Healing Combat Trauma

Vietnam Veteran: "Most Of Us Are Afraid to Love" - A Profound and Generalized Sense of Distrust

As part of our ongoing series on "healthy sexuality and the combat veteran," here are some fascinating excerpts from Yale-trained psychiatrist Robert Jay Lifton's work with Vietnam veterans in "rap groups" in the 60s and 70s. 

It's also interesting, in light of the extraordinary closeness and love that combatants feel for one another, how very little of that appears to be transferred successfully to relationships with intimate partners.  Combat seems to develop a closer bond than often even marriage; and the reasons for that are both various and fairly obscure -- not to mention, hardly ever even broached.  We have some ideas, and in the forthcoming months we will be discussing those.  But for now, we're setting the stage with more "raw material" from the veterans themselves about the difficulties they have touching love.

There are very few works that even mention sexuality and intimacy and the combat veteran -- literally, even mention the concept -- so it's interesting how many aspects of it he is able to cover here.  Quite thought-provoking.  "The word on the street" is that, among Vietnam veterans at least, this situation also hasn't changed in the decades since.  They're still pretty much stuck in the same patterns, for the same reasons, that Lifton talks about here:

(In Vietnam,) … even authentic intimacy and love had to be in some degree contaminated by the counterfeit universe, had to be a little distrusted.  Just as men felt that “Whenever you tried to be human you got screwed,” so one of them added, “If you got close you got burned.”

 

Vietnam had absolutized (or totalized) the whole question of intimacy for the American survivors.  Having experienced a particularly poisonous version of the “end of the world” image that characterizes extreme situations, they distrusted, feared, and could not believe in, the renewed human ties they so desperately craved as a psychological basis for reconstituting that world.  The death-dominated imagery they retained had to do with disintegration, stasis and separation.  The overall sense of disintegration (physical, psychic, moral) associated with the Vietnam environment is internally maintained in approaching the environment back home. 

 

The stasis or cessation of feeling derived from extreme psychic numbing in Vietnam leaves one with an image of a world that neither lives nor moves.  Vietnam’s extreme elements of separation – from familiar landscapes of any kind and especially from purposeful or visible images and symbols – results in an ability to find or catch hold of anything with which one can authentically connect.

 

Toward potentially intimate relationships the men at first brought a sense that any such promise of renewed life was counterfeit.  This intense suspicion of counterfeit nurturance – a form of “tainted dependency” in which love and help are equally strongly sought as a personal need, and resented as a sign of weakness – also had direct origins in the counterfeit universe of Vietnam.  There, as the men recalled all too readily, any form of help, nurturing or love was equated not only with weakness of the blind-helpless giant, but with the corruption of the executioner-victim.  To be sure, the men brought to Vietnam earlier imagery of a similar kind involving suspicion and doubt concerning love and nurturing they craved.  But that negative imagery, present from all childhoods, ordinarily combines with alternative images of trust involving one to respond to love and care with the mixed capacities characteristic of all adult life. 

 

In Vietnam, however, the negative inclination – the image of the counterfeit – is likely to be aggravated to the point of dominating one’s entire psychic life – which is why we can speak of the totalizing of conflicts around intimacy, love and nurturing.

 

The men revealed their sense of the importance of these issues in their energetic criticism of one another for maneuvers of any kind that seemed to be flights from intimacy – whether these took the form of shifting the discussion toward safely distant matters, telling shallow war stories, or suddenly shifting into revolutionary diatribes or leaden silences.  Adept as they were at exposing these maneuvers, none was free of profound individual conflict concerning intimacy.

 

Associating Vietnam as they did with their parents’ generation, ultimately with the whole of American society, their sense was something like, “After Vietnam, what could you trust of anything?”

 

---

 

A man with unusually profound difficulties with intimacy (exceeding but touching upon those of the others), he seemed to lapse into puzzling understatement when he went on to conclude: “People aren’t perfect,” and “People are fallible.”  But what he really meant, as his subsequent behavior revealed, was that unless people (and all relationships with them) were “perfect,” they were threatening, untrustworthy betrayers.

 

An engaging person with a certain talent for human relationships, his pattern of keeping people at a considerable emotional distance was interrupted by his falling in love with an attractive young married woman.  He enthusiastically described to the group their plans to save money in order to buy a Volkswagen bus and drive around the country together.  But at subsequent meetings he seemed much less certain and talked of going south alone for a couple of months in order to earn the money for the trip.  He also said that he wanted to “test the relationship” in various ways in order to find out “whether two people can really get along when they are with each other twenty-four hours a day.”

 

It was he who had the garbage-dump dream, and in it he was expressing (in addition to the themes already described) his fearful sense that all claim to love and intimacy was counterfeit, filthy, “garbage.”  Others in the rap group pointed out that he was being hopelessly absolute about the relationship, that nobody could stand anybody for twenty-four hours a day, that he was “manipulating” arrangements with the girl, “preparing a time bomb,” and “setting things up for a break.” 

 

He denied none of this, and was even willing to explore sources of his mistrust, but nonetheless insisted on doing things his way.  He went further and said, “If I can’t love her, then I don’t think I’ll be able to love anyone.”  And when one of the [other] men gently commented, “Most of us are afraid to love,” he answered with a poignant question, “How do you tell when you feel love?”

 

He was soon to prove the men right: before long the relationship dissolved.  But he went on insisting upon “complete independence – being able to get along without needing anybody.”  His all-or-nothing approach to relationships – the totalism we spoke of before – was discussed extensively. both in connection with the Vietnam experience and his own psychological development.  He did not, during the six months or so I knew him, overcome either this totalism or his profound and generalized sense of distrust.  But he did open himself a bit to his own feelings and to glimmerings of insight; and the rest of the group seemed to benefit greatly from what they learned about themselves through him.

 

Falling in love, or feeling oneself close to that state, could be especially excruciating – an exciting glimpse of a world beyond withdrawal and numbing, but also a terrifying prospect.  A typical feeling, when growing fond of a girl was “You’re getting close – watch out!”  The most extreme emotion of this kind expressed was:

 

“If I’m fucking, and a girl says I love you, then I want to kill her [because] if you get close…you get hurt.”

 

Love or intimacy, in other words, posed the threat of still another form of corruption and disillusionment, of still another ‘death.’[1]  It was much easier to avoid that risk and stay numb (remain in an evenly deadened state) – “I feel like hiding out in my own head,” was the way the same man expressed it.

 

But the men did of course fall in love.  When that happened, especially if soon after returning from Vietnam, they would find themselves breaking off relationships because “I couldn’t go through with it,” or “I didn’t want to be tied down to anything.” What they meant was that their psychological work as survivors was so demanding as to preclude, at least for a certain period of time, sustained intimacy or long-range personal commitment.

 

---

 

The general dilemma of these veterans had to do with the extraordinary intensity of both their need for and difficulty with sustained intimacy.  Breaking off relationships was as painful as it was necessary.  On many occasions, entire rap groups were devoted to such closely related themes as: the general problem of fidelity, notably sexual fidelity,[2] the hunger for love and nurturing, and the sense of being chained by sustained intimacy in a relationship; and the powerful influences of Vietnam corruptions – with their residual fear and guilt of great magnitude – extending backward and forward into old and anticipated corruptions that touch virtually all aspects of existence. 

 

This entire pattern of holding on and breaking off contained a continuing dialectic between persistent death imagery and imagery of life renewed.  But they came to realize that the equation was never simple: holding on could take the form either of revitalizing intimacy (life renewed) or of numbed distanced in proximity (a new death), and breaking off could be a pathetic need to reject the intimacy one craved (a self-inflicted death) or a liberating opening out to deep experience and greater self-knowledge (renewed life).  Over the course of time most of the men increased their capacity for intimacy, but that dialectic would simply not go away.

 

-- Source: Home from the War: Vietnam Veterans – Neither Victims nor Executioners, by Robert Jay Lifton, M.D. (Yale-trained psychiatrist).  New York: Simon and Schuster (1973).

---

[1] It is possible that he and many others continue to associated the nakedness of sex with Vietnam images of grotesque bodily disintegration – as did Guy Sajer, with memories from the German Army experience of World War II: “As soon as I saw naked flesh [in a beginning sexual encounter] I braced myself for a torrent of entrails, remembering countless wartime scenes, with smoking, stinking corpses pouring out their vitals.

 

[2] I use the term fidelity here to suggest more than loyalty, though loyalty itself was of great importance.   Also involved was authenticity – in sexual matters, for instance, the genuineness of an impulse to find a new partner at precisely the time that an existing relationship showed promise of deepening intimacy.  Fidelity thus involved being true to, having faith in, the animating principle of the new self being formed.  It included overcoming fears that one’s residual destructiveness and death taint would not harm or contaminate others.

Understanding the Veteran: Amount of Combat Experienced

Here's an interesting quote that helps to define the Vietnam experience, although the principle involved is the same irrespective of the war.  More combat = more chances to develop PTSD, as we've already covered in an earlier post, linked here.  It's important to learn from the combat veterans in your life just how much they actually experienced, even if they and you don't want to share the actual details.

"During World War II, the Sixth Marine Regiment served four years in the Pacific but only engaged the enemy for about four weeks. In Vietnam, the combat soldier typically served a 12-month tour of duty but was exposed to hostile fire almost every day of his tour."

Source: Article called "Vietnam Veterans, U.S. Crime and Prison," by John J. O'Connor in the New York Times, July 15, 1982.  The quotation is from the narration of a movie called "Vietnam Requiem."

Eyewitness to Combat - Misplaced Guilt Trip - Even the Survivors Lost (Survivor's Guilt)

This is possibly the most intense and heart-wrenching of the reminiscences of Pat, the young Marine who served two tours in Vietnam, whose recollections we are excerpting in this "Eyewitness to Combat" series.

 

He is shot five times, in the arm, leg, back and head, seriously wounded, medivaced out of Vietnam, and recovering stateside in Balboa Naval Hospital, when he gets some news that will change his life forever. If you read the foregoing episodes in the series, you learn a little of what the combat he saw was like. 

 

But let's pick up in his own words with how that affected him:

 

"Almost everything that I had done and experienced generated a corrosive guilt that continued to diminish any hope of a joyful life that I could have had. But the one event which brought overwhelming guilt and probably attributed more to my “death wish” than anything else was the one event which I had not even taken part in.

My unit had been completely destroyed and I wasn’t there to die with them. I was a coward: I had run away and hid and because of this, I was responsible for the complete elimination of “Bravo” Company.

 

That is what my mind was telling me -- even though I was stationed in the Balboa Naval Hospital, being treated for severe wounds that I had received when my platoon had been ambushed and annihilated on Hill 861 S. in Khe Sanh, South Vietnam.

 

I was notified of this event when a Navy Corpsman came into the ward that I was confined to and said “Weren’t you in Bravo Company, 1/9? I found an article in Time magazine that has an article about them getting wiped out. I thought you would like to read it.”

 

He could not have affected me more if he had hit me in the stomach. I read it and I silently cried for the first time since I had returned.

 

I was completely overcome with shame, and survival guilt took up permanent residence in my heart: I swore that I would never let the memory of them get lost, and that I would always carry the torch for them.

 

I looked out the window and there on the street outside of the Hospital entrance a large “anti-war” demonstration was in progress and the hatred was directed at the wounded vets while my beloved Bravo Company was gone, they were all dead, wounded or missing. I was twenty years old and I absolutely hated America.

 

The article epitomizes what the misplaced guilt trip was all about: “115 Dead, 276 Wounded, 26 Missing, A Battle Without Victory: The Wipe-Out of Bravo Company.” There were no winners, only losers again; even the survivors lost."

And then, in an echo of why other teenagers self-harm, such as by cutting themselves, in an attempt to "balance" the pain externally with the pain they feel within, we hear Pat describe the aftermath for him:

 

"I spent the next 35 years trying to find out “why some people survived and others didn’t”. More specifically, I needed to understand why I had “dodged the bullet” when so many other Marines had “bought it”. I constantly sought a place where the pain going on around me and outside of me matched the pain inside my head and which was literally eating me alive.

 

As weird as this sounds, the more I hurt physically, the calmer I felt. Only physical pain could suppress the mental pain that was always present. It was as if I had to be constantly punished just to survive. "

Despite the thousands of words that Pat has written to describe his experiences, his description of this episode in his life made me wonder if it in fact was the pivotal episode of all.  As to why he didn't deck the world's most insensitive human being -- the Navy Corpsman who "dropped" that bit of "news" in his lap?  Pat says that if he hadn't been lying in the hospital bed, shot up and paralyzed on one side, he would have been happy to.  I can easily see why.

The Other Purple Heart: For Wives, Husbands and Partners of Those with PTSD

The Bible, in the section known as Proverbs (from the Wisdom Literature tradition), has a stunning description of a woman known as the "Proverbs 31 Woman," or the "wife of noble character."  Here's just one sampling of what she's said to be like: "A wife of noble character who can find? She is worth far more than rubies. Her husband has full confidence in her and lacks nothing of value. She brings him good, not harm, all the days of her life."

From the spiritual to the secular, we have another example of the same in the praise that well-known philanderer Ben Franklin (and yes, that's a man who collects paramours, not stamps -- in his case, on two sides of the Atlantic) heaped on his wife, Deborah, for being the highly-cliched but apparently in their case, true, "wind beneath his wings."  While Franklin became famous for, among other things, his witticisms about wealth in "Poor Richard's Almanac," he often credited his wife and her good habits with being the reason they saved any money at all. (I'll find the reference later, but it's true.)

Well, if you scratch the surface of PTSD and veterans, you quickly find how many of the perhaps less famous (guys get famous) , nonetheless vitally key players, heroes and and true angels, are women.  There's Sarah Haley, who we read about the other day; Kathie Costos; Patience Mason; Aphrodite Matsakis; the list goes on and on.  (We fully expect that Kellee Twiggs was that kind of woman, too; as is Bet Ison; as is the highly-impressive Jennifer Briest, though that's TBI not PTSD.) And now, there's Pat Kemm Mann who we can add to the list.  (Not the same "Pat," whose wonderful insights and recollections into his time at war we've been reading about in the "Eyewitness to Combat" series.)  This lady is one impressive person, in her tremendous caring for her husband who she met and married when he had PTSD, as well as her remarkable smarts and strength of character in being the support he and their subsequent family needed.  Just an amazing woman. 

Not saying she's likely to be the only one out there -- actually, she reminds me very much of Kathie Costos, through whose blog I learned about her story, and secured permission to reprint it here -- but she IS very much worthy of our admiration, and she is also articulate and organized enough to tell her story in a compelling way: a story she's willing to share in the hopes that it helps younger wives and women learn what it takes to "love someone with PTSD" and be a real support to them in the life they build together.  As we read about yesterday in the Tao of Caring for Others, sometimes caring for someone else can be just an expression of who you are.  In Pat's case, that's the story.  Here it is, in her own words, about "loving someone with PTSD":

"At the age of 32, I met a man who wasn’t intimidated by my independence or education. A man who made me laugh, introduced spontaneity into my life and who cherished me. He was a 30 year old Nam vet...and twice divorced. But we shared the same family values and dreams for the future. When he proposed, I told him that I was not going to be his third wife; I would be his LAST wife. I only intended to get married once.

He told me that he had a dark side. I had no idea what he meant. I was to find out within months of our marriage. He was driven at work. Always put in more than was required. Naively, I just assumed he had a strong work ethic. I didn’t realize he was trying to escape demons. He had warned me about nightmares; told me how to wake him so he wouldn’t inadvertently hurt me. As a GI Brat growing up in a family with a strong, military tradition, I didn’t think it that unusual since I had several uncles with the same problem.

3 months after we married, however, his behavior began to change noticeably. He began “self-medicating” with alcohol. And he began seeing things that weren’t there. Hearing people calling him for help. Sometimes hearing a child cry would make him jumpy. The smell of urine would bring flashbacks. He had to sit with his back to the walls in restaurants. Anxiety attacks in crowded places. Sudden noises, like party balloons popping or a car back-firing would make him jump or even “hit the deck”. He would be embarassed and apologetic, telling me it sounded like small arms fire.

I was to learn that he had entered a 6 month period of “anniversary dates”. Not pleasant anniversaries. Anniversaries of the Tet Offensive, of being left for dead under a pile of bodies, of being a VC POW (until he managed to escape), of ambushes, being overrun, of being shot down, wounded and crawling and hiding for 7 days until he reached a friendly LZ. All of them crashing down on him like an avalanche of horror.

One day he came home from work and instead of coming into the kitchen where I was washing baby bottles, he went downstairs to the basement. That was unusual but I didn’t think too much about it. Then suddenly I felt an overwhelming sense of panic. I dropped the baby bottle and ran down the stairs. He was standing under them, in the dark, with a pistol in his hand. He was exhausted and terrified of going to sleep because at least when he was awake, he could see what was happening around him as well as the “film” his mind was playing. But he couldn’t make himself blow his brains out because he didn’t want me to have to live with that image forever burned in my brain.

The term PTSD wasn’t known then, or at least not known by many. But I knew my husband was suffering from “Combat Fatigue”. He didn’t want to believe that. Hell, he was a Hillbilly. A rough, tough coal miner. A combat hardened Marine. A third generation Marine... But one who’d been on Valium (through a civilian doctor) since he finished his second tour of duty.

He ended up starting therapy before our first anniversary. The man I had fallen in love with was slowly disappearing, being overshadowed by an often cold, uncommunicative loner. Sometimes I felt like a Life Guard, hanging on to a drowning man, refusing to let him go under.

But I had an advantage that many of the younger wives of combat vets didn’t have. Growing up on military bases. A brother and friends who’d gone to Vietnam while I was in college. I was 33 years old. And I had enough psych courses under my belt that I was able to "deal" with the nightmares, hallucinations, rages, and suicidal ideations as well as monitor and administer the massive quantities of anti-psychotic medications the VA was doling out... (and to eventually question the efficacy of most). Even so, the pain of seeing him look at me, with total confusion in his eyes - knowing he doesn’t know who I am but thinks he should... the pain and sorrow was indescribable.

His cup of stress was full to the brim from memories alone. Anything at all, no matter how minor, was like that one extra drop that causes the cup to overflow. Every car “accident” - always single car accidents, one near fatal - happened immediately following his 6 months of anniversary dates, when he had reached the limits of his endurance.

At one point, we lived on the Texas coast. Driving to the Houston VA was a challenge. It’s a nice, straight highway but for long stretches, it has rice paddies on both sides. He drove hunched over the steering wheel , knuckles white. Eyes darting constantly left and right. Muttering about damn rice paddies. I knew what he was doing and finally told him “I’ll drive. You watch for Gooks.” After that, I always drove that stretch.

I found myself “interpreting” other people’s actions and comments to my husband so he wouldn’t deck someone who had merely glanced our way but whom he thought was challenging him. He was quick to anger and quick to fight. But he was mostly able to keep his promise not to get in fights after I told him I knew he could take care of himself but no matter how the other guy looked, it hurt me to see him with scraped and swollen knuckles.

It wasn’t easy. And it wasn’t fun. But the man I loved was still in there and I was determined to beat back the demons that were dragging him down. We lost some friends who just saw him as crazy or irrational or scary. I remember once asking “Who are we not friends with this week?” His head kind of jerked, he looked at me for a moment and then he laughed. It stopped another rampage over an imagined insult or slight.

He had no patience at all. If we decided to go somewhere, the girls and I had to be ready to go the second he was. I’d remind him that no one’s life was in jeopardy if we were slower than he wanted. The thing that did the trick, though, was the time I finally took the car keys from him, handed over our two small daughters and told him that this time, HE could get them ready to go. I’D sit in the car and honk the horn.

He started group therapy and we found friends who understood because they were going through the same thing with minor variations. Almost all had done the “geographical tour”, moving from job to job or state to state as they tried to escape what was inside them. Some had used alcohol, prescription drugs or even street drugs to escape the psychological pain. And, like so many of the guys, his previous marriages didn't last simply because he couldn't let himself care that much and did everything he could to protect his fragile emotions from being fully engaged. A lesson he learned too well from losses in combat.

For some reason, he trusted me enough to open up about a few things that happened in Nam - things that clawed and burned in his mind. Which was both a good and a bad thing for him. He knew he had a safety net but letting those painful memories out (those he hadn't completely blocked, anyway) ripped the scabs off some horrendous memories.

Our two daughters were old enough to know that their Daddy was different from most of their friends’ daddies. But our daughters maintain that the thing that helped them understand their dad the most was that I always explained his behavior to them in terms that were age appropriate. One thing I'm especially proud of was when a VA Therapist asked me how I'd managed to raise such normal kids. While they didn't always LIKE him or what he was doing, they always loved him and knew that he loved them in return, even when he would "go bush", miss out on important events in their lives, or self medicate to excess.

And yes... he went to counseling and group therapies. We went through marital counseling and family counseling as well after one particularly rough patch. All of which were extremely helpful only because he was able to get outside his comfort zone, accept the validity of our feelings and make the effort to change certain behaviors.

When his PTSD, appointments and hospitalizations began to interfere with his ability to support his family, we began the torturous process of applying for disability. And we had to do it all over again for Social Security. Writing to every doctor he’d ever seen, every hospital he’d ever been in and trying to locate witnesses who had made it home, up to ten years after the fact.

I had to help him with the VA claim statement. I remember sitting, after the girls were in bed, writing down what he said as he spilled his guts and his pain all over the dining room table. Crying inside because of the horrors he went through and yet not daring to show any emotion on my face because it would have made him stop talking - for fear of upsetting me, disgusting me, or making me think less of him. And then having to sort through the jumble and make complete, intelligible sentences out of it.

I am eternally grateful to the PVA (Paralyzed Veterans of America) service rep who took the 13” thick stack of documents covering 10 years and went to bat for my husband.

In spite of one VA doctor who attempted to keep me out, I sat in on every appointment with my husband after I realized that the doctor didn’t know half of what was going on. This was something I felt very strongly about. I had to play an active role in his treatment. No one knew him better than I did.

The doctor would ask “How have you been since I last saw you?” And my husband would reply “Fine.” Then I’d jump in and tell the doctor what I’d observed. He WASN’T “fine”. And the fact that he couldn’t recognize his actions as irrational proved my point! Reactions that can keep you alive in combat are not always appropriate Stateside. Asking some of these guys how they are is like trying to get a blind person to describe the color yellow.

And I remember the anger I would feel each time a new doctor was assigned to my husband. The dreaded First Three Questions: Have you ever seen anyone killed? Have you ever been in fear of your life? Have you ever killed anyone? Check his records! 3 Purple Hearts. Siver Star. Bronze Star. Presidential Unit Citation. Combat Air Crew Wings with 3 or 4 devices. You don’t get those sitting behind a desk!

We've had our share of difficulties and I've often been asked why or how I stuck it out with him. My answer was always very simple: He's a good, kind, and decent man with serious problems. I wouldn't leave him if he had Cancer; I won't leave him because he's got emotional or mental problems. With close friends, I laugh and say "Because I'm strong, stupid or stubborn. Haven't figured out which yet!"

After almost 30 years, we're still married. Our family is stronger and closer than ever. The grandchildren all love their Pa-Pa and he adores them. Both daughters have chosen careers in medical fields where they can help others and are totally comfortable dealing with what some of their co - workers call "crazy Nam vets". And they're quite vocal in the defense of these guys. I'm proud of them. But then, almost all of our best friends are men (and their families) that we met while they were in the “Nuts and Flakes” wards at various VA Hospitals.

And I'm proud of my Marine, a crew chief and door gunner on med-evac choppers who served two tours (during which he endured being shot down 13 times, left for dead 3 times and 58 days as a POW of the VC). Once, he apologized to me for "being so weak". I told him he was the strongest man I'd ever met and that I would never want to be with a man who saw and went through what he did... without it bothering him.

My husband is worth the effort it’s taken and the rewards are immeasurable. He’s not “well” by any means, and he may never be because serious help came too late. But we have a good marriage filled with humor, love, respect and trust that goes both ways. Even with the problems, that’s still more than many have.

I have hope for our new Walking Wounded. No one questions the reality of PTSD anymore. More help is out there. I just hope that those who need it are informed that it is available... without the stigma my generation had to fight and without the delays that make it less successful.

Pat Kemm Mann
Fruitland Mesa
Crawford, CO 81415

Sarah Haley - Psychiatric Social Worker, PTSD Pioneer, Friend of Veterans

Gerald Nicosia's book Home to War: A History of the Vietnam Veterans' Movement, is fascinating reading, if only to keep in mind the wisdom of the George Santayana quote, "If we do not learn from the mistakes of history, we are doomed to repeat them."  Nicosia goes into much detail about how the PTSD diagnosis was first determined and included into the DSM, and along the way he paints the picture of many of the key participants, including Sarah Haley, in first treating Vietnam veterans for combat trauma and the resultant PTSD.

Whenever we look at history like this, it becomes apparent that whoever is impressive today in this work owes so much to pioneers like Haley (who Nicosia discusses) and Lawrence Kolb, M.D. (who Nicosia oddly does not).  "Standing on the shoulders of giants" is the semi-cliched expression about what present practitioners owe as a debt to the pioneers of the past, and it is certainly true about Haley's work: she was a true giant.

Here I'm going to excerpt, with Nicosia's permission, parts of the many passages about her work so you can see three important things: what her background was, which gave her a special compassion for the truth the veterans first presented with; the extent of her rapport with and trust established with the veterans themselves, which allowed her to help them; and some of her more intuitive leaps about what PTSD really meant from the lives of veterans with whom she consulted.  What a truly remarkable person; and what a shame she's no longer with us, so that we can continue to benefit from her truly outstanding work with veterans.  (Few of these quotes are continuous; most skip around from important part to important part, with the gap indicated by the ellipses)

Haley's background:

"It was a woman .. a psychiatric social worker named Sarah Haley, in the big VA outpatient clinic in Boston, whose research into veterans’ stress disorder literally blew the existing psychiatric definitions to pieces and began to put a whole new definition on the map.

"Sarah Haley [initially] seemed the least likely person in the world to make waves…

Her friends all warned her that the VA’s psychiatry program was “fifth-rate,” that she would find herself treating ‘chronic schizophrenia and passive-dependent men with bleeding ulcers,’ and that her career would surely go down the tubes.  But despite the fact that she entered upon her new VA job with the meagerest of expectations, she couldn’t help being ‘shocked at the low caliber of the general run-of-the-mill health person there.’  As she recalls, ‘These were not mental health people that you would want anybody in your family to get near.’"

 

Haley's first astounding discoveries:

"One day, a young man in a highly agitated state was brought into the clinic by his parents.  He had only been home from Vietnam for three days, and his parents had no idea what to do with him.  He was having total body tremors and exhibiting ‘startle response’ every few minutes.  If a car backfired or a door slammed, he would dive under the nearest table.  After much rambling, the young man told her he had been at a place called My Lai, that terrible things had happened there, but that it was difficult to piece it together.  He was confused and experiencing a lot of amnesia, but he did remember seeing the bodies of women and children and vomiting into the bushes.  He also remembered that he could not shoot anybody himself, that he had thrown his gun down.  The American soldiers who did the killing had sought to intimated him and the others who didn’t shoot: ‘If you ever tell anybody, we’ll come get you.  Or we may come get you anyway.’

 

…

"Indeed, any other intake worker might have dismissed [this recent Vietnam veteran] as delusional, but Haley had reason to believe him.

(Her father had been on special operations with the OSS in North Africa during World War II, a self-admitted ‘assassin for the government.’  He had told her about seeing a truckload of German prisoners who were led out and made to kneel in front of a ditch, where an American officer shot each one of them methodically in the back of the head.  Then the Americans dumped their bodies in the ditch and shoveled it over.  Thus Haley, as she puts it, had “no illusions about war.”)

 

How Haley worked with veterans and understood their particular trauma:

"Haley had nothing to go on but a big hunch, but she decided to follow it.  It seemed to hear that a lot of mental health professionals – especially those at the Boston VA clinic – had great difficulty in listening to the recital of trauma: as a defense, they either disbelieved it off the bat, turning it into the less threatening notion of “delusion,” or else withdrew from the patient as quickly as possible so as not to have to hear more about it. 

 

The other horn of this troubling dilemma was that the traumatized person, especially if he was a Vietnam veteran, would almost never come in and spill his guts to a perfect stranger.  Trauma patients need to establish trust with a therapist, and the Vietnam veterans coming into the VA clinic were never being given the chance to do this.  It was by the merest lucky chance that the My Lai veteran had seen something in Sarah Haley that made him believe he could confide in her, thereby opening the door not only to his own dark secrets, but also to possible help for a whole generation of trauma victims.

Haley perceived correctly that the reason the My Lai vet could not remember all the details of his trauma was that much of the most painful material had been repressed.  In the coming years, she would encounter the same phenomenon in hundreds of Vietnam veterans, some of whom could only recall five or six months of their 12- or 13-month tours of duty.

 

More insights into how Haley worked with veterans, and uniquely modified the approach for dealing with combat trauma:

"She further realized that the stuff was eating away at them would have to be brought slowly and steadily to the surface – that there were no quick fixes, like ‘5 mg. Stelazine daily.’  Equally ineffective, she would soon discover, was ‘the sort of non-authentic treatment’ where the professional would talk about family issues or other daily matters that were troubling the patient, but never bother asking about the existence of trauma in his past; for if the professional didn’t ask, the trauma victim would seldom bring it up on his own. Haley was aghast to learn, for example, that an analyst friend of hers had “successfully” treated a Vietnam veteran solely on the basis of working through the rivalry with his father and never even asked the veteran about his [combat experience.]

"Most of the Vietnam veterans Haley found were coming in to see a VA psychiatrist merely so that they could get their next month’s supply of Valium.  Haley would go to the psychiatrists and inquire whether they had ever asked these veterans about their Vietnam experience; the usual reply from the shrinks was that they had stopped asking because the veterans didn’t want to talk about it.  Haley was flabbergasted that none of the VA psychiatrists – with the exception of two notable women, Lillian Rodriguez and Constance Hartwell – evinced any interest in learning the cause of the tremendous anxiety for which they were blithely prescribing shelves of medication.

Unique problems to Vietnam veterans that Haley noted:

"During those first few years at the VA, Haley encountered a great many vets who talked about participation in atrocities.  she found most of them to be ‘terribly guilty, feeling unclean, and not worthy to be back in the world.’

…

 

"… Instead of hearing, “Doc, I have a bellyache,’ or “Doc, I’m seeing visions,” or “Doc, I’m terribly depressed,” what Haley would hear time after time was, “Doc, I think I’m a murderer… I slaughtered innocent civilians.”

 

And finally, Haley's substantial impact:

"Working with these men and the material they brought up was so painful that it took Haley almost two years to complete her article…which was immediately recognized as a landmark work.  By precise delineation of the symptoms of several veterans she had treated, Haley established that the Vietnam veteran who had witnessed or taken part in atrocities could not be handled merely as a traditional case of traumatic war neurosis, but presented a completely new challenge to psychotherapy."

Sarah Haley was indeed a remarkable woman, and a great Friend to Veterans.  So much of the unique and compassionate approach to understanding PTSD's impact on veterans comes directly from this woman's work, and for that we are deeply appreciative and honor her in memoriam.

Eyewitness to Combat: What Fluttered in the Trees

Another installment in our ongoing "eyewitness to combat" series.  Beware that this materail contains graphic images of war, not for the squeamish or the faint of heart (although the image to the left that appears to be a human being's body is actually a strangely human- shaped tree root):

During June of 1966, the entire Battalion was committed to Operation Liberty.  I was detached out to Foxtrot Company for this one.  We had been running County Fair Operations throughout the 2/9 TAOR and much of the northern part of it was declared as cleared of V.C. 

However, the southern portion south of the La Though River to the Key Lam River was still not cleared and was literally crawling with the V.C. This operation was supposed to be an on line sweep clear to the Key Lam River with each company having their own objective area of responsibility. 

 

We were to secure Route 4 to the river.  This area was where we had made contact with a large V.C. force in April and it really made me jumpy.  Mines and booby traps were everywhere and the area was covered with punji stakes and spider traps. 

 

As we moved across one rice paddy through a tree line to the next rice paddy, we had cleared a safe area. 

 

However, Nick Sparicino or some reason just cut through an unsecured brush area before we reached the cleared area.  He had just stepped into the tree line when he dropped and screamed in agony.  He had stepped into a punji pit.  The bamboo stakes had impaled his lower leg and calf and the punji stakes around the sides of the pit and pointing down had impaled his thigh pinning him there. 

 

He screamed; “Pat, Help Me! God Dammit! It Hurts. Hurry!”  I ran to him and Bradford and I grabbed him under the arms and tried to pull him up enough to get the pressure off of his leg.  Another guy started digging around the outside of the pit to get him out.  This took a really long time because he was so stuck and bleeding like crazy.  

We were all sweating like pigs and he kept slipping.  We would just about have him out and then he would slip and fall back full weight onto the punji stakes and he would scream out in pain.  The muscles in my arms were starting to cramp us but I couldn’t let him go until we got him out.

 

He continued to scream and started really shaking.  This made it harder to hold him up.  We finally got him free and were able to pull all of the stakes out of his leg.  One went up through his foot into his leg; another went up through the calf and ripped it completely open to the bone. He had three really deep punctures in his thigh where the lateral spikes had got him. 

 

Doc gave him morphine, the chopper came in and just like all of the others, he was gone, never to be mentioned again as if he also never had existed.  I had allowed myself to get close to him and we had been through a lot of shit together and he was gone.  I did not like making friends.  I was feeling very alone as we all did.  Hadn’t had been killed in the last of May, and now Nick was gone.

 

The next morning, around the 11th or 12th of June we moved across one large rice paddy, over a dike across a shallow channel and onto a grassy field bordered by very thick and dense tree lines.  The flanks and point squads had already moved across and then the center portion of the platoon came onto the field.  I was still carrying a flame thrower and could not clear the ditch in one jump, so I jumped into the bottom of it. 

 

When Nick had been wounded, I had to take the tank again and its weight caused me to bend at the knees and waist when I landed in the ditch.  There were several loud simultaneous explosions and dirt pelted me all over.  My ears were really ringing. 

 

When I came up, there were Marines knocked down all over the open field and the dry grass started to burn from the explosions.  We had walked into a mine field full of Bouncing Betties and booby trapped with artillery rounds.   This was some real serious stuff.  I was afraid to try to help because of more mines and afraid not to, too. 

 

I thought of De La Fante and dropped my tank and got to the nearest guy.  He was really messed up.  The other squads were now moving in to help.  I thought: “We are dead if they hit us now.” 

 

There were arms, hands, legs, feet, boots, helmets, busted rifles, and body parts and pieces of Marines and blood swaths scattered all over the field.  The fire was burning toward the wounded and dead and setting off other mines, taking out even more Marines.   I thought to myself, “This is some really, really, bad shit!” 

 

Guys were moaning and screaming out in pain all around me and their bodies were convulsing like crazy.  I didn’t know what to do other than to just try to stop the bleeding of the one that was next to me and put out the fire as it came close to someone.  Everyone around me was down.

 

The clothes on the wounded Marines were starting to catch on fire as they lay in its path. Other Marines started to pour out onto the field from the tree lines and rendered whatever aid they could as they began stomping out the flames around our guys and emptying their canteens on the burning Marines. 

 

When this was gone many of those rendering aid began to urinate on their buddies to put out the flames.  This became a very frantic effort as we also began to take sniper fire from the tree-line dropping other guys as they tried to help their wounded buddies. 

More jets came in and dropped 500 pound napalm bombs on the tree-lines and after a while the snipers became silent.  They had been either killed or had simply moved back down into their tunnels and disappeared. 

 

After the fire had swept through the field and the wounded were finally taken out by media, those of us that were left were ordered to get on-line and sweep across the area to police up body parts, equipment and ammo. 

 

As one of the choppers was taking off, I noticed something flutter in an un-scorched nearby bamboo tree-line. I looked closer and it was the face skin and scalp of one of our dead guys.  It had evidently been completely blown off of his skull and had landed in the bamboo thicket and was caught on one of it branches.  The blade wash from the chopper had caused it to flutter and move to where I could see it. 

 

It made me wonder what in the hell we were supposed to be accomplishing other than getting friggin blown away.  We took all of these horrific casualties and didn’t fire one friggin shot at anyone.  Hell, we didn’t even see anyone to shoot back at.  It took us all day just to clear the field of our wounded, dead and spent equipment and body parts.  I hated it then and just wanted to kill something really, really, really bad.

Eyewitness to Combat: Surviving the Casualties with "Out of Sight, Out of Mind"

(This material in this post is reminiscent of and confirms that in the recent one from the OEF/OIF era, that talks about how it's best to "shut down, block out, give up being yourself" -- if you intend to survive the psychological rigors of combat trauma.  Two different wars, separated by decades: same "coping" strategies of combat veterans.)

 

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In our ongoing series of "eyewitness to combat," here are some more remiscences of Pat, the young Marine's, first tour in Vietnam:

 

Sometime around the middle of April, I was still attached to Hotel Company and we had been moving south toward Highway 4.  It was constantly hot as hell and we had been taking sporadic and effective sniper fire and had encountered a few mines and some booby trapped gates.  However, we had not made any real eyeball-to-eyeball contact with the V.C. even though we knew that they were all over the place. 

 

There was an abandoned ARVN Army outpost at Phuong Thu.  We set in our position just north of Highway 4 right across the road bed.  We dug two man fighting holes or fox holes, and where I was, we were defending an area about the size of a football field. 

 

It got dark, real dark with no moon at all, and was very hot and still.  Again no one had slept much during the sweep and the mines had us all keyed up.  Several squads had been sent out to establish ambush sites and listening posts had also been sent out.  We rotated these every night with different squads going out, ambush one night, parameter defense the next, and sweeps during the day.

 

I had just finished my watch and had passed the watch to Worsley.  Just as he was waking up we started receiving mortar and recoilless rifle fire and all kinds of stuff broke out south of the road where one of the ambush squads were.  Tracers were going everywhere.  Worsley jumped up and said; “What the Hell?” 

 

Then the V.C. attacked from across the road and began to really lay down a high level of automatic AK 57 rifle fire. 

 

Through the flashes we could see that there were really a lot of them.  The mortars kept coming but were primarily hitting toward the center of our position.  Everyone was shooting and hollering and we shot a lot of them as they crossed the road toward our position. 

 

Whenever they came upon the road they were completely exposed and made a somewhat easy target.  A bunch of them were killed in the rice paddy in front of us.  Our own mortars were putting up illumination rounds as well as our artillery. 

 

When our 155’s started coming in, the V.C. shelling of our position stopped but they kept coming in to drag off their dead and wounded.  People were getting hit all around us and the call for “Corpsman Up” was going on from everywhere. 

 

After a real intense period of time, they stopped their main attack but continued to probe us the entire rest of the night, again mainly to get their dead.  I was real frightened and excited at the same time and for a while wasn’t real sure of the outcome.  

 

When daylight finally came, we were all completely exhausted from the intensity of the battle and from the gigantic adrenalin rushes we were experiencing.  However when we finally were able to take an accounting of the fire fight, all that we found of our elusive enemy was a whole bunch of blood trails, body parts and some clothing and a few weapons and scattered ammo. 

 

There were only about ten or so V.C. bodies that could be absolutely counted but we had experienced a whole lot more Marine Corps casualties than that: killed and wounded. 

This really did a mind job on us and made the hatred for them very engrained.  We had fought most of the night and the only thing we had to show for it was a bunch of our guys hit.  I think that we had almost 50 plus casualties but it looked like a hell of a lot to me. 

 

Choppers came in the next day to take them out.  There were a bunch of medivac Hueys. 

This was really discouraging.  I thought that finally we had had a real shot at ‘Charlie’ and we still got our asses kicked.

 

After all of the casualties were gone and the battle field was sanitized; we just filled in the fighting holes and continued on south of Highway 4 toward the Key Lam River, again as if those people never existed and to never be mentioned again.  You learned to survive the casualties by “Out of Sight, Out of Mind”.  Once you were hit and removed, it was like you’d basically never existed.

Eyewitness to Combat: A Farce of Filth, Fear and Killing

In our ongoing "Eyewitness to Combat" series, here's another recollection from Pat, the Marine who went to Vietnam right out of high school, and landed in a completely different world.  Beware: this entry has graphic images of war that are not for the faint of heart.

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"For the next couple of days we continued to sweep along rice paddy dikes, hedge rows, and toward some occupied villas that had been labeled V.C.  During this time we hit more mines and took sniper fire during the day and sporadic mortar fire at night, and lost more Marines but never saw the enemy or returned any fire. 

 

No one had fired a shot in their defense.  We couldn’t even hit back.  And all the while, the villagers just looked on as if we were just cattle.  We would hit a mine and they would look up from their field work, grin, and go about their business as if nothing had occurred.  There was just no one to shoot back at.  I felt like I was in a shooting gallery. 

 

A few more of the guys in the flank squads stepped into punji pits and had been impaled with punji stakes set out along the sides of the trails.  A sniper would open up and take out one of our guys; everyone would dive for cover and become impaled with the punji stakes. 

 

Then when we would try to recover our wounded the snipers would continue to take out our guys, piling them up like the flies that my granddad used to swat on his back porch. 

The incoming mortar fire, at night, became so accurate that we would set in just before nightfall; start digging in, and after dark, fill up the holes, move to a different location and re-dig in. 

 

I had been in-country less than 30 days and was real confused about what I was experiencing.  I kept waiting for this great enemy attack.  I thought that we should be doing something; like getting into the damn fight. 

 

This was a terrible feeling: to know that I could die at any time and not have ever been able to even fire a single shot in retaliation.

 

We were all exhausted, no one slept, we were extremely angry, we were miserable and everyone was real pissed off and we just wanted to get a crack at ‘Charlie’. 

Then we moved into the parameter of a small villa below the Cau Do in the Duong Son II hamlet area.  It seemed deserted except for some pigs, a couple of food dogs, and some Water Buffalo that were left in a pit beside a couple of hooches.  There did not appear to be anyone around.  

 

Then we took some sporadic small arms fire from one of the hutches, which dropped one of our guys.  Everyone instantly opened up and were firing and yelling like crazy men.

The lieutenant yelled, “flames up!” and Nick Sparicino and I moved immediately forward at a run.  The lieutenant pointed at one of the hooches and yelled: “Torch It!” 

 

I moved into the open area, struck the match (sparkler like igniter) and started torching it.  My heart was pounding so hard that it make my ears hurt. 

 

I fired into the doorway, through the front two window openings, and then up over the roof.  Suddenly the most frightening scream I had ever heard up to that time started coming from the inside of the hooch and someone ran out of the doorway still burning with napalm. 

 

I instinctively brought the flame down and followed the gook out into the courtyard and stayed on him until I ran out of fuel.  He was holding some form of weapon to his chest and I used that as my target.  The heat was so intense that it actually burned the hair off of my arms and face. 

 

Nick and I moved back.  The hooch went up faster than I had thought it would.  The screams lasted, it seemed to me, a long time.  The gook was knocked to the ground and was jerking, rolling, and thrashing his arms and legs kind of like De La Fante and in some way I felt a weird sort of satisfaction.  Nick shot him several times and then started firing into the hooch where other screams were still coming from. 

 

One of the other Marines had picked up a couple of the pigs and had also thrown them into the flames of the burning hooch.  They squealed like crazy.  The hooch collapsed and everything got real quiet.  The hooch was burning, the gooks were burning, the pigs were burning and there was an air of electrical energy everywhere. 

 

Nick kicked the weapon away from the gook and it was a small child, and the gook was a woman, probably the child’s mother.  Nick and I looked at each other and felt sick.  He just said: “Jesus Christ, Pat” and shook his head. 

 

This was the first time that he had fired his M-14, the first time I had fired the flamethrower in combat, and this just wasn’t the type of real combat that either of us had imagined. 

 

The other squads started shooting the other pigs, the dogs, and even the water buffalo in the pit.  They had also set fire to all of the other hooches in the villa and there were secondary explosions from the weapons and ammo stored in them. 

 

We pulled back a little further as these intensified.  I refilled my tank from Nick’s five gallon re-supply can of napalm.  Everything burned for quite a long time.  More gooks were pulled out of the hooches.  They were black, raw and burned to a crisp. 

 

Bones in the skulls, fingers and legs were showing.  The teeth on their faces showed and that really hit me hard.  I went over to pull one gook into the clearing and the skin on his arm came off in my hands leaving his arm raw red meat and bone. 

 

This also hit me like a blow in the stomach. When we had gotten all of them out of the hooch that Nick and I had torched there were five bodies; a man, two women, a small boy, and a baby. 

 

Their bodies were grotesque and the smell, like burning hair, was pungent and stung my nostrils.  I could never get that image out of my mind, ever.  Nick and I couldn’t even look at each other. 

 

I was 19 years old, Nick was 18, the Lt. was 21 and the Sergeant was the old man at age 25. The Sergeant just called in a body count with everyone having the same value, big or little, man or woman. 

 

If it had not been for the rage that had built up prior to the engagement I didn’t want to be there anymore.  This was not the kind of war that I had come to fight and I still had 12 months more of it to go.  In fact, this process was repeated more or less endlessly over the next three months in the friggin’ rice paddies.

 

I had lost something important, though, and no longer felt in control of my destiny.  I hated everyone who had sent me to Nam.  I was still numb, I was still angry, and now I was also emotionally dead. 

Catharsis: Art Therapy, Trauma and PTSD

At almost 500 posts, if I had to choose the them that represents the underlying intention of this blog, it would be the Greek word, catharsis -- a word which suggests a transformative state change, in which "the only way out is through." 

 

Combat trauma, which often so clearly plagues veterans' lives, and frequently develops into PTSD, is much easier to "diagnose" than it is to "cure."  My goal on this blog has always been to find what methods, no matter how diverse or unusual or at first, unlikely might have potential for "clearing' combat trauma from the combatant, to whatever degree is possible (and that may be different from person to person).  Understandably the images from and the experience of combat are lodged deep within the veteran's psyche, from where they often continue to torment him or her over the course of literally decades. 

 

While various approaches including psychotherapy, EMDR and especially pharmaceutical medications are typically tried in an effort to relieve, manage or otherwise control the symptoms, it seems that a greater goal would be to achieve any success in actually removing the pain and the grief associated with these memories.  This might allow the combat veteran to integrate these extremely difficult experiences into the whole of who they are today, realizing that they are as much a part of them as anything else they've experience over the course of their lives. 

 

Instead of focusing on the painful scars, the idea would be to clear as much of the associated pain and grief, leaving only the experience, without the accompanying triggers.  Can this be done?  Is anything managing to do that?  I think that's why this blog exists, is to take a look at each of those alternatives in turn, and see whether they appear to be useful and effective methods for clearing combat trauma.

 

To that end, we have considered pretty much everything that might possibly have merit, in the hopes that veterans will find among these offerings things that intrigue them or "speak to them" individually to try, ideally in concert with the efforts of a qualified healthcare provider, who is sensitive to veterans' concerns.  Periodically, we mention therapeutic approaches that do not seem to need an outside healthcare provider's involvement, things like like mindfulness meditation, yoga, mind-body medicine, art therapy, music therapy, writing and poetry, among others.

 

It's interesting to see that the New Dictionary of Cultural Literacy, Third Edition, defines "catharsis" as "An experience of emotional release and purification, often inspired by or through art."  In psychoanalysis, they continue, "catharsis is the release of tension and anxiety that results from bringing repressed feelings and memories into consciousness."

 

Notice how if we combine those two concepts, it suddenly has potential to attempt to clear some of the negative emotions associated with trauma through what amounts to art therapy.

 

Recently I interviewed a former Marine Vietnam veteran, Steve Piscitelli, who said that when he first was treated at the VA for PTSD in the course of the Vietnam war, his psychotherapists at the VA wanted to discuss standard psychological topics, such as his childhood, and how he felt about his parents, when he was aching in his desire to discuss what he believed was affecting him -- THE WAR. Eventually, Piscitelli turned to making art about his experiences -- to convey the images he remembered from war -- in an effort to turn the conversation with the therapist around, and focus more on what he believed the bigger issues were. 

 

Doing this -- literally, making art from war -- created a breakthrough in Piscitelli's therapy, he says.  Suddenly, what he'd been wanting to express was being understood.  From that day forward, he's made art on his own, often using it to purge the images he remembers, and destroying the art once it's "function" has been served.  At the same time, he's gone on to study art formally, and has become a sculptor, who vacillates between images of great aesthetic beauty (in his case, the form of ballerinas) and the most hideous images available to him, which come straight from his subconscious mind in the form of memories he carries with him from Vietnam.

 

I learned about Steve PIscitelli in a roundabout way, from the work of Kate Collie, who is mentioned in a truly superb article about art therapy and PTSD, written by Jenny Hontz, and published in the LA Times of March 20, 2006.  That article, entitled "The Healing Canvas: Art can soothe the mind and body, therapists say. Now science backs them up," is linked here.

 

Hontz writes:

A small 1997 study of in-patient Vietnam veterans with PTSD published in the Journal of Traumatic Stress compared the effectiveness of a single session of 15 different treatment methods administered to 25 veterans over 16 weeks. Art therapy was the only treatment method that reduced PTSD symptoms in the most severe patients. Researchers theorized that it not only provided a distraction, but it helped vets deal with traumatic memories at their own pace.

 

Additionally, Hontz writes:

 

Psychiatrists already have strong theories about how art therapy works, especially as it relates to trauma treatment. Allan Schore, associate clinical professor of psychiatry and biobehavioral sciences at UCLA's School of Medicine, says that traumatic and stressful memories are stored in the right hemisphere of the brain, which processes emotions, visual and nonconscious information.

 

The left brain controls logical thinking and verbal skills. But for therapy to be effective, "it has to get into the right brain," Schore said. Creating art is a fast way to access the right brain and the emotions stored there.

 

"Saying I'm scared and angry is one thing. Taking a crayon and scribbling on a piece of paper is a visceral way of not just saying it, but experiencing it," said Jan Oxenberg, a TV writer who tried art therapy after she was involved in a shooting during a civilian ride-along with the LAPD.

 

While making art activates the right brain, talking about it and constructing a coherent story about the traumatic experience activates the left hemisphere as well. Integrating the two leads to healing. "What is expanded is the interconnectivity of the brain," Schore said.

Kate Collie, MFA, Ph.D., who Hontz mentions in the LA Times article, worked with Piscitelli in a series she called "Soldier's Heart," linked here.  Collie did a series of paintings about the former Marine (2/5, 1969 and 1970, wounded three times, two Purple Hearts), and combined them with excerpts from her methodical interviews with him about his experiences: in Vietnam, back at home with PTSD from the war, and recovering from PTSD using art therapy. 

 

Collie's paintings of Piscetelli at various stages in his trajectory are striking, and the text that goes along with them, culled from in-depth conversations with the former Marine, is revealing as well.  (If you click on any of the images of the paintings themselves, you'll read recollections of Piscitelli's that go along with the artwork, such as those describing his PTSD or his recovery from it, using art therapy.)  Very much worth your time, as is Hontz's article, above.

Veterans Can Be a "Powerful Force for Healing in the World"

Again from Claude Anshin Thomas, a lovely quote about the true power of the combat veteran's experience.  For every veteran who suffers whether silently or with loud cries and tears; or who ends his or her life because they simply can't take the pain anymore (and I wish they wouldn't -- they have so much to give), here's a reflection on what their experience can really communicate:

 

"At the retreat Thich Nhat Hanh said to us, “You veterans are the light at the tip of the candle.  You burn hot and bright. You understand deeply the nature of suffering.”  He told us that the only way to heal, to transform suffering, is to stand face-to-face with suffering, to realize the intimate details of suffering and how our life in the present is affected by it.  He encouraged us to talk about our experiences and told us that we deserved to be listened to, deserved to be understood. He said we represented a powerful force for healing in the world.

 

He also told us that the nonveterans were more responsible for the war than the veterans.  That because of the interconnectedness of all things, there is no escape from responsibility.  That those who think they aren’t responsible are the most responsible.  The very lifestyle of the nonveterans supports the institutions of war.  The nonveterans, he said, needed to sit down with the veterans and listen, really listen to our experience.  They needed to embrace whatever feelings arose in them when engaging with us – not to hide from their experience in our presence, not to try to control it, but just to be present with us.”

-- From At Hell's Gate: A Soldier's Journey from War to Peace, by Claude Anshin Thomas.

The Vietnam Veteran as Exile: Missing in America, But Hidden in Plain Sight

My friend the veteran artist John Paul Hornbeck made this flag -- I just love it.  It carries forward the whole issue of POW/MIA into the present day, by asking in effect why the veteran is "still" Missing in America (that's the "MIA" part these days.)  He mocked up this flag, using the old and familiar symbol, to highlight the cause of homeless veterans in America -- a cause worth addressing.

I'm broadening the point, though, to something else:

Why ARE Vietnam veterans, in particular, still exiles in their own land?

And what should we, as a country, be doing about that?

Because failing to address that, failing to welcome back these warriors into their own land, perpetuating their exile both from what they've seen/done/experienced and how they were received when they returned -- has left a gigantic, gaping gash in the "fabric" of the American psyche; and decades worth of not addressing it has not resulted in any pain being healed.  Sure there are sporadic attempts made here and there, but they're relatively weak, lackluster, or involve too few people to really make a difference.

If you read Pat's "Welcome Home" story, or Claude Anshin Thomas', just to use the names of two representative Vietnam vets among thousands -- you find out that they are STRIKINGLY similar, almost verbatim copies of each other (and the rest who haven't written them, I suppose).  The hopes, the dreams, the flat-out fantasies (under the circumstances) of how they were to be received -- combined with the completely dashed, rejected and really shattered realities of how they were -- aie, the mind boggles.  It's surprising the whole generation of warriors didn't go postal, not just a few.  It also explains why so many of them are still living in pain to this day.  Turned into exiles by what they lived, that they had no possible means of integrating -- and shunned by the country they fought for.  If that woudn't give you issues, I'm not sure what would.

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So let's think outside the box on this, FAR outside the box.  (If the box is the status quo, that is, because that's not particularly impressive.)  What prevents us from giving veterans, in every city across America, down EVERY Main Street -- a true, genuine, and long-overdue "WELCOME HOME"?!

Couldn't we use that psychic energy we'd gain back as a nation -- from repairing the rent in our actual psyche -- to surge forward, and embrace our combat veterans from here on out, with all the services and the help they so desperately need?  We've seen the problem: it's been well-documented.  But even to go forward successfully, in this case, I think we also need to go backwards -- make use of the "invisible bridge" -- and welcome the group of veterans who are STILL waiting, 40 years out, for America to acknowledge their return.

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I learned a long time ago, that even in personal relationships, there's a big difference between the crappy/weak/self-serving apology -- "sorry IF I hurt your feelings" -- and an actual, gut-level, authentic and genuine apology, that takes responsibility, asks for forgiveness from the injured party, waits for the answer, or renegotiates the situation -- and then moves on, healed.  In the Bible, that's even called the difference between "worldly sorrow" (sorry I got caught) and "godly sorrow" (sorry that I did it, because I know it was wrong).  Without making a point about religion here, I'm merely trying to show that many traditions understand there's a difference between a heartfelt apology, a lame one, and none at all.  It's like the Oliver Wendell Holmes line from a few blog posts back, that "even a dog knows the difference between being kicked, and being tripped over."

---

Let's harness or leverage the momentum from the current groundswell of public "enthusiasm" for veterans' rights, exemplified by support for passage of the new GI bill, and the continuing emphasis on not settling for less in healthcare, particularly PTSD and TBI.  Let's expand that, though, to other issues of concern to veterans, before the "mood" passes -- as it surely will -- to be eclipsed by other different, pressing concerns.  Let's settle our largely unspoken national shame with how we treated Vietnam veterans, while a few of them are still alive to appreciate that our apology is genuine, and acceptance would heal us all to be able to move forward.  What we don't want to do is to create two different classes of veterans: the ones we care about, who get the right treatments for the right reasons; and the ones we don't, because we frankly made such a mess of it it's just easier to overlook it than apologize and move on.  It's time to make things right for ALL veterans.  Let's have those Welcome Home parades NOW...

Editor's note: John Paul Hornbeck is the artist (and veteran) who made "Shattered Soldier," the lifesize scultpture of a veteran with PTSD, that we blogged about earlier, here.  He is the child of an American Vietnam war veteran Army father, and a Vietnamese mother.

The Final Score of War: Brotherhood 1; Humanity 0

Periodically we come across great quotes (and poetry) that serve to illuminate the human condition in combat.  One is the Augustine of Hippo quote we learned about from Nate Fick, which we blogged about here, in 2006:

"Anyone who looks with anguish on evils so great must acknowledge the tragedy of it all; and if anyone experiences them without anguish, his condition is even more tragic, since he remains serene by losing his humanity." -- Augustine of Hippo. From One Bullet Away: The Making of a Marine Officer, by Nathaniel Fick.

Another one is the great Tim O'Brien one, which Jonathan Shay, M.D., Ph.D. wrote about here:

"As Vietnam combat veteran Tim O'Brien wrote in his novel, The Things They Carried: 'A true war story is never moral. It does not instruct, nor encourage virtue, nor suggest models of proper human behavior, nor restrain men from doing the things men have always done. If a story seems moral, do not believe it. If at the end of a war story you feel uplifted, or if you feel that some small bit of rectitude has been salvaged from the larger waste, then you have been made the victim of a very old and terrible lie. There is no rectitude whatsoever. There is no virtue. As a first rule of thumb, therefore, you can tell a true war story by its absolute and uncompromising allegiance to obscenity and evil ... You can tell a true war story if it embarrasses you. If you don't care for obscenity, you don't care for the truth; if you don't care for the truth, watch how you vote. Send guys to war, they come home talking dirty'." -- Achilles in Vietnam, by Jonathan Shay, M.D., Ph.D.

Do you see where this is going yet?  If a war story isn't brutal, isn't ugly, it isn't true.  People do unspeakable things to each other in combat; and the way they survive is focusing on how to get through (the band of brothers, for whom they fight -- the wet bond of blood -- fighting for the one who stands at your shoulder); and numbing themselves out so that they can keep going on, putting one foot in front of the other, but feeling ... nothing... that they can manage to feel at the time, because there simply isn't psychic space, isn't room.  If they feel at all, that will come later.  But not during.  God help the ones who feel, during.  They're likely to not even be able to go on.

To put this another way, they focus on what they can control (almost nothing, literally) -- like being there for the guy or gal next to them; not what they can't control (everything else, including why they're there, whether the mission now or ever did make sense, whether they'll survive, whether they'll ever see home again.)  By putting one foot in front of the other, by continuing to stand shoulder to shoulder, somehow, they make it through, often, just barely, and are left -- usually alone, I might add, and it's shameful that this is the case, these people we ask to fight -- to deal with the repercussions themselves, when they simply aren't capable of integrating such a great (as in mighty), all-encompassing, horrific, and horrifically graphic experience on their own.  Imagine trying to put these pieces together, yourself.  You simply could not; or you'd be the ridiculously rare and most likley superhuman individual if you could.  That's just not a realistic (or fair) expectation at all; so let's dispense with it, and get on with the business at hand: understanding what they actually went through, and developing some compassion -- fellow feeling -- for it.

As you read Pat's reminiscences -- the series of accounts of this young Marine, 17, in Vietnam, which I'm titling "eyewitness to combat" -- think about these things. 

Remember what Ernie Pyle, the greatest and significantly most humane American war correspondent called it?  "The Powerful Fraternalism of the Ghastly Brotherhood of War."  And he made the point, too, that these guys did it -- sometimes the only thing they could adequately focus on was that:

"He did it for the kid next to him; he couldn't let him down.  They needed one another so bad." 

So don't get up on your high horse and be horrified by what Pat's saying, if he has to say something that strikes you as terrible.  War IS terrible; it IS never moral; and it DOESN'T make for perky stories told in three points with a snappy introduction and a great takeaway message to mull on with your popcorn.  It's dirty, messy, evil business that often breaks those who participated in it, who rarely even come to terms with what went on while they were.  And we just stand by and WATCH that, and wonder, or criticize them, for not being able to cope "better" with what they went through.  What would be "better" be, exactly?  Would WE know it if we saw it; would THEY?

--

Remember too, you weren't there.  Our "Representative Veteran," Pat, was -- and he's still trying to process why he had to experience that, and what it means to him that he did.  The remiscences, of which we'll only be sharing some, took 40 years to get down in transmissable form.  That's a lot of painful "elephant" being fed through a very small aperture, so that it can be understood by the rest of us -- and hopefully taken to heart, so that we treat this generation of returning warriors better, and don't make them beg for the services, and the appreciation, that they deserve.  Remarkably, scratch a Vietnam vet -- lonely, neglected, cast off by society, EXILED in his own land -- and you find someone who would give half a paired something to see the current generation better than they were.  Not bitterness, a desire for betterness.  Well, most of them at least.  And the bitterness is easily understood, where and when it exists, as to why.

--

And by the way -- we never did give these guys an offical, actual "Welcome Home."  Chew on that instead, if you want to point fingers about who should have done what in war.  WE should have done THAT.  And in some small way, by making one combat veteran's experiences known in this manner, on this blog -- heh -- that's exactly what we're doing now. 

Welcome Home, Pat, Rob, Claude, Grif, Jeremy's dad, Ray, Shad, John Paul's dad, Steve, the other Steve, Congressman Thompson, Max Cleland, Kathie's husband, Bet's husband, Cecil, the cute flirty guy with the eye patch, who sat next to me at a photography exhibit (still learning!) and who'd just survived a stroke -- everybody else who didn't get that at the time, and we can guess with great certainty hasn't been able to since, either.  Oh, and that would certainly include the abandoned and forgotten guys on the streets (homeless), and the various guys lolling off to sleep in wheelchairs at the veteran's homes, with their little American flags staked into their chairs, who I am pretty sure aren't having visitors, and are dying by the score every month, lost to us for good. 

I had a conversation lately with Pat: how many of those guys are you still in touch with?  Because it sounded like very few.  This is what he had to say:

"The problem with being attached to [that group of] Marines is that very few of each deployment survived long enough to ever get together.  1/9 tried reunions for a while but too few [were alive] to meet so they suspended it.  2/9 still is trying but no one from my days are there.  The thirteen guys I went into the Marines with were either killed in action; died of their wounds; committed suicide later; [or] were so severely wounded that they are still in VA mental hospitals and don't recognize anyone [so there'd be no point].  Only two of us are still alive 'n kicking and we got together for eleven years on what we called our "kill day".  He drifted up into Canada, I drifted to Texas; we have not spoken for over 20 years so I don't even know if he is still around." Yikes.  See bolded statement for emphasis... 

Really and truly, America -- don't you dare criticize these people.  You haven't walked a mile in their shoes -- and until you do what YOU need to do, and uphold YOUR side of the bargain -- you really haven't earned the right.  If anything, read and learn -- and recognize how very human the motivations, compromises, and eclipsing of characters is.  And just be glad that you didn't have to be there; and do what you can to provide a measure of comfort, acceptance and acknowledgement to those who were.  Don't NEGLECT America's warriors; FAIL to welcome them home; STAND BY and watch them be crippled from what they experienced, for which they have often have no HEALTHY RECOURSE WHATSOEVER; and then have the NERVE to point out their moral turpitude, as if you knew.  You don't; they do.  Point, theirs.  And that's the only point worth hearing on this one; sorry.

"Anyone who looks with anguish on evils so great must acknowledge the tragedy of it all; and if anyone experiences them without anguish, his condition is even more tragic, since he remains serene by losing his humanity." -- Augustine of Hippo. From One Bullet Away: The Making of a Marine Officer, by Nathaniel Fick.

Eyewitness to Combat: I Didn't Want to Get to Know Anyone After That

I was lucky enough to be "given" one Marine's recollections of Vietnam and his struggle with PTSD since, whose storyline he spent 40 years crafting, apparently in an effort to explain the experience to his family, and himself.  I have his permission to excerpt it here on the blog and it's great stuff.  Not pretty; in fact, often very graphic; hmmmn, just like war.  Here goes the first installment:

 

---

 

When I arrived in Vietnam in January of 1966, I did not get there with any official orders.  They had somehow been lost on the way over from the States.  I was totally confused and quite anxious because no one knew who I was or that I was even in Vietnam.  I didn’t even receive any pay until four months later when I finally wrote to my dad and he went to Senator John Tower. 

 

However, on the 22 of February I was assigned to the “Flames” section of 2nd Battalion, 9th Marine Regiment which was operation in the Da Nang Special Sector TAOR from the Cau Do River to the North, Ky Lam River to the South, Highway 1 to the East, and the Da Nang N/S railroad to the West. 

 

After a one week crash course on using the flame thrower, I was sent out with Hotel Company as a Gunner with Nick Sparicino as my A-Gunner and ammo humper.  We were all given what were called the Rules of Engagement which meant that we couldn’t return fire unless we could actually see a clear target which was impossible, we could never see them. 

 

This area had hundreds of small villages and hamlets and we were told that about a quarter of a million people, made up of all Viet Cong or V. C. sympathizers-families of the V.C.  We were told that there were NO friendlies in our area of operation and that they all knew how to and did set mines and booby traps.

 

A special amount of time was spent letting us know the seriousness of this threat.  Our section leader, a sixteen year Marine by the name of Corporal Cook put a five gallon gas fuel can of napalm in a rice paddy, put a grenade on it and pulled the pin.  When it went off it produced a huge fire ball explosion. 

 

He then said: “Print that in your brain because that’s what you will look like if you hit one of the mines while carrying your flamethrower or the five gallon can of extra napalm.  That really scared the crap out of me.  Choppers were bringing people in from the field all of the time who had hit mines and were literally blown apart, some killed outright. 

 

Cook took us to a group of Marines covered with ponchos that was laid out by the command post for tagging.  He threw the ponchos off one of them.  There was a Marine, probably 18 or 19 with real blond hair, and deep blue eyes with one arm and one leg missing and the side of his head torn up. 

 

Cook told us to take a good look and that this wasn’t a friggin' game and that if we f---ed up we would be laying there where he was.  That was the first time that I had ever seen someone dead up close.  The area was mostly rice paddies, tree lines, hedgerows, streams, and grass or thatch roofed hutches.

 

Punji stakes, punji pits, and booby traps were everywhere and every hamlet seemed to be sitting over huge tunnel complexes and every tree line had bunkers and spider holes (V.C. fighting holes covered with vegetation) in them. 

 

Most of the Battalion’s casualties were from these devices, mortars, or snipers.  Mostly we just walked around and played moving target and sitting duck.  We would lose people every day and never fire a shot. 

 

We never saw the V.C. They would come up through a tunnel in a tree line and take out one of our guys, then disappear while the “friendly” villagers would stand in their fields and watch us hit ‘Bouncing Betty’ mines that they themselves would set.

 

We did this day after day, all of the time until I really hated these people. 

 

I was so scared every time that I went out with the flame that sometimes I thought that I wouldn’t be able to go on.  But you couldn’t show fear and you never talked about being scared, you just kept functioning and pushing forward into the unknown.  We couldn’t fight back and we didn’t know where the mines were until we hit them. 

 

I kept wondering, “What in the Hell are we doing? This is crazy!” Sometimes the feeling of helplessness was almost totally overwhelming. 

 

It was like a very dark cloud engulfing you but again no one spoke of it but when we looked at each other in the eyes you could see it in everyone.  So we just kept moving and taking casualties and getting madder and hating the Vietnamese; all of them.  We weren’t controlling the war; the V.C. was and we were their targets and whenever they wanted us.

 

The weather was so damn hot in the rice paddies that we lost people constantly to heat stroke.  I carried the 105 pound flame thrower plus an additional 35 to 40 pounds of personal gear; C-rations, ammo, water, a 45 pistol, and sometimes an M-14 rifle.  I only weighed 135 pounds and the weight and especially the heat, seemed unreal.

 

I would hump the flame during the day and run listening posts and ambushes at night with the M-14 rifle.  We never completed any “Clearing Operations” because the V.C. was still there after we would sweep through and they would re mine and re booby trap the areas that we had already moved past.

 

This got so bad that Col. Donahue ordered us to “Scrub the V.C. cancer out of the hamlets”.  We were told to destroy everything and anyone that we took fire from.  If we took sniper fire from a hamlet, then it was declared a free fire zone and anything that moved could be killed with malice. 

 

Choppers would fly over these hamlets dropping leaflets telling the inhabitants that they had to surrender all V.C. “infiltrators” or they would be killed.

A few days later we would go in and “take the hamlet apart” and torch it.  This was a real bad place to be because No one liked us and the V.C. was everywhere.

 

The entire five months that I operated in this area was so constantly scary that it made me completely numb which was the only way to survive.  If someone else hit a mine, they lost a leg or an arm.  If I hit one, my flamethrower tank would explode and I would go up like a fireball. 

 

No one ever got near me.  They stayed a good distance away and I felt isolated and numb that all I could do was to keep putting one foot in front of the other. 

 

When we took sniper fire, everyone else could lay flat but my tank stuck up like a huge pillow.  I always knew that I would die at any moment and couldn’t do a damn thing about it except wonder what it felt like to burn to death.  I even tried to get transferred back to a rifleman. 

 

But I was refused by the First Sergeant and told that the Marine Corps had put me where they had wanted me and that is where I would stay.  I was trained as a rifleman, not a flamethrower gunner, it bothered me and I hated every minute of it.

 

From the last of January, 1966 to about the middle of March we had been moving into position to conduct what was called a company sized “County Fair” operation in which the V.C. and V.C. sympathizers of hamlets would either be killed or captured, questioned and then killed.

 

These County Fair cordon search and destroy operations were directed at the hamlets directly north of the La Th o and Thanh Quit line where we had been hitting a lot of the mines.  It was miserably hot and the heat coming off of the rice paddies made us look like ghosts as it shimmered up and around us.

 

We looked like we were moving through a mirage. We stayed to the trails and the rice paddy dikes because there were punji stakes everywhere else.  We had come out of a tree line and were moving along one particular rice paddy dike. The flame was digging into my shoulder and my hands were getting numb. 

 

The column kept moving but I had to stop and readjust the straps, they were hurting me so much.  I stopped and squatted down; Nick Sparicino moved up to help me with the tank.  De La Fante moved off into the rice paddy in an arch around us.  He was still keeping his distance from us. 

 

Then all of a sudden there was a loud bang, and explosion.  The field had been mined.  We looked up and De La Fante’s body was flying through the air and hit the ground surrounded by dust and grey smoke. 

 

He had hit a mine and it had pulverized his legs and one arm.  He was flopping on the ground in shock convulsions like a fish out of water.  I was totally stunned. 

 

It was so hot and the load was so heavy that I was carrying that I wasn’t paying attention and was just concentrating on one-more-step.  The Sergeant yelled: “Everyone down!”

 

Nick and I started to move toward De La Fante and the Sergeant yelled again: “God dammit, I said get your asses down, NOW!”  De La Fante was screaming: “My legs, oh God, my legs!” Then he went into shock. 

 

I stayed in my position but kept thinking: “What in the hell is he (the sergeant) waiting for? De La Fante is hit and needs help now.” 

 

My gut felt like it was being ripped from my body.  I felt absolutely helpless and was getting really pissed off but I had been ordered down and that is what I did. 

 

I was so frustrated that I started to cry as I looked over at De La Fante on the ground and no one moving to help him.  I prayed: “God, please stop his pain, let him die.”  I think it was more for me than for him.  I couldn’t just squat there and watch him like that. 

 

The Sergeant finally called “Corpsman up, Doc, get the f—k over here”, and he and Doc moved very cautiously toward De La Fante. 

 

Upon reaching him, the Sergeant held him down, he was still bucking and jerking and Doc gave him morphine.  The Lt. called in a medivac chopper and I thought that it took forever.

 

I can remember how hot I was squatting next to the rice stubble and how dry my mouth was.  I couldn’t even spit.  The smell of powder, blood, feces, and burned flesh hit me hard: It was so dry that there weren’t any other odors.  I almost gagged.

 

The chopper came in; De La Fante was put on a poncho, placed on the chopper, and he was gone just like that.  The platoon Sergeant yelled “Move out and stay the hell off of the rice paddy!” and we resumed the patrol as if nothing had ever happened and as if De La Fante had never existed.

 

I never saw him again and no one ever mentioned his name after that.  He had simply disappeared from our existence.  While no one ever said anything, war is just like that, I felt unbelievably guilty for stopping to adjust my shoulder straps.

 

I kept thinking that had I kept going, then he would have not hit the mine.  Then I felt guilty about not going to get him after he was hit.  Even though we were ordered to stay down, I was also afraid to go get him because I didn’t want to hit a mine too. 

 

Now I felt like a coward and there wasn’t anything that I could do to change anything.  We moved out but I was totally numb but the anger started to really well up in me.  I wanted to kill someone.  I wanted to get at Charlie for De La Fante, for having to hump so damn much stuff in the friggin’ heat, and for not showing himself so that we could get a definable target to kill. 

 

I had been warned and told about this stuff and had seen the results of a mine but this was the first experience of watching it happen.  I blamed “Charlie” for every miserable thing that had ever happened to me in my entire life. 

 

After that incident, I never complained or shunned carrying the flamethrower.  In fact I was glad that it was my weapon because I wanted to get even, and I had developed a mature hatred for the enemy now.  I also didn’t want to get to know anyone after that.

Unhealthy Sexuality: A Bond That Is Strong, But Lack of Desire - We Just Gave Up

Here's an item from a woman I admire to the hilt, who has been the wife of a Vietnam veteran since she was 24.  Her husband, more or less 10 years older, fought in Vietnam, and has suffered from PTSD ever since. She ended up writing a book about how she came to learn about PTSD and how it affects the family, and since then has done exceptionally kind, warm-hearted and great work on behalf of veterans and their families with PTSD.  In her case, she found that being married to someone with PTSD presented unique relationship challenges, which didn't always work out to her satisfaction.  On balance, she still accepted and took comfort in the relationship, but the sexual aspect was hard to work through, and painful to talk about.  With her permission, we have excerpted the relevant passages from her book (these passages offer a look at a slice of life from decades ago, but they are very accurate nonetheless, as hard as this stuff is to share):

Some general information about the situation:

It is amazing what changes happen to a person. Facing Jack’s problems and sticking it out made me realize something about myself that had to be changed. It was time to make the same commitment to my current job and stick it out. All the other jobs I had, I ran away. I would quit the job and move on to another one. I was always good at what I did and tried to give 100% but I never felt that my effort was appreciated. I was always taken for granted and devalued. I was feeling the same way about my current job. I didn’t want to run away this time and end up learning a job all over again. I didn’t want to start from scratch. I was just going to make my attitude different and stick it out.

It took five years of going to the VA for help before Jack eventually dropped out of

treatment. The denials were like a knife in his back. He couldn’t take it any more. It was causing us financial hardship and he lost time at work going to the appointments along with the times he couldn’t function at all. There were so many times that he couldn’t bring himself to get up off the couch. There were times when I saw it coming. He would become edgy, agitated and quick to anger, then silent, motionless holding his head in his hands. I was losing the battle. The fight had gone out of me and I was looking for a reason to stay with a man who could no longer be a husband or a father. I was in all respects a single parent. I had stress at home and a stressful job.

It tore at me knowing that no matter what I did, I would not be happy. If I left him, I would have felt guilty for turning my back on part of my family. If I stayed I knew that I wouldn’t be happy knowing what I would never have again. I didn’t know if I could do it. I didn’t know if I could keep looking in the mirror as the years left their mark on me, knowing that I would never feel desire or passion again.

 

It was like living on a roller coaster. I would start to relax when Jack would level off and he would be easy to live with, then just when I was getting over the bad days, they would come again. It was as if he couldn’t stand being emotionally close to me. There were times of the year that seemed worse for him. November was bad, the month he went to Vietnam and the month he came home. It was also the same month that Camp Evans had the 122mm rocket and mortar attack. February was a bad month for him. So was April. The other months were bad but those three months seemed the worse for him. I suppose I could have become an angry, bitter woman. I could have taken out the unfairness of my life on others. I could have but I didn’t. I credit God and Jesus, as well as an understanding of the Bible for providing me with the strength and courage to stay true to who I was.

---

About their honeymoon, and subsequent relationship:

We went to Niagara Falls but it was not romantic. We had a king-size bed and I am sure that he didn’t sleep in it for more than a few hours. I’d wake up in the morning and Jack was sitting in the chair watching TV. I think that we made love once, maybe twice on our honeymoon. During the day it was romantic and we were happy. We kissed a lot, held hands and held each other. At night it was as if he couldn’t stand me near him. Sex was never really that important to us. I already had a marriage where sex was too important. That didn’t bother me as much as the fact that he didn’t want to hold me or be near me. I thought there was something wrong with me. It hurt. I understood quickly that to wake up Jack was like waking a grizzly bear. He was ready to attack but stopped himself.

We continued to visit his friends and enjoy life. I got over the hurt of his lack of desire and realized that he was older than I was. I thought that maybe his sex drive wore down with age. We still hugged and kissed a lot. We both worked hard, so when we did get to “fool around” it was enough. It was at least once a week and that was enough for me.

 

Once in a while we would end up down the beach and make love in the car even though we were married and finally had a place to be alone. He said it brought back memories. It felt good to just be in his arms.

 

There were still times when I wondered how this happened and I will probably wonder for the rest of my life. I wondered what it would have been like if the first time I left him, it ended. I listened to the experts on TV when they talked about marriage. They could only give advice on a limited basis to the “normal” side of society.

 

The experts never had much to say about a family like mine. I laughed knowing that a marriage could survive without sex, without the partnership. Children could thrive in a dysfunctional home if there is love there. An illness did not have to mean the end of everything. It was hard. Don’t get me wrong. There are families with alcoholics who in the process of their illness hurt the only ones who should matter to them. I believed that they feel so terrible about themselves that they strike out at the ones they are letting down unable to face the truth. The families are left to pick up the pieces of shattered lives and emotions. A father is supposed to love us and protect us. A mother is supposed to support us emotionally and nurture our souls. Husbands and wives are supposed to complete each other, keep us grounded when we get too full of ourselves and build us up when we feel pulled down. Home is supposed to be a place of refuge from the craziness of humanity and obligations. A place where we feel we are able to be ourselves and be loved despite ourselves.

I did have a place to be myself and I tried to give Jack a safe haven, a place where he didn’t have to worry about the outside world and his past. At times it seemed impossible but still there was a bond between us that existed before the illness was into full swing, before all the tragedies happened. We are not married in many senses of the word but the one that matters most of all to us, a bond that is strong.

The woman who wrote this is tremendously compassionate and knowledgeable about PTSD and veterans.  She is warm, caring, and selfless about sharing what she knows with others, and openness like this is only part of her "secret sauce" for helping veterans and their families cope with the many unforeseen difficulties of PTSD.

Unhealthy Sexuality: Unable to Touch Intimacy - "You Don't Want to Degrade Your Wife to That Level"

In our continuing, semi-regular series on "Healthy Sexuality and the Combat Veteran," we need to take a look at three or so "unhealthy" variations on a theme.  The first, here, is "inability to touch intimacy" -- there's plenty o' sex (promiscuity), just not with the wife.  The material is quoted from a Vietnam veteran participating in a program with Jonathan Shay, M.D., Ph.D.:

 

Nantucket in the summertime was a fucking playground.  You meet broads, we’re stationed there, we don’t know what the fuck we’re stationed there for.  A different broad every night, twosomes, threesomes, it was a liberal fucking place.  It was just fucking crazy, but it was a relief for a short period of time.  It worked better than booze.  In my mind it had intimacy.  With booze, I didn’t have intimacy.  You’re fucking someone you don’t even know; but you know that you’re fucking.  I wouldn’t even call it lust.  It’s what I’m supposed to do and I feel good doing it, but then you get up and leave.  After you’re done you couldn’t wait to get the fuck outta there.  Also on Nantucket.  Once you’re done everything popped back up [i.e., intrusive memories and emotions related to Vietnam.]  But for that five minutes you forget everything.  Then you get up and leave.

You know you’re walking down the street [today] and you see a guy with his wife, holding hands, and you wonder “why can’t I do that? Why can’t I hold hands like that?”  I want to, but I don’t know how.  It seems like there’s a process to it, but we don’t know the process.  You know, people hugging and shit like that?  We do it in different ways.  We take care of our wives, we give them what they want.  We make sure they’re not afraid of anyone – we’re there if anything fucking happens.  We have intimacy in that way.

You’re drunk, you’re slobbering over some broad – I touched it [intimacy].  I didn’t touch it with the person I want to [i.e., his wife], but I touched it.  Back then I didn’t know what it was for.  It felt good, and not too many things felt good lately and this is one of them.  You know I can drink till I drop.  Booze and fucking has a lot to do with our scenarios, booze would lead to sex.  Half of us don’t drink anymore.  The pact between booze and sex fucking ended.

And when I went home – you know, I think I still have a problem, I still have a problem today, approaching my wife for sex.  I don’t know if she wants me to approach her.  I don’t know the steps.  Every once in a while it’s okay, but most of the time it ain’t.  I won’t say it’s the punishment, but I’d say for us it’s the way it’s supposed to be.  We don’t put a lot of stock in it.

You’ve got a wife and a family, and you can’t abandon them, so, you just fuck.  There’s nights you don’t come home.  The wife, she figures you’re out on a drunk again.  And most of us did weird things, really, but we always left the money at home.  Like, “That’s for you, because this part of me isn’t good.”  [I would] fuck nasty, but you couldn’t do that kind of thing to your wife.  That’s a whole different thing.  That’s the woman who nurtures you, and puts you back together, and puts up with your bullshit.

If you look at a lot of us, we had solid women, the women were strong, they were solid.  That’s what we lost.  We were in the fucking jungle while they were going to their prom, the holding hands.  You know, the high school sweetheart, we gave that up.  Willingly, we gave that up.  We didn’t know it.  But we gave it up willingly and said, “I’m going to do this [fight a war],” so we can’t capture [what was lost], don’t know how to.  Before Nam, I remember going out with girls in high school, not fuck or anything, but making out all night, kissing and – I remember doing that.  [Before Vietnam] not really fucking.  It was that time in the early 1960s, you went home and took a cold shower half the time.  But the intimacy was there, the hugging and the kissing and you could put your arm around the girl you went out with.  These weren’t sluts…”

…

You don’t want to degrade your wife to that level.  [Like a slave?]  Yes.  There’s times when she approaches me, and you know what?  You’re very careful making love.  You’re very careful in your mind.  In your mind you don’t want to get dog-fucking dirty.  This is my wife, the mother of my kids.  She’s the one who holds the family together.  I supply [the family’s livelihood].  That’s a whole different thing.  I don’t have a word for it.

It has a type of relief that’s good for a while, sure as hell better than any booze.  Some of us ain’t drinking anymore so it’s harder.

The way we are, amongst ourselves, look at it is it’s just another price we pay.

Attemping to Cover Up the Pain Like a Blanket

More reflections from Claude Anshin Thomas:

 

"So you see that the war is not over; it never ends.  My involvement in this war has scarred me in many wars.  It scarred my body, it scarred my heart, it scarred my soul.  The reality of this war lives with me today.  It doesn’t go away.  There is no sense trying to hide it, because war does not go away.

 

 

 

 

Vietnam was the first war after which society could not sweep its soldiers’ pain and anguish under the carpet of heroism and adulation.  The defeat and shame of that war have allowed us to see more truthfully the defeat and shame of all war and all violence, but Vietnam veterans have paid a heavy price for this truthfulness.

 

 

 

The embrace of family and friends and the celebration of ticker tape parades can seem to justify much hardship and cruelty.  But as I have been able to interact more and more with people of my father’s generation, I have discovered just how many veterans from the Second World War spent their entire lives isolated from their families, suffering in silence.  They have spent endless hours in the garage or the basement alone, many of them – like my father and other veterans I grew up with – attempting to drink away the guilt, the shame, the confusion, the fear, the anger, all the feelings of lack of feelings that are the reality of war.  These men are trapped in a code of silence, and many of them are dying there.

 

 

 

The military teaches you to dehumanize, but much in our society also teaches us to dehumanize.  And once you dehumanize, once that becomes a habit, it doesn’t change easily.  When we dehumanize others, we lose our humanity.   This doesn’t just happen in the military: it happens through television, in the movies, in the magazines; it happens on the street; it happens in stores and in the workplace.  Those who haven’t served in the military are confronted with very similar kinds of issues.  Think of those shootings in schoolyards, people beating someone [else] to death because the person is gay, road rage.  Even just shouting at someone in a checkout line because we can’t tolerate the uncomfortable feelings that can arise when we have to wait. 

  

 In many life experiences, we are dehumanizing others and being dehumanized The war in Vietnam, the war in the Persian Gulf, the war in Kosovo, the war on the streets of [South Central] Los Angeles, Hartford, Denver, Cleveland, or any town, the wars that take place in our homes – what are the seeds of those wars?  Vietnam is only an expression of something that beings inside each and every one of us, male or female.  We all possess the seeds of violence, the seeds of war.

 

 

When I entered a rehabilitation center for drug addiction in 1983, I was able to stop using drugs, stop drinking.  After I stopped using drugs and alcohol, the obvious intoxicants, I began to be able to learn what the other intoxicants were that were preventing me from looking at myself.  And I began to stop using those things also.  I stopped using caffeine, I stopped using nicotine, I stopped eating processed sugar, I stopped eating meat, I stopped going from one relationship to another.  I kept coming more and more back to myself, in my commitment to heal, even though I did not understand (in any intellectual way) what it was that I was doing.

 

 

In 1990 it became impossible for me to hide from the reality of my Vietnam experience any longer.  Vietnam was not just in my head; it was all through me.  I had talked intellectually about Vietnam, but I had never fully opened myself to the totality of the experience.  Now the pain reached a point where it was so great that I only wanted to hide from it, to run from it yet again.  My first thought, of course, was to get drunk.  When I drink, it covers the pain like a blanket.  But under the blanket, inside me, is full of barbed wire; every time I move it cuts at me, tears my skin.  When I drink, I have the illusion that I have put a buffer between my skin and the barbed wire, but this is not the truth; when I am anesthetized, I am just not so aware of the ripping and tearing…"

 

--  from At Hell's Gate: A Soldier's Journey from War to Peace, by Claude Anshin Thomas.

Waking up to the Boundlessness of Suffering from War - One Veteran Learns How to Overcome

Continuing our theme of "mind-body medicine," which we revisit from time to time, one of the more interesting books to come out by a Vietnam veteran talking about his experiences in war and afterwards is "At Hell’s Gate: A Soldier’s Journey from War to Peace," by Claude Anshin Thomas. 

 

Thomas grew up like many guys who went to Vietnam: poor in a hardscrabble American town, son of a WW II veteran, with whom he had a rocky relationship; athlete in school who had perhaps a glorified view -- from his relationship with his dad and from athletics -- about what combat would really be like, or what it would do for him.  He was clearly under the impression that it would "make him a man," and when reality hit, and he saw the things war really was made of, and that he saw himself do, well, it was a little too late to turn back. That was Vietnam in 1966. The scars from that experience would be touchstones for the rest of his life, and honestly -- he's shown more healing than many. 

 

First and foremost probably because he's been willing to admit the level of pain and suffering that Vietnam left on his "soul."  Here's some of his reflections from his book that Michael Herr, author of Dispatches, says was "written with relentless courage and utter compassion."  According to Herr, "this account of violence and transformation is one of the most amazing and wonderful stories I've ever read."

 

---

 

Thomas, who went to Vietnam at 18, received numerous awards and decorations, including 27 Air Medals, a Distinguished Flying Cross, and the Purple Heart.  We first wrote about him back in February of 2006, and several times since, because his book -- and the way he's transformed his experience -- appear to be virtually one of a kind.  As he himself says, Vietnam is not unique in that "everyone has their Vietnam...everyone has their own experience of violence, or calamity or trauma."  What stands out about Thomas, though, is his willingness to acknowledge all the raw trauma, and somehow, to transform at least parts of it.  Now, for Thomas in his own words about some of the scarring, as well as some of the transformation from within:

 

"My body is covered with scars from my wars.  Every time I look at my body, touch one of these scars, I touch again the reality of war, and when I touch the reality of war, I touch all the suffering that is intrinsic to war.  In the past, when I felt pain from a scar, I tried to repress it, to hide it from myself.  But the physical wounds are not the most significant wounds of war.  The wounds of the soul, the spiritual wounds, the emotional wounds – they are far deeper, though less obvious.  And they are much more unpleasant to look at."

---

"Recently I spoke with a man who said, “If you didn’t feel things so deeply, if you were numb or if you were able to deny your feelings, you probably wouldn’t have any trouble with the war.”  But in fact, the vast majority of the people who have closed themselves off from the reality of their experiences in war are suffering tremendously.  Hiding or avoiding does not eliminate suffering, it just drives it more deeply underground.  Then our suffering controls us more profoundly, in one form or another.  We cannot hide from our pain.  Trying to do so is like attempting to pour a liter of red paint into a half-liter container: It will spill and spread, covering every aspect of our lives.

 

That’s what was happening to me when I hit bottom, a place where the pain was so intense I didn’t know how to hold it.  I thought my only option was to die.  As we wake up to suffering, we may feel at some points as if we might explode.  Because waking up to the boundlessness of suffering is intense, the pain is raw, the feelings immense – spaceless, formless, empty.

The practices of mindfulness and meditation have provided me with invaluable resources and tools in those moments, in those hell places.  They also help me to go to those places with others, to support them in caring for and healing themselves.  I am able to sit with the dying, the wounded, encouraging them to tell their stories and listening deeply. I  also go to the front lines and talk to soldiers about not fighting.  I talk candidly with them about the effects and consequences of war.  I am also able to go to the back wards of hospitals and mental institutions to visit the hidden casualties of war and listen to their stories.  I sit with the disenfranchised, the social and cultural lepers, and listen. In all these places, with all these people, I practice breathing in and breathing out.  I practice being fully present.  And I offer them the tools of Zen Buddhist practice (direct experience), spiritual practice.  I hope to help them discover the practices and tools that have helped saved my life: sitting meditation, walking meditation, mindful speech, and deep listening.  I also hope to provide the experience of sangha (community) – to demonstrate how community can support us on the path to healing and the path to awakening.

 

I invite people to bring an end to their isolation.  Because together we can do more than we can do alone.  These tools, this practice of meditation, are important, even critical, because suffering is a reality of our lives, the lives of all of us.  The “Apocalypse Now” is not just in Vietnam; it is not just for Vietnam veterans.  It exists for all of us because we have eaten the fruits of war, the fruits of violence, the fruits of hatred.  If we don’t wake up to this, it will destroy us.  From the inside out, it will destroy us.  I know this from my own experience.  And I know this because I observe this happening all the time.

-- At Hell’s Gate: A Soldier’s Journey from War to Peace, by Claude Anshin Thomas.

Vietnam War Poetry - "Waiting for the Fire"

An "interesting" poem about Vietnam, written by a combat veteran -- ironically, though, one from World War II, not Vietnam at all. While it is a powerful poem, it still feels a tad disingenuous, and perhaps too critical/judgmental about a combat experience he wasn't a part of. The Vietnam veterans I've talked to are anything but "dry-eyed" about their experiences there.  Poetry is wonderful, and people tend to take it at face value.  This one, however, makes me wonder why the poet didn't write about something more immediately within his own experience.  Had a Vietnam veteran written it instead, I would have a whole different reaction to it.  To the degree that it's still an important poem about war, it's worth knowing about, but maybe not taking as "gospel."

Waiting for the Fire

Not just the temples, lifting
lotuses out of the tangled trees,
not the moon on cool canals,
the profound smell of the paddies,
evening fires in open doorways,
fish and rice the perfect end of wisdom;
but the small bones, the grace, the voices like
clay bells in the wind, all wasted.
If we ever thought of the wreckage
of our unnatural acts,
we would never sleep again
without dreaming a rain of fire:
somewhere God is bargaining for Sodom,
a few good men could save the city; but
in that dirty corner of the mind
we call the soul
the only wash that purifies is tears,
and after all our body counts,
our rape, our mutilations,
nobody here is crying; people who would weep
at the death of a dog
stroll these unburned streets dry-eyed.
But forgetfulness will never walk
with innocence; we save our faces
at the risk of our lives, needing
the wisdom of losses, the gift of despair,
or we could kill again.
Somewhere God is haggling over Sodom:
for the sake of ten good people
I will spare the land.
Where are those volunteers
to hold back the fire? Look:
when the moon rises over the sea,
no matter where you stand
the path of the light comes to you.

-- Philip Appleman.

Philip Appleman received the Humanist Arts Award from the American Humanist Association in 1994. He served in the U.S. Army Air Corps from 1944 to 1945 and in the U.S. Merchant Marine Corps in 1946 and from 1948 to 1949. He is the author of three novels, including In the Twelfth Year of the War; a half-dozen nonfiction books, including the new third edition of the Norton Critical Edition, Darwin; and seven books of poetry, including New and Selected Poems, 1956-1996, from which the above poem is reprinted.

Transforming the Scars of War from Within

Considering that we're often used to looking for solutions primarily from outside ourselves, instead of doing the often harder work of looking within, here are two interesting meditatations on what "scars" really are, and how they affect our lives.  Scars such as the ones we receive from war -- the external, obvious ones; and even the internal, less visible ones, which often mark us as profoundly.  How do we come to grips with being scarred, and yet move forward in our lives effectively? 

The first passage is by a Vietnam veteran, Claude Anshin Thomas, who has studied with Thich Nhat Hanh, and the other is by Den Ming Dao, a classical Taoist scholar, poet and artist.

First, Claude Anshin Thomas:

Our suffering is not our enemy

“Society teaches us that suffering is an enemy. We are constantly encouraged to reject what is unpleasant, disappointing or difficult. “What’s all this suffering? Let’s be happy! Have fun!” But our suffering is not our enemy. It is only through a relationship with my pain, my sadness, that I reach the other side, that I truly can know and touch the opposite, which is my pleasure, my joy and my happiness.

“I often relate to my emotional suffering as though it were a physical pain. When I feel physical pain, society pushes me to take mediation to relieve it, not to touch it, not to explore it or seek to understand it. I am conditioned to make every effort to avoid discomfort. I went through a long period of my life living from this conditioning. I took a lot of drugs, so many that I couldn’t feel my physical pain or my emotional or spiritual pain – at the same time, it was also impossible for me to touch genuine joy, or healing, or anything at all. It was just impossible.

“My body is covered with scars from my wars. Every time I look at my body, touch one of these scars, I touch against the reality of war, and when I touch the reality of war, I touch all the suffering that is intrinsic to war. In the past, when I felt pain from a scar, I tried to repress it, to hide it from myself. But the physical wounds are not the most significant wounds of war. The wounds of the soul, the spiritual wounds, the emotional wounds – they are far deeper, though less obvious. And they are much more unpleasant to look at.

“Can I imagine a time in the future when these scars and these experiences will dissolve, drop away, so that I will finally be free? This is not actually a condition of freedom. I’m free right now. Because I can acknowledge that the scars are there. Because I no longer wish for them to be any different from what they are. Don’t get me wrong. I spent a long time wishing that the scars of my life would just go away. But the more I wished for this, the crazier I felt. Because the reality is that my scars are part of me, like my own hand. I needed to learn to acknowledge them and to live with them in peace and harmony.”

-- At Hell’s Gate: A Soldier’s Journey from War to Peace, by Claude Anshin Thomas. Boston: Shambala Press (2004).

---

And now, this by Den-Ming Dao, author of the superb book of daily contemplations, 365 Tao, which always start with a short poem:

Markings in dry clay disappear
Only when the clay is soft again.
Scars upon the self disappear
Only when one becomes soft within.

Throughout our life, but especially during our youth, many scars are inflicted upon us. Some of them are the results of violence, abuse, rape, or warfare. Others arise from bad education. A few come from humiliation and failure. Others are caused by our own misadventures. Unless we recover from these injuries, the scars mar us forever.

Classical scriptures urge us to withdraw from our own lusts and sins. But scars that have happened through no fault of our own may also bar us from spiritual success. Unfortunately, it is often easier to give up a bad habit than to recover from the incisions of others' violence. The only way is through self-cultivation. Doctors and priests can only do so much. The true course of healing is up to us alone. To do this, we must acquire many methods, travel widely, struggle to overcome our personal phobias, and perhaps most importantly of all, try to acquire as few new problems as possible. Unless we do, each one of them will bar us from true communion with Tao [the life force].

-- 365 Tao, Den-Ming Dao.

Swift Silent and Deadly - That's First Recon Marines - But It's Also Combat Trauma and PTSD

"Make that -- 'Swift, Silent, Deadly' -- and ridiculously hottt!"

That's a modified Paris Hilton-ism, we know, but... of course we're talking about Rudy Reyes, former 1st Recon Marine, playing himself on the HBO series, "Generation Kill," from the book of the same name, by Evan Wright. (If you've read Nate Fick's wonderful book, "One Bullet Away: The Making of a Marine Officer," you've also read about Rudy Reyes in that.)

We've written about Rudy Reyes before on this site; and we're secretly chuckling about how absurdly many people worldwide are searching for -- literally -- ANY scrap of news about The Hotness That Is Rudy-- or preferably any pictures.  His own website seems to be "under construction" -- let's hope it gets online soon to satisfy the teeming hordes of fans, internationally.

In the meantime, though -- it's important to remember that Rudy has seen and done, many many things in his time - in battles in Afghanistan and Iraq.  First Recon Marines are known as "Swift, Silent and Deadly" ... and if you think Marines in general are ROCK STARS (we certainly do -- our friend the Beautiful Redhead, married to a Marine officer, gave us a T-shirt that said just that) -- well, Recon Marines are all that and then some.  It's the most physically, emotionally, mentally demanding job in the Marine Corps.

If, while you're waiting around for Rudy Reye's website to become active, or learn more about his "Hero Living" DVD series planned -- you might want to take a few moments and educate yourself more fully about some of the downsides of being "the best of the best" -- it's the PTSD that can come from the obscene amounts of combat and arduous undertakings you're exposed to.  The good news is that not everyone gets PTSD.  The bad news is, the chances of it increase with exposure to combat trauma -- and, for those whom it affects, it's a battle harder than any fight they've ever had.

---

Rob Honzell, who, like Rudy Reyes, was also a Marine sergeant in First Recon -- but in Vietnam -- has written a good book about his experiences.  He calls it "First Person: Combat PTSD," and it's pretty eye-opening.  I had it on my bookshelf for quite a while before I opened it and really gave it a read -- but when I did, I couldn't put it down.  Rob in the meantime has become a friend, and frankly I was feeling guilty about not having taken his book more seriously; so I did.  It's quite a book.  

If you know Rob at all, you know that the reason he's willing to plumb the depths that he has in this book, and draw water from the deep end of the pool, is because of his deep, abiding and heartfelt concern that veterans today not have to go through what he's gone through as a combat veteran with PTSD.  Rob spent "one year, seven months, and twenty-one days" as a Recon Marine in Vietnam -- and has fought courageously ever since, to keep a toehold in the land of the living, and the land of the sane.  For anyone who thinks that Vietnam vets with PTSD just check out of life and don't contribute to society, Rob isn't in that mold.  He had his fun -- years as a traveling musician in Canada (he was a drummer in a bar band) -- but also his serious side -- decades spent in law enforcement as a police officer, police chief, K-9 officer, and criminal justice teacher.  He's completed his master's degree, and is struggling to complete a Ph.D. in psychology -- so that he can help other veterans, with PTSD. 

First, though, he has to get his own case in check, and that's been an arduous battle since Vietnam, where the nightmares and hallucinations started, while he was still in combat.  Killing dozens of people, up close and personal has left its mark -- in his book he gets wistful over snipers having it easier, because at least they kill their targets at a distance, and don't have to get soaked with their victims' blood, or watch them take their last breath, from inches away. By the end of the book, when you realize how many people Rob killed in combat, and then also realize the kind, caring person he is (evidenced by his work in law enforcement, for instance -- his book shares some good stories about that) -- you can see why his experiences in Vietnam got to him. 

On the one hand, he was at the top of his game.  His prowess in Okinawan karate gave the Marines an opportunity to further hone his skill as a killing machine; and his overall smarts helped him to be a very strategic, effective one at that.  But one thing comes through loud and clear in his book: that the innocent, 17 year old boy who joined the Marines straight out of high school, and later raised his hand to volunteer for Recon, when the call went out -- that boy not only died in Vietnam, that boy had literally no idea what he was getting himself into. 

Was 40 years of nightmares and the torture of a PTSD-wracked life, with all that that entails, a "fair trade" for not even two heavy-duty years in Vietnam?  That's a tough one.  How about the health problems, coping struggles, failed marriages, hard relationships with children, and simple fight for sanity and survival?  Rob carries the memory of the people he killed, and the way he killed them, every day.  I think that's part of how you can tell he's a "good person" -- because it still bothers him -- in fact it started bothering him at the time.  But of course he had to suppress that, a) to survive and b) to continue to do a good job.  Ever since, though, those memories have been a constant companion, despite the amount of good he's done in his life, and continues to do.

He writes poignantly in the book about that 17 year old boy, who's long gone by now, except in spirit, as he talks about what he imagines the "end of the road" will be like:

"I don't know when or where my journey will end.  You don't terminate dozens of people's lives and not have to stand in front of God and ask his forgiveness.  I have used, and I have been used, in my life; and I'm sure I'll have to answer to God for that also. I know it sounds weird, but I hope to go into heaven as that 17 year old boy that was always smiling, laughing, loving, and full of life..."

---

I have to say, because I've come to really care about Rob, I sure hope his "exit" isn't anytime soon.  But it's impossible to learn his story and not realize how high a price veterans can pay, in service to their country.  And the more intense the service -- like Recon Marines -- the more intense the price they're likely to have paid.  They deserve our respect, and honor, and with that, our compassion. 

In the civilian world, there's a concept called "Informed Consent." If someone informs you of the risks, say of surgery or medication, you can always evaluate them and decide pro or con.  Then, if something comes back to bite you later, at least you know that you were warned ahead of time, and made your own decision.  In the military world, obviously, not so much.

I seriously doubt that if any commanding officer had explained to that 17 year old guy at the time, "hey, you look to be in great physical shape, how'd you like to do a super-demanding job for us that's called being a Recon Marine" -- and then explained what the human cost of suffering would entail, for the next 40 years of his life -- that he'd have had any takers. I wonder sometimes whether even the officers knew what the costs would be for the recruits.  In any case, it's been one hell of a journey for Rob, during which he's contributed quite a bit of good to society, and also never been able to fully and completely manage the horrors of what being a Recon Marine exposed him to. 

I have to say, I'm proud of him for what he did -- both as a Marine, and as a veteran -- to do his job, no matter how terrible, excellently at the time, and then afterwards, have this considerable desire that other veterans not have to walk the same incredibly difficult path he's walked.  It's an honor to be his friend, and I hope that somewhere in the bazillions of hits from people wanting to find out about one former Recon Marine -- Rudy Reyes -- that they take the time to also learn about the life and struggles of another former Recon Marine -- Rob Honzell.  They're both worthy of our attention; but I wonder -- will they both receive it?  If you haven't picked up Rob's book, it's a short but effective education in what it takes to serve our country, and the cost that can exact from the veteran, in very human terms. 

I learned just the other day that Rob's counselor at the VA is hoping to recommend his book to all her patients who are combat veterans.  That's a nice, and belated, testament to the caring heart behind this warrior: someone who's willing to pull the skeletons out of his closet, in the hopes that more recent veterans, and their families and caregivers, will understand more quickly the tremendous costs of combat trauma in terms of human suffering among the participants.

---

Rudy Reyes is also a gem: someone who's had a hard life and made much of it, given it his all, and is pretty much poised right now to be a star.  I know he knows firsthand the challenges of extreme combat, as a Recon Marine.  I hope that he will use some of his burgeoning celebrity power and charisma for good -- lending his influence for issues that concern wounded Marines and other servicemembers, like combat PTSD.  Like Rob Honzell before him, and his prowess with Okinawan karate, Rudy's facility with martial arts has been a big part of his success, and where he finds some much-needed personal balance. 

Wherever life takes these men, I hope that others will continue to be blessed for knowing them, and for the substantial contributions they have made, both in service to their country and beyond. In Rob Honzell's case, with the publication of his book devoted to making clear the lifetime cost in suffering from just one former Marine's longtime battle with PTSD, I'm pretty sure we already are.  Thank you, Rob.

"Winners Go to Harvard, Losers Go to Vietnam..."

(Cough, cough -- sounds like bullsh*t to me!)

---

The post title comes from a wonderful -- though not to him, and not at the time -- reminiscence sent to me lately by a Vietnam veteran buddy, telling his sad tale of woe about linking up with an old high school friend on homecoming, and getting essentially tossed under the bus.  

I'll include Pat's retelling here, because it's much better than I could do paraphrasing it, but really -- there needs to be a special circle of hell reserved for dirtbags like this guy he mentions.  I wonder if anything happens to them in their later lives that would somehow even the score.  Perhaps they develop some compassion, or maybe if they do, it's just too little, too late. 

(In a reverse post-script added here before the text, not after, I have gone back and checked with Mother Harvard -- who practically keeps a retina scan of all of us who've ever gone there, in the vault, just in case we end up wealthy and can donate the big bux -- and the guy in question seems not even to have attended, let alone graduated from there, which only makes this story that much more painful to contemplate.) 

Herewith, Pat's story about a homecoming moment that has stuck with him ever since.  To set the stage, he had just finished fighting in Khe Sanh, in 1966, on his first tour with the Marine Corps, 2/9, H & S "Flames" Company:

"The C-130 took off immediately with us all tucked safely aboard on our way to the real world, The United States of America and for me; Houston, TEXAS.  On the hop from Hawaii to the world, I was thinking about my mom and dad, my two brothers and two sisters, my sweetheart-Betty Jo and all of the high school friends that I had left behind and even about my coach and teachers. 

I began to daydream that would get off of the plane in Houston and everyone would be there to meet me and they would all run out to me and hug me and cry.  I would take Betty into my arms and kiss her and swing her around in the air as I held her close to me.  We would laugh, we would cry and we would kiss.  She would smell so wonderful and would be so soft and it would be all great.  They would all shout and cheer and clap for me and push around me to reach out and touch my uniform.  I would be appreciated. 

I would go to this big homecoming party and there would be a "Welcome Home banner," eggnog, lots of hot food, every Christmas decoration ever made and everyone would be overjoyed to see me and so proud of me and elated that I had made it back alive.  I would be like a real hero and the center of attention.  

I would borrow my big brother Mike's 1965 red Ford Mustang and cruise by my old high school and everyone would be pumped to see me, have missed me, flock around me and want to know what I had been through.  I guess I really did want to be like my dad, a real war hero.  We had been deep in the bush on the verge of being overrun by a NVA Division, taking many casualties, less than 36 hours before -- and my brain could not seem to make the transition. 

We finally landed at Travis Air Force Base in California, the ramp went down and mules were there to unload the caskets on.  We filed off, were directed to a taxi area and caught a cab to the San Francisco Airport.  And then just like that we were walking around in downtown America.  I was so uncomfortable that I almost wanted to get back on the C-130 and go back to Nam... 

The airport was real busy and I don’t remember much except being real uptight and anxious like I expected something to jump out and get me.  There were mostly military personnel loading and unloading so I didn’t feel totally out of place with the people but just uneasy with the surroundings. 

We caught our flight to Houston, TX and it was very nice.  I remember smelling the perfume of the flight attendants and then the realization hit me: honest to God, I really was back in the “world”. 

But it all still kind of seemed like a dream, like I would move from real time to slow motion and back and always through a haze. 

I then allowed myself to let my guard down and I began to get real excited and almost cried but choked it back.

We landed and taxied into Houston Hobby Airport and my heart was pounding so fast and hard that I could feel it in my ears.  I was really, really excited!! 

As we came down the stair ramp I could see a crowd of people -- moms and dads, sisters and brothers, girlfriends and friends -- all running toward us and hugging the people disembarking from the plane.  They were laughing, crying, and talking loudly and excitedly.  I became to be overcome with emotion and my eyes completely teared up and I couldn’t see.  I couldn’t wait to see all of those I had waited so long to see.  As the crowd moved in small groups to the terminal I searched the area and the realization also hit me; no one was there to greet me. 

I was finally back home and all alone.  My breath went out of me in a gasp and a pain hit me like a bullet in the gut. I actually got dizzy.  I was left standing on the tarmac by myself as the crowd of people cleared out.  My heart sank to the bottom of my shoes with disappointment.  In all of the rush to get home, I had forgotten to call anyone and let them know that I was even coming home.  I had come from hell to paradise and no one even knew about it.  Man, I really felt bad. 

Even though it was my fault, I started getting really angry and went into the terminal to pick up my sea bag. Everyone was rushing every which way.  I guess I thought that everyone should have known I had just returned from Nam but they all just pushed past and around me like I didn’t even exist.  I wanted to shout: “Hey, I just got back from the friggin bush; I left buddies back there. I just came out of combat and was killing gooks two days ago.  Doesn’t anyone give a friggin damn?!”  But no one even looked at me. 

As I was making my way through the crowd, I spotted a friend of mine from Memorial High School, Jim Baird.  He and I had been on the high school swimming team together but he was from the upper class Memorial area and I was from the middle class Spring Branch area.  I thought we were friends, though. 

My heart jumped; here was my chance, someone to welcome me home and it was one of my ole swimming buddies.  I moved up behind him and said: “Hey Jim, where have you been?”  He turned, looked at me in my Class A’s and got a frown on his face.  He said coldly: “I’m going to Harvard”. He then turned abruptly away from me.  He didn’t even ask anything about me at all. 

I touched him on the shoulder and said: “Hey buddy, how have you been.  I’m real glad to see you again.  I’ve been in Vietnam for the past year.”  He said: “Why? Only losers go to Vietnam, winners go to Harvard.”  And he just turned again and walked off like I wasn’t alive. 

I was completely caught off guard and was actually shocked.  I had never expected anything like this.  To be rudely snubbed by someone I thought was a close friend.  I had heard of this back “in country” but really didn’t believe it.  My eyes watered up again but this time from God Damned seething anger and I hated the fucking world and everyone in it.   No one really did give a tinker's damn about us or if we were there or not.  I wanted to track him down and kill the son of a bitch."

---

Well, Pat, I wasn't gonna offer to help you track him and kill him -- and I know that's just a figure of speech you're using ;-) -- but I figured even at this long-distant remove, that if I helped you find him -- you could at least leave him a flaming paper bag of cowsh*t on his doorstep, ring the doorbell, and hide in the bushes while you watched, with pleasure, his attempting to stamp out the flames (in his loafers, with no socks?! It's a Harvard thing.  You wouldn't understand :-). 

(The flaming bag of cow poo is an age-old, country-esque revenge fantasy, conflated in my mind with the wonderful one Richard Brautigan wrote about in "The Good Work of Chickens" -- that involves dumping several tons of chickensh*t on someone's lawn who he's annoyed with, to teach them a lesson.) 

But the reality is, it doesn't sound like the guy even went to Harvard, after all.  So I'm not able to be of that much help.

However, Pat might be pleased to know -- in addition to his tormentor probably having been quite the BS-er himself -- than in the meantime, Harvard has developed some sensitivity towards veterans -- there's even a veterans group at Harvard, linked here. (They say that "there are thousands of living Harvard Veterans, and more than 1,200 Harvard graduates have given their lives in war." - 1,200 isn't a lot, proportional to the rest of the U.S., but it's still better than say, "none.")

According to their site:

"It is interesting to note that, on any given day, there are more than 150 members of the Armed Forces of the United States present in the classrooms and activities of Harvard University. 

There are approximately 85 returning Veterans who are pursuing degrees at the Harvard Business School, while 60, mostly active duty officers , are in Master’s Degree or Executive programs at the Harvard Kennedy School. There are small numbers of Veterans at other Harvard Graduate Schools, and 35 or so students are in the ROTC program at Harvard College, which is administered through the Paul Revere Battalion at MIT."

Also, although there's some dispute about whether Thucydides could ever have said this, there IS a quote attributed to him that has inspired smart Ivy League types to also become soldiers and Marines.  The quote that motivates them is this: "The nation that makes a great distinction between its scholars and its warriors will have its thinking done by cowards and its fighting done by fools."  Well, it's a catchy phrase, anyhow -- and gets its point across.

I can't remember whether that quote is one that inspired Nate Fick to become a (now a former) Marine officer -- Fick is a graduate of both Harvard's Kennedy School of Government, and the Harvard Business School -- he quotes a different Thucydides one in his superlative book, One Bullet Away: The Making of a Marine Officer":

"We should remember that one man is much the same as another, and that he is best who is trained in the severest school."

(Not sure whether that "severest school," though, is the Marine Corps, or Harvard, or both :-) 

In any case, just to prove that Harvard has in fact come a long way since not sending very many of its sons and daughters off to war, I was able to be an invited guest several years ago at a celebration honoring Harvard graduates who were veterans, held at the Harvard Business School, around the time of the Marine Corps' birthday.  The room was filled with all sorts of people, in uniform and out, milling around, networking, and really, it seemed like a great cross-section of graduates, from the very old to the very young, from the retired and former servicemembers to those who had just signed up. 

(It also provided me with one of my Embarrassing Life Moments -- asking a smartly-dressed man*, who later turned out to be a multi-star general out of uniform, and the keynote speaker -- what his "outfit" was, because it was so "interesting" and "beautiful."  To which he gamely replied, after explaining what it was, "and who, by the way, are you?!" or words to that effect.  He was probably more so looking to ask, "and who let the riffraff in"?!)  In any case, here's a photo or two from that event, which Nate Fick was actually emceeing.  Just to prove that there are in fact, graduates of Harvard who are also veterans -- though it truly seems that Pat's tormentor, above, actually had spine enough to be neither...

---

There's also an interesting OpEd piece from a recent issue of Military.com, in which another former Marine who served in Vietnam -- though later than Pat, above -- talks about the classic town v. gown disparity in who actually serves.  It's called, tellingly, "The Somerville Marines," and I wish someone in the Harvard veterans community would either confirm or rebut it, because it seems to need to a response from the other side of the fence.  (Somerville is one of Harvard University's poorer, working class neighbors, and the article's author, Joseph Kinney, makes the point that it sends disproportionately too many of its sons and daughters to die, versus Harvard.  The article is linked here.)

---

Editor's note: * My mistake, obviously, but hey, he didn't look like the guy in the published program -that guy was wearing a khaki green uniform -- and I'd never met a multi-star general before :-)  (Or since, either...)  Of course, it's faux pas like these that clearly explain why I blog :-) No social graces whatsoever :-)

Moving Violations, or the Needle in the Red Zone - Combat Veterans and Adrenaline Addiction

Adrenaline in combat helps the servicemember stay alive, and execute the plan.  Being addicted to the same adrenaline rushes after combat, though -- back on the home front -- can go from being an asset to a liability -- especially behind the wheel or on the motorcycle, and contributes to the sad phenomenon known as "non-combat deaths" from various origins.

Enough returning combat veterans kill themselves through reckless driving that different steps are being taken to warn participants of the semi-obvious dangers:

The Guardian (UK) newspaper has a story in today's paper, previously published yesterday in the Observer (UK), about the the British military's current advertising campaign to warn returned servicemembers about the dangers of amped-up, reckless driving.  The article, "Ads warn soldiers back from war zones against reckless driving," is linked here.

Says the article, "British soldiers are twice as likely as civilians to die as a result of reckless driving, because they have difficulty adjusting to normal life after returning home from active duty, according to official statistics."  The ads feature catchy slogans, such as "Drive Carefully.  You're Tough, but Not Invincible," and one directed to motorcyclists, "You're An Accident Waiting to Happen."  Hmmmn.  Those ads are likely to catch people's attention -- in fact, almost 60% of troops surveyed said they would think about slowing down, said the article, after considering them.

---

Rick Roger's article in the May 23 issue of the San Diego Union-Tribune talked about the rash of non-combat fatalities among Marines at Camp Pendleton, many of whom had died in motorcycle fatalities.  Five Marines had died in the past eight days, where the "confirmed or probable causes" were homicide, suicide and traffic accidents. The article described Marine commanders and commands "backtracking to see if we need to do anything different to avoid these things happening again.”

It also clarified:

“Two of these deaths were caused by apparent motorcycle accidents, an area of deep concern for our Corps as motorcycle fatalities continue to rise at an alarming rate,” the statement said. “In a recently released All-Marine Message, the commandant outlines guidance and directives designed to curb motorcycle injuries and fatalities.”

Motorcycle-related deaths in the Marine Corps have risen every year since 2004, when there were seven. Last year, there were 19, according to the Naval Safety Center.

As for efforts to minimize combat stress and substance abuse, Camp Pendleton officials said the base has programs, policies and officers devoted to outreach and education. They also said each unit conducts monthly random drug tests on a mandated percentage of its Marines."

(Since that article was published, even more Marines have died as a result of motorcycle accidents.  See the article by Trista Talton in Friday's Marine Corps Times, linked here.  She writes, "Twenty Marines have died in motorcycle wrecks since Oct. 1, making this fiscal year the deadliest on record despite the Corps’ efforts to reduce two-wheel fatalities."  YIKES.

---

From an article in the May 13, 2008 edition of the Marine Corps Times:

The new order, a work in progress for about six months, was initiated because of the number of motorcycle fatalities and injuries occurring within II MEF. From October 2007 to January 2008, more II MEF Marines died in motorcycle wrecks than in combat.

According to the order, released April 29, most of those deaths involved junior Marines and included things such as reckless behavior, blatant disregard of orders and policies, lack of proper training, little driving experience, alcohol and willfully disobeying state and federal traffic laws.

Information about the order is linked here.

 ---

"Adrenaline addiction" is a familiar concept but by no means an official diagnosis (there are, however, informal support groups for it, on the Web, although I wonder if they're not just catchy names for invitations to drag racing and hang gliding events :-).

Sgt. Chad T. Jones wrote about it, back in April of 2004, in an article called "Flipping Off the Switch Can Save Your Life," linked here, first published in a Fort Bliss military publication, called the NCO Journal.  He introduced the article by saying:

A Soldier who has recently returned from Iraq might experience a need for a combat-level rush, called adrenalin addiction. The cravings for this excitement could kill him, but a patient, informed leader can intervene to save the Soldier’s life.

This information is a little on the generic side (in other words, seems like common sense) -- but apparently it's worth thinking about for those who haven't already considered it.  (It would be interesting, too, to learn the age ranges of those surveyed, above, who thought that just seeing the ad's message would reinforce their behavior towards slowing down and being more reasonable.  My guess is those were the older survey participants, because with age comes wisdom -- or so they say -- and/or the change to experience a few close calls with reckless behavior, which also has an impact on slowing us down.

From the same 2004 article:

Adrenaline addiction is something Soldiers returning from deployment are susceptible to, and is described as the need to engage in excitement-seeking behavior, said Col. Robert Gifford (Dr.), associate professor of psychiatry, Uniformed Services University of Health Sciences.

“Soldiers, when they come back from a deployment, have often been observed engaging in ‘excitement-seeking behavior.’ It includes a lot of people who liked excitement before and
Soldiers who come back [from a deployment] and miss the excitement, and sense of purpose that comes with a deployment,” Gifford said.

Usually, Soldiers are able to adjust their lifestyle or compensate for the lower operation tempo, but unfortunately other Soldiers “can’t find adequate ways to fulfill themselves, and they become excitement junkies,” said Lt. Col. (Dr.) David M. Benedek, associate professor of psychiatry, Uniformed Services University of Health Sciences.

Specific evidence stating why a Soldier seeks danger is not existent, Gifford said. But a popular opinion among medical professionals is that Soldiers are trying to replace the constant adrenaline needed to be successful in a combat environment.

“Operational or combat environments require a sense of alertness all of the time and it is very difficult to turn that off when you return home. Even though Soldiers are glad to be home, many found features they enjoyed while deployed,” Gifford said. “Sure it’s hot and miserable, but there is a sense of purpose. Suddenly, you’re home and those senses of purpose or excitement are suddenly gone, and people may not want to give that up so quickly.”

One way emotion leads to the reckless behavior is that Soldiers feel indestructible when they get home because they survived combat. That carelessness or sense of being indestructible can be dangerous, Gifford said. “Clearly any person who gets involved with risky behavior puts themselves in a position to get hurt, or killed,” he said.

While "adrenaline addiction" or being an adrenaline "junkie" isn't a true "addiction," as defined by the experts, there are some obvious similarities, including developing cravings for the environmental stimulants that provide the adrenaline rush -- many of which were available in combat situations, but not on the home front.  It's hard for many returning servicemembers to calm down -- and this is understandable -- after the rigors and the scares of combat.

Says the article:

"Upon detection [of the problem], leaders have many options they can use to help the Soldier. “There are a variety of mental health sources,” he said, but many Soldiers feel more comfortable talking to Chaplains or someone else. The important thing is to get the problem surfaced.”  Once the problem is brought to light, it’s important to figure out why the behavior is occurring. “Reckless behavior may be a signal of a number of illnesses or situational things that might resolve itself on its own or it might take a medical professional to figure out what to do,” [Col. Robert] Gifford said."

As I'm typing this out, though, I'm reading an email from a favorite Vietnam vet, telling me about the battle for Hill 881, and saying, in part, "without masses of adrenaline rushing through us, we couldn't have done this..." Aye, there's the rub.  Sometimes it's a total asset to have it; and just as easily, it becomes a grave liability.  Context is everything.

If you remember watching the Kellee Twiggs video (SSgt. Travis Twigg's wife, speaking after his death from PTSD), you will recall her talking about how jumpy her husband was -- how he couldn't sit still long enough to watch a movie with her and the kids; that his legs were always twitching.  To a certain degree, this must be a conditioned response from combat -- all that hyper-alertness turns into just plain jumpiness, with nowhere to go.  No wonder people try to bleed it off, doing risky things -- it keeps the feedback loop primed.

Sad to say, though, it's a feature of post-deployment life that servicemembers will need to get a handle on, through any reasonable means necessary -- and with good advice from practitioners they trust -- because failing to do so will prolong their suffering, and put their safety and sometimes that of other people's at risk.  Good for the British to be doing these ads, but as the popular saying goes, you can't really regulate human behavior. Suggesting that there might be a problem, though -- may be what amounts to a start.  An attempt to get the needle back out of the red zone...

Doing My Time in Hell - War Just "Dirt, Death, Misery and Guilt," Not Glory - Say Veterans

This photograph of an American soldier displaying his ink about combat is by the noted photographer Zoriah, and is used with permission of the photographer.  (Zoriah's blog is linked here.) 

The tattoo reads: "Walk peacefully on heaven's streets,You've done your time in Hell."

Ahhh, if it only were that "easy." 

I've been keeping one eye on Zoriah's situation lately -- he's the embedded humanitarian war photographer whose iconic images of the true horrors of war apparently got him kicked out of Iraq -- and the other on some writing of Vietnam veterans, all of them Marines (but not for any particular reason), about what it was really like to "be there."  The outcome of my faux research?  Sounds like up close and personal, war can be plenty of "guts," but not necessarily all that much "glory."

"The flashbacks and the hallucinations manifested themselves while I was still in [combat], says one Vietnam veteran, adding, "They have stayed with me for the last forty years." (Rob Honzell, 1st Recon Marines. Rob Honzell's memoir is "First Person: Combat PTSD.)

Another Vietnam veteran questions why Americans reflexively call servicemembers who die in combat "heroes."  He writes,

"Heroes?!! I served two tours in Vietnam including the Tet Offensive of 1968. I killed someone -- a NVA solider -- I was elated -- but years later, I can still see my round hitting this guy. I never see any heroism in war -- just death, dirt, misery and guilt. I have never met a soldier or Marine who felt heroic. We do our jobs to protect our buddies and we want to get home and live our lives as ordinary men not as heroes. When you smell death you no longer have a glorified sense of war. There is honor and duty, but to kill or be killed does not make you a hero. I feel for these young people and their families -- but war and combat are not heroic actions -- they are doing a job and getting home."

(Or hoping to.)

---

I've been reading voraciously the accounts of the Marines who survived the ferociously fought battle for Hill 881, part of the battle for Khe Sanh in 1967 -- a particularly vicious conflict.  (You'll find out why, in a few posts, but not right now.) 

One Marine captain writes about his guys, from there:

"As far as the individual Marine goes, I think I learned to respect the individual Marine -- the 18-,19-, 20-year-old, more in this one particular battle than any other time that I've been in the Marine Corps. He was given a job; he went up in the fact of danger, in the face of just being blown away, more or less, and he went up and did his job. To see the faces of the Marines dragging back their dead buddies, their wounded buddies, you could see how close the Marines really were with each other. It was true brotherhood, and I was really proud at the conduct of the Marines." (Capt. David G. Rogers, C Battery, 1/12 Marines.)

Says another Marine, reflecting on his part in the vicious battle for Hill 881 -- "I should have cried" (at the time), but I didn't.  I didn't have time.  I would cry later, and when I did - the tears would never completely stop..."

---

It doesn't sound like war has changed all that much.  Remember Ambrose Bierce, Civil War era journalist and soldier, who we talked about a few weeks ago?  He wrote at the end of his highly-charged battle memory / short story, a line -- speaking about himself, after what he'd observed and taken part in -- "the life I should have thrown away, at Shiloh." (Bierce went on to stir things up for a few more years, though...)

---

A current veteran and fellow fan of Zoriah, now studying social work in an attempt to ease the burden of his fellow PTSD sufferers, has this to say about combat trauma, on his blog, "PTSD - a Soldier's Perspective," linked here:

"We tell a soldier or veteran of war "welcome home" because the battle never leaves us, as we return from conflict everyday of our lives. This is my story and struggle with PTSD, it affects every aspect of my life. I want people to know what a combat veteran goes through after the media and people forget."

And later:

Taking another's life in the name of freedom, patriotism and because of your job description profoundly changes the person. How do we reconcile the killing of another human being and still maintain our principles and values? Someone who has not done so can say all they want about what they think or believe. When a soldier goes home to his or her family, friends and community, how do we relate to people who expect the person that is no longer us? How do we tell them that each time we took a life that, we too died in spirit a little more? They congratulate us on a job well done and we tell ourselves that we did our job, what we were trained to do. They tell us how proud they are, and we cannot make them understand how we feel guilty for that pride. How do we tell them that we cannot get those faces or images out of our mind?

Dirt, death, misery and guilt -- that's a heavy, heavy burden for any one person to share.  Let's hope we shoulder it with them, and NEVER forget.

We Made History Together: The Oral and Written Histories of Combat Veterans

Combat veterans - where did your memories go?  Not as in, "have you lost your memories?" but more to the effect of, "how are you saving them or transmitting them, for posterity?"

This marvelous photograph was taken by photographer Jeremy Hogan, and is used with permission. Hogan wrote the "Poem for My Father" which we blogged about earlier, and in his free time, he's helping to document the history of his father's squadron in Vietnam.  He says about this photo, taken over Memorial Day weekend, that the subject is, "Ron Klus, who served with my dad at Quan Loi, and received a Distinguished Flying Cross with an Oak Leaf Cluster. Unfortunately, Klus died due to issues related to his PTSD and now the VA is now denying his widow death benefits."

Recently, I've been privileged to receive several veteran's memoirs, bound up in book form -- one is a work in progress, the other already published.  I know that Jeremy is working with at least one of the guys from his dad's old squadron (13th Signal Battalion, part of the 1st Cavalry Division Airmobile), a combat photographer who did multiple tours of Vietnam, on cataloging his old photos, and creating some sort of archive for posterity.  That photographer says he's been interviewed as well, and is the subject of an upcoming article in a military magazine, but admits that dredging up the memories has been extraordinarily painful, because all those memories just come rushing back, from where they've been suppressed all these years.  That situation is challenging enough -- but what of others, who will die before they set anything down on paper, or on tape, about what they went through?  Those memories, painful and otherwise, which capture who the person was, will forever be lost to time. Unless...they're preserved some kind of way.

We've written on this blog before about the exceptional StoryCorps project -- click here for that link -- but what else is there out there, that archives veterans' recorded stories of their adventures and misadventures in combat?  (By recorded, we mean "set down" -- which could be on paper, digitally, or taped.)  One thing I've run across -- and please let us know if you know of other things like this, that are national in scope, not just regional or local -- is the "Veterans History Project," a project of the "American Folklife Center" at the Library of Congress, linked here. 

To participate in the project takes a few easy steps (their words, not mine), and seems pretty straightforward.  You register for the project, print the project field kit, prepare f the interview, conduct the interview, and send the resulting work product to the collection at the Library of Congress (of course keeping at least one copy for yourself).  Students and teachers can make this an educational project for school credit, -- that information is linked here -- but veterans themselves should think about getting involved. There's even a very cool place on the site where you can search for histories by other people who've participated -- for all you know, you might find a wartime buddy via that search engine, which is linked here.

I recently shared a quick conversation and a hug with longtime Friend of Veterans Maxine Hong Kingston, and asked her my one burning question, which was how long it took veterans before they were willing to talk about their experiences.  She said, "20 years."  I'm hopeful it doesn't always take that long -- or won't take that long, for the current crop of veterans -- but when you read some individual's war experiences you can see exactly why that would be. 

Current veterans like Tony Neff, author of the short autobiographical piece on his injury and convalescence, called "All I Want Is What I Deserve," which was published on this blog a few months ago, definitely took the plunge and jumped right in -- good for him. (His story is linked, here.)  I just have the feeling the current group of vets, thanks to the Internet and technology, etc., and their general comfort level with same, is going to break through all previous barriers more quickly with getting their stories told and out there, for the general public and to memorialize what they went through. In fact, it will seem unusual for them not to! 

But for everyone else, from previous wars, it's gonna take a little more coaxing and cajoling. So what of it -- is it time to start getting involved, and sharing with the world what only you know and experienced?  It might even help your loved ones understand you a little bit better -- and in the process, perhaps help you to understand and forgive yourself a little more, too.  Can you hear me cheering you on from the sidelines?  That's good -- because that would be the point :-)

Two Graves for Forgiveness - One Vietnam Veteran's Poetry Helps Him Heal

In the spirit of the recent blog entries encouraging us that any time is the right time to write poetry -- including the very most difficult, troubling times in life, as well as the carefree and sweet -- and another one showing us how, here is one former Marine and Vietnam veteran's poem about the soul-destroying nature of combat, as he now sees it.  (Forgiveness - of one's self and others - is a common theme in veterans' poetry, understandably so.)

The author, Larry Winters, is a Vietnam veteran and psychotherapist who served with the Marine Corps in 1969 and 1970.  He apparently delivered this poem (meaning, spoke it) on the occasion of a dinner with General Diep and some others, on a return visit to Vietnam.  Winters is also the author of The Making and Unmaking of a Marine: One Man's Struggle for Forgiveness, linked here.  Here is the poem that he wrote:

If a man kills another man

He must dig two graves

One in the earth for the dead man

One in his heart

for his own spirit

Or he will not return.

Editor's note: An article entitled, "Poems of Pain Help Him Heal War Trauma," about Larry Winters and his work, was published in the Middletown, New York Times Herald-Record on March 19, 2007. The article is linked here. 

More importantly, Winter's own website about the book is linked here. Vietnam veterans and others may appreciate how much information, and photographs, Winters has packed into it.  It is sure to bring back a lot of memories.

Of Vietnamese and Veterans: To "Forgive Themselves and Heal..."

A story told by Edward Tick, Ph.D., author of War and the Soul: Healing Our Nations Veterans from Post-Traumatic Stress Disorder,  in an interfaith sermon from November, 2006:

Here is a story from My Lai, a hamlet as full of loss for the Vietnamese as Ground Zero, Manhattan is for us. I met a 75 year old woman there, the lone survivor of her entire family. Her parents, husband, children were all killed in the massacre. She said that it would have been far easier to die that day than survive to carry this pain her entire life.

Grandmother,” I said. “Then how do you feel about us Americans visiting you here?” "You must come,” she said. “Everyone must know the story.”

“I understand," I said. “That is why I am here. But what about our veterans? How do you feel about them returning? They might have killed your people. They might have even been here on that day.”

“No,” she answered. “You must understand this. Often I think the only reason I survived with this pain is so that I could live to meet your veterans, take their hands, look into their eyes, forgive them and help them forgive themselves and heal.”

Source: Tick's sermon, "Stop the Hate," from which this story comes, is linked here.  His book, War and the Soul: Healing Our Nations Veterans from Post-Traumatic Stress Disorder, is linked here. To read a quick web bio of him, click here.

When the Marine Corps Misses the Bigger Picture -- Zoriah, Eric Acevedo, and Censorship

It's discouraging to even have to post about this, but there it is:

In a fight between the Marine Corps and freedom of the press, the Marine Corps seems like it wants the win.  According to Google Playfights (see gimmicky graphic illustrating this post) it already has.  (Learn more about Google Playfights elsewhere: it's not central to this post.)

Following the recently-embedded independent photojournalist Zoriah's travails on his blog, it seems that he's just now been kicked out of Iraq, and risks being completely blacklisted as a war photographer, because of at least some higher-up Marine Corps officers' displeasure with images he posted.  Images that centrally could help America to really get a better grip on the true cost of war for its participants.  If you believe the experts -- and the poets --no one comes back from war unchanged.  Whether it's what you've done/seen/participated in or not been able to do/see/participate in, it exacts a tremendous psychic cost.  That doesn't mean we should stop fighting in wars -- just that we should be more aware of the actual costs to those who do.  For every combatant killed, so many more are injured, and will come home with injuries that in many cases will profoundly transform their lives, and that of their families, for decades to come.  It's a shame the Marine Corps doesn't seem to really want the rest of us wrap our brains around this concept more fully.  It would help make us better empathizers with the true cost of war to its participants.

I had my own experience with Marine Corps censorship, earlier, on this site.  In an attempt to humanize the story of an apparent PTSD sufferer who'd killed his girlfriend, I dug through the Marine Corps (public) archives on their website, and found a little backstory about the Marine, Eric Acevedo, who'd been accused of the crime.  In and amongst the materials were some very key items: a photo that showed the human side of his grief and pain; and some material -- if you knew where to look -- that explained just what he'd been exposed to, in terms of combat trauma, while he was on the deployment that apparently harmed him the most.  It was a tragic tale, but it was also public knowledge -- at least, information accessible by the public, that could be pieced together by someone like a journalist who knows how to dig and highlight the important parts of the story.  I posted what I found, in an entry linked here -- and within three days, the Marine Corps had taken pains to scrub ALL identifying information about this poor guy, Acevedo, from their site.  The photo was gone, the article about the memorial service he attended, for the multiple guys KIA from his battalion on the tour in question -- all gone.  I learned about this new development when a reporter from the Dallas Morning News contacted me and said that all my links were down (I'd included them in the original piece, so anyone could follow and see what my sources had been).  Together, we backtracked through the Marine Corps archives, and found NOTHING -- the site had been scrubbed clean of multiple mentions of the accused -- and has stayed that way ever since.

Nobody likes bad publicity, of course, including the Marine Corps -- but really, there's so much more at stake than that.  When it comes to combat trauma and PTSD, the focus of this site -- it's important as a society that we see, learn, and otherwise come to understand what veterans go through -- or we won't have the compassion that we need to, and we won't pull for them to get the services they deserve, otherwise.  We also need to see more clearly the link between instances of combat trauma, and ultimately developing PTSD.   Not so that "no one else will join the military" -- not at all.  So that those who do can get the help they need, and those in charge can allocate their resources accordingly.

It's my firm conviction that combat veterans don't "give" PTSD to themselves.  They "get" it from what they've experienced.  And this is a true cost of war, for the Marine Corps and others to "count" in advance, so that the right opportunities for treatment and ideally recovery can be provided.  We can see from the late SSgt. Travis Twiggs' battle with PTSD -- or many others like him -- just how powerful, thorough, and deadly an opponent it really is.  What we're not seeing, unfortunately, from the Marine Corps -- in these two instances -- is a reasonable, big picture view on how the horrors of war are not something the American public needs to shy away from, but embrace.  And where the two may be linked up, as in the Eric Acevedo story, it's crucial that the Marine Corps not distance itself from its warriors, even when they're dented with significant wounds, visible and invisible. Sanitizing war?  Why bother... Actually supporting the troops who go? Oh, definitely.  If knowledge is power -- we need more, not less - in order to do so, more effectively.

In the Zoriah situation, it sounds like someone may have snapped under the strain and started a bad ball rolling with that -- created a polarized position that no one could retreat from, gracefully.  If that's the case, that's a real shame.  There's a much bigger picture here, and finding a workable compromise would be greatly important.  I remember reading one Marine officer's published dispatches from Iraq, which got progressively darker and unpleasantly snappier as his tour went on, to the point that it sounded like another person writing them.  I commented about this to someone who knew that Marine, who told me a little side story that explained a lot.  Things had been going well until that Marine's superior, to whom he was very close, was seriously injured and almost died, taking part in a humanitarian mission with the Iraqi government.  At that point, the junior officer hit a wall, got bitter, and got very angry with the Iraqis who could have done that, while the Americans were just trying to help.  What I had been picking up in the Marine officer's writing reflected the personal struggles he was genuinely going through -- struggles which are highly understandable to anyone interested in human nature.  My guess is here, someone who felt very stressed and angry because of Marines he cared about being injured and dying, snapped down on the whole situation instead of privately (or publicly) processing his natural grief -- and the ultimate impact might be, if this continues to go wrong, to keep the rest of us from being able to experience war a little bit more, even vicariously - in order that we better understand, and grieve, with those who suffer.  I hope the Marine Corps finds a way to resolve this situation that respects the points of view of all sides involved, including the American public, which does have a need to know.  The same goes for the Eric Acevedo situation, and scrubbing the information from their archives.

The American public pays the bill for these wars: we have a right to know what they're like for those fighting them.  And those who fight them pay the ultimate price: and we respect their efforts and the character it takes to be warriors, very much.

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I shared a very bleak, grim quote with a Marine Corps Vietnam vet the other day, from an Italian in the Middle Ages who said, "Life is a voyage on uncharted waters, ending in shipwreck.  There are no survivors."  The former Marine, still struggling all these years later with PTSD, said the quote was almost right -- but would be better if we switched out "life" with "combat" or, "war."  Then, he said, it would be more accurate, because, quoting him, there are no true "survivors, only shipwrecked lives..."

Editor's Note: You can read about Zoriah's developing situation on his blog, linked here.  You can also read previous entries on this blog where we've mentioned him, here and here.  You can read about the Travis Twiggs story here, and in many other entries on this blog; and the Eric Acevedo story here; both as I've blogged about them. 

And while you're at it, considering asking the Marine Corps to put the Eric Acevedo material (and anyone else's they've removed, in similar circumstances) back on their publicly-searchable archives, as it was before.  I'm sure his defense lawyer would appreciate it, because any good defense of this client is going to need to advance theories that involve his extenuating circumstances (combat) and things that speak to his state of his mind (PTSD), both of which it's hard to picture were NOT service-related.  Acevedo's crime?  A  truly terrible one.  The combat trauma he experienced, and the PTSD he likely developed?  Also terrible.  Without war coverage like Zoriah's "tragic and amazing" photography, also a big picture we're likely to miss.

Find the Cost of Freedom, Buried in the Ground

It's an old Crosby, Stills & Nash song, by Steven Stills. Many of us who were there in the 70s still remember the words. I know I can recite them from memory: "Find the cost of freedom, buried in the ground. Mother Earth will swallow you; lay your burdens down."

Tomorrow is the Fourth of July.  Not only my favorite holiday the whole year through -- sorry, I'm a New Englander, we're just born that way -- but also another opportunity - along with Memorial Day, and Veterans Day - to stop and honor the service of those who sacrificed their lives for freedom, or at least, responded to what they saw as the call of duty that they responded to, while others did not. Those whose blood was shed on American soil -- in Lexington, Massachusetts, in the Revolutionary War -- and also, more recently, in the jungles of Vietnam, in the mountains of Afghanistan and in the sands and urban jungles of Iraq.

I'm thinking today about censorship -- and the power of an image to convey, in a single instance, what those of us who labor over our words perhaps never can.  The picture, they claim, is worth 1,000 words -- perhaps because it communicates, in an instant, across barriers of language, space and time -- what human beings instinctively understand, nonverbally.  With war: that there is a price; that it is never really glorious; that those who give their lives often do so -- as the poet W.H. Auden wrote about the famous art masterpiece, the "Fall of Icarus," by the Dutch painter, Brueghel -- in a depressingly inglorious context:

"About suffering they were never wrong,

The Old Masters; how well they understood

Its human position; how it takes place

While someone else is eating or opening a window or just walking dully along...

If you don't remember the Greek myth of Icarus you might need some refreshing.  He's the pre-Wright Brothers son of Daedalus, whose father built him a pair of wings, in order to take flight and escape from the island of Crete.  But the father glued the wing feathers in with wax, and then warned his son not to fly too close to the sun (probably without explaining actually why.)  Icarus partially succeeded in his goal -- he was able to fly, but in flying, did get too close to the sun -- at which point the sun's rays melted the wing feathers' wax and he literally dropped out of the sky, into the ocean -- having succeeded in his fabulous quest and also painfully failed, all at the same time.  That's not the parallel with the armed forces: the parallel worth drawing here is that sometimes death on a glorious "mission" turns out to be a most pedestrian thing, and the rest of us, unless we're apprised of it, don't even notice or celebrate.  On a deeper level, it brings up the question: as Americans, how exactly do we "support the troops," if we're not even really aware of what they're up against?

Unlike Vietnam, where grainy black and white news footage of U.S. soldiers fighting and dying in foreign jungles was often watched during dinner, with Walter Cronkite narrating -- in Iraq and Afghanistan, we're reduced to very little coverage and certainly not much that could "upset" our "overly tender sensibilities."  No flag-draped coffins being offloaded at Dover Air Force Base, instantly communicating that for every loss in combat there's a grieving, distraught family and a hole in the community, left by that veteran, that will never be filled.  Even those, like me, who don't exactly excel at math -- we're more than dimly aware that for every servicemember KIA -- or killed in action -- there are scores more wounded and disfigured for life -- emotionally scarred (invisibly) as well as visibly.  The human costs are staggering: those are daddies and mommies, sons and daughters, brothers and sisters, employees and employers who come home different: maybe unable to work, maybe unable to function - initially or long-term; maybe unable to take care of their families while they struggle with their own wounds of war.  This is the human cost of war: it exists whether we are personally dialed in to it and aware of it, or not.  It is, to use the words of Hedley Peach, a "generic effect of combat."

And while the news media gives scant coverage to what is happening in the conflicts in Afghanistan and Iraq, as surely as the hands of our clock tick daily the minutes and the hours, somebody's sons, daughters, brothers, sisters, fathers, and mothers are dying, and being injured -- somewhere.  We can be for or against the wars -- forget that noise for now -- but at the very least, we ought to be for the veterans.  And their families.  If what happens is fully what they signed up for: so be it.  I'll say this for myself, if no one else: They're better people than I am.  If it's not what they bargained for: even more reason to feel compassion for what they're going through.  But here's a pretty elementary principle: if we don't see it, we can't grasp it -- and we move on with our lives as though nothing were really happening.  No coffins at Dover? No bodies on the news?  I guess this war isn't really costing that much in human terms after all...it's just another blip on our radar, hardly making a difference among the rest of the pronounced concerns of our lives and welfare.  Except that it IS happening -- and men and women are dying, and being injured, often grievously -- and we're, generally speaking, like the villagers in the Icarus poem, above (read the whole thing) pretty unaware of how that affects us, or if it even does.

And THAT is where journalism comes in, and photojournalism -- to convey in a single image, what dozens of column inches can barely touch.  A single image that resourcefully, potently conveys the reality of life and death on the knife edge, on the tip of the spear -- somewhere around the globe, and challenges you, me, us -- the viewer -- to say that it matters, and that we finally understand.

Maybe that's why in every craptastic Third World-ish revolution, they always kill -- um, that would be the military who does the killing -- the intelligentsia -- the artists, the poets, the thinkers, the intellectuals -- first.  Because I guess if you even goad the populace at large to think, why, you're a highly dangerous individual, and should be stopped -- before you can do any more harm (I mean, good.)

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Want a riveting image, that "stops the presses," and conveys for all time the intrinsic truth -- or at least, one powerful truth -- about an experience?  Turn to a photojournalist.  I've read more words than I can think of in my time, but if you want to know what I remember -- it's the images, often Pulitzer Prize-winning, from the eras of our shared experience.  Vietnam? It's the naked young girl, covered in Napalm, running from her burning village.  (We dropped the Napalm, btw...) Famine in Africa?  It's the buzzard, waiting for the tiny dark baby with its protruding ribs to just "hurry up and die, wouldja?!" so the buzzard could eat it.  (The photographer who shot that amazing scene, and won a Pulitzer Prize for it, later killed himself -- perhaps because those who witness tremendous suffering, also suffer tremendously themselves.)

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I'm not going to say who it is, because -- call me a fatalist -- I don't want to wake up tomorrow and find out that he's dead.  ESPECIALLY not on the Fourth of July -- that would be offensive in the extreme.  But the other day, some well-known and ridiculously good photojournalist blogrolled me -- stuck a link to this blog on his blog -- and I checked it out, to see what his stuff was like -- and of course it was riveting.  He's an embedded photojournalist in Iraq, or was, I should say, until the Marine brass apparently got fed up with him, and summarily pulled him out of his embedded assignment and out of the country.  His only offense, from the sounds of things?  Shooting the aftermath of a suicide blast in Ramadi -- you know, the Anbar province -- the Sunni triangle -- the previous hotbed of violence in Iraq -- which if we're to read the mainstream media, why, all that has calmed down considerably from a few years ago, and there's hardly anything brewing there at all.  Well, except for the lives of scores of people who died there, INCLUDING MARINES, in a suicide bombing just last week.  This guy documented it -- as sensitively as one could, given the horrific nature of the scene -- and he expressed the emotional toll it was taking on him, as no other experience had.  And somebody in the Marine Corps upper echelons took offense at what the rest of us call -- oh, I don't know -- the First Amendment -- and took steps to pull him out of there, on the double.

Let's HOPE the guy lives long enough to evacuate safely.  Really.  And then let's hope he still gets to show what he shot, at great personal cost -- because some of the rest of us (it's a refresher course: we're called Americans) want to actually SEE the cost of freedom -- in a way that those of us who don't serve, don't know; and those of us who do, and did -- know only too well.  It's only fair.  If we sanitize the living daylights out of these wars -- for what? -- not only will the American public not "get" the tremendous price paid by those serving AND their families; they won't be as compassionate to the same people afterwards as they need to be.  It's in all of our best interests to actively fight for, and preserve, the freedom of the press.  And that means photojournalists, who document war's horror, sufferings, and triumphs in a way no print journalist could ever begin to approximate.

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For my part, when I saw the photos in question the other day, I had myself a good, therapeutic, and instantaneous cry -- not just for the crumpled bodies of THOSE Marines on the ground -- he was subtle, nuanced and concerned enough not to show their faces, or anything else that identified them -- but for all the others I knew and knew about, who'd fought, been injured, or died there -- or returned home, not quite as intact, in body or soul, as when they'd left.  To deny us, as Americans, the chance through images like this to share the plight of those who are fighting on our behalf elsewhere in the world, is to deny us the chance to share what servicemembers are going through; and to deny them the chance to know that somewhere out there are people who "get," admire and respect the tremendous price they've paid through their service.

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The Marine Corps, which wants to sign more patriotic young sons and daughters up to fight, apparently thinks that by constraining the version of what reality is to just a portion of the whole will keep them happy and us in the dark, and people like this brave guy, the photographer, well, in complete limbo.  Little do they know that the patriots will still fight, but the rest of us could use an education course in compassion, sensitivity and yes, tenderness for those who've fought in battle, that only comes through expanding our horizons, and by facing the whole truth of what they're really going through, as combatants. Don't sugar coat the truth: everyone who goes to war comes back changed -- that's just how it is.  Let's develop a compassion and an understanding for what they go through, not sweep it under the rug.  The death and injury of those with whom they serve is often the most scarring aspect of combat there is.  Just ask those who've never been the same since.

So especially on this Fourth of July, as one extraordinarily talented photojournalist sits in limbo, let's hope still alive, ripped out of the fight for no other reason than that he was getting a little too close to home in showing us what war is really like -- I'm appalled to think that as Americans, we're not being trusted with the whole truth, when it's expressly the whole truth that we need, as Martin Luther King once said, to set us free.  We need to know the human costs of these battles we're in.  And suppressing the images of that just harms our servicemembers and their families, and cripples the compassion of us as a people.

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Until I looked it up just now, I didn't realize that Crosby, Stills and Nash song had other lyrics.  Apparently it does.  Besides the chorus (above), which I remember so well, there's another verse as well:

Daylight again, following me to bed
I think about a hundred years ago, how my fathers bled
I think I see a valley, covered with bones in blue
All the brave soldiers that cannot get older been askin' after you
Hear the past a callin', from Armegeddon's side
When everyone's talkin' and no one is listenin', how can we
decide?

On the behalf of all those "brave soldiers that cannot get older," could we at least not suppress and crush the efforts of those who are trying to get us to see the whole truth?  What truth is that, you may ask?  The very cost of freedom, buried in the ground -- in Iraq, in Afghanistan, and in Vietnam beforehand. Godspeed, Z.  You are a witness on ALL of our behalf, to the price that war really exacts, on those who serve in it.

The Art of War - but Not Sun Tzu's: Three B&W Iconic Images from Iraq, Vietnam and Afghanistan Depict War and Its Toll on the Warrior

Three images to ponder -- three black and white depictions of war and the veteran:

This first image, by the humanitarian photojournalist Zoriah -- currently in Iraq -- is profound, stark and spectacular.  It is also very recent.  Zoriah narrowly survived a bombing in the Anbar province last Thursday.  This is an image he captured from last Monday -- of a young U.S. soldier.  Zoriah writes: "A couple of days ago I went out on a foot patrol in Sadr City with a young a soldier and noticed the tattoo on his arm, featuring a rosary and the words “Forgive Me.”  I asked him what the story behind it was.

He said, “After my first tour in Iraq, I went back home to the states and all my friends called me a murderer and killer.  I guess I started thinking a lot about all the things I had done over here…you know.”

(Zoriah's blog, filled with inescapably riveting images like this one, is linked here.  Stay safe, Zoriah!)                                               

The second image is of a Vietnam-era veteran, standing, head bowed, in front of the Vietnam Memorial in Washington, DC, also known as "The Wall."  It's taken by French Canadian photographer, Patrick-Andre Perron, whose website is here.  Interestingly, on Perron's website, he "illustrates" this photograph with a poem he must particularly like, that he apparently saw on the wall.  We include it here:

"If you are able, save for them a place inside of you and save one backward glance when you are leaving for the places they can no longer go.

Be not ashamed to say you loved them,
though you may or may not have always.
Take what they have taught you with their dying and keep it with your own.

And in that time when men decide and feel safe to call the war insane,
take one moment to embrace those gentle heroes you left behind." 

- Major Michael Davis O'Donnell
1 January 1970, Dak To, Vietnam, Listed as KIA February 7, 1978

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The third image is of Lance Cpl. Nicholas G. Ciccone, USMC, captured by Marine Combat Artist and Warrant Officer Michael D. Fay, whose blog, Fire and Ice, is linked here.  This is a pencil sketch of a young Marine, core-level exhausted after a nine-day firefight in Afghanistan.  Says Fay: This "was the face of Lance Cpl. Ciccone I looked upon inside the freezing gutted remains of Kandahar International Airport in early January 2002. His platoon had just dragged themselves into the terminal building after completing a nine-day combat patrol. They had originally intended to be out for only twelve hours, but found a huge weapons cache and the Taliban wanted it back. I don’t know what happened during those long days, but whatever it was, these Marines had the look. And of them all, Ciccone had it in spades. The drawing shows him the very moment he’s dropped his backpack and removed his helmet. Looking at it now I realize what it was about him — the weight was still there."

Sadly, Lance Cpl. Nicholas G. Ciccone later lost his own battle with PTSD, killing himself in October of 2003. Ciccone's suicide, Fay remarked, "made me acutely aware that not all fatal wounds are physical."

Needless Trauma: What Vietnam Vets Still Don't Know about Their Service Could Hurt Them

Saw this recent press release from a California congressman, who himself is a decorated Vietnam vet, and wondered about the pain that comes from NOT knowing the full extent of what you've been exposed to, as you were serving your country.  For the particulars, keep on reading:

– Today (June 12), Congressman Mike Thompson (D-CA) took another step toward helping veterans who were unknowingly tested with chemical and biological weapons in the 1960s and 70s.

The House Subcommittee on Disability Assistance and Memorial Affairs held a hearing on a Thompson-authored bill that would give these veterans health benefits and compensation for illnesses resulting from “Project 112” weapons tests. Thompson hopes this hearing will ultimately push his bill toward consideration by the House.

Project 112, which included ship-based Project SHAD, was conducted between 1963 and 1973 by the Department of Defense (DoD) and other federal agencies. The DoD now admits that during these projects, unknowing military personnel were involved a number of chemical weapon tests such as VX nerve gas and Sarin nerve gas and were exposed to biological weapons such as E. Coli, Tularemia (Rabbit Fever) and Q fever.

“First the government denied the tests existed. Then they said the tests happened but were harmless. Now they admit dangerous substances were used on our military personnel, yet they still refuse to give them care for their illnesses,” said Thompson. “We can’t change the past, but we can begin to right this wrong by giving these men the proper healthcare and compensation they earned.”

HR 5954, introduced by Thompson and Congressman Denny Rehberg (R-MT) in May, provides veterans of Project 112 a “Presumption of Service Connection.” This means the Department of Veterans Affairs (VA) presumes the relationship between service and a health condition, making the veterans involved eligible for medical benefits and/or compensation for their conditions. For example, veterans exposed to Agent Orange during the Vietnam War are already given a “Presumption of Service Connection.”

“I understand security classifications and the sensitivity of our operation,” said Jack B. Alderson, a retired Lt. Commander from the U.S. Navy Reserves and resident of Thompson’s district. “However, these were not volunteers but service personnel ordered to do a dangerous job and they did it, and did it well, now their nation needs to take care of them.”

In 1964, Alderson was the officer in charge of five U.S. Army light tug boats that were used to test chemical and biological weapons. The tug boats acted as sampling stations and targets for disseminated weapon clouds.

After the DoD admitted to Thompson that the tests did exist and included harmful agents, they released more than 6,000 names of military personnel used in the tests. However, the GAO reported in February that the DoD had halted their efforts to disclose additional names and many veterans remain unaware that they were even involved. The Thompson-Rehberg legislation would require the DoD to hand over all the names to the VA, which must then notify the veterans.

The Thompson-Rehberg legislation has been endorsed by the Vietnam Veterans of America, Veterans of Foreign Wars, American Legion, Disabled American Veterans and Paralyzed Veterans of America.

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CONTACT: Anne Warden at (202) 225-3311, (703) 338-4480 and anne.warden@mail.house.gov.

For a link to Congressman Thompson's office, click here.

Living in the Prison of PTSD - a Poem by a Vietnam Vet and Suicide

I received a photo of this poem, by a Vietnam veteran who committed suicide shortly after he wrote it, in the manuscript of another Vietnam veteran's memoirs from his time as a Marine in Vietnam, and after homecoming.  This poem is apparently up on the wall of the "Post Traumatic Stress Unit" at the Veterans Affairs Medical Center in Waco, Texas.

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(It's easy to understand honoring the vet who wrote this poem as one of his last pleas, but seriously -- if I were being treated for PTSD and were struggling with some of the same issues, I'm not sure it would be that perky to go by this particular wall art regularly and remind myself, oh yeah, right after that guy wrote that -- well, he ended things.  Even though it's perfectly understandable why he felt things had gotten to that point; and equally well how the other vets and the staff there would want to honor his passing with this tribute.  People who believe in the ancient Chinese art of placement, feng shui, would say, never hang anything on the wall that brings your energy down, not up, when you look at it.  But I'm sure they did it out of love and respect for the guy concerned...)

As for the poem -- well, it's not gonna win any awards as a poem, but in terms of conveying one man's brokenness and pathos, it does that really well. Very sorry the story had to have such a sad ending, and not just for this veteran, but for many others like him, from Vietnam and other wars.  Here's what the poet, known only to us by his initials, "A.W.D.," wrote in 1989:

Solitude

I have lived in this prison I built for most

        of my life

And I have blocked out all reason, all guilt

        and all strife.

No one may enter this prison of mine

For I have failed at life,

        now I resign.

Now as I sit here too cloudy to think

My mind and body, they no longer link

My life I see before me, like old movies that

        aren’t real

But that’s what I see and

        that’s what I feel.

May God have mercy, may He not be cruel

May He understand the prayer of a fool

Inside of me, I hear the screams of distress

Let me out of this prison

        Please let me rest.

-- A.W.D., 1989

NPR Local Affiliate KQED's Story about VA Being Sued over Veterans' Healthcare

According to a story aired today on KQED -- a San Francisco public radio and television station, and NPR affiliate -- Berkeley, California's Disability Rights Advocates recently filed a lawsuit "that could affect thousands of veterans returning from Iraq and Afghanistan. They allege that the Department of Veterans Affairs is unable to provide timely mental health treatment for returning veterans. It describes a backlog of 600,000 claims for vets seeking care — some dating all the way back to the Vietnam War." To listen to the approximately five minute story, click here.  (And yes, this is the lawsuit that's produced the incendiary emails that have lately been in the news, including the infamous "shhh..." one about veterans suicides, which we blogged about earlier, here.)

Editor's Note: For more information about the veterans access to healthcare lawsuit in Federal court, as provided by the Disability Rights Advocates website, click here.

Rob Honzell's First Person Account, as a Vietnam Vet, of Combat PTSD

An update on an earlier blog post, from February of this year.  Rob Honzell, Sr., M.S.'s book, First Person: Combat PTSD, is now available at Amazon.com.  It's Honzell's account, in his own words, of what his Vietnam experience was like, and how they've affected the ensuing years since.  Not sure how much of it relates specifically to PTSD, despite the title -- I've just started leafing through it -- but to the extent that it's written by a Vietnam veteran who's been coming to terms with what he experienced ever since, it's worth knowing it's out there, and maybe seeing if your local library will buy a copy, to keep the Vietnam experience alive so we can keep learning from it.

It's also fair to say, not many people are able to write about their own experiences with PTSD - it's just too devastating.  We mentioned the other day a book that's just come out by an Army Ranger, Nate Self, about his Two Wars: with insurgents and with his own PTSD -- from the current OIF/OEF conflict.  With hundreds of books about the wars in our collective lifetimes, the just aren't many that address this topic directly, by people who've experienced PTSD.  Let's hope these are the start of many more contributions to the first person narrative literature on the subject.

Healing Hands: Cranio-Sacral Therapy, Veterans and PTSD

Before we leave off talking about Complementary and Alternative Medicine (CAM) therapeutic strategies for dealing with PTSD (usually, in addition to other approaches, not instead of other approaches) -- as we have been discussing lately on this blog, an index to which is linked, here -- it's important to mention one other therapeutic technique: Cranio-Sacral Therapy, developed by Dr. John Upledger (pictured at left).  You'll have to go elswhere -- like the Upledger Institute's website, linked here -- to learn more about the practice -- it would take too long to explain here, because there are several schools of thought on why it might work, and it's a fairly esoteric practice to begin with.  But...an important but...it is a bodywork therapy, akin to massage but not the same as massage, which has shown some effectiveness in improving the symptoms of PTSD.   Digging around on the Upledger Institute's site may help you learn about who practices it in your area of the country, but that is unlikely to be a completely comprehensive list.

For those who believe -- and it surely isn't everyone who does, but many do -- that the physical body "stores" trauma, craniosacral therapy attempts to "release" the stored trauma through the very light, deft touch of the craniosacral therapist.  Not everyone who's been through trauma wants to "talk about it," or "take medications for it" -- for those who are comfortable with a massage-like experience, craniosacral therapy is an opportunity to see if trauma can be cleared, lightly or substantially, using a different method.  (Rumor has it that the Navy and/or the Marine Corps, on the West Coast, is experimenting with using craniosacral therapy to treat PTSD -- more news as that develops.)

Dr. Upledger, and another West Palm Beach, FL-area craniosacral therapist, who I have known for years, and who used to practice together, worked in a novel program years ago to treat Vietnam veterans who were struggling with the effects of PTSD.  In their program were a handful of veterans and at least one medical nurse who had served during Vietnam.  The treatment program allegedly helped some, didn't help some others, and had at least one anomaly as a result: a patient who died in an unrelated car accident, soon after he reported to his family, unfortunately, how much relief he was gaining from the program.  So the results were mixed, but in general, more positive than negative.  (There was even some interest from a famous Hollywood filmmaker, who shall remain anonymous, but who's a big fan of veterans and the Vietnam experience, in filming the experience of veterans undergoing the treatments, but that created controversy for the program, and the idea was eventually dropped.)

Years later, Dr. Upledger did more work with other veterans, and at least one of them, Steve Shumelda, LMT, an ex-military guy with injuries of his own, including PTSD -- was so impressed by the treatments that he gave up whatever he was doing for a living before, and studied craniosacral therapy instead.  He has a practice in South Florida now, and has written about his experience with craniosacral therapy.  You can read more about the Upledger Institute's work with veterans and PTSD, here.

Dr. Upledger has apparently done a video that is available via his Institute on PTSD and veterans and craniosacral therapy.  You can contact their office to see about purchasing a copy.  For additional resources to read up on the topic of craniosacral therapy, veterans and PTSD, click here for a separate blog entry we did recently that consolidates a few in one place.  To read about Vietnam veteran and former Navy corpsman Steve Shumelda, LMT's experience with PTSD and craniosacral therapy, click here.

CranioSacral Therapy, PTSD and Veterans Resources

(This is a drawing by a young child who had PTSD but clearly was not a veteran, given to his CranioSacral practitioner, illustrating what he felt to be her "healing hands.") 

Some resources about CranioSacral therapy and PTSD (this list is not meant to be exhaustive):

An article written by Dr. John Upledger, founder of CranioSacral Therapy, published in the November, 2001 issue of Massage Today magazine, on "The Role of CranioSacral Therapy in Addressing Post-Traumatic Stress," linked here;

An article from the January, 2001 issue of Massage Today magazine, written by the magazine's editorial staff, called "The Power of Touch: Promising Studies on Treatment of Post-Traumatic Stress Disorder," linked here;

An article from the Internationa Alliance of Healthcare Educators (IAHE) newsletter, date unknown but possibly current/2008, written by the Upledger Institute, called "Upledger Research Effective for Vietnam Vets," linked here;

An article from the Upledger Institute's newsletter, apparently from 2007, entitled "CranioSacral Therapy Breaks 20 Year Cycle of PTSD," linked here.  That's the article that talks about Vietnam veteran and former Navy corpsman Steve Shumelda, LMT's experience with PTSD and craniosacral therapy, which predated his career path change.  That article is linked here.

PTSD Trauma for Veterans and Their Families is Predictable - "The Generic Effects of Combat"

In an article from Australia, there's a great quote about combat trauma/PTSD, and its very ordinariness.

(The article's topic is how "mental health problems caused by war service afflict veterans' families and children too.)  One of the premises of the article is that, based on a study, "Sons and daughters of Vietnam veterans are three times more likely to commit suicide than those of similar age in the general population (Australian Institute of Health and Welfare 2000, Suicide in Vietnam veterans' children: Supplementary report no.1).  According to the same report, "They are also more likely to die of accidental death, experience depression and abuse alcohol or other drugs."

That's the overall pretext for the article.  However, now comes the excellent quote, with a bit of preamble from the article itself, linked here:

According to Professor Hedley Peach, conducting research into veterans' sons and daughters is vital, not only to examine in detail the reasons behind their poor health but to set up support services that work for them.  He is also eager for doctors to consider war service when treating patients, as in many cases it could help diagnosis ....  Peach, a member of the scientific committee advising the Government on the feasibility study and professorial fellow at the University of Melbourne, says the Government should also consider studying grandchildren of Vietnam veterans to avoid more problems spiralling down through the generations.

''If the sons and daughters have got mental health problems and have young children themselves, what effect will that have on the grandchildren? We have to break the cycle.''

He suggests stressful familial environments could be behind the children's mental health problems, already highlighted by existing research. While many people with mental illness have a genetic predisposition to their condition, veterans were screened for mental illness before they went into the service, making stress a more likely factor in the children's ill health.

''In studies done by clinical psychologists running PTSD clinics for Vietnam veterans, children have reported a high level of dysfunction in families,'' he says. ''When we focused on Agent Orange so much in the past we missed the bigger picture. We are seeing the same sorts of problems in veterans of the Iraq and Gulf Wars, and fighters in World War II are now saying they suffered from the same problems. It is not due to any specific war, it is the generic effect of combat.''

Thanks to Kathie Costos for this reference...

Floyd "Shad" Meshad, MSW

After earning his Masters degree in Psychiatric Social Work from Florida State University in 1968, Shad went on active duty in 1969 as a Captain in the U.S. Army. In 1970, he served one tour as a Social Work/Psychology Officer for I and II Corps in the Republic of South Vietnam.

Upon his return to the states, Meshad continued his dedication to American veterans by starting the Vietnam Veterans Re-Socialization Unit at the Brentwood, CA VA Hospital in 1971. He spent eight years working with Vietnam veterans and their severe readjustment problems in the Los Angeles area. Shad was one of the pioneers in the study of the disorder known as Post-Traumatic Stress Disorder, or PTSD.

In the past 27 years, Shad has received many service awards and recognitions for his work. He authored a book about his year in Vietnam, Captain for Dark Mornings, which, highly acclaimed, is in its second printing. Meshad has made appearances on many major television networks and cable news talk shows, including 60 Minutes, 20/20, Dateline, Nightline, and CNN News. Shad continues to consult, train, and counsel nationally and internationally.

In 1986, Shad started a stress management and consulting service. In the early 90's he began focusing on treating compassion fatigue. This condition is identical to secondary traumatic stress disorder (STSD) and is the equivalent of PTSD. It is the stress resulting from helping or wanting to help a traumatized person. Through his associations, Shad introduced Charles Figley, Ph.D., a long-time friend and colleague to Dr. Roger Callahan who developed Thought Field Therapy. Dr. Callahan approached Meshad with the opportunity to study the effect of TFT therapy on veterans who suffered from PTSD. Impressed by the amazing results of this study, Shad has become a certified TFT diagnostician and practitioner, offering seminars on Levels I and II TFT nationwide.

In 2000 Shad founded Quantum Performance Institute with the goal of utilizing the amazing power of energy psychology techniques in the area of negative emotional states and attaining one's optimum performance level.

(More information follows, from a separate bio)

For more than 30 years, National Veterans Foundation (NVF) Founder and President Shad Meshad has worked as a therapist for veterans and an advocate for veterans’ rights. After receiving his master’s degree in psychiatric social work from Florida State University, he enlisted in the army in 1970, and served as a counselor for U.S. soldiers in Vietnam.

Upon his return to the U.S., Meshad founded and directed the Vietnam Veterans Re-Socialization Unit at the VA Hospital in Los Angeles, California. It was the first program of its kind, focusing on the readjustment problems of Vietnam veterans. During this time, Meshad was among the first to study the disorder now known as Post-Traumatic Stress Disorder, or PTSD.

In 1978, he worked to develop and lobby for the National Vietnam Veterans Readjustment Bill. In 1979, he founded the Vet Center Outreach Program, which now serves veterans in more than 200 locations across the country.

In 1980, Meshad was nominated for the first Olin Teague Medal of Service Award. In 1982, he published a memoir of his experiences in Vietnam, entitled “Captain for Dark Mornings.” In 1985, he founded the Vietnam Veterans Aid Foundation, which he later renamed the National Veterans Foundation.

He has served on the faculty of the International Critical Incident Foundation; as President and Board Member of the Association of Traumatic Stress Specialists; and, recently, was appointed to the Board of Directors of the Green Cross Project.

In the wake of the catastrophic events of September 11, 2001, Meshad was called upon by the U.S. government to help train the critical incident and trauma teams at Ground Zero.

Today, Meshad consults and teaches stress reduction and anger management techniques to mental health, law enforcement, and critical incident professionals through Quantum Performance Institute, a firm he established in 2001. He continues his work with veterans in the Los Angeles area, helping them through the process of healing and readjustment.

One Great Book: "Home to War - A History of the Vietnam Veterans Movement," by Gerald Nicosia

"The Past Does Not Equal the Future" -- queue Tony Robbins -- well, unless we refuse to learn the copious lessons of the past, in which case it very well might -- or it might make the past look positively enlightened, by comparison.  Another take on the same thing, by the perennial, inveterate quotemeister himself, Ben Franklin: "Experience keeps a dear [expensive] school, but fools will learn in no other."  I'm reading the greatest book right now, recommended by another journalist who's interested in veterans issues -- "Home to War: A History of the Vietnam Veterans Movement," by Gerald Nicosia, linked here.  It's 2 lbs., 10 oz., 689 pages, and roughly 136 cubic inches of nowhere-else-to-be-found material on the actual history of what created the Vietnam veterans' movement, which informs the veterans' rights movement of today, including the efforts to destigmatize PTSD, figure out what it was, re-include it in the DSM manual for psychiatrists (where it had been removed), etc.  Just fascinating.  All the players are there -- dozens of politically important types, including John Kerry, Ron Kovic (if you've seen "Born on the Fourth of July," you know who he is) as well as therapeutically important ones -- Shad Meshad, Ray Scurfield, Arthur Blank, M.D., Sarah Haley, etc. 

As a late-model Child of the Sixties, I had completely forgotten how much sheer effort -- blood, sweat and tears -- it took to get certain things passed that we now take for granted: better care at the VA, better provisions in the GI Bill, etc.  I had totally forgotten about the armed protests, the hunger strikes and sit-ins at the VA, etc.  It made me wonder whether leaders of the current veteran rights movements actually KNOW this history, and know how far their predecessors had to go, to secure the rights veterans rely on today -- which still need to keep pace with the times, and haven't.  The book is just plain fascinating, and b/c it's relatively neutrally written (as opposed to written with partisanship), with a steadfast focus on the facts and the key participants -- and because it's based on 600 or so interviews with the actual players, it's both extremely well done (a PBS series in book form, but with more depth!) and should keep my interest for quite a while.  So fascinating to know, or begin to hazily recall, the all-important "backstory" of where we are today.  And the insights on the genesis of understanding PTSD are well worth revisiting, all on their own.  Great book - wish I'd known about it before. As more and more veterans send me (unsolicited, I might add) their life stories, or their experiences with PTSD, I have to say -- this book really puts an awful lot together, behind the scenes, as to why they suffered in silence for so long.  Wonderful effort, and a pleasure to read.

Too bad tomorrow is already "Father's Day," but if you're lacking a gift for a veteran dad, Vietnam era or later, and can find this in stock at a local bookstore, it's a superlative collection of everything that went before, and helps us to understand the issues of the present, through the highly informing prism of the past.

Survivors Quilt: Combat Veterans Patch Meaning Together in Quilts about PTSD, War and Loss

You've heard of survivors' guilt - here we've got survivors' QUILTS.  (Bad pun, I know -- but true.)

We've been talking a bit lately about art therapy, and how combat veterans with PTSD use it successfully to tap into, and work through, some of the pain they feel inside. The photos here, by Mike Kane, at the Seattle Post-Intelligencer, are from a story published on March 19 about how the inpatient PTSD program at the VA hospital in Seattle has a "wall" of quilt squares, made by combat veterans, and encouraged by a nurse, Betsy Shapiro (she's at right, above), now retired, who gave deeply hurting veterans 6x6" cotton squares, on which to draw something or paint something that related to their experience: something they could leave behind, to let others know about them and what they had gone through. 

Initially, there was moaning and groaning, and reluctance to comply.  But shortly thereafter, everyone produced something, and the results were really pretty impressive.  The veterans also gave input into how they wanted the resultant squares displayed -- not set in pretty frames, like squares in a regular patchwork quilt might be, but together, side-by-side, touching.  The article, by Mike Barber, is called "Veterans tell stories in patchwork of memories," and it's linked here.

In an earlier article, from the Honolulu Advertiser from October 2, 2007, linked here, Glenn Reys, an Air Force vet in Honolulu worked through his recovery from drugs and alcohol by immersing himself in making a Hawaiian quilt, symbolic of his homeland, but also incorporating patriotric U.S. symbols.  He found himself devoted to the practice, and able to quilt for hours at a time.  "This kept me busy," Reys said. "When I do sewing like this, I can sew for like six or eight hours, and it's no problem. That's what I do in my continuing recovery."

In one of the best articles I've read about a Vietnam vet, Cecil Ison, struggling with PTSD, the author, Kathy Dobie, talks about visiting his home in Kentucky and watching his wife, Bet, a quilter, work on a quilt with Vietnam themes. Cecil and his two brothers all served in combat in Vietnam, and each responded in a different way.  Cecil's wife, Bet, attempted to capture her view of what they suffered in the quilt, turning an abstract -- feelings about the war, and the isolation it produced -- into something very concrete -- the quilt. She says that the quilt is too painful for Cecil to address directly, but through it, she is able to give vent to some of her feelings, about what she has watched her husband and his brothers go through.  Kathy Dobie writes:

[Cecil's wife, Bet, and I are spending time one afternoon.] We’re talking upstairs in the sewing room while she works on her Vietnam quilt. The room is stuffed with fabric: tweeds, cottons, velvets, hundreds of men’s ties. Bet sews at a small table by the window. She listens to oral histories of Vietnam veterans as she works. On the left side of the quilt is an army-green map of Vietnam, showing the three cities where James, Cecil, and Arnold served. The rest of the quilt is blue, and three male figures float there, separated from one another and bearing labels: anger, despair, and guilt. The quilt reads: "my husband and his brothers came home from vietnam…three islands in an ocean of silence."  James is the Angry one, Cecil the figure of Despair, and Arnold is Guilt.

(This is the quilt in question, pictured to the right.  From top to bottom, you can see "Anger," "Despair," and "Guilt," and "Vietnam" is written lengthwise, on the left.)  Quilt copyright Bet Ison.

Below is another quilt with Vietnam imagery by Bet Ison.  Both quilts are copyright Bet Ison, and property of the author.  Photos are shared with Bet Ison's permission.

(The article by Kathy Dobie article in GQ, is called "The Long Shadow of War," and we blogged about it earlier, here.  Dobie is also the author of the excellent article in the Nation, recently, called "Denial in the Corps" -- about Marines and the stigma of mental health issues, including PTSD, which we've also blogged about, here.)

Quilting is a uniquely American tradition.  Not that other countries haven't had their own versions of it, but it's uniquely tied up in the "fabric," as it were, of American history.  There are so many examples, from crazy quilts made of just scraps of silk, satin and wool garments, patched together on wagon trains as Americans headed West, to quilts made from flour sacks by pioneer women, to Civil War era "album quilts," to today's photo transfer quilts.  Quilts are often about "making do" with just the materials available, and there's something therapeutic about the needlework involved.  In 1837, American writer Nathaniel Hawthorne wrote in The Scarlet Letter, "Women derive a pleasure, incomprehensible to the other sex, from the delicate toil of the needle."  Well, by the 1970s, even he-men like football great Rosey Grier had picked up the needle, though not necessarily to quilt (he favored needlepoint instead).  Quilting is an unusual 3D art form that combines texture (the fabric, and the stitchwork) with color and design, and has a long and storied American history, besides.  It's interesting that combat veterans and their loved ones would find an outlet for some of their feelings in quilting.  Whether it's a square, a bed quilt, or a wall hanging, quilting allows for freedom of expression, and a form of "art therapy" that may just help those who are hurting to focus and transform their experience into something physical that they can share with others. 

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Editor's Note: If you want to continue this conversation about quilting and paying homage to a combat experience, your own or someone else's, email tributequilts AT gmail DOT com. 

"Art Relaxes Me" - Combat Veterans Using Art Therapy to Heal

We've blogged recently about the potential for art therapy to treat combat trauma and PTSD -- not instead of other types of therapy, but in addition to them -- here and here.  One very good article from about a year ago is worth including in the discussion.  The article, by Jackie Spinner, was published April 15, 2007 in the Washington Post, and it's called "War's Pain, Softened with a Brush Stroke" and linked here.  (Spinner herself is the author of, Tell Them I Didn't Cry: A Young Journalist's Story of Joy, Loss and Survival in Iraq, linked here.)  The article talks about how combat veterans have been helped by art therapy, in finding ways to express what's happened to them that brings them a modicum of peace and transformation.  It also talks about the great downturn in the availability of art therapy for PTSD, after its heyday in the 1970s, with the Vietnam war -- which is a shame, because to those it helps, it's really been quite beneficial.  A very few combat veterans are able to take art therapy classes through the VA; but far fewer than in past years, primarily because of budget cuts.  Apparently just like in the public schools, art is one of the first items to be cut when budgets are trimmed. If you read the article, though, you'll gain an appreciation for just what it provides -- and wish more veterans had the opportunity to experience it.  As one injured veteran said, speaking for many, "Art relaxes me..."

SSgt. Travis Twiggs - Well-Loved U.S. Marine and Hurting PTSD Hero - the Update

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.

The Dose-Response Relationship with PTSD: More Combat = More PTSD, Earlier Study Shows

"If you aim for simplicity, you must first master complexity" -- said the 17th century Chinese painter, Wang Kai. Almost 400 posts in on this blog, I still enjoy the moments when something profoundly complex like combat trauma is nevertheless reduced to something quite simple to understand.  Here's one such observation: the more combat one is exposed to, the greater the chances of experiencing PTSD.  Makes sense, doesn't it?  Although we've talked about that concept recently on this blog -- with a great graphic that shows the linear relationship quite profoundly, that entry linked here -- here's another, earlier study that says the same thing, in an article linked here.

Researchers who went back and analyzed two conflicting, large-scale studies of PTSD -- one done by the Centers for Disease Control (CDC), the other the National Vietnam Veterans' Readjustment Study -- found, among other things, that although "most veterans who experienced very highly traumatic events did not develop PTSD," still, the more war trauma a veteran experienced, the higher a veteran's odds of developing PTSD.  Researchers called this the "dose-response relationship," and said their work, going back over the two major studies and attempting to reconcile their findings, found that it was "even stronger than previously reported."

SOURCES: Dohrenwend, B.P. Science, Aug. 18, 2006; Vol. 313: pp. 979-982. McNally, R.J. Science, Aug. 18, 2006; Vol. 313: pp. 923-924.

Pick Up the Phone, Hon - That's the VA Calling!

In a seemingly odd, but -- one would hope -- nonetheless proactive move -- the Department of Veterans Affairs (VA) is now placing outgoing calls to in a nationwide campaign to inform and connect returning combat veterans with the services the VA provides.  The calls, which are being outsourced to a provider called EDS, are initiated by the VA and follow a very specific, and laudable intention,  In a PR blurb published on the Web at TCRNet, the following information was provided about the program:

The Combat Veteran Call Center is expected to make more people aware of health care and benefits eligibility for veterans of the wars in Iraq and Afghanistan. It’s the first task order awarded under the General Services Administration’s $2.5 billion USA Contact contract vehicle, according to EDS.

Calls to veterans began on May 1 and plans include reaching out to nearly 570,000 recent wartime veterans over the next six months. The campaign will initially focus on roughly 17,000 veterans who, based on their wartime injuries or illnesses, are considered candidates for care management.

The second phase will include contacting about 550,000 Operation Iraqi Freedom and Operation Enduring Freedom veterans who have not yet enrolled for VA health care services."

Additionally, "Officials at the company say EDS phone representatives will make initial calls to veterans to complete interview that will assess their needs. Representatives also will provide information about available VA health care services and benefits. Follow-up calls will also be completed to ensure that the veteran has had his or her needs met."

 

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At least one Veterans Service Officer I spoke with, while praising the existence of this program, also cautioned that its emphasis on prioritizing contact with OIF/OEF veterans over those of previous wars, could have the unintended consequence of creating friction between Vietnam veterans and Iraq and Afghanistan veterans -- groups which have been reasonably supportive of each others' existence, so far.  In fact, Vietnam veterans have been incredibly gracious about seeing that veterans of more recent conflicts get the help they feel was denied to them.  So any move that pits the two groups against each other in triaging care runs the risk of causing unnecessary friction and competition for what amounts to limited resources.  And speaking of limited resources -- although the proactive calling is in some ways a good idea (and positive PR for the frequently embattled agency) -- more and different solutions are desperately needed.  Examples include: hiring more psychotherapists, exploring treatments other than drugs and group therapy, making sure patients get seen quickly, expanding services to include outreach and education for family members, and freeing up some cash for paying private providers who are now giving their time for free, to make sure veterans get seen.  Oh, and eliminating the stigma of mental health care to career veterans, who are sometimes afraid to be seen for the impact it might have on their career advancement.  We're not even gonna mention the "shhh!!!" email here -- or the tendency to want to call PTSD by any other name including adjustment disorder -- there's enough about that in the news already.

Professor Hedley G. Peach (Australia)

BSc(Hons) (Wales), MBBCh (Wales) PhD(London), FFPH(UK)
University of Melbourne

(Retired) Professor, School of Public Health, Queensland University of Technology, Kelvin Grove, Queensland, AUSTRALIA.

Professor Hedley Peach is a Visiting Consultant at the Ballarat Base Hospital, and Professional Fellow at the University of Melbourne.

Professor Hedley Peach qualified as a doctor in Wales where he became interested in the social causes of illness. This interest led him to train in community medicine at the renowned St. Thomas's Hospital in London where he worked for seven years as a lecturer/senior lecturer. In 1985 he migrated to Australia where he was Foundation Professor of Tropical Health at James Cook University for three years and, subsequently, Professor of Community Medicine at Melbourne University for fourteen years. He retired earlier this year but continues as an honorary Professorial Fellow of Melbourne University. He has been interested in the nexus between religion, spirituality and health for a number of years. In 2002, he wrote the first article on this topic to appear in the Medical Journal of Australia to stimulate debate on how the medical profession should respond to research and recommendations from the USA. He has authored book chapters and papers on spirituality and women's health, the religions of rural Australians, and other topics. He has given many radio and newspaper interviews on spirituality and health. He is the author of several books, including The Epidemiology of Common Diseases and Disablement in the Community, as well as the leading author of more than 100 articles in scientific journals. He is a member of the National Heart Foundation's expert group on psychosocial causes of heart disease.

The Doppelganger of PTSD: the Unwelcome Stranger Who Follows You Home from War

Over time, more and more grassroots efforts spring up as veterans try to help one another deal with the effects of combat trauma and PTSD.  Some of these are simply conversations, where those who went share what the experience was like, and how they've suffered since -- and ideally, also what they've been able to do about it that helps.  The Peoria Journal Star in today's paper has an article about just such a conversation, held by local central Illinois veterans in conjunction with a traveling exhibit of the Vietnam Wall.  The article is short but poignant in the reminiscences shared by predominantly Vietnam veterans about how combat trauma and resultant PTSD has changed their lives, and not for the better.  Click here for the link to that story. 

There's nothing particularly "extraordinary" or "dramatic" about these men's PTSD or their comments about it -- but that's the thing.  They've very representative of what actual people go through who weren't expecting the experience to scar them for years after combat.  Just one example: a combat photographer with a Ph.D. talks about his own experience. "Divorce, alcohol, drugs, jail, attempted suicide ... I've done them all," he said.  If combat trauma is the stone thrown into the pond, just think of the ripple effects of every item he just mentioned.  Sadly, combat trauma affects not only the participants, but also many of the people in their lives.  Recently I received an unsolicited memoir from a former Marine and Vietnam veteran about his experiences with war and PTSD, and on practically every page the same thing ran true: the enormous remorse and regret he felt from the pain he'd inadvertently inflicted on his family members, because of what he was going through at the time, and couldn't cope with.  Combat trauma, left untreated (and we don't mean, with drugs and alcohol ;-), can become the uninvited guest in far too many veterans' homes and every family gathering.

The German word "Doppelgänger" or "double-goer" comes to us from literature, but seems to have some application with what veterans go through as well.  The Doppelgänger is a person's double, often but not exclusively seen as an evil twin, and often in ominous contexts (premonition of someone's death, etc.).  But in the straight meaning of a connected but separate other self, a veritable "double" self, it conveys what some veterans seem to go through.  The memory of war they've experienced is so profound and powerful, it's permanently "attached" to them.  When they return to society, and have to "re-integrate," the combat self actually never leaves them, and this seems to produce a lot of the pain that they feel.  They frequently acknowledge being "permanently changed" by war -- but yet when the war is over, or when they come back, they're expected to integrate back into society, and into the lives they formerly led.  Many veterans talk about how almost no attention is paid to this experience by the military: you come back, and have to figure this part out for yourself, but it can be deeply troubling.  You can't shake the person you became in war -- in fact, it's always with you, as a "second self."  But at some point you have to come to terms with the fact that both those selves are you, and there is no separation.  In a lot of the pain you hear, see and feel from Vietnam veterans as they share about their experiences, you get a very profound impression that they are in fact feeling shame (and yet connectedness) with the person they became because of war, as well as a desire to protect their loved ones, however incapably, from that very person.  Tremendously, what you also see is a deep desire for other, more recent veterans to profit from their experience.  The "older brothers" (and sisters, but it's mostly men) want their "younger brothers and sisters" not to have to experience the tremendous pain, ostracizing, and neglect they felt -- as well as the inability to come to terms with what it meant.  The Vietnam veterans seem to have a deep, and laudable, desire to become the "readjustment counselors" for today's OIF/OEF veterans.  However, their own healing has to take place first -- and from the expressions of deep pain that get conveyed, you can tell how difficult that healing really is, and sadly, how infrequently it's been able to take place.  (True healing, after all, means going through the pain, processing it, and integrating it into the whole self.  Many people accomplish a "form" of superficial healing, which turns out to abandon them later, by masking over the pain with other "drugs," from drugs and alcohol, to social isolation, to even workaholism, to keep the pain at bay.)

Although we need to write more about this topic separately, even "workaholism" can be a drug to suppress painful memories and experiences.  This "drug" is better suited to some than others -- probably the 'Type A' types "enjoy" it most -- but it's effective as far as it goes, which of course is never quite far enough.  I heard an amazing story from a veterans service officer the other day about the most elapsed time he'd ever seen between someone suffering from combat trauma and realizing he had PTSD.  That's referred to as "delayed onset" but check out how delayed it really was, because of workaholism, most likely.  A World War II veteran, 84 years old.  Had fought in Normandy, Ardennes, the Battle of the Bulge.  He felt he'd led a "blessed life," and had in fact just retired (at 84!).  But in his retirement, with all sorts of unstructured time on his hands, started experiencing nightmares, and would wake up, having soaked the bed.  The nightmares were about what he'd experienced, over 60 years ago(!!!), but which he'd finally had "time" to start bringing up from the vault of memory.  And he was suddenly in terrific psychic pain from this.  Although I applaud the amazing things this man must have done during the intervening 60 years to consider he'd led a "blessed life," I can only wish that he'd also been able to find some healing during that time as well.  Experiencing delayed onset PTSD in your mid-80s, from battle you saw in your 20s, must be a terrible thing indeed.  It's also another reminder about how combat trauma continues to affect veterans from all wars.  And how extending compassion, wisdom and healing to veterans from every war is part of what we ought to be doing, as a society, and often do quite minimally, if at all.

Kathie Costos, Chaplain

Kathie Costos, also known as "Nam Guardian Angel," is a certified, ordained Chaplain and member of the International Fellowship of Chaplains ("IFOC").  The daughter of a Korean War veteran, and the wife of a Vietnam veteran, she has been active in veterans issues since the 1970s.  For the last 25+ years, she has focused on Vietnam veterans with Post-Traumatic Stress Disorder.

As a chaplain with a devout Greek orthodox background, Kathie nevertheless believes that "no matter what church people belong to, they belong to the family of God as God's children."  Years of volunteering with Vietnam veterans and their families has taught her to take care of the spiritual needs of people and not just the already "faithful."

Kathie is the author of a well-regarded book, called For the Love of Jack, His War/My Battle -- about how her family coped with the legacy of PTSD that her husband returned with from the Vietnam War.  She self-published the book immediately after 9/11, out of concern that the word needed to get out about what PTSD was, before many more people began to suffer from it.  The book is available for downloading on her website, and Kathie has also produced many educational videos about PTSD that are also available on her website.  A list of those videos include the following, but because Kathie is always expanding the list of videos she's made about this topic so close to her heart, it also makes sense to "favorite" her on YouTube, where a list of all her videos is linked, here.  A list of those videos current as of this writing include the following (each is hyperlinked to YouTube or Google video, so you can watch them directly):

• Wounded Minds: PTSD and Veterans (Google)
• Coming Out of the Dark: PTSD and Veterans
• When War Comes Home, Part One
• When War Comes Home, Part Two
• Hero After War
• Death Because They Served - PTSD Suicides (Google)
• Wounded and Waiting, Part One
• Wounded and Waiting, Part Two
• Women At War
• The Voice, Women At War
• Nam Nights Of PTSD Still
• PTSD After Trauma
• PTSD Not God's Judgment
• Homeless Veterans Day

A link to Kathie's website about PTSD is here.  For a direct link to the book she wrote about her husband and family surviving PTSD, click here. For a link to her ever-expanding list of videos about PTSD and veterans, click here.

A favorite quote of Kathie's: "The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive veterans of early wars were treated and appreciated by our nation." -- George Washington.

Actor and Vietnam Vet Produces Film about PTSD

Military.com has an item today about a new movie, Soldier's Heart, by actor and Vietnam veteran, Brian Delate.   In Military.com's blurb about their interview with Delate they say, "Vietnam veteran and accomplished actor Brian Delate has released his vision of the challenges facing warriors upon their return in his movie "Soldier's Heart."  At a time where a handful of films are being released about the wars and the challenges faced by soldiers, from thoughtful documentaries, to bigger-budget Hollywood treatments for a mass audience, a movie like Delate's -- ostensibly, from someone who knows -- should be a welcome addition.  PTSD is a timely topic, and who better to tell the story than a veteran who's struggled with it himself, as Delate says that he has.  Sounds very promising, and relatable - and likely to make a difference.

The promotional material about the movie -- which looks like it could have used some help in the copywriting department -- is as follows:

"PTSD - sometimes you don't know you have it until your life falls apart.  Elliot (James Kiberd), a Vietnam vet with PTSD has held it together until participation in a documentary about the Vietnam War causes unacknowledged feelings about his experience as a soldier to surface, threatening his marriage to Linda (Cady McClain), alienating his best friend, Richie (Brian Delate) and damaging his career.  In this journey of the heart, PTSD forces Elliot to re-design his blueprint for living with courage and some humor as the truth of his war experience emerges, allowing him to gain a deeper understanding of himself as a veteran, his father as a World War II vet, Richie as a Vietnam vet, and to forge a stronger bond with Linda."

"Finally, a unique film about veterans as told by a veteran -- Soldier's Heart is about Vietnam vet Elliot's waking up to the present and his journey to a deeper self-acceptance -- with regard to the long term effects (PTSD) from the war and his relationships to his family, wife and friends.  Writer/Director and Vietnam veteran Brian Delate is also a veteran actor of film, stage and television.  If you are a veteran -- from any war or you know a veteran, this is a must-see movie."

A link to the film is here. A link to the podcast on Military.com, where writer/director (and actor) Brian Delate talks about his own war experiences, including how he dealt with his PTSD, is here.

Editor's note: Though similarly titled, this film is not the same as the PBS show on Frontline, called "The Soldier's Heart," which we blogged about earlier, here.

A Poem for My Father

Medic! Medic!

I wish I could yell, and someone would come,

But they don’t

I call in air support but the pilots are all stricken too

The infantry has gone into the bunkers

MIA in their own wars like yours …

Forty years after ...

Under a hundred starry nights … stained with blood

Comrades lost, in the winds of Battles gone

In a war over there, in the napalmed jungles

Where Agent Orange still stains the ground

A million screams now silent,

Except those in your mind, which will echo

For all time

We are alone

And we fight the war, together, after you’ve come home

Medic! Medic!

You were wounded in the Nam

Spiritually, wounded, for a country that has forgotten what you’ve done

And what was done to you

Medic! Medic!

Nobody to help us, just you and me

You are wounded, and I your son, a warrior too,

Help you carry on

Though I have never seen the jungles

I am there with you

Fighting a war

In jungles of PTSD, anger, fits of rage

Flashback ...

Incoming, again!

You duck into your psyche until choppers pass

Ones you hear, though we are standing here in suburbia

Guns firing, shrapnel flying,

Once again ... it happens often

We go on, me carrying you, and you wounded

Through the battle under the blood stained heavens

Fighting the war together, the one they forgot

The war you still fight, I fight with you

Medic! Medic!

© 2007 by Jeremy Hogan, photojournalist, son of Jerry Hogan, a Vietnam veteran with longtime PTSD.  The photo is of Jerry Hogan.  Used with permission.

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Editor's Note: April is National Poetry Month.  We're initiating it with this poem, written by a son about his Vietnam veteran dad's experience with PTSD.

Not an April Fool's Joke: Vietnam Vet Just Received Compensation for His PTSD Claim

The Wadena Pioneer Journal of Wadena, Minnesota, published a story recently, touting the eventual -- and I do mean, eventual -- "victory" of a Vietnam-era veteran receiving compensation for his PTSD.  That's the pioneering Eugene Foster himself, in the photo at left.  Minnesotans must be made of very strong, enduring stuff, because Mr. Foster has persisted through a two and a half year claims process, and three appeals, to achieve his victory of $65,000, or $2,527 a month from Veterans Affairs for the rest of his life, according to the story.  The article also quotes Mr. Foster as saying, "I don’t give up too easy...I come from a long line of stubborn people."  Good thing, considering the Vietnam war ended 33 years ago next month, and, at 64, Mr. Foster's life expectancy is just 15 more years, a number probably discounted further by years of poor health.  Ever alert for a touch of irony in these heart-breaking situations, I find it in this comment of his veterans service officer: "“The only thing I can say is the system works.”

Well, provided you're not in any hurry, I guess.  Mr. Foster had another claim out, according to the paper, for "continuing knee problems he said stem from a shrapnel wound he sustained during the Tet Offensive in January, 1968."  But, he "dropped that claim during the process of receiving his PTSD settlement, he said."

Like the narrator in Langston Hughes' poem, "Mother to Son," who lamented that "life for me ain't been no crystal stair," Mr. Foster has had, arguably, more than his share of suffering and pain in this lifetime,  much of it thanks to his Vietnam experience, and his attempts to cope with that through his own methods and means.  The article in the Wadena Pioneer Journal is brief, but it mentions about a dozen difficult life experiences.  A brief catalog of this veteran's hard luck life: the Vietnam War itself, PTSD, his Vietnamese fiancee killed by the Viet Cong; the shrapnel wound; the knee problems; the lifetime spent self-medicating his depression with alcohol, till he kicked that habit; high blood pressure; and getting around in a walker and a wheelchair, in an apartment that had stairs.   Thankfully, Mr. Foster persisted, and now the small settlement will allow him to move apartments, and ideally be able to find a "two-bedroom condominium with all new carpets, floor heating and dishwasher..."  Small, reasonable goals for someone who served his country, honorably.  As Mr. Foster cautions others veterans, "Fight, don't give up."  Veterans "deserve what compensation they get." (We won't argue with that.  They even deserve it in a timely fashion, and enough to live on.)  As he says, "A lot of people should be compensated who don't have it."

Editor's note: Click this link to find the article.  The original article on the Wadena Pioneer Journal's website has some technical difficulties accessing it.

Raymond Monsour Scurfield, DSW, ACSW, LCSW

Dr. Scurfield is Professor of Social Work, Director of the Katrina Research Center and President of the Gulf Coast Faculty Council, University of Southern Mississippi Gulf Coast.  He was the 2006 Mississippi NASW social Worker of the Year for his post-Katrina efforts, and he continues to provide counseling at the University of Southern Mississippi Gulf Coast to students, faculty and staff. His MSW and DSW are from the University of Southern California.  He was a social work Army officer on a psychiatric team in Vietnam (1968-69) and has co-led return trips to peace-time Vietnam in 1989 and 2000.

Previously, Dr. Scurfield had a 25-year career with the Department of Veterans Affairs in which he directed several regional and national Post-traumatic Stress Disorder (PTSD) programs from Washington, DC to Tacoma, WA, to Hawaii and American Samoa. He has over 60 publications, has been PI or Co-PI in several PTSD research studies, has given over 350 presentations in the U.S. and abroad and has made numerous media appearances, to include 60 Minutes, Nightline, Nightwatch, National Public Radio and numerous NPR-affiliated radio stations nationwide. Dr. Scurfield has been active in post-disaster interventions and is a certified Compassion Fatigue Educator and Compassion Fatigue Therapist. Dr. Scurfield’s most recent writings are about post-Katrina interventions on the Mississippi Gulf Coast. His November, 2004, book was the first book in a series, A Vietnam Trilogy. Veterans and Post Traumatic Stress, 1968, 1989 & 2000. The second and third books in the trilogy were published in 2006: Healing Journeys. Study Abroad with Vietnam Veterans, and Volume 3, War Trauma. Lessons Unlearned From Vietnam to Iraq that describes over 30 unlearned lessons about war, its impact and what to do about it.

To download Prof. Monsour's CV, click Download raymond_monsour_scurfield.doc .