Hidden Battles on Unseen Fronts

by Patricia Driscoll

  “Last evening at 10:18 a Desert Storm veteran called the hotline from a cell phone. I could hear traffic whizzing by while he stated that he was standing on a bridge intending to jump off. He was tearful, and spoke of being hopeless and helpless. He focused on all of the things that he has lost in his life and said he saw no way for his life to get better or a reason to go on. He did give me his name and the last four digits of his SSN but would not tell me his location because he said, “Then you will send the police and I will not die.” I kept him on the phone as long as I could while another staff member called the police, but she was told that unless we knew which bridge he was on they could not dispatch officers. He finally hung up stating, “No one can help me.” I tried to call him back but he hung up and then turned off his phone. I was able to identify him through the electronic medical record system through process of elimination. We called the police back, giving them his home address and asking them to dispatch officers to the closest bridge to his house, and with our insistence they did dispatch officers. I called back about 30 minutes later to hear the outcome and was told that additional officers responded to the scene, with four officers at that time. I called back about 30 minutes later and was told that now six officers were at the scene. Finally, at about 12:25 p.m., I spoke with the initial responding officer. He told me that after an hour’s time, and six police officers and the crisis intervention team responding, they were able to talk him off the bridge and bring him for a mental health evaluation.”

  “At 2:55 am I got a call from a 21-year-old OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom) veteran, who said that he no longer wanted to live. He reported that he was discharged from the army after he attempted to kill his roommate with a plan to then kill himself. He reported a history of self-injurious behaviors and the desire to kill other family members. He told the responder that his plan was to cut himself so deep that he would bleed to death. He reported drinking a half-gallon of Crown Royal that evening as well as taking drugs. He said he had several guns, loaded and not loaded, knives and a sword in the home. He made vague references about the safety of his father who was sleeping in his bedroom of the trailer they shared. He continuously said that he did not want to go on and that he will not go on. Approximately 30 minutes into the call, emergency services were initiated. The caller would not give us any identifying information, and using our tracking capabilities the Hotline came up with only limited information. However, the caller was using a cell phone that the police were able to trace to get an address. This took quite some time and I had to establish good rapport to keep the caller on the line. A team of police, firemen with equipment and ambulances surrounded the home, having been told to approach it with lights and sirens off. Another staff person got on the phone with the police department’s hostage negotiator so the call center could coordinate communication with them. Working together with the hostage negotiator, I was able to facilitate a three-way call between the veteran, the call center and the hostage negotiator. Over the course of the next hour the veteran had extreme difficulty trusting the negotiator, but he remained on the line because he trusted me. Eventually, he put the phone down and went outside where he was apprehended. He was transferred to a community hospital for an evaluation and then to the VA Medical Center for a psychiatric admission. The veteran’s father was confirmed to be safe.”

  “Late this morning a Vietnam Vet with PTSD called the hotline. He found out last night that his wife was leaving him, thought about it all night, and decided that he would kill himself rather than suffer any more pain. He was in extreme distress, having increased PTSD symptoms, and feeling hopeless. He called the hotline as a last resort. He had a gun and a plan. He refused 911 services but said he would leave the gun and drive to the VA where he was enrolled. He was apprehensive about telling people in admissions or the ER his story, and felt he really couldn’t explain the situation to any more people. I made an immediate referral to the Suicide Prevention Coordinator who called the Veteran and made arrangements to meet him at the door. The patient was escorted through the system and admitted voluntarily to the inpatient unit where he is safe and doing well.”

  “Around 6:00 this evening a young man, crying and very depressed, called the hotline. He asked us if hotlines really worked, because if he didn’t get help he had no other options. He was a Reservist recently back from deployment. He hadn’t accessed VA services and had never really thought about it being a real option, but he decided to choose the veteran option on the hotline number when he called, on the chance that someone would understand his problems. After about 30 minutes of interaction on the call, he decided that he would accept VA help. We were able to connect with the Suicide Prevention Coordinator at the nearest VA medical center, who in turned called him and arranged for him to come in for an evaluation later that evening. When we called him back he was getting ready to go to the VA, his friend had agreed to take him, and he repeatedly expressed his gratitude and thanks for providing him with help. He said that just knowing we were ready to help him made him feel like he should keep trying.”

  The VA National Suicide Hotline is only one piece of the overall VA Suicide Prevention Strategy. All of the pieces are dependent on each other and are based on the premise that suicide prevention is effective when there is accelerated and easy access to high quality mental health care supplemented by enhanced care specifically aimed at reducing the risk for suicide. This strategy depends on the concept that “suicide is everybody’s business.” To that end, massive awareness and education efforts are being made within the VA to ensure that all VA staffmembers are aware of the risk factors and warning signs for suicide.

  Suicide Prevention Coordinators and in some cases Suicide Prevention Teams have been placed at each VA Medical Center across the country. These individuals and teams are the conduit by which Veterans in need—even in crisis—get this enhanced level of care that they need. Various systemic programs have been put into place to assist the Suicide Prevention Coordinators provide this high level of preventative care.

  For example, the VA has developed a high-risk notification system so that the patient’s medical record alerts other providers when they are working with someone known to be at high risk for suicide. The system also provides health care staff with safety planning templates to guide discussion with the high-risk veteran about actions to take that can help prevent getting into a crisis situation or acting on suicidal thoughts when in a crisis. Evidence-based treatment programs are being piloted, and training in various psychotherapeutic approaches is being done. Community awareness programs are being conducted across the country. The media has been called upon to help the VA get the message out to veterans that help is available.

  It’s an incredibly awesome task and goal, reducing suicide in the veteran population. We are at war. The economy is struggling. Our older veterans are experiencing loss and physical illness. Our newer veterans are sometimes coming home to broken relationships, economic hardship or dealing with physical injury. Substance abuse and mental illness continue to affect some of our population. The numbers of veterans now diagnosed with Post Traumatic Stress Disorder and Traumatic Brain Injury are growing, and these both may be risk factors for suicide.

  Over 35,000 veterans have called the hotline. The local Suicide Prevention Coordinators have received many more local referrals from staff and the community. The media campaign and outreach efforts have touched hundreds of thousands of people. The VA Suicide Prevention program is making a difference all day and every day, all across the country, one veteran at a time.

  9

  A SHARPSHOOTER FIRES BACK

  The Story of Army PFC Robert Kislow

  “I wish I could go back and make a movie of that day because I remember every detail. How the wind was blowing and the smell of the brush… how I slid down the rocks… how the man looked after he’d shot me and how he looked after I’d killed him. A Delta Force guy sent me a photo of his body. To be truthful, it helps
me sleep knowing he is dead.”

  For Army Specialist Rob Kislow, the exotic game hunt at James Ryffel’s Eagle Ranch outside of San Antonio on June 5, 2007 almost ended before it began. Rob, who had lost his right leg fighting with the 82nd Airborne in Afghanistan, was walking to get some ice from a cooler after his arrival when he tripped on some rocks, fell and broke his prosthesis. “I thought ah, man, I just got here and now I’ll be on crutches. My hunt’s over.”

  “I could see the frustration in his eyes,” Eagle Ranch manager “RB” Parker said. “He looked like he was going to cry. So I went over and asked, ‘What’s that thing made of. I bet I can fix it.’” With a little Texas ingenuity, epoxy and duct tape, Rob was back in business. “For the next three days I shot at everything that moved. I went out with the ranch owner’s two sons and we were walking through the wilderness and they said, ‘We heard you were a sniper,’ and I said ‘Yup’ and they said, ‘What can you do?’ A little while later we saw some deer running in a herd about 200 yards away. All I had was a .22 Hornet rifle with open sights and no scope but I took a shot and hit two deer just like that. One of the kids said, ‘That was awesome!’ That whole experience made me feel free again.”

  Rob grew up in Northampton, a rural town 10 miles outside of Bethlehem, Pennsylvania surrounded by an extended family of enthusiastic outdoorsmen. As soon as he was old enough to hold a rifle or a bow, he learned how to shoot them, trailing along with brothers, Ryan, Michael and Jason and his father. He hunted deer, turkey, dove, pheasant, groundhog and rabbit. “When I was around ten my brothers and I were messing around with .22s and a grouse flew out of the brush. It scared the crap out of me. My reaction was to blast it out of the air. My dad says that was when he realized I had the potential to be a good shot.”

  Rob and his brothers used to go “plinking.” “We’d toss acorns into the air and try to hit them, or shoot European starlings which are nuisance birds around where I come from. They’re the size of a parakeet and fly real fast. When they land you’ve got about two seconds before they’re off again. The European starling—that’s what made me a sharpshooter.” Before he shipped out to Afghanistan, Rob’s going away present from his father was a bear hunt. “Dad said I had to experience one just in case I didn’t come back.” He almost didn’t.

  It wasn’t long after joining the Army straight out of high school that someone noticed Rob could shoot. While at the Ranger Indoctrination Program at Fort Benning Georgia, his training got accelerated until by Christmas 2004 he’d graduated infantry and airborne school and become a sharpshooter for the 82nd Airborne.

  On April 3, 2005 he deployed to Afghanistan and was assigned to Forward Operation Base Salerno, located just north of Khost on the mountainous border between Afghanistan and Pakistan. At the time the facility was occupied by the 3rd Battalion, 505th Parachute Infantry Regiment, and was named for the Italian beachhead that the 505th parachuted onto on September 14, 1943. Because of its size and close proximity to the Pakistan border, a large contingent of engineers and supporting troops were stationed at the base, including Alpha and Bravo Companies of the 82nd Airborne’s 3/505th. Bravo prowled around the jagged, mountainous terrain of the Afghan/Pakistan border “looking to kick ass and take names… ferret out the bad guys, Taliban, insurgents, you name it.” Rob had just turned nineteen.

  “Most of my team was older than me, but I’d spent my life hunting and fishing and blowing things up, so ‘lock and load’ was business as usual.” Mountain warfare fit Rob to a tee. Fording rivers and scrambling through scrub oak on search and destroy missions wasn’t so different from tracking down a deer in the Pennsylvania woods. The mountain villages were also fertile territory for weeding out insurgents, and Bravo Company was soon performing house-to-house “kick in the door,” “search and question” missions. The adrenaline surge never let up: “There were always rocket attacks and mortar fire.” Three months into his tour of duty Rob had what soldiers call their “Alive Day.” Rob’s was June 10th, 2005.

  “There were three teams of us and we were engaging the enemy in a mountainous area right on the Pakistan border when we discovered another group of insurgents was flanking our position. They dropped in some Special Forces guys by helicopter to help us and we were channeling the enemy into a ravine, sort of like a bull run. My buddy Derrick, who was front man, was shot in the knee. They got him to cover and I took his place in the assault position. Suddenly everyone said ‘Fuck it! We’re going down after them!’”

  Rob scrabbled down a steep ravine through the underbrush chasing some of the insurgents, when one popped up in front of him and shot him point blank in the leg, arm and head. “He was less than ten meters away. My right arm, my trigger hand, blew up in front of my eyes.” Somehow Rob managed to crawl behind some rocks, pull himself together and take aim. His first round killed the man who had shot him. “I wish I could go back and make a movie of that day because I remember every detail. How the wind was blowing and the smell of the brush… how I slid down the rocks… how the man looked after I’d killed him. A Delta Force guy sent me a photo of his body. To be truthful, it helps me sleep knowing he is dead.”

  In a makeshift field hospital, while Navy surgeons reattached his arm and removed the bullet lodged behind his left ear, Rob stayed awake, insisting that he be the one to call home to tell the family he’d been injured. Twenty-four hours later he was at Landstuhl Medical Center in Germany, and then Walter Reed Medical Center in Silver Spring, Maryland, where he would spend the next two years.

  Besides recovering from his arm and head injuries, he had to cope with severe TBI. “I used to talk real fast but now my speech was all screwed up. I talked like a drunken sailor. I couldn’t pronounce vowel sounds. I had hearing loss and big time memory loss.” Because the trauma was on the left side of his brain, it was his right arm that became numb, the one that was already injured, making physical therapy twice the challenge. “But I was never alone, and that can make or break you. I don’t think there was a person I knew from before Afghanistan who didn’t come and see me. My dad stayed a whole month straight. My mom, who is divorced from my dad, came from California.”

  But it wasn’t the TBI or even the gradual onslaught of PTSD symptoms that caused him the most frustration. He was in a battle to keep his right arm while at the same time convincing doctors to amputate his left leg. The blast to Rob’s elbow had almost severed his arm, and there were times throughout the 13 reconstructive surgeries he had to fight to keep the surgeons from amputating it. “Ultimately they did a great job of patching me up with rods and fake tendons to maximize what functions I had left, but it took a lot of arguing on my part.”

  Rob argued for the opposite solution for his leg injury. His ankle had been almost completely shot off. “My doctors tried replacing it with every substance known to medical science, from cadaver bone to coral to synthetic bone. Even my dad said I should try to save it, but I just wanted it gone. I wanted them to cut the damn thing off so I could get on with my life and out of Walter Reed. No amount of therapy was going to help me because just being there was more depressing than anything else.” Seventeen operations and one year later, on June 12, 2006, Rob finally got his wish. By fall he received his 30 days of convalescent leave and went home with his first prosthesis.

  “Even when I got home I was pretty depressed. I’d lost my memory and couldn’t sleep. My buddies said, ‘It’s pheasant season. Let’s go hunting.’ So we did, and it was the best therapy I could possibly have had.” He went hunting in the Pennsylvania woods with camouflaged crutches. “That was when I first broke my prosthesis, chasing a pheasant through some roughage and jumping over a fallen tree.”

  When he returned to Walter Reed he earned himself designation as the perfect patient to endurance-test prostheses. He went through twelve. “They tried all the new technologies, and found that the only thing I couldn’t destroy was titanium with a carbon fiber socket. He would hop up and down the steps of the hospital doing impact tests.
“The problem was “stump shrink.” Your leg shrinks so they have to keep replacing the socket at $5,000 a pop. But once they got it right, I could run, bike, fish, hunt. I won myself a little aluminum boat in a bass fishing contest. I even got myself a sponsorship on an amateur paintball team.” Rob prided himself on creating his own physical therapy regime. “I never liked PT. I hated them telling me what I could and couldn’t do. I tried it myself, and surprisingly ended up doing almost everything they said I’d never be able to do. From the beginning I did my own research by talking to other amputees.”

  Before Rob broke one of his later prosthesis at the exotic game ranch, he’d already made an impression on Armed Forces Foundation volunteers, all successful businessmen who had put the hunt together for four wounded warriors, including Rob and a wheelchair-ridden veteran named Andrew. The problem of transportation to Texas was solved by Ted Gateman, the president of Greenpak, who had offered his corporate jet. “It was my first hunt and it was one of the most rewarding experiences I’ve ever had,” recalls Jeff Shaver, a Greenpak vice president who was part of the group. “I have this visual memory as we’re boarding in Manassas,” says Shaver, “of Andrew in a wheelchair and I’m wondering, ‘How is he going to get on the plane?’ and then Rob crouches down in front of him and says, ‘Get on my back.’ Rob carried Andrew onto the plane. That’s how the trip started. Inspirational isn’t the word for it.”

  At 22, Rob is taking courses at Northampton Community College in Bethlehem, Pennsylvania, where his family lives. His ability to walk was recently tested by scientists at the University of Delaware. “They wanted to see how it was possible for me to walk as well as I did. I impressed the hell out of them.” He plans on opening a garage that services foreign cars, he just got a truck, and is in the midst of building a race car. Meanwhile, in the spring of 2008 he received an all expenses paid, four-day vacation to the Venetian Hotel in Las Vegas courtesy of the Armed Forces Foundation.