smiled, a welcome relief for both of us. “That’d be great.”

So I did. It was a standard-issue, bound, black notebook, the kind we used to use to record lab results in organic chemistry.

“I could only get out a few pages,” he said as I walked back into the room.

“No problem,” I replied as I sat down.

I was scarcely able to crack the cover before he jumped back in. “I . . . I just got so upset when I finished the first one, I had to put it down. But then when I came back later, I  couldn’t get  back into the scene to go on. I was so mad at myself. I guess that’s why I wrote the second one.”

I looked down at the page before me. His printing was sure, yet not overbearing. There were no scratch-outs, no revisions, just line after line, seemingly calling out to prepare myself for a momentum that awaited.

“May I read it aloud?” I asked.

He nodded.

So I did.

As I recall, I paused periodically as I read, occasionally stumbling over a misread word that he had to correct, but far more often simply . . . pausing.

That’s what I did when I finished reading. Paused. Not a short while.

“Is it . . .” he whispered.

I looked back into those eyes, into that facial smoothness that now I knew–knew what I had only intuited before–would never have the opportunity again to claim the trait of softness.

“Is it OK?” he asked.

I saw the apprehension in his features, that terrible fear each of us carries within us, inserted with such self-justified rectitude by some middle-school English teacher, the horror that our words that had tried so hard to express our deepest self just somehow didn’t pass muster. I knew I had to allay that apprehension–and quickly–but . . . well, I just hadn’t quite yet pulled myself back together sufficiently.

“It’s excellent,” I whispered. “Amazing.”

“Really?” he asked, with a single word mocking my very brilliance of having known, with the self-assurance of italics, even, that he could never find “softness” again. For there it was: a soft smile, the kind that inches its way onto a face when one realizes that, wow, you mean everything might be OK after all, really?

“Yes, really,” was all I could answer

That was when the thought hit me. Even at that moment, I questioned my motives, a doubt quite deservedly inserted into me by a generation of teachers who had warned me of the dangers of asking anything out of a patient except for payment for my time (the tab here for which the VA is picking up quite nicely). Still, I thought: this voice needs to be heard.

Yes, it does.

“What would you think,” I began, “if I published this on my blog and then published my response. If you’d like,  you could then respond to my response, and I’d publish that, and the two of us could begin a kind of correspondence together–but again only if you’d like and only for as long as you’d like. You have  a powerful voice, though, and I believe that it is important that people have the chance to hear what you and your fellow combat veterans have to say. If I can help make your voice known to as many people as possible, I’m glad to do that.”

At one point, I might have found it hard to believe that his smile could have become even softer and more surprised. But there it was.

“You mean that?”

“Of course.”

“That . . . that’d be great.”

“You don’t have to wait until we meet next. You can e-mail something to me, or . . .” I paused as I realized what should have been obvious, given what I had just looked at as I had read. “Or you could write it down, too. Does it help to feel it coming out of your pen?”

“Yes,” he replied. “I like to feel it. But I could scan it and e-mail it to you, how about that?”

I’m old enough to have the right to say: what a world we live in.

“Sounds good. So what ‘name’ would you like to have for this correspondence?”

He sat back with the look of someone who’d just been granted an extra wish from the genie.

“Winston,” he eventually replied, quite satisfied with himself, obviously. “I’ve always like that name, Winston.”

I had to smile. What else could I do.

“Then Winston, it is.”

And so, for as long as Winston desires: it begins.


It was hot, the sun glaring down upon the sand. Looking out onto the horizon, the heat causing the air to be thick, boots pound the sand, dust flying all around me, the ground worn from so much war.

People say that sand is golden brown, but not here. It glowed red. All the blood for thousands of years stained the earth, ground into flour, fluffy to the touch. As the day goes by, the sun rotates over my right shoulder, setting off in the distance, as it looks like you can walk up and touch it. The earth breathes as the ground cools.

Water is of gold to this place. People line up for a chance to have cold water. A small boy and his father wait patiently in line. Sweat glitters his forehead like rain on a windshield, his feet cracked and bruised from all the dry hot air, his sandals, sacred to him, as he only owns one pair, his clothes solid white without a stain, the little boy with a deep thought beneath his eyes.

He ponders on how to approach me, at 190 labs, full body armor pressing against my body, my helmet heavy. Black is what he sees when he gazes into my glasses. My knife sits right below my chest, pistol on my hip, my rifle laying across my chest, slip sitting comfortably in the well, brass sets in the chamber, with the round held back by only the pull of the finger. Grenades line my belt, red white and blue on my shoulder. My hands kept tight beneath my gloves. The carbon fiber lays across my knuckles.

Watching as the crowd grows larger, the water almost gone, patience wearing thin with these fucking people, the smell of sweat and shit linger in the air. Standing to my right and left are 12 other guys ready to lay down their lives for me at any given moment, without hesitation.

The little boy tugs at my sleeve and asks me what is my name. As I bend to to tell him, his father’s hand slaps his face, dragging him back into the line. My blood boils as it pumps through my veins, my eyes cross as my fist clinches my weapon. Without a thought the man is laying on the ground as my fists pierce his face, the sound of his bone cracking. Blood pours from his nose. My mind is a fury.

The little boy grabs my arm and says, “Mister, please.” As I pull back my hand and stand up, the little boy stares into my soul. I give him my water, a pencil, and some food. He smiles as his dad pulls him away from the line.


I look back on those days that were so long, sitting in the guard tower, thinking about my life and what it meant. I thought about my wife and daughter and my friends and family, what they were doing, if they were okay. I tried to picture them in places I had been before I left.

I thought to myself that people all over the world have no idea what is going on. Why are we here doing these things? I thought about the first person to bring up the idea of going to war, the stupid fucking selfish lazy fucking dumbass politics. If you asked them to go fight for their country, they would hide like little bitches under their desks. I would like to line them all up and slap the fucking teeth out of their mouths. I hope they all suffer for their arrogant selfish mindless actions.



Thank you, Winston. Back with you as soon as I can.

Again: thank you.

Hands and the Unfathomable

The consultation was an unusual one. A combat veteran was referred to me by another physician after the veteran had had some puzzling medical complications. The doctor was wondering whether “this gentleman’s problems might be related to his PTSD.”

Now, truthfully, if I’d just heard about this man’s symptoms in a case presentation, “PTSD” would not have been on the top of my list in (what we call in medical parlance) the differential diagnosis.

Apparently it was, though, for the veteran. For he had been the one to bring up the possibility.

When I first saw him, he appeared surprisingly chipper, given what he’d gone through medically only quite recently. He proceeded to tell me that although he was having problems remembering certain parts of his then-recent illness, he definitely recalled a time during it when he had felt “as if I were watching myself.”

“Has that every happened before?” I asked.

“Well, yes and no,” he replied. “Since I’ve been back from deployment, I’ve had some really strange experiences, but I have to say: nothing quite like this, certainly not during the day.”

“At night?”

“That’s been a different story, I’ll admit. Sometimes I’ve woken up and realized that I’d been wandering in some part of the house for who-knows-how-long, without a clue as to how I got there. And sometimes my wife says I start having these conversations with her in the middle of the night, going on and on about something or other dealing with The War, when I later can’t remember a thing.”

The man spoke with a certain assured air, if one could say such a thing about someone who was talking about being, at times, anything but assured about reality itself. He was a big guy, though in no way fat. True, he’d probably been a bit more toned, shall we say, in times gone by, but the adjective “husky” would have always been a mark of respect for him, never a euphemism. His dark hair was short, not in a military way, rather more like in the way of the decent guy next door who’d called to you over the fence some Friday evening to see if you and yours would like to join him and his for burgers and brats (and a bottle or two of Fat Tire).

“When were you over there?”

“2003, 2004. Flew over on my twenty-third birthday, flew back on my twenty-fourth.”

I looked at him and said nothing. He looked back and did the same.

I’m in fact never quite sure what to say when I find out a combat veteran took part in the initial invasion of Iraq. I only imagine, knowing that I can never begin to imagine, knowing, therefore, that anything I have to say will only be trivial, at best.

“Not good?”

He snorted, thankfully in a resigned way, rather than the disdainful way that question deserved.

“You could say that.”

“What was your MOS?” (i.e., his assignment)


Once again, I’m never quite sure what to say.  As I’ve noted before (e.g., in Kilroy Wasn’t Here), when I hear that a veteran was a combat medic, I try not to react too blatantly to other imaginings of mine, imaginings of gunfire, explosions, screams, hands being held for the final time. Rarely am I successful, though.

Twenty-three, a combat medic, in Iraq.

I wasn’t successful this time either. He noticed.

“Where were you over there?” I finally asked.

“You name it.”

In spite of the relatively terse answers, he was not at all wary or distant. In a way, it was as if he’d already been through this drill many a time before, so no need to get all worked up about it, after all. But then neither was he cool nor nonchalant. Instead, he very much exuded this feel of “if you’re willing to ask, I’m willing to answer,” a certain, pleasant-enough quid pro quo, if you will–one straight out of Hell, of course.

“How many close to you did you lose?”

He looked down, again in that tired, even matter-of-fact way.

“Four I was really close to,” he replied, as if both steeling himself for inner pain, yet somehow at the same time planning to be bored by it.

“Were you with any of them when they died?”

He looked back up at me, again not indifferently, yet, what, wearily, as if one more damn trip down the back alley of unspeakable memories was simply too much to ask of him today, too much.

“One.” He sighed ever so slightly, with a been-there done-that look on his face that could only radiate to the world that he would never finish being-there, never be finished doing-that, never. “One.”

It had been an officer, a man he had deeply admired, deeply cared about. It was awful. There were plenty more awfuls, though. Over the next five, ten minutes, he recounted some of them. He spared not a detail.

Clearly he cared deeply, about everything. Clearly he was struggling to find another ounce of energy to care any more, about anything.

“I was twenty-three. I saw things no twenty-three year-old, no one should have to see. I had to put my hands where no one–twenty-three, no one–should have to put his hands.”

It was the latter image, of course, that grabbed hold of my lower spine and squeezed with a vengeance. It’s been years since I medically invaded a body, drew blood, inserted catheters, dropped a nasogastric tube. Yet the physicality of the hand inserted where no hand should go: my own body reminded me that once I had been more than close to pulsating organs–holding retractors only, of course, while others far more daring than I invaded, inserted themselves further, deeper. Yet I knew that I could imagine such a scenario–hands as strangers in a strange land–far more easily than I would like to know.

He had stopped talking. He did not appear ready to cry, to lose his composure, nothing of the kind. Yet, still, his tiredness as way of life: the façade was beginning to crack.

“What’s the greatest sadness in you?” I finally asked.

Honestly, I have no clue where that question came from. Clearly he had been expecting it as little as I had been planning it.

He cocked his head slightly, almost as if he were taking a moment to admire my chutzpah, practically radiating one of those “well, who’d a-thought” looks. After five seconds or so, he finally said:

“You know, there was once a time when a question like that would have sent me over the edge. I don’t know quite how to say this, but . . . that question makes sense to me now. You know what’s my greatest sadness? The fact that I’m never not sad, no matter how I might appear on the outside, no matter what I say, no matter that I love my family more than anything. Please understand: I have happiness. My wife, my kids, they’re wonderful, they keep me going. But it’s as if I know one truth more than any other, a truth I couldn’t get rid of even if I wanted to: although I’m happy, I’ll never be happy again.”

“I mean,” he continued, “I shouldn’t be alive. You’ve got to understand how crazy it is that I’m sitting here with you. Good men are dead, and here I am. Over there, it got to the point that I didn’t care, period, didn’t care. I’d walk into the middle of a fire fight, thinking ‘so what’? Dead, alive, it didn’t matter. If you want to know the truth, I’m still like that, basically. I don’t want to die. I’m not going to hurt myself. I want to be alive for my family. And yet I can honestly say to you: I don’t care if I’m alive or not.”

I could say that I made no effort to calm him in all this, but that would give quite a misleading impression. He was quite calm, in fact. Or rather, should I say, he was quite calm and he wasn’t even close to being so.

Yes. That’s it.  Not even close.

“You know what?” he finally asked. “I was so messed up when I got back from Iraq. I hadn’t even heard of the term “survivor guilt,” but that was all I was, survivor guilt, all day, all the time, wandering, trying to figure out how I could muster the courage to carry out the only decent act left for me to do: die. But I couldn’t even kill myself. One time I had everything in place to do just that. But in the only minutes I realistically had to carry out the plan, the means I’d chosen just wouldn’t work. I tried, and I tried, and I tried, but nothing. And then once the chance passed, the means suddenly started working again, but it was too late. It’s like I’m being kept alive, even when I don’t care one way or the other. Yet I do care. For my family, I want to live. But I don’t want to live, see? Yet at the same time, I can’t even care enough not to want to live. Is any of this even making sense?”

“Yes,” was all I could reply. For, in listening to him, it did.

“You still in the medical field?” I finally asked.

“God, no,” he answered. “I lived enough of that as it was. I can’t even imagine doing it again. No, I want to become a counselor. People say I’m a good listener. They lean on me. That’s what I want to do. Maybe that’s how all of it will make sense one day. I don’t know.”

For a few seconds I looked at him, husky, sporting his brat-and-burger haircut, his smile still discernable behind that look of indifferent confusion, confused indifference.

“You’ll be good, you know,” I told him. I meant that.

Clearly he’d not been expecting that response either.

“You speak clearly, candidly, straight from the heart,” I continued. “You’re willing to live with your own confusion. That’s key in this job, believe me. I’ll have to say one thing, though.”

With that latter statement, his indifference vanished. Only plain old-fashioned confusion remained to face the music.

“What’s that?” he asked.

“Well,” I said, “if you’re planning to make it possible for others to live better, then you’re going to have to live better yourself. Even if you think that you don’t care, that you’re really not that into living: sorry, reality check. You do and you are. Your hope, that goal of becoming a counselor who will listen to another combat vet no matter what is remembered, what is said: they betray you, the real you behind all the indifference towards the next sunrise, the next cup of coffee, the next diaper change. Hate to break the news to you, guy, but it ain’t just your family who’s keeping you alive. You are as well.”

For the first time, his eyes went into lock-down, obviously determined not to let any lacrimal material even consider escape into the light of day.

“You’re probably right,” he finally said, his every milligram of emotional fortitude on full alert.

Truth be told, though, he looked–at least to me–to be more on the relieved side than anything else. Guess it’s not so bad to be found out after all.

In the end, I told him I’d be glad to work with him. He smiled.

“You know, almost all the psychology types I met in the service were worthless, didn’t have a clue. They really thought they could slice open a huge scab on your heart, muck around there for an hour or so, and then expect you to go home and be just as fine as they were going to be that night, as if to say. ‘OK, now that you’re all ripped up and raw, see you next week and we’ll pick up where we left off.’ Nuts, totally nuts.”

I smiled back. “Me too?” I asked.

He sat back, with a smile perhaps not quite yet ready to make an offer, let alone accept one, but, at the same time, a smile not exactly ready to pack up and leave the negotiation table either.

“Maybe I should start talking with someone again,” he mused, eyes still riveted to mine, while in no way giving me the pleasure of being right about one darn thing. “Who knows? Maybe that’ll help.”

I gave him my card. He took it. We’ll see what comes of it.

I can’t remember anyone being quite so graphic with me as he’d been when describing his experiences. A reference he made to a scene near the end of Kubrick’s The Shining, as a prototype for the setting of one of his rescues, was more than apt. And if I may be so bold: the horror of Nicholson’s imitation of McMahon earlier in that film had nothing, not a thing on the horror this guy saw coming at him day after day after day.

In being so explicit, so raw, I don’t at all think that he was giving me some kind of test, as if to see how well I could “take it.” No, sadly, I fear all was just as it appeared: horror had become so commonplace for him, so sleight-of-invading-hand in its routine manifestations during combat, each of the stories was simply another day at the office, as far as he was concerned.

An unfathomable day at the office, perhaps. But he reminded me of a truth so well-known, tragically, to so many men and women who once saw what their twenty-three, nineteen, thirty-five year-old eyes should never have seen: one doesn’t to have to reach a fathom into a body, a soul to get to a horror that can leave a sadness in its wake that can become so intrinsic, one can narrate a c’est-la-vie assessment of it and almost–almost–get away with it.

No, for that, just a simple hand-length will do.

Dona Ei Requiem

Late last week I received a call from our Emergency Department, directly to my office phone.

This is not usual.

“Doctor Deaton,” a voice greeted me, the edge therein more than a little palpable.  “This is the charge nurse in the ER.  One of the doctors has a question for you about Suboxone.  Can you speak with her?”

This too is not usual.

It turned out that a young man had appeared in our emergency room who was in great abdominal pain.  He had been on Suboxone through a private doctor in town, and when he became no longer able to afford the medication, he had to stop it, precipitating withdrawal symptoms.  The situation was even more unusual, though, in that the man had only been on a relatively small dose of Suboxone, yet was having quite serious abdominal symptoms.  By the time the doctor got to me on the phone, matters had become so difficult that, shall we say, help was rapidly needed in the ER to keep matters under control. (I heard the call for it over the hospital loudspeaker.  Never a good sign.)

The young man was hurting, and apparently he was not a happy camper.

Eventually he was admitted to a medical floor of the hospital, from which another doctor called to ask me to consult in a few days about the Suboxone.  When I did call those few days later, I learned from the young doctor caring for the man that “he’s got a lot more problems than just Suboxone.  His wife says that he’s really got problems from the war, and I’ll tell you:  he really looks like he’s suffering over here, too, especially at night.  I think he may need some time on the Psychiatry service.”

Fortunately by the time this young man had arrived at my office, much had improved.  He was back on a good dose of Suboxone.  He was taking medication both for his nightmares and for his mood swings.  He was living in a much calmer world.

Sitting there before me, in his late twenties, he was the paragon of the “good old country boy”: on the slim side, but still with a military man’s body, along with a respectable blotch of hair on his chin and a respectful grin on his face that would have made Andy Griffith proud.  Obviously, he was feeling much better.

“I’m back on the Suboxone dose I was on before,” he told me.  “It’s a lot better.  And the new medicines are helping, too, already.  I’ve slept better these last couple of days.”

Matters had been worsening for a while, long before he stepped into our hospital for the first time that previous week.  He is several years out of his last deployment.  Fortunately he has been able to work effectively, but he’s been just as fortunate to have understanding superiors who have genuinely liked him and appreciated his hard work.  Apparently he has not always been a pleasure to work around.

Similarly, he is fortunate beyond belief that he has had the family he does.  He married his high school sweetheart quite young, and their first child quickly followed. His wife has stuck with them through thick and thin.  His parents have been extremely supportive of the couple, and they remain so to this very day.

Still, he had had opiate problems long before his enlistment.  He did become clean for his first few years of service, but after an injury in the field, he returned to the medications, first as prescribed, but later, especially when he returned home, as a way to deal with all the demons that were haunting him.  He finally got himself to a Suboxone provider in the community, and matters changed for him.


“What was your MOS?”  I asked him.   (MOS is, essentially, his job in the military).

“Infantry,” he told me, sheepishly, yet still pleasantly.  “But I spent most of my time on transport.  We were ‘outside the wire’ all the time.”

With that final sentence, his whole tone, his whole demeanor changed.  When a soldier or Marine is “outside the wire,” he or she is outside the (very, very relative) safety of the operating base and out in the world of curious kids begging for chocolate bars–oh, and IED’s (improvised explosive devices) ready to destroy everything in range, including you.

The change in him was dramatic.  I paused.  He suddenly looked about ten years younger, far more vulnerable, far less sanguine.  He was staring down at the carpet–or through a tunnel of time, I’m not sure.

“Bad?” I finally say.

He nodded, said nothing.

“How many did you lose?”  I asked, trying to keep my voice at a respectful quiet.

“Four,” he finally whispered.  “One . . . one was my best friend in the world.”

“Who was he?”

He told me his name.

“Where’d you guys meet?”

He looked back at me, a slight smile returning.

“We were in AIT together (Advanced Individual Training, where one goes after Basic Training to learn one’s job).  We just hit it off.  He was a farm boy like me, you know, just simple, no big deal.  He was so funny.  We’d laugh our heads off.  He . . .”

He looked back down, his smile suddenly retracted into his face with the breath he’d drawn in, held.  It appeared that his body was betting that if he just didn’t move, that tear at the end of his left eye wouldn’t dare move either.

I said nothing.

As he began breathing again, he looked back at me.  The tear had already headed points south.

“He was just twenty, Doc,” he barely whispered.  “He was a lot younger than me.  He was just twenty when he died.  He . . .”

Our eyes remained padlocked on each other’s.  Ever so slightly, he began to shake his head.  As he did, he bit his lower lip–but the tear in the other eye paid no heed.

“He never even lived, Doc.  He never even got a chance to live his life.”

This was not, of course, the first time I’d heard that sentiment.  Yet somehow, coming from him at that moment, so honestly, so sincerely, so achingly, almost as if Jim Nabors had transported his Gomer Pyle across time to sit right there in front of me, but this time with no “Howdy, Sergeant!”, no “Gollllllllllly!”, just a farm boy’s face, trying, begging to understand.

“What happened?” I finally asked.

“He was in the Humvee right ahead of me, inside.  Then all of a sudden, everything exploded.  The gunner on top just blew right off, the gun and everything, gun landed right on top of the guy in the hole that had just opened up.  I ran up, and . . . and my buddy still had a pulse in his leg, I could feel it, but they . . .  they Med-Evac’ed him but  . . . he never made it.”

We were staring at each other, but the padlock on our gaze had fallen off.  The chain connecting our eyes just hung there, limply.

“The NCO,” he continued, “we got a tourniquet on his leg in time.  He lost it later, but he made it.”

Neither of us said a word.

“Does anybody,” I finally whisper, “understand what’s going on inside you?”

Our interocular chain dropped, he briefly looked down, smiled, and then looked back.  “Yes,” he nodded.  “My wife.  She knew him, too.  He and I were stationed together.  He lived over in the barracks, and we had our own apartment, and he’d come over every weekend and stay with us, and . . .”

He stopped, pursed his lips, seemingly sending another telegram to the eyes to lay off.

Obviously they didn’t receive it.

A few seconds, nothing, then,

“She really loved him, too.  I was his big brother.  He was my little brother.  She . . . she knew he was dead before I did, heard it on the news.  She was freaking out.  She knew we were joined at the hip.  She . . .”

A tear was nestled in the bush of hair on his chin.  He was so sincere, so genuine.  Gomer himself never looked that genuine.

“He was only twenty, Doc.  Twenty.”


“I don’t want to live like this any more, Doc.  I’m tired.  I can’t do it.”

Now it was my turn to smile, ever so slightly.

“You want to make it right for your family.  For his sake.  Your kids would have played with his kids.  Now you’ll just raise your kids right and remember him, in his honor.  True?”

Slowly the smile arose on his face.  It was still slight, but the eyes–they had brightened ever so slightly.

“Thank you,” he whispered.  “I’d never thought of it that way.  That helps.  Thank you.”

After he left, I decided to do it.  After all, I cannot remember the last time I had a full name.  I went to Google.  I found him, he who, unlike Harry Potter, was the boy who never lived.

I looked at his picture, smiling brightly, his beret just at the right angle to add a year or two to that face, that . . . young, so full-of-life face.

As I looked at that young man’s face, I saw the face of my daughter’s boyfriend, of her buddy beaming from the stage of his Rent production, of her boyfriend’s roommate who could win at least a silver medal in whatever “sardonic smiles” competition he might enter, of the young man across the street whom I’ve watched grow up since he was in kindergarten.

I couldn’t stop looking at it.  I couldn’t help but imagine the three of them, this young man in the beret, my patient, his wife, all laughing their heads off.

On the way home, it hit me, a memory of my own.

Twenty-five years ago, the minister and his wife of the church I was attending, the church at which I met my wife in the choir, lost their six-year-old daughter to cancer.  The congregation was devastated.  The funeral was huge, unforgettable.

From that time, what I can least forget is one song, the choir accompanying a duet of two sopranos, one the wife of one of my law school classmates, the other–my wife, a voice major from Michigan.   It was Andrew Lloyd Webber’s Pie Jesu, which at that time had just recently debuted.

Back in the present, when I got home, I grabbed my phone and headed straight to Spotify.  There I found it, the original recording of the song with Webber’s then-wife Sarah Brightman and the boy soprano, Paul Miles-Kingston.  I played it.

It was as I remembered it.

Pie Jesu means “kind Jesus,” and it forms part of the old Latin funeral, or Requiem, Mass.  Webber takes those words and combines them with another phrase of the Mass, the Agnus Dei, the “Lamb of God,” to create a seamless hymn of memorial:

Pie Jesu, pie Jesu
Kind Jesus, kind Jesus,

Qui tollis peccata mundi
Who takes away the sins of the world.

Dona eis requiem
Grant them rest.

Agnus Dei, agnus Dei
Lamb of God, Lamb of God

Qui tollis peccata mundi
Who takes away the sins of the world.

Dona eis requiem sempaeternum.
Grant them eternal rest.

To this day, it remains the song I recall immediately when contemplating the death of one who has died too soon, one who never even had the chance to live.  It is the song I recalled as I looked at that smiling face under that dapper beret.

We live in an odd world.  Here they are, two farm boys, both laughing their heads off as they make their dads proud when they go into the military, honorably, bravely.  The last thing on their minds would have ever been some high-falutin’ song sung in Latin, of all things, Latin.

Yet for centuries we have all mourned the loss of those who never had the chance to live, the Roman church through its Mass, the country Baptist church of this young man’s childhood through its hymnody, a group of Iraqi women who cry over their sons, their daughters who never wanted to harm anyone, who got caught in the crossfire, wrong place, wrong time, through the soft sounds, the wails of their songs.

All of us are united.

And today, the song weaves its way around two country boys.  To say goodbye to one of them.

Creator God, dona ei requiem.  Grant him rest.  Amen.

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