Disentangling

In so many ways, it was just another day.  I had not expected to see him.  He had, however, spoken with a colleague about his concerns about his painkiller usage, so the call had come:  could you see him?  He’s in bad shape.  He really seems sincere.

I said I’d be glad to.

When I walked into the waiting area, I saw a soldier’s soldier.  He looked like a high school wrestler who had aged rather well, thank you, hairline ever so slightly receding, strong facial bone structure.  He was looking at something in front of him that, I would estimate, must have been about twelve miles from where we were.  His whole demeanor was resolute–sort of, not really, but yes, really, it’ll be OK, but . . .   It’ll be OK.  Yes.

When I introduced myself, he looked me right in the eye as he popped up, ever the straight, good soldier he was, not rigid, but solid, putting out his hand confidently, sort of, not really, but yes, but . . .

“Thank you for seeing me.”  He spoke with definitiveness, yet vulnerability, as if both to assure me that all was going to be fine as well as to assure me that he was desperately needing my help, this was not a drill.

“Good to meet you,”  I replied.  We shook hands, again his grip both soldierly solid and humanly tentative.

His story was a familiar one.  He had injured himself in the Middle East.  He had begun opiates to ease the pain.  He came home, and the PTSD symptoms started.  He had seen a lot of war up close and personal.  The images continue to haunt day and night.  The painkillers did make them go away.  Somewhat.  Not really.

He’d reached a huge daily dosage.  He was desperately seeking it from whatever source he could.  A few days before he looked at his child and realized that he could barely focus on the kid, not because his eyes were weak, not because he was high–but because he could only think pills, pills, pills, God, where will I get the next pills.

As he told me this, I could see the tears gather, but he was a good soldier.  He didn’t let them go.  He sat rigidly and narrated his tale.  He sat limply.  He appeared in control.  He appeared desperate.

He loved his child.

We talked about Suboxone, the opiate substitution product that has helped so many of these veterans.  He was anxious to start.  Our converstion, though, had taken its toll on him.  He stood up to go out of the room.  He was not crying.  Sort of.  Not really.

But if he were to take one more step toward the door, he was going to start sobbing.  I knew it.  He knew it.

“It’s no problem, your staying here and pulling together a bit if you’d like,” I said.

At first he looked at me blankly, but within seconds came the smile of relief.  “Thanks,” he whispered.  He sat down.

Deep breaths, he took.  Sort of reminded me of the breaths you take before you’re about to try to shimmy up the rope on the obstacle course, I can do this, I can do this, I can do this.  Deep breath.  I can do this.

He looked at me, eyes resolute, eyes ready to release their torrents.

“I hate this,” he said.

I don’t know why I said it to him.  It’s not my usual opening statement when starting the guys on Suboxone.  I just felt:  I need to tell him.

“You know, the problem is that you guys came back with someone else in your soul.  The war.  The war’s there.  It’s not going away.  You know that.  I know that.”

He nodded his head ever so slightly.  “I know,” more of a swallow than a response.

“But the real problem,” I continued, “is that you guys feel that only the war came back, that the war is all you are, that you disappeared over there and only the war came home, full of rage and pain, the war-is-hell war, the war that makes you too horrible for anyone to love, to care anything whatsoever about.  Am I right?”

He nodded.  This was one determined man.  Breathe.  You can do it.  Breathe.

“You’ve got to trust me on this,” I said to him.  “You’re still there, inside you.  While I in one way don’t know you from Adam, I do know war when I feel it.  I feel the war in you.  But I feel someone else as well.  I know you don’t.  But you’re going to have to trust me.  You and the war are too entangled.  We’ve got to disentangle you.  It won’t happen just like that.  But it’s possible.  You’re not gone, the you that went on deployment.  He’ll never be alone again.  But he’s not gone.  Believe me.”

That was when the first tear began to respond to gravity.  He was still breathing, ready for the rope, trying to stop gravity’s pull on that tear simply out of sheer will.

“I can’t take the war out of you,” I continued.  “You wouldn’t believe me if I told you I could.  You will always have to live with it.  But you are not it, and once you can begin to feel that more consistently, you will be able to begin to find a way to live with it.  There’ll always be some pain, but it doesn’t have to hurt like this forever.  Once you get disentangled, it’ll work better.  Trust me.”

He swallowed.

“Really?” he whispered.

“Really.”

He closed his eyes and looked down.  A few pre-shimmying breaths again.  Then he looked up, first at nothing in particular, then at me.

“Thank you,” he said.

“Sure thing.  See you tomorrow, to adjust the dose?”

He nodded.  “Yes.”

I nodded.  “OK.”

He stood up, soldier straight.  One more breath.  A very resolute, very warm smile.  He gave me his hand.  I shook it.

He came the next day.  We adjusted the dose.  That’s how it goes with disentangling.  Steady.  Keep going.  Breathe.

Shimmy.

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