Hidden Battles on Unseen Fronts

by Patricia Driscoll

  It would be another three months before Michael was medically discharged from the Army. “I never dreamed of retiring at my age. My goal in the Army was to retire as an E-7 just as my father did. Yet today I do not regret, nor do I blame myself for what happened to me on June 14. I have learned so much about myself, about my family and what is really important in my life. I realized that I still have so much to offer, and my passion to help my fellow brothers in arms was very strong.” Michael created a web site where a veteran or family member or anyone with questions can reach out at any time of day or night and connect to someone who understands their pain. He has been asked to speak in several classrooms and at various public venues. “I try to put the focus on the struggles of life and about the challenges I have had to face and how I have faced them. Especially when I talk to children, I emphasize how important it is to ask for help and not internalize your emotions. Each time I tell my story, provide resources for someone or am able to listen to a soldier in need, I am healing.”

  Today, Michael and Suki do not dwell on that awful period of their lives. “We choose to remember because it taught us both so much, about each other and ourselves. We are loved, we are strong and we survived.”

  In January 2009 Michael was selected for Operation Mend, for a plastic surgery to his face performed by a world-renowned plastic surgeon. The project is a partnership between UCLA and Brooks Army Medical Center along with a private philanthropist.

  MEDALS

  Purple Heart, Combat Action Badge, 3 Army Commendation Medals, 2 Army Achievement Medals, Army Good Conduct Medal, 2 National Defense Service Medals, Iraq Campaign Medal, Global War on Terrorism Service Medal, 2 Non-Commissioned Officer Professional Development Ribbons, Army Service Ribbon, Overseas Service Ribbon, Marksmanship Badge (Sharpshooter w/Rifle), Driver and Mechanic (w/Driver-Wheeled Vehicle[s]).

  “In the first of what could become many revisions in its disability ratings, the Veterans Affairs Department announced that it is changing how it evaluates traumatic brain injuires, a move that could increase disability compensation for thousands of veterans who have been injured by roadside bombs or other explosions in Iraq and Afghanistan. The new regulation describes traumatic brain injury as an injury that has immediate effects, such as loss of consciousness, amnesia, and other neurological symptoms. The problems could be temporary, but also may cause prolonged effects such as physical or mental impairment or emotional and behavior problems.”

  —“VA to Increase Compensation for TBI,” Navy Times, September 23, 2008

  34

  TENDING, ATTENDING AND HEALING

  All Together, One by One

  By Dr. Joseph Bobrow

  As a society, we don’t take very good care of one another. Ours is a disposable culture: our children, our elders, our ill and infirm, our natural resources are often ignored, overlooked, forgotten or mistreated. But what we do not include, recognize and care for does not disappear. The impacts last for ages, and they affect everyone. The web of life is our connective tissue and what we fail to adequately care for, we do so at our own peril. Our veterans and their families, their suffering, humanity and the true costs of their service have often gone unrecognized. Since we are all of us interconnected at the core, what happens here impacts what happens there. Unattended to, the wounds of war fester and deepen, wreaking havoc on individuals, families, communities and our entire culture.

  The impacts of war are legend; some are visible but many are not. Injuries that are invisible to the eye nonetheless radiate deep and wide into a person’s life, health and web of relationships. TBI patients and their families have a saying, “When the hair grows over…” When the injuries we can see heal, the wounds to mind, heart, spirit and relationships often go ignored. I am not only referring to PTSD: thousands of veterans suffer from anguish that does not meet the specific criteria for a diagnosis of PTSD, but nonetheless is profoundly disturbing to their functioning and well-being, and their families’ as well. “What’s the matter, the war’s over,” someone once said to a veteran. “Yeah, over and over and over,” the vet replied. The ever-present traumatic past crowds out the open present, collapsing hope and possibly the future.

  Combat-related traumas cannot be reduced to an anxiety disorder. They impact our identity, the sense of meaning, purpose, ethics and spirituality that comprise our world view, that holds our world together. War can shatter it all. Rebuilding damaged connectivity among body, mind, heart, brain, core values, worldview; among thoughts, feelings, actions, views, relationships, speech and conduct, is critical.

  It is important to learn skills to reduce symptoms of stress and anxiety and to help modulate and manage strong emotions. However it is just as important to rebuild damaged or undeveloped capacities to digest, metabolize and transform the profound impacts of trauma. And, as we rebuild internal connectivity, to rebuild connections among family members, and among family and community. This takes safety, trust, absence of judgment, and unconditional acceptance, compassion and love. How veterans are held by their community, culture and country forms a matrix that can contain and help transform trauma. What we cannot hold, we cannot process. What we cannot process, we cannot transform. What we cannot transform haunts us. It takes another mind to help us heal ours. It takes other minds and hearts to help us grow and re-grow the capacities we need to transform suffering. This is done in concert, re-weaving all together the web of connective emotional, relational and spiritual tissue that cumulative trauma tears asunder. In dialogue with other minds and hearts, with an informed, compassionate culture, it is possible, as psychoanalyst Hans Loewald wrote, to transform ghosts into ancestors.

  Symptom reduction is not the only barometer of healing: ending the haunting of the present by the traumatic past, finding a container wide, deep and sturdy enough to help transform ghosts into ancestors is the X-Factor that often goes ignored. It is a factor in why some at our best treatment facilities observe, puzzled, “Vets come in once or twice, but we have trouble getting them to come back for treatment.” It is not simply a matter of exploring new and alternative methodologies. There is no silver bullet. The quick fix is a by-product of narrow thinking. If war-related trauma damages human connectivity and the transformational capacities it engenders at multiple levels—individual, family, organizational and cultural—then unless we repair or grow these critical elements, our solutions will be partial, limited and transient at best. While lack of resources is certainly a concern, if the ways we think and work together are compartmentalized and limited, then our prescriptions may not work very well, even when we throw money at the problems as we construe them.

  Concealed within damage often lies great strength. Resilience runs deep, but its resources need to be nurtured. It is like a seed that has been buried in a disaster; it needs tending, attending. When the great redwoods are damaged in a fire, their seedpods are not destroyed. There is clearly devastation, but often the forest can return to health with adequate protection, care and skill. The seeds of renewal and transformation are there—if we cultivate the intention to be of help, if we take the time and energy, if we realize that the responsibility for healing the impacts of war is collective. It takes a village and it begins with each of us. Each veteran, each partner, child, sibling, parent and grandparent, deserves our loving, skillful, attentive care for the visible AND invisible injuries. They don’t only need a new set of techniques. They need us to harness our own humanity—head, heart, body and spirit—and our native connectivity and capacity to respond, in order to make a difference. They need us to participate in creating a culture in which the wounds of war are lovingly and skillfully enveloped as part of a welcoming community, where they can heal and be transformed. Fundamental inter-connectivity takes the form of a responsive community that holds the vets and their families in its attentive, loving embrace.

  The Coming Home Project is a team of psychotherapists, veterans, family members and interfaith leaders devoted to helping restore and build connectio
n in the individual, the family and in the wider military culture. Since 2006 we have offered a set of interconnected programs to address the mental, emotional, spiritual and relationship problems of OIF and OEF veterans and their family members. We provide pro bono, confidential psychological counseling; education, training and self-care for service providers, community forums; and innovative residential workshops that are not psychotherapy but whose effects are therapeutic. They bring together group process, stress management skills training, creative expression like writing and drawing, and outdoor recreation in beautiful places. The Coming Home Project harnesses the best from ancient and modern approaches and creates a culture and community of support and healing—an informed, compassionate, inclusive response. A safe place. Coming Home programs are open to all OIF and OEF veterans and families and no particular political, ideological or religious belief or affiliation is represented or required. Everyone is welcome as they are, and all are treated with respect.

  To give you a feel for the elusive quality of safety and welcome in community, let me close by sharing a few vignettes from our very first workshop:

  Kenny Sargent and Rory Dunn are Iraq veterans who both sustained serious TBIs. One was shot in the head, one was hit by an IED. Both also suffer from PTSD. They meet outside the workshop and seem like long-lost brothers. Neither sees well, a result of their injuries, and they come up real close to one another. They began to run their hands over one another’s face and neck, touching each other’s wounds, comparing scars and experiences, forging a deep connection. The emotions are palpable.

  Stephanie Pelkey, former Army Captain, who feels isolated in Houston where she lives with the legacy of her husband’s suicide, is taken in like family within minutes of meeting the other vets’ families.

  The first words of our first workshop are spoken during the opening moments of silence, as we are remembering those unable to be with us. Ben, Stefanie’s 2-1/2-year-old son, is playing with another young child around the edges of our circle. Amidst the reverent quiet, all 40 of us hear Ben say to his playmate, “My daddy died in Iraq.” Although Stefanie’s husband Michael actually killed himself back home, out of the mouth of babes, in the embrace of the beloved community, comes another truth: something in Ben’s dad did indeed die in Iraq.

  As we’re all saying our goodbyes, Rory comes my way and we hug. I notice near his seat a scrap of paper crumpled up and thrown on the floor. I pick it up, unravel it and ask if it's his. ”Yeah, it’s nothing,” he says. I see three family trees. I ask him about it: “It’s all the people blown away by my buddies’… dying.” I look closer: a girlfriend, baby, church members, mother, father, sister and so on, three little stories, three little family trees. Rory has a serious TBI and PTSD. But as his drawing attests, he can think, feel and communicate. Being able to represent his experience—and reclaim it—in a safe, and unconditionally accepting setting, is part and parcel of a transformation which continues to this day. It helps Rory—despite his many recurrent symptoms—find renewed meaning, purpose, aliveness and yes, even some joy, in living. And it allows him enough freedom to begin to help others.

  “This war has imposed an enormous strain on our armed forces. These men and women are serving in harsh, nerve-wracking conditions, in a war where there are no clear front lines. Thanks to advances in battlefield medicine we are saving many more of the injured than in previous wars. There are 7.5 wounded for every fatality, compared with a ratio of under 3 in Vietnam and Korea. Many of these are grievous injuries that include TBI, amputations, burns, blindness, spinal injuries and polytrauma—which is a combination of such things. If you include all those who are wounded in combat, or injured in a vehicle accident or contract a disease, there are 14 casualties for every death.”

  —Hearing on the Economic Costs of the Iraq War, Testimony before US House of Representatives Committee on the Budget, October 24, 2007, by Linda Bilmes, Lecturer in Public Policy, John F. Kennedy School of Government, Harvard University

  35

  SLEEPLESS IN SILVER SPRING

  The Story of National Guard Specialist 1st Class Duval Diaz

  “Then there is our culture’s whole machismo thing. Our men will never admit anything is wrong. In our culture men don’t cry, so when I’d ask Duval how he was, he’d always say ‘everything is fine,’ but I knew it wasn’t. I knew he was lost. I knew he felt alone. I think re-enlisting was a good thing for my brother. It made him feel needed, until he got hurt.”

  In Kandahar in mid-June 2003, a landmine blew up directly in front of the open jeep where 43-year-old Duval Diaz was riding shotgun. The driver spooked, swerved hard to the right, and Duval fell into the road, landing on his back. Since he was able to get right back up again, he didn’t pay much attention to the incident. As a cook, driver and security guard with a 104th Aviation company for the past six months, his attempts to travel anywhere, countryside or city, by vehicle or foot were all exercises in the probability of being blown up by a landmine. One more explosion wasn’t going to make that much of a difference. “It was business as usual, flat-out 18 hours a day until September when I hopped on a cargo plane to get some R&R in Qatar. When we landed seven hours later I couldn’t move.”

  The injury to his spine three months earlier had been aggravated by the flight. He was sent back to Afghanistan where doctors did an MRI, gave him a prescription for Diludan and even offered an epidural directly into his spine. “When I saw the size of the needle I said, no thanks, but the next morning I was on my knees to them. ‘Sure anything. Stop the pain.’” Duval was flown from Kandahar to Landstuhl Medical Center in Germany to Fort Dix, New Jersey where two months of physical therapy only made the pain worse. After a second MRI, Duval was transferred to Walter Reed Medical Center where he would spend over two years recovering from his spinal surgery, enduring operations for a chronic sinus condition, being diagnosed, operated on and recovering from prostate cancer and coping with severe PTSD.

  “That wasn’t how it was supposed to turn out. I should have joined the Air Force, not the Army,” he jokes. “I should have moved over to the Blue.” Duval joined the Army National Guard in 1978 when he was eighteen. He worked as a cook for five years before getting out. Over the next seventeen years he worked as a security guard for liquor stores, a professional bodyguard, a cook, and a chauffeur. The morning of September 11, 2001 he had just come on shift as a security guard at Los Angeles Airport at 5:30 a.m. when he heard the television news from New York City. He reenlisted in the National Guard the next day. It wasn’t just the attack on the World Trade Towers. Duval needed to find a new purpose in life. He was still reeling from the death of his father from Alzheimer’s, and seven months later the death of his 10-year-old son.

  He joined up with the 104th Aviation, ultimately deploying to Kuwait for staging, then to Qatar for a month, and finally to Afghanistan where the 104th’s Chanute helicopters supported a handful of units in and around Kandahar. It was nerve-wracking. “When I was working in the mess hall I couldn’t tell the difference between a missile attack and a landmine. But at night the landmines were so close that when they exploded our whole tent shook.” He quickly learned to trust no one. “I’d be driving and another car would pass by and shoot at us. I saw a lot of bad stuff.” But the demands of the job took his mind off himself. “I was responsible for all the meals for four crews, pilots, co-pilots and gunners. I enjoyed working in the mess.” He had dreams of becoming a gunner. “I was a helluva shooter.”

  Duvalia, his half-sister who works helping Hispanics better understand their Social Security and Medicare benefits, recalls his emails to her during this time as positive. “Duval has had a hard life. Our father left him and his mother when he was two, and their family never had much money. He was so very angry with our father. He would come over and scream at him,’ You deserted me!’ but then by the time he was ready to reconcile, my father couldn’t remember who he was. The same thing happened with his son. He and his wife split up and he didn’t see
his own son for eight years. Then right after seeing him for the first time, his son died. Then there is our culture’s whole machismo thing. Our men will never admit anything is wrong. In our culture men don’t cry, so when I’d ask Duval how he was, he’d always say ‘everything is fine,’ but I knew it wasn’t. I knew he was lost. I knew he felt alone. I think reenlisting was a good thing for my brother. It made him feel needed, until he got hurt that is.”

  Maybe it was the stress of being diagnosed with cancer while still recovering from his spinal surgery, or maybe it was that he repressed what he had seen in Afghanistan and now it was catching up with him, but once he was at Walter Reed, Duval’s struggles with nightmares increased. Night after night he’d wake up trembling, soaked with sweat. “I was on the front line and I was in charge. My job was to get my soldiers across safely but I never could do it. There were blasts and people being killed.”

  He also had occasional flashbacks. “I kept seeing how this one certain street looked after an explosion. There was blood and body parts everywhere.” He started losing his concentration and forgetting things. He became jumpy. “I still cannot tolerate anyone walking behind me.” He found himself becoming irritable over the slightest upset or postponement, whether it was a doctor’s appointment or a tardy phone call from Duvalia. When he did talk to her, her advice was always the same: See one of the military psychiatrists for his mental problems while he was still at the hospital.

  “I couldn’t come down to DC to visit him because of my work and the new baby, but I must have spent a thousand hours talking to him on the phone. I had to make him see that all his denial was just hurting him. He had to get over the macho thing, this badge of honor not to admit weakness. He was so depressed, and I’d tell him,’ Go talk to someone. No one is going to think badly of you if you admit you’re depressed. Getting help doesn’t mean you’re a pansy’.”