It's nice to know that the exceptionally tragic story of PSTD sufferer and well-loved Marine SSgt. Travis N. Twiggs hasn't completely faded from view -- a story we broke here, days before the national media even picked it up. This weekend it looks like the Times-Picayune has a two-part series about Twiggs on the NOLA.com website, linked here, and the story is both well-written, and contains - gasp - actual reporting, including conversations with the dad and stepmom, both Louisiana residents. (The Twiggs brothers spent their formative years in Ama, Louisiana.) It's a shock to me that CNN never covered the Twiggs story -- although they did cover the story of the Marine on leave who was murdered over $8 in his pocket. I guess the fear-mongering, anxiety-producing shock value of that "news," while terrifically sad in itself, beats the prospect of actually covering a story with some complexity and depth, in which we as Americans could stand to learn more about the life and background of an American hero whose death we mourn. Weird values, CNN (or maybe complete lack of them...)
One nice development since our original reporting on this story, back in mid-May when it happened. The Marine Corps Gazette, which originally published Travis Twiggs' story about his battle with PTSD, put the article back in print. It's available on their website now, linked here. And they added a nice little blurb about mourning his passing and extending their condolences to his family, which is appropriate. It also sounds like there was a Memorial Service for the extremely well-loved Staff Sergeant at Quantico a week ago, which allowed his fellow Marines and those he'd come in contact with over the years, to pay their respects. Also a very nice, and well-deserved touch. (So much better than just sweeping the whole situation under the rug, because it had such a tragic ending.)
Other nice developments include hearing more from Travis Twiggs' wife, Kellee, about her husband's ongoing and difficult battle with PTSD. We've blogged about her here and here, and those entrees are well worth reading, to learn more about the spouse and family's battle with PTSD, since it ultimately involves them very much. Kellee is an impressive American hero herself, and their two lovely girls will now grow up without their dad -- and with undoubtedly many questions about why he had to die -- because of this terrible opponent he faced, which ultimately defeated him. (And don't think they won't struggle with that: research has shown that PTSD does have consequences into future generations. We've blogged about that elsewhere here.)
It turns out that Kellee Twiggs and Travis Twiggs went way back, and had known each other since childhood, though married for the last decade. In other words, a wife who really knew her husband, and what was, or wasn't, normal for him to be like, behavior-wise. I still remember some of her first words from a tv report, on learning of her husband's violent death in Arizona. It's from an audio clip, and she's obviously upset, and her words at the end just trail off, like she's debating about whether she can even say what she's wanting to say. The quote? "He was sick, mentally. with PTSD. and this is the result of it. He now leaves me, and two beautiful daughters, because NOBODY in the Marine Corps, here at Quantico, wanted to take the time..." To do what? Here's where it gets so difficult...
To listen? PTSD sufferers often don't want to talk about what they're really going through. A note from someone who was undergoing treatment with Travis at Bethesda let me know that as great a guy as Travis was, and he really WAS, his friend emphasized, he definitely didn't want to talk about his down times. To treat it? Sounds like Travis Twiggs had gone through multiple forms of treatment for his PTSD, but none of them were effective -- and that's pretty par for the course, in some ways. The current thinking seems to be, hand someone a handful of pills -- at one time, Travis was taking 19 different medications -- and hope for the best. There was some counseling involved, but it sounds like very little -- and the whole emphasis of the medication is on "forgetting" or "blurring out" (numbing out) the memories -- so when you're on the medication you're pretty much a zombie (his wife speaks of his being -- great made-up word -- in "comatose-dom" while he was on medication), and when you're off, why, the memories of what you're trying to forget just come flooding back. Intrusive memories (meaning, you get them when you don't want them) are a hallmark of PTSD.
And Twiggs had some memories he was very much trying to forget. Not things that he was at fault for, per se -- but things that troubled him at the deepest possible level, and for which he felt some, perhaps unfounded, responsibility. His loss of "two of his boys" -- Lance Cpl. Robert F. Eckfield, Jr., 23, from Cleveland, Ohio, and Lance Cpl. Jared J. Kremm, 24, of Hauppauge, N.Y., who died on October 27, 2005 from an "indirect fire explosion'' in Saqlawiyah, Iraq. (Kremm died at the scene of the explosion, and Eckfield died of injuries later at a battlefield medical center where he was evacuated.) Twiggs felt, whether accurately and wisely, or not -- the burden of their deaths -- as a form of guilt he never overcame. And here's where I wonder whether the Marine Corps' heavy emphasis on never leaving a brother behind, while laudable, can also be overdone a bit -- to the point that someone with a sensitive conscience -- for lack of any better way to describe it -- can't manage the pain afterwards of realizing some died on his watch. "Everything in balance," the Taoists used to say -- and that includes troubling, painful emotions like grief. In a heartbreaking, terrible situation like this, you can perhaps see why.
I've been reading Raymond Scurfield, DSW lately -- in particular, A Vietnam Trilogy: Veterans and Post-Traumatic Stress: 1968, 1989, 2000 -- and some things really never change, including the nature of combat, and its affects on those who suffer its obvious trauma. (Scurfield, a social work professor, worked for years with the VA on PTSD, and started his career as a social work medic in Vietnam.) At the very beginning of his book, he talks about meeting a (deranged) Marine, who'd had a serious psychotic breakdown in Vietnam. In moments of lucidity, this Marine would plead, in absolute anguish, for Scurfield to help him get back to Vietnam to rescue his buddies -- buddies he had left behind. But this Marine, unlike Twiggs, had deserted his guys -- or at least believed that he had. Desertion in the actual military sense of the word. Not so, Twiggs. The Vietnam-era Marine cried out to Scurfield the social worker, "I have got to get back! I let my fellow Marines down terribly [when he broke down and was medically evacuated.] I have to go back -- to prove that I am a man! Can you help me, to get back?" Even 40 years later, you can still hear the anguish of that man's cries. AND his confusion over whether he'd actually deserted his men, by getting so sick that he had to leave. Scurfield writes about what a tortured experience that was to go through, because he knew that the man of course was never going to be able to get back, in his present condition, and would likely be broken by the guilt he felt about the matter. "He could never make right," Scurfield writes, "What I later came to understand, is perhaps the most unforgiveable and egregious shame that can befall any combat soldier -- 'deserting' or otherwise letting down one's buddies in the heat of battle." ("The image of this tormented soldier stays with me still," Scurfield concludes.)
Of course, Twiggs wasn't guilty of deserting his buddies in battle -- they died because they were attacked, and he was powerless to prevent their death. But that wasn't the way he looked at it, apparently -- and an additional "head trip," that probably only added to this -- was the event Twiggs talks about in his PTSD essay, where unbeknownst to him, some of the first people he met upon hitting the ground at the homecoming ceremony for his battalion, just back from Iraq -- were the FAMILIES of those two men, who he apparently was not expecting to see. Apparently seeing them in the midst of an otherwise mutedly joyful occasion just further seared into Twiggs' mind that the reason those guys weren't here with the rest of them was somehow, inexplicably, his fault.
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I do think this is where the Marine Corps needs to bear some responsibility, unless it already does, for right training on the matter - again, a matter of "balance." OF COURSE you want to do everything in your power, from boot camp all the way through repeated deployments -- to keep your buddies alive and as safe from harm as you can make them -- but the important points are, taking responsibilty for only what's within your power to have happen (disregarding fate), and, realizing that beyond obviously, we're talking combat here, and people are gonna die. It seems like both sides of that coin -- care for your brothers, and understanding that not everyone comes back alive -- are equally important, and maybe only philosophical, sophisticated thinkers can balance both sides of that concept at the same time. I'm not making fun here, a favorite Marine officer who was grievously wounded in Iraq once told me that he thought the ability to balance two contradictions in your mind at once, without denigrating the importance of either, was high intelligence indeed.
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I know that the Marine Corps includes Sun Tzu's famous Chinese classic on the art of military strategy, The Art of War, in its Commandant's reading list -- that every Marine reads through, appropriate to his or her grade -- but it might be a good idea to broaden the exposure to what other Taoists think, since they're such admirable realists about the dual nature of life. (Curiously, Taoism is such a non-possessive school of thought that someone can be a practicing Catholic, Unitarian, Wiccan, or no religion at all, and not find a conflict of religious "allegiance".) Here's what one latter-day Taoist philosopher and poet had to say about the compulsive nature of intrusive thoughts and worry, and it relates directly to what Travis Twiggs and others underdo all the time, in combat and its aftermath. "Worry is an addiction that interferes with compassion," writes Deng Ming Dao in 365 Tao, and continues, "Worry is a problem that seems to be rampant. ... Whatever the source, it is clear that worry is not useful. It is a cancer of the emotions -- concern gone compulsive. It eats away at body and mind."
"It does no good to say," he continues, "'Don't think about it'." You'll only worry more. It is far better to keep walking your path, changing what you can. The rest must be dissolved ... In this world of infants with immune deficiencies, economic imbalance, personal violence, and international conflict, it is impossible to address everyone's concerns. Taking care of yourself and doing something good for those whom you meet [and serve with?!] is enough. That is compassion, and we must exercise it even in the face of overwhelming odds [combat?!]. Whenever you meet a problem, help if it is in your power to do so. After you have acted, withdraw and be unconcerned about it..." (Not to belabor the obvious, but not "unconcerned" in the sense of "we don't care," unconcerned in the sense that, we've already done what we can, and let's not continue to ruin more lives in the process, with needless worry...)
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Back to Ray Scurfield, for a moment. Isolation is a hallmark of PTSD, because of the very real risks that NOT isolating yourself from others, in combat, creates. Unfortunately, it's hard to turn this skill "on" and "off" like a light switch. But in combat, you bond heavily with others at your (eventual) peril. It's possible that SSgt. Travis Twiggs, well-loved by his Marines and his family, just didn't "get" this, and it's part of what eventually killed him, when he broke under the strain of his perhaps misplaced guilt and PTSD. Writes Scurfield, "Indeed, the bonds formed during war can be so powerful that men become closer than brothers. Unfortunately, this is a two-edged sword. Brothers-in-arms protect each other, look out for each other, help to get each through the war." "On the other hand," he continues," if something happens to your close buddy, it can be devastating. Many vets talk about how, at some point during their war tour, they suffered the tragic loss of someone whom they had let themselves get close to; the impact is profound."
Scurfield includes a story from a suffering Vietnam vet who did just that, to drive home his point. Scurfield retells the story in the man's own words: "I had been warned by some of the seasoned vets not to let other people get close to you -- "because it hurts too much if something happens to them." In spite of my better judgment, I did get close, real close [to another veteran, during combat] ... [He] and I got closer than I have been with anyone before or since; we became as close as any two people could possibly be." And, after [his buddy] got killed, I hurt so bad...And I knew right then, I was never going to let anyone get close to me again. And I didn't. I looked out for number one. Period."
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"A great guy, a horrible tragedy"
Travis Twiggs, who from all accounts was a very big-hearted, loving guy, apparently never did close himself off like the Vietnam vet in Scurfield's account did. If you know anyone who knows Travis Twiggs, you know that he was a well-loved guy. His Marines loved him, his wife loved him, his family loved him -- heck even his landlord loved him, and people he'd just barely met -- even when his PSTD was full-blown. And if that isn't a testament to what kind of guy he was, I don't know what is. (His landlord in Virginia, "Mr. Bob," as his Twiggs' wife, Kellee, sweetly calls him, the head of a famous international philanthropic organization in the D.C. area, basically broke all land-speed records trying to get the word out, after Twiggs' death, that he was being mischaracterized in the media as a violent criminal, when in fact he was the sweetest and warmest guy imaginable, who literaly would do anything for anybody. Many who knew Twiggs seemed to feel the same way.)
One of the true delights of having broken this story early was hearing in emails from people who did know Travis, and let's just say for the record -- it was all good. Here's one of the best ones I received, though, from a professional guy in Washington, D.C., who spent some time in the same ward at Bethesda as Travis Twiggs did, back in March of this year (the same time period where I was trying to get in touch with him, and getting worried about what his silence actually meant.) Here's what this guy had to say:
"In the two weeks I was there as a patient, I got a chance to know Travis. Travis was a great guy, he had a heart of gold and would befriend anyone. The staff loved him - he had been there the longest (two months). While I was there, I had a few conversations with him - mostly about what his current duty was and his plans for discharge. While he was a outwardly friendly guy, it was clear he was also in a great deal of pain (I never asked him the details of his PTSD - one learns quickly that those are depressed (like me) can talk more openly than those who have PTSD - who typically are reluctant to open up). So, I did not know the extent of his pain, just that he was in alot of pain. When he was in pain, he tended to withdraw. When not in pain, he was quite lively and was always the center of attention. I think he really wanted to get better and heal, but just got caught in a bad situation and did not reach out to those who could have helped. I don't know anymore beyond what I have been told and what I have read. Like I said, he was a great guy and this is a horrible tragedy.
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I know I spent quite a bit of angst in March wondering what had happened to Travis Twiggs, well before his untimely end, and hoping I could get in touch with him -- both to see how he was really doing (I had my doubts), and to see if I could republish his original article from the Marine Corps Gazette, in full -- because I believed it could greatly help other veterans who were suffering. I got an email back from him -- an autoreply -- mentioning another email address of his, referencing "War Pig." It made me curious just what was behind this "War Pig" reference -- was his battalion nicknamed that, like Eric Acevedo's had been nicknamed, War Dogs? (It wasn't.) Did it have to do with some fondness for Light Armored Vehicles? (Also nicknamed War Pigs.) That seems a bit much, even for a Marine :-) (No, it turns out it wasn't.) Or did it maybe have to do with some lyrics from an old "Black Sabbath" song called War Pigs, which Twiggs was himself old enough to remember? But those are pretty anti- at least the insanity of war, pretty un-likely for a guy who'd been a career active duty Marine. (Twiggs was such a gung-ho Marine that, on top of his five deployments(!), he'd actually left the Marine Corps at one point -- and come back!)
It turns out there's a much better story to what "War Pig" signifies, told by a Twiggs family member. Apparently when Twiggs served in Cuba, he was up so many days straight being a Marine, doing his duty, that when he finally got to sleep, he slept for literally days. So long, in fact, that a commanding officer wrote a sign and stuck it over his sleeping form, "Here lies the War Pig." Indeed.
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It's heartbreaking that Travis Twiggs, straight-ahead U.S. Marine, loving father, husband, son and brother, leader of Marines, hospitable neighbor, friend of many, including those he'd barely met -- lost his painful, deeply personal struggle with PTSD. It's especially heartbreaking to think of how much of the trouble he suffered seemed to revolve around the loss of his guys -- a loss he would have been powerless to prevent, and for which he had suffered, and grieved, already enough. The rending cruelty of PTSD is that by his own dying, not only did he not take the pain of his Marines' losses away, but he also actually added to it, with his own. Now his Marines grieve, but also his family grieves, and everyone has to go forward without him, who was heavily there for others, but ultimately couldn't be so for himself.
There are a lot of lessons from Travis Twiggs' needless death from PTSD, and I don't think we're in any position to realize all of them, yet. Or to attend to them, and "fix" their consequences, so things like this don't happen anymore. We're sadly still a long way off from that. One "clue" in all this was left by Travis himself: that a handful of medications doesn't really work to solve the problem, if the underlying felt problem is guilt. All the medications do -- besides complicate matters -- is keep the patient numbed out, but not capable of working through his very real torment. Take away the medications, some of which are probably vital, but not all -- and the torment is right where it was before, more or less unchanged. More needs to be done to uncover the roots of PTSD -- who gets it, and why, and most of all, how to treat it, successfully -- but whatever ends up being the "magic bullet" will undoubtedly be a combination of things: medication, talk therapy, and even the seemingly far-fetched (see our recent series on Complementary and Alternative Medicine and PTSD). It would be pretty Taoist to say, whatever ends up helping, let's use it, because what we care about is not what type of solution it is, but how much it helps those who are suffering, in the throes of it. We can already tell what doesn't work, which is pretty much the status quo: a handful of medications to mix (against the rules) with drugs and alcohol, combat veterans' frequent and very understable choice.
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At the risk of oversimplifying things, what's killing veterans with PTSD is what they can't forget, and what they feel somehow responsible for seeing, doing, experiencing -- or not, in some cases. It's this responsibilty that may be ultimately wrongly placed. As combatants, they're just doing the best they can, under the circumstances. In war, more so than any other situation on earth, it's pretty clear that sh*t happens, and that's hard enough to deal with, without going away thinking for years that it's your fault. Maybe it's time to cut back a little on the gung-ho warrior's creed of never leaving a brother on any level, because it's messing with people's heads when they ultimately have to, through no fault of their own. Couldn't at least some sort of balance be taught? You want to give your all for your brothers (and sisters), but when stuff happens, and you can't, you've done things to the best of your abilty, and maybe you can let it go -- let IT go, not THEIR memories. Again, a powerfully difficult concept to live -- but nevertheless, an equally powerfully freeing one. "Right thinking" needs to become part of right warfare -- because the casualties of not having that are starting to become really obvious. Far more young guys (and women, but mainly guys) kill themselves as combat veterans when they just can't take it anymore -- it's much less common when older guys do. At 36, Twiggs was older than many Marines he served with. Undoubtedly, he felt that only added to his responsibilty. But even this week, there are stories in the news about older OIF/OEF veterans who have killed themselves from PTSD -- one is an Army major in the Midwest, who was about to get orders to go back.
So the horrible finale of PTSD -- suicide -- while primarily a young servicemember's act, is by no means limited to them. (We're in the midst of blogging about this topic; look for more on this, later.) We're also dealing with an all-volunteer military that has an average age that is strikingly quite young. The one career Marine I know who's been deployed almost as many times as Twiggs was, but did get help for his PTSD -- did it because he knew that without it, he was affecting his family too much. Extremely commendable. He got the help, and stayed a Marine. And he's still alive today. Twiggs, whose case may have been worse, tried some to get help, and couldn't get past what was killing him, despite his love for his family, and his Marines. It's a sad, sad tale that ends this way, with the crushing feeling that it really didn't have to, but how?!! I'm glad that more all-encompassing coverage is finally being given to who Travis Twiggs was, not just how he died -- but I can't help thinking about his death, and how, "Here Lies the War Pig," finally getting his rest, at last, is at least as fitting a tribute, as any.
