Shell-shocked US marine, Hue, Vietnam, February 1968. Photograph: Don McCullin
It is nighttime, and I am sitting in a plywood building full of computers, separated by short plywood privacy walls. There are perhaps 20 computers in the room. Soldiers, with black metal rifles strapped to their backs, sit on metal folding chairs staring at computer screens. Some wear headsets, and speak in one-sided conversations to the images on the screens in front of them. A 45-minute wait in a line out front allows a 15 minute call home via the miracle of Skype. As I scrape back my metal chair to take my seat, I glance sideways and see the face of a young infant, magnified ludicrously and filling the big computer screen to my right, big blue baby eyes and a crinkling smile. A single tooth visible in the smile. A bit of drool. The soldier, from behind, so intimidating in camouflage and boots and rifle, now in my side vision wears a similar smile, with similar shining eyes. He is entranced.
"Hi, baby..." he croons softly, very unwariorlike, to the smiley image on the screen, as if it is just the two of them in the world. "Hi, there baby..."
When was the last time he held his baby?
Has he ever held his baby?
I sign onto the computer, and from behind me, another soldier, sounding angry and distraught, the volume of his voice escalating.
"Baby, I'm just asking you to listen to me. I need you to listen to me....Do you think I'm not thinking about you? How the f*** can you think that...You don't understand a f****ing thing..... Do you know what my f*****ing life is like right now. Baby, I just need you to f***ing think about me for a minute...... Do you have any f***ing idea?!"
He escalates. In my mind, I cringe. I close my eyes briefly and sigh for the irrational, aggressive, desperation that is his tone.
His fifteen minutes to call home.
Quickly spiraling downward into a f***ing disaster.
Where has this soldier come in from today. Where has he been? What front line? What mundane or hideous or unspeakable situation. What has he seen or done, that makes him beg his girl -- ungraciously, yes -- to think about him for just... one... minute.
"You obviously don't f***ing give a sh*t.... You don't want to give me the f***ing time of day...Like I don't f***ing think about you..."
Don't do it, I think. Calm down, I think. Pull it together. Don't do it...
"Well, f**k you..." he yells. "F**k... you..!!"
The last word cracks, in what one might interpret to be a small sob. I hear a slamming on the keyboard behind me. The slamming of a headset onto the dusty plywood table. A giant, angry, frustrated expulsion of breath, and the scraping of metal chair legs against the floor. The stomp of exiting feet.
No one turns to look.
And so, the call is terminated. The call to the girl whose photograph probably sits, crinkled, inside of his helmet. Or in a pocket, always against his heart. The face on the paper he pulls out and stares at on his lonely nights lying in his bunk, or his pit in the sand...his connection to peace and normalcy and home and what used to be. That time from before. That place that he cannot quite return to...perhaps, ever again.
Where does she sit? It what city or small town. Had she awaited this call for days, weeks...months? What series of words triggered his reaction? Was it warranted? Or just an explosion of stress and emotion from a person who otherwise has very little outlet for emotional expression. She cannot pick up the phone to call him back. And, as evidenced by the empty metal chair sitting askew behind me, she will not be hearing back from him tonight.
Does she know what happens after the profanity and the cutting of the connection. Did she hear the crack of his voice, revealing the inner desperation? Is she now sitting at home, helpless to reach out to him? Does she know he storms outside, to pace in the nocturnal, dusty, putrid smelling stench of sewage that wafts outside this building, perhaps lighting a cigarette and taking a giant drag, wanting to explode, but unable to go anywhere to explode? Does she sense his probable almost instantaneous regret of his uninhibited words?
My thoughts are interrupted by a sharp sudden "BOOOOM" to the wall to my left. The plywood rattles and releases a cloud of fine dust. Like startled deer in a field, all heads turn suddenly and stare at the wall, breaths halted. Frozen. Three solders are on their feet in an instant. Two have hit the ground on their hands and knees in a blink of an eye.
"What the F**k was that??!" one of the standing soldiers asks the room in a low, aggressive tone.
"Soccerball," someone declares from the side. "They're playing soccer outside. Must'a hit the wall."
Grumbling curses erupt across the room. Eyes meet each other, sheepishly. The three standing soldiers sit down. The other two get up, dusting off their knees with slapping hands. And also sit.
Soccerball.
Around me is the cohort of men and women who, if they safely return home to the United States after their time in this war, will struggle to adapt in the culture shock that is mundane, main stream America. Returning home to families, who have gone on with life, effectively, without them. Trying to reintegrate; trying to once again find their place in a peaceful, uneventful world. Trying to reacquaint with their wives and their children. Jumping at the sound of a backfiring car. Madly swerving and accelerating at the site of a shiny object on the side of the highway. Trying to harness the tangle of hypervigilant, animalistic, sometimes terrifying, caffeine and tobacco and jet engine and rocket driven, mundane, lonely, solitary, base emotions that are, in part, Afghanistan...and shove them effectively back down into the subconscious...and go on living.
I have met this returning soldier, in my family practice, in Alaska. Several times. And so, I am sure, have you.
The US Department of Veteran's Affairs has surveyed members of the Army and Marines who have served in Iraq and Afghanistan. Of events considered by the government to be "combat stressors", the following stats reflect the experiences (in a 2003 study) of returning marines: seeing dead bodies -- 95%, being shot at -- 97%, being attacked/ambushed: 95%, receiving rocket/mortar fire -- 92%, know someone killed or seriously injured -- 87%.
Since the beginning of these wars, more than 1 million Americans have served and returned home. Of these, 46% have sought medical care in the Veterans Administration hospitals -- and of these, 48% have been diagnosed with mental health conditions directly related to combat. That's nearly a quarter of a million returned soldiers, diagnosed with mental illnesses -- including depression and post traumatic stress disorder (PTSD). And that is just for those who presented for care. Many more fail to seek help, due to fear and negative perceptions of a diagnosis of mental illness, or due to lack of access to mental health services.
Of course, it is not only Americans and NATO soldiers who suffer such sequellae. One recent study of Afghani women living in combat regions found an overhwelming, a distressing, but perhaps not surprising, 98% suffer the effects of PTSD.
If you wonder how you can help reduce the reverberating impact of this war, consider the following:
Advocate for improved access for mental health services for war veterans. Particularly in rural America, mental health services are limited and frequently completely inaccessible.
Know that PTSD is very real, and has broad reaching impact on our society. Not just on returning soldiers, but on their families and communities. It is very treatable with counseling and medications. And if untreated, can be devastating, in the form of depression, suicide, substance abuse, and family violence. The first step is considering the diagnosis. The second is encouraging the one suffering to seek help. The third is working to remove the stigma of accessing mental health services.
Signs of PTSD in someone you know, or someone you love:
Re-experiencing the traumatic event
- Intrusive, upsetting memories of the event
- Flashbacks (acting or feeling like the event is happening again)
- Nightmares (either of the event or of other frightening things)
- Feelings of intense distress when reminded of the trauma
- Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)
Avoidance and numbing
- Avoiding activities, places, thoughts, or feelings that remind you of the trauma
- Inability to remember important aspects of the trauma
- Loss of interest in activities and life in general
- Feeling detached from others and emotionally numb
- Sense of a limited future (don’t expect to live a normal life span, get married, have a career)
Increased anxiety and emotional arousal
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hypervigilance
- Feeling jumpy and easily startled
Can a mind that is stretched... ever go back?
Could you?
No comments:
Post a Comment