By Bombs and Brainspotting Blindsided

“It’s finished, over. Everyone knows now. I’m a drunk, that’s it, face it, nothing more. I’ve lost everything.”

I can’t say this was the first time that I had heard such an opening line from a patient. Such regrets are pro forma among addicts who have, at least for the day, come to the end of the line. Sometimes everything changes with such statements, à la The Hallmark Channel, sometimes not. It’s the stuff 12-step meetings and skid rows are made of.

Granted, this particular soldier had “hit bottom” (as the AA folks are wont to say) in a particularly, shall we say, noteworthy way. He’d hidden his alcohol dependence well for years, even from those closest to him. He’d never done anything small his whole life, though, so why not expose oneself as grandly as one can? Would we still be talking of Icarus had he not taken that selfsame route?

Right around the time my patient and I met, the Irish actor Peter O’Toole died. His obituary in the New York Times was a fitting tribute to Life lived intensely and hard, a life in which one works hard to reframe regrets as opportunities—and woe to anyone who dares intimate they might be otherwise. It would be a stretch to claim that my patient resembled the man who made T.E. Lawrence alluring enough to fill a Cinerama screen for four hours, intermission notwithstanding. Yet in spirit, they could have been brothers: success, booze, the whole bit.

Who knows, perhaps I was thinking of the Shakespearean actor O’Toole as I was listening to the opening lines of my patient. To steal inelegantly from Queen Gertrude, I found myself musing, “The man doth confess too much, methinks.”

“You started out in the Marines, didn’t you?” I asked him.

“Yeah, but then I got out. When 9/11 hit, I had to get back in, but the Marines wouldn’t take me. The Army would, though. The rest is history.”

That much of history, I had already known, and thence my Hamlet-ian suspicion. For I had known that he had been involved in the initial fighting in Iraq, the “Shock and Awe” that did so much more than both for all those involved at that time, civilian or military.

You were in the initial invasion, correct?”

Still wrapped in his shame—not wallowing, mind you, just wrapped—he scarcely seemed to register the question.

“Yes.”

“Quite the time, eh?” I asked.

That, he registered. He looked directly at me, not with hostility, nor with anguish, but more with the detached empathy of a good 60 Minutes interview by Scott Pelley.

“It was hell,” he replied. “But we did what we had to. I don’t let it bother me that much.”

The Bard in me continued wondering.

“Did you drink this much before the War?”

For a couple seconds, he just stared at me, as if I’d just said something to him in Ukrainian, or Armenian, maybe. Then his eyes darted to the right, his head tilted ever so slightly, sort of like that puzzled dog you see looking at the gramophone in the old RCA Victor ads.

“Come to think of it,” he said as he looked back at me, “I guess not. I mean, I had my problems, but . . .”

“Nothing like that,” I filled in.

Another pause, his eyes apparently scanning the entire library of his frontal lobe one last time, just to make sure.

“No,” he answered, his eyes returning to mine empty-handed. “I guess not.”

I decided to go for it.

“So how do you know whether the War’s been bothering you or not? You basically haven’t been sober since you hit stateside some ten years or so ago.”

In a matter of seconds, that brought another eyes-darting, head-tilting to the right, not one this time of canine puzzlement, though, but rather one far more familiar to me from my past few years of working with combat veterans: the long look down a road marked “To Baghdad.”

“All I remember is a blast,” he said softly, to no one in particular, or so it seemed. “It was meant for me, you know. I was all hot-shot, gung-ho. I had the military experience, so my Command used me to help gather information from locals. I was always at the same spot, every day, and that day I just happened to turn back to check on something, wasn’t where I should have been, where I always was, right across from where that car bomb went off. I . . . I shouldn’t be here.”

He looked back at me, almost as if he were trying to refocus his eyes after having stared at the sun.

“God, so . . . so much happened.”

“You ain’t been soused all these years for nothing, eh?” I said, meaning it just as pointedly as I had said it.

As reality set in, he shook his head, just slightly.

“No one knew, my wife, my Command, nobody. I can’t believe I’ve hidden it all these years, the drinking. I . . . I just couldn’t take it any longer.”

I leaned forward. “It’s not just the drinking, you know. It’s the drinking and the War. You’ve got to face them both. No either-or here.”

For a few seconds, he didn’t even breathe, staring.  “How do I do that?” he finally said, quite genuinely, poised as if he dare not ask.

I looked  into his eyes. More often than not, the gaze of those who are coming off alcohol has a certain cloudiness to it, as if the entire brain behind it were stuck in a perpetual state of “Huh?” Not his, though: coordinated, focused, driven he still appeared, with the look that his Command must have seen so many years ago, the same look that somehow, through all the leftover remnants of the booze from the nights before, Command must still have been seeing day in, day out since.

“I want you to talk to my colleague tomorrow,” I answered. “She works with a form of treatment called Brainspotting. It’s an off-shoot of something they call EMDR, Eye Movement Desensitization and Reprocessing. You might have heard of that one. It’ll sound totally wacko, Brainspotting, I’ll warn you: it’s based on the idea of presenting the brain with alternating stimuli via hearing, touch, while having you find a spot in your visual field that, believe it or not, does seem to be almost a nodal point for the body’s experience of emotion. Most of the soldiers around here are skeptical as all get out about it—until after they’ve done it once. Give it a chance. With your detoxing, I’m not sure you’re ready for it, but we’ll see what she says.”

He gave me the smile of someone waiting for the punch line.

“This something like voodoo hypnosis?” he asked.

“Talk to her,” was all I replied. “See for yourself.”

When I spoke with him the next evening, after he had worked for a couple hours with my colleague, he had neither the clouded look of the alcoholic nor the steely look of the up-and-coming sergeant. It was a look well-familiar to me since I have been working here at the unit in Nashville: the look of someone who’s just ridden the park’s meanest roller coaster ten times and somehow, in some way is actually feeling . . . calm.  Exhausted. But calm.

“So how was it?” I asked, barely able to keep the “I told you so” off my face.

“My God,” he stage-whispered, just tired enough not to have the energy to slap that look off my face, just with-it enough to let me know how lucky I therefore was. “What was that? I mean, she had me dredge up stuff I hadn’t thought of in years, and . . .”

“And you’re OK enough with it,” I replied, well familiar with this conversation. “Not ‘OK’ in that you’re fine and dandy, but OK enough, exhausted, but OK.”

Apparently after my words had found their correct spots in his cortex, delayed a bit more than usual by some routing neurons that were still shaking their heads at each other and asking “What the hell . . .?” he simply said, “Yeah.”

I love that moment.

“You’re going to need to put together a solid recovery plan,” I said to him, “and you’re going to have to keep talking to her—and then keep talking to someone after you leave here. It’s both, not one or the other. You’re not ‘just an alcoholic.’  You’re not just another veteran with PTSD.  Don’t let anyone tell you otherwise, even though you’ll find a few who’ll try.”

After a few seconds, neurons apparently having decided to get back to work, he leaned forward. “So there’s hope?” he asked.

“Sounds as if your body is saying so,” I replied.

He half-smiled, half-grimaced. “My body is telling me to get some sleep.”

I love that moment as well.

“Sounds like a good idea,” was all I could say.

Techniques aside, established or controversial, we all now respect the brain for what it is: in the words of Dr. Samuel Wang from Princeton, it’s a “survival machine, not a computer.” It does what it needs to do in order to keep us doing what we hope to keep trying to do, day in, day out. It will lead us down one path of destruction if by doing so it senses that it can avoid what, to it, appears to be an even worse path. Our brains and our bodies are efficient, not necessarily wise. Sometimes we don’t know a good path until it’s laid out before us in neon chartreuse, long after we’ve exhausted every other, even blatantly ludicrous alternative.

Thank goodness we sometimes can be hit from our blind side, whether having been previously blinded by the light of an explosion or the darkness of an addiction.  Thank goodness that some Icarus’s can learn, can take the risk of flying just a bit lower than their energy might otherwise take them, for a while, for a purpose, until an AA sponsor can be found, until certain memories can be processed with words and without, until a body can find more internal order, until a life can create more external order, until such Icarus’s can land on a safer shore, only then to take off one more time, not as a desperate escape, but simply as a way to get to the next challenge. And the next.

JD/rjsd

Yes, Mama, Yes, Ma’am

When I asked her if she would be interested in my writing a blog entry about our work together, she at first appeared pleased, but then turned wary, ever so slightly.

“I’d talk about your mother,” I assured her.

With that, the smile I had come to admire beamed like the proverbial spotlight.

“Well, OK, then,” she replied, her whole head-to-toe demeanor practically shouting in addition, “And, Lord, won’t that be a hoot . . .”

How true, how true.

My patient is the first woman combat veteran I have written about.

I have received some criticisms for not having written previously about the women combat veterans I’ve had the honor to serve, some intimations of misogyny, even. Until now, I’ve not known quite how to express my challenge.

Thankfully, she’s changed all that.

My challenge has been one all too familiar to those who work with women combat veterans, one all too rarely addressed even remotely adequately: many, if not most, of the women combat veterans I’ve served were, at some point in their careers, sexually traumatized by the men with whom—and even worse, often under whom—they had been serving.

As the months have gone on, I’ve come to write this blog as a sort of memoir, reflections rendered in the form of “I remember So-and-So,” glimpses (I hope) of men whom I’ve served as filtered through how they have impacted my own experiences, my own understandings of what it means to be both incredibly powerful and yet incredibly vulnerable in the world. I have always strived to assume that I have no idea as to the men’s actual sufferings, but rather, through my inklings of those sufferings, to consider that I can nevertheless find a way to fathom what little of those sufferings I can fathom and then to respect them for all that must (thankfully) remain unfathomable to me (at least so far in my life, thanks be to God).

With military sexual trauma, however, whether perpetrated on women or on men, I have been loath to make any assumptions whatsoever.

How often we hear platitudes such as “War is war,” or, in the immortal words of Donald Rumsfeld, “Stuff happens.” Behind them is that most questionable, yet rarely-questioned of “truths”: even if the violence of War feels personal, nine times out of ten, it’s not. You don’t get shot at, in other words, because you’re you, but rather because you’re American or Afghan or in the wrong place at the wrong time, etc., etc.

Not so, sexual trauma, the zenith of the personal, even among strangers, let alone so-called friends.

As a man, I’ve had occasion to know (again) an inkling of the feeling of imagining myself powerful when, all of sudden, I am anything but. As a man, however, I have never grown up in a world where the power differentials between me and the other fifty per cent of civilization have confronted me day in, day out, where my deepest desires can be, at any moment, hijacked and obliterated without an intelligible word being spoken. I have never had to find a way to redefine myself in such a fundamental way vis-à-vis the other men and/or women—other humans—in my life such that I have had to decide whether today is a day worth surviving.

I have never had to face how someone who is supposedly on my side of the “Good vs. Bad” continuum can force me to redefine not only me, even after years of faithful military service, but even more those very words good and bad that have formed me.

As I have no inkling, I have believed that I dare not even intimate that I have a right to reflect on such—here unquestionable—truths.

My patient, however, reminded me that the treatment of trauma is not always about trauma, and certainly not just about trauma. It can be, should be about Life itself.

Fortunately I have a wise, dynamic, deeply empathetic psychologist colleague at my current job who just happens to be female in addition, and she and my patient found together the words that needed to be found to deal with, as well as could be dealt with, all that needed to be spoken, at least for now. I was, at first, glad simply to be the medication consultant, a man willing to listen, a man willing to face that my very being could itself be traumatizing. My patient and I did the best we could. She soldiered on. She began to feel better.

Then one day I overheard a conversation on the phone. “No, Mama, you can’t bring all your friends down here with you.”  A pause, then “It’s a hospital, Mama. Visiting is for family.” Another pause, and then, “Well, Mama, I know you don’t like it, but that’s the way it is.”

We spoke together a few minutes later.

“Was that your Mom?” I asked.

Even though our previous conversations had mainly been marked by few words and even fewer emotions, she gave me the semblance of a half-smile, sort of.

“Oh, yeah,” she replied.

“Sounds as if she’s got quite the mind of her own,” I quipped, careful not to put too much emotion into my end, either.

That provoked a three-quarters-smile.

“You can say that again.”

“She wanting to bring half the church with her or something?”

Seven-eighths, now, with even a shake of the head.

“Don’t tempt her.”

We were on a roll, so I thought, why not?

“Pack up the church bus and maybe the van, too?”

This time she even leaned forward slightly, the asymptotic smile approaching, approaching . . .

“You’ve met my Mama?”

I gave in to the first chuckle.

“You know, there’s that old heliport out there that they’re not using. They could set up a meeting, bring a musician and a keyboard, have themselves a whole service, wave at you during the greeting time, the whole bit.”

Apparently, with that, asymptote reached, laugh achieved.

“I told you,” she grinned, “don’t tempt her.”

Thus began our own continuing rendition of “I Remember Mama.”

“I’m somehow suspecting that nobody had better cross your Mama,” I remarked later that week.

“Just let ‘em try,” she answered, the smile by then so much easier to appear, the demeanor so much less tense. “My Mama might not be tall, but you’d never know it. She still tells me, ‘Girl,’ and I hop to. Why, I’d once been out one night when I was a kid—just one night, mind you—and I sure learned never to do that again, I tell you. It wasn’t more than a couple of weeks later I walked upstairs from the basement, looked at her, she looked at me, and then she gave me this little swat, just like that. I asked her, ‘What did I do?’ all self-righteous, you know? And she just looked me dead in the eye and said, ‘You looked like you were about ready to do something.’”

At that, my patient paused and gave me, I think, her first of many full-faced, eyes-twinkling smiles.

“She was probably right,” was all she said.

My, how the stories went on.

I finally had a chance to meet her mother a few weeks later. In front of me indeed was a woman who may not have been that tall, but I sure didn’t know it. She was decked out in what they used to call a “pant suit,” and I mean it was a pant suit, bought full retail, no doubt, for no self-respecting outfit like that would last long enough in the store to make it to the sale rack. And did she know how to accessorize, let me tell you, not too much, not too little, without old-lady shoes to boot. My patient had once told me that her mother always flies, thank you, never drives to Nashville or anywhere else her kids might be.

Seeing the lady in front of me, I had no doubt of that whatsoever.

“Nice to meet you, ma’am,” I said, offering her my hand.

Her posture perfect, her head tilted slightly, she offered me her hand in return, not regally, for that would be too stiff, too formal, just pleasantly and confidently. Imagine the Queen Mother with a pinch of attitude.

“Nice to meet you, too, Doctor,” she replied.

“Doing my best to keep her honest,” I said, my head nodding toward her daughter.

As she let go of my hand, she turned her own head toward her, gave her one of those looks, and then she turned back to me to give me the selfsame. “Good luck with that,” she muttered, her wry smile telling the rest of the story.

I looked at my patient. She looked at me. What else could she say but, “Yes, Mama.”  What else could I say but “Yes, Ma’am.”

There is no tidy way to wrap up a trauma narrative, sexual or otherwise. All of us bring givens, histories to our every encounter that shape what can or cannot, should or should not be said. Sometimes all I can do as a therapist is watch and hope that this other human being before me can re-find and redefine all that he was, all that she will become.

Other times, though, I catch a break. I get to meet women who have served faithfully, suffered as they must, and never let go, no matter what. I get to see strength cross a generational divide and infuse both sides not only with hope, but with a smile. And I get to learn, once again, that some stories are best told in their subplots, down in the deep streams of human connection that just flow on, baby, just flow on.

At least you can get a good laugh out of it every now and then. And believe you me, if anyone is good for a laugh, it’s Mama.

Yes, ma’am.  And thank you.

 

JD/rjsd

Veteran’s Day 2013

Last year on Veteran’s Day, I posted the following. Sadly I can only add to it this year, names of veterans I have known only by their impact on others (Dr. Peter Linnerooth, Clay Hunt), names of veterans I have known deeply by their impact on me (Porthos, Ethan, Kurt) .

Yet with deepest respect, I can only say it all again. Gladly:

I’ve said it many times before: there are much easier ways to get an education than by going through boot camp, a statement as true in times of peace as in times of war. In basic training one learns—body, heart, and mind-—that one may have not only to kill, but also to die, and furthermore that one may have to do both precisely because one is not the center of the universe, because one has chosen to become part of a group that has volunteered to defend a larger group from those who would harm the innocent.

Some persons in this world will voluntarily choose martyrdom to promote the cause of peace, i.e., will choose their own deaths rather than inflict death on another.

Many, if not most persons, however, feel no need whatsoever to make a similar choice. Those who choose to serve in the military take up a different calling, therefore: they choose to serve the “many” such persons, if necessary, unto death so that the innocent will not have to be forced into martyrdom–or, perhaps better put, will not have to be slaughtered.

Every veteran knows that and can look another veteran in the eye and know that the other veteran knows that as well.

And so today is November 11. Because of this blog, however, because of the men and women I have been privileged to serve, this year I remembered Veterans’ Day early, on November 4, three days after November 1, All Saints Day.

We in the Mennonite tradition are more of the “Low Church” ilk, meaning that we have, through our history, tended not to take much notice of such “High Church” occasions  as Advent, Lent, Epiphany, etc. At our Indianapolis congregation, however, we have for several years now chosen the Sunday after All Saints Day to remember those in our congregation and in our lives who have, in the words of the writer of the Epistle to the Hebrews, joined our “great . . . cloud of witnesses.”

In recent years we have done so in a visually striking way: at the front of the sanctuary, on a table before the pulpit, small, flat votive candles are floated in glass bowls filled with water. Initially, as a member of our pastoral staff reads off the names of all members of the congregation who have died during our church’s nearly sixty years of existence, another staff member lights a candle as each name is read. Afterwards, we in the congregation are invited to come forward as we would like to light a candle for those whom we remember and whom we honor.

This year, as the members of the congregation came up front, the rest of us sang a song from the Taizé Community of France with the words, “Within our darkest night, You kindle the fire that never dies away,” a simple melody accompanied by organ, a solo flute, and a solo violin, the congregation and the instruments performing a canon of sorts again and again until all had lit their candles.

As I sat there, four names came to my mind: Danny, TJ, Mike, and Donald, the names of the best friends of four of the men I’ve had the honor to serve. All four men died in front of the men whom I’ve come to know. All four of the men I’ve come to know pause at the mention of these names, no matter how often, no matter when.

I walked up to the table and took the long, fireplace match from the women who had been standing in front of me. The match had burned down about a third of the way, still quite afire, ready. I lowered the flame down to one of the white votives floating in the water. It bobbed ever so slightly, requiring that I hold the match steadily, right at the tip of the wick, to await the few seconds until the flame recreated itself, fire one more time symbolizing lives engulfed, spirits rekindled, light continued.

For a moment I stood there, match now burned nearly halfway down, still alighted, nonetheless, both flames, match’s and candle’s, reflecting in the water below.

I lifted the match near my lips and blew. The carbon remains fell into the water, not scattering, merely floating, remnants, reminders that none of these four men ever reached his twenty-second birthday.

It was time to go back to my seat. Others were awaiting their turn. Death waits for no one.

Tonight I see that floating candle in my mind. Yet on this Veterans’ Day I also recall that life waits for no one as well. The dead float in our souls not simply to be remembered, but even more to be revived, reborn, remade. Life goes on for each of the men whom I continue to serve. Danny’s buddy struggles to keep his emotions under control long enough to feel a future. TJ’s buddy is coming closer every day to accepting that he must take time to grieve so that he will find the time to rebuild. Mike’s buddy is taking that time even as we speak. And Donald’s buddy finally got his old job back.

Thankfully, though death and life do not, hope waits for us all.

If we only dare hope that it will.

To Danny, TJ, Mike, Donald, and now well over two thousand men and women from OEF/OIF/OND, I say “thank you.” To my Uncle Raymond and those who died in Europe and the South Pacific over half a century ago, I say “thank you.” To the best buddy of Danny’s father and those who died with him in Southeast Asia now almost a half century ago, I say “thank you.”

And to all of you who survive, “thank you.” No matter whether one agrees with the wisdom of violence, we all agree to its existence, and on this day that was supposed to have marked the end of the “War to End All Wars,” I thank those who wish to find meaning in protection, even protection unto death. War may or may not ever be justified, ever be wise. War is never a good. Yet its end has not come, nor, sadly, will it.

Thank you to all those who have been and are still willing to live faithfully in light of that.

Semper Silouan

I got out of Nashville quite late this past Monday, so I was heading into a long trip up I-65. It turned out not too badly, though, all said and done. Eastside Indianapolis should probably be farther than four-ish hours away from Northside Nashville, but the weather was great, the truckers were anything but reserved in their speed, and I was listening to interesting ideas about trauma and the brain (spare me what you’re thinking), so the destination was achieved with minimal consternation: my first time back to Indy since the move this summer, a quick one, in and out, for a conference at which I presented on Wednesday. I’d planned on keeping a low profile, hoping to catch up on dictations (thanks to the miracle of Citrix and an iPad) in quiet, quiet, quiet.

Silouan had other plans, however. Not so much as to the low profile. More as to the quiet.

Great name, Silouan.  Check it out on the Fount of All Knowledge, i.e., Wikipedia. Apparently it’s the Russian version for Silvanus, Latin for Silas, the companion of Saint Paul (as in “old time religion” and “good enough for Paul and Silas, good enough for me,” remember?) Middle English is Selwyn. Greek is Σιλουανος,  Silouanos.

My nerdiness embarrasses my children to no end.

Silouan Green is a Marine’s Marine. Think Jethro Gibbs on NCIS, raise him up a couple of inches, replace the graying brunette with closely-cropped sandy-brown—more spare on the top, granted, but certainly no worse for the wear, trust me. He strode onto the main stage of the conference as if he were just checking on the house before heading out to the lake, blue dress shirt, open-collared, slate-gray khaki’s, flat front (what else? why waste the cloth?) His voice didn’t command attention, just claimed it.

Our Marine’s Marine grew up in small-city Indiana before heading to college down here in my new neighborhood, Vanderbilt. Math major, officer candidate school, top graduate. Getting the picture?

So what else to do other than to become a Marine pilot?

In case you’re wondering, it’s no walk in the park to become a Marine pilot.

That he did, though, très à la Gibbs, with fervor and (I have no doubt) aplomb. Fly, he did as well. Until the day his plane’s engine caught fire on take-off.  And he and his fellow pilot were ejected from the aircraft. And his fellow pilot didn’t make it. And he sort of did.

To say that Silouan mesmerizes as he tells his story of trauma and recovery is to be unfair both to him and to Mesmer. In no way does he resort to the cheap parlor tricks of some reformed huckster, lulling listeners into an emotional trance with the prosody of his voice, the alliteration of his words, luring their souls onto the stage, syllable by syllable, only then to slap them to attention with an emotional zinger, a climax leading to a denouement of the audience’s tearful adoration of the bravery of this “suffering soul” who has overcome nevertheless, whether by the grace of God or the force of Will (or both).

Hardly.

Instead Silouan let me sit in my chair, body and soul, and brought himself to me. His energy, his candor, his roughness, his softness, his him: with each anecdote, each exhortation, all of it filled the room, never demanding I join it, always inviting me to. Here was a man whose military career had meant so much to him, he’d spent nine months sleeping with a loaded gun to his head, each night granting himself the option of allowing the Corps the luxury of not having to pursue his (forced) medical retirement any further. Here was a man who, through grace and through love, finally decided to give Life another chance instead.

When I got back home to Nashville, I could describe him to colleagues in only one way: an utterly disarming mixture of unabashed cockiness and true humility.

So why write of him, you ask?

First, I’m more than willing to offer him free advertising. If you’re looking for a veteran who’s suffered not only the loss of a friend, of his health, of his career, but even more the loss of his very identity, a veteran who has re-found and reformulated that identity in spite of an exhausted body and soul that had been doing what they could to thwart him, a veteran who is willing to speak to anyone who will listen about despair and hope in a way that will never leave you the same—check out www.silouan.com. Get him to come speak. Advertise well. Prepare to walk away different from how you arrived. Period.

He has also put together an excellent study guide to help traumatized individuals to re-find- and reformulate their very own identities, www.theladderupp.com.  I’m planning on using it with every soldier who comes to our facility.

Even more, though, I write of him to honor his pain, to honor his continuing recovery, and to remind everyone—veteran, family member, friend, mental health professional, human—that Life can bring down even the unabashedly cocky, the competent beyond your wildest dreams, the golden boys and girls who will do what you could never hope to do better than you could have ever dreamed of doing it and that Life is nonetheless still willing to give them a humble second chance. Or three.

If Life will do that for them, it’ll do it for all of us.

Semper fidelis, the Marine’s motto, “always faithful.” Silouan is certainly that. But like most of his fellow Marines, soldiers, and the men and women of the Navy, the Air Force, and the Coast Guard, it doesn’t stop there. Semper paratus, so says the Coast Guard, “always ready”: that, too. Semper fortis, “always strong”? As much as any person can be on any given day, sure. Semper humilis, “always humble”? What if we think of the humble as those who are not so much lowly as they are grounded, down-to-earth, unafraid to look up and acknowledge something, some ones, Someone higher?

So let’s just make it easier on ourselves, shall we? Semper Silouan. Enough said.

To Err Is Human, To Forgive Is Gary Cooper

I’m not sure that even now he fully understands the impact of his presence, this soldier, notwithstanding our having discussed it several times. Of average height and very strong build, he, to be fair, would not necessarily stand out on an Army base filled with men of such description, if all you were to do were to view him in a still pose, standing or sitting.

It’s how he moves.

I’ll never forget first seeing him walk, sit down, lean forward, fold his hands, bend his head downward. He was not the first burdened soldier I’d met, not by a long shot. Yet there was something so measured about him, so willing to accept the load, no matter how heavy. It was as if Atlas had volunteered to Zeus to bear the weight of the heavens so that no one else would be so encumbered, no hint of martyrdom anywhere, simply duty and faithfulness.

Unfortunately for him, though, he had taken on weight that had been unfairly farmed out to the innocent, whether by the questionable decisions of superiors or by Life. As a veteran of four Middle East deployments, he had had more than his share of opportunities to do that.

Only then to return home and to discover that Life does not cease to provide such opportunities once you’ve hopped a plane back stateside.

More pertinent to this tale, moreover: true to form, to his character, he was even willing to bear such a weight for me.

It was probably our second, maybe third time speaking together. Already, in just those short encounters, I had come so to admire him, even as I had also come to feel so much sadness at his recurring assumption that if someone was going to have to take the “hit” for Life’s cruelties, it might as well be him.

The conversation that day took an innocent enough turn, in retrospect, a discussion of possible future options, as I recall, tossed out as one scenario among many.

I said what I said.

He didn’t respond as he could have. As I babbled on, he simply nodded his head in that most soldierly of manner, the ever-ready “Roger that, sir,” I’m sure, right there on his lips.

It was I who had to stop in mid-sentence, smacked in the psychic face by the import of the words I had just spoken to him.

You see, I had just “tossed out” an option that would have been impossible precisely because of something that had happened to him, something about which he had felt the greatest of blame, even though there had been none for him “realistically” to take on. For a moment, I had acted as if what had most rent his heart had never happened at all. I might as well have been talking to Atlas about that oversized beach ball on his shoulders.

This was not the first time this had happened to me, of course, although fortunately a mistake of this gravity is a rare one. Once I realized my mistake, I think I must have just sat there open-mouthed, wide-eyed, the whole bit. All I can remember is his face, a single swallow, a deep breath with his mouth closed, in and out, no change in countenance whatsoever, followed by that look of being willing to take the hit one more time and then to listen attentively to whatever my next words might have been.

“Oh, my God, I’m so sorry,” was all I could utter. I then spoke my mistake out loud.

“That’s all right,” he whispered, although the quick catch in his voice revealed that it had been anything but.

“No, it’s not,” I shot back, quite aware of my need to allow him, even urge him to put blame where blame was due. “You deserve better than your doctor even momentarily forgetting what I forgot.”

His discomfort was crescendoing. “Really, sir, it’s OK. I forget things all the time. No big deal, really.”

This was a hard decision point for me. On the one hand, I needn’t—and what’s more, shouldn’t—keep harping on something that a soldier has no desire to rehash. He or she has the right to request that we just let it go, already.

Yet somehow I knew that this was not one of those times.

For a few frantic microseconds, I dove inward, trying to interrogate every neuron I possibly could: “Why did I do that?”  Only one thought, more image than language, came to me: I was already experiencing him as the strong, good, fulfilled man that he could and can be.  I was, in other words, already experiencing him as having moved forward.

“You know,” I finally said. “I have no clue as to whether this will make things better or worse, but I do want you to know: I think at that moment I was experiencing you as the strong man you are, even though I realize that you’re feeling anything but that. Even though I know full well that you are struggling, I still think of you, feel you as the man who I know you want to become.”

For a few seconds, he stared at me, still not angry, but less anxious as well. He then looked down and even, for an instant, smiled, more out of recognition than out of anything approaching levity.

“You know, one of the other soldiers told me that exact thing, just yesterday, that I’m exactly the kind of guy he sees himself wanting to become. It . . . it helped.”

I leaned forward.

“You appear to be having no problem forgiving me for my blunder, am I right?”

He looked back at me. “Absolutely.”

“Then, maybe,” I replied, “could you see how all the rest of us, whether alive or not, would have no problem forgiving you—if in fact there were actually something to forgive? The hardest person on you is you.”

He dropped his head back down. “It’s always been that way.”

“Do you see, then,” I went on, “how because of what just happened, we proved together at least one instance of something that you’ve doubted much of your life: that words can make a difference, that trying to work something out is more than half the answer to whatever it is that comes between two people? All your life you’ve felt that words really don’t make a difference, so just soldier on. Sure, you’ve been to War four times: so you know that’s very often the case, the only case. But it’s not always the case, especially between two people who are trying to understand each other. Good intentions may not always lead to good results, but sometimes they’re all we have—and they really are at least better than silence.”

It took only him only a few seconds to look back at me with both that same “what do you know” smile and the words that I’d been expecting all along: “Roger that, sir. Roger that.”

Gary Cooper was certainly a complex man in real life, but on the silver screen he came to stand for all men of few words, yet of deep feeling. I’m not so sure that the sheriff in High Noon was ultimately that interested in forgiveness, truthfully. So I’m glad his counterpart in my life turned out to be more amenable to the notion.

The soldier has worked hard to understand himself, to give himself over to what cannot be changed, to begin to change what can. He’d have always been the type to live the Serenity Prayer more than say it, truth be told, though I’m sure he’d not be against it. Wise men, young ones included, are willing to give even the standardized a shot.

He’s still frustrated, no doubt of that, sad as well. But together we discovered that words can make at least the beginning of a difference when said sincerely by two persons trying to make Life better. The old analysts always said that there is no such thing as a “mistake.” It’s never random when we disappoint one another. I’m afraid they’re probably right.

Thank goodness that in spite of that, my Sergeant Cooper was willing to give voice to at a least a few more words than “yup,” “nope,” and “can’t rightly say.”

I am indeed most fortunate.

 

JD/rjsd

I’ll Fly Away

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

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

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

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

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

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

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

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

“A story you’d like to tell?”

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

“Yes, sir.  Yes.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What else could I do but beam myself and chuckle?

“Yes, it is. Yes, it is.”

You go, Norm.

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

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

And the dog and I parted friends. I think.

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

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

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

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

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

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

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

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

Amen to that, Pastor.

And fly away, fly-boy. Fly away.

JD/RJSD

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

Adieu, A Dieu

It’s good to be back.

While my two-month delay has had a lot to do with the demands of my new job, I have to be honest: the real reason says far more about the challenges of farewells than it does about the challenges of paperwork.

About three weeks before Memorial Day, I made the decision to cross the therapist’s Rubicon, to go, like Caesar, where I had been told I was not to go, fully aware that my crossing, like his, would be an irrevocable one, an act, even, of rebellion.

I comfort myself now by revealing that my Julian meeting was at least not going to be a secret one: I had discussed it with my wife beforehand, given that I could not guarantee her that I would be home any time before 10:00 AM on that Monday before my second daughter’s high school graduation open house.

My wife had been fine with my going, nonetheless, especially given that my young adult children would most likely not even have been humanoid by that hour anyway, so she had figured that she most likely would still be nursing her Keurig-brewed Starbucks at said hour, channel-surfing in a desperate attempt to find something worth watching on TV after her having bid the day’s farewell to Charlie Rose on CBS This Morning.

Now true, I had told no one at the VA about the proposed meeting, but so it goes . . .

“You going to be free on Memorial Day—early, I mean, like 7:30 or so?” I asked the young veteran on that fateful, “the die is cast” day, both of us seated quite comfortably in my office.

It was an honest question, after all. I knew that he too had had a big event planned for the same day as my daughter’s, so I hadn’t been sure that the woman in his life would be as flexible as she in mine had been.

Brides can be funny about wedding days, after all.

“Why do you ask?” he replied, in a manner both comfortable, yet somewhat guarded, that hallmark of so many of our interactions.

“Well, you know,” I stammered, “in a matter of a few weeks, I won’t be your doctor any more, and you won’t be my patient, or at least officially you won’t be my patient—although some people do say ‘once a patient, always a patient,’ and I guess they have a point, if you think about it, but then—“

“Doc,” he said, his smile a familiar one, his roll of the eyes one that had once been a recurring response to a well-loved battle buddy of his, one still so missed by us both. “Just spit it out, why don’t you?”

I had to smile myself. Step in water. Cross. Step out of water. March.

“I was thinking,” I went on. “Last year on Memorial Day, I went to Crown Point Cemetery and placed a flag at the grave of a patient’s father, and . . . well, this year I was thinking of doing that at Porthos’ grave, you know?”

The young veteran’s smile slowly melted, first into the quizzical and then, dare I say, into the hesitant. Yet he didn’t say a word.

“So I was wondering,” I faltered on, “whether you would have the time or whether you would like to meet me there, at the cemetery, you know. We could . . . get a bit to eat afterwards, maybe. You know? If you’d like, of course. Only . . . if you’d like.”

Thirty years I’ve been a psychiatrist, with well over twenty more years behind me practicing the art of basic communication in the English tongue. One would think I could have come up with something better than that, but there you have it.

Thankfully, a rhetorical critic, Athos, the last Musketeer, is not.

“Of course, Doc,” he whispered, smile back in full force. “I’d love to.”

Apparently my children were not the only ones planning on sleeping in that Monday. I suppose every bride needs her beauty rest.

I bought the flag at the Canteen at the VA about a week before the Holiday, one of those tchotchkes that you always see people waving along the side of the road whenever the President is passing by in his motorcade from the airport to a convention center stage that looks the same in Seattle as it does in Poughkeepsie. I left said flag in the back seat of my Volkswagen, truthfully just so that I wouldn’t forget it and leave it at the hospital, yet also gambling that the sun would be merciful on it for the week’s wait, especially given that the chemical fibers of the flag’s “cloth” (ha-ha) would probably be strong enough to melt the sun itself before the latter would have the audacity to attempt to melt the former.

Monday morning, Memorial Day celebrated, finally came, and at the crack of dawn (i.e., 6:30 AM, same thing at my house on a three-day weekend) I headed south of Indianapolis, not even sure if the gates of my municipal cemetery destination would be unlocked at that time.

At 7:15, aided by the absence on the road of all drivers who had been smart enough to stay in bed that morning, I arrived to find the gates wide open.

It had been almost a good two months since I’d been there that first time. Yet without hesitation I recognized the winding road, visualized the tree by the veterans’ memorial, recalled the casket suspended over its final destination. Within minutes, destination found, I eased the car to a stop, turned off the engine, and just sat there, looking.

As if on cue, my cell phone rang.

“Sorry, Doc,” whispered the voice at the other end, in a tone familiar to anyone who has experienced that profoundest of parental joys, i.e., the waking up of teenagers on the first school day after Christmas vacation. “I overslept.”

No surprise, of course. By his report he’d never been the morning-type, even long before War had made sure that the dawning of a new day would never again spot him a feel-good freebie.

“No problem,” I replied. I remembered a mom-and-pop joint I’d passed by on the way into town. “Is it any good?” I asked. “We could eat before we head over.”

I swear I heard the smile over the phone. “Porthos and I ate there all the time,” he answered.

“See you when you get there,” was all I replied.

OK, so now: think Indiana. Now think of every diner that you’ve ever seen on TV where the show’s protagonists meet for coffee in the morning and where the waitress then walks up and reminds them that it’s Wednesday, so there’s still some peach cobbler left over from the day before, if they want some.

You’re there.

He arrived only about five minutes after I had, barely enough time for my downing two swigs of a coffee that, though not exactly flavorful, was not pitiful either, thank God. As he sat down, his whole demeanor, his whole “him” hit me again, full force. I could only imagine him in my mind’s eye, in some back-street club in Nashville, maybe, clad in a plain T-shirt and a pair of jeans, sitting by himself on a stool on the front stage, a couple of lights highlighting his each side, looking down at his guitar, strumming, quietly singing his soul as the patrons look on, their Miller Lites from the tap half-drunk, joining him in musical reveries of what had been, what might have been, what might still be hoped for.

“You gotta try the fried biscuits,” he said in an excited voice that I just as easily could also have imagined his having used with me had such a dream suddenly turned into a reality, after his having taken a break after the first set, probably, followed then by something akin to “Pretty good crowd tonight, Doc, you think?”

“The ones with the apple butter?” the real me asked. Yes, I’d seen them on the menu, I admit it.

“Porthos loved ’em. He’d practically swallow them whole.”

So of course I got them. Athos settled on biscuits and sausage gravy. What else for a Southern boy, right?

Porthos had known whereof he’d swallowed, it turned out. Lord, that place was so quintessential, I suspect they have one of the original patents on the whole breakfast menu.

We talked, not exactly buddy-talk, but certainly not doctor-patient “dialogue,” either. He was so excited to be getting married, so dyed-in-the-wool jittery. I talked some of my upcoming move, as I recall, as well as something of my daughter’s graduation, I’m sure, or of my son’s looking forward to his new school in Nashville, my wife’s looking forward to our downsizing, perhaps. Honestly I can’t quite remember. We needed only one java refill apiece, though, not that there hadn’t been time for more. I suspect neither of us had at that moment the stomach for more, literally and, yes, figuratively.

“Want to head over?” I finally asked.

For a few seconds he just looked at me, his face not exactly frozen, yet not exactly responsive either. He then looked down at his empty coffee cup, the only distraction available before him, the plate of gobbled-up biscuits long having been cleared away with a rapidity worthy of any waitress named Flo this side of the Mississippi.

“No,” he whispered, only then to bring his eyes back to mine. “But yes.”

As always, an honest man.

When we arrived at the graveside, we were still the lone living among the dearly departed, given the hour, most likely, but perhaps for other reasons as well, who knows. I got out first, shut my door, looked back at him in the car behind me. He was sitting behind the wheel, staring toward the grave. A few seconds later, jolted apparently by some slap across the face of his soul, given the sudden, quasi-violent shake of his head, he looked up at me, smiled (or at least tried to), and got out himself.

The headstone had not yet been placed at the grave, but the latter had certainly not been unattended: some flowers, a small wreath, tributes not having been lavished on any other soldiers’ remains in the entire area.

“His folks?” I asked Athos as soon as we’d reached the spot.

“I suspect so,” he answered.

“You come here any?” I continued, rolling the balsa wood flagpole in my fingers back and forth, back and forth.

He was gazing down toward the flowers and the settling earth before them. He’s a couple inches taller than I am, far more angular in appearance. Given that I was having literally to look up to him, his face somewhat silhouetted by the rising sun, for a moment he struck me as a young Lincoln, believe it or not, far more handsome, most definitely, yet just as burdened, just as sad.

“Every once in a while,” he finally said.

I turned my own gaze downward with him. After a few more moments of silence, I knelt down and inserted the flag into the ground, right next to the flowers. Down on my haunches, I was, for a few seconds at least, aware only of the man whose remains were below me, the man who only months earlier had so proudly assured me that he would get his prescription from the VA pharmacy on that day that he’d left his ID at home (an absolute no-no, of course), the man who’d then sashayed his way back into my office a half-hour later, dangling a sack of medications from his raised right hand, practically purring to me that “she thought I was cute, Doc, I told you. They taught us how to do that in Special Forces training, told you, told you.”

God, I miss him.

As I stood up, I heard a chuckle behind me. I turned to find Athos still staring downward, but smiling to beat the band.

“He’d have been so tickled that you did this, Doc,” he whispered, pausing only a few seconds before looking up at me, the tear trickling down his cheek, I suspect mine mirroring his.

The smile could only last so long.

“I miss him so much,” was all he could then say, clearly lest the single tear be joined by compatriots far too many, far too insistent.

It was only as we embraced right then, however, that our truth, his and mine, was spoken.

“I’m going to miss you so much, too,” he whispered into my ear, for a few moments hugging me even harder, only then to release me, to push himself back, to look down at the ground, to swallow, to look back up at me and then, without pause, to look back down again, his hands inserted into his pockets, his feet shifting, side, to side, to side.

“You know we’re going to stay in touch, don’t you, right?” I said after my own pause. I then moved a few steps toward him, took his face, and pulled it up slightly, bringing us one more time to that spot so familiar, so comfortable, so distressing to us both: eye to eye. “I won’t be able to do anything about the VA or anything like that, no medications, the whole bit. But . . . we’ll still talk. Just like always. Promise.”

I don’t think I’ll ever forget the gaze he gave back to me at that moment, the gaze of a man half my age, yet one who had lain by the coffin of Aramis in the belly of an airplane for hours on end, one who had taken Porthos’ folded flag from the hands of the highest-ranking officer of Indiana’s National Guard, only to pass it on to his buddy’s uncle with a solemn salute, the one who had buried his father, his sister. The last one standing.

He was reminding me that he could not afford to forget what I was trying so hard not to acknowledge: that separations matter, that Skype and FaceTime can only save us so much, that “still, just like always” is never either.

“Roger that, Doc” he whispered.

The good soldier, protecting his “superior” to the end.

I’m happy to report that he and I have indeed stayed in touch since my move. But, yes, it’s not just like always.

My last day at the Indianapolis VA was Friday, June 28, 2013. At 0400h (yes, that’s right) on July 1, 2013, my wife and I took my younger two children to the Indianapolis Airport to board a plane to Phoenix, Arizona, where they attended the national convention for the Mennonite Church USA. Only about an hour later, I drove my ridiculously-packed-up, blue Volkswagen away from my father’s house, where we’d been camping out since the sale of our home, after twenty-two years heading out of town one last time, now toward Nashville, Tennessee, toward a very different hospital than the VA, a very different life.

Yet I-65 South toward Louisville, with Nashville beyond, leads past a spot not too far away from a cemetery I’d visited just a month before. I thought of taking a brief detour. Yet I had a meeting to make in about four hours and then, after that, it was to be off to another meeting at Fort Campbell, Kentucky, forty-five minutes northwest of Nashville. No rest for the wicked. Or the weary.

So I drove on by. And remembered.

______________________________

It has been ten days since I penned those last words. I’m still as clueless as to how to wrap up this essay as I was then.

We all so wish we could tidy up our lives’ endings, slap on some aphoristic wisdom and then mosey on down the road to another venue, another opening of another show.

Yet how do I do that, how do I tidily say “goodbye” to young men and women who have known so up-close-and-personally, often time after time after time, those most untidy of Life’s endings? How dare I even think that a nice thought at seventy miles per hour, followed by a sentence fragment penned three months later, could be enough to say to a Musketeer and his battle buddies, both literal and figurative, adieu, let alone claim to say à Dieu, Godspeed.

As I sit in the quiet of my brand-new, far-smaller condo, I almost literally experience faces pass before me, faces of those who have cried who have raged, who have laughed. Unlike the faces of the dead, these do not haunt me, thankfully. They do remind me, though, how much Life matters, how quickly it can change, for good or no, how long it lingers even after it has allegedly moved on.

And so I listen on.

Adieu, mes amis. À Dieu.

An IED on the Rocks, Please, With a Twist

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

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

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

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

Except for this one time.

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

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

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

“Sure, I’ll see him,” I said.

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

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

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

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

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

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

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

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

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

But he did.

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

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

And, indeed, he was acting like one.

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

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

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

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

Finally, I had to speak it.

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

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

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

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

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

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

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

Another silence.

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

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

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

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

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

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

I was not about to let him off that easily.

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

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

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

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

How wrong, how utterly wrong they often are.

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

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

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

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

I hope that somewhere tonight he is feeling more peaceful.

I wish I could be more hopeful in my hope.

God, be with him.

Lambs, Lions, Lights

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

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

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

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

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

_________________________________________________________

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

“If you’d like, of course.”

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

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

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

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

(Until lambs become lions)

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

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

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

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

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

The Soliloquy

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

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

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

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

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

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

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

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

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

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

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

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

The “Aperion”

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

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

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

Sometimes I walk
But this void is endless.

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

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

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

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

I reflect on my travel and trials
I have faced.

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

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

I enter the fire willingly from whence I came.

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

And bring a reality of serenity into being.

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

_________________________________________________________________

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

Have no fear, soldier. You didn’t.

No way, nohow.

A Goede Hombre

I received the text earlier this week, at 1404h, Central Daylight Time, Tuesday, July 2, 2013, a picture.

He looked great, wearing what appeared to be a simple, black suit/tux, sporting with it a white, pointed-collar shirt, well-starched, and a formal black tie, half-Windsor knotted. I suspect the picture had originally been taken at his older brother’s wedding not long ago.  He had that certain “brother of the groom” air about him, after all: slightly annoyed to be all decked out on a day that wasn’t exactly his, yet pleased well enough all the same, knowing full well, of course, that he looked mighty fine in these trappings, if he did say so himself.

In the background was an American flag and the unmistakable emblem of the United States Marine Corps. He would, undoubtedly, have been far more proud of those than he would have of his handsome mugshot.

I have finally made the move to Nashville. I have finally found the time to sit quietly with my cup of Tazo Zen tea. I have finally found the courage to announce, again with the permission of his family, that on Friday, July 5, 2013, another fine young man whom I had the honor to serve was laid to rest.

He died early in the morning hours of my final day of service at the VA in Indianapolis. I learned of his passing late that afternoon. As had been Ethan’s death (Reporting for Duty, Sir), his had not appeared to have been self-inflicted, and it had come without warning. He had spoken to family and to his best friend mere hours before, in good spirits, looking forward to his and my final meeting together before my move, even more looking forward to plans for treatment and for a new chance at a life perhaps less pain-filled, definitely more hope-filled.

He was buried in a community far both from my former home and my new one. I had a couple chances to speak with his mother. I asked her to convey my sincerest condolences to his father, his brother, his grandfather, and all those whom he had loved and who had loved him.

I did not, therefore, hear “Taps” a third time in as many months. Yet as I sit here, watching the Cumberland River quietly drift by me, ferrying branches big and small toward destinations perhaps just around the bend, perhaps miles away, with the occasional speed boat barreling by, ferrying revelers trying to swig down one last Miller Lite before heading back to post-Fourth of July reality, I can so easily imagine a bugler standing on the shore opposite me, looking me directly in the eye, nodding, lifting his instrument to his lips to announce not only to me but to anyone else within earshot that another who tried the best he could to do the best he could has departed us, only then, after the fading of the last note, lowering that instrument, tucking it under his left arm, raising his right hand in that four-count salute rendered only to those who deserve it, holding it, lowering his arm in another four counts, then looking up at me, nodding, and finally with a sharp about-face, turning to walk away from the bank, into the trees, into the memory and the imagination from which he had come.

My patient—let’s call him “Kurt”—came from a successful family of international entrepreneurs, his father’s lineage Dutch, his mother’s, Hispanic. He’d attended the finest of schools as a boy, a teenager. Easily he could have attended the finest of universities after that. He was smart, multilingual, bearishly handsome, affable, after all: Cambridge, New Haven, New York, Princeton, all would have gladly welcomed him, no questions asked.

But this boy had an energy that only the Marines could handle.

He was so proud of his unit. He had given me a copy of its insignia, all ready to be mounted on my rear window should I have so desired (and with his full permission, I might add, implying that such would have been enough to get me through any subsequent interrogations by fellow Marines as to why I might have been claiming  the right to be lollying around town with such an honored accouterment).  He was a Marine’s Marine.

Thus, he never forgave himself for the training incident the week prior to his deployment, the one during which his right arm was so shattered, he finally had to lose one bone altogether in order to preserve whatever function allowed to him, the one after which he was separated  permanently from the other two men on his team whom he’d come to love more than Life itself . . .

From the other two men who—along with Kurt’s replacement, less prepared than Kurt had been—died only weeks later in an IED explosion that Kurt, to his final moments, I’m certain, believed with his every living cell that he could have avoided had he been there or, at the very least, he could have endured with his friends together, one final time.

From that point on, Kurt’s life was embedded within pain. He had to take pain medications at levels that still cause me to tremble at the very thought. He endured constant nightmares of a vicious home invasion he had survived as a youth—with night after night after night of such nightmares ending with his escaping (which, in real life, he had), while his Marine buddies, captured in the dream, were slaughtered by the intruders, over and over and over again.

Yet, there was not always pain between us.

The day had not started out well, almost two years ago, now. His pain had been  so acute, he was considering suicide. He refused to stay in the hospital. I refused to let him leave. It was tense, to say the least. Finally I had to call the VA Police to stand watch outside my office as I arranged the admission in the secretary’s office next door.

Then I heard it.

“Hey, Doc!” came the policeman’s voice, not exactly panicked, but not exactly calm either.

Good God, I could only think.

“What?”

“Uh, sir . . . I’m not quite sure how to tell you this, but your patient just jumped out your office window.”

I kid you not.

Now, fortunately, it was a first-floor office. Yet it was still a good six-foot drop.

I had barely turned around before seeing said policeman zoom around the corner, heading toward the front door of the building, the words he’d been  shouting into his walkie-talkie lingering behind him like an ether cloud, as sound apparently could not travel as fast as that man was moving. I’ll never forget walking up to my office, by this point all alone (since all others within fifty feet had made similar dashes around said corner), only to see my office window wide open.

I’d not even had a clue that the window could have been opened.

But that’s not the best part.

Within five minutes, Kurt marched right back in, now accompanied by three policemen and a host of other witnesses, with that same nonchalant look that, come to think of it, he’d shown in that picture from his brother’s wedding.

“What happened?” I asked (a stupid question, I know, but I couldn’t think of anything else to say).

“I needed a cigarette,” he told me, as calmly as all get-out. “The cop said I couldn’t go out to get one, and I knew I couldn’t smoke upstairs in the hospital, so I just decided I’d find me a way to get one more cigarette while I still could.”

I do so wish there had a been a picture of my face at the moment, given that my memory of his face was that he was still struggling to figure out what all the big deal was about.

“Are you kidding me?” was all I could say, standing there, as I was,  in front of a good half the Hospital’s police force, along with God and all Nature, to boot.

“He’s not,” the original policeman chimed in. “Really. By the time we got out there, he was just standing there, putting his lighter back in his pocket, taking a few puffs, asking us why we were all so upset.”

Kurt just smiled. “I told ‘em I just wanted to smoke a cigarette. I guess they didn’t believe me.”

I repeat: kid you not.

I swear to God, also: by the next day I had so many environmental engineers swarming into that office, I’d have died hermetically-sealed in said room should any disaster have struck thereafter, nuclear or otherwise. I wonder if, now that I”m gone, Homeland Security is using it as a holding cell for those too dangerous for Gitmo.

One of my other patients, a former Marine officer, had heard the “Legend of the Jumping Marine” somewhere along the way (who hadn’t?), and I’ll never forget the smile as wide as the nearby White River when he spoke to me about said affaire mémorable.

“Now that’s a Marine, I tell you. You tell them to go take that hill, and they ask you ‘How many times, Sir?’ You gotta love ‘em.”

Indeed, you do.

So I sit here, now sipping San Pellegrino, and I ask myself, “What can I say?” How can I honor him in the same way that phantom bugler did only a short time ago, disturbing the peacefulness of the river in my mind’s eye not so as to upset, but rather so as to remind, to call me to remember what it means for some men and women to choose to accept a life that they were not forced to accept, to choose to face risks that many of us would have preferred that they not have faced, whether for reasons of love or for those of ideology

I can only do so at this moment, I believe, by honoring his pain, honoring it so that others may know the depth of his suffering, honoring it so that others, perhaps, can begin to know something of the sufferings of many, many of his brothers and sisters who have served in combat, who entered War and left War with a capacity for emotional power that few had allowed themselves to realize before, let alone even to accept now.

With each passing day, with each troop or veteran I meet, I become more convinced that many, many civilians simply cannot begin to fathom the physicality of the warrior’s emotions, whether that warrior be a man or a woman. Granted, there are some civilians (more than a few, I might add) who are “warriors in spirit,” who can indeed find themselves caught up, sometimes quite frequently, in similar depths. Yet most civilians, I assert with solid confidence, must learn the following formula and apply it, whether they think they should have to or not:

Take whatever emotion you have ever felt in your life—joy, curiosity, grief, rage, anxiety, sensuality, shame, whatever—localize it in your body, and then imagine it now crashing down into your gut with a force that draws your every inner organ into it like some whirlpool out of Hell. Then repeat, shoving all of it down into that whirlpool even more deeply. Then repeat. Eight more times.

By the time you hit Whirlpool Ten, you’ll be close to the emotional experience of the Warrior. Not there. But close.

I have yet to meet a troop or a veteran who has not known, full well with bells on his/her toes, that he or she was going to have to “Move On” from his/her wounds of the extremities, of the brain, of the soul.  That’s never the issue, no matter how many times, no matter who adds the adverb just to that phrase, as if somehow the person uttering such nonsense were finally giving said troop or veteran the psychological equivalent of a reminder that s/he could have also had a V-8.

It’s never about “moving on.” It’s about what one has to drag along, from the very depths of one’s soul, whenever one does move on.

Everyone has experienced gut-wrenching emotions. Not everyone has had to experience such emotions every single time that door marked “Emotions” is opened, even when one is desperately, desperately hoping that the last five loads of psychic lumber with which you’d tried to nail that door shut will hold, please, dear God, please.

I sometimes read “pain experts” pontificate about the “psychological overlay” of pain as if they were finally giving us the news that we’d never considered and that will now finally open all of us to the Promised Land of the cognitive. I know about all the evidence. I know about all the good intentions of all who have so published in the journals, opined in the op-ed pieces, spoken to the cameras in the well-orchestrated segments of the latest news show, the latest radio spot.

Yet Kurt’s grief over his fallen buddies, his shame over his injuries, his anxiety over his future: they so Hurt with a capital H, so overran his biological pain receptors with the same ferocity, the same violence with which those intruders had once overran his boyhood home, he had to sweat with psychic blood every ounce of hope that he was able to earn. Hope, for him, was a hill that made Iwo Jima look like Kiddieland.

But he always asked me the same thing, every time, every time: “How many times do you want me to take it, Sir?”

How many times.

Until the day you have been able to imagine your whole body being wracked with an emotion so powerful that it brings you to your knees, always figuratively, often literally, with each sunrise; until the day you have been able to imagine the courage it takes to rise up, under such circumstances, and walk ten miles or, maybe, just take the dog out; until the day you can feel your most powerful emotion in your most painful of spots and can then say to yourself, “Oh, my God: do you mean it can feel worse than this?” and know that there are men and women out there in their teens, in their twenties, thirties, forties, fifties, sixties and beyond who can answer a resounding “Yes!” while trying not to relive, yet never to forget horrors and truths that, hopefully, you’ll never even have to imagine imagining—until then, please, please, please: never speak to a troop or a combat veteran the equivalent of the English words, “Move on.”

My title, of course, is a polyglot admixture, the Dutch goed with the Spanish hombre, the admixture of “A Good Man,”  the admixture that was Kurt, the admixture that could have taken a much easier road, but whohad refused to do so, the admixture who so many times had wanted to give up on that hill called Hope, so far from Bill Clinton’s Arkansas hometown of the same name, the admixture who had many, many times stumbled and fallen as he’d tried to take that hill, the admixture who had nevertheless kept trying, kept trying, semper fidelis to the end.

As with Porthos, as with Ethan, I have not earned the right to salute you, Kurt, my friend, as that bugler did in my mind mere minutes ago. So I can only give you what I gave them, unfortunately only in the Spanish of your lengua maternal and not also in the Dutch of your paternal tongue.

But do know that if  I could have spoken both languages, I would have. As always, Kurt. As always.

El dolor ha pasado, Kurt. Duerme siempre en paz.

The pain is over, Kurt, hallelujah. Rest in peace.

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