“Goodbye, My Friend” and “In Memoriam: Porthos, 1985-2013” (Encore)

Silhouette of a soldier against the sun.

 

On the evening of Monday, March 25, 2013, I was leaving a dinner meeting w aith colleagues, a group with whom I had been meeting for just under twenty years, once a month during the school year, to eat together and to support each other in our work. We’d been through births, deaths, marriages, divorces, new practices, failing practices, the whole bit. We ate that night at the cafe at Nordstrom’s, up at the Fashion Mall on the north side of Indianapolis.

I had just stepped into my Chevy Traverse, in the free parking garage just north of the mall, third floor as I recall, easier to reach from the skybridge connecting store to parking facility. It must have been around 830 PM or so.

My phone rang.  I recognized the number. It was Athos.

When I answered, I heard the only vocal inflection that one dreads more to speak than to hear.

“Doc, it’s me. I’m sorry to bother you at home, but…it’s about Porthos. He was in a car wreck this afternoon, coming back from Fort Brag.  He’s…he’s dead.

At 2:16 AM, Tuesday, March 26, 2013, I published the following blog post, entitled Goodbye, My Friend:

Mere hours ago, one of my patients died, not by his own hand, but suddenly, unexpectedly, far too young, far too soon.

Words fail me. Yet at the same time, I cannot let this night pass without my having typed at least a few such words onto a screen, into cyberspace, for him, whose smile I will never again see.

My God, never again.

Goodbye, my friend. For indeed we were not just “doctor and patient,” were we? It matters not that in another few hours, in the very next daylight I will see, I will write my final note in your chart, does it, for you were never just another note, never just words under federal protection.

These very words that I type, at this very moment: God, I wish you could see them.  I wish I could see you seeing them. I wish we could laugh about them.  I wish I could hear you say, “Jesus, Doc, lighten up, why don’t you.”

I promise, my friend, that one day I will.  The memory of your smile will help me do just that.

But for now, I have to ask you to give me a few hours, a few days, as long as it will take.

May somewhere, somehow, not just my memory of you, but you—you—know: it was never just a job.

At this very moment, you cannot know how glad I am that I can write that.

But then on second thought: maybe you always did know that.

Ergo, your smile.

Goodbye, my friend. Goodbye.

On Saturday morning, March 30, 2013, I then posted the following, under the title In Memoriam: Porthos, 1985-2013:

With the permission of his family, and with much sadness, I let you all know that this week, as I said before, I lost not only a patient, but a friend: a man whom some of you have come to know as Porthos.

In the late afternoon of Monday, March 25, 2013, he died in an auto accident, leaving his parents, his brothers, his family and friends, me—and a brave, tired, bereft battle buddy, Athos—rich in memory, yet broken in heart. He will be buried with full military honors this coming week.

I then quoted extensively from the both No Trouble at All and Merry Christmas, Reality Notwithstanding, from the latter an excerpt that had spoken of Porthos’ younger brother.

Porthos returned to a family with whom he has cried, laughed, struggled. He returned to a younger brother who can outflank his every protestation, yet who can then quietly shed his own tears as he listens to his big brother’s overwhelming grief.

To that, I then added

Again, with tears that younger brother called me Monday evening, just as I was texting him to express my concern and condolences. We spoke only briefly. There was little to say.

Yet as I thought about it that night, the night I wrote the previous entry, Goodbye, My Friend, I did realize there was indeed one more thing to say, to text to this handsome, younger brother, to this—perhaps?—D’Artagnan:

“I wanted you to know: when he and I met on Friday, he told me that he was worried about you and asked me to check on you. . . I know the two of you could go at it at times, but please do know that he loved you dearly and was proud to be your brother. That I know, and that I wanted you to know as well.”

I then added an excerpt from To Remember, Not Relive, ending it with the following quote from the blog post:

Still exhausted, but somewhere, unbelievably, still rakish, [Porthos] closed his eyes, took in a deep breath, opened his eyes back up, looked into mine, and merely whispered, “If you say so, Doc. If you say so.”

I do say so. And I do believe so.

I concluded the post as follows:

And I can at least say this, for the sake of his family, for the sake of Athos, for the sake of all combat veterans who have worried that, indeed, “hope” is an oxymoron: he was indeed getting better. He had a long ways to go. His road would have been a challenging one. But he was walking it. He would have continued to walk it.

The reliving was becoming remembering. In a way, he’d gone out on the road this past weekend to continue that very process. It was the process he was living when his time—like that of Aramis, also one to Live capitalized until the very end—came.

I can write no more now. Amazing what you can do with the Ctrl-C and the Ctrl-V commands. Copy and paste. Works like a charm.

I’m dreading next Wednesday. I’m dreading the guns. I’m dreading “Taps.”

And yet who am I, really? I did not raise him. I did not wrestle with him, argue with him, dream about the future with him, at five, fifteen, even twenty-five. I did not stand with him over the body of a dead comrade, sing with him at the top of our lungs Back Where I Come From, miles and miles away.

But he did permit me to feel his heart, to honor me with his pain, to trust me with his future.

I so wish there had been more of the latter, Porthos. I so, so wish.

He died at age twenty-seven, having seen so much death, having hurt so much pain, yet having also smiled so many smiles, having pulled so many pranks, having charmed his way out of so many tight squeezes, having watched so many episodes of The Vampire Diaries with his Dad, having known he could talk to his Mom about anything, having deeply enjoyed his brothers’ happiness with the loves of their lives, having texted one last time to Athos, the last Musketeer, just hours before his death, “Love you, bro.”

And he did, Athos. He did. That I know, and that I wanted you to know as well.

Goodbye, my friend. Goodbye.

Three years. So much changes. So much does not.

Until tomorrow, be well,

Doc

To Remember, Not Relive (Encore)

Silhouette of a soldier against the sun.

As I continue to remember with you Porthos, Athos, and Aramis, the three Army Musketeers, now three years later, I find that a good way to distance myself from my emotional responses is to critique my writing—which is, I must say, quite worthy of critique. Less noble it is, I guess, yet how more pragmatic to edit rather than to wonder what should have been, might have been, or to shed a tear or two.

One of the privileges of aging is to find that one can condemn oneself and then grant clemency to the offender, all within the same breath. Or paragraph, at least.

So, editing is for another day. Today, it is instead 03 February, 2013, and I’ll take my post’s advice: To Remember, Not Relive.

I have written about him before, most recently in the posts Merry Christmas, Reality Notwithstanding and Taking Him On Home. He’s Porthos, the fun-loving rake to the quieter, more relaxed Athos–and their deeply-loved, fallen comrade, Aramis.

Porthos and I have known each other for a while. Our relationship has always been warm–though, shall we say, complicated as well. As the middle of three strong-willed sons born to a strong-willed father, he knows how to make his wants and wishes known. Fear not that, I can assure you.

And I might add: I wouldn’t get into a scuffle with him. Some of the more foolhardy in his time have. They learned. Forthwith.

Yet can that boy pour on the charm, or what. His is a perfect mixture of the quite genuine and the quite consciously manipulative. He’s had more than his fair share of practice through the years.

He actually leaves me reeling much of the time, truth be told. I’m never quite sure whether I want to give him a warm rub on the top of his head or smack the living daylights out of him. Usually both.

Porthos, in other words, is one of those individuals about whom no one–and I mean, no one–can feel nonchalant.

I’ve taken my share of hits from VA colleagues about him. We’re a bit of a known pair, again, truth be told. Some have made it clear, for example, that they think that I “coddle” him. Many have intimated that I should be more “firm” with him, although none has been able to tell me exactly how such “firmness” should look.

Our struggles with each other have usually been around two subjects: medications, i.e., which kinds, how much, how often, etc., etc.; and psychotherapy, i.e., which kinds, how much, how often, etc., etc. Simple.

Although he and I have had our disagreements, he certainly has not been one merely to “demand” something and then pitch a fit if he were not to get what he’d wanted. Quite the contrary: he does his research, and our negotiations around various regimens have reached points of complexity that I can only call “admirable” on his part. Still, disagree, we have, and sometimes strongly. In the end, though, he has always acquiesced to the fact of life that ‘tis I, not he, who has the MD behind the name.

For example, about ten days ago.

Details are not relevant, but it had been one of our more intense, so-called discussions. He let me know in no uncertain terms that I had not started his weekend out on a pleasant footing. I let him know in similar terms that even though that had not been my intention, I could only be so upset thereabout.

We met the following Monday.

He had agreed to come in twice a week, at least for some focused, therapeutic contact, and he had agreed to hook himself up again with one of our intensive group programs. He had also agreed to two-week supplies of his medications, and he had agreed to the dosages I’d recommended.

But that was only a small part of the story.

He’d thought a lot during the weekend, about himself, his family, his sadness, his frustration over the physical limitations that have been plaguing him post-deployment. Of that, I had no doubt: when I opened the door to my office, he was standing there, with just enough of an impatient, “can we get going here, please?” edge to him to keep me on my toes, but with a countenance that more implored me to notice how worn-down he was, how very, very worn-down.

“Hey,” he said, most definitely without the exclamation point.

“Hey.”

“Do you mind if I put my leg up?” he asked, eyes darting to his left, my right, to the second chair in the room which often does its part to relieve his lower back of the pressure that can gnaw at him whenever he sits for any length of time.

“Of course. No problem.”

Soon we were both situated. For a few moments we just sat there, looking at each other, the semi-grin, semi-skepticism on his face, I’m sure, only a mirror of the same on mine.

“We still on speaking terms?” I finally ask, my semi-grin having turned full.

He rolled his eyes.

“I understand,” he replied, full-smiled as well, although for only briefly. “I know I’ve got to do something about myself. I . . .”  Suddenly, he shifted forward.  “Please, Doc, you understand, don’t you? How hard it is without her?”

“Her,” of course, is the young woman to whom he’d deeded not only his heart and soul, but a goodly portion of his every quantum of thought as well. They’d talked of marriage, of having children together, but then finally she’d decided that she could not make it work.

“Dad tells me that I’ve got to move on, but . . . I just can’t get him to understand. It’s not that easy. I don’t want to move on. I know that if she just knew how hard I’m trying . . . But she won’t return my calls, texts, nothing. I’m not going to be a stalker-type. I’m not going to go over to her place. No one’s going to accuse me of that, no one. But if she could just see me, see how hard I’m trying, see how much she means to me–God, Doc, she’d understand, wouldn’t she? Wouldn’t she? I mean, Doc, am I wrong? Can you understand why I just can’t give up yet, why I just can’t move on? Please, tell me you understand, please!”

Porthos is quite a handsome man. How we think the attractive never have to suffer, don’t we? How wrong we are. Anguish is just anguish, whether on the good-looking or on the plain.

“Porthos, here’s what I would say: don’t give up until you’re ready to give up. When it’s time, if it’s ever time, you’ll know. What you’ll then have to do is live out what you will already know. That will be the hard part.”

He looked at me, with a face both steeled and tear-stained. He has all the gear in place for “Leading Man” status, yet I’m hard-pressed to come up with a modern exemplar for him, given that most A-list stars today are simply too “pretty.” Perhaps a young Mark Harmon as the surgeon on the St. Elsewhere of the 1980’s, even then oozing the NCIS Gibbs-attitude that would one day make him America’s favorite Marine, back then painfully walking down that hospital hall for the final time, his character well-aware that he might soon die of AIDS.

“I sometimes just don’t know if I can do this, Doc,” he finally whispered. “I’m not going to kill myself or anything, but sometimes I’m afraid I won’t make it. It just hurts so, her, Aramis, the War, everything. It just so, so . . . hurts.”

The final word had plopped out of him, as if it had been teetering on his lip all the while, not wanting to risk the reality that would result from its mental equivalent having found voice, sound, transmitted out to a world, to me, to . . . what?

And then it happened: in the middle of his anguish, he started to look as if he were ready to fall asleep, to look as I imagined he must have looked at the end of that twenty-four hours he and Athos had had to stand watch over the body of Aramis, waiting for the helicopter to arrive: too exhausted to run, too charged to collapse.

And I realized: he wasn’t with me. He was in Iraq.

“No one has any idea, do they?’ I finally asked, too exhausted, too charged myself. “You’re there, right now, aren’t you.”

He was staring off to the side, grudgingly allowing one tear at a time past the checkpoint, his eyelids in a bizarre, internal arm-wrestling, the upper halves determined to shut this show down, the lower halves determined not to give in ever, do you hear me, ever!

“I’m sorry, Doc,” he whispered, his tears, few as they were, so robust, so proud to be Army-strong, his eyes fixated miles away. “I’m trying, really I am. I hope you believe me. Please believe me, Doc. Please.”

“I do,” I answered, hoping perhaps that some information, meager as it was, would jar us both out of the grip of those tears. “Listen, this is neurologic, Porthos. You see, trauma separates the part of the brain that feels, sees, hears from the part that makes sense of events, of Time, of those very feelings.

“They then stay separated, physiologically. You can only ‘remember’ if the front part of your brain can pull the ‘you that’s you,’, that is, your experience of the trauma, of yourself–your ‘Self’–away from the trauma enough to get the whole brain on the same page, the page that says ‘OK, this has happened, but that was then, this is now.’ Until then, it’s as if your brain is experiencing the trauma in an eternal present. You’re reliving it, not remembering it.

“That’s where the nightmares come from, the flashbacks. When you hurt because your girlfriend’s gone, you’re hurting not only because she’s gone, but because Aramis is gone, because all your buddies who died in the convoy are gone, because you had to pick up what was left of them, all of them. It’s as if your brain is saying, “Oh, my God, here we go again! We’ll never escape!

“Even when the front part of your brain knows–knows without a doubt–that it’s today, not back then; that it’s about your girlfriend, not about Aramis; that you’re in Indianapolis, not the desert: even then, it cannot yet grab onto that other part of the brain that is still feeling, hearing, seeing, smelling, tasting the destruction, the confusion, the adrenaline. The death.”

Pretty good, eh?

One problem, though, a big one:  with each of those words, I knew that I was both helping and hurting him, both assuring him that he was not crazy, yet reminding him that he felt crazy even so. His energy, his intense drive, his inner push never to give up, never: there they were, torturing him, yet keeping him alive, simultaneously, right in front of me, with my every verbal reminder of the truth, the Truth.

It was horrible to watch.

All I could think at the moment was, “My God, this is what they all go through, isn’t it, all these men and women, the ones whose Facebook posts, whose blogs I read, who talk of being walloped back and forth through Time, through emotion, psychically miles away from the loved one before them, then within nanoseconds careening right into them, then back, then in, tethered to a yo-yo only Satan himself could have manufactured–with a smile.”

I had to stop. Had to.

I had learned in a new way what I had never wanted to know. I was Katniss at the end of The Hunger Games, wasn’t I, gazing down at Cato, her nemesis, he nearly devoured by unearthly hounds, begging her, with his eyes only, to end it all, now, please, please.

Like Cato, Porthos looked at me, fortunately not devoured, yet no longer charged. Just exhausted.

“Will it ever get better, Doc?” he asked.

Fortunately, I am not Katniss. I have more than arrows to work with.

“Yes, it can,” I said as I leaned forward. “I’m learning a technique, EMDR, that stands for ‘Eye Movement Desensitization and Reprocessing.’ I’ll give you a website to read about it. Check it out. Go ahead and read other stuff about it on Google, too. I’ll promise you: you’ll find a lot of hot-shot people with M.D. and Ph.D. degrees who’ll swear on a stack of Bibles that it’s hogwash and witchcraft. I once thought that myself. But I was wrong. The technique can help link that experiencing part of the brain with the contextualizing part, maybe not perfectly, but for many veterans, well enough to allow some real, meaningful healing to begin. You’d be one of the first that I try it out on, but I work with a smart teacher, and together, the three of us will find a way to discover how that powerful intensity inside you can save you, not destroy you.”

Still exhausted, but somewhere, unbelievably, still rakish, he closed his eyes, took in a deep breath, opened his eyes back up, looked into mine, and merely whispered, “If you say so, Doc. If you say so.”

I do say so. And I do believe so.

As best as I can determine, remember comes from a Latin root for memory. Yet there is something about the English word, re-member, as if member were a verb to mean “piecing together, putting the members of a body, a group back together.” Horror and grief without context are horror and grief eternal. When re-membered, though, sown back into the tapestry of Time, they hurt no less, but they need hurt no longer. Re-living can then become mere living. How good.

Yes, Porthos, how good.

Until tomorrow, be well,

Doc

Taking Him on Home (Encore)

Silhouette of a soldier against the sun.

 

Thank you for continuing to join me in my remembering.

It was a new year, 2013. So much ended up changing over the coming months. But on January 10, 2013, there were new possibilities.

There still are, of course. Just different ones.

From that date, here is Taking Him on Home:

I met with Athos last week, one of the “Three Musketeers” whom I had described in an earlier post, Merry Christmas, Reality Notwithstanding. Athos is the second of the two men I have had the chance to work with, the quieter one, the Tobey Maguire/Nick Carraway to my first patient’s, Porthos’, Leonardo DiCaprio/Jay Gatsby, as you might recall.

The third musketeer, Aramis, was the man they each mourn to this day.

“I sent the link of your blog post to my Mom,” Athos told me before either of us had even had a chance to consider sitting down. “She wanted me to tell you ‘Thank you for taking care of my boy.’”

As he finally did begin to lower himself into his seat, he flashed a hint of the smile that, no doubt, keeps him his “Mom’s boy” even to this day. Even after all that has happened.

“Well, tell her ‘thank you’ as well,” I replied. “It remains my pleasure.”

“I haven’t sent it to Aramis’ folks yet, but I’m planning to,” he then said, a bit sheepishly, even though at the same time definitively, if such a combo could be possible.

“You stay in touch with them?”

“Oh, yes. I talk to them a lot. I’d spent time with them, gotten to know them. I mean, at his funeral, it was like I was there in his place, like a son, you know?”

“They let you come home for his funeral?” I asked. That’s not the usual practice, after all, not by a long shot, especially during the period of the conflict in which Aramis was killed.

Athos hesitated a bit, as if he hadn’t quite been expecting my query.

“Yes, I . . .” His swallow betrayed less an impending tear than more an impending dread, the dread of here we go, one more time, remember, one more time. “Yes, I came home with him.”

For a moment, I couldn’t quite place the scenes in my mind again, Aramis’ death, Athos’ and Porthos’ positions, their responses.

“You were there, weren’t you, when he died?”

“Yes, sir.” He swallowed again.

“Porthos too, right?”

“Yes, sir. We were both right there. We’d all gone by the spot earlier, and we were on our way back. Somehow we missed those guys the first time through. They must have just sat there as we walked past them that first time, I guess, I don’t know. But then they opened fire, just like that. I mean, man, I went down for cover, but Aramis just charged ahead, shooting right at them. They hit him five times, last one through the head, the one that killed him.”

I didn’t pause. I’m not sure whether I felt his momentum or dreaded it.

“You saw it all?”

“Yes, sir. I just started shooting. I’d never shot at anybody before. I just shot and shot and shot. Then I started to run out to him. I heard somebody shout at me to get back, and all I can remember doing was shouting back, ‘F*** you, I just lost my best friend.’ Then all of a sudden, I felt a hand on my shoulder, and I whirled around, and there was my sergeant. He just looked at me, only could have been seconds, and he just said, not yelled, ‘I know, but not now, not now,’ and he pulled me back.”

Now there was a pause.

“You know,” he continued, in his mind perched on some rock thousands of miles away, in heat so real to him even I could almost feel it, “we couldn’t get his body out for about twenty-four hours, so we just stayed with him, Porthos and I, we couldn’t leave him. It was hot, it was . . . it was bad. The medic had covered his face, you know? So that . . . we didn’t see it. I took his gun, all his stuff. His blood was still all over everything. When the helicopter came, I climbed in one side and Porthos climbed in the other, his body in between us, and we were off to get him on the Blackhawk to get him out of there.”

“But what was even more crazy,” he then said, “was that when I got out of the helicopter, I just started walking–I mean, I didn’t even know which way was up, you know what I’m saying?–and then out of the blue this airman leaps right on me and starts screaming at me that I’d about walked into the propeller. And you know what, Doc, you know what?”

I figured that he was going to say what he finally did say. And even though he saw that I had already had it figured, no matter: he said it anyway.

“I wouldn’t have cared if it had.”

He meant what he said, of course, yet I have to say this as well: there was something less definite about him that day we spoke, less miles-away, less certain, as if somehow futile was slowly easing its way out of the centerpoint of his vocabulary.

Then after a few seconds, “And it was right after that that the big guy pulled me aside and asked me.”

“Asked you what?”

He snorted, although hardly at all, truthfully, and certainly not at all one of contempt, but more like one of a person’s somehow still not quite believing that what happened actually happened. He looked right at me.

“He asked me if I wanted to take Aramis on home, back to the States, to his family. And I didn’t hesitate for a second, not a second. I just said, ‘Yes, sir.’” Slowly his gaze left mine, wandered past my head, toward the window, out. “Yes . . . sir,” he then whispered.

I’m sure the next silence was only seconds long, but with his looking through the window, he pushed me back a good six psychic inches from him, not too far, mind you, but far enough to privilege me only with the sharing of his story, but not with participating too closely in it. He was in a world that was his and Aramis’s, theirs alone.

“When they put him in the plane to take him back, I just crawled in and lay down next to him. I didn’t leave his side the whole way. We’d heard that the escorts sometimes would do s*** like putting their feet up on the bodies. No way, man. No way.”

Those last words were not spoken to me, were no mere descriptions of what was or was not going to happen. Those words were a vow, spoken to a best friend who, though not hearing, would nevertheless know that Athos had not only had his back, but finally also his whole body, to the end, the very end.

Then, all of a sudden, he smiled, just enough to bring us both back to my office, to each other and to each other’s gaze.

“You know, Doc: that’s when I found out what happens when you’re lying on the bottom of one of those planes as it’s coming in for a landing. I mean, the presssure?” He gave me a are-you-kidding-me look well worth the price of admission. “Not good, Doc, not good.”

Freed from the reverie of his final one-on-one trip with his “bestest buddy,” he returned to a more steady, though still thoughtful narrative pace. He talked of his time with Aramis’ family, the funeral, the motorcade to the national cemetery, the graveside service.

“But you know what I’ll never forget?” he then said. “I’d just gotten out of the limo, and I was like standing there, not even sure where I was, who I was, nothing. And so I look up, and there he was, the big guy, the senior man himself, looking right at me. It took me a few seconds, but then I saw what he was looking at: I had something hanging from my uniform. But before I could even react, all he did was walk toward me, take a pin off his own uniform, and then pin mine back together. He put his hand on my shoulder and just said, ‘There you go, son. There you go.’ And he squeezed my shoulder and walked on. I . . . I couldn’t believe it.”

We talked more, about Aramis still for a while, but soon we were talking about his own girlfriend and his (quite funny) memories of trying to keep Porthos in line while they were back in the military. By hour’s end, he had already stood up to leave, our plans for our next meeting having been made, when he paused and looked right at me.

“I don’t know if I’ve ever told anybody all that, Doc. But, you know: I made it through without crying. That’s . . . that’s a start, Doc. That’s a start.”

With that, he walked out.

A week later, the pictures in my mind that I cannot shake are two. One is the picture of a young man, barely into his twenties, lying on the bottom of a cargo plane next to a box, vowing to remain faithful until the landing at Dover, protecting another man’s honor that, in one way, was only a memory and that, in another way, was the only bit of Aramis that no one–no one–would ever take from him. No one.

The second is of a senior officer looking into the eyes of a young enlisted man, quietly saying, “There you go, son. There you go.”

There is no glory in War. Only days before that officer took Athos’ shoulder, a family over in the Middle East had buried another man, a man perhaps who had died with hatred and malice in his heart, a man perhaps who had, instead, merely died wanting only to get these armed strangers out of his country. I will never know.

I do know that Athos, Porthos, Aramis, each believed he was “born to protect.” Each believed that 9/11 was an Act of War. Each believed that their mission was part of a greater mission to assure that 9/11 would not happen again. What others believed or to this day believe about that mission, that never was the point. They believed honorably. They acted as men, real men capable of rage and love. Their commanders saw them as men, real men capable of respect and even worthy of the title “son.”

One of them did not come home alive.

He did not, however, come home alone.

For it was, to the end, as Alexandre Dumas put in the mouths of his famous trio, “One for all, all for one.”

All for one.

Until tomorrow, be well,

Doc

Merry Christmas, Reality Notwithstanding (Encore)

Silhouette of a soldier against the sun.

 

Today, I continue to ask you to join me as I remember Three Musketeers: one whom I never met, one whom I’ll not meet again, one who still lives his life in the best memories of both.

Anniversaries are not the only times to remember. So are Holidays. So it was three years ago, in December.

From December 25, 2012 comes our next tale, Merry Christmas, Reality Nothwithstanding.

I’d say they came as a matched set, but since I knew one of them a year before the other, that’s not quite true.

That, of course, doesn’t mean that the second one was not quite aware of me that whole time.

I’ve already spoken of the first one before, in No Trouble At All. He and I have struggled back and forth over what to do, when to do it, how to do it. He’s always respectful, quite engaging, the whole gamut from jocular to irritable (with an apology therefor immediately afterwards, I might add).

He comes from a professional family, several members of which are not, shall we say, reticent to express views that he’s not too thrilled to hear, his younger brother in particular. They’re an intriguing pair, these brothers: both quite physically striking in appearance, kinetic-energy extroverts par excellence. When they sit in the room together, they jockey for position as to who is going to make the next comment about whom–and have no fear, the younger one is not about to be the loser any more than fifty per cent of the time. One might be tempted to call each of them a “pretty boy”–but believe you me, you’d better not do so to their faces, and you’d better not count on the usual associations to that term if you were to get on their wrong sides.

Recently, though, even with all the Sturm und Drang in essentially every area of his life, my patient has primarily been grieving the loss of a deeply-loved girlfriend. As a man who has in all areas of his life been big in all the meanings possible in that italicized word, he has not given up this big pattern in his grief over love lost. He can only speak of her with me briefly before he visibly begins to shake, clutch his gut, and shed more than a few tears.

He has come to acknowledge the past, that what’s done is done, that there is nothing more he can do. Still…

My patient had always told me about his best friend, his battle buddy “who’s not doing much better than I am, Doc. I wish he’d come see you, but he can’t stand the VA.”

About two months ago, his friend finally did come.

_______________________________________

Borrowing from this coming year’s release of a new film version of The Great Gatsby, if my first patient is Leonardo DiCaprio’s Jay Gatsby, my second is Tobey Maguire’s Nick Carraway. Quite handsome himself, he is—though in that Maguire kind of way that made Peter Parker so alluring to Kirsten Dunst’s Mary Jane Watson.

When I walked out to meet him that first time, he was sitting quietly in his chair in the waiting room, eyes downcast, sporting a full beard that was neatly trimmed, dressed as if ready to head out for deer hunting just as soon as we were done—yet alone, most likely, with mixed feelings as to whether he would really want to shoot one of God’s creatures or not.

He looked up at me with a mixture of apprehension and deep sadness. I soon found out why.

His experiences at VA’s have not been particularly positive. He is from the South, where he grew up in a small, working-class family that has endured more than its fair share of tragedy, leaving him now the only living child of his parents. He moved up here to Indianapolis to live near my patient, and here he met a female friend of my patient (not the patient’s ex-girlfriend) who has become “my love, my rock, my everything.” They are planning on getting married as soon as they can afford to, and he is deeply happy.

About that.

Yet he too has struggled with intense symptoms of combat trauma/PTSD. He had once even come close to ending his life. He remembers his time in a VA hospital after that episode as one spent trying to avoid the angry, demented old veterans in wheelchairs, as well as the overtly psychotic, middle-aged ones who would suddenly start screaming for no apparent reason.

Then, in his recounting his most recent encounters with VA treaters, he told me that he was made to feel like a “drug abuser” and a “self-centered jerk, like someone unwilling to take responsibility for his life.”

He has been less-than-impressed, in other words, with the Veterans Health Administration.

As he spoke, I quickly glanced at some of the notes written from various providers from different VA’s. I have to say: it’s quite amazing what people will write down on a computer, leaving permanent, electronic traces, you know, for others to find no matter where, no matter when.

Consequently—and sadly—I have no trouble believing my patient on this one.

We talked for a while, about his symptoms, his treatment history, his relationship with my other patient. Then he just fell silent, head down.

“Is there something else?” I asked him, a bit taken aback by the sudden change.

Slowly he raised his head to look at me. He saw that I saw the tear streaming down his cheek.

“What’s the matter?” I whispered.

He swallowed and then quietly said, “I’m sorry, Doc. I’m a little distracted, I guess. You see, I got a phone call while I was driving down here. It was my mother. They found my father dead today.”

To be fair, it is not unusual for patients to talk for extended periods of time before finally, usually at the end of the hour, they muster the courage to tell me what has been weighing most heavily on their hearts.

Still, this was one for the books, I’ll grant you.

The details are of secondary importance here, except to say that his father’s death had been one more tragic chapter of a painful family tale. What was so strikingly clear, however, was how my patient had clearly entertained no thought whatsoever that I would take much interest in the fact of his father’s death or even consider trying to help him find a way to make it safely back to his home state, multiple hours away by car.

With tears now streaming down his face, he said to me quite calmly—and, I might add, without a hint of malice—“I just never thought that VA doctors would care that much to hear about something like my father dying.”

I’d like to say that I was stunned, horrified that a combat veteran could feel that way. I’d read those previous notes, however.

Fast forward two weeks, after he’d made it down there, made it through the funeral at which he’d played guitar with his father’s best friend because, when both he and his father had had one beer too many, his father had told him time and again that he had wanted the two of them to sing this one particular song at his funeral.

Should that day ever come.

I had to bring it up, of course, his guilt over his not being there for his father in his father’s time of need. There are ways, after all, to do that which are not too invasive. He didn’t seem to mind.

“He was always there for me, rooting for me, even when I did stupid things,” he said, now having no embarrassment over the tears, trickling as they were. “I miss him so much. I wish I could have been there for him. He knew he was dying. I just can’t believe I can’t pick up the phone and call him.”

We talked some more. He smiled through his tears, cried through his smiles. It does appear that he will one day come to acknowledge the past, that what’s done is done, that there is nothing more he can do. Still…

It is at moments such as these that I have to make the “therapist’s decision.” Links from the past to the present always present themselves, especially with combat veterans, yet brilliant interpretations can often be nothing more than cheap psycho-pyrotechnics if one is not careful, a therapist’s (i.e., my) momentary narcissistic gratification (“Look, supervisor-in-my-head, no hands!”) at the expense of a soul suffering in front of one.

Yet somehow, for both of these men, on different days, in different contexts, it felt right to say it, to one man grieving a lost love over which he had no control, to another grieving a lost father over whose suffering he had no control.

“It’s like TJ, you know. You couldn’t help him either. And he was everything to you.”

For you see, the Dynamic Duo had once been The Three Musketeers. Porthos and Athos had once had an Aramis.

Whenever my first patient of the two—the rakish Porthos, if you will—had spoken of TJ, he’d only been able to choke out a few words before telling me that he could say no more. I never could learn from him their buddy’s full name, simply because he could never bring himself to speak it without beginning quietly to sob.

My second patient, though—the fatherly Athos—had been able to speak more, tell me TJ’s full name, tell me about his large family, his Aramis-like youthfulness, his faithfulness to the religious faith of his family, his willingness to say whatever, to crack them both up over and over and over again.

He had been able describe his death in front of both of them, taking bullets that should have been either of theirs to absorb.

Both men realize that they will one day have to acknowledge the past, that what’s done is done, that there is nothing more either of them could have done. Still…

_______________________________________________________

So what does any of this have to do with Christmas?

At one point during our second conversation, the second veteran’s (Athos) phone began to ring. At the sound of the melodic ring tone, he smiled.

“That’s Porthos right there,” he said as he allowed the call to go to voice mail.

“What’s that song?” I asked him.

“Oh,” he replied with a smile both sad and relieved, “that’s Kenny Chesney’s song, “Back Where I Come From.”  Porthos and I used to sing it all the time when we were over there. It’s kind of how we kept each other going, you know? We’d sing about where we came from, where we hoped we could go back to. TJ died just days after we arrived in the theater. That’s how we coped.”

Chesney is an American country-western singer, and the song has become a semi-trademark of his. The words are as follows:

In the town where I was raised 
The clock ticks and the cattle graze 
Time passed with Amazing Grace 
Back where I come from

Now you can lie on a riverbank 
Paint your name on a water tank 
Or miscount all the beers you drank 
Back where I come from

Back where I come from 
Where I’ll be when it’s said and done 
I’m proud as anyone 
Back where I come from

We learned in Sunday school 
Who made the sun shine through 
I know who made the moonshine, too 
Back where I come from

Blue eyes on a Saturday night 
Tan legs in the broad day light 
TV’s, they were black and white 
Back where I come from

. . .

Some say it’s a backward place 
Narrow minds on a narrow way 
I make it a point to say 
That that’s where I come from

That’s where I come from 
Where I’ll be when it’s said and done 
I’m proud as anyone 
That’s where I come from

_________________________________________________________

Where we “come from” always remains a place to which to return whenever we find ourselves lost in life. For many combat veterans, thankfully, where one “came from” can be synonymous with a family who will always be there, even when they cannot be. Others are not that fortunate, yet still can find a “family” in the brothers and sisters who had once had their backs, with whom they had been, wherever they had been, when all indeed could have been said and done, with a single gunshot, a single IED.

Porthos returned to a family with whom he has cried, laughed, struggled. He returned to a younger brother who can outflank his every protestation, yet who can then quietly shed his own tears as he listens to his big brother’s overwhelming grief.

Athos returned to a family with whom he has cried, laughed, struggled. He made his father proud. Now he has laid the man to rest with overwhelming grief and a song.

Both men still fall silent at the memory of the funny kid who lost his opportunity to return to his own loud, ethnic family so that they could in fact return to theirs.

Combat veterans, like parents of children in Connecticut or spouses of firefighters in New York, know well how oxymoronic the words Merry and Christmas often seem together. Merry? You serious?

Yet if Holidays provide us memories of stockings overturned in a frenzy next to an artificial tree, or memories of Seder meals and who’s going to find the matzoh this year, or memories of the whole clan getting together on Memorial Day weekend to endure one more round of Uncle Harry’s high school football stories—or even memories of sitting in a godforsaken desert with once-total strangers who now mean the world to you, singing “Silent Night,” even if slightly off-key—they often, thankfully, also  remind many of us of one more thing:  we come from somewhere.

Relationships, Time, Life, all once mattered.

________________________________________

For my children, Christmas Eve will always bring memories of candlelight services at the only church they have ever known, at the end of which each person, with his or her own personal candle, files out into our large atrium, singing quite on-key, in four-part harmony, all verses of “Silent Night,” until finally all are present within the hall, illuminated by only a hundred or so candles, everyone humming a capella one more time the song that many Mennonites can still sing one verse of which in German.

It will then bring memories of our coming home to eat shrimp cocktail with cheese and crackers, after which they open up one present, only one, which is always pajamas, into which they change and then take turns hanging up the twelve tree bulbs which narrate Clement Clark Moore’s The Night Before Christmas.

One day they will have their own families, and it is from these memories that they will create their own, whether or not their mother and I will ever be able to join them.

I acknowledge that one day, Reality may make it such that we may have to cherish such memories without them. On such a day, I will be devastated. I will not be merry.  But I will have a place in my heart where I “come from.”

For that reason, as I blew out my candle in that atrium, I remembered TJ.

Perhaps that’s all that “Merry Christmas” is, especially for combat veterans: a reminder that there once was a place where they “came from,” even if such a place was miles from wherever they actually came from. Maybe it’s simply a reminder that Life can have meaning, a meaning which bring both smile and tear, a meaning which once was, and–perhaps–a meaning which, though never the same, can in some other form be again.

Perhaps.  It’s a lot to ask of two words. But it’s a start.

To the Porthos and his family, Merry Christmas. To Athos, his girlfriend, and his mother, Merry Christmas. To the family of Aramis, Merry Christmas.

To my wife, my children, my family, my friends and colleagues, to combat veterans everywhere and those whom they love . . .

Merry Christmas.

Until tomorrow, be well,

Doc

No Trouble at All (Encore)

Silhouette of a soldier against the sun.

 

Good to be back with you all.

A date is approaching, next month actually. Seasons move forward through the years, yet certain ones halt us, if only temporarily, reminding us again of what once was, of who was once.

It has almost been three years since I stood with my hand upon a young combat vet’s coffin. To this day, I cannot watch a Harry Potter movie without, at some point, feeling his presence. These next few days, I ask your leave to remember him again with you as well, from prologue to epilogue, with encores of blog posts from March 2012 through October 2013.

As a psychiatrist, I often come upon spots in my heart where certain patients have trod, some stealthily, some ploddingly. This one young former US Army soldier did both and more, through passageway after passageway, still now in memory leading me back to spots where we laughed together, even shed a tear together, always with that smile on his face that made me roll my eyes and smile as well.

There were once, you see, Three Musketeers: Porthos, Athos, and Aramis, united not in Dumas’s France this time, but in the United States Army, in a hot land far from home.

Two have since fallen. One is making the life he can. Here are the times we traveled together, in body and in spirit.

From March 11, 2012 comes the prologue, No Trouble at All.

Today I was in contact again with one of the veterans I work with, one who has struggled almost incessantly since coming home.  He’s a dashing rake, by anybody’s measure.  He comes from a well-educated family.  He’s smart.  He’s intense.  He was once a bit of a bad-boy, but he’s working now to pull his life together, to find love, to find a place back in his family, back in this world.

In a matter of days after landing in the Middle East, this man’s dearest friend—his brother to the core—was dead.  Others in his unit soon followed.  He wakes up in the night screaming, sweating, panicked.  Not a day goes by that he doesn’t think of his friend, often-—usually-—with tears.  To this day, when he promises me something important, he does so on that man’s memory and on his grave.

He’s been trying to get back to school.  It’s been anything but a cakewalk, to say the least, though that says absolutely zero about his talents and his potential, both of which are quite abundant.  He endures the lectures that many of us remember in those 100-level courses, trying to stay focused, trying not to wonder what these kids around him are thinking about him, kids who are just about the age he was when he walked off that plane.

When he sent his buddy’s body back home.

He’s trying.  He’s trying his darndest.

It’s the courses with the papers, though.  They’re the ones that get him.  Too much time to sit in front of a computer.  And remember.

He tries not to overuse his medications.  He’s put his family in charge of them.  Yet there are the times that he wakes at night and can’t stop shaking, can barely move, barely swallow.  He knows a pill won’t save him.  But, God:  it’s so awful.  A war raging, smack dab in the middle of his bedroom.  In the middle of his soul.

He always apologizes when he contacts me.  He’s so ashamed to do so.  But he gets so desperate.  And he hopes against hope that I won’t hold the contact against him, one more time, another, another.

Honestly, they’re indeed no trouble at all.  He knows the drill:  if I can get back with him, I will.  If I don’t right away, he knows that I’m with family or with other patients.  He knows I’ll get back to him eventually, even if it’s just a “hang in there.”  He knows he’ll have his time later that week to come see me, to try somehow to find that devilish smile of his one more time, to remember when it was all easier, to borrow as hope what is my certainty:  that he will find a better day.  One day.  Not today.  Most likely not soon.  But one day.

I can say that because he’s a warrior’s warrior, through and through.  Behind that Abercrombie facade (albeit a brunette one), there’s a force of nature.  He was a handful as a kid.  He’s a handful now.  He won’t give up.  Never did.  Never will.

All I can say is:  good for him.

We took care of today’s matters in short order.  He thanked me quite genuinely.  “I’m sorry,” he said again, “to mess up your weekend.”  I heard the break in his voice, quick, but definitely there.

“No trouble at all,” was my reply.  I had a few minutes on the way to the Starbucks, after all.  I have a few minutes now on the porch, absorbing this quite pastoral Sunday afternoon for mid-March in Indiana.

What else do we have, really, except time, a future.

He doubts he has a future, of course.  My job—our job, as professionals—is to disabuse him and those like him of that notion one day at a time.  No guarantees of any particular outcome.  Just life, with its joys, its challenges, its months off, its back-to-works.

We’ll see each other tomorrow.

And so the story went on.

Until tomorrow, be well,

Doc

The Slide Show (Encore)

Silhouette of a soldier against the sun.

 

From January 2012 through August 2013, I blogged regularly about my experiences working with Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) combat vets at the Richard L. Roudebush Veterans Administration Medical Center in Indianapolis, Indiana, USA. Given the anonymity of the large setting, I was able to write, with the full permission of all the veterans profiled, openly about their experiences and about their impact on my experiences.

Since then I have worked in settings that are not as anonymous, and therefore I have not been able, at least on a regular basis, to write similar pieces. So given that it’s now been at least two years since many of those essays were written, periodically I will plan on sharing them with you.

I plan to label them “encore” pieces, and they will be longer than the usual daily musings, so you’ll know them when you see them. I will present them, for the most part, unchanged from the originals. Some of these veterans I still keep in touch with periodically. Others, I merely remember.

But all I remember with great respect and, I’ll say it, with great fondness.  Today’s piece speaks well of what it was like to watch these young vets suffer, grow, falter, pick up and try again, especially as an older man the age of their parents, watching what easily could have been, in an alternative life, my very own child.

Today, it is “The Slide Show,” originally posted on 06 April 2012.

Truth be told, he and I never should have met in the first place.

Working at a VA associated with a major university has its perks, the most glorious being–residents!  Believe you me:  I am more than thankful to have the opportunity to work with young psychiatrists-in-training, not only because of their energy, their intelligence, their curiosity–but also, yes, I admit it, because of their being on-call in the hospital every night.  We staff psychiatrists have it nice as a result, I do grant you.  Even though we’re on call for a week at a time, four to five times a year, it’s all by beeper.  The men and women slogging it out in the trenches at 2AM are half my age.  They might beep me at 3AM to discuss a case, but, hey:  I fall back asleep easily.  Hallelujah.  For residents and for sleep.

In the latter part of 2010, however, it was not always so.  For reasons too complicated to explain, the staff psychiatrists had to serve as the first-call person on the weekends.  Poor us, I know.  Still, another glorious perk of Med Center VA life?  Having  very competent social workers working through the night in our emergency department, triaging and making life livable for all.  Sweet.  Plus, since we are able to access our VA computer accounts via a secure website, we doctors were able to manage all other matters that fall from the quiet of our homes.  Sweet x 2.

I did, though, cover one particularly memorable weekend:  ten admisions to our inpatient service in the span of two days, with two discharges.  None of the admissions was easy.  None of the discharges was.  By late Sunday evening, both I and the very competent, always-faithful nursing staff had just about had enough, thank you.

It was about 9:30 that evening when the ER social worker called me.

She had interviewed a young man who was struggling with acute drug intoxication issues (among other quite complicated matters, it should be added).  This social worker is quite savvy, yet she was struggling to know what to recommend for the man.  Given his impulsivity, she was quite concerned for his safety.  Still, he had “a way” about him, she told me, that made her wonder whether it might not indeed be OK to release him that night to his family, with outpatient care to be scheduled within a day or so.  I remember her words well, listening to them as I was while sitting in an easy chair in our family’s spare bedroom:  “It’s times like these that I miss having the residents here.  Sometimes that was all it took:  having an MD sit with the patient and convince the guy face-to-face that he’d be better off if he’d just come into the hospital for a while and get himself settled down.”

She was right.  I knew that.  I too was not pleased with the thought of this guy’s just going home in the condition he was in.  I knew I was on solid ground to ask the social worker to contact hospital security and then tell the patient that he was going to have to stay, whether he wanted to or not.  I knew that our VA police, our ER staff, and our inpatient staff were all quite competent enough to make that happen with only the minimal Sturm und Drang.  Nevertheless, I also knew:  Sturm and Drang there would be.  The kid was “strong and wiry,” according to the worker, and “he wouldn’t go down without quite the fight.”   “Code Orange” is what we call such a melee in our neck of the woods.  No good comes from such high drama, for anybody, certainly not at 10PM on a Sunday night and certainly not with an already overworked nursing staff (two admitted patients were already on one-to-one nursing monitoring).  I knew that.

Still, I’ve got the initials behind my name.  All I had to do was to say the word, hang up, and go back to reading my Kindle.  The inpatient doctor would have had to have picked up the pieces in the morning.  Wouldn’t have been the first time.

“OK,” I finally said.  “I’ll be there in a half hour.”

I have colleagues who still roll their eyes on hearing that–and rightly so, I might add.  Their knowing half-smiles say it all:  only you, Rod.  Only you.

After arriving and then enduring the knowing half-smiles of the ER staff, I walked into the young man’s room.  He was lying on his side, facing the wall.  He barely turned his head to look at me.  He wasn’t hostile, but believe me, he wasn’t impressed either.  “I don’t know, man,” was about all he could say.  “I don’t know.”

He eventually did turn to face me.  It had been Afghanistan, I finally learned–that, and a quite, quite complicated life pre-deployment.  Bad, the whole scene, really bad.  He just couldn’t take it any more, the waking up screaming, the never-ending newsreel of blood and body parts in his head, the absolute certainty that it would never end, that it never should end, given what he’d seen, what he’d done, halfway around the world, just the other side of town.  He wasn’t going to kill himself, or at least not really.  He just didn’t care.  About anything.

His family had brought him in.  I sat with them for a good half-hour or so in a secluded corner of the waiting room.  I still can see his father, fighting back the tears that he was too worn out to hide:  “We just don’t know what to do.  I love him more than anything, but . . . we just don’t know what to do.”

When I went back to the patient and told him what his family had said, he looked genuinely shocked.  “You mean they’re still here?” he asked.

“Yes.  They’re worried.  Big time.”

Wiry and strong as he was, he dropped his head and began to cry.  “I’m so terrible to them,” he finally whispered.  “They love me so much.  I don’t deserve it.”  Slowly he raised his head.  “OK.  I’ll stay.”

By the time all the admission dog-and-pony show was over, it was about 1AM.  I was about to head out of our inpatient unit when I saw him sitting by himself in our day room, clad in the standard-issue hospital pj’s, staring at the floor, strong, wiry–and anything but.

All right.  I’ll confess it to the entire world.  Here it goes, ready?

Sometimes the Dad in me takes a gut punch whenever I look at these guys, see that far-off look in their eyes, watch their slow breathing, their mouths slightly opened, with just enough shortness of breath to remind both of us that it can all be so tiring, life.  Death.  These are the sons and daughters of my peers.  Each one of them could have been mine.

There.  I said it.

It’s called “countertransference” in the lingo of my trade, the all-too-human feelings that arise in us all-too-human treaters in our all-too-human work.  It can be a problem.  It’s not always, not by a long shot.  It just happens.  I’m no neophyte to this.

Still, it had been a long night.  For him.  Strong, wiry, lost–him.

I went over and sat across from him at the table.  He looked up, a bit confused, even.

“You don’t have to stay, you know,” he said.

“I know.”  We just looked at each other.

I launched into my spiel, the one about feeling so intensely, so deeply that a group of men can almost think the same thoughts simultaneously, not quite knowing where one of them ends and the other one picks up.  About love.  About having a part of your soul ripped out of you when you realize your brother of brother’s not there any more, not even in one piece any more, never again to laugh, cuss, get drunk, stare at a computer screen, reading an e-mail.

“Were you in the military?” he finally asked.

“No.”

Once again, he looked genuinely shocked.  “So how do you know all this?”

“You guys tell me.”

It was his first smile of the evening, skeptical though it was.  “You actually listen?”

I wasn’t quite sure what to say.  I suspect I smiled as well.  “Yeah, that’s sort of the point, you know,” is what I think I finally said, something like that.

The smile disappeared, yet replaced not with a frown, but rather with this look of puzzlement that had a sort of “well, who’d-a thought . . .” quality to it.

“Thanks, man,” he finally whispered.  We shook hands.  I went home.

It’s been a long road since then.  Really long.  Good stuff.  Not-so-good stuff.  He’s told me more than once:  “I think about that night a lot, you sitting there with me at that table.  I really do, man.  I really do.”

It had been a while since I’d seen him.  Stuff.  Not-so-good kind, at least recently.  He looked good, though, better than I’d seen him in a while.  He was so proud of himself, of all the work he’d been doing trying to get his life together, of his dreams to help other veterans.  He was wearing a well-worn Indiana University soccer outfit, still strong, still wiry.  He has one of those “Yeah, I know, I’ve been bad, but you still like me, don’t you?” smiles.

He’s right.  And he knows it.

He handed me a CD.  “Here, man.  I want you to have this.  It’s pictures, from Afghanistan, different stuff.  Just us mainly messing around, you know.  Not really any combat.  I just want you to have it.”

“Thanks.”  I took it.

After he was gone, after I’d written my encounter note, I opened up the D: drive of my laptop and pressed the CD down into it.  My photo program opened up the first picture.  He  was lying on a cot, shirtless, clearly just waking up, clearly not that impressed with the photographer.  I hit the slide show button.

My photo program eases one picture into another, like moseying along through the family album, giving you a few seconds to prepare yourself for the ridiculous look on whoever’s face is about the grace the screen, a sort of retrospective, “This Is Your Life” quality, know what I mean?

It was his smile.  Over and over.  He’s quite photogenic, actually.  Combat fatigues, physical training outfits, swimming trunks, goofy T-shirts, posing with local troops, robed men at fancy hotels, cute kids, even with President Bush, no lie.  There was this family wedding picture.  He was in a tux, holding what looked to be the ring-bearer, his hair slightly longer than Army-issue, sun-bleached just enough.  Went well with the smile.  The whole look.

I didn’t cry.  Yet there was something inside me, that Dad something again.  It’s a sincere smile, his is, one of those “you gotta love me” types, one of those that says–not shouts, mind you, just says–“Here I am, world.”  Here I am.

God, I wish he didn’t know what he knows.

Please, dear God.  Let him find peace.

Until tomorrow, be well,

Doc

Heroism and a Different Veteran

 

Doing What It Takes, In a Moment, In a Life

Today, I move away from combat veterans, but only in a literal sense. For in a more figurative sense, if we speak of those who are willing to serve through thick and thin, but even more who are willing to react to the unexpected horror of the world in ways that, without thought, move toward others rather than away from them: if we speak thus, then we’re not heading into new territory whatsoever.

Today I write in memory of a fallen hero, not in a far-off desert or mountain range, but in a suburban schoolyard

Today’s article is from The Washington Post, and it is entitled, “Talking About a Legend”: Indiana School Principal Dies Saving Children in Path of Bus.”

For twenty-two years, Susan Jordan was principal of Amy Beverland Elementary School, located on the far northeast side of Indianapolis, Indiana, USA. In those years she held together a faculty and a student body of diverse ethnicity and class, creating a community of “Amy Beverland Stars” that not only sheltered and empowered children through their pre-teen years, but well into their adulthoods and their own growth into parenthood and caretaking.

On Tuesday, January 26, 2016, mid-afternoon, at the end of another school day of announcements, lunch lines, and recesses, as students ages six through twelve were loading into buses or waiting for parents outside the building, Mrs. Jordan was where she always was, stewarding the hyper and the worn-out, the gabby and the sullen, all toward home, with a smile, a hug, a pat on the back, even an occasional high-five.

Suddenly a bus shifted into gear and lunged over the curb, toward a group of children. Mrs. Jordan lunged in response. In seconds she managed to push away all but two of the children out of the bus’s path. Those two children, ages 10, were seriously injured when struck, but are alive and will return one day to school.

For Mrs. Jordan, Tuesday became her last day of class.

The school district’s superintendent later that day called her “a legend.”

For my two younger children, now young adults, from the first day they stepped off a bus into the first grade until the last day they stepped onto one at the end of fifth grade, she was just “Mrs. J.”

From August 2001 until May 2008, I saw Susan Jordan at countless assemblies, concerts, fundraisers—and daily school pick-ups. A good ten years my senior, she had energy and enthusiasm that put me to shame. From the very beginning she knew my daughter and son by name. She even remembered regularly to ask about my eldest daughter, after she had, in 1999, steered us to send our first-born to another elementary school across the township because she knew “that would be the perfect place for her.”

We use the word “hero” so freely these days. Combat veterans are loathe to accept it. I have no doubt Mrs. Jordan would have felt similarly.

Yet in so many ways the heroic is heroic precisely because, when truly lived, it is so mundane. Hour by hour, day by day the future hero makes decisions as to how and where she will focus her attention, her energies. She scouts out what she values, whom she values, adjusting her gaze onto familiar patterns, attuning her ear to familiar sounds.

Then in that horrible moment, it happens. Connection happens. Love happens. No thought, just motion, motion toward a future for others, whether or not it ends the future for oneself.

I salute you, Mrs. Jordan. If I may be so bold, on behalf of all the combat veterans whom I have served and whom I will serve until my own time comes, I salute you again.

On September 11, 2001, you stood at the door of your school and reunited my worried wife with my confused, seven-year-old daughter. In the years since, you oversaw the education of hundreds of children who had to learn about writing and multiplication in a world that no longer was so easily ignorable by comfortable, suburban Americans. You guided children through the deaths of classmates, through the dissolution of their families, through their own medical illnesses. You created an atmosphere of warmth and rigor that supported my children’s teachers to become the finest that they were.

You were heroic, in the most commonplace of moments, in the most extraordinary.

From all of us who knew you, from all those who serve their fellow citizens in places of greatest danger precisely because of heroes like you, thank you.

From my family, from me, thank you.

Rest in peace.

Until tomorrow, be well,

Doc

The Zombies’ Discharge Papers

Silhouette of a soldier against the sun.

Vets. Zombies. Seriously

Today it’s vets and zombies.

I’m serious. Vets. Zombies. Vets and Zombies.

It’s a new world, folks. A new world.

For a conventional take, try Army Times´ Trailer for Veteran-Made ‘Range 15’ to Debut During Sundance.” For a more in-your-face (or should I say, in-your brain?) take, try Broadly.’s “The Disabled Iraq Veteran Starring in a Military Zombie Film.”

Either way, get ready. They’re coming.

I know, I know: you thought this was all taken care of by Brad Pitt in World War Z, or if not, at least by Ms. Bennet and Mr. Darcy in everyone’s classic favorite, Pride and Prejudice and Zombies.

Nay, nay, ‘twas not the end.

Recently I talked about the veteran-run clothing marketer, Article 15, and especially its quite irreverent take on T-shirts and other items to reflect military humor. Capitalism and good military competition being what they are, though, the good folks at Article 15 are anything but alone. For example, another group, Ranger Up, provides similar apparel meant to be worn and, oh, yes, noticed and remembered.

Well, like any good service members, the vets of both companies carry competition only so far, and their joint identities as ex-military have brought them together to make a film that too is meant to be, you got it, noticed and remembered.

It’s called “Range 15,” and it’s being billed as a “zombie-comedy-action-thriller.”

I think that about covers it.

Maybe there’s a love story in there as well, who knows. I’m afraid to ask.

I’ve previously mentioned Matt Best of Article 15. He’s one of the producers. But so is Ranger Up’s founder, Nick Palmisciano, a former United States Army infantry officer. And Captain Kirk’s in it: really, William Shatner. And Marcus Luttrell.  And the trailer just appeared at the Sundance Film Festival.

And 2016 is just getting started.

And you’ve got to check out the Broadly. article that features the female lead, combat vet and former US Army Explosive Ordinance Disposal (EOD, i.e., bomb squad) technician, Mary Dague. Ms. Dague lost both her forearms in an explosion in Iraq. She’s quite proud of her “nubs,” as she calls them. I suspect the zombies find out in the film why she likes also to think of herself as a T-rex.

When I tell people that I work with combat vets, they often respond with a cross with between awe and pity, as if somehow both I and the vets I serve are lucky to leave our sessions with our souls intact, given what we go through together. That is, on some days, indeed the case.

Yet on other days, I can say that I have never laughed in a professional office as hard as I have laughed with many of these men and women. Of course the best comedy usually has knifing anger weaved into it. Aristotle himself told us, after all, that comedy is about foibles, and foibles always mean that someone somewhere is angry, ashamed, or both.

Yet what is the old cliché? “Either laugh or cry?” To laugh is to remember all the laughs that have gone on before, to remember those we have laughed with, whether or not we will laugh with them again. To remember them at some of their best moments: a stifled giggle when the officer passes by who ain’t gonna be too pleased when he sees what awaits him in his quarters, a body-shaking guffaw as she can’t honestly believe that you really fell for that and actually put that in your mouth!

All right, true: the psychoanalyst in me could have a heyday with the idea of zombies and veterans, together. But, you know, come to think of it: why?

They say that Freud said that “sometimes a cigar is a cigar.” Whether he did or not, sometimes a good laugh should just be that: a good laugh.

Just don’t laugh your head off.

If you do, have the mustard and Wonder bread handy. Some patrons take their burgers raw. And they don’t like waiting.

Until tomorrow, be well,

Doc

Desert Sands at 25 Years

Silhouette of a soldier against the sun.

Wars, Blogs, Lives

Podcast of Blog Entry:

 

Twenty-five years ago, on January 16, 1991 (US time), Operation Desert Storm began, with coalition forces initiating military activities that would eventually lead to the expulsion of Iraqi forces out of Kuwait. By the end of February, it was “over.”

If only.

Today I want to introduce you to a blog I recently discovered, a blog of a combat vet who would dispute any claim that War is over when it’s “over,” yet one who also appears determined never to forget that he has what it takes. Welcome to the blog, Stuck in the Sand: PTSD and College.

Even though the blog’s author gives links that easily lead to your finding his name, he writes the blog without name. He’s a college student, finishing up at the University of Wisconsin, heading out to California to find fame and fortune in the tech industry. By UW standards, he’d be an “older” student, but he doesn’t seem to mind. He loves to code.

Who doesn’t, these days.

Don’t for a moment think, though, that he writes as if hiding in some wretched corner of Madison. Quite the contrary: he openly writes his confusions, his hopes, his losses, his gains, the more painful parts of his life story, the more joy-filled parts. He is no great fan of the US Veterans Administration, especially its medical facilities, but neither does he rant about the VA incessantly. He’s been homeless. He’s been divorced. He’s been down-and-out, up-and-in, resentful, grateful, you name it.

He is simply living, trying to make sense of a life that arose out of a desperate childhood, only to find itself in the middle of a War that was somehow being touted as a video game writ large. All twenty-five years ago, all today.

I find the blogs of many combat vets quite compelling. Often entries appear haphazardly, written in crisis perhaps, or perhaps in a moment of unforeseen, but well-savored joy. The authors frequently excuse themselves as not being adequately articulate, adequately accurate, even adequately reliable. Stuck in the Sand’s author often deprecates himself so, even as he speaks his truth with both a poetry and a coarseness that leaves a reader with scenes easily imagined, emotions easily felt.

Like most other vet bloggers, Stuck in the Sand’s author makes no claim to universality. He readily acknowledges that others have perhaps suffered just as much as he has, likely more. Yet by the very act of writing he also acknowledges that his own pain is not nothing, is not no-big-deal. It is the pain that draws him to a computer screen somehow, keystroke by keystroke, to find a way to alleviate that suffering momentarily, reshape it, re-envision it.

Whether with thesaurus words or with F-bombs strategically placed for proper effect. And affect.

As I find blogs, I’ll let you know. If one grabs you, stick with it for a while, notice the rhythms of a life that has known War and is trying now to know peace, listen for the “what it takes” in the phrasing, see it in the sentence structure, feel it as it blasts and as it whispers.

Twenty-five years is a long time, especially for a War that was supposed to be one step beyond a weekend, Xbox marathon, just aim and shoot. Stuck in the Sand is doing what he can not to remain stuck so. I look forward to reading more. I wish him the best.

Perhaps some of you will as well.

Until tomorrow, be well,

Doc

One Brave Voice

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Not Politics, But Truth

Listen to Podcast of Blog Entry:

 

In the January 23, 2016 New York Times, an op-ed appeared entitled “Sarah Palin, This Is What PTSD Is Really Like.”  While I do my best to avoid the political in this blog, the old truth remains: the personal is political. And the political is personal. Because of the piece’s context, I cannot help but speak politically. But because of its truth, I can admire it so much the more for the personal, for the person behind it, for the persons who live it daily.

Nathan Bethea served in the United States Army as an infantry officer for seven years, including a deployment to Afghanistan from 2009 to 2010.  As best as I can extrapolate from the op-ed piece, he must have been stationed in Alaska during Mrs. Palin’s run as a vice-presidential candidate for the 2008 United States presidential elections—and her then-term as governor of the state.

Mr. Bethea appears to be no grand fan of Mrs. Palin. I must say that I join him in less-than-enthusiastic appraisal of her. But for him—and for me—she’s more a foil, a bearer of ideas far-too-widely spread among civilians, ideas that Mr.Bethea confronts with quiet bravery and quiet conviction.

He wrote his piece in response to Mrs. Palin’s linkage of her son Track’s recent arrest for domestic violence with his experiences both in and after combat since having served in the United States Army.

I will let Mr. Bethea speak for himself:

“Mrs. Palin seemed to suggest that the policies of President Obama had somehow worsened her son’s condition. And by explaining away domestic violence as the “ramifications of PTSD,” she intimated that her son’s actions are logical consequences of what he experienced while deployed. This is, of course, a disingenuous argument from a career opportunist. However, in a roundabout way, Mrs. Palin reignited a valuable discussion of combat and its psychological effects. Her portrayal of her son’s condition seems aligned with enduring renditions of veterans as ticking time bombs, as damaged beings primed to harm.”

He then wrote:

“Within a week of my return in March 2010…I found myself in a hot, loud and crowded room full of aloof young strangers. In that moment, I felt a sudden burst of panic, something completely unexpected. I felt as if I was going to die. I had to leave the room, to return to the safety of my truck parked outside in the snow. Something was very wrong; something about me was clearly defective.”

Then:

“Later, I realized that many of my friends had experienced similar moments: extreme reactions to emotional stimuli, hours of fear, weeks of hyper-vigilance. The common thread was not a tendency toward violence but rather toward self-hate. There were no flashbacks of combat. There was instead a sinking feeling that I’d always be a downer, always on guard, never able to relax. It was the fear of being permanently broken.”

Mr. Bethea was both fortunate and brave: fortunate in that he was able to access adequate treatment and support for his challenges, brave in that he was and is willing to accept both in order to make his post-combat life as meaningful as possible, currently, among others, as a writing instructor for the New York City-based creative arts program, Voices from War. He confronted stigma while in the Army. He confronts possible stigma right now as he contemplates his literary career.

And he’s a combat vet. He has what it takes to do what needs to be done. He seeks out missions, connections, strives for them, lives for them. He’s even willing to sign his name to them, in one of the most high-profile media outlets in the world.

That’s both a political choice and a choice beyond the political, utterly personal, yet so bravely public. Whether or not one agrees with his words, one has to admire that he, like so many other war writers, is not willing to let War have the last word. Not by a long shot.

He ends his piece this way:

“I can function in society because I was able to seek care, and I want to make that care more accessible to people who need it.

“That process begins by speaking frankly. Facing up to destructive or abusive behavior comes next, along with the assertion that we are responsible for our actions, no matter what burdens we carry. Post-traumatic stress is no excuse for violence or abuse, nor should it be considered a default association. I’d like to hope that, beneath the bluster and the political talking points, Sarah Palin understands this. I hope even more that her son seeks care and finds peace.”

What more can an old, civilian psychiatrist say except this:

Mr Bethea, Mr. Palin: may you both never forget who you have been. May you both never give up on who you might become. May I and my colleagues never fail you. May you both find peace, now and always.

Until tomorrow, be well,

Doc

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