Last week, the New York Times published James Dao’s article titled ‘A Companion for the Journey’ about a Navy veteran with Post-Traumatic Stress Disorder. The subject of the feature–a young female surface warfare officer– was not who you would normally envision or associate with the word ‘PTSD.’
The scraggly-toothed, Vietnam-era homeless vet who stood on the side of the road near the local mall used to come to mind. With his VA card dangling from a lanyard around his neck, he mumbled to himself as he held a cardboard sign asking for cash. That image has been replaced by others, more familiar ones although, at first, I didn’t want to admit it. PTSD was something that affected other people, like the woman in James Dao’s article. Not my friends and co-workers. No way. But Dao’s article triggered something and I started counting up the stories.
Steve* came back from the war zone; he told me he was unable to sleep at night. His nervous energy and insomnia bothered his girlfriend so much she relegated him to the sofa. He recalled a situation in which insurgents detonated a bomb underneath one of the USMIL vehicles, killing the passengers, including his Special Forces counterparts. “That bomb was meant for me,” he said in a shaky voice. “I was supposed to be in that vehicle. We switched (places) at the last minute.”
After his six-month deployment, Mike* almost did not make it to his welcome home party. His wife said he had been disappearing for hours each day, avoiding her and the kids.
Ollie* returned from Afghanistan and asked me to meet him for dinner after work. When I found him in the restaurant, he was alone at a table in the dimly lit back corner. When I suggested going to a place after dinner for more drinks, his looked around furtively and asked, “Are there going to be a lot of people there?” Four months before, he had seen and heard the explosion when a suicide bomber killed seven Americans. Although we had never talked about that incident in detail, I suspected he had been involved in the recovery efforts.
The elite community in which I serve is, in many ways, akin to a professional football team. You keep playing. You suck it up, tape up the injury, go in, and play for the second half. Take the late Junior Seau. Despite multiple, yet undocumented concussions, according to his ex-wife, “He( Junior) always bounced back and kept on playing, He’s a warrior. That didn’t stop him.” His Wikipedia bio described how the NFL linebacker “would play when hurt, and often refused to leave games.” Both military and professional sports cultures subscribe to a philosophy in which warriors do not acknowledge injury or admit weakness. Immaturity is the excuse for a bout of rage. A night of binge drinking is a legitimate way to blow off steam. I myself had trouble recognizing the less-obvious symptoms in other friends, unwilling to admit they might have returned from war as changed people.
Back in November, when Cave Man* confided in me that he wanted to bring the dog he had just adopted to work, I was incredulous. It didn’t cross my mind that the dog, which had served as a explosives detection dog in Afghanistan might also have experienced combat stress. I told my friend Kathleen about his plan.
“Is he crazy (bad word choice on my part)?” I ranted. “The command is a professional workplace. In the military, we don’t have ‘Bring-Your-Child-To-Work-Day’, let alone ‘Bring-Your-Dog-To-Work-Day’. He’s needs to grow up!”
Kathleen’s father was a veteran. “Maybe he has PTSD and the dog provides him comfort, like a security blanket,” she suggested.
Maybe. Even though he had just returned from Afghanistan, served two tours in Iraq, and not only fought in heavy combat but seen friends blown up, I didn’t completely buy it. I was skeptical.
Two weeks ago, one of our civilian employees pulled me aside. Jay* was concerned. He asked if I noticed the ‘thousand-yard stare’ some of the guys projected. The non-emotional, matter-of-fact manner in which the SEALs discussed details of missions and human targets as casually as the chai latte from Starbucks they just drank was equally unsettling to him. I didn’t sympathize. Instead, I rationalized. “Think about it,” I told him. “SOF (Special Operations forces) can’t afford to feel any emotion.” I did my best put it in context and rationalize the behavior to someone who had never seen combat, I tried to justify the behavior as if it were part of the job. In not so many words, I had just told him to get onboard, and get used to it. Suck it up. At the time, it didn’t occur to me that the thousand-yard stare might not be part of the job but a result of the job.
Lack of sleep, avoidance of crowds, depression, becoming withdrawn or combative are all signs of PTSD. Physical trauma such as Traumatic Brain Injury (TBI) can cause PTSD. Constant exposure to explosions can rock the brain inside the skull and cause the same effects as a concussion. Blunt force impact, such as a football or sports injury in which your head hits the ground is not the only way to have a lasting impact on your mind. Psychological trauma is another factor. Most people cannot relate to the horror of having to pick up your friend’s body parts and put them in a plastic bag or living with the fear of whether an IED will destroy the Humvee you are riding in, The irony of the situation? My friends who have never served in the military were more sensitive to the issue than I was.
It took my friend Liz* to put it in perspective.
“What would you do if your friends had a broken leg? Or pneumonia?” she prodded. “Would you take them to see a doctor?”
“Of course,” I replied.
“Then why is mental illness or PTSD any different? Is it because of the stigma?” Liz said gently. “Just because you can’t see physical symptoms, doesn’t mean they don’t have injuries.”
I didn’t have an answer. She was right. I finally understood.
*Not their real names.
